Sample records for clinical features permanent

  1. The association between prune belly syndrome and dental anomalies: a case report.

    PubMed

    Basso, Maria Daniela; Favretto, Carla Oliveira; Cunha, Robson Frederico

    2012-12-18

    Prune belly syndrome is a rare condition produced by an early mesodermal defect that causes abdominal abnormalities. However, the literature indicates that disturbances related to ectodermal development may also be present. This is the first case report in the literature to suggest that dental abnormalities are part of the broad spectrum of clinical features of prune belly syndrome. Because the syndrome causes many serious medical problems, early diagnosis of abnormalities involving the primary and permanent dentitions are encouraged. The authors report the clinical case of a 4-year-old Caucasian boy with prune belly syndrome. In addition to the triad of abdominal muscle deficiency, abnormalities of the gastrointestinal and urinary tracts, and cryptorchidism, a geminated mandibular right central incisor, agenesis of a mandibular permanent left incisor, and congenitally missing primary teeth (namely, the mandibular right and left lateral incisors) were noted. This original case report about prune belly syndrome highlights the possibility that dental abnormalities are a part of the broad spectrum of clinical features of the syndrome. Therefore, an accurate intra-oral clinical examination and radiographic evaluation are required for patients with this syndrome in order to provide an early diagnosis of abnormalities involving the primary and permanent dentitions.

  2. The association between prune belly syndrome and dental anomalies: a case report

    PubMed Central

    2012-01-01

    Background Prune belly syndrome is a rare condition produced by an early mesodermal defect that causes abdominal abnormalities. However, the literature indicates that disturbances related to ectodermal development may also be present. This is the first case report in the literature to suggest that dental abnormalities are part of the broad spectrum of clinical features of prune belly syndrome. Because the syndrome causes many serious medical problems, early diagnosis of abnormalities involving the primary and permanent dentitions are encouraged. Case presentation The authors report the clinical case of a 4-year-old Caucasian boy with prune belly syndrome. In addition to the triad of abdominal muscle deficiency, abnormalities of the gastrointestinal and urinary tracts, and cryptorchidism, a geminated mandibular right central incisor, agenesis of a mandibular permanent left incisor, and congenitally missing primary teeth (namely, the mandibular right and left lateral incisors) were noted. Conclusion This original case report about prune belly syndrome highlights the possibility that dental abnormalities are a part of the broad spectrum of clinical features of the syndrome. Therefore, an accurate intra-oral clinical examination and radiographic evaluation are required for patients with this syndrome in order to provide an early diagnosis of abnormalities involving the primary and permanent dentitions. PMID:23249412

  3. Permanent alopecia in patients with breast cancer after taxane chemotherapy and adjuvant hormonal therapy: Clinicopathologic findings in a cohort of 10 patients.

    PubMed

    Fonia, Athina; Cota, Carlo; Setterfield, Jane F; Goldberg, Lynne J; Fenton, David A; Stefanato, Catherine M

    2017-05-01

    Anagen effluvium with reversible scalp alopecia is a known side effect of chemotherapy. However, there are an increasing number of reports in the literature documenting permanent alopecia in patients treated with taxanes. We sought to describe the clinicopathologic features in breast cancer patients who underwent treatment with taxanes and adjuvant hormonal chemotherapy. We reviewed the clinical and histopathologic information of a cohort of 10 patients treated with taxanes and adjuvant hormonal chemotherapy. We have observed 3 types of clinical patterns of alopecia (types A, B, and C), and have validated the histopathologic features showing alopecia areata-like and female pattern hair loss. The study was based on a small sample size and retrospective retrieval of clinical information and histopathologic review of posttreatment slides. We hypothesize a clinicopathologic model of hair follicle cycle disruption in response to the chemoinflammatory and hormonal insults to the hair follicles resulting in permanent alopecia. Clinicopathologic correlation is paramount to the understanding of the morphobiologic pathways in chemotherapy-induced alopecia caused by taxanes and adjuvant hormonal treatment. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  4. A Rare Bilateral Presentation of Multiple Dens Invaginatus, Shovel-Shaped Incisor and Talon Cusp With Mesiodens.

    PubMed

    Hegde, S; Jain, M; Shubha, A B

    2014-01-01

    The aim of this paper is to describe a unique and unusual case of concomitant appearance of morphological dental anomalies in the maxillary anterior region, along with its management in a patient with no systemic abnormality. This case report describes the clinical and radiographic features of talon cusp, dens invaginatus, shovel-shaped incisors and a supernumerary tooth occurring in a single patient, which is a rare presentation. All 4 permanent maxillary incisors had dens invaginatus, the permanent maxillary canines showed the presence of talon cusps, the permanent maxillary central incisors were shovel-shaped and an erupted mesiodens was also observed. Treatment included restorative, surgical and orthodontic approaches.

  5. Permanency analysis on human electroencephalogram signals for pervasive Brain-Computer Interface systems.

    PubMed

    Sadeghi, Koosha; Junghyo Lee; Banerjee, Ayan; Sohankar, Javad; Gupta, Sandeep K S

    2017-07-01

    Brain-Computer Interface (BCI) systems use some permanent features of brain signals to recognize their corresponding cognitive states with high accuracy. However, these features are not perfectly permanent, and BCI system should be continuously trained over time, which is tedious and time consuming. Thus, analyzing the permanency of signal features is essential in determining how often to repeat training. In this paper, we monitor electroencephalogram (EEG) signals, and analyze their behavior through continuous and relatively long period of time. In our experiment, we record EEG signals corresponding to rest state (eyes open and closed) from one subject everyday, for three and a half months. The results show that signal features such as auto-regression coefficients remain permanent through time, while others such as power spectral density specifically in 5-7 Hz frequency band are not permanent. In addition, eyes open EEG data shows more permanency than eyes closed data.

  6. Long-term outcomes in younger men following permanent prostate brachytherapy.

    PubMed

    Shapiro, Edan Y; Rais-Bahrami, Soroush; Morgenstern, Carol; Napolitano, Barbara; Richstone, Lee; Potters, Louis

    2009-04-01

    We reviewed the long-term outcomes in men undergoing permanent prostate brachytherapy with a focus on those presenting before age 60 years. Between 1992 and 2005 a total of 2,119 patients with clinical stage T1-T2, N0, M0 prostate cancer treated with permanent prostate brachytherapy were included in this study. Treatment regimens consisted of permanent prostate brachytherapy with or without hormone therapy, permanent prostate brachytherapy with external beam radiotherapy, or all 3 modalities. Biochemical recurrence was defined using the Phoenix definition. Multivariate analysis was performed to determine if age and/or other clinicopathological features were associated with disease progression. The Kaplan-Meier method was used to calculate rates of freedom from progression with the log rank test to compare patients younger than 60 vs 60 years or older. Median followup was 56.1 months. In the study population 237 patients were younger than 60 years at diagnosis (11%). The 5 and 10-year freedom from progression rates were 90.1% and 85.6%, respectively, for the entire population. Multivariate analysis demonstrated that prostate specific antigen (p <0.01), biopsy Gleason score (p <0.0001) and year of treatment (p <0.001) were associated with freedom from progression while age (p = 0.95) and clinical stage (p = 0.11) were not. There was no significant difference in freedom from progression between men younger than 60, or 60 years or older (log rank p = 0.46). In the younger cohort the 10-year freedom from progression for patients presenting with low, intermediate and high risk disease was 91.3%, 80.0% and 70.2% compared to 91.8%, 83.4% and 72.1%, respectively, for men 60 years or older. Our long-term results confirm favorable outcomes after permanent prostate brachytherapy in men younger than 60 years. Outcomes are impacted by disease related risk factors but not by age or clinical stage. Definitive treatment options for younger men with clinically localized prostate cancer should include permanent prostate brachytherapy.

  7. ACUTE RETINAL ARTERIAL OCCLUSIVE DISORDERS

    PubMed Central

    Hayreh, Sohan Singh

    2011-01-01

    The initial section deals with basic sciences; among the various topics briefly discussed are the anatomical features of ophthalmic, central retinal and cilioretinal arteries which may play a role in acute retinal arterial ischemic disorders. Crucial information required in the management of central retinal artery occlusion (CRAO) is the length of time the retina can survive following that. An experimental study shows that CRAO for 97 minutes produces no detectable permanent retinal damage but there is a progressive ischemic damage thereafter, and by 4 hours the retina has suffered irreversible damage. In the clinical section, I discuss at length various controversies on acute retinal arterial ischemic disorders. Classification of acute retinal arterial ischemic disorders These are of 4 types: CRAO, branch retinal artery occlusion (BRAO), cotton wools spots and amaurosis fugax. Both CRAO and BRAO further comprise multiple clinical entities. Contrary to the universal belief, pathogenetically, clinically and for management, CRAO is not one clinical entity but 4 distinct clinical entities – non-arteritic CRAO, non-arteritic CRAO with cilioretinal artery sparing, arteritic CRAO associated with giant cell arteritis (GCA) and transient non-arteritic CRAO. Similarly, BRAO comprises permanent BRAO, transient BRAO and cilioretinal artery occlusion (CLRAO), and the latter further consists of 3 distinct clinical entities - non-arteritic CLRAO alone, non-arteritic CLRAO associated with central retinal vein occlusion and arteritic CLRAO associated with GCA. Understanding these classifications is essential to comprehend fully various aspects of these disorders. Central retinal artery occlusion The pathogeneses, clinical features and management of the various types of CRAO are discussed in detail. Contrary to the prevalent belief, spontaneous improvement in both visual acuity and visual fields does occur, mainly during the first 7 days. The incidence of spontaneous visual acuity improvement during the first 7 days differs significantly (p<0.001) among the 4 types of CRAO; among them, in eyes with initial visual acuity of counting finger or worse, visual acuity improved, remained stable or deteriorated in nonarteritic CRAO in 22%, 66% and 12% respectively; in nonarteritic CRAO with cilioretinal artery sparing in 67%, 33% and none respectively; and in transient nonarteritic CRAO in 82%, 18% and none respectively. Arteritic CRAO shows no change. Recent studies have shown that administration of local intra-arterial thrombolytic agent not only has no beneficial effect but also can be harmful. Prevalent multiple misconceptions on CRAO are discussed. Branch retinal artery occlusion Pathogeneses, clinical features and management of various types of BRAO are discussed at length. The natural history of visual acuity outcome shows a final visual acuity of 20/40 or better in 89% of permanent BRAO cases, 100% of transient BRAO and 100% of nonarteritic CLRAO alone. Cotton wools spots These are common, non-specific acute focal retinal ischemic lesions, seen in many retinopathies. Their pathogenesis and clinical features are discussed in detail. Amaurosis fugax Its pathogenesis, clinical features and management are described. PMID:21620994

  8. Nonmetric traits of permanent posterior teeth in Kerala population: A forensic overview

    PubMed Central

    Baby, Tibin K; Sunil, S; Babu, Sharlene Sara

    2017-01-01

    Introduction: Dental morphology is a highly heritable characteristic which is stable with time and has a fairly high state of preservation. Nonmetric dental traits have crucial role in ethnic classifications of a population that helps in forensic racial identification purposes. Aims and Objectives: To determine the frequency and variability of possible nonmetric tooth traits using extracted permanent posterior teeth from Kerala population for discerning racial ethnicity. Materials and Methods: This qualitative, cross-sectional study was carried out using 1743 extracted intact permanent posterior teeth collected from different dental clinics situated all over Kerala. Results: The more common features on premolars were multiple lingual cusps (31.21%), distal accessary ridges (16.28%) and Tom's root (17.9%). In upper first molars, Carabelli trait expression was 17.78% and other common features included metaconulo, cusp 5 and enamel extensions. Conclusion: Posterior tooth traits had variable expression in the study population. Low prevalence rate of Carabelli trait in this study is characteristic of Asian population. This research explored new elements of invaluable tooth traits values to understand racial ethnicity of Kerala population. PMID:28932045

  9. Histologic features of alopecias: part II: scarring alopecias.

    PubMed

    Bernárdez, C; Molina-Ruiz, A M; Requena, L

    2015-05-01

    The diagnosis of disorders of the hair and scalp can generally be made on clinical grounds, but clinical signs are not always diagnostic and in some cases more invasive techniques, such as a biopsy, may be necessary. This 2-part article is a detailed review of the histologic features of the main types of alopecia based on the traditional classification of these disorders into 2 major groups: scarring and nonscarring alopecias. Scarring alopecias are disorders in which the hair follicle is replaced by fibrous scar tissue, a process that leads to permanent hair loss. In nonscarring alopecias, the follicles are preserved and hair growth can resume when the cause of the problem is eliminated. In the second part of this review, we describe the histologic features of the main forms of scarring alopecia. Since a close clinical-pathological correlation is essential for making a correct histopathologic diagnosis of alopecia, we also include a brief description of the clinical features of the principal forms of this disorder. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

  10. Histologic features of alopecias-part I: nonscarring alopecias.

    PubMed

    Bernárdez, C; Molina-Ruiz, A M; Requena, L

    2015-04-01

    The diagnosis of disorders of the hair and scalp can generally be made on clinical grounds, but clinical signs are not always diagnostic and in some cases more invasive techniques, such as a biopsy, may be necessary. This 2-part article is a detailed review of the histologic features of the main types of alopecia based on the traditional classification of these disorders into 2 major groups: scarring and nonscarring alopecias. Scarring alopecias are disorders in which the hair follicle is replaced by fibrous scar tissue, a process that leads to permanent hair loss. In nonscarring alopecias, the follicles are preserved and hair growth can resume when the cause of the problem is eliminated. In the first part of this review, we describe the histologic features of the main forms of nonscarring alopecia. Since a close clinical-pathological correlation is essential for making a correct histologic diagnosis of alopecia, we also include a brief description of the clinical features of the principal forms of this disorder. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

  11. Tooth eruption in a patient with craniometaphyseal dysplasia: case report.

    PubMed

    Hayashibara, T; Komura, T; Sobue, S; Ooshima, T

    2000-10-01

    Craniometaphyseal dysplasia (CMD) is a very rare genetic disorder of bone remodeling caused by osteoclast dysfunction. The clinical and radiographical features of oral findings are presented in a sporadic case of CMD in a child (age 10 years, 7 months). An intraoral examination showed severe malocclusions, including anterior crossbite and deep bite. Furthermore, a radiographic examination showed increased radiopacity of the maxilla and mandibular bones due to hyperostosis and sclerosis of the jaw. There was no root resorption of the canines or molars in the primary dentition, although root formation of the permanent teeth was proceeding. Dental age was calculated to be approximately 1 year, 4 months younger than his chronological age. The eruption speed of the permanent lateral incisors after the gingival emergence was shown to be within normal values, and we discuss whether the canines and premolars in the permanent dentition could erupt or not.

  12. [Neonatal diabetes mellitus].

    PubMed

    Gurgel, Lucimary C; Moisés, Regina S

    2008-03-01

    Neonatal diabetes is a rare condition characterized by hyperglycemia, requiring insulin treatment, diagnosed within the first months of life. The disorder may be either transient, resolving in infancy or early childhood with possible relapse later, or permanent in which case lifelong treatment is necessary. Both conditions are genetically heterogeneous; however, the majority of the cases of transient neonatal diabetes are due to abnormalities of an imprinted region of chromosome 6q24. For permanent neonatal diabetes, the most common causes are heterozygous activating mutations of KCNJ11, the gene encoding the Kir6.2 sub-unit of the ATP-sensitive potassium channel. In this article we discuss the clinical features of neonatal diabetes, the underlying genetic defects and the therapeutic implications.

  13. Permanent scalp alopecia related to breast cancer chemotherapy by sequential fluorouracil/epirubicin/cyclophosphamide (FEC) and docetaxel: a prospective study of 20 patients.

    PubMed

    Kluger, N; Jacot, W; Frouin, E; Rigau, V; Poujol, S; Dereure, O; Guillot, B; Romieu, G; Bessis, D

    2012-11-01

    To analyze the clinical and histological features of permanent alopecia following a sequential fluorouracil/epirubicin/cyclophosphamide (FEC) and docetaxel regimen for adjuvant breast cancer treatment. Women treated for breast cancer by a sequential adjuvant FEC and docetaxel regimen who developed permanent alopecia diagnosed between 2007 and 2011 were identified from the Department of Dermatology (Saint-Eloi Hospital, Montpellier, France) and the Department of Medical Oncology (CRLC Val d'Aurelle, Montpellier, France). Data were collected regarding demographics, type of cancer, delay of onset after chemotherapy, Dermatology Life Quality Index (DLQI), clinical description of the lesions, scalp biopsies, laboratory explorations investigating steroid hormonal, iron, zinc and thyroid status, therapy and outcome. Twenty white Caucasian females were included. Hair loss presented with a moderate or intense androgenetic-like pattern of scalp alopecia. Biopsy specimen examinations were normal or displayed the androgenetic-like pattern. Laboratory explorations ruled out iron or zinc deficiency and thyroid disorders and confirmed hormonal menopause without hyperandrogenism. The overall mean DLQI score reflected the distressing psychological consequences in the patients' lives. No spontaneous regrowth of the scalp hair was noted. Treatment including vitamins, minoxidil, psoralen and ultraviolet A therapy and spironolactone proved to be ineffective. Permanent and severe alopecia is a newly reported complication of the FEC 100-docetaxel breast cancer regimen.

  14. Primary cicatricial alopecia: clinical features and management.

    PubMed

    Ross, Elizabeth K

    2007-04-01

    The primary cicatricial alopecias are an uncommon, complex group of disorders that result in permanent destruction of the hair follicle, usually involving scalp hair alone. Prompt diagnosis and treatment are needed to help thwart continued hair loss and the distress that often accompanies this hair loss. Nurses can facilitate the diagnostic and treatment process and, through educational and emotionally supportive measures, have a meaningful, positive impact on the patient's well being.

  15. Periocular hemangiomas: what every physician should know.

    PubMed

    Ceisler, Emily J; Santos, Laura; Blei, Francine

    2004-01-01

    Hemangiomas are the most common benign tumor of infancy. Most hemangiomas remain asymptomatic and can be managed by close observation; however, immediate treatment is indicated for hemangiomas that may cause significant complications. Periocular hemangiomas warrant close evaluation and early, active treatment of those with the potential to threaten or permanently compromise vision. Herein we review the clinical features of periocular hemangiomas, differential diagnosis, possible ophthalmologic complications and sequelae, and therapeutic modalities.

  16. BRAF Mutation Correlates With High-Risk Langerhans Cell Histiocytosis and Increased Resistance to First-Line Therapy.

    PubMed

    Héritier, Sébastien; Emile, Jean-François; Barkaoui, Mohamed-Aziz; Thomas, Caroline; Fraitag, Sylvie; Boudjemaa, Sabah; Renaud, Florence; Moreau, Anne; Peuchmaur, Michel; Chassagne-Clément, Catherine; Dijoud, Frédérique; Rigau, Valérie; Moshous, Despina; Lambilliotte, Anne; Mazingue, Françoise; Kebaili, Kamila; Miron, Jean; Jeziorski, Eric; Plat, Geneviève; Aladjidi, Nathalie; Ferster, Alina; Pacquement, Hélène; Galambrun, Claire; Brugières, Laurence; Leverger, Guy; Mansuy, Ludovic; Paillard, Catherine; Deville, Anne; Armari-Alla, Corinne; Lutun, Anne; Gillibert-Yvert, Marion; Stephan, Jean-Louis; Cohen-Aubart, Fleur; Haroche, Julien; Pellier, Isabelle; Millot, Frédéric; Lescoeur, Brigitte; Gandemer, Virginie; Bodemer, Christine; Lacave, Roger; Hélias-Rodzewicz, Zofia; Taly, Valérie; Geissmann, Frédéric; Donadieu, Jean

    2016-09-01

    Langerhans cell histiocytosis (LCH) is an inflammatory myeloid neoplasia with a broad spectrum of clinical manifestations and outcomes in children. The somatic BRAF(V600E) mutation occurs frequently, but clinical significance remains to be determined. BRAF(V600E) mutation was investigated in a French LCH cohort. We analyzed associations between mutation status and clinical presentation, extent of disease, reactivation rate, response to therapy, and long-term permanent sequelae. Among 315 patients with successfully determined BRAF status, 173 (54.6%) carried a BRAF(V600E) mutation. Patients with BRAF(V600E) manifested more severe disease than did those with wild-type BRAF. Patients with BRAF(V600E) comprised 87.8% of patients (43 of 49) with multisystem LCH with risk organ involvement (liver, spleen, hematology), 68.6% of patients (35 of 51) with multisystem LCH without risk organ involvement, 43.9% of patients (86 of 196) with single-system LCH, and 42.1% of patients (8 of 19) with lung-involved LCH (P < .001). BRAF(V600E) mutation was also associated with organ involvement that could lead to permanent, irreversible damage, such as neurologic (75%) and pituitary (72.9%) injuries. Compared with patients with wild-type BRAF, patients with BRAF(V600E) more commonly displayed resistance to combined vinblastine and corticosteroid therapy (21.9% v 3.3%; P = .001), showed a higher reactivation rate (5-year reactivation rate, 42.8% v 28.1%; P = .006), and had more permanent, long-term consequences from disease or treatment (27.9% v 12.6%; P = .001). In children with LCH, BRAF(V600E) mutation was associated with high-risk features, permanent injury, and poor short-term response to chemotherapy. Further population-based studies should be undertaken to confirm our observations and to assess the impact of BRAF inhibitors for this subgroup of patients who may benefit from targeted therapy. © 2016 by American Society of Clinical Oncology.

  17. Bilateral sudden sensorineural hearing loss as a presenting feature of systemic lupus erythematosus

    PubMed Central

    Chawki, Sylvain; Aouizerate, Jessie; Trad, Selim; Prinseau, Jacques; Hanslik, Thomas

    2016-01-01

    Abstract Introduction: Sudden sensorineural hearing loss is an unusual presenting clinical feature of systemic lupus erythematosus. Case report: We report the case of a young woman who was admitted to hospital for sudden sensorineural hearing loss and hemophagocytic syndrome which was attributed to systemic lupus erythematosus on the basis of specific renal involvement, thrombocytopenia, and consistent autoantibodies. Favorable outcome was obtained on high-dose corticosteroids, and the hearing fully recovered. Discussion: Sudden sensorineural hearing loss in systemic lupus erythematosus is seemingly more frequently associated with severe systemic involvement and antiphospholipid antibodies may be present. Although management remains empirical, the high risk of permanent hearing impairment seems to justify emergency treatment with high-dose corticosteroids. When the clinical and laboratory criteria of antiphospholipid syndrome are met, antiplatelets agents or anticoagulation therapy shall be considered. PMID:27603334

  18. Establishing the diagnostic criteria for eruption disorders based on genetic and clinical data.

    PubMed

    Rhoads, Stephanie Golubic; Hendricks, Heather M; Frazier-Bowers, Sylvia A

    2013-08-01

    Proper diagnosis and management of eruption disturbances remains challenging but is critical to a functional occlusion. The objective of this study was to establish definitive criteria to differentiate and diagnose eruption disorders, specifically primary failure of eruption (PFE) and ankylosis. Sixty-four affected persons were placed into 3 cohorts: PFE diagnosed through confirmed PTH1R mutation (n = 11), PFE diagnosed based on clinical criteria (n = 47), and ankylosis diagnosed based on clinical criteria (n = 6). These groups were assessed to identify clinical features that differentiate PFE and ankylosis. Ninety-three percent of the subjects in the genetic and clinical PFE cohorts combined (n = 58) and 100% in the genetic PFE cohort had at least 1 infraoccluded first permanent molar. Additionally, a novel functional PTH1R mutation, 1092delG, was identified and linked to PFE in the deciduous dentition. An infraoccluded, supracrestal first molar is a hallmark of PFE, often involving both arches in the permanent or deciduous dentition, and with unilateral or bilateral affection, infraoccluded second premolar or second molar, and multiple affected adjacent teeth. Our results further suggest that PFE and ankylosis might be clinically indistinguishable without knowledge of prior trauma, treatment history, genetic information, or obliteration of the periodontal ligament space. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  19. Post-ASFA Permanency Planning for Children in Foster Care: Clinical and Ethical Considerations for Art Therapists

    ERIC Educational Resources Information Center

    Malloy, Jennifer N.

    2017-01-01

    The process of determining permanent living arrangements for children residing in foster care is referred to as permanency planning. I provide a preliminary framework for art therapists working with foster children and their families during the permanency planning process, and identify clinical and ethical issues that have resulted from the…

  20. Permanent-Magnet Meissner Bearing

    NASA Technical Reports Server (NTRS)

    Robertson, Glen A.

    1994-01-01

    Permanent-magnet meissner bearing features inherently stable, self-centering conical configuration. Bearing made stiffer or less stiff by selection of magnets, springs, and spring adjustments. Cylindrical permanent magnets with axial magnetization stacked coaxially on rotor with alternating polarity. Typically, rare-earth magnets used. Magnets machined and fitted together to form conical outer surface.

  1. The first permanent molar: spontaneous eruption after a five-year failure.

    PubMed

    Mistry, Vinay N; Barker, Christopher S; James Spencer, R

    2017-09-01

    It is rare for a first permanent molar (FPM) to temporarily exhibit clinical features of failure of eruption, followed by regeneration of full eruptive capacity 5 years later. Indeterminate failure of eruption (IFE) is a diagnosis of exclusion where the distinction between primary failure of eruption (PFE) and mechanical failure of eruption (MFE) is unclear, including patients too young to specify. An 11-year-old girl attended the orthodontic clinic at Mid Yorkshire Hospitals NHS Trust regarding an unerupted lower right FPM. Her medical and dental trauma history was unremarkable. She presented with a Class II division 2 malocclusion in the mixed dentition, with all other FPMs fully erupted. This report documents that an unerupted FPM in an 11-year-old patient may still have the eruptive potential to become functional within the dentition. The period spent monitoring the FPM's outcome prior to surgical intervention has avoided an operation under general anaesthetic and potentially unnecessary orthodontic treatment, as the tooth subsequently erupted without treatment. © 2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. A Self-Propelled Wheel for Wheeled Vehicles.

    DTIC Science & Technology

    1996-09-05

    embodiments of both types, in 16 general the axial permanent magnet motors feature a stator disk, 17 or drum, with a central opening and electrical...6 In general, in radial permanent magnet motors , the stator is 7 annularly-shaped and is concentrically disposed around a 8 generally cylindrically...is to provide a motor 6 assembly which is more efficient than the presently available 7 axial permanent magnet motors and radial permanent magnet motors 8

  3. Retrosplenial Cortex Codes for Permanent Landmarks

    PubMed Central

    Auger, Stephen D.; Mullally, Sinéad L.; Maguire, Eleanor A.

    2012-01-01

    Landmarks are critical components of our internal representation of the environment, yet their specific properties are rarely studied, and little is known about how they are processed in the brain. Here we characterised a large set of landmarks along a range of features that included size, visual salience, navigational utility, and permanence. When human participants viewed images of these single landmarks during functional magnetic resonance imaging (fMRI), parahippocampal cortex (PHC) and retrosplenial cortex (RSC) were both engaged by landmark features, but in different ways. PHC responded to a range of landmark attributes, while RSC was engaged by only the most permanent landmarks. Furthermore, when participants were divided into good and poor navigators, the latter were significantly less reliable at identifying the most permanent landmarks, and had reduced responses in RSC and anterodorsal thalamus when viewing such landmarks. The RSC has been widely implicated in navigation but its precise role remains uncertain. Our findings suggest that a primary function of the RSC may be to process the most stable features in an environment, and this could be a prerequisite for successful navigation. PMID:22912894

  4. Clinical features and treatment outcomes of Langerhans cell histiocytosis: a nationwide survey from Korea histiocytosis working party.

    PubMed

    Kim, Bo Eun; Koh, Kyung-Nam; Suh, Jin Kyung; Im, Ho Joon; Song, Joon Sup; Lee, Ji Won; Kang, Hyoung Jin; Park, Kyung Duck; Shin, Hee Young; Choi, Hyoung Soo; Lee, Soo Hyun; Yoo, Keon Hee; Sung, Ki Woong; Koo, Hong Hoe; Jung, Hye Lim; Chung, Nak-Gyun; Cho, Bin; Kim, Hack Ki; Lyu, Chuhl Joo; Baek, Hee Jo; Kook, Hoon; Park, Jun Eun; Park, Hyeon Jin; Park, Byung-Kiu; Yoo, Eun Sun; Ryu, Kyung Ha; Lee, Kun Soo; Kim, Heung Sik; Lee, Jae Min; Park, Eun Sil; Yoon, Hoi Soo; Lee, Kwang Chul; Lee, Mee Jeong; Lim, Young Tak; Kim, Hwang Min; Park, Sang Kyu; Park, Jeong-A; Kim, Soon Ki; Park, Meerim; Lim, Yeon-Jung; Lee, Young Ho; Seo, Jong Jin

    2014-03-01

    A nationwide survey was conducted to clarify the clinical features and outcomes of Korean children with Langerhans cell histiocytosis (LCH). Korea Histiocytosis Working Party analyzed the data of 603 patients who were diagnosed with LCH between 1986 and 2010 from 28 institutions in Korea. Median age at diagnosis was 65 months (range, 0 to 276 mo). Bone was the most frequently affected organ (79.6%) followed by skin (19.2%). Initially, 419 patients (69.5%) had single-system involvement (SS), 85 (14.1%) with multisystem (MS) disease without risk organ involvement (MS-RO), and 99 (16.4%) multisystem disease with risk organ involvement (MS-RO). The 5-year overall survival (OS) rates in the SS, MS-RO, and MS-RO groups were 99.8%, 98.4%, and 77.0%, respectively (P<0.001), and the 5-year reactivation rates were 17.9%, 33.5%, and 34.3%, respectively (P<0.001). The OS rate was lower in patients with RO involvement (P=0.025) and lack of response to initial treatment (P=0.001). MS involvement (P=0.036) was an independent risk factor for reactivation. Permanent consequences were documented in 99 patients (16.4%). Reactivation of disease, MS involvement, and age at diagnosis ≤ 2 years were associated with higher incidence of permanent consequences. This study emphasized that further efforts are required to improve survival of MS-RO patients and reduce reactivation in younger patients with MS involvement.

  5. WebCIS: large scale deployment of a Web-based clinical information system.

    PubMed

    Hripcsak, G; Cimino, J J; Sengupta, S

    1999-01-01

    WebCIS is a Web-based clinical information system. It sits atop the existing Columbia University clinical information system architecture, which includes a clinical repository, the Medical Entities Dictionary, an HL7 interface engine, and an Arden Syntax based clinical event monitor. WebCIS security features include authentication with secure tokens, authorization maintained in an LDAP server, SSL encryption, permanent audit logs, and application time outs. WebCIS is currently used by 810 physicians at the Columbia-Presbyterian center of New York Presbyterian Healthcare to review and enter data into the electronic medical record. Current deployment challenges include maintaining adequate database performance despite complex queries, replacing large numbers of computers that cannot run modern Web browsers, and training users that have never logged onto the Web. Although the raised expectations and higher goals have increased deployment costs, the end result is a far more functional, far more available system.

  6. A Review of Clinical Data for Currently Approved Hysteroscopic Sterilization Procedures

    PubMed Central

    Basinski, Cindy M

    2010-01-01

    Two hysteroscopic permanent sterilization procedures are approved for use in the United States: Essure® Permanent Birth Control System (Conceptus Incorporated, Mountain View, CA) and Adiana® Permanent Contraception (Hologic, Inc., Bedford, MA). This review compares the clinical trial data for these procedures. A notable difference is the resultant clinical pregnancy risk. The clinical trials for the Essure procedure have reported no pregnancies in 643 relying women in the 9 years since initiation of the studies. The clinical trial for the Adiana procedure has reported 12 pregnancies in 570 relying women in nearly 5 years of collected data. Other clinical outcome parameters concerning Essure and Adiana are examined in this review. PMID:21364861

  7. SU-G-201-09: Evaluation of a Novel Machine-Learning Algorithm for Permanent Prostate Brachytherapy Treatment Planning

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

    Nicolae, A; Department of Physics, Ryerson University, Toronto, ON; Lu, L

    Purpose: A novel, automated, algorithm for permanent prostate brachytherapy (PPB) treatment planning has been developed. The novel approach uses machine-learning (ML), a form of artificial intelligence, to substantially decrease planning time while simultaneously retaining the clinical intuition of plans created by radiation oncologists. This study seeks to compare the ML algorithm against expert-planned PPB plans to evaluate the equivalency of dosimetric and clinical plan quality. Methods: Plan features were computed from historical high-quality PPB treatments (N = 100) and stored in a relational database (RDB). The ML algorithm matched new PPB features to a highly similar case in the RDB;more » this initial plan configuration was then further optimized using a stochastic search algorithm. PPB pre-plans (N = 30) generated using the ML algorithm were compared to plan variants created by an expert dosimetrist (RT), and radiation oncologist (MD). Planning time and pre-plan dosimetry were evaluated using a one-way Student’s t-test and ANOVA, respectively (significance level = 0.05). Clinical implant quality was evaluated by expert PPB radiation oncologists as part of a qualitative study. Results: Average planning time was 0.44 ± 0.42 min compared to 17.88 ± 8.76 min for the ML algorithm and RT, respectively, a significant advantage [t(9), p = 0.01]. A post-hoc ANOVA [F(2,87) = 6.59, p = 0.002] using Tukey-Kramer criteria showed a significantly lower mean prostate V150% for the ML plans (52.9%) compared to the RT (57.3%), and MD (56.2%) plans. Preliminary qualitative study results indicate comparable clinical implant quality between RT and ML plans with a trend towards preference for ML plans. Conclusion: PPB pre-treatment plans highly comparable to those of an expert radiation oncologist can be created using a novel ML planning model. The use of an ML-based planning approach is expected to translate into improved PPB accessibility and plan uniformity.« less

  8. Electric-Drive Propulsion for U.S. Navy Ships: Background and Issues for Congress

    DTIC Science & Technology

    2000-07-31

    over electric drive concerns electric motors. The five basic types in question – synchronous motors, induction motors, permanent magnet motors , superconducting...drive technology for ships – synchronous motors, induction motors, permanent magnet motors , superconducting synchronous motors, and superconducting...synchronous motors and is also developing systems featuring induction and permanent magnet motors . ! an industry team led by General Dynamics Corporation

  9. Job stress and mental health of permanent and fixed-term workers measured by effort-reward imbalance model, depressive complaints, and clinic utilization.

    PubMed

    Inoue, Mariko; Tsurugano, Shinobu; Yano, Eiji

    2011-01-01

    The number of workers with precarious employment has increased globally; however, few studies have used validated measures to investigate the relationship of job status to stress and mental health. Thus, we conducted a study to compare differential job stress experienced by permanent and fixed-term workers using an effort-reward imbalance (ERI) model questionnaire, and by evaluating depressive complaints and clinic utilization. Subjects were permanent or fixed-term male workers at a Japanese research institute (n=756). Baseline data on job stress and depressive complaints were collected in 2007. We followed up with the same population over a 1-year period to assess their utilization of the company clinic for mental health concerns. The ERI ratio was higher among permanent workers than among fixed-term workers. More permanent workers presented with more than two depressive complaints, which is the standard used for the diagnosis of depression. ERI scores indicated that the effort component of permanent work was associated with distress, whereas distress in fixed-term work was related to job promotion and job insecurity. Moreover, over the one-year follow-up period, fixed-term workers visited the on-site clinic for mental concerns 4.04 times more often than permanent workers even after adjusting for age, lifestyle, ERI, and depressive complaints. These contrasting findings reflect the differential workloads and working conditions encountered by permanent and fixed-term workers. The occupational setting where employment status was intermingled, may have contributed to the high numbers of mental health-related issues experienced by workers with different employment status.

  10. Microscopic and ultrastructural features in Wolcott-Rallison syndrome, a permanent neonatal diabetes mellitus: about two autopsy cases.

    PubMed

    Collardeau-Frachon, Sophie; Vasiljevic, Alexandre; Jouvet, Anne; Bouvier, Raymonde; Senée, Valérie; Nicolino, Marc

    2015-11-01

    Wolcott-Rallison syndrome (WRS) is a rare autosomal recessive disorder characterized by the association of permanent neonatal or early-infancy insulin-dependent diabetes, multiple bone dysplasia, hepatic dysfunction, and growth retardation. All clinical manifestations result from gene mutations encoding pancreatic endoplasmic reticulum eIF2 α kinase (PERK), an endoplasmic reticulum transmembrane protein that plays a role in the unfolded protein response. Histological and ultrastructural lesions of bone and pancreas have been described in animal models and WRS patients. However, histological and ultrastructural findings of other organs, especially of the liver, are lacking. Autopsy specimens from two pediatric patients with WRS were analyzed. An immunohistochemical study was performed on the pancreas. An ultrastructural study was realized from samples of liver, pancreas, kidney, and myocardium. Our findings were compared with those of the literature and correlated with the molecular data. Hepatocytes and pancreatic exocrine cells exhibited very peculiar features of necrosis suggestive of secondary changes because of endoplasmic reticulum overload. Steatosis occurred in renal tubular cells, hepatocytes, and myocardial fibers. Abnormal mitochondria were noted in renal and myocardial fibers. Pancreas islets were characterized by a marked reduction in the number of insulin-secreting β cells. The histological and ultrastructural features that occur in WRS are directly or indirectly linked to endoplasmic reticulum (ER) dysfunction and can explain the peculiar phenotype of this syndrome. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Image processing based automatic diagnosis of glaucoma using wavelet features of segmented optic disc from fundus image.

    PubMed

    Singh, Anushikha; Dutta, Malay Kishore; ParthaSarathi, M; Uher, Vaclav; Burget, Radim

    2016-02-01

    Glaucoma is a disease of the retina which is one of the most common causes of permanent blindness worldwide. This paper presents an automatic image processing based method for glaucoma diagnosis from the digital fundus image. In this paper wavelet feature extraction has been followed by optimized genetic feature selection combined with several learning algorithms and various parameter settings. Unlike the existing research works where the features are considered from the complete fundus or a sub image of the fundus, this work is based on feature extraction from the segmented and blood vessel removed optic disc to improve the accuracy of identification. The experimental results presented in this paper indicate that the wavelet features of the segmented optic disc image are clinically more significant in comparison to features of the whole or sub fundus image in the detection of glaucoma from fundus image. Accuracy of glaucoma identification achieved in this work is 94.7% and a comparison with existing methods of glaucoma detection from fundus image indicates that the proposed approach has improved accuracy of classification. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. The impact of an anti-gravity treadmill (AlterG) training on walking capacity and corticospinal tract structure in children with cerebral palsy.

    PubMed

    Azizi, Sh; Marzbani, H; Raminfard, S; Birgani, P M; Rasooli, A H; Mirbagheri, M M

    2017-07-01

    We studied the effects of an anti-gravity treadmill (AlterG) training on walking capacity and corticospinal tract structure in children with Cerebral Palsy (CP). AlterG can help CP children walk on the treadmill by reducing their weights up to 80% and maintain their balance during locomotion. AlterG training thus has the potential to improve walking capacity permanently as it can provide systematic and intense locomotor training for sufficiently long period of time and produce brain neuroplasticity. AlterG training was given for 45 minutes, three times a week for two months. The neuroplasticity of corticospinal tract was evaluated using Diffusion Tensor Imaging (DTI). The fractional Anisotropy (FA) feature was extracted to quantify structural changes of the corticospinal tract. Walking capacity was evaluated using popular clinical measurements of gait; i.e., walking speed, mobility and balance. The evaluations were done before and after training. Our results revealed that AlterG training resulted in an increase in average FA value of the corticospinal tract following the training. The outcome measures of clinical assessments of gait presented enhanced walking capacity of the CP subjects. Our findings indicated that the improved walking capacity was concurrent with the enhancement of the corticospinal tract structure. The clinical implication is that AlterG training may be considered as a therapeutic tool for permanent gait improvement in CP children.

  13. A tubular flux-switching permanent magnet machine

    NASA Astrophysics Data System (ADS)

    Wang, J.; Wang, W.; Clark, R.; Atallah, K.; Howe, D.

    2008-04-01

    The paper describes a novel tubular, three-phase permanent magnet brushless machine, which combines salient features from both switched reluctance and permanent magnet machine technologies. It has no end windings and zero net radial force and offers a high power density and peak force capability, as well as the potential for low manufacturing cost. It is, therefore, eminently suitable for a variety of applications, ranging from free-piston energy converters to active vehicle suspensions.

  14. Ectopic eruption of permanent incisors after predecessor pulpectomy: five cases.

    PubMed

    Tannure, Patricia Nivoloni; Fidalgo, Tatiana Kelly da Silva; Barcelos, Roberta; Gleiser, Rogerio; Primo, Laura Guimaraes

    2011-01-01

    Pulpectomy in primary teeth is a common technique that preserves teeth in the oral environment and maintains or recovers periapical tissues to a healthy condition. This article describes the ectopic eruption of permanent incisors whose primary predecessors underwent pulpectomy using ZOE filler paste. In a group of 135 teeth that received pulpectomy therapy due to caries, 10 primary maxillary incisors had overretention and were followed for at least 3.5 years (mean time of 4.2 years), both clinically and radiographically, until the permanent teeth erupted. The proposed treatment included extraction of the overretained primary incisors based on permanent successor eruption chronology and contralateral eruption. Seven permanent teeth erupted ectopically. Autocorrection of the permanent tooth positions was observed in five cases. It can be concluded that periodic clinical and radiographic assessments are essential to verify radicular and filling paste resorptions and to avoid overretention and any subsequent malocclusion.

  15. Traumatic lingual ulcer in a child: Riga-Fede disease.

    PubMed

    Ceyhan, A M; Yildirim, M; Basak, P Y; Akkaya, V B; Ayata, A

    2009-03-01

    Riga-Fede disease RFD is an extremely rare, benign inflammatory disorder characterized by reactive, traumatic ulceration of the oral mucosa especially located on the tongue. It is most commonly associated with natal or neonatal teeth in newborns. Mucosal lesions are often caused by repetitive traumatic damage due to backward and forward motions of the tongue over the lower incisors. Failure to diagnose and treat these lesions properly may result in inadequate food intake, growth retardation and permanent lingual deformity. We report a 15-month-old healthy infant with tongue ulcer diagnosed as RFD based on history and clinical features.

  16. 78 FR 76772 - Special Conditions: Airbus Model A350-900 Airplanes; Permanently Installed Rechargeable Lithium...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-19

    ... Installed Rechargeable Lithium-Ion Batteries and Battery Systems AGENCY: Federal Aviation Administration... feature associated with permanently installed rechargeable lithium-ion batteries and battery systems... batteries and battery systems on aircraft. Lithium-ion batteries and battery systems have new hazards that...

  17. Poikiloderma with Neutropenia in Morocco: a Report of Four Cases.

    PubMed

    Aglaguel, Ayoub; Abdelghaffar, Houria; Ailal, Fatima; Habti, Norddine; Hesse, Sebastian; Kohistani, Naschla; Klein, Christoph; Bousfiha, Ahmed Aziz

    2017-05-01

    Poikiloderma with Neutropenia (PN) is inherited genodermatosis which results from a biallelic mutation in the USB1 gene (U Six Biogenesis 1). PN, first described in Navajo Native Americans, is characterized by early onset poikiloderma, pachyonychia, palmo-plantar hyperkeratosis, and permanent neutropenia. This condition results in frequent respiratory tract infections during infancy and childhood. From 2011 to 2013, four cases of PN were diagnosed in Morocco. In this paper, we report the first four cases of PN diagnosed in Morocco, out of three unrelated consanguinous families. We investigated the genetic, immunological, and clinical features of four Moroccan patients with PN from three unrelated consanguinous families. Mean age at onset was 3 months and mean age at diagnosis was 7.5 years. The diagnosis of these PN patients was made based on clinical features and confirmed by molecular analysis for three cases. We identified two undescribed homozygous mutations in the USB1 gene: c.609 + 1G>A in two siblings and c.518 T>G(p.(Leu173Arg)) in the other case. This report confirms the clinical and genetic identity of Poikiloderma with Neutropenia syndrome.

  18. Towards Text Copyright Detection Using Metadata in Web Applications

    ERIC Educational Resources Information Center

    Poulos, Marios; Korfiatis, Nikolaos; Bokos, George

    2011-01-01

    Purpose: This paper aims to present the semantic content identifier (SCI), a permanent identifier, computed through a linear-time onion-peeling algorithm that enables the extraction of semantic features from a text, and the integration of this information within the permanent identifier. Design/methodology/approach: The authors employ SCI to…

  19. Clinical Evaluation of Microhybrid Composite and Glass lonomer Restorative Material in Permanent Teeth.

    PubMed

    Kharma, Khalil; Zogheib, Tatiana; Bhandi, Shilpa; Mehanna, Carina

    2018-02-01

    The aim of this study was to clinically compare glass ionomer cement (GIC) with microhybrid composite resin used in class I cavities on permanent teeth over a period of 9 months. A total of 40 teeth with class I cavities were divided into two groups (n = 20) and restored with GIC (EQUIA; GC) and microhybrid resin composite (Amelogen Plus; Ultradent). Restorations were evaluated at ×4.5 magnification using the United States Public Health Service (USPHS) criteria every 3 months. Statistical analysis was performed using the Fisher's exact test (a < 0.05). The data obtained reported no statistical significance difference between both groups in regard to anatomical shape, color, postoperative sensitivity, secondary caries, material handling, adaptation, and marginal staining. The results of this clinical study showed that GIC (EQUIA; GC) can be used for the restoration of permanent teeth and may be more appropriate for certain clinical situations than the resin composite material. EQUIA (GIC) is a viable alternative to resin composite in restoring class I cavities in permanent teeth.

  20. Update in Pathological Diagnosis of Orbital Infections and Inflammations

    PubMed Central

    Lam Choi, Vincent B.; Yuen, Hunter K. L.; Biswas, Jyotirmay; Yanoff, Myron

    2011-01-01

    Orbital infections and inflammations include a broad spectrum of orbital diseases that can be idiopathic, infectious, from primary or secondary inflammatory processes. Being able to properly diagnose and manage these orbital diseases in a timely manner can avoid permanent vision loss and possibly save a patient's life. When clinicians are faced with such patients, quite often the exact diagnosis cannot be made just based on clinical examination, various laboratory tests and imaging are needed. Moreover, orbital biopsies with histopathological analyses are often required, especially for the atypical cases. Thus, it is important for the clinicians to be familiar with the pathological features and characteristics of these orbital diseases. This review provides a comprehensive update on the clinical and pathological diagnosis of these orbital infections and inflammations. PMID:22224014

  1. Developmental Disturbances of a Maxillary Central Incisor due to Trauma to Its Predecessor: A Case Report

    PubMed Central

    Karataş, Merve Safa; Sönmez, Işıl Şaroğlu

    2013-01-01

    Objective To report the effects of a primary tooth trauma on the underlying permanent tooth germ. Clinical Presentation and Intervention A 12-year-old girl was referred to our clinic with a complaint of poor aesthetic appearance. The crown of the permanent maxillary left central tooth exhibited an increased clinical crown height with an ‘enamel hyperplasia’ in the cervical third and had hypoplastic enamel with yellowish-brown discoloration extending from the middle third to the incisal edge. Radiographic examination revealed that the permanent maxillary left central tooth had abnormal root morphology with root dilaceration. The patient revealed a history of trauma at the age of 4 years. An aesthetic restoration with light-curing resin composite was performed on the vestibular surface of the maxillary left permanent central tooth. Conclusion Sequelae of a primary tooth trauma on the permanent tooth were restored. We recommend that parents should be aware of the consequences of untreated trauma to a primary tooth. Educational and preventive programmes on dental trauma are required to educate parents about emergency knowledge and sequelae of dental trauma. PMID:23689528

  2. Analysis and design of asymmetrical reluctance machine

    NASA Astrophysics Data System (ADS)

    Harianto, Cahya A.

    Over the past few decades the induction machine has been chosen for many applications due to its structural simplicity and low manufacturing cost. However, modest torque density and control challenges have motivated researchers to find alternative machines. The permanent magnet synchronous machine has been viewed as one of the alternatives because it features higher torque density for a given loss than the induction machine. However, the assembly and permanent magnet material cost, along with safety under fault conditions, have been concerns for this class of machine. An alternative machine type, namely the asymmetrical reluctance machine, is proposed in this work. Since the proposed machine is of the reluctance machine type, it possesses desirable feature, such as near absence of rotor losses, low assembly cost, low no-load rotational losses, modest torque ripple, and rather benign fault conditions. Through theoretical analysis performed herein, it is shown that this machine has a higher torque density for a given loss than typical reluctance machines, although not as high as the permanent magnet machines. Thus, the asymmetrical reluctance machine is a viable and advantageous machine alternative where the use of permanent magnet machines are undesirable.

  3. Dental eruption in afrotherian mammals

    PubMed Central

    Asher, Robert J; Lehmann, Thomas

    2008-01-01

    Background Afrotheria comprises a newly recognized clade of mammals with strong molecular evidence for its monophyly. In contrast, morphological data uniting its diverse constituents, including elephants, sea cows, hyraxes, aardvarks, sengis, tenrecs and golden moles, have been difficult to identify. Here, we suggest relatively late eruption of the permanent dentition as a shared characteristic of afrotherian mammals. This characteristic and other features (such as vertebral anomalies and testicondy) recall the phenotype of a human genetic pathology (cleidocranial dysplasia), correlations with which have not been explored previously in the context of character evolution within the recently established phylogeny of living mammalian clades. Results Although data on the absolute timing of eruption in sengis, golden moles and tenrecs are still unknown, craniometric comparisons for ontogenetic series of these taxa show that considerable skull growth takes place prior to the complete eruption of the permanent cheek teeth. Specimens showing less than half (sengis, golden moles) or two-thirds (tenrecs, hyraxes) of their permanent cheek teeth reach or exceed the median jaw length of conspecifics with a complete dentition. With few exceptions, afrotherians are closer to median adult jaw length with fewer erupted, permanent cheek teeth than comparable stages of non-afrotherians. Manatees (but not dugongs), elephants and hyraxes with known age data show eruption of permanent teeth late in ontogeny relative to other mammals. While the occurrence of delayed eruption, vertebral anomalies and other potential afrotherian synapomorphies resemble some symptoms of a human genetic pathology, these characteristics do not appear to covary significantly among mammalian clades. Conclusion Morphological characteristics shared by such physically disparate animals such as elephants and golden moles are not easy to recognize, but are now known to include late eruption of permanent teeth, in addition to vertebral anomalies, testicondy and other features. Awareness of their possible genetic correlates promises insight into the developmental basis of shared morphological features of afrotherians and other vertebrates. PMID:18366669

  4. Glossopharyngeal neuralgia with syncope.

    PubMed

    Taylor, P H; Gray, K; Bicknell, P G; Rees, J R

    1977-10-01

    Thirty-two cases of glossopharyngeal neuralgia complicated by syncope, cardiac arrhythmias or convulsions, singly or together, have been reported in the world literature. A further case is described and the clinical features of these thirty-three are reviewed. It is recommended that treatment should be undertaken as a matter of urgency. In the first place, Carbamezapine, with often the addition of Atropine, may prove effective. However, surgical intervention appears to give a better chance of permanent relief. Four alternative methods of surgery are discussed and the cervical or the intracranial approach recommended. Surgery should not be delayed in patients who fail to respond to medical treatment or in whom recurrence of symptoms occurs.

  5. Feature Binding in Visual Working Memory Evaluated by Type Identification Paradigm

    ERIC Educational Resources Information Center

    Saiki, Jun; Miyatsuji, Hirofumi

    2007-01-01

    Memory for feature binding comprises a key ingredient in coherent object representations. Previous studies have been equivocal about human capacity for objects in the visual working memory. To evaluate memory for feature binding, a type identification paradigm was devised and used with a multiple-object permanence tracking task. Using objects…

  6. Nodular skin reactions in eyebrow permanent makeup: two case reports and an infection by Mycobacterium haemophilum.

    PubMed

    Wollina, Uwe

    2011-09-01

    Permanent makeup is becoming more and more popular. The procedures, however, bear some medical risks. We will describe possible adverse effects of the procedure. This is a report of clinical observations. We report about two women aged 26 and 47 years, who developed nodules with some delay after permanent tattooing the eyebrows. Clinical, histologic, and laboratory investigations revealed a noninfectious granulomatous reaction not responding to topical calcineurin inhibitor but corticosteroids in the younger patient. In the other woman, an infection by Mycobacterium haemophilum could be identified. A triple combination of clarithromycin, ciprofloxacin, and rifampicin succeeded in clearance of the lesions. Adverse reactions after permanent makeup need a medical evaluation to identify health risks and initiate early treatment. © 2011 Wiley Periodicals, Inc.

  7. Heterozygous ABCC8 mutations are a cause of MODY.

    PubMed

    Bowman, P; Flanagan, S E; Edghill, E L; Damhuis, A; Shepherd, M H; Paisey, R; Hattersley, A T; Ellard, S

    2012-01-01

    The ABCC8 gene encodes the sulfonylurea receptor 1 (SUR1) subunit of the pancreatic beta cell ATP-sensitive potassium (K(ATP)) channel. Inactivating mutations cause congenital hyperinsulinism (CHI) and activating mutations cause transient neonatal diabetes (TNDM) or permanent neonatal diabetes (PNDM) that can usually be treated with sulfonylureas. Sulfonylurea sensitivity is also a feature of HNF1A and HNF4A MODY, but patients referred for genetic testing with clinical features of these types of diabetes do not always have mutations in the HNF1A/4A genes. Our aim was to establish whether mutations in the ABCC8 gene cause MODY that is responsive to sulfonylurea therapy. We sequenced the ABCC8 gene in 85 patients with a BMI <30 kg/m², no family history of neonatal diabetes and who were deemed sensitive to sulfonylureas by the referring clinician or were sulfonylurea-treated. All had tested negative for mutations in the HNF1A and HNF4A genes. ABCC8 mutations were found in seven of the 85 (8%) probands. Four patients were heterozygous for previously reported mutations and four novel mutations, E100K, G214R, Q485R and N1245D, were identified. Only four probands fulfilled MODY criteria, with two diagnosed after 25 years and one patient, who had no family history of diabetes, as a result of a proven de novo mutation. ABCC8 mutations can cause MODY in patients whose clinical features are similar to those with HNF1A/4A MODY. Therefore, sequencing of ABCC8 in addition to the known MODY genes should be considered if such features are present, to facilitate optimal clinical management of these patients.

  8. Estimated prevalence of erosive tooth wear in permanent teeth of children and adolescents: an epidemiological systematic review and meta-regression analysis.

    PubMed

    Salas, M M S; Nascimento, G G; Huysmans, M C; Demarco, F F

    2015-01-01

    The main purpose of this systematic review was to estimate the prevalence of dental erosion in permanent teeth of children and adolescents. An electronic search was performed up to and including March 2014. Eligibility criteria included population-based studies in permanent teeth of children and adolescents aged 8-19-year-old reporting the prevalence or data that allowed the calculation of prevalence rates of tooth erosion. Data collection assessed information regarding geographic location, type of index used for clinical examination, sample size, year of publication, age, examined teeth and tissue exposure. The estimated prevalence of erosive wear was determined, followed by a meta-regression analysis. Twenty-two papers were included in the systematic review. The overall estimated prevalence of tooth erosion was 30.4% (95%IC 23.8-37.0). In the multivariate meta-regression model use of the Tooth Wear Index for clinical examination, studies with sample smaller than 1000 subjects and those conducted in the Middle East and Africa remained associated with higher dental erosion prevalence rates. Our results demonstrated that the estimated prevalence of erosive wear in permanent teeth of children and adolescents is 30.4% with high heterogeneity between studies. Additionally, the correct choice of a clinical index for dental erosion detection and the geographic location play an important role for the large variability of erosive tooth wear in permanent teeth of children and adolescents. The prevalence of tooth erosion observed in permanent teeth of children and adolescents was considerable high. Our results demonstrated that prevalence rate of erosive wear was influenced by methodological and diagnosis factors. When tooth erosion is assessed, the clinical index should be considered. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Iterative variational mode decomposition based automated detection of glaucoma using fundus images.

    PubMed

    Maheshwari, Shishir; Pachori, Ram Bilas; Kanhangad, Vivek; Bhandary, Sulatha V; Acharya, U Rajendra

    2017-09-01

    Glaucoma is one of the leading causes of permanent vision loss. It is an ocular disorder caused by increased fluid pressure within the eye. The clinical methods available for the diagnosis of glaucoma require skilled supervision. They are manual, time consuming, and out of reach of common people. Hence, there is a need for an automated glaucoma diagnosis system for mass screening. In this paper, we present a novel method for an automated diagnosis of glaucoma using digital fundus images. Variational mode decomposition (VMD) method is used in an iterative manner for image decomposition. Various features namely, Kapoor entropy, Renyi entropy, Yager entropy, and fractal dimensions are extracted from VMD components. ReliefF algorithm is used to select the discriminatory features and these features are then fed to the least squares support vector machine (LS-SVM) for classification. Our proposed method achieved classification accuracies of 95.19% and 94.79% using three-fold and ten-fold cross-validation strategies, respectively. This system can aid the ophthalmologists in confirming their manual reading of classes (glaucoma or normal) using fundus images. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. [Progress in the development of insulin pumps and their advanced automatic functions].

    PubMed

    Prázný, Martin

    2015-04-01

    Patients with type 1 diabetes are exposed to permanent burden consisting of careful glucose self-monitoring and precise insulin dosage based on measured glucose values, carbohydrates content in the food and both planned and non-planned physical activity. Erroneous insulin dosing causes frequent both hypoglycemia and hyperglycemia. Hypoglycemia is, however, the most clinically significant complication limiting the optimal diabetes control. Automatic features for insulin dosage integrated in insulin pumps are thus very important. Low glucose suspend (LGS) and Predictive Low Glucose Management (PLGM) use glucose sensor values to prevent hypoglycemia, shorten the time spent in hypoglycemic range and present further step forward to fully closed-loop system of insulin treatment.

  11. [Elements of a clinical differential diagnosis between Asperger syndrome and the schizoid/paranoid personality].

    PubMed

    Mottron, Laurent; Soulières, Isabelle; Ménard, Edith

    2007-01-01

    Individuals with Asperger syndrome may, when exposed to hostility (e.g. bullying at school or at work), develop hostile ideas against their social environment, sometimes leading to aggression. These ideas and acts may be confounded with those arising from a persecutory state in schizoid or schizotypal personality, or even schizophrenia. These entities can be confounded with Asperger syndrome due to their permanent nature, and the presence of atypical social and emotional behaviours. This paper proposes cognitive (Wechsler profile), developmental (course of hostile behaviours), discursive (qualitative features of discourse reporting hostile thoughts), which may contribute to differential diagnosis in the presence of hostile thoughts and behaviours. Consequences for case management are also reported.

  12. Dental Anomalies in Permanent Teeth after Trauma in Primary Dentition.

    PubMed

    Bardellini, Elena; Amadori, Francesca; Pasini, Stefania; Majorana, Alessandra

    This retrospective study aims to evaluate the prevalence of dental anomalies in permanent teeth as a result of a trauma concerning the predecessor primary teeth. A total of 241 records of children (118 males and 123 females, mean age 3.62 ± 1.40) affected by trauma on primary teeth were analyzed. All patients were recalled to evaluate the status of the permanent successor teeth by clinical and radiographic investigations. Out of 241 patients, 106 patients (for a total of 179 traumatized primary teeth) presented at the recall. Dental anomalies on successor permanent teeth were detected in 21 patients (19.8%), for a total of 26 teeth (14.5%) and 28 anomalies. Anomalies of the eruptive process were the most observed disturbances (60.7%), followed by enamel hypoplasia (25%) and white spots (14.3%). A higher percentage of anomalies on permanent teeth was observed when trauma occurred at an age less than 36 months (38.5% of cases). Intrusive and extrusive luxation were related with the most cases of clinical disturbances in the successor permanent teeth. The results of this study highlight the risk of dental anomalies after a trauma in primary dentition, especially in early-aged children and in case of intrusive luxation.

  13. Chronic neuropathic facial pain after intense pulsed light hair removal. Clinical features and pharmacological management.

    PubMed

    Gay-Escoda, Cosme; Párraga-Manzol, Gabriela; Sánchez-Torres, Alba; Moreno-Arias, Gerardo

    2015-10-01

    Intense Pulsed Light (IPL) photodepilation is usually performed as a hair removal method. The treatment is recommended to be indicated by a physician, depending on each patient and on its characteristics. However, the use of laser devices by medical laypersons is frequent and it can suppose a risk of damage for the patients. Most side effects associated to IPL photodepilation are transient, minimal and disappear without sequelae. However, permanent side effects can occur. Some of the complications are laser related but many of them are caused by an operator error or mismanagement. In this work, we report a clinical case of a patient that developed a chronic neuropathic facial pain following IPL hair removal for unwanted hair in the upper lip. The specific diagnosis was painful post-traumatic trigeminal neuropathy, reference 13.1.2.3 according to the International Headache Society (IHS). Neuropathic facial pain, photodepilation, intense pulse light.

  14. Ultrasonographic features and clinical characteristics of Warthin-like variant of papillary thyroid carcinoma.

    PubMed

    Kim, Ga Ram; Shin, Jung Hee; Hahn, Soo Yeon; Ko, Eun Young; Oh, Young Lyun

    2016-04-25

    Warthin-like variant of papillary thyroid carcinoma (WVPTC) is a rare entity recently characterized. We evaluated ultrasonographic (US) features and clinical characteristics of WVPTC. Nine patients were diagnosed with WVPTC through surgery in our institution from May 2005 to January 2015. Eight of nine patients had available preoperative US images. A retrospective review of the US and clinical characteristics was performed. WVPTC compromised of 0.06% of 14,071 PTCs surgically confirmed. A mean age of nine patients was 53.2 years (range, 32-75 years). The mean nodule size of nine WVPTCs was 0.9 cm (range, 0.5-1.5 cm). Two patients showed central nodal metastasis and one patient with conventional PTC as an index tumor underwent central and lateral neck dissection. No one showed recurrence or distant metastasis during the follow-up period (mean, 4.6 years; range, 0.6-10 years). The most common US features of WVPTCs were solid composition (62.5%), hypoechogenicity (75%), and wider-than-tall shape (100%), respectively. Four (50%) of eight nodules showed well-defined margin and three (37.5%) of them had cystic component. One of eight resembled focal thyroiditis. Three nodules were considered as probably benign with US. All nine cases demonstrated underlying heterogeneous parenchymal echogenicity and accompanied chronic lymphocytic thyroiditis in permanent sections. Thyroid function tests in all patients were normal except for one with subclinical hypothyroidism. WVPTC is an uncommon subtype of PTC and has favorable prognosis, which can be misdiagnosed as a probably benign nodule or focal thyroiditis with US. All cases are associated with heterogeneous parenchyma in the background.

  15. JPRS Report. Soviet Union: Political Affairs.

    DTIC Science & Technology

    1990-07-10

    following three essential features: voluntary member- ship; self -management; and a permanent nature. All NATIONAL PARTY AND STATE AFFAIRS JPRS-UPA-90-040...voluntary, self -managed, permanently functioning association of citizens organized on a not- for-profit basis. This wording, which takes in the basic...problems which had long been present in the depths of society, including a most serious one—national self -preservation. As soon as the possibility of

  16. Permanent Central Diabetes Insipidus as a Complication of S. pneumoniae Meningitis in the Pediatric Population.

    PubMed

    Statz, Hannah; Hsu, Benson S

    2016-05-01

    Diabetes insipidus is a rare but recognized complication of meningitis. The occurrence of diabetes insidipus has been previously attributed to Streptococcus pneumoniae (S. pneumoniae) in a handful of patients and only once within the pediatric subpopulation. We present the clinical course of a previously healthy 2-year, 8-month-old male child ultimately diagnosed with central diabetes insipidus (CDI) secondary to S. pneumoniae meningitis. Permanent CDI following S. pneumoniae meningitis is unique to our case and has not been previously described. Following the case presentation, we describe the etiology, pathophysiology, diagnosis, and treatment of CDI. The mechanism proposed for this clinical outcome is cerebral herniation for a sufficient duration and subsequent ischemia leading to the development of permanent CDI. Providers should be aware of CDI resulting from S. pneumoniae meningitis as prompt diagnosis and management may decrease the risk of permanent hypothalamo-pituitary axis damage. Copyright© South Dakota State Medical Association.

  17. A Plasma Display Terminal.

    ERIC Educational Resources Information Center

    Stifle, Jack

    A graphics terminal designed for use as a remote computer input/output terminal is described. Although the terminal is intended for use in teaching applications, it has several features which make it useful in many other computer terminal applications. These features include: a 10-inch square plasma display panel, permanent storage of information…

  18. Exclusion of chromosome 1q21-q31 from linkage to three pedigrees affected by the pigment-dispersion syndrome

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

    Paglinauan, C.; Haines, J.L.; Del Bono, E.A.

    1995-05-01

    The pigment-dispersion syndrome is a form of open-angle glaucoma that usually affects individuals in the first 3 decades of life. In addition to the typical optic-nerve degeneration seen in all types of glaucoma, the pigment-dispersion syndrome is characterized by distinctive clinical features including the deposition of pigment granules from the iris epithelium on a variety of ocular structures including the trabecular meshwork. Frequently this disorder affects young myopic individuals. In the early stages of the disease, affected individuals may have clinical evidence of dispersed pigment without an associated elevation of intraocular pressure and optic-nerve degeneration. However, as the disease processmore » progresses, many affected individuals ({approximately}50%) will develop elevated intraocular pressure and degeneration of the optic nerve, causing a permanent loss of sight. The pigment-dispersion syndrome shares several clinical features with the form of autosomal dominant juvenile open-angle glaucoma that recently has been mapped to the 1q21-q31 region of chromosome 1. Our results indicate that the pigment-dispersion syndrome, a form of glaucoma that may also affect the juvenile population, is genetically unrelated to the autosomal dominant form of juvenile glaucoma caused by a defect in a gene located in the 1q21-q31 region of chromosome 1. 15 refs., 2 figs., 1 tab.« less

  19. Medical returns: seeking health care in Mexico.

    PubMed

    Horton, Sarah; Cole, Stephanie

    2011-06-01

    Despite the growing prevalence of transnational medical travel among immigrant groups in industrialized nations, relatively little scholarship has explored the diverse reasons immigrants return home for care. To date, most research suggests that cost, lack of insurance and convenience propel US Latinos to seek health care along the Mexican border. Yet medical returns are common even among Latinos who do have health insurance and even among those not residing close to the border. This suggests that the distinct culture of medicine as practiced in the border clinics Latinos visit may be as important a factor in influencing medical returns as convenience and cost. Drawing upon qualitative interviews, this article presents an emic account of Latinos' perceptions of the features of medical practice in Mexico that make medical returns attractive. Between November 15, 2009 and January 15, 2010, we conducted qualitative interviews with 15 Mexican immigrants and nine Mexican Americans who sought care at Border Hospital, a private clinic in Tijuana. Sixteen were uninsured and eight had insurance. Yet of the 16 uninsured, six had purposefully dropped their insurance to make this clinic their permanent "medical home." Moreover, those who substituted receiving care at Border Hospital for their US health insurance plan did so not only because of cost, but also because of what they perceived as the distinctive style of medical practice at Border Hospital. Interviewees mentioned the rapidity of services, personal attention, effective medications, and emphasis on clinical discretion as features distinguishing "Mexican medical practice," opposing these features to the frequent referrals and tests, impersonal doctor-patient relationships, uniform treatment protocols and reliance on surgeries they experienced in the US health care system. While interviewees portrayed these features as characterizing a uniform "Mexican medical culture," we suggest that they are best described as unique to the private clinics and hospitals returning migrants visit. In short, we suggest that the perceived contrast in cultures of medicine derives from the difference in organization of health care services on each side of the border. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Prospective study of tricuspid valve regurgitation associated with permanent leads in patients undergoing cardiac rhythm device implantation: Background, rationale, and design

    PubMed Central

    Dokainish, Hisham; Elbarasi, Esam; Masiero, Simona; Van de Heyning, Caroline; Brambatti, Michela; Ghazal, Sami; AL-Maashani, Said; Capucci, Alessandro; Buikema, Lisanne; Leong, Darryl; Shivalkar, Bharati; Saenen, Johan; Miljoen, Hielko; Morillo, Carlos; Divarakarmenon, Syam; Amit, Guy; Ribas, Sebastian; Brautigam, Aaron; Baiocco, Erika; Maolo, Alessandro; Romandini, Andrea; Maffei, Simone; Connolly, Stuart; Healey, Jeff

    2015-01-01

    Given the increasing numbers of cardiac device implantations worldwide, it is important to determine whether permanent endocardial leads across the tricuspid valve can promote tricuspid regurgitation (TR). Virtually all current data is retrospective, and indicates a signal of TR being increased after permanent lead implantation. However, the precise incidence of moderate or greater TR post-procedure, the exact mechanisms (mechanical, traumatic, functional), and the hemodynamic burden and clinical effects of this putative increase in TR, remain uncertain. We have therefore designed a multicenter, international, prospective study of 300 consecutive patients (recruitment completed, baseline data presented) who will undergo echocardiography and clinical assessment prior to, and at 1-year post device insertion. This prospective study will help determine whether cardiac device-associated TR is real, what are its potential mechanisms, and whether it has an important clinical impact on cardiac device patients. PMID:26779517

  1. Handheld magnetic probe with permanent magnet and Hall sensor for identifying sentinel lymph nodes in breast cancer patients.

    PubMed

    Sekino, Masaki; Kuwahata, Akihiro; Ookubo, Tetsu; Shiozawa, Mikio; Ohashi, Kaichi; Kaneko, Miki; Saito, Itsuro; Inoue, Yusuke; Ohsaki, Hiroyuki; Takei, Hiroyuki; Kusakabe, Moriaki

    2018-01-19

    The newly developed radioisotope-free technique based on magnetic nanoparticle detection using a magnetic probe is a promising method for sentinel lymph node biopsy. In this study, a novel handheld magnetic probe with a permanent magnet and magnetic sensor is developed to detect the sentinel lymph nodes in breast cancer patients. An outstanding feature of the probe is the precise positioning of the sensor at the magnetic null point of the magnet, leading to highly sensitive measurements unaffected by the strong ambient magnetic fields of the magnet. Numerical and experimental results show that the longitudinal detection length is approximately 10 mm, for 140 μg of iron. Clinical tests were performed, for the first time, using magnetic and blue dye tracers-without radioisotopes-in breast cancer patients to demonstrate the performance of the probe. The nodes were identified through transcutaneous and ex-vivo measurements, and the iron accumulation in the nodes was quantitatively revealed. These results show that the handheld magnetic probe is useful in sentinel lymph node biopsy and that magnetic techniques are widely being accepted as future standard methods in medical institutions lacking nuclear medicine facilities.

  2. Reach on sound: a key to object permanence in visually impaired children.

    PubMed

    Fazzi, Elisa; Signorini, Sabrina Giovanna; Bomba, Monica; Luparia, Antonella; Lanners, Josée; Balottin, Umberto

    2011-04-01

    The capacity to reach an object presented through sound clue indicates, in the blind child, the acquisition of object permanence and gives information over his/her cognitive development. To assess cognitive development in congenitally blind children with or without multiple disabilities. Cohort study. Thirty-seven congenitally blind subjects (17 with associated multiple disabilities, 20 mainly blind) were enrolled. We used Bigelow's protocol to evaluate "reach on sound" capacity over time (at 6, 12, 18, 24, and 36 months), and a battery of clinical, neurophysiological and cognitive instruments to assess clinical features. Tasks n.1 to 5 were acquired by most of the mainly blind children by 12 months of age. Task 6 coincided with a drop in performance, and the acquisition of the subsequent tasks showed a less agehomogeneous pattern. In blind children with multiple disabilities, task acquisition rates were lower, with the curves dipping in relation to the more complex tasks. The mainly blind subjects managed to overcome Fraiberg's "conceptual problem"--i.e., they acquired the ability to attribute an external object with identity and substance even when it manifested its presence through sound only--and thus developed the ability to reach an object presented through sound. Instead, most of the blind children with multiple disabilities presented poor performances on the "reach on sound" protocol and were unable, before 36 months of age, to develop the strategies needed to resolve Fraiberg's "conceptual problem". Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. DNA Methylation in Schizophrenia.

    PubMed

    Pries, Lotta-Katrin; Gülöksüz, Sinan; Kenis, Gunter

    2017-01-01

    Schizophrenia is a highly heritable psychiatric condition that displays a complex phenotype. A multitude of genetic susceptibility loci have now been identified, but these fail to explain the high heritability estimates of schizophrenia. In addition, epidemiologically relevant environmental risk factors for schizophrenia may lead to permanent changes in brain function. In conjunction with genetic liability, these environmental risk factors-likely through epigenetic mechanisms-may give rise to schizophrenia, a clinical syndrome characterized by florid psychotic symptoms and moderate to severe cognitive impairment. These pathophysiological features point to the involvement of epigenetic processes. Recently, a wave of studies examining aberrant DNA modifications in schizophrenia was published. This chapter aims to comprehensively review the current findings, from both candidate gene studies and genome-wide approaches, on DNA methylation changes in schizophrenia.

  4. PubMed Central

    GALLUS, R.; FETONI, A.R.; MARTINA, B.M.; MUZZI, E.; ORZAN, E.; BASTANZA, G.

    2016-01-01

    SUMMARY In the context of permanent childhood hearing loss, early audiological diagnosis is a prerequisite for activation of an adequate rehabilitation program to prevent or limit the known effects that auditory deprivation determines on language development and cognitive skills in neonates. Audiological diagnosis consists schematically of three phases: identification of subjects at risk, definition of hearing loss and/or children features, verification of appropriateness of diagnosis itself and a rehabilitation programme. Strategies and methods of audiological diagnosis are well defined and include an integration of data coming from objective methods with clinical and behavioural data. Although the substantial effectiveness of procedures and a general consensus on their use and interpretation have been defined, there are several critical issues concerning the achievement of this objective, which will be discussed in this paper. PMID:27054387

  5. The use of pure carbon for permanent percutaneous electrical connector systems

    NASA Technical Reports Server (NTRS)

    Mooney, V.; Hartmann, D. B.; Mcneal, D.; Benson, J.

    1973-01-01

    Pure carbon was used as an electrode in the clinical application of long-term neuromuscular stimulation, as well as a connector for permanent neuroelectrodes. The history of this material and some examples of the material in use are presented.

  6. Variability of the cranial and dental phenotype in Williams syndrome.

    PubMed

    Axelsson, Stefan

    2005-01-01

    Williams syndrome (WS) is a rare congenital disorder involving the cardiovascular system, connective tissue, and the central nervous system, resulting in mild to moderate mental retardation, a specific cognitive profile, unique personality characteristics, distinctive facial features, and cardiovascular disease. The majority of individuals with a clinical diagnosis of WS have a contiguous gene deletion at chromosome 7 (7q11.23). Physical features include characteristic facial features with full prominent cheeks, wide mouth, long philtrum, small nose with depressed nasal bridge, heavy orbital ridges, medial eyebrow flare, dental abnormalities, hoarse voice, growth retardation, and cardiovascular abnormalities (most commonly supravalvular aortic stenosis and/or peripheral pulmonary artery stenosis). The cognitive profile is distinctive, consisting of strengths in auditory memory, language, and face-processing, but extreme weakness in visuospatial, numerical and problem-solving abilities. Neurological studies have identified a significantly decreased brain volume in adult individuals with WS with relatively normal development of the limbic, frontal and cerebellar structures. The aims were to analyse the neurocranium, the craniofacial region, and the dentition in a well defined Norwegian group of individuals with WS. In order to accomplish this, normative cephalometric standards for the neurocranium, including the cranial base and the sella turcica, were established for Norwegian males and females from 6 to 21 years of age, using lateral radiographic cephalograms from the Oslo University Craniofacial Growth Archive. The study material comprised radiographic lateral cephalograms, orthopantomograms and dental casts from 62 individuals with WS ranging from 4 to 44 years. The lateral cephalograms, orthopantomograms and dental casts were analysed using standard methods reported in the literature. Neurocranium: The results from the cephalometric analyses showed that the size and shape of the neurocranium in WS differed from normal controls. A flattening of the superior aspect of the parietal bone was found and the posterior prominence of the occipital bone was larger. These findings were in concordance with published neuroanatomical/neuropathological studies on WS and fit well with the reported anatomical aberrations in the WS brain, e.g. a smaller brain volume where some parts are of relatively normal size while others are decreased. The anterior and posterior cranial base was shorter in WS, but with a normal cranial base angle. The thickness of the calvarian bones, especially the frontal and occipital bones, was greater in WS than in normal controls. Sella turcica: The size of the sella turcica was somewhat smaller in WS compared with normal controls, though not significant. Aberrant types of shape of the sella turcica in WS are demonstrated. The correlation between prenatal malformation in the pituitary gland/sella turcica and the postnatal morphology of the sella turcica is discussed. The craniofacial skeleton: Two areas, in addition to the cranial base, have been identified to contribute to the characteristic facial appearance in WS; the anterior inclination of the maxilla, and the shape of the mandible. The severely deficient bony chin in combination with the high mandibular plane angle can explain earlier clinical descriptions of a retrusive mandible in WS. Frequent mouth breathing during childhood and the smaller cranial base may be associated with the characteristic craniofacial pattern. Dentition: In individuals with WS over 10 years of age 40.5 per cent had agenesis of one or more permanent teeth and 11.9 percent had agenesis of 6 teeth or more. The missing permanent teeth in the maxilla most commonly included 2nd premolars, 1st premolars, and lateral incisors. In the mandible most commonly 2nd premolars, 1st premolars, and central incisors were absent. The tooth crowns of permanent teeth were smaller, both in the mesio-distal and labio-lingual dimension. The permanent tooth crowns have several characteristic deviations from normal shape; especially incisors in both jaws were tapered or screwdriver-shaped. An evaluation of taurodontism on permanent molars was performed. However, most of the molars rated as being taurodontic had short total tooth lengths and could thus be rated taurodontic without meeting the classical definition. These studies have shown aberrations in the neurocranium including the sella turcica in WS not previously reported. In the craniofacial skeleton specific traits have been identified to contribute to the characteristic facial appearance in WS. Dental aberrations in the permanent dentition including agenesis, smaller size, and aberrant shape of teeth, are common in WS.

  7. Demonstration of Single-Shot Picosecond Time-Resolved MeV Electron Imaging Using a Compact Permanent Magnet Quadrupole Based Lens

    NASA Astrophysics Data System (ADS)

    Cesar, D.; Maxson, J.; Musumeci, P.; Sun, Y.; Harrison, J.; Frigola, P.; O'Shea, F. H.; To, H.; Alesini, D.; Li, R. K.

    2016-07-01

    We present the results of an experiment where a short focal length (˜1.3 cm ), permanent magnet electron lens is used to image micron-size features (of a metal sample) with a single shot from an ultrahigh brightness picosecond-long 4 MeV electron beam emitted by a radio-frequency photoinjector. Magnification ratios in excess of 30 × were obtained using a triplet of compact, small gap (3.5 mm), Halbach-style permanent magnet quadrupoles with nearly 600 T /m field gradients. These results pave the way towards single-shot time-resolved electron microscopy and open new opportunities in the applications of high brightness electron beams.

  8. PCR-based identification of selected pathogens associated with endodontic infections in deciduous and permanent teeth.

    PubMed

    Cogulu, Dilsah; Uzel, Atac; Oncag, Ozant; Eronat, Cemal

    2008-09-01

    The aim of the present study was to evaluate the presence of the selected pathogens in samples from deciduous and permanent tooth root canals by using PCR method and to determine the association of these organisms with clinical symptoms. A total of 145 children, 5 to 13 years old, were involved in this study. The presence of selected pathogens (Actinomyces israelii, Candida albicans, Enterococcus faecalis, Fusobacterium nucleatum, Porphyromonas endodontalis, Porphyromonas gingivalis, Prevotella intermedia, Streptococcus intermedius, Treponema denticola, Parvimonas micra, Tannerella forsythensis, Enterococcus faecium, Prevotella melaninogenica) in infected root canals was studied using PCR. T. denticola (P = .012, .02) and E. faecalis (P = .012, .04) were highly associated with periapical radiolucency and previous pain, while P. gingivalis was associated with tenderness to percussion in both deciduous and permanent teeth (P = .01, .015). The results of the present study confirm that certain species of microorganisms are associated with clinical signs and symptoms of endodontic disease in both deciduous and permanent teeth.

  9. The age of permanent tooth emergence in children of different ethnic origin in the Auckland region: a cross-sectional study.

    PubMed

    Kanagaratnam, Sathananthan; Schluter, Philip J

    2012-06-01

    To report robust and contemporary estimates of permanent teeth emergence ages in children of Māori, Pasifika, Chinese, Indian and European ethnic origin in the Auckland region. A stratified, two-stage cross-sectional study. Strata were defined by school decile status. Schools defined the first-stage sampling unit, and students the second stage. Invitations and consent forms were distributed to eligible participants at school for completion at home. Participants were examined at school-based clinics or in a mobile clinic. PARTICIPANTS/MATERIALS, AND METHODS: Children aged between 5 and 13 years enrolled within the Auckland Regional Dental Service. Schools were randomly selected and then all students within selected schools were invited to participate. Eligible participants completing a consent form had an additional tooth assessment that complemented their routine dental examination. A generalised gamma failure-time model was employed to estimate permanent tooth eruption ages. Visually based assessment of permanent tooth emergence. Overall, 3,466 children participated. Differences in median permanent tooth emergence ages were seen among ethnic groups and sexes (P < or = 0.01). Pasifika children had earlier median eruption time than sex-matched Māori children, who (in turn) were more advanced than sex-matched European children. Median eruption age occurred earlier in girls than boys for all permanent teeth. Despite known demographic, geographic and ethnic differences, estimates of permanent teeth emergence timing widely used in New Zealand are based on historical overseas populations. The presented estimates provide new standards and may be more appropriate for dental therapists and dentists when assessing permanent teeth emergence in New Zealand children.

  10. High Temperature, Permanent Magnet Biased, Fault Tolerant, Homopolar Magnetic Bearing Development

    NASA Technical Reports Server (NTRS)

    Palazzolo, Alan; Tucker, Randall; Kenny, Andrew; Kang, Kyung-Dae; Ghandi, Varun; Liu, Jinfang; Choi, Heeju; Provenza, Andrew

    2008-01-01

    This paper summarizes the development of a magnetic bearing designed to operate at 1,000 F. A novel feature of this high temperature magnetic bearing is its homopolar construction which incorporates state of the art high temperature, 1,000 F, permanent magnets. A second feature is its fault tolerance capability which provides the desired control forces with over one-half of the coils failed. The construction and design methodology of the bearing is outlined and test results are shown. The agreement between a 3D finite element, magnetic field based prediction for force is shown to be in good agreement with predictions at room and high temperature. A 5 axis test rig will be complete soon to provide a means to test the magnetic bearings at high temperature and speed.

  11. Loss of Permanent First Molars in the Mixed Dentition: Circumstances Resulting in Extraction and Requiring Orthodontic Management.

    PubMed

    Mathu-Muju, Kavita R; Kennedy, David B

    2016-10-15

    Extraction of significantly compromised permanent first molars may be indicated during the mixed dentition stage of occlusal development. The purpose of this article was to review circumstances that can result in the loss of a permanent first molar-including dental caries, molar incisor hypomineralization, eruption disturbances of permanent teeth, and failure of restorative treatment to affirm that a complete dental arch is not necessary for the existence of a functional dental arch. The extraction of permanent first molar(s) with subsequent orthodontic treatment in a young patient can be considered a cost-effective alternative to placing complex restorations that require replacement over the lifespan. Approaches to establish a functional dental arch in the event of the loss of a permanent first molar(s) are outlined. Additionally, orthodontic diagnostic and treatment principles are reviewed. Case histories are provided to illustrate the clinical management of permanent first molar extractions to achieve a functional dental arch.

  12. Molecular differences between mature and immature dental pulp cells: Bioinformatics and preliminary results.

    PubMed

    Chen, Long; Jiang, Yifeng; Du, Zhen

    2018-04-01

    Although previous studies have demonstrated that dental pulp stem cells (DPSCs) from mature and immature teeth exhibit potential for multi-directional differentiation, the molecular and biological difference between the DPSCs from mature and immature permanent teeth has not been fully investigated. In the present study, 500 differentially expressed genes from dental pulp cells (DPCs) in mature and immature permanent teeth were obtained from the Gene Expression Omnibus online database. Based on bioinformatics analysis using the Database for Annotation, Visualization and Integrated Discovery, these genes were divided into a number of subgroups associated with immunity, inflammation and cell signaling. The results of the present study suggest that immune features, response to infection and cell signaling may be different in DPCs from mature and immature permanent teeth; furthermore, DPCs from immature permanent teeth may be more suitable for use in tissue engineering or stem cell therapy. The Online Mendelian Inheritance in Man database stated that Sonic Hedgehog (SHH), a differentially expressed gene in DPCs from mature and immature permanent teeth, serves a crucial role in the development of craniofacial tissues, including teeth, which further confirmed that SHH may cause DPCs from mature and immature permanent teeth to exhibit different biological characteristics. The Search Tool for the Retrieval of Interacting Genes/Proteins database revealed that SHH has functional protein associations with a number of other proteins, including Glioma-associated oncogene (GLI)1, GLI2, growth arrest-specific protein 1, bone morphogenetic protein (BMP)2 and BMP4, in mice and humans. It was also demonstrated that SHH may interact with other genes to regulate the biological characteristics of DPCs. The results of the present study may provide a useful reference basis for selecting suitable DPSCs and molecules for the treatment of these cells to optimize features for tissue engineering or stem cell therapy. Quantitative polymerase chain reaction should be performed to confirm the differential expression of these genes prior to the beginning of a functional study.

  13. [Features of autonomic dysfunction in myofascial pain syndromes cervicobrachial localization].

    PubMed

    Морозова, О Г; Ярошевский, А А; Липинская, Я В

    2015-01-01

    The relevance of this study is due to the prevalence of autonomic disorders and musculoskeletal pain, especially among the young people of working age. In recent years, many authors in scientific works have been highlighted aspects of mutual development myofascial and autonomic dysfunction, which is caused by neurophysiological preconditions and anatomical and topographical relationships that need to be considered in the diagnostic and therapeutic approaches. To study the characteristics of the formation and flow of autonomic dysfunction syndrome with paroxysmal and permanent types of flow in patients with myofascial pain syndromes cervicobrachial localization. Using clinical neurological, vertebral neurological, neuropsychological methods of studying the severity of pain (visual analogue scale and Pain questionnaire of Mac Gill) examined 84 patients suffering from autonomic dysfunction on the background of myofascial pain syndromes cervicobrachial localization. To identify the features of vegetative regulation of patients were divided into two groups: group 1 (51 people) - with a permanent type of course; group 2 (33 patients) - a type of paroxysmal of course of autonomic dysfunction. It was found more pronounced disturbances in patients with paroxysmal type of course of autonomic dysfunction. The frequency and severity of autonomic paroxysms associated with the severity of musculo-tonic syndrome and location of active trigger points in the muscles of the neck and shoulder girdle, due to anatomic and topographic features of these muscles, namely the proximity of their location to the sympathetic formations neck. The formation and development of emotional and affective disorders in both groups played a significant role of pain and musculo-tonic syndrome. The syndrome of autonomic dysfunction, in particular its paroxysmal type of flow, on the one hand is a response to the development of myofascial pain syndromes cervicobrachial localization, with another - a factor that facilitates the development of pain and muscular-tonic syndromes, burdening the disease. In the diagnosis and treatment of myofascial and autonomic dysfunction should take into account comorbidity data of pathological conditions, which is important for developing individual therapeutic regimens.

  14. Diabetes mellitus in newborns and infants.

    PubMed

    Menon, P S; Khatwa, U A

    2000-06-01

    Diabetes mellitus is uncommon in infancy and newborn period. The two common forms seen are the transient and permanent forms of diabetes mellitus of the newborn. They have to be differentiated from the transient hyperglycemic states (Blood sugar > 125 mg/dl) seen in newborns who receive parenteral glucose infusions and in those with septicemia and CNS disorders. Transient diabetes mellitus of the newborn (TDNB) is defined as hyperglycemia occurring within the first month of life lasting at least 2 weeks and requiring insulin therapy. Most of these cases resolve spontaneously by 4 months. It has a reported incidence of 1 in 45,000 to 60,000 live births. The most likely etiology is a maturational delay of cAMP mediated insulin release. The clinical features include small for datedness, proneness for birth asphyxia, open-eye alert facies, dehydration, emaciation, polyuria and poydipsia. These children are prone to septicemia and urinary tract infections. They have hyperglycemia, glucosuria, absent or mild ketonuria, low basal insulin, C-peptide and IGF-1 levels. Treatment consists of hydration and judicious administration of insulin with close monitoring. Thirty percent of these children are likely to develop permanent neonatal diabetes. Compared to transient form, permanent diabetes mellitus is uncommon. It is usually due to pancreatic dysgenesis often associated with other malformations and rarely due to type 1 diabetes mellitus. The diagnosis is based on the demonstration of both exocrine and endocrine pancreatic dysfunction. These children are managed as type 1 diabetes mellitus. They are prone to develop the vascular complications of diabetes at an earlier date.

  15. The application of Halbach cylinders to brushless ac servo motors

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

    Atallah, K.; Howe, D.

    1998-07-01

    Halbach cylinders are applied to brushless ac servo motors. It is shown that a sinusoidal back-emf waveform and a low cogging torque can be achieved without recourse to conventional design features such as distributed windings and/or stator/rotor skew. A technique for imparting a multipole Halbach magnetization distribution on an isotropic permanent magnet cylinder is described, and it is shown that the torque capability of a Halbach ac servo motor can be up to 33% higher than conventional brushless permanent magnet ac motors.

  16. Ectopic eruption of first permanent molars: presenting features and associations.

    PubMed

    Mooney, G C; Morgan, A G; Rodd, H D; North, S

    2007-09-01

    To investigate presenting features of ectopically erupting first permanent molars and associations with other dental anomalies. Prospective convenience study. 28 panoral radiographs were collected, over a 24-month period, of 7-11 year-old children with radiographic evidence of ectopic eruption of first permanent molars who presented to a Dental Teaching Hospital in the North of England. A further 20 radiographs were collected of matched patients with no evidence of ectopic molar eruption. All radiographs were analysed under standard conditions to record the distribution and type of ectopic eruption (if present). In addition, the presence of the following dental anomalies was noted: cleft lip and/or palate; supernumerary teeth; hypodontia, and infraocclusion of primary molars. Chi-squared analysis was performed to determine any significant differences in the frequency of these dental anomalies between ectopic molar and control groups. For patients with ectopic molar eruption, the majority demonstrated ectopic eruption of either one or two first permanent molars (32% and 57% of subjects respectively). There were a similar proportion of 'jumps' and 'holds'. 92% of these were maxillary teeth and there was equal left and right distribution. Interestingly, a positive record of ectopic eruption was only documented in the dental records of 35.7% of these subjects. Children with ectopic eruption were significantly more likely to have at least one additional dental anomaly than was the case for the control group (60.7% versus 25%). Notably, primary molar infraocclusion and cleft lip/palate were significantly more frequent in the ectopic group. This study, the first in a British population, has identified a significant association between ectopic eruption of first permanent molars and other dental anomalies. A multifactorial aetiology is thus supported and clinicians should be alert to the co-existence of ectopic eruption and other dental anomalies.

  17. Treatment Options: Biological Basis of Regenerative Endodontic Procedures

    PubMed Central

    Hargreaves, Kenneth M.; Diogenes, Anibal; Teixeira, Fabricio B.

    2013-01-01

    Dental trauma occurs frequently in children and often can lead to pulpal necrosis. The occurrence of pulpal necrosis in the permanent but immature tooth represents a challenging clinical situation since the thin and often short roots increase the risk of subsequent fracture. Current approaches for treating the traumatized immature tooth with pulpal necrosis do not reliably achieve the desired clinical outcomes, consisting of healing of apical periodontitis, promotion of continued root development and restoration of the functional competence of pulpal tissue. An optimal approach for treating the immature permanent tooth with a necrotic pulp would be to regenerate functional pulpal tissue. This review summarizes the current literature supporting a biological rationale for considering regenerative endodontic treatment procedures in treating the immature permanent tooth with pulp necrosis. PMID:23439043

  18. Impacted Lower Second Permanent Molars at the Ramus and Coronoid Process: A New Clinical Symptom of the WNT10A Mutation in Ectodermal Dysplasia.

    PubMed

    Sfeir, Elia; Aboujaoude, Samia

    2017-01-01

    Hidrotic ectodermal dysplasia (ED) with the WNT10A mutation produces variable dentofacial symptoms. The aim of this study was to describe a new clinical symptom, i.e., specific to the WNT10A mutation in hidrotic ED. The study investigated the migratory trend of the lower second permanent molars to the ramus or coronoid process. To the best of authors' knowledge, no data in the literature describe this trend in cases of hidrotic ED. A three-generation family pedigree was established for seven families after the diagnosis of hidrotic ED in a 10-year-old boy. Thereafter, a genetic and clinical study was conducted on three families with at least one individual affected by hidrotic ED (20 individuals). We selected the children with molar germs 37 and 47. The eruption axes of these germs were then traced on the panoramic images at the initial time (T 0 ) and 1 year later (T 0 + 1 year), and the deviations between these axes were measured. A significant familial consanguinity was shown. Eight subjects presented with the hidrotic ED phenotype. Among them, three individuals carried germs 37 and 47. Over time, the measured deviations between the eruption axes of the latter displayed, in the majority of the cases, a distal inclination toward the ramus. A larger sample size is mandatory to assess the frequencies and treatment modalities. The presence of germs in the lower second permanent molars in patients with hidrotic ED is an important clinical symptom that should be monitored to detect and prevent ectopic migration of these teeth. In hidrotic ED cases, the study of the presence of the second lower permanent germs must include clinical and radiological examinations. Establishing an inter-ceptive treatment is necessary to prevent the migration of the molars in question. How to cite this article: Sfeir E, Aboujaoude S. Impacted Lower Second Permanent Molars at the Ramus and Coronoid Process: A New Clinical Symptom of the WNT10A Mutation in Ectodermal Dysplasia. Int J Clin Pediatr Dent 2017;10(4):363-368.

  19. 76 FR 1261 - Establishment of the Permanent Certification Program for Health Information Technology

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-07

    ...This final rule establishes a permanent certification program for the purpose of certifying health information technology (HIT). This final rule is issued pursuant to the authority granted to the National Coordinator for Health Information Technology (the National Coordinator) by section 3001(c)(5) of the Public Health Service Act (PHSA), as added by the Health Information Technology for Economic and Clinical Health (HITECH) Act. The permanent certification program will eventually replace the temporary certification program that was previously established by a final rule. The National Coordinator will use the permanent certification program to authorize organizations to certify electronic health record (EHR) technology, such as Complete EHRs and/or EHR Modules. The permanent certification program could also be expanded to include the certification of other types of HIT.

  20. 42 CFR 491.5 - Location of clinic.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... underserved population. (3) Both the RHC and the FQHC may be permanent or mobile units. (i) Permanent unit... Secretary (on the basis of the ratio of primary care physicians to the general population) to have an... stipulated population density, have combined populations of 50,000 and constitute, for general economic and...

  1. Taking a Glance at Anterior Crossbite in Children: Case Series

    PubMed Central

    Ceyhan, Derya; Akdik, Canan

    2017-01-01

    Anterior crossbite is a malocclusion that takes place for various reasons, leads to major problems and may be fixed using various methods. This study aimed to provide an update regarding the methods used for anterior crossbite treatment presenting treatments of the removable active acrylic appliance with bite plane. Clinical examination of aged 9–15, seven healthy children who visited our clinic due to crowding and esthetic displeasure in anterior teeth indicated that one or more permanent maxillar incisor teeth were positioned behind of permanent mandibular incisor teeth. After clinical-radiographical examinations, removable active acrylic appliances with bite plane were decided to apply. Patients with adapted-activated appliances were called to follow-ups once a week. Treatments continued 4–6 weeks in mixed dentition, 7–8 weeks in permanent dentition. In choosing the method, advantages-disadvantages, indications-contraindications of methods should be discussed. Correct indication and suitable motivation are important for the success of anterior crossbite treatment. PMID:29326528

  2. Acute choroidal ischemia associated with toxoplasmic retinochoroiditis.

    PubMed

    Khairallah, Moncef; Yahia, Salim Ben; Zaouali, Sonia; Jenzeri, Salah; Attia, Sonia; Messaoud, Riadh

    2007-09-01

    To describe eight patients with active toxoplasmic retinochoroiditis (RC) who had features suggestive of acute choroidal ischemia. A retrospective review of the clinical records of 23 consecutive patients with acute toxoplasmic RC was performed. All patients underwent detailed ophthalmic examination at presentation and throughout follow-up, including dilated biomicroscopic fundus examination, fundus photography, fluorescein angiography, and indocyanine green (ICG) angiography. Of 23 patients, 8 (34.8%) had a large area of retinal whitening surrounding a small focus of RC. Fluorescein as well as ICG angiography showed a well demarcated geographic area of early choroidal hypofluorescence that extended beyond the clinical borders of the white retinal lesion, particularly by ICG angiography. Associated findings for these 8 patients included old retinochoroidal scars (7 [87.5%]), serous retinal detachment (3 [37.5%]), retinal hemorrhages (1 [12.5%]), and multiple satellite dark dots by ICG angiography (6 [75%]). Seven of eight patients were treated using a combination of antitoxoplasmic drugs and corticosteroids. All findings seen at the acute stage resolved in 2 weeks to 6 weeks. A small atrophic retinochoroidal scar replaced the active toxoplasmic lesion and was surrounded with mild or moderate retinal pigment epithelium changes that were associated with decreased final visual acuity in 2 patients (25%). Patients with toxoplasmic RC may develop features suggestive of choroidal ischemia that can result in a transient or permanent decrease in vision. Choroidal ischemia can only be suspected clinically, and fluorescein angiography and ICG angiography are required to establish the definitive diagnosis.

  3. Chronic neuropathic facial pain after intense pulsed light hair removal. Clinical features and pharmacological management

    PubMed Central

    Párraga-Manzol, Gabriela; Sánchez-Torres, Alba; Moreno-Arias, Gerardo

    2015-01-01

    Intense Pulsed Light (IPL) photodepilation is usually performed as a hair removal method. The treatment is recommended to be indicated by a physician, depending on each patient and on its characteristics. However, the use of laser devices by medical laypersons is frequent and it can suppose a risk of damage for the patients. Most side effects associated to IPL photodepilation are transient, minimal and disappear without sequelae. However, permanent side effects can occur. Some of the complications are laser related but many of them are caused by an operator error or mismanagement. In this work, we report a clinical case of a patient that developed a chronic neuropathic facial pain following IPL hair removal for unwanted hair in the upper lip. The specific diagnosis was painful post-traumatic trigeminal neuropathy, reference 13.1.2.3 according to the International Headache Society (IHS). Key words:Neuropathic facial pain, photodepilation, intense pulse light. PMID:26535105

  4. Acute Symptomatic Seizures Caused by Electrolyte Disturbances

    PubMed Central

    Nardone, Raffaele; Brigo, Francesco

    2016-01-01

    In this narrative review we focus on acute symptomatic seizures occurring in subjects with electrolyte disturbances. Quite surprisingly, despite its clinical relevance, this issue has received very little attention in the scientific literature. Electrolyte abnormalities are commonly encountered in clinical daily practice, and their diagnosis relies on routine laboratory findings. Acute and severe electrolyte imbalances can manifest with seizures, which may be the sole presenting symptom. Seizures are more frequently observed in patients with sodium disorders (especially hyponatremia), hypocalcemia, and hypomagnesemia. They do not entail a diagnosis of epilepsy, but are classified as acute symptomatic seizures. EEG has little specificity in differentiating between various electrolyte disturbances. The prominent EEG feature is slowing of the normal background activity, although other EEG findings, including various epileptiform abnormalities may occur. An accurate and prompt diagnosis should be established for a successful management of seizures, as rapid identification and correction of the underlying electrolyte disturbance (rather than an antiepileptic treatment) are of crucial importance in the control of seizures and prevention of permanent brain damage. PMID:26754778

  5. Demonstration of Single-Shot Picosecond Time-Resolved MeV Electron Imaging Using a Compact Permanent Magnet Quadrupole Based Lens.

    PubMed

    Cesar, D; Maxson, J; Musumeci, P; Sun, Y; Harrison, J; Frigola, P; O'Shea, F H; To, H; Alesini, D; Li, R K

    2016-07-08

    We present the results of an experiment where a short focal length (∼1.3  cm), permanent magnet electron lens is used to image micron-size features (of a metal sample) with a single shot from an ultrahigh brightness picosecond-long 4 MeV electron beam emitted by a radio-frequency photoinjector. Magnification ratios in excess of 30× were obtained using a triplet of compact, small gap (3.5 mm), Halbach-style permanent magnet quadrupoles with nearly 600  T/m field gradients. These results pave the way towards single-shot time-resolved electron microscopy and open new opportunities in the applications of high brightness electron beams.

  6. Manipulation of permanent magnetic polymer micro-robots: a new approach towards guided wireless capsule endoscopy

    NASA Astrophysics Data System (ADS)

    Hilbich, D.; Rahbar, A.; Khosla, A.; Gray, B. L.

    2012-10-01

    We present the initial experimental results for manipulating micro-robots featuring permanent magnetic polymer magnets for guided wireless endoscopy applications. The magnetic polymers are fabricated by doping polydimethylsiloxane (PDMS) with permanent isotropic rare earth magnetic powder (MQFP 12-5) with an average particle size of 6 μm. The prepared magnetic nanocomposite polymer (M-NCP) is patterned in the desired shape against a plexiglass mold via soft lithography techniques. It is observed that the fabricated micro-robot magnets have a magnetic field strength of 50 mT and can easily be actuated by applying a field of 8.3 mT (field measured at the capsule's position) and moved at a rate of 5 inches/second.

  7. 33 CFR 148.725 - What are the design, construction and operational criteria?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) DEEPWATER PORTS DEEPWATER PORTS: GENERAL Environmental Review... permanent interference with natural processes or features that are important to natural currents and wave...

  8. An EEG-Based Person Authentication System with Open-Set Capability Combining Eye Blinking Signals

    PubMed Central

    Wu, Qunjian; Zeng, Ying; Zhang, Chi; Tong, Li; Yan, Bin

    2018-01-01

    The electroencephalogram (EEG) signal represents a subject’s specific brain activity patterns and is considered as an ideal biometric given its superior forgery prevention. However, the accuracy and stability of the current EEG-based person authentication systems are still unsatisfactory in practical application. In this paper, a multi-task EEG-based person authentication system combining eye blinking is proposed, which can achieve high precision and robustness. Firstly, we design a novel EEG-based biometric evoked paradigm using self- or non-self-face rapid serial visual presentation (RSVP). The designed paradigm could obtain a distinct and stable biometric trait from EEG with a lower time cost. Secondly, the event-related potential (ERP) features and morphological features are extracted from EEG signals and eye blinking signals, respectively. Thirdly, convolutional neural network and back propagation neural network are severally designed to gain the score estimation of EEG features and eye blinking features. Finally, a score fusion technology based on least square method is proposed to get the final estimation score. The performance of multi-task authentication system is improved significantly compared to the system using EEG only, with an increasing average accuracy from 92.4% to 97.6%. Moreover, open-set authentication tests for additional imposters and permanence tests for users are conducted to simulate the practical scenarios, which have never been employed in previous EEG-based person authentication systems. A mean false accepted rate (FAR) of 3.90% and a mean false rejected rate (FRR) of 3.87% are accomplished in open-set authentication tests and permanence tests, respectively, which illustrate the open-set authentication and permanence capability of our systems. PMID:29364848

  9. An EEG-Based Person Authentication System with Open-Set Capability Combining Eye Blinking Signals.

    PubMed

    Wu, Qunjian; Zeng, Ying; Zhang, Chi; Tong, Li; Yan, Bin

    2018-01-24

    The electroencephalogram (EEG) signal represents a subject's specific brain activity patterns and is considered as an ideal biometric given its superior forgery prevention. However, the accuracy and stability of the current EEG-based person authentication systems are still unsatisfactory in practical application. In this paper, a multi-task EEG-based person authentication system combining eye blinking is proposed, which can achieve high precision and robustness. Firstly, we design a novel EEG-based biometric evoked paradigm using self- or non-self-face rapid serial visual presentation (RSVP). The designed paradigm could obtain a distinct and stable biometric trait from EEG with a lower time cost. Secondly, the event-related potential (ERP) features and morphological features are extracted from EEG signals and eye blinking signals, respectively. Thirdly, convolutional neural network and back propagation neural network are severally designed to gain the score estimation of EEG features and eye blinking features. Finally, a score fusion technology based on least square method is proposed to get the final estimation score. The performance of multi-task authentication system is improved significantly compared to the system using EEG only, with an increasing average accuracy from 92.4% to 97.6%. Moreover, open-set authentication tests for additional imposters and permanence tests for users are conducted to simulate the practical scenarios, which have never been employed in previous EEG-based person authentication systems. A mean false accepted rate (FAR) of 3.90% and a mean false rejected rate (FRR) of 3.87% are accomplished in open-set authentication tests and permanence tests, respectively, which illustrate the open-set authentication and permanence capability of our systems.

  10. Short-Term and Long-Term Effects of Orthopedic Biodegradable Implants

    PubMed Central

    Amini, Ami R.; Wallace, James S.; Nukavarapu, Syam P.

    2012-01-01

    Presently, orthopedic and oral/maxillofacial implants represent a combined $2.8 billion market, a figure expected to experience significant and continued growth. Although traditional permanent implants have been proved clinically efficacious, they are also associated with several drawbacks, including secondary revision and removal surgeries. Non-permanent, biodegradable implants offer a promising alternative for patients, as they provide temporary support and degrade at a rate matching tissue formation, and thus, eliminate the need for secondary surgeries. These implants have been in clinical use for nearly 25 years, competing directly with, or maybe even exceeding, the performance of permanent implants. The initial implantation of biodegradable materials, as with permanent materials, mounts an acute host inflammatory response. Over time, the implant degradation profile and possible degradation product toxicity mediate long-term biodegradable implant-induced inflammation. However, unlike permanent implants, this inflammation is likely to cease once the material disappears. Implant-mediated inflammation is a critical determinant for implant success. Thus, for the development of a proactive biodegradable implant that has the ability to promote optimal bone regeneration and minimal detrimental inflammation, a thorough understanding of short- and long-term inflammatory events is required. Here, we discuss an array of biodegradable orthopedic implants, their associated short- and long- term inflammatory effects, and methods to mediate these inflammatory events. PMID:22043969

  11. 47 CFR 15.19 - Labelling requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... material fastened to the equipment by welding, riveting, or a permanent adhesive. The label must be... intended for use with cable service or the quality of such features are acceptable so long as such...

  12. 47 CFR 15.19 - Labelling requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... material fastened to the equipment by welding, riveting, or a permanent adhesive. The label must be... intended for use with cable service or the quality of such features are acceptable so long as such...

  13. 47 CFR 15.19 - Labelling requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... material fastened to the equipment by welding, riveting, or a permanent adhesive. The label must be... intended for use with cable service or the quality of such features are acceptable so long as such...

  14. A possible cranio-oro-facial phenotype in Cockayne syndrome

    PubMed Central

    2013-01-01

    Background Cockayne Syndrome CS (Type A – CSA; or CS Type I OMIM #216400) (Type B – CSB; or CS Type II OMIM #133540) is a rare autosomal recessive neurological disease caused by defects in DNA repair characterized by progressive cachectic dwarfism, progressive intellectual disability with cerebral leukodystrophy, microcephaly, progressive pigmentary retinopathy, sensorineural deafness photosensitivity and possibly orofacial and dental anomalies. Methods We studied the cranio-oro-facial status of a group of 17 CS patients from 15 families participating in the National Hospital Program for Clinical Research (PHRC) 2005 « Clinical and molecular study of Cockayne syndrome ». All patients were examined by two investigators using the Diagnosing Dental Defects Database (D[4]/phenodent) record form. Results Various oro-facial and dental anomalies were found: retrognathia; micrognathia; high- arched narrow palate; tooth crowding; hypodontia (missing permanent lateral incisor, second premolars or molars), screwdriver shaped incisors, microdontia, radiculomegaly, and enamel hypoplasia. Eruption was usually normal. Dental caries was associated with enamel defects, a high sugar/carbohydrate soft food diet, poor oral hygiene and dry mouth. Cephalometric analysis revealed mid-face hypoplasia, a small retroposed mandible and hypo-development of the skull. Conclusion CS patients may have associated oro-dental features, some of which may be more frequent in CS children – some of them being described for the first time in this paper (agenesis of second permanent molars and radiculomegaly). The high susceptibility to rampant caries is related to a combination of factors as well as enamel developmental defects. Specific attention to these anomalies may contribute to diagnosis and help plan management. PMID:23311583

  15. [A preliminary approach of the malocclusion of second permanent molar].

    PubMed

    Lin, Z

    1992-11-01

    We examined 2183 cases of orodental malocclusion in our clinic. 420 cases of deep-overjet of second permanent molar were found. In this paper we discussed the sex and age of the patients, distribution of tooth position, ratio, degree of overjet, causes of malocclusion, malocclusion condition, endangerment, prevention and treatment.

  16. Management of a rare case of idiopathic multiple unerupted impacted permanent teeth in an adult female patient

    PubMed Central

    Shetty, Karunakar; Kumar, Mahesh; Amanna, Susan; Sridharan, Srirangarajan; Reddy, Satyanarayan

    2016-01-01

    This clinical case report describes the multi-disciplinary approach in the management of an unusual presentation of idiopathic multiple unerupted impacted permanent teeth in a 20-year-old female patient. The case was unique in that, not only were there multiple missing permanent teeth, but also over retained deciduous teeth and attrited existing permanent teeth with loss of vertical dimension of occlusion. Since the patient was young, it was decided to retain all the erupted permanent teeth and extract the infected deciduous teeth with the objective of fabricating overlay complete dentures. This is a simple, reversible and an economical treatment modality, which satisfies both the esthetic and functional demands where the extraction of teeth is not generally indicated and, in addition, provides a stable occlusion. PMID:27621553

  17. Treatment of a periorbital cyst in a dog by creation of a permanent drainage opening.

    PubMed

    Kaiser, S; Driesen, A; Malberg, S; Kramer, M; Thiel, C

    2015-01-01

    An inflammatory periorbital cyst with secondary pressure atrophy of the maxilla was treated by surgical creation of a drainage opening to the nasal cavity in a 4-year-old Yorkshire Terrier. Following treatment, clinical signs resolved and computed tomography 5 weeks after surgery confirmed the permanence of the drainage opening. Eight months later, the dog showed no clinical abnormalities. Therefore, the procedure described in this report may offer a suitable treatment option in cases where the cyst's size or localization prevents complete excision.

  18. Longevity of direct and indirect resin composite restorations in permanent posterior teeth: A systematic review and meta-analysis.

    PubMed

    da Veiga, Ana Maria Antonelli; Cunha, Amanda Carneiro; Ferreira, Daniele Masterson Tavares Pereira; da Silva Fidalgo, Tatiana Kelly; Chianca, Thomaz Kauark; Reis, Kátia Rodrigues; Maia, Lucianne Cople

    2016-11-01

    The aim of this systematic review and meta-analysis was to assess the differences in clinical performance in direct and indirect resin composite restorations in permanent posterior teeth. PubMed, the Cochrane Library, Web of Science, Scopus, LILACS, BBO, ClinicalTrials.gov and SiGLE were searched without restrictions. We included randomized clinical trials (RCTs) that compared the clinical performance of direct and indirect resin composite restorations in Class I and Class II cavities in permanent teeth, with at least two years of follow-up. The risk of bias tool suggested by Cochrane Collaboration was used for quality assessment. After duplicate removal, 912 studies were identified. Twenty fulfilled the inclusion criteria after the abstract screening. Two articles were added after a hand search of the reference list of included studies. After examination, nine RCTs were included in the qualitative analysis and five were considered to have a 'low' risk of bias. The overall risk difference in longevity between direct and indirect resin composite restorations in permanent posterior teeth (p>0.05) at five-year follow-up was 1.494 [0.893-2.500], and regardless of the type of tooth restored, that of molar and premolars was 0.716 [0.177-2.888] at three-year follow-up. Based on the findings, there was no difference in longevity of direct and indirect resin composite restorations regardless of the type of material and the restored tooth. Contemporary dentistry is based on minimally invasive restorations. Any indication of a less conservative technique must have unquestionable advantages. In vitro and in vivo studies reveal contradictory evidence of the clinical performance of direct and indirect resin composite restorations in posterior teeth. Thus this study clarified this doubt. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Banding versus bonding of first permanent molars: a multi-centre randomized controlled trial.

    PubMed

    Nazir, Mariyah; Walsh, Tanya; Mandall, Nicky A; Matthew, Susie; Fox, Dee

    2011-06-01

    To assess the effectiveness of banding versus bonding of first permanent molars during fixed appliance treatment; in terms of attachment failure, patient discomfort and post-treatment enamel demineralization. Multi-centre randomized clinical trial. One District General Hospital Orthodontic Department and two Specialist Orthodontic Practices. Orthodontic patients aged between 10 and 18 years old, randomly allocated to either receive molar bands (n=40) or molar bonds (n=40). Bands were cemented with a conventional glass ionomer cement and tubes were bonded with light-cured composite to all four first permanent molar teeth for each subject. Attachments were reviewed at each recall appointment to assess loosening or loss. The clinical end point of the trial was the day of appliance debond. Enamel demineralization at debond was assessed using the modified International Caries Assessment and Detection System (ICDAS). The first time failure rate for molar bonds was 18·4% and 2·6% for molar bands (P=0·0002). Survival analysis demonstrated molar bonds were more likely to fail compared with molar bands. First permanent molars with bonded tubes experienced more demineralization than those with cemented bands (P=0·027). There was no statistically significant difference in discomfort experienced by patients after banding or bonding first permanent molars (P>0·05). This study shows that as part of fixed appliance therapy, American Orthodontics photoetched first permanent molar bands cemented with 3M ESPE Ketac-Cem perform better than American Orthodontics low profile photo-etched and mesh-based first permanent molar tubes bonded with 3M Unitek Transbond XT in terms of failure behaviour and molar enamel demineralization.

  20. New Cogging Torque Reduction Methods for Permanent Magnet Machine

    NASA Astrophysics Data System (ADS)

    Bahrim, F. S.; Sulaiman, E.; Kumar, R.; Jusoh, L. I.

    2017-08-01

    Permanent magnet type motors (PMs) especially permanent magnet synchronous motor (PMSM) are expanding its limbs in industrial application system and widely used in various applications. The key features of this machine include high power and torque density, extending speed range, high efficiency, better dynamic performance and good flux-weakening capability. Nevertheless, high in cogging torque, which may cause noise and vibration, is one of the threat of the machine performance. Therefore, with the aid of 3-D finite element analysis (FEA) and simulation using JMAG Designer, this paper proposed new method for cogging torque reduction. Based on the simulation, methods of combining the skewing with radial pole pairing method and skewing with axial pole pairing method reduces the cogging torque effect up to 71.86% and 65.69% simultaneously.

  1. Predictors of Early-Onset Permanent Hearing Loss in Malnourished Infants in Sub-Saharan Africa

    ERIC Educational Resources Information Center

    Olusanya, Bolajoko O.

    2011-01-01

    The objective of this study was to determine the predictors of early-onset permanent hearing loss (EPHL) among undernourished infants in a low-income country where routine screening for developmental disabilities in early childhood is currently unattainable. All infants attending four community-based clinics for routine immunization who met the…

  2. Permanent His-bundle pacing: a systematic literature review and meta-analysis.

    PubMed

    Zanon, Francesco; Ellenbogen, Kenneth A; Dandamudi, Gopi; Sharma, Parikshit S; Huang, Weijian; Lustgarten, Daniel L; Tung, Roderick; Tada, Hiroshi; Koneru, Jayanthi N; Bergemann, Tracy; Fagan, Dedra H; Hudnall, John Harrison; Vijayaraman, Pugazhendhi

    2018-04-26

    Permanent cardiac pacing of the His-bundle restores and retains normal electrical activation of the ventricles. Data on His-bundle pacing (HBP) are largely limited to small single-centre reports, and clinical benefits and risks have not been systematically examined. We sought to systematically examine published studies of patients undergoing permanent HBP and quantify the benefits and risks of the therapy. PubMed, Embase, and Cochrane Library were searched for full-text articles on permanent HBP. Clinical outcomes of interest included implant success rate, procedural and lead complications, pacing thresholds, QRS duration, and ejection fraction at follow-up, and mortality. Data were extracted and summarized. Where possible, meta-analysis of aggregate data was performed. Out of 2876 articles, 26 met the inclusion criteria representing 1438 patients with an implant attempt. Average age of patients was 73 years and 62.1% were implanted due to atrioventricular block. Overall average implant success rate was 84.8% and was higher with use of catheter-delivered systems (92.1%; P < 0.001). Average pacing thresholds were 1.71 V at implant and 1.79 V at >3 months follow-up; although, pulse widths varied at testing. Average left ventricular ejection fractions (LVEFs) were 42.8% at baseline and 49.5% at follow-up. There were 43 complications observed in 907 patients across the 17 studies that reported safety information. Among 26 articles of permanent HBP, the implant success rate averaged 84.8% and LVEF improved by an average of 5.9% during follow-up. Specific reporting of our clinical outcomes of interest varied widely, highlighting the need for uniform reporting in future HBP trials.

  3. High targeted migration of human mesenchymal stem cells grown in hypoxia is associated with enhanced activation of RhoA

    PubMed Central

    2013-01-01

    Introduction A feature which makes stem cells promising candidates for cell therapy is their ability to migrate effectively into damaged or diseased tissues. Recent reports demonstrated the increased motility of human mesenchymal stem cells (hMSC) grown under hypoxic conditions compared to normoxic cells. However, the directional migration of hMSC cultured in hypoxia has not been investigated. In this study we examined the in vitro transmembrane migration of hMSC permanently cultured in hypoxia in response to various cytokines. We also studied the involvement of RhoA, a molecule believed to play an essential role in the migration of MSC via reorganization of the cytoskeleton. Methods We compared the directional migration of human hMSCs grown permanently under normal (21%, normoxic) and low O2 (5%, hypoxic) conditions until passage 4 using an in vitro transmembrane migration assay. A series of 17 cytokines was used to induce chemotaxis. We also compared the level of GTP-bound RhoA in the cell extracts of calpeptin-activated hypoxic and normoxic hMSC. Results We found that hMSC cultured in hypoxia demonstrate markedly higher targeted migration activity compared to normoxic cells, particularly towards wound healing cytokines, including those found in ischemic and myocardial infarction. We also demonstrated for the first time that hMSC are dramatically more sensitive to activation of RhoA. Conclusions The results of this study indicate that high directional migration of hMSCs permanently grown in hypoxia is associated with the enhanced activation of RhoA. The enhanced migratory capacity of hypoxic hMSC would further suggest their potential advantages for clinical applications. PMID:23295150

  4. The Effect of Multiple Sulfatase Deficiency (MSD) on Dental Development: Can We Use the Teeth as an Early Diagnostic Tool?

    PubMed

    Zilberman, Uri; Bibi, Haim

    2016-01-01

    Multiple sulfatase deficiency (MSD) is a rare autosomal recessive inborn error of metabolism due to reduced catalytic activity of the different sulfatase. Affected individuals show neurologic deterioration with mental retardation, skeletal anomalies, organomegaly, and skin changes as in X-linked ichthyosis. The only organ that was not examined in MSD patients is the dentition. To evaluate the effect of the metabolic error on dental development in a patient with the intermediate severe late-infantile form of MSD (S155P). Histological and chemical study were performed on three deciduous and five permanent teeth from MSD patient and pair-matched normal patients. Tooth germ size and enamel thickness were reduced in both deciduous and permanent MSD teeth, and the scalloping feature of the DEJ was missing in MSD teeth causing enamel to break off from the dentin. The mineral components in the enamel and dentin were different. The metabolic error insults the teeth in the stage of organogenesis in both the deciduous and permanent dentition. The end result is teeth with very sharp cusp tips, thin hypomineralized enamel, and exposed dentin due to the break off of enamel. These findings are different from all other types of MPS syndromes.Clinically the phenotype of intermediate severe late-infantile form of MSD appeared during the third year of life. In children of parents that are carriers, we can diagnose the disease as early as birth using X-ray radiograph of the anterior upper region or as early as 6-8 months when the first deciduous tooth erupt and consider very early treatment to ameliorate the symptoms.

  5. Radiological features of experimental staphylococcal septic arthritis by micro computed tomography scan

    PubMed Central

    Fatima, Farah; Fei, Ying; Ali, Abukar; Mohammad, Majd; Erlandsson, Malin C.; Bokarewa, Maria I.; Nawaz, Muhammad; Valadi, Hadi; Na, Manli

    2017-01-01

    Background Permanent joint dysfunction due to bone destruction occurs in up to 50% of patients with septic arthritis. Recently, imaging technologies such as micro computed tomography (μCT) scan have been widely used for preclinical models of autoimmune joint disorders. However, the radiological features of septic arthritis in mice are still largely unknown. Methods NMRI mice were intravenously or intra-articularly inoculated with S. aureus Newman or LS-1 strain. The radiological and clinical signs of septic arthritis were followed for 10 days using μCT. We assessed the correlations between joint radiological changes and clinical signs, histological changes, and serum levels of cytokines. Results On days 5–7 after intravenous infection, bone destruction verified by μCT became evident in most of the infected joints. Radiological signs of bone destruction were dependent on the bacterial dose. The site most commonly affected by septic arthritis was the distal femur in knees. The bone destruction detected by μCT was positively correlated with histological changes in both local and hematogenous septic arthritis. The serum levels of IL-6 were significantly correlated with the severity of joint destruction. Conclusion μCT is a sensitive method for monitoring disease progression and determining the severity of bone destruction in a mouse model of septic arthritis. IL-6 may be used as a biomarker for bone destruction in septic arthritis. PMID:28152087

  6. 42. View forward on afterdeck, showing steering gear box in ...

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

    42. View forward on afterdeck, showing steering gear box in foreground, aft elevation of cabin beyond; weather canopy overhead is not an original or permanent feature - Schooner WAWONA, 1018 Valley Street, Seattle, King County, WA

  7. [DENTAL STATUS OF PATIENTS WITH INTRAUTERINE GROWTH RESTRICTION IN PAST HISTORY DURING PERIOD OF REMOVABLE AND PERMANENT DENTITION].

    PubMed

    Garmash, O V; Ryabokon, E N

    2014-12-01

    The analysis of the dental status in patients with IUGR in past history in period of removable and permanent dentition was conducted. 39 patients with intrauterine growth retardation in past history were examined. The clinical, statistical methods were held. Concluded that the child, who was born with IUGR, later in future life, has a great risk of dental diseases. The most considerable violations were found in patients with "symmetrical" form of intrauterine growth retardation. It is proposed to use clinical markers as possible predictors of periodontal diseases.

  8. Unpacking Clinical Supervision in Transitional and Permanent Supportive Housing: Scrutiny or Support?

    PubMed

    Choy-Brown, Mimi; Stanhope, Victoria; Tiderington, Emmy; Padgett, Deborah K

    2016-07-01

    Behavioral health organizations use clinical supervision to ensure professional development and practice quality. This qualitative study examined 35 service coordinators' perspectives on supervision in two distinct supportive housing program types (permanent and transitional). Thematic analysis of in-depth interviews yielded three contrast themes: support versus scrutiny, planned versus impromptu time, and housing first versus treatment first. Supervisory content and format resulted in differential perceptions of supervision, thereby influencing opportunities for learning. These findings suggest that unpacking discrete elements of supervision enactment in usual care settings can inform implementation of recovery-oriented practice.

  9. Unpacking clinical supervision in transitional and permanent supportive housing: Scrutiny or support?

    PubMed Central

    Choy-Brown, Mimi; Stanhope, Victoria; Tiderington, Emmy; Padgett, Deborah K.

    2015-01-01

    Behavioral health organizations use clinical supervision to ensure professional development and practice quality. This qualitative study examined 35 service coordinators' perspectives on supervision in two distinct supportive housing program types (permanent and transitional). Thematic analysis of in-depth interviews yielded three contrast themes: support versus scrutiny, planned versus impromptu time, and Housing First versus Treatment First. Supervisory content and format resulted in differential perceptions of supervision, thereby influencing opportunities for learning. These findings suggest that unpacking discrete elements of supervision enactment in usual care settings can inform implementation of recovery-oriented practice. PMID:26066866

  10. A clinical evaluation of mineral trioxide aggregate for root-end closure of non-vital immature permanent incisors in children-a pilot study.

    PubMed

    Sarris, Spyridoula; Tahmassebi, Jinous F; Duggal, Monty S; Cross, Ian A

    2008-02-01

    The aim of this pilot study was to evaluate the clinical efficacy of mineral trioxide aggregate (MTA) as an apexification material when used in non-vital immature permanent incisors in children. Fifteen children with a mean age of 11.7 years and 17 non-vital permanent incisors were ajudged suitable for inclusion. Standard endodontic procedures were followed and an apical plug of 3-4 mm was created by using MTA after a calcium hydroxide intracanal dressing had been applied for at least 1 week. Final obturation was completed by using thermoplastisized Gutta-Percha (Obtura II) at least 1 week following MTA placement. Subjects were reviewed clinically and radiographically at 3-month intervals. Mean follow-up time for MTA was 12.53 months (+/-2.94 SD). Of the total of 17 teeth treated, MTA placement was considered to be adequate in 13 teeth. The procedure showed clinical success in 94.1% of the cases, radiographic success was found to be 76.5% and in further three cases (17.6%) the outcome was considered to be uncertain. This is one of the very few studies that have reported the out coming of MTA as an apexification material in children with non-vital teeth and incomplete root development. However, larger clinical studies are required to evaluate the long-term success of this procedure.

  11. [Minor Head Injury – a Silent Epidemic].

    PubMed

    Stocker, Reto; Letta, Claudio

    2016-05-11

    The vast majority out of the 20 000 patients annually hospitalized after sustaining a head injury belong to the minor head injury/cerebral concussion continuum. Fortunately, most of the patients show full recovery after days to weeks. However, about 15 % of these patients suffer from prolonged up to permanent sequels potentially impairing their quality of life to a considerable extent. This especially holds true for those who suffer from recurrent minor head injuries (i.e. victims from contact sport accidents). Unfortunately, many of these patients are never diagnosed in an appropriate way and therefore looked at as hypochondriacs or simulants. This prevents adequate rehabilitation and support. This review aims to present current knowledge about pathophysiology and clinical features of minor head injuries and to give some information about diagnostics and treatment according to current guidelines.

  12. Migraine and anti-phospholipid antibodies.

    PubMed

    Shuaib, A; Barklay, L; Lee, M A; Suchowersky, O

    1989-01-01

    Anti-phospholipid antibodies (APA), initially described with SLE, have in recent years received much attention because of an associated increased risk of thrombo-embolic disease, recurrent abortion and thrombocytopenia. Although commonly seen with SLE or other collagen vascular diseases, the antibodies frequently occur in the absence of any such disease. Neurologic complications include transient or permanent ischemic episodes, migraine or related phenomena, myelopathy and a Guillain-Barré type syndrome. In this report we describe the presenting features and clinical course of six patients with anti-phospholipid antibodies where migraine was an early and prominent symptom. All six patients, however, were recognized only after a second more serious event had occurred. As this entity becomes more widely recognized and better treatments evolve an earlier diagnosis of patients with migraine as the only manifestation of APA may prevent the development of other serious complications.

  13. Prediction of Future High Caries Increments for Children in a School Dental Service and in Private Practice.

    ERIC Educational Resources Information Center

    Imfeld, Thomas N.; And Others

    1995-01-01

    A method for predicting high dental caries increments for children, based on previous research, is presented. Three clinical findings were identified as predictors: number of sound primary molars, number of discolored pits/fissures on first permanent molars, and number of buccal and lingual smooth surfaces of first permanent molars with white…

  14. Clinical Evaluation of Ozone on Dentinal Lesions in Young Permanent Molars using the Stepwise Excavation.

    PubMed

    Safwat, Osama; Elkateb, Mona; Dowidar, Karin; El Meligy, Omar

    To evaluate the clinical changes in dentin of deep carious lesions in young permanent molars, following ozone application with and without the use of a remineralizing solution, using the stepwise excavation. The sample included 162 first permanent immature molars, showing deep occlusal carious cavities that were indicated for indirect pulp capping. Teeth were divided into 2 main groups according to the method of ozone treatment. Each group was further subdivided equally into test and control subgroups. Following caries excavation, color, consistency and DIAGNOdent assessments of dentin were evaluated after 6 and 12 months. Regarding dentin color and consistency, no significant differences were observed following ozone application, with and without a remineralizing solution. There were no significant differences between ozone treatment, and calcium hydroxide during the different evaluation periods, except in group I cases after 6 months, concerning the dentin color. The DIAGNOdent values were significantly reduced following ozone application, with or without a remineralizing solution, as well as between test and control cases in group I after 6 months. Ozone application through the stepwise excavation had no significant effect on dentin color and consistency in young permanent molars. DIAGNOdent was unreliable in monitoring caries activity.

  15. Permanent molar pulpotomy with a new endodontic cement: A case series

    PubMed Central

    Asgary, Saeed; Ehsani, Sara

    2009-01-01

    The aim of this case series was to determine the clinical and radiographic success rate of pulpotomy, with new endodontic cement (NEC), in human mature permanent molar teeth. Twelve molars with established irreversible pulpitis were selected from patients 14 – 62 years old. The selection criteria included carious pulp exposure with a positive history of lingering pain. After isolation, caries removal, and pulp exposure, pulpotomy with NEC was performed and a permanent restoration was immediately placed. At the first recall (+1 day) no patients reported postoperative pain. One wisdom tooth had been extracted after two months because of failure in coronal restoration. Eleven patients were available for the second recall, with a mean time of 15.8 months. Clinical and radiographic examination revealed that all teeth were functional and free of signs and symptoms. Histological examination of the extracted teeth revealed complete dentin bridge formation and a normal pulp. Although the results favored the use of NEC, more studies with larger samples and a longer recall period were suggested, to justify the use of this novel material for treatment of irreversible pulpitis in human permanent molar teeth. PMID:20379438

  16. Long-Term Clinical Response to Treatment and Maintenance of Localized Aggressive Periodontitis: A Cohort Study

    PubMed Central

    Miller, Karina A. F. S.; Branco-de-Almeida, Luciana S.; Wolf, Sandra; Hovencamp, Nicole; Treloar, Tina; Harrison, Peter; Aukhil, Ikramuddin; Gong, Yan; Shaddox, Luciana M.

    2016-01-01

    Aim To evaluate long-term clinical response to periodontal therapy and maintenance in localized aggressive periodontitis (LAP). Materials and Methods One hundred forty-one African-Americans diagnosed with LAP, aged 5–25 years, were enrolled. Patients underwent periodontal mechanical debridement plus one week of amoxicillin/metronidazole. Mechanical therapy was repeated as needed and clinical parameters were recorded at baseline, 3, 6, 12, 18, and 24 months, and 2 additional annual follow-up visits after treatment. Radiographs from primary dentition of patients with LAP in permanent dentition, and additional healthy siblings (HS) were analyzed retrospectively. Results Periodontal therapy significantly improved probing depth and clinical attachment level up to 4 years (mean reductions: 2.18 ± 1.03 and 2.80 ± 1.43 mm, respectively). Percentage of affected sites was reduced at all timepoints and maintained up to 4 years. Noncompliance with antibiotics/appointments negatively affected the treatment response. Ninety percent of LAP patients in permanent dentition and 32% of HS presented radiographic bone loss in primary dentition. Conclusions Mechanical debridement with one-week of systemic antibiotics along with proper periodontal maintenance was effective in the treatment and successful maintenance of LAP for up to 4 years. LAP in permanent dentition may be preceded in the primary dentition. Clinicaltrials.gov #NCT01330719. PMID:27767222

  17. Onyx embolization of intracranial arteriovenous malformations in pediatric patients.

    PubMed

    Soltanolkotabi, Maryam; Schoeneman, Samantha E; Alden, Tord D; Hurley, Michael C; Ansari, Sameer A; DiPatri, Arthur J; Tomita, Tadanori; Shaibani, Ali

    2013-04-01

    The authors undertook this study to assess the safety and efficacy of Onyx embolization in the treatment of intracranial arteriovenous malformations (AVMs) in pediatric patients. All pediatric Onyx embolization of intracranial AVM cases performed consecutively at a single children's hospital over a 5-year period were collected and evaluated. Twenty-five patients (mean age 10.5 years) underwent a total of 38 procedures. An aggregate of 56 pedicles were embolized (mean 1.47 per session). The Spetzler-Martin grade was determined in all cases. Onyx embolization resulted in complete obliteration of the AVM in 3 cases (12%) and partial obliteration in 22 cases (88%). A total of 23 patients underwent surgical treatment. The mean preoperative AVM devascularization in these cases was 72%. One patient was treated with radiosurgery following Onyx embolization. Overall, 10 complications occurred in a total of 38 procedures (26.3%). None of the complications resulted in permanent neurological morbidity. The rate of transient neurological complications was 10.5% (4 of 38 procedures) and the rate of transient nonneurological complications was 5.3% (2 of 38 procedures). The remaining 4 complications were clinically silent (rate of 10.5%). There were no procedure-related deaths in this study population. There was no significant difference in patients with and without complications in terms of demographic characteristics, AVM grade, or embolization features (p ≥ 0.2). Deep venous drainage was associated with higher complication rates (p = 0.03). Onyx utilization is feasible for preoperative or primary embolization in the treatment of pediatric intracranial AVMs; however, the spectrum of complications encountered is broad, and attention must be paid to the technical nuances of and indications for its use to avoid many potential dangerous effects. Although the overall complication rates were higher than expected, all were either clinically silent or had only transient clinical effects. Thus, this experience suggests that Onyx embolization can be performed safely with a low rate of permanent morbidity in pediatric patients harboring these difficult lesions.

  18. Frequency and clinical presentation of UTI among children of Hazara Division, Pakistan.

    PubMed

    Anis-ur-Rehman; Jahanzeb, Muhammad; Siddiqui, Tahir Saeed; Idris, Muhammad

    2008-01-01

    Urinary tract infection is common in children and result in permanent renal damage and end stage renal failure in significant number of patients. It is imperative to diagnose urinary tract infection early and to treat adequately. We carried out this study to look into frequency and clinical profile of UTI in children admitted in our unit. Three hundred and seventy five patients with UTI, diagnosed by urine culture with age from 0-15 years admitted in pediatric unit during 2003-2006 were included in study. Urine sample for culture was collected by midstream clean catch, urine collecting bag and Suprapubic methods depending upon the age of patient. A proforma was used to record clinical presentation and laboratory findings of these patients. Frequency of Urinary tract infections among children examined by urine culture was 375 out of 1000 (37.5%) out of which 36 (9.6%) were male and 339 (90.4%) were females. Almost half of them 48.5% were less than 3 years old. About 60% of patients belong to Kohistan and Batagram districts and failure to thrive was common presenting feature (56.6%) in patients of these two districts. Fever was common clinical presentation 91% followed by Dysuria (65%) and failure to thrive (40%). Frequency and clinical profile of urinary tract infection in children in Hazara Division is not significantly different from that of developing and developed countries.

  19. Effect of clinical use of nickel-titanium springs.

    PubMed

    Magno, Amanda Fahning; Monini, André da Costa; Capela, Marisa Veiga; Martins, Lídia Parsekian; Martins, Renato Parsekian

    2015-07-01

    Our objectives were to determine whether there are changes on the load deflection rate (L/DP) and the average force (FP) of the superelastic pseudoplateau, and whether permanent deformation is changed in nickel-titanium closed-coil springs (CCSs) after 6 months of clinical use. Twenty-two nickel-titanium CCSs (Sentalloy 100 g; Dentsply GAC, York, Pa) were subjected to tensile mechanical testing at 37°C on activations varying from 3.2 to 16.0 mm before and after 6 months of clinical use. A regression line was fitted over the most horizontal area of the unloading part of the stress-strain graph of every CCS, and its slope was used as L/DP. The FP was determined by the midpoint of the longest segment of the curve that could be fit within the regression line with a R(2) of at least 0.999, and permanent deformation was determined graphically by obtaining the strain value when the measured stress reached zero. The data were analyzed by 3 analyses of variance at 2 levels, with 5% of significance. Time and activation significantly influenced the variables tested (P < 0.001). Time increased the L/DP and permanent deformation but decreased the FP. Activation decreased L/DP, FP, and permanent deformation. Significant interactions between time and activation were detected for FP (P = 0.013) and deformation (P < 0.001). After 6 months of active clinical use, the analyzed springs had a significant but small increase in their L/DP; FP dropped up to 88%, and the CCSs deformed up to 1.26 mm. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  20. Comparative evaluation of platelet-rich fibrin and mineral trioxide aggregate as pulpotomy agents in permanent teeth with incomplete root development: a randomized controlled trial.

    PubMed

    Keswani, Deepa; Pandey, Ramesh K; Ansari, Afroz; Gupta, Shalini

    2014-05-01

    The purpose of this study was to evaluate and compare, clinically and radiographically, the effects of platelet-rich fibrin (PRF) and mineral trioxide aggregate (MTA) as pulpotomy agents in permanent teeth with incomplete root development. A total number of 70 children requiring pulpotomy in 70 permanent molars with incomplete root development were screened. Sixty-two patients met the inclusion criteria and were enrolled in the study. The patients were randomly allocated equally in 2 treatment groups. MTA pulpotomy was performed in group A (the control group), and PRF pulpotomy was performed in group B (the experimental group). The treated teeth were restored with amalgam followed by stainless steel crowns. Clinical and radiographic evaluations were performed after 6, 12, and 24 months. Thus, the data obtained were blindly analyzed using the chi-square test. There was no significant difference between the 2 groups in terms of clinical and radiologic success. Radiographically, all available cases (53 teeth) showed evidence of root growth and canal narrowing. Complete apical closure was observed in 88.8% in the PRF group (experimental group) and 80.07% of roots in the MTA group (control group), respectively, at 24 months. PRF could be used as a suitable biological and economic alternative to MTA in pulpotomy procedures of permanent teeth with incomplete root development. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  1. Magnetic resonance imaging-based cerebral tissue classification reveals distinct spatiotemporal patterns of changes after stroke in non-human primates.

    PubMed

    Bouts, Mark J R J; Westmoreland, Susan V; de Crespigny, Alex J; Liu, Yutong; Vangel, Mark; Dijkhuizen, Rick M; Wu, Ona; D'Arceuil, Helen E

    2015-12-15

    Spatial and temporal changes in brain tissue after acute ischemic stroke are still poorly understood. Aims of this study were three-fold: (1) to determine unique temporal magnetic resonance imaging (MRI) patterns at the acute, subacute and chronic stages after stroke in macaques by combining quantitative T2 and diffusion MRI indices into MRI 'tissue signatures', (2) to evaluate temporal differences in these signatures between transient (n = 2) and permanent (n = 2) middle cerebral artery occlusion, and (3) to correlate histopathology findings in the chronic stroke period to the acute and subacute MRI derived tissue signatures. An improved iterative self-organizing data analysis algorithm was used to combine T2, apparent diffusion coefficient (ADC), and fractional anisotropy (FA) maps across seven successive timepoints (1, 2, 3, 24, 72, 144, 240 h) which revealed five temporal MRI signatures, that were different from the normal tissue pattern (P < 0.001). The distribution of signatures between brains with permanent and transient occlusions varied significantly between groups (P < 0.001). Qualitative comparisons with histopathology revealed that these signatures represented regions with different histopathology. Two signatures identified areas of progressive injury marked by severe necrosis and the presence of gitter cells. Another signature identified less severe but pronounced neuronal and axonal degeneration, while the other signatures depicted tissue remodeling with vascular proliferation and astrogliosis. These exploratory results demonstrate the potential of temporally and spatially combined voxel-based methods to generate tissue signatures that may correlate with distinct histopathological features. The identification of distinct ischemic MRI signatures associated with specific tissue fates may further aid in assessing and monitoring the efficacy of novel pharmaceutical treatments for stroke in a pre-clinical and clinical setting.

  2. High-quality permanent draft genome sequence of the Parapiptadenia rigida-nodulating Cupriavidus sp. strain UYPR2.512

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

    De Meyer, Sofie E.; Fabiano, Elena; Tian, Rui

    Cupriavidus sp. strain UYPR2.512 is an aerobic, motile, Gram-negative, non-spore-forming rod that was isolated from a root nodule of Parapiptadenia rigida grown in soils from a native forest of Uruguay. Here we describe the features of Cupriavidus sp. strain UYPR2.512, together with sequence and annotation. We find the 7,858,949 bp high-quality permanent draft genome is arranged in 365 scaffolds of 369 contigs, contains 7,411 protein-coding genes and 76 RNA-only encoding genes, and is part of the GEBA-RNB project proposal.

  3. High-quality permanent draft genome sequence of the Parapiptadenia rigida-nodulating Cupriavidus sp. strain UYPR2.512

    DOE PAGES

    De Meyer, Sofie E.; Fabiano, Elena; Tian, Rui; ...

    2015-04-11

    Cupriavidus sp. strain UYPR2.512 is an aerobic, motile, Gram-negative, non-spore-forming rod that was isolated from a root nodule of Parapiptadenia rigida grown in soils from a native forest of Uruguay. Here we describe the features of Cupriavidus sp. strain UYPR2.512, together with sequence and annotation. We find the 7,858,949 bp high-quality permanent draft genome is arranged in 365 scaffolds of 369 contigs, contains 7,411 protein-coding genes and 76 RNA-only encoding genes, and is part of the GEBA-RNB project proposal.

  4. Greener Protection for Steel Bridges : Testing Nano-Enhanced Corrosion-Resistant Coatings

    DOT National Transportation Integrated Search

    2013-06-03

    Permanent deformation within the unbound granular is a predominant feature that results in the degradation and loss of serviceability to the pavement structure as the passage of traffic wheel loads accumulate. Proper characterization of the multi-lay...

  5. Oncological emergencies: clinical importance and principles of management.

    PubMed

    Samphao, S; Eremin, J M; Eremin, O

    2010-11-01

    Oncological emergencies are common conditions associated with significant morbidity and mortality. Delay in diagnosis and treatment can result in unfavourable outcomes. Cancer itself, cancer-related hormones or cytokines, or treatment effects can cause emergency problems. Febrile neutropaenia, frequently associated with chemotherapy, can lead to life-threatening conditions. Treatment requires systematic evaluation and early empirical antibiotics. Hypercalcaemia of malignancy is the most common metabolic emergency in cancer patients. Non-specific clinical features may cause delay in diagnosis and increase morbidity and mortality. Treatment includes active fluid resuscitation, diuretics and intravenous bisphosphonates. Superior vena cava syndrome is usually caused by external compression. Computerised tomography is useful to confirm diagnosis, evaluate the extent of disease and guide invasive tissue diagnosis. Treatment and prognosis depend on the underlying malignancies. Spinal cord compression is a true emergency due to risk of permanent neurological impairment. Localised back pain is the most common presenting symptom while late presentation of neurological deficit is associated with irreversible outcomes. Magnetic resonance imaging is the investigation of choice. Treatment includes corticosteroids, radiotherapy and/or decompressive surgery. © 2009 The Authors. European Journal of Cancer Care © 2009 Blackwell Publishing Ltd.

  6. Rapid Palatal Expansion in the absence of posterior cross-bite to intercept maxillary incisor crowding in the mixed dentition: a CBCT evaluation of spontaneous changes of untouched permanent molars.

    PubMed

    Rosa, M; Lucchi, P; Manti, G; Caprioglio, A

    2016-12-01

    The aim of this study was to investigate the reaction of untouched permanent molars following RPE, anchored on deciduous teeth in the early mixed dentition, aimed to solve maxillary anterior crowding in the absence of posterior cross-bite. A prospective clinical trial comprised 35 consecutive patients (20 males and 15 females) treated by the same orthodontist (MR). All patients showed crowding of the upper permanent incisors in the early mixed dentition in the absence of posterior cross-bite. RPE was anchored on second deciduous molars and on the deciduous canines. CBCT was taken before and after the removal of the RPE appliance. The transverse linear changes in width and the variation in the torque of the permanent molars were measured in the coronal plane. Relief of incisor crowding was found in all patients. The transverse width between permanent molars increased significantly. The apices of the upper permanent molars spontaneously expanded more than the crowns, while the opposite happened on the lower permanent molars. Moreover, the untouched upper permanent molars spontaneously uprighted palatally, while the lower permanent molars spontaneously uprighted buccally. The variation in the torque of the permanent molars mirrored transverse normal growth. In the early mixed dentition and in the absence of posterior cross-bite, it is possible to expand transversally the palate while uprighting the upper permanent molars in the opposite direction. RPE anchored on the deciduous teeth in the early mixed dentition, in the absence of posterior cross-bite, provides an "anticipation of transverse growth" and could be indicated to expand the anterior portion of the maxillary arch perimeter to solve upper incisor crowding.

  7. Mapping turbidity in the Charles River, Boston using a high-resolution satellite.

    PubMed

    Hellweger, Ferdi L; Miller, Will; Oshodi, Kehinde Sarat

    2007-09-01

    The usability of high-resolution satellite imagery for estimating spatial water quality patterns in urban water bodies is evaluated using turbidity in the lower Charles River, Boston as a case study. Water turbidity was surveyed using a boat-mounted optical sensor (YSI) at 5 m spatial resolution, resulting in about 4,000 data points. The ground data were collected coincidently with a satellite imagery acquisition (IKONOS), which consists of multispectral (R, G, B) reflectance at 1 m resolution. The original correlation between the raw ground and satellite data was poor (R2 = 0.05). Ground data were processed by removing points affected by contamination (e.g., sensor encounters a particle floc), which were identified visually. Also, the ground data were corrected for the memory effect introduced by the sensor's protective casing using an analytical model. Satellite data were processed to remove pixels affected by permanent non-water features (e.g., shoreline). In addition, water pixels within a certain buffer distance from permanent non-water features were removed due to contamination by the adjacency effect. To determine the appropriate buffer distance, a procedure that explicitly considers the distance of pixels to the permanent non-water features was applied. Two automatic methods for removing the effect of temporary non-water features (e.g., boats) were investigated, including (1) creating a water-only mask based on an unsupervised classification and (2) removing (filling) all local maxima in reflectance. After the various processing steps, the correlation between the ground and satellite data was significantly better (R2 = 0.70). The correlation was applied to the satellite image to develop a map of turbidity in the lower Charles River, which reveals large-scale patterns in water clarity. However, the adjacency effect prevented the application of this method to near-shore areas, where high-resolution patterns were expected (e.g., outfall plumes).

  8. 40 CFR 63.681 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... drain system, a gravity-operated conveyor (such as a chute), and a mechanically-powered conveyor (such... features permanently integrated into the design of the unit. Emission point means an individual tank, surface impoundment, container, oil-water or organic-water separator, transfer system, process vent, or...

  9. Preliminary definition of a lunar landing and launch facility (Complex 39L)

    NASA Technical Reports Server (NTRS)

    Matthews, H. Dennis; Jenson, Eric B.; Linsley, Jerald N.

    1992-01-01

    A preliminary definition of a lunar landing and launch facility has been formulated. A permanently manned lunar base and a baseline lunar module are assumed. The major features of the facility are specified and major design areas are described.

  10. 40 CFR 63.681 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... drain system, a gravity-operated conveyor (such as a chute), and a mechanically-powered conveyor (such... features permanently integrated into the design of the unit. Emission point means an individual tank, surface impoundment, container, oil-water or organic-water separator, transfer system, process vent, or...

  11. 40 CFR 63.681 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... drain system, a gravity-operated conveyor (such as a chute), and a mechanically-powered conveyor (such... features permanently integrated into the design of the unit. Emission point means an individual tank, surface impoundment, container, oil-water or organic-water separator, transfer system, process vent, or...

  12. Automated phenotyping of permanent crops

    NASA Astrophysics Data System (ADS)

    McPeek, K. Thomas; Steddom, Karl; Zamudio, Joseph; Pant, Paras; Mullenbach, Tyler

    2017-05-01

    AGERpoint is defining a new technology space for the growers' industry by introducing novel applications for sensor technology and data analysis to growers of permanent crops. Serving data to a state-of-the-art analytics engine from a cutting edge sensor platform, a new paradigm in precision agriculture is being developed that allows growers to understand the unique needs of each tree, bush or vine in their operation. Autonomous aerial and terrestrial vehicles equipped with multiple varieties of remote sensing technologies give AGERpoint the ability to measure key morphological and spectral features of permanent crops. This work demonstrates how such phenotypic measurements combined with machine learning algorithms can be used to determine the variety of crops (e.g., almond and pecan trees). This phenotypic and varietal information represents the first step in enabling growers with the ability to tailor their management practices to individual plants and maximize their economic productivity.

  13. Retrieval of a Broken Sewing Needle from the Sacrum Aided by a Permanent Magnet: A Case Report and Literature Review

    PubMed Central

    Fan, Jian; Wang, Ming-Ming; Liu, Yu-Ping

    2017-01-01

    Abstract Penetrating sacral injuries are very rare, but foreign bodies that penetrate the sacrum often cause pain, cerebrospinal fluid leakage, and neurological symptoms. Careful preoperative medical and imaging examinations, determining the position of the foreign body, and surgical exploration are essential in the management of such cases. We present the case of a woman who visited our emergency department with a broken sewing needle in her sacrum. The incident occurred when the patient accidentally sat on the needle while sewing by hand. Pain while sitting was the main clinical finding after the accident. The patient was treated successfully by surgical exploration aided by a permanent magnet. At follow-up a few months later, she was symptom-free. In clinical practice physicians often encounter patients with metallic foreign bodies. Permanent magnets play an important role in the removal of metallic foreign bodies, and emergency department physicians should master the methods and techniques. PMID:29318191

  14. Retrieval of a Broken Sewing Needle from the Sacrum Aided by a Permanent Magnet: A Case Report and Literature Review.

    PubMed

    Fan, Jian; Wang, Ming-Ming; Liu, Yu-Ping

    2017-01-01

    Penetrating sacral injuries are very rare, but foreign bodies that penetrate the sacrum often cause pain, cerebrospinal fluid leakage, and neurological symptoms. Careful preoperative medical and imaging examinations, determining the position of the foreign body, and surgical exploration are essential in the management of such cases. We present the case of a woman who visited our emergency department with a broken sewing needle in her sacrum. The incident occurred when the patient accidentally sat on the needle while sewing by hand. Pain while sitting was the main clinical finding after the accident. The patient was treated successfully by surgical exploration aided by a permanent magnet. At follow-up a few months later, she was symptom-free. In clinical practice physicians often encounter patients with metallic foreign bodies. Permanent magnets play an important role in the removal of metallic foreign bodies, and emergency department physicians should master the methods and techniques.

  15. Online 3D Ear Recognition by Combining Global and Local Features.

    PubMed

    Liu, Yahui; Zhang, Bob; Lu, Guangming; Zhang, David

    2016-01-01

    The three-dimensional shape of the ear has been proven to be a stable candidate for biometric authentication because of its desirable properties such as universality, uniqueness, and permanence. In this paper, a special laser scanner designed for online three-dimensional ear acquisition was described. Based on the dataset collected by our scanner, two novel feature classes were defined from a three-dimensional ear image: the global feature class (empty centers and angles) and local feature class (points, lines, and areas). These features are extracted and combined in an optimal way for three-dimensional ear recognition. Using a large dataset consisting of 2,000 samples, the experimental results illustrate the effectiveness of fusing global and local features, obtaining an equal error rate of 2.2%.

  16. Online 3D Ear Recognition by Combining Global and Local Features

    PubMed Central

    Liu, Yahui; Zhang, Bob; Lu, Guangming; Zhang, David

    2016-01-01

    The three-dimensional shape of the ear has been proven to be a stable candidate for biometric authentication because of its desirable properties such as universality, uniqueness, and permanence. In this paper, a special laser scanner designed for online three-dimensional ear acquisition was described. Based on the dataset collected by our scanner, two novel feature classes were defined from a three-dimensional ear image: the global feature class (empty centers and angles) and local feature class (points, lines, and areas). These features are extracted and combined in an optimal way for three-dimensional ear recognition. Using a large dataset consisting of 2,000 samples, the experimental results illustrate the effectiveness of fusing global and local features, obtaining an equal error rate of 2.2%. PMID:27935955

  17. Adalimumab for Treatment of Noninfectious Uveitis: Immunogenicity and Clinical Relevance of Measuring Serum Drug Levels and Antidrug Antibodies.

    PubMed

    Cordero-Coma, Miguel; Calleja-Antolín, Sara; Garzo-García, Irene; Nuñez-Garnés, Ana M; Álvarez-Castro, Carolina; Franco-Benito, Manuel; Ruiz de Morales, Jose G

    2016-12-01

    To evaluate the rate of immunogenicity induced by adalimumab and its relationship with drug serum levels and clinical responses in patients with noninfectious uveitis. Prospective observational study. Consecutive patients from 1 referral center who initiated treatment with adalimumab for active noninfectious uveitis resistant to conventional therapy. All patients received 40 mg adalimumab every other week. Patients were evaluated clinically and immunologically before and after 4, 8, and 24 weeks of treatment. Clinical evaluation included assessment of changes in visual acuity, degree of inflammation in the anterior chamber and vitreous cavity, central macular thickness, and retinal angiographic leakage. Immunologic evaluation included assessment of serum trough adalimumab and antibodies against adalimumab (AAA) levels and class II HLA typing. Twenty-five patients were enrolled. Overall, 18 of 25 patients (72%) showed a favorable clinical response to adalimumab therapy. Eleven patients (44%) achieved a complete response and 7 (28%) achieved a partial response. However, 7 of 25 patients (28%) were considered nonresponders. Median trough adalimumab serum levels were higher in responders than in nonresponders (P < 0.001). We observed AAA positivity (AAA+) at least 1 time point in 8 of 25 patients (32%), including 4 with transitory AAA and 4 with permanent AAA. In all patients with permanent AAA+, trough adalimumab levels became undetectable (P < 0.001). However, in patients who demonstrated transitory AAA+, no correlation was observed between AAA titers and adalimumab trough levels (P = 0.2).Concomitant immunosuppression did not show any protective effect on adalimumab immunogenicity in our cohort. An association between the presence of AAA+ and a worse uveitis outcome was observed only in patients with permanent AAA+, which correlated with undetectable adalimumab trough levels (P = 0.014). Treatment of noninfectious uveitis with adalimumab is associated with high rates of favorable clinical response. Overall, adalimumab trough levels were higher in responder patients. Development of permanent AAA was associated with undetectable trough adalimumab levels and worse uveitis outcome. Immunogenicity was more common in patients in whom uveitis was associated with a systemic disease and was not influenced by concomitant immunosuppressors. Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  18. Early definition of type, degree and audiogram shape in childhood hearing impairment.

    PubMed

    Conti, G; Gallus, R; Fetoni, A R; Martina, B M; Muzzi, E; Orzan, E; Bastanza, G

    2016-02-01

    In the context of permanent childhood hearing loss, early audiological diagnosis is a prerequisite for activation of an adequate rehabilitation program to prevent or limit the known effects that auditory deprivation determines on language development and cognitive skills in neonates. Audiological diagnosis consists schematically of three phases: identification of subjects at risk, definition of hearing loss and/or children features, verification of appropriateness of diagnosis itself and a rehabilitation programme. Strategies and methods of audiological diagnosis are well defined and include an integration of data coming from objective methods with clinical and behavioural data. Although the substantial effectiveness of procedures and a general consensus on their use and interpretation have been defined, there are several critical issues concerning the achievement of this objective, which will be discussed in this paper. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  19. Medical research funding may have over-expanded and be due for collapse.

    PubMed

    Charlton, B G; Andras, P

    2005-01-01

    The continual and uninterrupted expansion of medical research funding is generally assumed to be a permanent feature of modern societies, but this expectation may turn out to be mistaken. Sciences tend to go through boom and bust phases. Twentieth century physics is an example where huge increases in funding followed an era of scientific breakthroughs. Speculative over-expansion led to diminishing returns on investment, then a collapse in funding. We predict that medicine will follow the same trajectory. After prolonged over-funding of the 'basic-to-applied' model of clinical innovation, and a progressive shift towards Big Science organization, medical research has become increasingly inefficient and ineffective. Although incremental improvements to existing treatment strategies continue, the rate of significant therapeutic breakthroughs has been declining for three decades. Medical science now requires rationalization and modernization. From this perspective, the current level of medical research funding looks like a bubble due to burst.

  20. Pediatric morphea (localized scleroderma): review of 136 patients.

    PubMed

    Christen-Zaech, Stéphanie; Hakim, Miriam D; Afsar, F Sule; Paller, Amy S

    2008-09-01

    Morphea is an autoimmune inflammatory sclerosing disorder that may cause permanent functional disability and disfigurement. We sought to determine the clinical features of morphea in a large pediatric cohort. We conducted a retrospective chart review of 136 pediatric patients with morphea from one center, 1989 to 2006. Most children showed linear morphea, with a disproportionately high number of Caucasian and female patients. Two patients with rapidly progressing generalized or extensive linear morphea and arthralgias developed restrictive pulmonary disease. Initial oral corticosteroid treatment and long-term methotrexate administration stabilized and/or led to disease improvement in most patients with aggressive disease. Retrospective analysis, relatively small sample size, and risk of a selected referral population to the single site are limitations. These data suggest an increased prevalence of morphea in Caucasian girls, and support methotrexate as treatment for problematic forms. Visceral manifestations rarely occur; the presence of progressive problematic cutaneous disease and arthralgias should trigger closer patient monitoring.

  1. Automated detection of age-related macular degeneration in OCT images using multiple instance learning

    NASA Astrophysics Data System (ADS)

    Sun, Weiwei; Liu, Xiaoming; Yang, Zhou

    2017-07-01

    Age-related Macular Degeneration (AMD) is a kind of macular disease which mostly occurs in old people,and it may cause decreased vision or even lead to permanent blindness. Drusen is an important clinical indicator for AMD which can help doctor diagnose disease and decide the strategy of treatment. Optical Coherence Tomography (OCT) is widely used in the diagnosis of ophthalmic diseases, include AMD. In this paper, we propose a classification method based on Multiple Instance Learning (MIL) to detect AMD. Drusen can exist in a few slices of OCT images, and MIL is utilized in our method. We divided the method into two phases: training phase and testing phase. We train the initial features and clustered to create a codebook, and employ the trained classifier in the test set. Experiment results show that our method achieved high accuracy and effectiveness.

  2. Vigil Network sites: A sample of data for permanent filing

    USGS Publications Warehouse

    Leopold, Luna Bergere; Emmett, William W.

    1965-01-01

    The Vigil Network consists of places where observations are made through time to record changes in landscape features over a long period. Resurveys will usually be made once each year or every few years and the period of observation, hopefully, will extend through and beyond the International Hydrological Decade.Vigil Network sites will usually be chosen to represent some typical feature of a given landscape. In the example shown here, the feature is a small ephemeral channel in a basin of moderate relief underlain by silty sandstone typical of the surrounding area. Vigil sites are not protected from man's influence and indeed may be selected because of the possible or portending cultural influences. In this respect they differ from the Bench Mark Network whose purpose is to make precise observations of hydrologic factors in areas uninfluenced by and protected from man's use.The factors which might be observed are many and varied. A few might be mentioned here, others are explained at length elsewhere (Miller and Leopold, 1963; Leopold, 1962). Streamchannel position, form, depth, and profile; vegetation in form of transects or quadrats; soil movement on slopes; rock movement on slopes or in channels. These and many more would yield valuable information on changes with time.To assure permanence of initial field observations, including reference points, bench marks, and cross sections, brief descriptions, maps, and initial data should be filed identically in designated repositories where the data will be made available for inspection by any interested scientist. It is recommended that the designation of two such locations where records of the type here attached will be filed be taken up by the Coordinating Council of the International Hydrological Decade. In designating such repositories it should be recognized that there is no need for elaborate indexing. The main requirement is merely the maintenance of a simple file where the data are stored and can be inspected or copied by any scientist. There need be no special provision for lending or reproduction services.The present document is an example showing what data, maps, and descriptions should be included in those permanent files at the two repositories. The material in these repositories should be sufficient to permit someone in the indefinite future to find and remeasure the same features described now. Thus the scientific value of the original surveys increases with time, - provided that the descriptions are sufficient to allow a person to find with assurance the original feature in the field.It must be visualized that a permanent repository must economize in space. Thus, as the example here shows, the filed material is not all of the original field notes but a summary, brief but descriptive.

  3. Education, Development, and the Rebuilding of Urban Community.

    ERIC Educational Resources Information Center

    Keith, Novella Z.; Keith, Nelson W.

    The paper asks what are appropriate policies for urban school reform in the context of global transformations affecting cities in both developed and "Third World" countries. Features of this transformation include growing population diversity, a semi-permanent underclass, and the informal economy. Comprehensive community development…

  4. Dental anomalies in 14 patients with IP: clinical and radiological analysis and review.

    PubMed

    Santa-Maria, Fernanda D; Mariath, Luiza Monteavaro; Poziomczyk, Cláudia S; Maahs, Marcia A P; Rosa, Rafael F M; Zen, Paulo R G; Schüller-Faccini, Lavínia; Kiszewski, Ana Elisa

    2017-06-01

    Current knowledge on dental anomalies in patients with incontinentia pigmenti (IP) has been obtained by examining case reports; however, an overall characterization of such alterations remains lacking. The objective of this study was to determine the frequency, type and location of dental alterations in IP using a case series. Fourteen patients (9 children and 5 adults) with a clinical diagnosis of IP who presented dental anomalies were included in this study. All patients were administered a clinical questionnaire, dental examination and radiological investigation. In the present case series, agenesis of primary dentition was present in 60 % of patients and agenesis of permanent tooth was present in 92.8 % of patients. Most cases were missing at least 6 teeth. Second molar agenesis was present in 13 patients (92.8 %). Anomalies in dental crowns occurred in 71.4 % of cases, and the central incisor was most frequently affected. Two adult patients still had primary teeth. Malocclusion was found in 10 patients (71.4 %). High-arched palate was observed in 7 (50 %) patients. Patients with IP present alterations in both primary and permanent dentition. Because the agenesis of permanent teeth is more common, primary teeth are not always replaced. In addition, the durability of primary dentition appears to be greater in IP. This study shows that patients with IP experience significant loss of teeth, especially in permanent dentition, and have an increased risk of high-arched palate compared to the general population. Prophylactic care of primary teeth in IP is relevant for improving functional and aesthetic outcomes until dental prostheses are implanted.

  5. Acute renal infarction: Clinical characteristics and prognostic factors.

    PubMed

    Caravaca-Fontán, Fernando; Pampa Saico, Saúl; Elías Triviño, Sandra; Galeano Álvarez, Cristina; Gomis Couto, Antonio; Pecharromán de las Heras, Inés; Liaño, Fernando

    2016-01-01

    Acute renal infarction (ARI) is an uncommon disease, whose real incidence is probably higher than expected. It is associated with poor prognosis in a high percentage of cases. To describe the main clinical, biochemical and radiologic features and to determine which factors are associated with poor prognosis (death or permanent renal injury). The following is a retrospective, observational, single-hospital-based study. All patients diagnosed with ARI by contrast-enhanced computed tomography (CT) over an 18-year period were included. Patients were classified according to the cardiac or non-cardiac origin of their disease. Clinical, biochemical and radiologic features were analysed, and multiple logistic regression model was used to determine factors associated with poor prognosis. A total of 62 patients were included, 30 of which had a cardiac origin. Other 32 patients with non-cardiac ARI were younger, had less comorbidity, and were less frequently treated with oral anticoagulants. CT scans estimated mean injury extension at 35%, with no differences observed between groups. A total of 38% of patients had an unfavourable outcome, and the main determinants were: Initial renal function (OR=0.949; IC 95% 0.918-0.980; p=0.002), and previous treatment with oral anticoagulants (OR=0.135; IC 95% 0.032-0.565; p=0.006). ARI is a rare pathology with non-specific symptoms, and it is not associated with cardiological disease or arrhythmias in more than half of cases. A substantial proportion of patients have unfavourable outcomes, and the initial renal function is one of the main prognostic factors. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  6. Dental anomalies in primary dentition and their corresponding permanent teeth.

    PubMed

    Gomes, R R; Fonseca, J A C; Paula, L M; Acevedo, A C; Mestrinho, H D

    2014-05-01

    The objectives of this paper are to estimate the prevalence of dental anomalies in primary dentition in a sample of 2- to 5-year-old Brazilian preschool children, determine their distribution, and investigate their occurrence in the succedaneous teeth of the sample compared with a control group of children with no dental anomalies in the primary dentition. The one-stage sample comprised 1,718 two to five-year-old children with fully erupted primary dentition clinically examined for dental anomalies. All children presenting dental anomalies underwent panoramic radiographs. Descriptive statistics were performed for the studied variables. A control group matched by sex and age was studied to compare the prevalence ratio for dental anomalies in the permanent dentition. The prevalence of dental anomalies in the primary dentition was 1.8 %, with no significant statistical difference between sexes. Double teeth were the most frequently observed. Dental anomalies on the succedaneous permanent teeth were diagnosed in 54.8 % of the children with affected primary dentition. The prevalence ratio (PR) for dental anomalies in the succedaneous permanent teeth was 17.1 (confidence interval (CI) 5.33-54.12) higher compared with the control group, higher in children with bilateral anomalies (PR = 31.2, CI 10.18-94.36). An association between anomalies of the permanent dentition and the presence of dental anomalies in primary teeth was observed, especially when they occur bilaterally. The results in the present study have a clinical relevance in the diagnosis of children with dental anomalies in primary dentition. Early identification of these anomalies can aid the dentist in planning dental treatment at the appropriate time.

  7. Prevalence of dental anomalies in the permanent dentition of children with Down syndrome.

    PubMed

    Sekerci, Ahmet Ercan; Cantekin, Kenan; Aydinbelge, Mustafa; Ucar, Faruk İzzet

    2014-01-01

    The purpose of this study was to evaluate the prevalence of various congenital dental anomalies in the permanent dentition of Turkish children with Down syndrome. The sample consisted of 216 diagnostic records of children diagnosed with Down syndrome. All subjects had a clinical examination as well as radiographs and photographs taken. Anomalies in the permanent dentition were documented. There was a high incidence of dental anomalies, the most frequent being taurodontism (81 percent), rotation (28 percent), hypodontia (26 percent), tooth impaction (18 percent), ectopic eruption (14 percent), microdontia (13 percent), and hyperdontia (9 percent). Differences in prevalence of congenitally missing teeth, structural anomalies, and positional anomalies reached a statistically significant level regarding gender (P<.05). Turkish children with Down syndrome presented a high incidence of anomalies affecting the permanent dentition, and, in most cases, individuals presented with more than one anomaly.

  8. Amelogenesis Imperfecta with Coronal Resorption: Report of Three Cases.

    PubMed

    Bhatia, Shannu K; Hunter, M Lindsay; Ashley, Paul F

    2015-12-01

    Intracoronal resorption of the permanent dentition in cases of amelogenesis imperfecta (AI) is a rare finding which poses an added complication to the already complex management of this condition. This paper presents three cases of AI associated with delayed eruption of permanent teeth in which asymptomatic intracoronal resorption occurred. CPD/Clinical Relevance: This paper highlights the fact that teeth affected with amelogenesis imperfecta may undergo asymptomatic intracoronal resorption which is only identifiable radiographically.

  9. 30. View of main deck at bow (looking aft from ...

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

    30. View of main deck at bow (looking aft from samson post, upper deck removed), showing anchor windlass (left foreground), head (right foregound), and forward deckhouse; weather canopy overhead not an original or permanent feature - Schooner WAWONA, 1018 Valley Street, Seattle, King County, WA

  10. 7 CFR 1924.108 - Grading and drainage.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... exposed for long periods during construction. (d) Storm water systems. The design of storm water systems... basin level. Storm water systems should be compatible with the natural features of the site. In areas with inadequate drainage systems, permanent or temporary storm water storage shall be an integral part...

  11. 7 CFR 1924.108 - Grading and drainage.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... exposed for long periods during construction. (d) Storm water systems. The design of storm water systems... basin level. Storm water systems should be compatible with the natural features of the site. In areas with inadequate drainage systems, permanent or temporary storm water storage shall be an integral part...

  12. 7 CFR 1924.108 - Grading and drainage.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... exposed for long periods during construction. (d) Storm water systems. The design of storm water systems... basin level. Storm water systems should be compatible with the natural features of the site. In areas with inadequate drainage systems, permanent or temporary storm water storage shall be an integral part...

  13. 7 CFR 1924.108 - Grading and drainage.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... exposed for long periods during construction. (d) Storm water systems. The design of storm water systems... basin level. Storm water systems should be compatible with the natural features of the site. In areas with inadequate drainage systems, permanent or temporary storm water storage shall be an integral part...

  14. 7 CFR 1924.108 - Grading and drainage.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... exposed for long periods during construction. (d) Storm water systems. The design of storm water systems... basin level. Storm water systems should be compatible with the natural features of the site. In areas with inadequate drainage systems, permanent or temporary storm water storage shall be an integral part...

  15. Standards on the permanence of recording materials

    NASA Astrophysics Data System (ADS)

    Adelstein, Peter Z.

    1996-02-01

    The permanence of recording materials is dependent upon many factors, and these differ for photographic materials, magnetic tape and optical disks. Photographic permanence is affected by the (1) stability of the material, (2) the photographic processing and (3) the storage conditions. American National Standards on the material and the processing have been published for different types of film and standard test methods have been established for color film. The third feature of photographic permanence is the storage requirements and these have been established for photographic film, prints and plates. Standardization on the permanence of electronic recording materials is more complicated. As with photographic materials, stability is dependent upon (1) the material itself and (2) the storage environment. In addition, retention of the necessary (3) hardware and (4) software is also a prerequisite. American National Standards activity in these areas has been underway for the past six years. A test method for the material which determines the life expectancy of CD-ROMs has been standardized. The problems of determining the expected life of magnetic tape have been more formidable but the critical physical properties have been determined. A specification for the storage environment of magnetic tape has been finalized and one on the storage of optical disks is being worked on. Critical but unsolved problems are the obsolescence of both the hardware and the software necessary to read digital images.

  16. Standards on the permanence of recording materials

    NASA Astrophysics Data System (ADS)

    Adelstein, Peter Z.

    1996-01-01

    The permanence of recording materials is dependent upon many factors, and these differ for photographic materials, magnetic tape and optical disks. Photographic permanence is affected by the (1) stability of the material, (2) the photographic processing, and (3) the storage conditions. American National Standards on the material and the processing have been published for different types of film and standard test methods have been established for color film. The third feature of photographic permanence is the storage requirements and these have been established for photographic film, prints, and plates. Standardization on the permanence of electronic recording materials is more complicated. As with photographic materials, stability is dependent upon (1) the material itself and (2) the storage environment. In addition, retention of the necessary (3) hardware and (4) software is also a prerequisite. American National Standards activity in these areas has been underway for the past six years. A test method for the material which determines the life expectancy of CD-ROMs has been standardized. The problems of determining the expected life of magnetic tape have been more formidable but the critical physical properties have been determined. A specification for the storage environment of magnetic tapes has been finalized and one on the storage of optical disks is being worked on. Critical but unsolved problems are the obsolescence of both the hardware and the software necessary to read digital images.

  17. [Gender identity disorder: challenges and specificity in the treatment of requests for sexual reassignment].

    PubMed

    Pécoud, P; Pralong, F; Bauquis, O; Stiefel, F

    2011-02-16

    Gender identity disorder is defined as a permanent desire to relieve one's own sexual features to acquire the sexual features and line to life of the opposite sex. The diagnosis is based on the psychiatric evaluation and treatment on an interdisciplinary approach by endocrinologists, surgeons and psychiatrists, and can be conceptualized into distinct phases: diagnostic evaluation, real life experience, hormonal treatment and surgery. Multiples challenges have to be faced, especially by the psychiatrist who follows the patient during the whole process.

  18. A neurologist's reflections on boxing. V. Conclude remarks.

    PubMed

    Unterharnscheidt, F

    1995-01-01

    Clinical and morphological publications have shown convincingly, that participation in boxing leads to a severe permanent brain damage. The extent of the brain damage is correlated to the number of bouts fought, which correspondents in a certain way how many blows against his head a boxer received and to his weight class. The intensity of a boxing blow of a heavyweight is much more severe than those achieved by boxers of lighter weight classes. The permanent brain damage in a boxer, the amateur and the professional boxer, manifests itself in several clinical syndromes in which the pyramidal, the extrapyramidal and the cerebellar systems are involved. A traumatic Parkinsonism, in its complete or abortive form, develops as the result of the numerous boxing blows a boxer sustains in his boxing career. Especially lateral parts of the substantia nigra are affected and reveal at macroscopical and microscopical examination a severe loss of pigmented neurons. Melanin pigment is visible free in the tissue and/or is phagozytosed in macrophages and glial cells. The traumatic Parkinson syndrome, often only in an abortive form, is combined in a boxer with additional clinical and morphological findings due to traumatic lesions in other areas of the brain. It is not as pure as in a patient with a Parkinson syndrome sui generis. The permanent brain damage in a boxer is diffuse, involving all areas of the brain. Especially involved are the large neurons of different layers of the cerebral cortex, the neurons of the Ammons horn formation, the Purkinje cells of the cerebellum. In place of destroyed and lost neurons, proliferation of glial elements, especially astroglial cells, has occurred. The defects are first replaced by protoplasmatic astroglial elements, and later by fibrillary astroglia. The destroyed neurons are replaced by glial scar tissue, which cannot perform the functions of the lost neurons. It is a process which is called partial necrosis of brain tissue. There is no reparation or restitution of the destroyed neural tissue of the brain. What is destroyed remains so, a restitution ad integrum does not occur. As the result of the diffuse loss of neurons in the brain a cerebral atrophy exists. The septum pellucidum, which consists of two thin lamellae, and is small or very small in a normal brain, forms a Cavum septi pellucidi, which is considerably enlarged. The walls of this structure, especially in its dorsal parts are considerably thinned; they show fenestrations and are, in dorsal parts no longer detectable, so that a direct connection between the two lateral ventricles exists. The clinically and morphologically existing permanent brain damage is the result of the boxing activity. Diagnostically, processes of another origin, such as alcoholism, luetic processes, other forms of dementia, etc. can undoubtedly be excluded. A permanent brain damage develops in professional and amateur boxers. The objection, which are voiced by members of the different Amateur Boxing Association, that such permanent brain damage in amateur boxers today no longer exists, after stricter protective measurements were introduced, is not tenable. Individuals who represent today the opinion, that a permanent brain damage or punch drunkenness in boxers does not occur, are not familiar with the pertinent medical literature. The argument, the injury quotient in boxing is lower than in all other athletic activities is not sound, since the statistics show only the inconsequential injuries of boxers, as lesions of the skin of the face, injuries of the hand, fractures, etc. but not the much more important and severe permanent brain damage, which is not taken into consideration in these so-called statistics. Besides of the permanent brain damage of former boxers as the result of the repeated and numerous blows against their head, severe permanent damage of the eyes and the hearing organ exists.

  19. High-frequency sonography of temporary and permanent dermal fillers.

    PubMed

    Grippaudo, Francesca Romana; Mattei, Mauro

    2010-08-01

    Dermal fillers are used widely; some have a permanent effect, whereas others are temporary. The aim of this study is to describe the ultrasonographic features of permanent and temporary fillers injected into patients for cosmetic purposes. Between December 2006 and April 2009, 36 subjects, aged 25-45, who had received lips or nasolabial fold filler augmentation, were enrolled for a high-frequency sonographic examination by a blinded investigator. The criteria for exclusion were a history of autoimmunity, infection, neoplastic diseases or episodes of local reactions to the injected filler. Twenty patients underwent a sonographic exam after the injection of a temporary filler (collagen or hyaluronic acid) by FRG; the rest were enrolled among patients seeking a consultation for further cosmetic reasons, but had been treated with an identifiable filler before. It was always possible to identify the filler at the site of injection. Seldom was it possible to discover a silent inflammatory reaction, otherwise unsuspected. The sonographic images differed according to the temporary or the permanent nature of the filler. Ultrasonography has proved to be a useful, non-invasive tool for the identification of the presence and type of the filler injected.

  20. The case for Mars: Concept development for a Mars research station

    NASA Technical Reports Server (NTRS)

    Welch, S. M. (Editor); Stoker, C. R. (Editor)

    1986-01-01

    A program to establish a permanent scientific research base on Mars is described. A Mars base as the much needed long-term focus for the space program is presented. A permanent base was chosen rather than the more conventional concept of a series of individual missions to different sites because the permanent base offers much greater scientific return plus greater crew safety and the potential for eventual growth into a settlement. The Mars base will strive for self-sufficiency and autonomy from Earth. Martian resources will be used to provide life support materials and consumables. The Martian atmosphere will provide a convenient source of volatiles: CO2, N2, and water. Rocket propellant (for returning vehicles), fuels, breathable air, and fertilizers will be manufactured from Mars air. Food will be grown on Mars using Martian materials as plant nutrients. A permanent human presence will be maintained on Mars beginning with the first manned landing via a strategy of crew overlap. This permanent presence will ensure safety and reliability of systems through continuous tending, maintenance, and expansion of the base's equipment and systems. A permanent base will allow the development of a substantial facility on Mars for the same cost (in terms of Earth departure mass) as a series of temporary camps. A base equipped with surface rovers, airplanes, and the ability to manufacture consumables and return propellant will allow far more extensive planetary exploration over a given period of years than would approaches featuring a series of short exploration missions such as the Apollo Moon program.

  1. The case for Mars: Concept development for a Mars research station

    NASA Astrophysics Data System (ADS)

    Welch, S. M.; Stoker, C. R.

    1986-04-01

    A program to establish a permanent scientific research base on Mars is described. A Mars base as the much needed long-term focus for the space program is presented. A permanent base was chosen rather than the more conventional concept of a series of individual missions to different sites because the permanent base offers much greater scientific return plus greater crew safety and the potential for eventual growth into a settlement. The Mars base will strive for self-sufficiency and autonomy from Earth. Martian resources will be used to provide life support materials and consumables. The Martian atmosphere will provide a convenient source of volatiles: CO2, N2, and water. Rocket propellant (for returning vehicles), fuels, breathable air, and fertilizers will be manufactured from Mars air. Food will be grown on Mars using Martian materials as plant nutrients. A permanent human presence will be maintained on Mars beginning with the first manned landing via a strategy of crew overlap. This permanent presence will ensure safety and reliability of systems through continuous tending, maintenance, and expansion of the base's equipment and systems. A permanent base will allow the development of a substantial facility on Mars for the same cost (in terms of Earth departure mass) as a series of temporary camps. A base equipped with surface rovers, airplanes, and the ability to manufacture consumables and return propellant will allow far more extensive planetary exploration over a given period of years than would approaches featuring a series of short exploration missions such as the Apollo Moon program.

  2. [Retrospective study about periodontal ligament healing of replanted permanent teeth in children].

    PubMed

    Bai, J; Zhao, Y M; Qin, M

    2015-04-18

    To analyze the prognosis about periodontal ligament healing of replanted permanent teeth in children and to examine the associated factors. The sample consisted of 49 children with 61 avulsed permanent teeth, whose injuries had been managed in the period from 2000 to 2012. The clinical data of replanted teeth were collected, and the follow-up period was no less than 12 months. The factors were analyzed in relation to postoperative outcomes, classified as functional periodontal healing (FH), infection-related (inflammatory) resorption (IRR) and replacement resorption (RR). The functional healing rate was 23.0%, while replacement resorption rate was 72.1%. The replacement resorption (ankylosis) was usually observed earlier by clinical examination than by radiographic examination. 86.0% (40/47) resorptive processes were diagnosed within the first year. Physiological storages, such as milk, saline and saliva were significantly better to periodontal ligament healing than nonphysiological storages, such as tap water and sterilizing solutions (chloramine and alcohol). Functional healing was found significantly more frequent in canines and premolars. The factor significantly affecting periodontal ligament healing is storage medium. Replacement resorption is the most common type of root resorption. The replacement resorption diagnosis must combine the radiographic examination with the clinical examination. It is better to follow up more than 1 year after tooth replantation.

  3. 40 CFR 63.681 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... features permanently integrated into the design of the unit. Emission point means an individual tank... system is not a drain and collection system that is designed and operated for the sole purpose of..., or transfer system used to manage off-site material. Off-site material service means any time when a...

  4. 40 CFR 63.681 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... features permanently integrated into the design of the unit. Emission point means an individual tank... system is not a drain and collection system that is designed and operated for the sole purpose of..., or transfer system used to manage off-site material. Off-site material service means any time when a...

  5. Leaving College: Rethinking the Causes and Cures of Student Attrition.

    ERIC Educational Resources Information Center

    Tinto, Vincent

    The dimensions and consequences of college student attrition and features of institutional action to deal with attrition are discussed. Patterns of student departure from individual colleges as opposed to permanent college withdrawal are addressed. After synthesizing the research on multiple causes of student leaving, a theory of student departure…

  6. Mage: A Tool for Developing Interactive Instructional Graphics

    ERIC Educational Resources Information Center

    Pavkovic, Stephen F.

    2005-01-01

    Mage is a graphics program developed for visualization of three-dimensional structures of proteins and other macromolecules. An application of the Mage program is reported here for developing interactive instructional graphics files (kinemages) of much smaller scale. Examples are given illustrating features of VSEPR models, permanent dipoles,…

  7. A survey of early Virginia road stones : sign rocks, milestones, and related objects.

    DOT National Transportation Integrated Search

    2009-01-01

    A Virginia law of 1738 required that all crossroads be marked by posts of directions. Most of these signs were made of wood and have not survived. But some roads in Virginia featured more permanent forms of markers: directional signs and mileposts ma...

  8. [Curricular adjustments in the clinical fields].

    PubMed

    Uribe Elías, Roberto

    2011-01-01

    The 2010 undergraduate medical degree curriculum at the National Autonomous University of Mexico (UNAM) faculty of medicine is based on the reality of the operating structure of the medical care units qualified for teaching. The clinical teaching/learning is based on the cooperative work of the professor and student; this means, it is based on the institutional physician responsible for medical care in a professor/assistant action together with the student being brought up. Therefore, the permanent education and training of all medical teams in the institutions offering teaching is essential. Teaching must be one distinctive characteristic of excellence for the units of the Health Ministry as it is teaching the central factor that raises the quality of medical care. The clinical evaluation must be permanent, improving the value of the daily action in front of a patient at the formative level and as a means to allow the assessment for its development, as it is the clinical aspect that is the essence of medicine.

  9. Early working memory as a racially and ethnically neutral measure of outcome in extremely preterm children at 18-22 months

    PubMed Central

    Lowe, Jean R.; Duncan, Andrea Freeman; Bann, Carla M.; Fuller, Janell; Hintz, Susan R.; Das, Abhik; Higgins, Rosemary D.; Watterberg, Kristi L.

    2013-01-01

    Background Difficulties with executive function has been found in preterm children, resulting in difficulties with learning and school performance. Aim This study evaluated the relationship of early working memory as measured by object permanence items to the cognitive and language scores on the Bayley Scales-III in a cohort of children born extremely preterm. Study Design Logistic regression models were conducted to compare object permanence scores derived from the Bayley Scales-III by race/ethnicity and maternal education, controlling for medical covariates. Subjects Extremely preterm toddlers (526), who were part of a Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network's multi-center study, were evaluated at 18-22 months corrected age. Outcome Measures Object permanence scores derived from the Bayley Developmental Scales were compared by race/ethnicity and maternal education, controlling for medical covariates. Results There were no significant differences in object permanence mastery and scores among the treatment groups after controlling for medical and social variables, including maternal education and race/ethnicity. Males and children with intraventricular hemorrhage, retinopathy of prematurity, and bronchopulmonary dysplasia were less likely to demonstrate object permanence mastery and had lower object permanence scores. Children who attained object permanence mastery had significantly higher Bayley Scales-III cognitive and language scores after controlling for medical and socio-economic factors. Conclusions Our measure of object permanence is free of influence from race, ethnic and socio-economic factors. Adding this simple task to current clinical practice could help detect early executive function difficulties in young children. PMID:23993309

  10. Early working memory as a racially and ethnically neutral measure of outcome in extremely preterm children at 18-22 months.

    PubMed

    Lowe, Jean R; Duncan, Andrea Freeman; Bann, Carla M; Fuller, Janell; Hintz, Susan R; Das, Abhik; Higgins, Rosemary D; Watterberg, Kristi L

    2013-12-01

    Difficulties with executive function have been found in preterm children, resulting in difficulties with learning and school performance. This study evaluated the relationship of early working memory as measured by object permanence items to the cognitive and language scores on the Bayley Scales-III in a cohort of children born extremely preterm. Logistic regression models were conducted to compare object permanence scores derived from the Bayley Scales-III by race/ethnicity and maternal education, controlling for medical covariates. Extremely preterm toddlers (526), who were part of a Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network's multi-center study, were evaluated at 18-22 months corrected age. Object permanence scores derived from the Bayley Developmental Scales were compared by race/ethnicity and maternal education, controlling for medical covariates. There were no significant differences in object permanence mastery and scores among the treatment groups after controlling for medical and social variables, including maternal education and race/ethnicity. Males and children with intraventricular hemorrhage, retinopathy of prematurity, and bronchopulmonary dysplasia were less likely to demonstrate object permanence mastery and had lower object permanence scores. Children who attained object permanence mastery had significantly higher Bayley Scales-III cognitive and language scores after controlling for medical and socio-economic factors. Our measure of object permanence is free of influence from race, ethnic and socio-economic factors. Adding this simple task to current clinical practice could help detect early executive function difficulties in young children. Published by Elsevier Ireland Ltd.

  11. Miniature Pulpotomy of Symptomatic Mature Permanent Teeth: A Report of Two Cases.

    PubMed

    Asgary, Saeed; Nourzadeh, Mahdieh; Eghbal, Mohammad Jafar

    2016-01-01

    Human dental pulp inflammation can progress to periapical lesion formation and conventional root canal treatment (RCT) has been the traditional method for disease management. This observational study presents two cases of vital pulp therapy in mature molars diagnosed with irreversible pulpitis and associated with apical periodontitis. In these two clinical cases, the involved teeth had deep carious lesions with a history of spontaneous/lingering pain and radiographic examinations revealed the presence of apical radiolucencies. A conservative miniature pulpotomy (MP) using calcium-enriched mixture (CEM) was performed and the teeth were permanently restored with amalgam. Clinical evaluations indicated resolution of pain 24 hours after treatment; the teeth showed normal vitality, remained asymptomatic and maintained normal function after recall examinations. Furthermore, the 18-month radiographic evaluation showed healing of the apical lesions. Vital pulp therapy using the MP technique with CEM appeared successful in avoiding RCT intervention. These two reports of case outcome suggest that simple MP using a CEM bioregenerative technique may provide a favorable outcome for permanent teeth diagnosed with irreversible pulpitis and associated with apical periodontitis.

  12. Frequency of second mesiobuccal canal in permanent maxillary first molars using the operating microscope and selective dentin removal: A clinical study.

    PubMed

    Das, Suroopa; Warhadpande, Manjusha M; Redij, Saurabh A; Jibhkate, N G; Sabir, Husain

    2015-01-01

    The aim of this study was to investigate whether the combination of operating microscope and selective dentin removal increased the frequency of second mesiobuccal (MB2) canal detection in permanent maxillary first molar teeth. One hundred fifty permanent maxillary first molars indicated for root canal treatment were randomly selected from patients belonging to the age group of 18-45 years irrespective of gender. After access cavity preparation and location of main canals, the MB2 canal orifice was sought in all teeth with an endodontic explorer under direct vision (Stage I), then under magnification with the aid of operating microscope (Stage II) and finally with the combined use of operating microscope and selective dentin removal (Stage III). MB2 canals were detected in 36%, 54% and 72% of the teeth in Stages I-III, respectively. This study demonstrated that dental operating microscope when used along with adjunctive aids such as selective dentin removal/troughing and good clinical knowledge will increase the ability of dental clinician to locate MB2 canals.

  13. Profile of vemurafenib-induced severe skin toxicities.

    PubMed

    Peuvrel, L; Quéreux, G; Saint-Jean, M; Brocard, A; Nguyen, J M; Khammari, A; Knol, A C; Varey, E; Dréno, B

    2016-02-01

    Vemurafenib, a BRAF inhibitor, is commonly associated with skin toxicity. The impact of severe forms is unknown. To determine the rate of permanent vemurafenib discontinuation due to grade 3-4 skin toxicity, features of these toxicities, their recurrence rate after a switch to dabrafenib and their impact on overall survival. Retrospective cohort study of 131 patients treated with vemurafenib for melanoma between November 2010 and December 2014. Data on skin toxicities, the need for vemurafenib adjustment and the impact of switching to dabrafenib were collected. Regarding survival analysis, a conditional landmark analysis was performed to correct lead-time bias. Among the 131 vemurafenib-treated patients, 26% developed grade 3-4 skin toxicity. Forty-four percent of them permanently discontinued their treatment, mainly due to rash and classic skin adverse reactions (Steven-Johnson syndrome, Drug Reaction with Eosinophilia and Systemic Symptoms). Conversely, photosensitivity and carcinomas rarely required treatment adjustment. Grade 3-4 rashes were associated with clinical or biological abnormalities in 94% of patients. Among the 10 patients who subsequently switched to dabrafenib, skin toxicity recurred only in one patient. Overall survival was significantly prolonged in case of severe skin toxicity emerging within the first 4 (P = 0.014) and 8 weeks (P = 0.038) on vemurafenib, with only a trend at 12 weeks (P = 0.052). Median overall survival was also prolonged in case of severe rash. In this study, vemurafenib was continued in 56% of patients with grade 3-4 skin toxicity, which was associated with prolonged overall survival when emerging within the first 4 and 8 weeks of treatment. While developing severe skin adverse reactions permanently contraindicates vemurafenib use, other rashes should lead to retreatment attempts with dose reduction. In case of recurrence, dabrafenib seems to be an interesting option. For other skin toxicities, including photosensitivity and cutaneous carcinoma, treatment adjustment is usually not needed. © 2015 European Academy of Dermatology and Venereology.

  14. Magnetic superelevation design of Halbach permanent magnet guideway for high-temperature superconducting maglev

    NASA Astrophysics Data System (ADS)

    Lei, Wuyang; Qian, Nan; Zheng, Jun; Huang, Huan; Zhang, Ya; Deng, Zigang

    2017-07-01

    To improve the curve negotiating ability of high-temperature superconducting (HTS) maglev system, a special structure of magnetic superelevation for double-pole Halbach permanent magnet guideway (PMG) was designed. The most significant feature of this design is the asymmetrical PMG that forms a slanting magnetic field without affecting the smoothness of the PMG surface. When HTS maglev vehicle runs through curves with magnetic superelevation, the vehicle will slant due to asymmetry in magnetic field and the flux-pinning effect of onboard HTS bulks. At the same time, one component of the levitation force provides a part of the centripetal force that reduces lateral acceleration of the vehicle and thus enhances its curve negotiating ability. Furthermore, the slant angle of magnetic superelevation can be adjusted by changing the materials and the thickness of the added permanent magnets. This magnetic superelevation method, together with orographic uplift, can be applied to different requirements of PMG designs. Besides, the applicability of this method would benefit future development of high-speed HTS maglev system.

  15. Design and analysis of a new flux-intensifying permanent magnet brushless motor with multilayer flux barriers

    NASA Astrophysics Data System (ADS)

    Yang, Shen; Zhu, Xiaoyong; Xiang, Zixuan; Fan, Deyang; Wu, Wenye; Yin, Jianing

    2017-05-01

    This paper proposes a new flux-intensifying permanent magnet brushless motor for potential application in electric vehicles. The key of the proposed motor is to adopt the concept of flux-intensifying effect, thus the preferable flux-weakening ability and extended speed range can be achieved. The usage of segmented and relatively thinner permanent magnet (PM) in the proposed motor contributes to the increase of d-axis inductance Ld. In addition, the multilayer flux barriers along q-axis flux path will effectively decrease q-axis inductance Lq. As a result, the unique feature of Ld>Lq can be obtained, which is beneficial to extending the speed range of the proposed motor. Furthermore, the flux-intensifying effect can reduce the risk of irreversible demagnetization in PMs. The electromagnetic performances of the proposed motor are analyzed and investigated in details by using the finite element methods, which demonstrate the excellent flux-weakening capability and wide speed range can be achieved in the proposed FI-PMBL motor.

  16. An all permanent magnet electron cyclotron resonance ion source for heavy ion therapy.

    PubMed

    Cao, Yun; Li, Jia Qing; Sun, Liang Ting; Zhang, Xue Zhen; Feng, Yu Cheng; Wang, Hui; Ma, Bao Hua; Li, Xi Xia

    2014-02-01

    A high charge state all permanent Electron Cyclotron Resonance ion source, Lanzhou All Permanent ECR ion source no. 3-LAPECR3, has been successfully built at IMP in 2012, which will serve as the ion injector of the Heavy Ion Medical Machine (HIMM) project. As a commercial device, LAPECR3 features a compact structure, small size, and low cost. According to HIMM scenario more than 100 eμA of C(5+) ion beam should be extracted from the ion source, and the beam emittance better than 75 π*mm*mrad. In recent commissioning, about 120 eμA of C(5+) ion beam was got when work gas was CH4 while about 262 eμA of C(5+) ion beam was obtained when work gas was C2H2 gas. The design and construction of the ion source and its low-energy transportation beam line, and the preliminary commissioning results will be presented in detail in this paper.

  17. Breast cancer detection in axillary sentinel lymph nodes: the impact of the method of pathologic examination.

    PubMed

    Calhoun, Benjamin C; Chambers, Karinn; Flippo-Morton, Teresa; Livasy, Chad A; Armstrong, Edward J; Symanowski, James T; Sarantou, Terry; Greene, Frederick L; White, Richard L

    2014-12-01

    At Carolinas Medical Center, before 2008, axillary sentinel lymph nodes (SLNs) from breast cancer patients were evaluated with a single hematoxylin and eosin-stained slide. In 2008, the protocol changed to include a limited step sectioning at 500 μm. In this study, we compared the intraoperative and permanent section pathologic findings for SLN biopsies from 2006 to 2007 to those from 2009 to 2010. We hypothesized that evaluating 2 slides would increase the detection of micrometastases and isolated tumor cells (ITCs) on permanent sections and correspondingly decrease the sensitivity of intraoperative touch preparation cytology (IOTPC). From 2006 to 2007, 140 (23.5%) of 597 of SLN permanent sections contained tumor cells: 92 macrometastases (65.7%), 36 micrometastases (25.7%), and 12 ITCs 0.2 mm or less (8.6%). The sensitivity of IOTPC for 2006 to 2007 was 51.4% for any tumor cells and 71.7% for macrometastases. From 2009 to 2010, 160 (21.9%) of 730 SLN permanent sections were positive for any tumor cells: 76 macrometastases (47.5%), 55 micrometastases (34.4%), and 29 ITCs (18.1%). The sensitivity of IOTPC for 2009 to 2010 was 39.4% for any tumor cells and 76.3% for macrometastases. With limited step sectioning, we observed an approximately 10% increase in the detection of both micrometastases and ITCs in SLN. The increased detection of ITCs on permanent sections reached statistical significance (P = .018). However, under current clinical guidelines, patients with limited SLN involvement may not be required to undergo completion axillary lymph node dissection. The ability to detect SLN tumor deposits less than 2 mm must be balanced with the clinical utility of doing so. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Clinical manifestations of postpartum thyroid disease.

    PubMed

    Lazarus, J H

    1999-07-01

    Postpartum thyroiditis (PPT) occurs in 5%-9% of unselected postpartum women; hyperthyroidism and hypothyroidism develop, the latter being permanent, in up to 25 %-30% of women. PPT is strongly associated with antithyroid peroxidase (anti-TPO) antibodies, but 50% of anti-TPO positive women do not develop thyroid dysfunction. Symptom analysis has shown that lack of energy and irritability were the most frequent hyperthyroid symptoms whereas lack of energy, aches and pains, poor memory, dry skin, and cold intolerance were the significant hypothyroid features. Some of these symptoms were more frequently observed than in antibody-negative controls even when these patients were euthyroid and in anti-TPOAb positive women who did not develop PPT at all. The diagnosis of PPT is based on the observation of abnormal thyroid function tests in a postpartum anti-TPOAb-positive woman: transient hyperthyroidism occurs at 14 weeks and hypothyroidism at 19 weeks postpartum. Diffuse or multifocal hypoechogenicity of the thyroid is seen on echography and a thyroid destructive process is evidenced by an increase in serum thyroglobulin and urinary iodine excretion. In addition to the 25%-30% of women who develop permanent hypothyroidism at 3 years, recent data indicate that 50% of women who have developed PPT will be hypothyroid 7-9 years later. The long-term risk is only 5% for those anti-TPOAb positive women not developing thyroid dysfunction postpartum. The risk of recurrent PPT is 70% if previous PPT was experienced and 25% if the patient was euthyroid after the first pregnancy.

  19. [SICI-GISE position paper on drug-coated balloon use in the coronary district].

    PubMed

    Cortese, Bernardo; Sgueglia, Gregory A; Berti, Sergio; Biondi-Zoccai, Giuseppe; Colombo, Antonio; Limbruno, Ugo; Bedogni, Francesco; Cremonesi, Alberto

    2013-10-01

    Drug-coated balloons are a new tool for the treatment of patients with coronary artery disease. The main feature of this technology is a rapid and homogeneous transfer of an antiproliferative drug (paclitaxel) to the vessel wall just at the time of balloon inflation, when neointimal proliferation, in response to angioplasty, is the highest. Moreover, drug-coated balloons share adjunctive advantages over stents: the absence of permanent scaffold and polymer, the respect of the original coronary anatomy, and limited inflammatory stimuli, thereby allowing for short-term dual antiplatelet therapy. At present, a variety of devices are available in the market, with limited scientific data for the vast majority of them. Thus, the Italian Society of Interventional Cardiology (SICI-GISE) decided to coordinate the efforts of a group of renowned experts in this field, in order to produce a position paper on the correct use of drug-coated balloons in all settings of coronary artery disease, giving a class of indication to each one, based on clinical evidence. This position paper represents a quick reference for operators, investigators and manufacturers to promote the understanding and the correct use of the drug-coated balloon technology in everyday clinical practice.

  20. New-generation devices for transcatheter aortic valve implantation.

    PubMed

    Gatto, Laura; Biondi-Zoccai, Giuseppe; Romagnoli, Enrico; Frati, Giacomo; Prati, Francesco; Giordano, Arturo

    2018-04-20

    Transcatheter aortic valve implantation (TAVI) has overcome the pioneering phase and thanks to accrued clinical evidence has become a mainstay alternative to surgical aortic valve replacement (SAVR) in patients at high risk for post-operative complications. Despite these successes, TAVI remains a junior technology facing momentous developments in techniques and devices. Indeed, several new-generation devices for TAVI have become available in the last few years, including Acurate, Allegra, Evolut, Lotus, JenaValve, Portico, and SAPIEN3. Despite the inevitable setbacks, such as the one represented by DirectFlow, these new devices appear associated with comparative benefits, especially for minimal invasiveness, rates of permanent pacemaker implantation, and risk of residual aortic regurgitation. Indeed, no single device appears clearly better than the others, and a tailored and individualized approach should be sought in using these prostheses, taking into account operator and institutional expertise, on top of patient features. Few comparative effectiveness studies are available to date to guide decision making, and thus careful scrutiny is needed even in everyday clinical practice, especially if seeking to expand the current indications of TAVI. Further guidance will however come from long-term follow-up of completed studies and from results of ongoing trials.

  1. Anti-inflammatory and antioxidant effects of Tualang honey in alkali injury on the eyes of rabbits: Experimental animal study

    PubMed Central

    2011-01-01

    Background Alkali injury is one of the most devastating injuries to the eye. It results in permanent unilateral or bilateral visual impairment. Chemical eye injury is accompanied by an increase in the oxidative stress. Anti-inflammatory and antioxidant agents play a major role in the treatment of chemical eye injuries. The purpose of this study is to evaluate the anti-inflammatory (clinical and histopathological) and antioxidant effects of Tualang honey versus conventional treatment in alkali injury on the eyes of rabbits. Methods A preliminary study was carried out prior to the actual study to establish the alkali chemical injury on rabbit's cornea and we found that alkali chemical injury with 2 N NaOH showed severe clinical inflammatory features. In actual study, alkali injury with 2 N NaOH was induced in the right eye of 10 New Zealand White rabbits' cornea. The rabbits were divided into two groups, Group A was given conventional treatment and Group B was treated with both topical and oral Tualang honey. Clinical inflammatory features of the right eye were recorded at 12 hours, 24 hours, 72 hours, 5th day and 7th day post induction of alkali burn on the cornea. The histopathological inflammatory features of the right corneas of all rabbits were also evaluated on day-7. The level of total antioxidant status and lipid peroxidation products in the aqueous humour, vitreous humour and serum at day-7 were estimated biochemically. Fisher's Exact, Chi-Square and Mann-Whitney test were used to analyse the data. Results There was no statistically significant difference in clinical inflammatory features (p > 0.05) between honey treated and the conventional treated group at different times of examination. Histopathological examination of the cornea showed the number of polymorphonuclear leucocytes was below 50 for both groups (mild grade). There was also no significant difference in the level of total antioxidant status as well as lipid peroxidation products in aqueous humour (p = 0.117, p = 0.382 respectively), vitreous humour (p = 0.917, p = 0.248 respectively) and serum (p = 0.917, p = 0.332 respectively) between honey treated and the conventional treated group. Conclusion Tualang honey has almost the equal effects when compared with the conventional treatment in treating alkali injury on rabbit's eye. Future research with more number of rabbits and control group is warranted to explore the anti-inflammatory and antioxidant effects of Tualang honey. PMID:21982267

  2. Anti-inflammatory and antioxidant effects of Tualang honey in alkali injury on the eyes of rabbits: experimental animal study.

    PubMed

    Bashkaran, Karuppannan; Zunaina, Embong; Bakiah, Shaharuddin; Sulaiman, Siti Amrah; Sirajudeen, Kns; Naik, Venkatesh

    2011-10-09

    Alkali injury is one of the most devastating injuries to the eye. It results in permanent unilateral or bilateral visual impairment. Chemical eye injury is accompanied by an increase in the oxidative stress. Anti-inflammatory and antioxidant agents play a major role in the treatment of chemical eye injuries. The purpose of this study is to evaluate the anti-inflammatory (clinical and histopathological) and antioxidant effects of Tualang honey versus conventional treatment in alkali injury on the eyes of rabbits. A preliminary study was carried out prior to the actual study to establish the alkali chemical injury on rabbit's cornea and we found that alkali chemical injury with 2 N NaOH showed severe clinical inflammatory features. In actual study, alkali injury with 2 N NaOH was induced in the right eye of 10 New Zealand White rabbits' cornea. The rabbits were divided into two groups, Group A was given conventional treatment and Group B was treated with both topical and oral Tualang honey. Clinical inflammatory features of the right eye were recorded at 12 hours, 24 hours, 72 hours, 5th day and 7th day post induction of alkali burn on the cornea. The histopathological inflammatory features of the right corneas of all rabbits were also evaluated on day-7. The level of total antioxidant status and lipid peroxidation products in the aqueous humour, vitreous humour and serum at day-7 were estimated biochemically. Fisher's Exact, Chi-Square and Mann-Whitney test were used to analyse the data. There was no statistically significant difference in clinical inflammatory features (p > 0.05) between honey treated and the conventional treated group at different times of examination. Histopathological examination of the cornea showed the number of polymorphonuclear leucocytes was below 50 for both groups (mild grade). There was also no significant difference in the level of total antioxidant status as well as lipid peroxidation products in aqueous humour (p = 0.117, p = 0.382 respectively), vitreous humour (p = 0.917, p = 0.248 respectively) and serum (p = 0.917, p = 0.332 respectively) between honey treated and the conventional treated group. Tualang honey has almost the equal effects when compared with the conventional treatment in treating alkali injury on rabbit's eye. Future research with more number of rabbits and control group is warranted to explore the anti-inflammatory and antioxidant effects of Tualang honey.

  3. Technological and economical analysis of salient pole and permanent magnet synchronous machines designed for wind turbines

    NASA Astrophysics Data System (ADS)

    Gündoğdu, Tayfun; Kömürgöz, Güven

    2012-08-01

    Chinese export restrictions already reduced the planning reliability for investments in permanent magnet wind turbines. Today the production of permanent magnets consumes the largest proportion of rare earth elements, with 40% of the rare earth-based magnets used for generators and other electrical machines. The cost and availability of NdFeB magnets will likely determine the production rate of permanent magnet generators. The high volatility of rare earth metals makes it very difficult to quote a price. Prices may also vary from supplier to supplier to an extent of up to 50% for the same size, shape and quantity with a minor difference in quality. The paper presents the analysis and the comparison of salient pole with field winding and of peripheral winding synchronous electrical machines, presenting important advantages. A neodymium alloy magnet rotor structure has been considered and compared to the salient rotor case. The Salient Pole Synchronous Machine and the Permanent Magnet Synchronous Machine were designed so that the plate values remain constant. The Eddy current effect on the windings is taken into account during the design, and the efficiency, output power and the air-gap flux density obtained after the simulation were compared. The analysis results clearly indicate that Salient Pole Synchronous Machine designs would be attractive to wind power companies. Furthermore, the importance of the design of electrical machines and the determination of criteria are emphasized. This paper will be a helpful resource in terms of examination and comparison of the basic structure and magnetic features of the Salient Pole Synchronous Machine and Permanent Magnet Synchronous Machine. Furthermore, an economic analysis of the designed machines was conducted.

  4. Assessing the mechanism of response in the retrosplenial cortex of good and poor navigators☆

    PubMed Central

    Auger, Stephen D.; Maguire, Eleanor A.

    2013-01-01

    The retrosplenial cortex (RSC) is consistently engaged by a range of tasks that examine episodic memory, imagining the future, spatial navigation, and scene processing. Despite this, an account of its exact contribution to these cognitive functions remains elusive. Here, using functional MRI (fMRI) and multi-voxel pattern analysis (MVPA) we found that the RSC coded for the specific number of permanent outdoor items that were in view, that is, items which are fixed and never change their location. Moreover, this effect was selective, and was not apparent for other item features such as size and visual salience. This detailed detection of the number of permanent items in view was echoed in the parahippocampal cortex (PHC), although the two brain structures diverged when participants were divided into good and poor navigators. There was no difference in the responsivity of the PHC between the two groups, while significantly better decoding of the number of permanent items in view was possible from patterns of activity in the RSC of good compared to poor navigators. Within good navigators, the RSC also facilitated significantly better prediction of item permanence than the PHC. Overall, these findings suggest that the RSC in particular is concerned with coding the presence of every permanent item that is in view. This mechanism may represent a key building block for spatial and scene representations that are central to episodic memories and imagining the future, and could also be a prerequisite for successful navigation. PMID:24012136

  5. The Multidimensional Structure of University Absenteeism: An Exploratory Study

    ERIC Educational Resources Information Center

    López-Bonilla, Jesús Manuel; López-Bonilla, Luis Miguel

    2015-01-01

    Absenteeism has been a common and very extended problem in university spheres for several years. This problem has become a permanent feature in academic studies in general, yet it has received scarce empirical research attention. This work is focused on the analysis of the factors that determine university absenteeism. It evaluates a series of…

  6. Productivism, Vocational and Professional Education, and the Ecological Question

    ERIC Educational Resources Information Center

    Anderson, Damon

    2008-01-01

    As the major supplier of skilled and certified labour, vocational and professional education (VPE) fuels the engine of economic growth. As such, it is directly implicated in the reproduction of productivism, the globally dominant ethos which presupposes that economic growth and paid work are permanent and necessary features of human existence,…

  7. 14 CFR 77.15 - Construction or alteration not requiring notice.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... existing structures of a permanent and substantial character or by natural terrain or topographic features... where it is evident beyond all reasonable doubt that the structure so shielded will not adversely affect safety in air navigation. (b) Any antenna structure of 20 feet or less in height except one that would...

  8. Access to Information and Freedom of Information Requests: Neglected Means of Data Production in the Social Sciences

    ERIC Educational Resources Information Center

    Walby, Kevin; Larsen, Mike

    2012-01-01

    Access to information (ATI) and freedom of information (FOI) mechanisms are now relevant features of governments in many liberal democracies today. Citizens, organizations, and permanent residents in several countries across the globe can request unpublished information from federal, provincial, state, county, and municipal government agencies.…

  9. Arctic Ocean Gravity Field Derived From ERS-1 Satellite Altimetry.

    PubMed

    Laxon, S; McAdoo, D

    1994-07-29

    The derivation of a marine gravity field from satellite altimetry over permanently ice-covered regions of the Arctic Ocean provides much new geophysical information about the structure and development of the Arctic sea floor. The Arctic Ocean, because of its remote location and perpetual ice cover, remains from a tectonic point of view the most poorly understood ocean basin on Earth. A gravity field has been derived with data from the ERS-1 radar altimeter, including permanently ice-covered regions. The gravity field described here clearly delineates sections of the Arctic Basin margin along with the tips of the Lomonosov and Arctic mid-ocean ridges. Several important tectonic features of the Amerasia Basin are clearly expressed in this gravity field. These include the Mendeleev Ridge; the Northwind Ridge; details of the Chukchi Borderland; and a north-south trending, linear feature in the middle of the Canada Basin that apparently represents an extinct spreading center that "died" in the Mesozoic. Some tectonic models of the Canada Basin have proposed such a failed spreading center, but its actual existence and location were heretofore unknown.

  10. RESIF national datacentre : new features and forthcoming evolutions

    NASA Astrophysics Data System (ADS)

    Pequegnat, C.; Volcke, P.; le Tanou, J.; Wolyniec, D.; Lecointre, A.; Guéguen, P.

    2013-12-01

    RESIF is a nationwide french project aimed at building an high quality system to observe and understand the inner earth. The goal is to create a network throughout mainland France comprising 750 seismometers and geodetic measurement instruments, 250 of which will be mobile, to enable the observation network to be focussed on specific investigation subjects and geographic locations. The RESIF data distribution centre, which is a part of the global project, is operated by the Université Joseph Fourier (Grenoble, France) and is being implemented for two years. Data from french broadband permanent network, strong motion permanent network, and mobile seismological antenna are freely accessible as realtime streams and continuous validated data, along with instrumental metadata, delivered using widely known formats and requests tools. New features of the datacentre are : - new modern distribution tools : two FDSN WEBservices has been implemented and deliver data and metadata. - new data and datasets : the number of permanent stations rose by over 40 % percent in one year and the RESIF archive now includes past data (down to 1995) and data from new networks. Moreover, data from mobile experiments prior to 2011 is progressively released, and data from new mobile experiments in the Alps and in the Pyrenean mountains is progressively integrated. - new infrastructures : (1) the RESIF databank is about to be connected to the grid storage of the University High Performance Computing (HPC) centre. As a scientific use case of this datacenter facility, a focus is made on intensive exploitation of combined data from permanent and mobile networks (2) the RESIF databank will be progressively hosted on a new shared storage facility operated by the Université Joseph Fourier. This infrastructure offers high availability data storage (both in blocks and files modes) as well as backup and long term archival capabilities, and will be fully operational at the beginning of 2014.

  11. Prolonged effect of a mother-child caries preventive program on dental caries in the permanent 1st molars in 9 to 10-year-old children.

    PubMed

    Gomez, Santiago S; Emilson, Claes-Göran; Weber, Adriana A; Uribe, Sergio

    2007-10-01

    To evaluate the prevalence of caries in the permanent 1st molars of a group of 9 to 10-year-old children, and to determine the long-term effect of a mother-child preventive dental program (PDP) that started when the women were pregnant and continued until the children were 6 years of age. The permanent 1st molars of 37 children in the PDP group were evaluated for caries, both clinically and radiographically, and compared with those of a control group of 42 children who had not participated in the PDP. Of children in the PDP group, 70% were caries free compared to 33% in the control group (p<0.001). Of permanent 1st molars in the PDP group, 87% were caries-free compared to 61% in the control group (p<0.001). The mean DFS of the PDP children 10 years of age was 0.519+/-0.93 versus 1.57+/-1.38 for the control children (p=0.002). Examination of children 4 years after discontinuation of a caries preventive program reflected a long-term reduction in the DFS score of permanent 1st molars.

  12. Exploring the Relationship Between Resilience and Ostomy Adjustment in Adults With a Permanent Ostomy.

    PubMed

    Scardillo, Jody; Dunn, Karen S; Piscotty, Ronald

    2016-01-01

    The aims of this study were to describe the relationship between resilience and ostomy adjustment in adults with permanent stomas and to determine if participants who report higher levels of resilience also report higher levels of adjustment to a permanent ostomy. Descriptive, correlational research design utilizing the Roy Adaptation Model as the theoretical framework was used. Persons with permanent stomas were recruited from ostomy support groups on the East Coast of the United States. The study sample included 48 respondents. Their mean age was 66 ± 12.7 years (mean ± SD); the majority (60.4%) were women, had an ileostomy (62.5%), and had a history of inflammatory bowel disease (62.5%). Respondents completed a questionnaire that queried demographic and pertinent clinical data, along with 2 previously validated instruments, the Resilience Scale and Ostomy Adjustment Inventory-23. The relationships between levels of resilience, levels of adjustment to an ostomy, and demographic characteristics were examined. Participants with higher levels of ostomy adjustment had higher levels of resilience than respondents who reported lower levels of ostomy adjustment (r = 0.65, P ≤ .01). Findings from this study suggest that higher levels of resilience facilitate adjustment to a permanent ostomy.

  13. A Longitudinal Study of the Presence of Dental Anomalies in the Primary and Permanent Dentitions of Cleft Lip and/or Palate Patients.

    PubMed

    Suzuki, Akira; Nakano, Masayuki; Yoshizaki, Keigo; Yasunaga, Atsushi; Haruyama, Naoto; Takahashi, Ichiro

    2017-05-01

      The aim is to survey primary and permanent dental anomalies: hypodontia, microdontia, a supernumerary tooth, and fused teeth in patients with cleft lip and/or palate.   Retrospective longitudinal study Subjects :  The subjects were selected from all 1724 patients with cleft lip and/or palate who were registered at the orthodontic clinic of Kyushu University Hospital, Fukuoka, Japan, from 1970 to 2009. Finally, 994 subjects were evaluated for primary dentition, 1352 for permanent dentition, and 871 for the longitudinal changes from primary to permanent dentition.   The prevalence of dental anomalies was compared for each tooth type, among various cleft types, between males and females, and between the alveolar cleft area and the noncleft area.   The prevalence of hypodontia was 16.2% for primary dentition and 52.7% for permanent dentition in the subjects with cleft lip and/or palate. Hypodontia increased with the severity of the cleft type. Multiple hypodontia was found more frequently in the subjects with bilateral cleft lip and palate and the subjects with unilateral cleft lip and palate. Microformed lateral incisors were found in 22.7% of permanent lateral incisors but not in primary dentition. Supernumerary teeth were found in 17.7% of the subjects with cleft lip and/or palate for primary maxillary dentition and in 5.7% for permanent maxillary dentition.   The prevalence of hypodontia was greater in permanent dentition than in primary dentition; although, it was not much different between males and females or between the right and left sides. The prevalence of dental anomalies was significantly different among four groups by cleft type: cleft lip, cleft lip and alveolus, cleft lip and palate, and cleft palate.

  14. Permanent right-to-left shunt is the key factor in managing patent foramen ovale.

    PubMed

    Rigatelli, Gianluca; Dell'Avvocata, Fabio; Cardaioli, Paolo; Giordan, Massimo; Braggion, Gabriele; Aggio, Silvio; Chinaglia, Mauro; Mandapaka, Sangeeta; Kuruvilla, John; Chen, Jack P; Nanjundappa, Aravinda

    2011-11-15

    We sought to prospectively evaluate risk of stroke and impact of transcatheter patent foramen ovale (PFO) closure in patients with permanent right-to left shunt compared with those with Valsalva maneuver-induced right-to-left shunt. Pathophysiology and properly management of PFO still remain far from being fully clarified: in particular, the contribution of permanent right-to-left shunt remains unknown. Between March 2006 and October 2010, we enrolled 180 (mean age 44 ± 10.9 years, 98 women) of 320 consecutive patients referred to our center for transcatheter PFO closure, who had spontaneous permanent right-to-left shunt on transcranial Doppler and transthoracic/transesophageal echocardiography. All patients fulfilled the standard current indications for transcatheter closure and underwent preoperative transesophageal echocardiography and brain magnetic resonance imaging, with subsequent intracardiac echocardiographic-guided transcatheter PFO closure. We compared the clinical echocardiographic characteristics of these patients (Permanent Group) with the rest of 140 patients with right-to-left shunt only during Valsalva maneuver (Valsalva Group). Compared with the Valsalva Group patients, patients of the Permanent Group had increased frequency of multiple ischemic brain lesions on magnetic resonance imaging, previous recurrent stroke, previous peripheral arteries embolism, migraine with aura, and-more frequently-atrial septal aneurysm and prominent Eustachian valve. The presence of permanent shunt confers the highest risk of recurrent stroke (odds ratio: 5.9, 95% confidence interval: 2.0 to 12, p < 0.001). No differences were recorded between the 2 groups with regard to recurrence of ischemic events after the closure procedure. Despite its small-sample nature, our study suggests that patients with permanent right-to-left shunt have potentially a higher risk of paradoxical embolism compared with those without. Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  15. Prevention and treatment of recurrent laryngeal nerve injury in thyroid surgery

    PubMed Central

    Jiang, Yan; Gao, Bo; Zhang, Xiaohua; Zhao, Jianjie; Chen, Jinping; Zhang, Shu; Luo, Donglin

    2014-01-01

    Aim: To summary the experience for prevention and treatment of recurrent laryngeal nerve (RLN) injury in thyroid surgery. Methods: Clinical features of 623 patients who received thyroid surgery from January 2010 to December 2012 were analyzed retrospectively, and the features of RLN injury and intraoperative as well as postoperative treatments were reviewed. Results: RLN injury occurred in 31 patients (4.98%), in which, unilateral RLN injury occurred in 27 patients and bilateral RLN injuries occurred in 4 patients (temporary injury in 28 patients and permanent injury in 3 patients). 6 patients underwent RLN anastomosis during surgery and exhibited transient hoarseness after surgery. RLN exploration and decompression was given in 1 patient and the patient got normal vocal cord motion 2 months after surgery. 1 patient with bilateral injuries received tracheotomy and CO2 laser resection of arytenoid cartilage and achieved recovery 1 year later. Conclusions: In order to prevent RLN injury, the anatomic variations of RLN should be mastered. Routine exposure of RLN can effectively prevent the injury in patients receiving the second or multiple surgeries. Early interventions for RLN injury include mainly early discovery, early exploration and early anastomosis, and the function of RLN in some patients can recover completely. Subsequent treatments mainly focus on the improvement of the voice, expansion of glottis and melioration of dyspnea. PMID:24482694

  16. An integrated mechanism of pediatric pseudotumor cerebri syndrome: evidence of bioenergetic and hormonal regulation of cerebrospinal fluid dynamics

    PubMed Central

    Sheldon, Claire A.; Kwon, Young Joon; Liu, Grant T.; McCormack, Shana E.

    2015-01-01

    Pseudotumor cerebri syndrome (PTCS) is defined by the presence of elevated intracranial pressure (ICP) in the setting of normal brain parenchyma and cerebrospinal fluid (CSF). Headache, vision changes, and papilledema are common presenting features. Up to 10% of appropriately treated patients may experience permanent visual loss. The mechanism(s) underlying PTCS is unknown. PTCS occurs in association with a variety of conditions, including kidney disease, obesity, and adrenal insufficiency, suggesting endocrine and/or metabolic derangements may occur. Recent studies suggest that fluid and electrolyte balance in renal epithelia is regulated by a complex interaction of metabolic and hormonal factors; these cells share many of the same features as the choroid plexus cells in the central nervous system (CNS) responsible for regulation of CSF dynamics. Thus, we posit that similar factors may influence CSF dynamics in both types of fluid-sensitive tissues. Specifically, we hypothesize that, in patients with PTCS, mitochondrial metabolites (glutamate, succinate) and steroid hormones (cortisol, aldosterone) regulate CSF production and/or absorption. In this integrated mechanism review, we consider the clinical and molecular evidence for each metabolite and hormone in turn. We illustrate how related intracellular signaling cascades may converge in the choroid plexus, drawing on evidence from functionally similar tissues. PMID:25420176

  17. Maintaining clinical tissue archives and supporting human research: challenges and solutions.

    PubMed

    Giannini, Caterina; Oelkers, Michael M; Edwards, William D; Aubry, Marie Christine; Muncil, Maureen M; Mohamud, Koshin H; Sandleback, Sara G; Nowak, John M; Bridgeman, Andrew; Brown, Marie E; Cheville, John C

    2011-03-01

    The increasing number of requests for use of clinically archived tissue in translational research poses unique challenges. Conflicts may arise between pathologists who are responsible for overseeing and preserving the tissues and investigators who need these materials for research purposes. To evaluate the status of our institution's Tissue Registry Archive and to develop updated written policies and procedures to support a new modern and robust tracking system with features of a library loan system. An observational study was performed. We found the existing process for managing loans of tissue (slides and paraffin blocks) to be insufficient for the complexity and volume of this task. After extensive customization, a new tracking system was implemented in January 2008. Analysis of the first year of the system's use (2008) showed that of the 206,330 slides and 51,416 blocks loaned out in 2008, 92% and 94%, respectively, were returned by the due date. These rates were markedly improved from those before the new system: 61% and 47%, respectively, in 2005. Material permanently "lost" in 2008 represented only 0.02% of slides and 0.05% of blocks, none of which was the only diagnostic material for the case. With expanding needs for archived tissues for clinical care and growing demands for translational research, it is essential that pathology departments at institutions with large tissue-based research endeavors have a tracking and management system in place to meet clinical, educational, and research needs, as well as legal requirements.

  18. Clinical characteristics of central diabetes insipidus in Taiwanese children.

    PubMed

    Liu, Shih-Yao; Tung, Yi-Ching; Lee, Cheng-Ting; Liu, Hon-Man; Peng, Shinn-Forng; Wu, Mu-Zon; Kuo, Meng-Fai; Tsai, Wen-Yu

    2013-10-01

    Data on the clinical features of children with central diabetes insipidus (CDI) are lacking in Taiwan. This study investigated the clinical manifestations and etiology of CDI in Taiwanese children. From 1983 to 2012, 62 children with permanent diabetes insipidus were enrolled in the study. They were diagnosed at the Department of Pediatrics of National Taiwan University Hospital. Their medical records were thoroughly reviewed and their clinical symptoms and signs, laboratory data, and etiologies were analyzed. The patients' median age at diagnosis was 10 years and the median interval between initial manifestations and diagnosis was 0.5 years. The most common symptoms and signs were polyuria, polydipsia, nocturia, and growth retardation. Most patients had low urine osmolality and elevated plasma osmolality on diagnosis. Absence of a posterior pituitary hyperintense signal and thickening of the pituitary stalk were common findings on magnetic resonance imaging. Approximately 80% of the patients had anterior pituitary hormone deficiency and all patients had growth hormone deficiency. Approximately 60% of patients had intracranial lesions, the most common causes of which were germ cell tumor and Langerhans cell histiocytosis. Two patients were initially believed to have idiopathic CDI but intracranial lesions were detected during the follow-up period. Because a delayed diagnosis of CDI is common in Taiwanese children, a high index of suspicion is important. The underlying etiology of CDI in children may not initially be obvious. Long-term surveillance is therefore necessary, especially for the early detection of evolving treatable intracranial lesions. Copyright © 2013. Published by Elsevier B.V.

  19. Mutations in COL1A1 and COL1A2 and dental aberrations in children and adolescents with osteogenesis imperfecta – A retrospective cohort study

    PubMed Central

    Dahllöf, Göran; Lindahl, Katarina; Kindmark, Andreas; Grigelioniene, Giedre; Åström, Eva; Malmgren, Barbro

    2017-01-01

    Osteogenesis imperfecta (OI) is a heterogeneous group of disorders of connective tissue, caused mainly by mutations in the collagen I genes (COL1A1 and COL1A2). Dentinogenesis imperfecta (DGI) and other dental aberrations are common features of OI. We investigated the association between collagen I mutations and DGI, taurodontism, and retention of permanent second molars in a retrospective cohort of 152 unrelated children and adolescents with OI. The clinical examination included radiographic evaluations. Teeth from 81 individuals were available for histopathological evaluation. COL1A1/2 mutations were found in 104 individuals by nucleotide sequencing. DGI was diagnosed clinically and radiographically in 29% of the individuals (44/152) and through isolated histological findings in another 19% (29/152). In the individuals with a COL1A1 mutation, 70% (7/10) of those with a glycine substitution located C-terminal of p.Gly305 exhibited DGI in both dentitions while no individual (0/7) with a mutation N-terminal of this point exhibited DGI in either dentition (p = 0.01). In the individuals with a COL1A2 mutation, 80% (8/10) of those with a glycine substitution located C terminal of p.Gly211 exhibited DGI in both dentitions while no individual (0/5) with a mutation N-terminal of this point (p = 0.007) exhibited DGI in either dentition. DGI was restricted to the deciduous dentition in 20 individuals. Seventeen had missense mutations where glycine to serine was the most prevalent substitution (53%). Taurodontism occurred in 18% and retention of permanent second molars in 31% of the adolescents. Dental aberrations are strongly associated with qualitatively changed collagen I. The varying expressivity of DGI is related to the location of the collagen I mutation. Genotype information may be helpful in identifying individuals with OI who have an increased risk of dental aberrations. PMID:28498836

  20. Association of tumor growth on nude mice and poor clinical outcome in soft tissue sarcoma patients.

    PubMed

    Budach, W; Budach, V

    2001-09-01

    Permanent growth in nude mice (PGNM) may be associated with poor clinical outcome. We tested this hypothesis in a group of soft tissue sarcoma (STS) patients. Small chunks from fresh tumor biopsies of 81 patients with STS were transplanted subcutaneously into NMRI-nu/nu nude mice. Tumor cell lines exhibiting growth in nude mice for more than three tumor passages were considered as permanently established. Clinical outcome of all patients was monitored with a median follow-up of 38 months. 39/81 (48%) STSs exhibited PGNM. High grade, high S-phase proportion, and aneuploidy were significant predictors of PGNM. Overall survival (OS) at 3 years was 21% (+7% standard error of median) for STS patients with PGNM and 53% (+/-8%) for patients without PGNM (P<0.01). Considering only patients without distant metastasis at the time of biopsy (n = 49), 3-year-OS was 25% (+/-10%) and 71% (+/-9%) for STS with PGNM and without PGNM, respectively (P<0.01). In the univariate analysis, PGNM, aneuploidy high S-phase proportion, tumor location at the trunk, high tumor grade, and non-liposarcoma histology were associated with reduced survival time. In the multivariate analysis, aneuploidy and tumor location at the trunk were the only independent predictors of overall survival. Permanent growth of STS on nude mice is associated with poor clinical outcome in the univariate analysis, but is not an independent predictor of survival in the multivariate analysis due to a strong co-correlation to other known adverse prognostic factors.

  1. Will permanent LVADs be better than heart transplantation?

    PubMed

    Massad, M G; McCarthy, P M

    1997-04-01

    Current interest in permanent mechanical support systems has been renewed as a result of the present shortage of human heart donors, and in view of the satisfactory results obtained with their use as a bridge-to-transplant. As the number of donors is unlikely to increase dramatically in the near future, there is an urgent need to develop mechanical alternatives to transplantation. Preliminary data on the use of the implantable electric LVAD as a bridge-to-transplant indicate that the adverse clinical and mechanical events in outpatients are few and do not preclude use of the device on a permanent basis. Except for infections, transplant issues relating to need for endomyocardial biopsies, rejection, malignancies, and graft arteriosclerosis do not apply to LVAD recipients who face important issues relating to device durability, cost, and potential need for concomitant right heart support. This lack of data on long-term durability contrasts with a yearly mortality rate of about 5% after the first year of transplant. With the initiation of clinical trials on the permanent use of the electric LVAD, several design modifications and upgrading of the currently available devices are expected. Completely sealed systems with steadily improving durability will hopefully appear. Inductive coupling techniques under investigation and development appear to be able to transmit energy without damage across the skin. It is anticipated that with more reliable electronic microprocessors, the future generation of implantable LVADs will be smaller, more reliable and longer lasting.

  2. Postoperative chronic renal failure: a new syndrome?

    PubMed Central

    Merino, G E; Buselmeier, T J; Kjellstrand, C M

    1975-01-01

    Of 125 patients with postsurgical acute tubular necrosis, 87 died, 34 regained clinical normal renal function, and 4 survivors (9.5%) were left with severe permanent renal failure, two of whom required chronic dialysis and transplantation. Preoperatively these 4 patients had normal renal function. The 4 patients were above age 60, two had undergone methoxyflurane anesthesia, and nephrotoxic antibiotics were used in all. The incidence of permanent renal failure is much higher than ever reported and may reflect the survival of patients who previously died because of less ideal dialysis. We believe that the cause of this permanent lesion is multifactorial, including age (over 60 years), nephrotoxic antibiotics (particularly cephalothin and gentamicin sulfate), and nephrotoxic anesthetic (methoxyflurane) agents. This combination of factors should be avoided whenever possible. Images Fig. 2. PMID:1147707

  3. COMPARISON OF PERMANENT STAINING METHODS FOR THE LABORATORY DIAGNOSIS OF TRICHOMONIASIS

    PubMed Central

    MENEZES, Camila Braz; MELLO, Mariana dos Santos; TASCA, Tiana

    2016-01-01

    Trichomonas vaginalis is the etiologic agent of trichomoniasis, the most common non-viral sexually transmitted disease (STD) in the world. The diagnosis is based on wet mount preparation and direct microscopy on fixed and stained clinical specimens. The aim of this study was to compare the performance of different fixing and staining techniques used in the detection of T. vaginalis in urine. The smears were fixed and submitted to different methods of permanent staining and then, the morphological aspects of the parasites were analyzed and compared. The Papanicolaou staining with ethanol as the fixative solution showed to be the best method of permanent staining. Our data suggest that staining techniques in association with wet mount examination of fresh specimens contribute to increase the sensitivity in the diagnosis of trichomoniasis. PMID:26910452

  4. Targeted delivery of brain-derived neurotrophic factor for the treatment of blindness and deafness

    PubMed Central

    Khalin, Igor; Alyautdin, Renad; Kocherga, Ganna; Bakar, Muhamad Abu

    2015-01-01

    Neurodegenerative causes of blindness and deafness possess a major challenge in their clinical management as proper treatment guidelines have not yet been found. Brain-derived neurotrophic factor (BDNF) has been established as a promising therapy against neurodegenerative disorders including hearing and visual loss. Unfortunately, the blood–retinal barrier and blood–cochlear barrier, which have a comparable structure to the blood–brain barrier prevent molecules of larger sizes (such as BDNF) from exiting the circulation and reaching the targeted cells. Anatomical features of the eye and ear allow use of local administration, bypassing histo-hematic barriers. This paper focuses on highlighting a variety of strategies proposed for the local administration of the BDNF, like direct delivery, viral gene therapy, and cell-based therapy, which have been shown to successfully improve development, survival, and function of spiral and retinal ganglion cells. The similarities and controversies for BDNF treatment of posterior eye diseases and inner ear diseases have been analyzed and compared. In this review, we also focus on the possibility of translation of this knowledge into clinical practice. And finally, we suggest that using nanoparticulate drug-delivery systems may substantially contribute to the development of clinically viable techniques for BDNF delivery into the cochlea or posterior eye segment, which, ultimately, can lead to a long-term or permanent rescue of auditory and optic neurons from degeneration. PMID:25995632

  5. High-quality permanent draft genome sequence of Bradyrhizobium sp. Th.b2, a microsymbiont of Amphicarpaea bracteata collected in Johnson City, New York

    DOE PAGES

    Tian, Rui; Parker, Matthew; Seshadri, Rekha; ...

    2015-05-16

    Bradyrhizobium sp. Th.b2 is an aerobic, motile, Gram-negative, non-spore-forming rod that was isolated from an effective nitrogen-fixing root nodule of Amphicarpaea bracteata collected in Johnson City, New York. Here we describe the features of Bradyrhizobium sp. Th.b2, together with high-quality permanent draft genome sequence information and annotation. The 10,118,060 high-quality draft genome is arranged in 266 scaffolds of 274 contigs, contains 9,809 protein-coding genes and 108 RNA-only encoding genes. In conclusion, this rhizobial genome was sequenced as part of the DOE Joint Genome Institute 2010 Genomic Encyclopedia for Bacteria and Archaea-Root Nodule Bacteria (GEBA-RNB) project.

  6. High-quality permanent draft genome sequence of Bradyrhizobium sp. Th.b2, a microsymbiont of Amphicarpaea bracteata collected in Johnson City, New York

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

    Tian, Rui; Parker, Matthew; Seshadri, Rekha

    Bradyrhizobium sp. Th.b2 is an aerobic, motile, Gram-negative, non-spore-forming rod that was isolated from an effective nitrogen-fixing root nodule of Amphicarpaea bracteata collected in Johnson City, New York. Here we describe the features of Bradyrhizobium sp. Th.b2, together with high-quality permanent draft genome sequence information and annotation. The 10,118,060 high-quality draft genome is arranged in 266 scaffolds of 274 contigs, contains 9,809 protein-coding genes and 108 RNA-only encoding genes. In conclusion, this rhizobial genome was sequenced as part of the DOE Joint Genome Institute 2010 Genomic Encyclopedia for Bacteria and Archaea-Root Nodule Bacteria (GEBA-RNB) project.

  7. A compact permanent magnet cyclotrino for accelerator mass spectrometry

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

    Young, A.T.; Clark, D.J.; Kunkel, W.B.

    1995-02-01

    The authors describe the development of a new instrument for the detection of trace amounts of rare isotopes, a Cyclotron Mass Spectrometer (CMS). A compact low energy cyclotron optimized for high mass resolution has been designed and has been fabricated. The instrument has high sensitivity and is designed to measure carbon-14 at abundances of < 10{sup {minus}12}. A novel feature of the instrument is the use of permanent magnets to energize the iron poles of the cyclotron. The instrument uses axial injection, employing a spiral inflector. The instrument has been assembled and preliminary measurements of the magnetic field show thatmore » it has a uniformity on the order of 2 parts in 10{sup 4}.« less

  8. CBCT evaluation of multiple idiopathic internal resorptions in permanent molars: case report.

    PubMed

    Kalender, Atakan; Oztan, Meltem D; Basmaci, Fatma; Aksoy, Umut; Orhan, Kaan

    2014-04-16

    Internal inflammatory root resorption is a rare condition in permanent teeth, which requires the presence of necrotic and infected pulp tissue within the coronal portion of the root canal system as well as inflamed pulp tissue apical to the resorptive defect. The aetiology of internal root resorption is not completely understandable, trauma and chronic pulpitis are considered the main risk factors. We report a rare case of the multiple idiopathic resorption in the permanent maxillary and mandibular molars in a healthy 33-year-old female patient. In addition to clinical examination the patient was imaged using conventional radiography techniques and cone beam computed tomography (CBCT).The patient had recurrent throbbing pain in her # 46. The radiographic examination including "panoramic radiography and CBCT" revealed that radiographic evidence of internal resorption in #37 #36 #35 #34 #33 #47 #46 #45 #44 #43 #16 #15 #14 #13 and also including in unerupted #17, #26, #27, #28 teeth. The definitive diagnosis was made with the histopathological examination of the extracted tooth. Internal root resorption is a rare clinical process that should be examined using different radiographic modalities. CBCT seems to be useful in evaluation of the lesions with superior diagnostic performance.

  9. A Treatment Protocol for Restoring Occlusal Vertical Dimension Using an Overlay Removable Partial Denture as an Alternative to Extensive Fixed Restorations: A Clinical Report

    PubMed Central

    Patel, Mit B; Bencharit, Sompop

    2009-01-01

    Treatment options for patients with severe attrition resulting in reduced occlusal vertical dimension are often limited to fixed prosthesis to reestablish proper occlusal vertical dimension and functional occlusion. In some cases such as when there are limited finances, minimal esthetic concerns, and medical considerations fixed prosthesis may not be the ideal treatment option. Overlay removable partial dentures (ORPDs) can be used as a provisional or interim prosthesis as well as permanent prosthesis in these cases. While ORPDs can provide a reversible and relatively inexpensive treatment for patients with a significantly compromised dental status, there is not much scientific evidence in the literature on ORPDs. Most studies published on ORPDs to date are primarily reviews and clinical reports. In this article, literatures on ORPDs are summarized and a patient treated with interim and permanent ORPDs is presented. This article reviews previously published literatures on the use of ORPDs. Indications, advantages and disadvantages are discussed. Treatment protocol with an example of the prosthodontic treatment of a patient with severely worn dentition with an interim ORPD and later a permanent ORPD are discussed in details. PMID:19915723

  10. The Growing Genetic and Functional Diversity of Extended Spectrum Beta-Lactamases

    PubMed Central

    Ali, Tariq

    2018-01-01

    The β-lactams—a large class of diverse compounds—due to their excellent safety profile and broad antimicrobial spectrum are considered to be the most widely used therapeutic class of antibacterials prescribed in human and veterinary clinical practices. This, unfortunately, has also given rise to a continuous increased resistance globally in health care settings as well as in the community due to their permanent selective force driving diversification of the resistance mechanism. Resistance against β-lactams is increasing rapidly as novel β-lactamases, enzymes that degrade β-lactams, are being discovered each day such as recent emergence of extended spectrum β-lactamases (ESBL) that have the ability to inactivate most of the cephalosporins. The complexity and diversity of ESBL are increasing so rapidly that more than 170 variants have thus far been described for only a single genotype, the blaCTX-M-encoding ESBL. This review is to organize all the current updated literature describing genomic features, organization, and mechanism of resistance and mode of dissemination of all known ESBLs. PMID:29780833

  11. Historic land use and grazing patterns in northern New Mexico

    Treesearch

    Carol Raish

    1996-01-01

    The entrance of the Spanish into what is now New Mexico in the 1500s permanently altered aboriginal land use and subsistence patterns by the introduction of domesticated animals such as horses, cattle. sheep, goats, and pigs. During the Spanish Colonial and Mexican periods, both the Puebloan groups and the Hispanic settlers practiced mixed farming featuring small...

  12. The "Set Map" Method of Navigation.

    ERIC Educational Resources Information Center

    Tippett, Julian

    1998-01-01

    Explains the "set map" method of using the baseplate compass to solve walkers' navigational needs as opposed to the 1-2-3 method for taking a bearing. The map, with the compass permanently clipped to it, is rotated to the position in which its features have the same orientation as their counterparts on the ground. Includes directions and…

  13. Evolution of Apprenticeships and Traineeships in Australia: An Unfinished History. Occasional Paper

    ERIC Educational Resources Information Center

    Knight, Brian

    2012-01-01

    This paper traces the evolution of Australia's apprenticeship and traineeship system since permanent European settlement in 1788. The system was imported from Great Britain; it has evolved and diverged in some areas but retains many of the features of the British model. Most major changes have occurred in the last 25 years. The apprenticeship…

  14. Annotated bibliography of remote sensing methods for monitoring desertification

    USGS Publications Warehouse

    Walker, A.S.; Robinove, Charles J.

    1981-01-01

    Remote sensing techniques are valuable for locating, assessing, and monitoring desertification. Remotely sensed data provide a permanent record of the condition of the land in a format that allows changes in land features and condition to be measured. The annotated bibliography of 118 items discusses remote sensing methods that may be applied to desertification studies.

  15. Evidence-based clinical practice guideline for the use of pit-and-fissure sealants: A report of the American Dental Association and the American Academy of Pediatric Dentistry.

    PubMed

    Wright, John T; Crall, James J; Fontana, Margherita; Gillette, E Jane; Nový, Brian B; Dhar, Vineet; Donly, Kevin; Hewlett, Edmond R; Quinonez, Rocio B; Chaffin, Jeffrey; Crespin, Matt; Iafolla, Timothy; Siegal, Mark D; Tampi, Malavika P; Graham, Laurel; Estrich, Cameron; Carrasco-Labra, Alonso

    2016-08-01

    This article presents evidence-based clinical recommendations for the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars in children and adolescents. A guideline panel convened by the American Dental Association (ADA) Council on Scientific Affairs and the American Academy of Pediatric Dentistry conducted a systematic review and formulated recommendations to address clinical questions in relation to the efficacy, retention, and potential side effects of sealants to prevent dental caries; their efficacy compared with fluoride varnishes; and a head-to-head comparison of the different types of sealant material used to prevent caries on pits and fissures of occlusal surfaces. This is an update of the ADA 2008 recommendations on the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars. The authors conducted a systematic search in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and other sources to identify randomized controlled trials reporting on the effect of sealants (available on the US market) when applied to the occlusal surfaces of primary and permanent molars. The authors used the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the quality of the evidence and to move from the evidence to the decisions. The guideline panel formulated 3 main recommendations. They concluded that sealants are effective in preventing and arresting pit-and-fissure occlusal carious lesions of primary and permanent molars in children and adolescents compared with the nonuse of sealants or use of fluoride varnishes. They also concluded that sealants could minimize the progression of noncavitated occlusal carious lesions (also referred to as initial lesions) that receive a sealant. Finally, based on the available limited evidence, the panel was unable to provide specific recommendations on the relative merits of 1 type of sealant material over the others. These recommendations are designed to inform practitioners during the clinical decision-making process in relation to the prevention of occlusal carious lesions in children and adolescents. Clinicians are encouraged to discuss the information in this guideline with patients or the parents of patients. The authors recommend that clinicians reorient their efforts toward increasing the use of sealants on the occlusal surfaces of primary and permanent molars in children and adolescents. Copyright © 2016 American Academy of Pediatric Dentistry and American Dental Association. Published by Elsevier Inc. All rights reserved.

  16. Dentoskeletal features in individuals with ectopic eruption of the permanent maxillary first molar

    PubMed Central

    Rozzi, Matteo; Cardoni, Giulia; Ricchiuti, Maria Rosaria; Cozza, Paola

    2015-01-01

    Objective The aim of the study was to analyze the prevalence and distribution of ectopic eruption of the permanent maxillary first molar (EEM) in individuals scheduled for orthodontic treatment and to investigate the association of EEM with dental characteristics, maxillary skeletal features, crowding, and other dental anomalies. Methods A total of 1,317 individuals were included and randomly divided into two groups. The first 265 subjects were included as controls, while the remaining 1,052 subjects included the sample from which the final experimental EEM group was derived. The mesiodistal (M-D) crown width of the deciduous maxillary second molar and permanent maxillary first molar, maxillary arch length (A-PML), maxillomandibular transverse skeletal relationships (anterior and posterior transverse interarch discrepancies, ATID and PTID), maxillary and mandibular tooth crowding, and the presence of dental anomalies were recorded for each subject, and the statistical significance of differences in these parameters between the EEM and control groups was determined using independent sample t-tests. Chi-square tests were used to compare the prevalence of other dental anomalies between the two groups. Results The prevalence of maxillary EEM was 2.5%. The M-D crown widths, ATID and PTID, and tooth crowding were significantly greater, while A-PML was significantly smaller, in the EEM group than in the control group. Only two subjects showed an association between EEM and maxillary lateral incisor anomalies, which included agenesis in one and microdontia in the other. Conclusions EEM may be a risk factor for maxillary arch constriction and severe tooth crowding. PMID:26258065

  17. Frequency and variability of dental morphology in deciduous and permanent dentition of a Nasa indigenous group in the municipality of Morales, Cauca, Colombia.

    PubMed

    Díaz, Eider; García, Lorena; Hernández, Michelle; Palacio, Lesly; Ruiz, Diana; Velandia, Nataly; Villavicencio, Judy; Moreno, Freddy

    2014-01-01

    To determine the frequency, variability, sexual dimorphism and bilateral symmetry of fourteen dental crown traits in the deciduous and permanent dentition of 60 dental models (35 women and 25 men) obtained from a native, indigenous group of Nasa school children of the Musse Ukue group in the municipality of Morales, Department of Cauca, Colombia. This is a quantitative, descriptive, cross-sectional study that characterizes dental morphology by means of the systems for temporary dentition from Dahlberg (winging), and ASUDAS (crowding, reduction of hypocone, metaconule and cusp 6), Hanihara (central and lateral incisors in shovel-shape and cusp 7), Sciulli (double bit, layered fold protostylid, cusp pattern and cusp number) and Grine (Carabelli trait); and in permanent dentition from ASUDAS (Winging, crowding, central and lateral incisors in shovel-shape and double shovel-shape, Carabelli trait, hypocone reduction, metaconule, cusp pattern, cusp number, layered fold protostylid, cusp 6 and cusp 7). The most frequent dental crown features were the shovel-shaped form, grooved and fossa forms of the Carabelli trait, metaconule, cusp pattern Y6, layered fold, protostylid (point P) and cusp 6. Sexual dimorphism was not observed and there was bilateral symmetry in the expression of these features. The sample studied presented a great affinity with ethnic groups belonging to the Mongoloid Dental Complex due to the frequency (expression) and variability (gradation) of the tooth crown traits, upper incisors, the Carabelli trait, the protostylid, cusp 6 and cusp 7. The influence of the Caucasoide Dental Complex associated with ethno-historical processes cannot be ruled out.

  18. Safety of carotid endarterectomy while on clopidogrel (Plavix). Clinical article.

    PubMed

    Wait, Scott D; Abla, Adib A; Killory, Brendan D; Starke, Robert M; Spetzler, Robert F; Nakaji, Peter

    2010-10-01

    Many patients undergoing carotid endarterectomy (CEA) regularly take clopidogrel, a permanent platelet inhibitor. The authors sought to determine whether taking clopidogrel in the period before CEA leads to more bleeding or other complications. The authors performed a retrospective, institutional review board–approved review of 182 consecutive patients who underwent CEA. Clinical, radiographic, and surgical data were gleaned from hospital and clinic records. Analysis was based on the presence or absence of clopidogrel in patients undergoing CEA and was performed twice by considering clopidogrel use within 8 days and within 5 days of surgery to define the groups. Taking clopidogrel within 8 days before surgery resulted in no statistical increase in any measure of morbidity or death. Taking clopidogrel within 5 days was associated with a small but significant increase in operative blood loss and conservatively managed postoperative neck swelling. No measure of permanent morbidity or death was increased in either clopidogrel group. Findings in this study support the safety of preoperative clopidogrel in patients undergoing CEA.

  19. A preliminary study for fully automated quantification of psoriasis severity using image mapping

    NASA Astrophysics Data System (ADS)

    Mukai, Kazuhiro; Iyatomi, Hitoshi

    2014-03-01

    Psoriasis is a common chronic skin disease and it detracts patients' QoL seriously. Since there is no known permanent cure so far, controlling appropriate disease condition is necessary and therefore quantification of its severity is important. In clinical, psoriasis area and severity index (PASI) is commonly used for abovementioned purpose, however it is often subjective and troublesome. A fully automatic computer-assisted area and severity index (CASI) was proposed to make an objective quantification of skin disease. It investigates the size and density of erythema based on digital image analysis, however it does not consider various inadequate effects caused by different geometrical conditions under clinical follow-up (i.e. variability in direction and distance between camera and patient). In this study, we proposed an image alignment method for clinical images and investigated to quantify the severity of psoriasis under clinical follow-up combined with the idea of CASI. The proposed method finds geometrical same points in patient's body (ROI) between images with Scale Invariant Feature Transform (SIFT) and performs the Affine transform to map the pixel value to the other. In this study, clinical images from 7 patients with psoriasis lesions on their trunk under clinical follow-up were used. In each series, our image alignment algorithm align images to the geometry of their first image. Our proposed method aligned images appropriately on visual assessment and confirmed that psoriasis areas were properly extracted using the approach of CASI. Although we cannot evaluate PASI and CASI directly due to their different definition of ROI, we confirmed that there is a large correlation between those scores with our image quantification method.

  20. Pre-referral rectal artesunate to prevent death and disability in severe malaria: a placebo-controlled trial

    PubMed Central

    Gomes, MF; Faiz, MA; Gyapong, JO; Warsame, M; Agbenyega, T; Babiker, A; Baiden, F; Yunus, EB; Binka, F; Clerk, C; Folb, P; Hassan, R; Hossain, MA; Kimbute, O; Kitua, A; Krishna, S; Makasi, C; Mensah, N; Mrango, Z; Olliaro, P; Peto, R; Peto, TJ; Rahman, MR; Ribeiro, I; Samad, R; White, NJ

    2009-01-01

    Summary Background Most malaria deaths occur in rural areas. Rapid progression from illness to death can be interrupted by prompt, effective medication. Antimalarial treatment cannot rescue terminally ill patients but could be effective if given earlier. If patients who cannot be treated orally are several hours from facilities for injections, rectal artesunate can be given before referral and acts rapidly on parasites. We investigated whether this intervention reduced mortality and permanent disability. Methods In Bangladesh, Ghana, and Tanzania, patients with suspected severe malaria who could not be treated orally were allocated randomly to a single artesunate (n=8954) or placebo (n=8872) suppository by taking the next numbered box, then referred to clinics at which injections could be given. Those with antimalarial injections or negative blood smears before randomisation were excluded, leaving 12 068 patients (6072 artesunate, 5996 placebo) for analysis. Primary endpoints were mortality, assessed 7–30 days later, and permanent disability, reassessed periodically. All investigators were masked to group assignment. Analysis was by intention to treat. This study is registered in all three countries, numbers ISRCTN83979018, 46343627, and 76987662. Results Mortality was 154 of 6072 artesunate versus 177 of 5996 placebo (2·5% vs 3·0%, p=0·1). Two versus 13 (0·03% vs 0·22%, p=0·0020) were permanently disabled; total dead or disabled: 156 versus 190 (2·6% vs 3·2%, p=0·0484). There was no reduction in early mortality (56 vs 51 deaths within 6 h; median 2 h). In patients reaching clinic within 6 h (median 3 h), pre-referral artesunate had no significant effect on death after 6 h or permanent disability (71/4450 [1·6%] vs 82/4426 [1·9%], risk ratio 0·86 [95% CI 0·63–1·18], p=0·35). In patients still not in clinic after more than 6 h, however, half were still not there after more than 15 h, and pre-referral rectal artesunate significantly reduced death or permanent disability (29/1566 [1·9%] vs 57/1519 [3·8%], risk ratio 0·49 [95% CI 0·32–0·77], p=0·0013). Interpretation If patients with severe malaria cannot be treated orally and access to injections will take several hours, a single inexpensive artesunate suppository at the time of referral substantially reduces the risk of death or permanent disability. Funding UNICEF/UNDP/World Bank Special Programme for Research and Training in Tropical Diseases (WHO/TDR); WHO Global Malaria Programme (WHO/GMP); Sall Family Foundation; the European Union (QLRT-2000-01430); the UK Medical Research Council; USAID; Irish Aid; the Karolinska Institute; and the University of Oxford Clinical Trial Service Unit (CTSU). PMID:19059639

  1. An all permanent magnet electron cyclotron resonance ion source for heavy ion therapy

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

    Cao, Yun, E-mail: caoyun@impcas.ac.cn; Li, Jia Qing; Sun, Liang Ting

    2014-02-15

    A high charge state all permanent Electron Cyclotron Resonance ion source, Lanzhou All Permanent ECR ion source no. 3-LAPECR3, has been successfully built at IMP in 2012, which will serve as the ion injector of the Heavy Ion Medical Machine (HIMM) project. As a commercial device, LAPECR3 features a compact structure, small size, and low cost. According to HIMM scenario more than 100 eμA of C{sup 5+} ion beam should be extracted from the ion source, and the beam emittance better than 75 π*mm*mrad. In recent commissioning, about 120 eμA of C{sup 5+} ion beam was got when work gasmore » was CH{sub 4} while about 262 eμA of C{sup 5+} ion beam was obtained when work gas was C{sub 2}H{sub 2} gas. The design and construction of the ion source and its low-energy transportation beam line, and the preliminary commissioning results will be presented in detail in this paper.« less

  2. OBJECT REPRESENTATION, IDENTITY, AND THE PARADOX OF EARLY PERMANENCE: Steps Toward a New Framework.

    PubMed

    Meltzoff, Andrew N; Moore, M Keith

    1998-01-01

    The sensorimotor theory of infancy has been overthrown, but there is little consensus on a replacement. We hypothesize that a capacity for representation is the starting point for infant development, not its culmination. Logical distinctions are drawn between object representation, identity, and permanence. Modern experiments on early object permanence and deferred imitation suggest: (a) even for young infants, representations persist over breaks in sensory contact, (b) numerical identity of objects ( O s) is initially specified by spatiotemporal criteria (place and trajectory), (c) featural and functional identity criteria develop, (d) events are analyzed by comparing representations to current perception, and (e) representation operates both prospectively, anticipating future contacts with an O , and retrospectively, reidentifying an O as the "same one again." A model of the architecture and functioning of the early representational system is proposed. It accounts for young infants' behavior toward absent people and things in terms of their efforts to determine the identity of objects. Our proposal is developmental without denying innate structure and elevates the power of perception and representation while being cautious about attributing complex concepts to young infants.

  3. OBJECT REPRESENTATION, IDENTITY, AND THE PARADOX OF EARLY PERMANENCE: Steps Toward a New Framework

    PubMed Central

    Meltzoff, Andrew N.; Moore, M. Keith

    2013-01-01

    The sensorimotor theory of infancy has been overthrown, but there is little consensus on a replacement. We hypothesize that a capacity for representation is the starting point for infant development, not its culmination. Logical distinctions are drawn between object representation, identity, and permanence. Modern experiments on early object permanence and deferred imitation suggest: (a) even for young infants, representations persist over breaks in sensory contact, (b) numerical identity of objects (Os) is initially specified by spatiotemporal criteria (place and trajectory), (c) featural and functional identity criteria develop, (d) events are analyzed by comparing representations to current perception, and (e) representation operates both prospectively, anticipating future contacts with an O, and retrospectively, reidentifying an O as the “same one again.” A model of the architecture and functioning of the early representational system is proposed. It accounts for young infants’ behavior toward absent people and things in terms of their efforts to determine the identity of objects. Our proposal is developmental without denying innate structure and elevates the power of perception and representation while being cautious about attributing complex concepts to young infants. PMID:25147418

  4. Continued root maturation despite persistent apical periodontitis of immature permanent teeth after failed regenerative endodontic therapy.

    PubMed

    Lin, Louis M; Kim, Sahng G; Martin, Gabriela; Kahler, Bill

    2018-01-16

    Three immature permanent teeth with pulp necrosis and apical periodontitis were treated with regenerative endodontic therapy (RET), which included root canal disinfection with sodium hypochlorite irrigation, intra-canal medication with calcium hydroxide paste, 17% EDTA rinse, induction of periapical bleeding into the canal, collagen matrix and MTA coronal seal, and composite resin restoration of access cavities. After different periods of follow-up, it was observed that continued root maturation, especially apical closure occurred despite persistent apical periodontitis of immature permanent teeth after failed RET. This finding is of interest as the secondary goal of further root maturation occurred despite failure of the primary goal of elimination of clinical symptom/sign and periapical inflammation. The possible biological mechanisms that could allow for further root maturation to occur in spite of persistent root canal infection of immature permanent teeth are discussed. Based on these observations, the biology of wound healing of immature permanent teeth after injury is not fully understood and should be further investigated. This case report demonstrates that whilst further root maturation is considered a successful outcome for teeth treated with RET, the primary objective must be the resolution of the signs and symptoms of apical periodontitis. © 2018 Australian Society of Endodontology Inc.

  5. The mediating role of resilience in the relationship between social support and posttraumatic growth among colorectal cancer survivors with permanent intestinal ostomies: A structural equation model analysis.

    PubMed

    Dong, Xiaoling; Li, Guopeng; Liu, Chunlei; Kong, Linghua; Fang, Yueyan; Kang, Xiaofei; Li, Ping

    2017-08-01

    Information on posttraumatic growth (PTG) among colorectal cancer (CRC) survivors with permanent intestinal ostomies is limited. The aim of this cross-sectional study was to investigate the occurrence of PTG among CRC survivors with permanent intestinal ostomies and its association with perceived social support and resilience. This study was conducted with 164 CRC survivors with permanent intestinal ostomies at least one month after surgery. Participants completed questionnaires assessing socio-demographic and clinical characteristics, perceived social support, resilience and PTG. The mean total score on the Post Traumatic Growth Inventory was 66.74 (SD = 13.99). Perceived social support (r = 0.450) and resilience (r = 0.545) were significantly positively correlated with PTG. Structural equation modeling analysis showed that resilience mediated the relationship between perceived social support and PTG in which the indirect effect of perceived social support on PTG through resilience was 0.203 (P < 0.001). Moderate to high PTG was found in CRC survivors with permanent intestinal ostomies. The most important implication of this study was that improving social support and resilience might be scientific intervention strategies for promoting PTG among CRC survivors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. [Orthodontic Management of the Impacted Mandibular Second Molar Tooth].

    PubMed

    Mah, Michael; Takada, Kenji

    2016-09-01

    When the mandibular permanent second molar becomes impacted, it is identified as a malocclusion that needs treatment as it often leads to unwanted complications such as caries and periodontitis of the adjacent permanent first molar. Other less common complications include root resorption of the adjacent first molar root or continued root development to be in close proximity to the inferior dental alveolar nerve. This paper seeks to differentiate various levels of severity of impaction and review treatment options that are considered clinically available for the proper management of the impacted mandibular permanent second molar. Treatment options that will be discussed in this article include timing of second molar removal for replacement by the third molar, relief of impaction via second premolar removal, surgical repositioning and the combination of third molar removal, surgical exposure and orthodontic uprighting of the impacted tooth. Depending on the severity of the impaction, most impactions can be easily and predictably corrected with nickel titanium archwires or auxillary open coil springs or uprighting springs. Uncommonly, the mandibular permanent second molar can become severely impacted and in close proximity to the inferior dentoalveolar nerve. In these instances, the use of temporary anchorage devices such as microimplants has shown to be successful in uprighting the severely impacted mandibular permanent second molars. © EDP Sciences, SFODF, 2016.

  7. Guided eruption of palatally impacted canines through combined use of 3-dimensional computerized tomography scans and the easy cuspid device.

    PubMed

    Caprioglio, Alberto; Siani, Lea; Caprioglio, Claudia

    2007-01-01

    The permanent maxillary canine has a high incidence of impaction. In the clinical treatment of impaction, the first problem is diagnosis and localization. The new diagnostic 3-dimensional systems shown in this article provide valid support in understanding anatomic connections and planning the movements needed for orthodontic correction. Thus, the clinician can reduce the incidence of iatrogenic damage of adjacent structures. This article reviews several biomedical systems for guided eruption of palatally impacted canines and discusses a new device for guided eruption of the surgically disimpacted tooth. This device, called Easy Cuspid, is designed to reduce recognized problems with reaction forces through a simple method. A clinical case of bilateral impaction of the permanent maxillary canines shows the application of the diagnostic method and the biomechanical system, Easy Cuspid.

  8. Therapeutic effects of an anti-gravity locomotor training (AlterG) on postural balance and cerebellum structure in children with Cerebral Palsy.

    PubMed

    Rasooli, A H; Birgani, P M; Azizi, Sh; Shahrokhi, A; Mirbagheri, M M

    2017-07-01

    We evaluated the therapeutic effects of anti-gravity locomotor treadmill (AlterG) training on postural stability in children with Cerebral Palsy (CP) and spasticity, particularly in the lower extremity. AlterG can facilitate walking by reducing the weight of CP children by up to 80%; it can also help subjects maintain an appropriate posture during the locomotor AlterG training. Thus, we hypothesized that AlterG training, for a sufficient period of time, has a potential to produce cerebellum neuroplasticity, and consequently result in an effective permanent postural stability. AlterG training was given for 45 minutes, three times a week for two months. Postural balance was evaluated using posturography. The parameters of the Romberg based posturography were extracted to quantify the Center of Balance (CoP). The neuroplasticity of Cerebellum was evaluated using a Diffusion Tensor Imaging (DTI). The evaluations were done pre- and post-training. The Fractional Anisotropy (FA) feature was used for quantifying structural changes in the cerebellum. The results showed that AlterG training resulted in an increase in average FA value of the cerebellum white matter following the training. The results of the posturography evaluations showed a consistent improvement in postural stability. These results were consistent in all subjects. Our findings indicated that the improvement in the posture was accompanied with the enhancement of the cerebellum white matter structure. The clinical implication is that AlterG training can be considered a therapeutic tool for an effective and permanent improvement of postural stability in CP children.

  9. Analysis and Design of a Double-Divert Spiral Groove Seal

    NASA Technical Reports Server (NTRS)

    Zheng, Xiaoqing; Berard, Gerald

    2007-01-01

    This viewgraph presentation describes the design and analysis of a double spiral groove seal. The contents include: 1) Double Spiral Design Features; 2) Double Spiral Operational Features; 3) Mating Ring/Rotor Assembly; 4) Seal Ring Assembly; 5) Insert Segment Joints; 6) Rotor Assembly Completed Prototype Parts; 7) Seal Assembly Completed Prototype Parts; 8) Finite Element Analysis; 9) Computational Fluid Dynamics (CFD) Analysis; 10) Restrictive Orifice Design; 11) Orifice CFD Model; 12) Orifice Results; 13) Restrictive Orifice; 14) Seal Face Coning; 15) Permanent Magnet Analysis; 16) Magnetic Repulsive Force; 17) Magnetic Repulsive Test Results; 18) Spin Testing; and 19) Testing and Validation.

  10. MicrobeWorld Radio and Communications Initiative

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

    Barbara Hyde

    2006-11-22

    MicrobeWorld is a 90-second feature broadcast daily on more than 90 public radio stations and available from several sources as a podcast, including www.microbeworld.org. The feature has a strong focus on the use and adapatbility of microbes as alternative sources of energy, in bioremediation, their role in climate, and especially the many benefits and scientific advances that have resulting from decoding microbial genomes. These audio features are permanantly archived on an educational outreach site, microbeworld.org, where they are linked to the National Science Education Standards. They are also being used by instructors at all levels to introduce students to themore » multiple roles and potential of microbes, including a pilot curriculum program for middle-school students in New York.« less

  11. Usefulness of bedside tissue Doppler echocardiography and B-type natriuretic peptide (BNP) in differentiating congestive heart failure from noncardiac cause of acute dyspnea in elderly patients with a normal left ventricular ejection fraction and permanent, nonvalvular atrial fibrillation: insights from a prospective, monocenter study.

    PubMed

    Arques, Stephane; Roux, Emmanuel; Sbragia, Pascal; Pieri, Bertrand; Gelisse, Richard; Luccioni, Roger; Ambrosi, Pierre

    2007-05-01

    The incremental role of bedside tissue Doppler echocardiography and B-type natriuretic peptide (BNP) over the clinical judgment has been recently reported in the emergency diagnosis of congestive heart failure with a normal left ventricular ejection fraction (HFNEF). However, how well does this diagnostic strategy be applicable in the setting of atrial fibrillation is unknown. To investigate the usefulness of bedside tissue Doppler echocardiography and BNP in the emergency diagnosis of HFNEF in elderly patients with permanent, nonvalvular atrial fibrillation. Forty-one consecutive elderly patients with an ejection fraction > or =50% (mean age 84 years; 22 with HFNEF and 19 with noncardiac cause), hospitalized for acute dyspnea at rest, were prospectively enrolled; bedside septal E/Ea and BNP were obtained at admission. By multivariable logistic regression analysis including the clinical judgment of heart failure, E/Ea and BNP, E/Ea (P = 0.014) and BNP (P = 0.018) provided independent diagnostic information. Optimal cutoffs were 13 for E/Ea (area under the ROC curve of 0.846, P < 0.0001; sensitivity 81.8%, specificity 89.5%) and 253 pg/ml for BNP (area under the ROC curve of 0.928, P < 0.0001; sensitivity 86.4%, specificity 89.5%). The concordance between the clinical judgment and BNP concentration at the cutoff of 253 pg/ml correctly classified 24 of 25 patients; E/Ea at the cutoff of 13 correctly classified 14 of the 16 patients with discrepancy. Bedside tissue Doppler echocardiography and BNP provide useful additional diagnostic information over the clinical judgment for the emergency diagnosis of HFNEF in elderly patients with permanent, nonvalvular atrial fibrillation.

  12. Wolcott-Rallison Syndrome Is the Most Common Genetic Cause of Permanent Neonatal Diabetes in Consanguineous Families

    PubMed Central

    Rubio-Cabezas, Oscar; Patch, Ann-Marie; Minton, Jayne A. L.; Flanagan, Sarah E.; Edghill, Emma L.; Hussain, Khalid; Balafrej, Amina; Deeb, Asma; Buchanan, Charles R.; Jefferson, Ian G.; Mutair, Angham; Hattersley, Andrew T.; Ellard, Sian

    2009-01-01

    Context and Objective: Mutations in EIF2AK3 cause Wolcott-Rallison syndrome (WRS), a rare recessive disorder characterized by early-onset diabetes, skeletal abnormalities, and liver dysfunction. Although early diagnosis is important for clinical management, genetic testing is generally performed after the full clinical picture develops. We aimed to identify patients with WRS before any other abnormalities apart from diabetes are present and study the overall frequency of WRS among patients with permanent neonatal diabetes. Research Design and Methods: The coding regions of EIF2AK3 were sequenced in 34 probands with infancy-onset diabetes with a clinical phenotype suggestive of WRS (n = 28) or homozygosity at the WRS locus (n = 6). Results: Twenty-five probands (73.5%) were homozygous or compound heterozygous for mutations in EIF2AK3. Twenty of the 26 mutations identified were novel. Whereas a diagnosis of WRS was suspected before genetic testing in 22 probands, three patients with apparently isolated diabetes were diagnosed after identifying a large homozygous region encompassing EIF2AK3. In contrast to nonconsanguineous pedigrees, mutations in EIF2AK3 are the most common known genetic cause of diabetes among patients born to consanguineous parents (24 vs. < 2%). Age at diabetes onset and birth weight might be used to prioritize genetic testing in the latter group. Conclusions: WRS is the most common cause of permanent neonatal diabetes mellitus in consanguineous pedigrees. In addition to testing patients with a definite clinical diagnosis, EIF2AK3 should be tested in patients with isolated neonatal diabetes diagnosed after 3 wk of age from known consanguineous families, isolated populations, or countries in which inbreeding is frequent. PMID:19837917

  13. Determination of Frequency of the Second Mesiobuccal Canal in the Permanent Maxillary First Molar Teeth with Magnification Loupes (× 3.5)

    PubMed Central

    Hasan, Muhammad; Raza Khan, Farhan

    2014-01-01

    INTRODUCTION: The mesiobuccal root of the maxillary first molar has generated more research and clinical investigation than any root. An inability to detect and treat a second mesiobuccal (MB2) canal is a reason for endodontic failure in maxillary first molars. Modifications in the endodontic access and detection techniques, along with advancements in illumination and magnification technology, have aided in the location and treatment with the second mesiobuccal canal of maxillary first molars. OBJECTIVE: To determine the frequency of the second mesiobuccal canal in the permanent maxillary first molars with magnification loupes (× 3.5). MATERIALS AND METHODS: A total of 53 teeth were assessed using a moderate magnification for second mesiobuccal canal in mesiobuccal root of first permanent maxillary molars in vivo. Detection of this canal in maxillary first molars was done through a clinical access cavity preparation under magnification loupes (× 3.5). Data was analyzed using SPSS 15.0. Frequency distribution of variables was determined and the level of significance was kept at 0.05. RESULTS: We were able to detect second mesiobuccal canal in 27 out of 53 (50.9%) of the permanent maxillary first molars that were studied. It was found that the males tend to have a higher proportion of second mesiobuccal canals (up to 31%) as compared to the females in whom the second mesiobuccal canals could be identified only 19% of the time. Whilst, there was no association found between age, gender and chamber obliteration with the presence of second mesiobuccal canal. CONCLUSIONS: In conclusion, within its limitations, this study suggested that the use of magnification loupes enhanced both the detection (50.9%) and negotiation (86.8%) of the second mesiobuccal canals in the permanent maxillary first molars beyond what could be achieved with naked eye. PMID:25324702

  14. Dental age estimation in Japanese individuals combining permanent teeth and third molars.

    PubMed

    Ramanan, Namratha; Thevissen, Patrick; Fleuws, Steffen; Willems, G

    2012-12-01

    The study aim was, firstly, to verify the Willems et al. model on a Japanese reference sample. Secondly to develop a Japanese reference model based on the Willems et al. method and to verify it. Thirdly to analyze the age prediction performance adding tooth development information of third molars to permanent teeth. Retrospectively 1877 panoramic radiographs were selected in the age range between 1 and 23 years (1248 children, 629 sub-adults). Dental development was registered applying Demirjian 's stages of the mandibular left permanent teeth in children and Köhler stages on the third molars. The children's data were, firstly, used to validate the Willems et al. model (developed a Belgian reference sample), secondly, split ino a training and a test sample. On the training sample a Japanese reference model was developed based on the Willems method. The developed model and the Willems et al; model were verified on the test sample. Regression analysis was used to detect the age prediction performance adding third molar scores to permanent tooth scores. The validated Willems et al. model provided a mean absolute error of 0.85 and 0.75 years in females and males, respectively. The mean absolute error in the verified Willems et al. and the developed Japanese reference model was 0.85, 0.77 and 0.79, 0.75 years in females and males, respectively. On average a negligible change in root mean square error values was detected adding third molar scores to permanent teeth scores. The Belgian sample could be used as a reference model to estimate the age of the Japanese individuals. Combining information from the third molars and permanent teeth was not providing clinically significant improvement of age predictions based on permanent teeth information alone.

  15. Investigating Mercury's South Polar Deposits: Arecibo Radar Observations and High-Resolution Determination of Illumination Conditions

    NASA Astrophysics Data System (ADS)

    Chabot, Nancy L.; Shread, Evangela E.; Harmon, John K.

    2018-02-01

    There is strong evidence that Mercury's polar deposits are water ice hosted in permanently shadowed regions. In this study, we present new Arecibo radar observations of Mercury's south pole, which reveal numerous radar-bright deposits and substantially increase the radar imaging coverage. We also use images from MESSENGER's full mission to determine the illumination conditions of Mercury's south polar region at the same spatial resolution as the north polar region, enabling comparisons between the two poles. The area of radar-bright deposits in Mercury's south is roughly double that found in the north, consistent with the larger permanently shadowed area in the older, cratered terrain at the south relative to the younger smooth plains at the north. Radar-bright features are strongly associated with regions of permanent shadow at both poles, consistent with water ice being the dominant component of the deposits. However, both of Mercury's polar regions show that roughly 50% of permanently shadowed regions lack radar-bright deposits, despite some of these locations having thermal environments that are conducive to the presence of water ice. The observed uneven distribution of water ice among Mercury's polar cold traps may suggest that the source of Mercury's water ice was not a steady, regular process but rather that the source was an episodic event, such as a recent, large impact on the innermost planet.

  16. Managing data from remeasured plots: An evaluation of existing systems

    Treesearch

    John C. Byrne; Michael D. Sweet

    1992-01-01

    Proper management of the valuable data from remeasured (or permanent) forest growth plots with data base management systems (DBMS) can greatly add to their utility. Twelve desired features for such a system (activities that facilitate the storage, accuracy, and use of the data for analysis) are described and used to evaluate the 36 systems found by a survey conducted...

  17. "Heads I Win, Tails You Lose": Anti-Black Racism as Fluid, Relentless, Individual and Systemic

    ERIC Educational Resources Information Center

    Gillborn, David

    2018-01-01

    Derrick Bell's thesis, that racism is a permanent feature of society, is frequently misrepresented by detractors as signaling a view of racism as monolithic--bold, obvious, and unchanging. This paper argues that critical race theory [CRT] reveals a very different understanding of racism as relentless, yet fluid, and quick to morph depending on…

  18. Transverse phase space diagnostics for ionization injection in laser plasma acceleration using permanent magnetic quadrupoles

    NASA Astrophysics Data System (ADS)

    Li, F.; Nie, Z.; Wu, Y. P.; Guo, B.; Zhang, X. H.; Huang, S.; Zhang, J.; Cheng, Z.; Ma, Y.; Fang, Y.; Zhang, C. J.; Wan, Y.; Xu, X. L.; Hua, J. F.; Pai, C. H.; Lu, W.; Mori, W. B.

    2018-04-01

    We report the transverse phase space diagnostics for electron beams generated through ionization injection in a laser-plasma accelerator. Single-shot measurements of both ultimate emittance and Twiss parameters are achieved by means of permanent magnetic quadrupole. Beams with emittance of μm rad level are obtained in a typical ionization injection scheme, and the dependence on nitrogen concentration and charge density is studied experimentally and confirmed by simulations. A key feature of the transverse phase space, matched beams with Twiss parameter α T ≃ 0, is identified according to the measurement. Numerical simulations that are in qualitative agreement with the experimental results reveal that a sufficient phase mixing induced by an overlong injection length leads to the matched phase space distribution.

  19. Transverse phase space diagnostics for ionization injection in laser plasma acceleration using permanent magnetic quadrupoles

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

    Li, F.; Nie, Z.; Wu, Y. P.

    We report the transverse phase space diagnostics for electron beams generated through ionization injection in a laser-plasma accelerator. Single-shot measurements of both ultimate emittance and Twiss parameters are achieved by means of permanent magnetic quadrupole. Beams with emittance of μm rad level are obtained in a typical ionization injection scheme, and the dependence on nitrogen concentration and charge density is studied experimentally and confirmed by simulations. A key feature of the transverse phase space, matched beams with Twiss parameter α T ≃ 0, is identified according to the measurement. Lastly, numerical simulations that are in qualitative agreement with the experimentalmore » results reveal that a sufficient phase mixing induced by an overlong injection length leads to the matched phase space distribution.« less

  20. High-quality permanent draft genome sequence of Bradyrhizobium sp. Tv2a.2, a microsymbiont of Tachigali versicolor discovered in Barro Colorado Island of Panama

    DOE PAGES

    Tian, Rui; Parker, Matthew; Seshadri, Rekha; ...

    2015-05-17

    Bradyrhizobiumsp. Tv2a.2 is an aerobic, motile, Gram-negative, non-spore-forming rod that was isolated from an effective nitrogen-fixing root nodule of Tachigali versicolor collected in Barro Colorado Island of Panama. Here we describe the features of Bradyrhizobiumsp. Tv2a.2, together with high-quality permanent draft genome sequence information and annotation. The 8,496,279 bp high-quality draft genome is arranged in 87 scaffolds of 87 contigs, contains 8,109 protein-coding genes and 72 RNA-only encoding genes. In conclusion, this rhizobial genome was sequenced as part of the DOE Joint Genome Institute 2010 Genomic Encyclopedia for Bacteria and Archaea-Root Nodule Bacteria (GEBA-RNB) project.

  1. Permanent dentition occlusion in Chinese, Indian and Malay groups in Malaysia.

    PubMed

    Woon, K C; Thong, Y L; Abdul Kadir, R

    1989-03-01

    This survey outlines the proportion of the various features of occlusion in the permanent dentition of the three ethnic races, Chinese, Malay and Indian in Malaysia. The mean age of the high school children surveyed was 16.4 years. The Chinese and Malays had almost similar distribution of the different types of occlusion. There was a significantly higher prevalence of Class III occlusion among the Chinese and Malays as compared to the Indians. In addition, an edge to edge incisor relationship seemed to be a norm in the Chinese (54%) and Malays (50%) whilst the overjet of between 2-4 mm and the overbite of between 1/3 to 2/3 was more normal to Indians (50%). A crowded dentition was also a norm for the three races.

  2. Transverse phase space diagnostics for ionization injection in laser plasma acceleration using permanent magnetic quadrupoles

    DOE PAGES

    Li, F.; Nie, Z.; Wu, Y. P.; ...

    2018-02-22

    We report the transverse phase space diagnostics for electron beams generated through ionization injection in a laser-plasma accelerator. Single-shot measurements of both ultimate emittance and Twiss parameters are achieved by means of permanent magnetic quadrupole. Beams with emittance of μm rad level are obtained in a typical ionization injection scheme, and the dependence on nitrogen concentration and charge density is studied experimentally and confirmed by simulations. A key feature of the transverse phase space, matched beams with Twiss parameter α T ≃ 0, is identified according to the measurement. Lastly, numerical simulations that are in qualitative agreement with the experimentalmore » results reveal that a sufficient phase mixing induced by an overlong injection length leads to the matched phase space distribution.« less

  3. Drug-coated balloon treatment of coronary artery disease: a position paper of the Italian Society of Interventional Cardiology.

    PubMed

    Cortese, Bernardo; Berti, Sergio; Biondi-Zoccai, Giuseppe; Colombo, Antonio; Limbruno, Ugo; Bedogni, Francesco; Cremonesi, Alberto; Silva, Pedro Leon; Sgueglia, Gregory A

    2014-02-15

    Drug-coated balloons are a new tool for the treatment of patients with coronary artery disease. The main feature of this technology is a rapid and homogenous transfer of an antiproliferative drug (paclitaxel) to the vessel wall just at the time of balloon inflation, when neointimal proliferation, in response to angioplasty, is the highest. Moreover, drug-coated balloons share adjuntive advantages over stents: the absence of permanent scaffold and polymer, the respect of the original coronary anatomy, and limited inflammatory stimuli, thereby allowing for short-term dual antiplatelet therapy. To this day, a lot of devices are available in the market, with limited scientific data for the vast majority of them. Thus, the Italian scientific society of interventional cardiologists GISE decided to coordinate the efforts of a group of reknown experts on the field, in order to obtain a Position Paper on the correct use of drug-coated balloons in all the settings of coronary artery disease, giving a class of indication to each one, based on the clinical evidence. This Position Paper represents a quick reference for operators, investigators, and manufactures to promote the understanding and the correct use of the drug-coated balloon technology in everyday clinical practice. Copyright © 2013 Wiley Periodicals, Inc.

  4. Cryopreservation of GABAergic Neuronal Precursors for Cell-Based Therapy

    PubMed Central

    2017-01-01

    Cryopreservation protocols are essential for stem cells storage in order to apply them in the clinic. Here we describe a new standardized cryopreservation protocol for GABAergic neural precursors derived from the medial glanglionic eminence (MGE), a promising source of GABAergic neuronal progenitors for cell therapy against interneuron-related pathologies. We used 10% Me2SO as cryoprotectant and assessed the effects of cell culture amplification and cellular organization, as in toto explants, neurospheres, or individualized cells, on post-thaw cell viability and retrieval. We confirmed that in toto cryopreservation of MGE explants is an optimal preservation system to keep intact the interneuron precursor properties for cell transplantation, together with a high cell viability (>80%) and yield (>70%). Post-thaw proliferation and self-renewal of the cryopreserved precursors were tested in vitro. In addition, their migration capacity, acquisition of mature neuronal morphology, and potency to differentiate into multiple interneuron subtypes were also confirmed in vivo after transplantation. The results show that the cryopreserved precursor features remained intact and were similar to those immediately transplanted after their dissection from the MGE. We hope this protocol will facilitate the generation of biobanks to obtain a permanent and reliable source of GABAergic precursors for clinical application in cell-based therapies against interneuronopathies. PMID:28122047

  5. Clinically oriented device programming in bradycardia patients: part 2 (atrioventricular blocks and neurally mediated syncope). Proposals from AIAC (Italian Association of Arrhythmology and Cardiac Pacing).

    PubMed

    Palmisano, Pietro; Ziacchi, Matteo; Biffi, Mauro; Ricci, Renato P; Landolina, Maurizio; Zoni-Berisso, Massimo; Occhetta, Eraldo; Maglia, Giampiero; Botto, Gianluca; Padeletti, Luigi; Boriani, Giuseppe

    2018-04-01

    : The purpose of this two-part consensus document is to provide specific suggestions (based on an extensive literature review) on appropriate pacemaker setting in relation to patients' clinical features. In part 2, criteria for pacemaker choice and programming in atrioventricular blocks and neurally mediate syncope are proposed. The atrioventricular blocks can be paroxysmal or persistent, isolated or associated with sinus node disease. Neurally mediated syncope can be related to carotid sinus syndrome or cardioinhibitory vasovagal syncope. In sinus rhythm, with persistent atrioventricular block, we considered appropriate the activation of mode-switch algorithms, and algorithms for auto-adaptive management of the ventricular pacing output. If the atrioventricular block is paroxysmal, in addition to algorithms mentioned above, algorithms to maximize intrinsic atrioventricular conduction should be activated. When sinus node disease is associated with atrioventricular block, the activation of rate-responsive function in patients with chronotropic incompetence is appropriate. In permanent atrial fibrillation with atrioventricular block, algorithms for auto-adaptive management of the ventricular pacing output should be activated. If the atrioventricular block is persistent, the activation of rate-responsive function is appropriate. In carotid sinus syndrome, adequate rate hysteresis should be programmed. In vasovagal syncope, specialized sensing and pacing algorithms designed for reflex syncope prevention should be activated.

  6. Employment and sociodemographic characteristics: a study of increasing precarity in the health districts of Belo Horizonte, Brazil

    PubMed Central

    Coelho, Maria Cristina Ramos de Vasconcellos; Assunção, Ada Ávila; Belisário, Soraya Almeida

    2009-01-01

    Background The fundamental importance of human resources for the development of health care systems is recognized the world over. Health districts, which constitute the middle level of the municipal health care system in the city of Belo Horizonte, Brazil, deal with demands from all parts of the system. This research seeks to provide the essential features required in order to understand the phenomenon of increase in precarity of employment in these health districts. Methods The legal and human resource management documents used by the Municipal Health Secretariat of the City of Belo Horizonte were adopted as the corpus for this research. In order to analyse the changes in employment (2002–2006), the data were collected from ArteRH, a computerized database dealing specifically with data related to human resources, which began operating in 2001. The workers were classified into permanent and non-permanent groups, and their contractual rights were described. Employment dynamics and changes were examined, concentrating on the incorporation of workers and on their social and employment rights during the period under study. The comparative data for the two groups obtained were presented in frequency distribution tables according to type of employment, sex, age group, level of education and wages from 2002 to 2006. Results There was a clear difference between the permanent worker and non-permanent worker groups as regards existing guaranteed employment rights and social security. The increase in the number of non-permanent workers in the workforce, the growing proportion of older workers among the permanently employed and the real wage reductions during the period from 2002 to 2006 are indicative of the process of growing precarity of employment in the group studied. Conclusion It is a plausible supposition that the demand for health reforms, along with the legal limits imposed on financial expenditure, gave rise to the new types of contract and the present employment situation in the health districts in Belo Horizonte. PMID:19594922

  7. Employment and sociodemographic characteristics: a study of increasing precarity in the health districts of Belo Horizonte, Brazil.

    PubMed

    de Vasconcellos Coelho, Maria Cristina Ramos; Assunção, Ada Avila; Belisário, Soraya Almeida

    2009-07-13

    The fundamental importance of human resources for the development of health care systems is recognized the world over. Health districts, which constitute the middle level of the municipal health care system in the city of Belo Horizonte, Brazil, deal with demands from all parts of the system. This research seeks to provide the essential features required in order to understand the phenomenon of increase in precarity of employment in these health districts. The legal and human resource management documents used by the Municipal Health Secretariat of the City of Belo Horizonte were adopted as the corpus for this research. In order to analyse the changes in employment (2002-2006), the data were collected from ArteRH, a computerized database dealing specifically with data related to human resources, which began operating in 2001. The workers were classified into permanent and non-permanent groups, and their contractual rights were described. Employment dynamics and changes were examined, concentrating on the incorporation of workers and on their social and employment rights during the period under study. The comparative data for the two groups obtained were presented in frequency distribution tables according to type of employment, sex, age group, level of education and wages from 2002 to 2006. There was a clear difference between the permanent worker and non-permanent worker groups as regards existing guaranteed employment rights and social security. The increase in the number of non-permanent workers in the workforce, the growing proportion of older workers among the permanently employed and the real wage reductions during the period from 2002 to 2006 are indicative of the process of growing precarity of employment in the group studied. It is a plausible supposition that the demand for health reforms, along with the legal limits imposed on financial expenditure, gave rise to the new types of contract and the present employment situation in the health districts in Belo Horizonte.

  8. Revascularization for a necrotic immature permanent lateral incisor: a case report and literature review.

    PubMed

    Kottoor, Jojo; Velmurugan, Natanasabapathy

    2013-07-01

    Revascularization is a valuable treatment in immature necrotic teeth that allows the continuation of root development. This article describes the successful revascularization treatment of an immature maxillary lateral incisor that was initially diagnosed with apical periodontitis. The tooth was asymptomatic and functional clinically and radiographically during the follow-up period of 5 years. The follow-up showed evidence of progressive thickening of the dentinal walls, development of root length and apical closure. The article also discusses the currently available literature regarding revascularization of immature permanent teeth. © 2012 John Wiley & Sons Ltd, BSPD and IAPD.

  9. Sacral neuromodulation in the treatment of the unstable bladder.

    PubMed

    Bosch, J L

    1998-07-01

    Sacral neuromodulation as a treatment for urge incontinence in patients with an unstable bladder is the subject of ongoing clinical studies. Although approximately 75% of the patients treated with a permanent sacral foramen electrode implant have experienced significant improvements, it is now also clear that there is an initial failure rate of about 25%. Recent studies have pointed out the importance of improved patient selection on the basis of sex differences, urodynamic parameters and psychological factors. Also, newer forms of test stimulation and permanent electrode implantation are being explored in an effort to improve on the present results.

  10. Kirschner-wire fixation for postburn flexion contracture deformity and consequences on articular surface.

    PubMed

    Sungur, Nezih; Ulusoy, Mustafa Gürhan; Boyacgil, Süreyya; Ortaparmak, Hülya; Akyüz, Mihriban; Ortak, Turgut; Koçer, Uğur; Sensöz, Omer

    2006-02-01

    Kirschner-wire (K-wire) fixation for 3-6 weeks is an approved method for stabilization of the fingers after the release of flexion contracture deformity. On the other hand, articular surface damage in small joints due to pin fixation is still a topic of debate. Reports claiming permanent joint destruction due to this procedure exist in the literature. To clarify this doubt, a prospective study was carried out in 72 patients with flexion contracture of the hand fingers. After the surgical release of the deformity, immobilization of the interphalangeal (IP) and metacarpophalangeal (MCP) joints was carried out with K-wire fixation for 3 weeks. Clinical evaluation of the patients was accomplished with total active motion (TAM), grip, and pinch force measurements, whereas magnetic resonance (MR) and radionuclide imaging were used as radiodiagnostic tools. Mean follow-up period of the patients was 32 months. Satisfactory results were obtained in terms of functional and esthetic aspects. Evaluation of the data derived from the clinical and radiologic measurements revealed no permanent articular surface damage. K-wire fixation was documented to be an invaluable therapeutic approach not only to prevent recurrence of the contracture deformity but also to stabilize the skin graft effectively. This technique was concluded to provide effective immobilization without permanent articular damage.

  11. Geospatial tools for the identification of a malaria corridor in Estado Sucre, a Venezuelan north-eastern state.

    PubMed

    Delgado-Petrocelli, Laura; Camardiel, Alberto; Aguilar, Víctor Hugo; Martinez, Néstor; Córdova, Karenia; Ramos, Santiago

    2011-05-01

    Landscape ecology research relies on frameworks based on geographical information systems (GIS), geostatistics and spatial-feature relationships. With regard to health, the approach consists of systems analysis using a set of powerful tools aimed at the reduction of community vulnerability through improved public policies. The north-oriental malaria focus, one of five such foci in Venezuela, situated in the north-eastern part of the Estado Sucre state, unites several social and environmental features and functions as an epidemiological corridor, i.e. an endemic zone characterised by permanent interaction between the mosquito vector and the human host allowing a continuous persistence of the malaria lifecycle. A GIS was developed based on official cartography with thematic overlays depicting malaria distribution, socio-economic conditions, basic environmental information and specific features associated with the natural wetlands present in the area. Generally, malaria foci are continuously active but when the malaria situation was modelled in the north-oriental focus, a differential, spatio-temporal distribution pattern situation was found, i.e. a situation oscillating between very active and dormant transmission. This pattern was displayed by spatial and statistical analysis based on the model generated in this study and the results were confirmed by municipal and county malaria records. Control of malaria, keeping the incidence at a permanently low level within the regional population, should be possible if these results are taken into account when designing and implementing epidemiological surveillance policies.

  12. Canadian Open Genetics Repository (COGR): a unified clinical genomics database as a community resource for standardising and sharing genetic interpretations.

    PubMed

    Lerner-Ellis, Jordan; Wang, Marina; White, Shana; Lebo, Matthew S

    2015-07-01

    The Canadian Open Genetics Repository is a collaborative effort for the collection, storage, sharing and robust analysis of variants reported by medical diagnostics laboratories across Canada. As clinical laboratories adopt modern genomics technologies, the need for this type of collaborative framework is increasingly important. A survey to assess existing protocols for variant classification and reporting was delivered to clinical genetics laboratories across Canada. Based on feedback from this survey, a variant assessment tool was made available to all laboratories. Each participating laboratory was provided with an instance of GeneInsight, a software featuring versioning and approval processes for variant assessments and interpretations and allowing for variant data to be shared between instances. Guidelines were established for sharing data among clinical laboratories and in the final outreach phase, data will be made readily available to patient advocacy groups for general use. The survey demonstrated the need for improved standardisation and data sharing across the country. A variant assessment template was made available to the community to aid with standardisation. Instances of the GeneInsight tool were provided to clinical diagnostic laboratories across Canada for the purpose of uploading, transferring, accessing and sharing variant data. As an ongoing endeavour and a permanent resource, the Canadian Open Genetics Repository aims to serve as a focal point for the collaboration of Canadian laboratories with other countries in the development of tools that take full advantage of laboratory data in diagnosing, managing and treating genetic diseases. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Central diabetes insipidus: clinical profile that suggests organicity in Peruvian children: Lima - Peru 2001-2013.

    PubMed

    De Los Santos, Miguel Angel; Águila, Carlos Manuel Del; Rojas, Maria Isabel; Falen, Juan Manuel; Nuñez, Oswaldo; Chávez, Eliana Manuela; Espinoza, Oscar Antonio; Pinto, Paola Marianella; Calagua, Martha Rosario

    2016-12-01

    Central diabetes insipidus (CDI) is a heterogeneous disease caused by arginine vasopressin deficiency; its management implies a profound understanding of the pathophysiology and the clinical spectrum. The aim of the study was to describe the clinical characteristics that indicate organicity in children and adolescents with central diabetes insipidus treated at the Department of Endocrinology from The Child Health's Institute during 2001 to 2013. Cross-sectional, retrospective study. 79 cases of patients diagnosed with CDI (51 males and 28 females) from 1 month to 16 years of age were reviewed. For the descriptive analysis, measures of central tendency and dispersion were used; groups of organic and idiopathic CDI were compared using χ2-test and t-test. A p-value<0.05 was considered significant. The average age of patients was 8.1±4.2 years. Organic causes were intracranial tumors, 44 (55.7%), Langerhans cell histiocytosis (LCH), 11 (13.9%) and cerebral malformations in 7 (8.9%) patients, while the idiopathic group was 14 (17.7%) patients. Regarding clinical characteristics suggestive of organicity, headache (p=0.02) and visual disturbances (p=0.01) were found statistically significant. The anterior pituitary hormonal abnormalities were documented in 34 (52.3%) organic CDI patients. Furthermore, we did not find a significant difference in the average daily dose of desmopressin between patients with permanent vs. transitory CDI (0.81±0.65 vs. 0.59±0.62; p=0.363). The main clinical features suggestive of organicity in pediatric patients with central diabetes insipidus were headache and visual disturbances; furthermore, anterior pituitary hormonal abnormalities suggest an underlying organic etiology.

  14. Stent Polymers: Do They Make a Difference?

    PubMed

    Rizas, Konstantinos D; Mehilli, Julinda

    2016-06-01

    The necessity of polymers on drug-eluting stent (DES) platforms is dictated by the need of an adequate amount and optimal release kinetic of the antiproliferative drugs for achieving ideal DES performance. However, the chronic vessel wall inflammation related to permanent polymer persistence after the drug has been eluted might trigger late restenosis and stent thrombosis. Biodegradable polymers have the potential to avoid these adverse events. A variety of biodegradable polymer DES platforms have been clinically tested, showing equal outcomes with the standard-bearer permanent polymer DES within the first year of implantation. At longer-term follow-up, promising lower rates of stent thrombosis have been observed with the early generation biodegradable polymer DES platforms compared to first-generation DES. Whether this safety benefit still persists with newer biodegradable polymer DES generations against second-generation permanent polymer DES needs to be explored. © 2016 American Heart Association, Inc.

  15. [Injuries to permanent teeth. Part 1: diagnosis of the tooth injury].

    PubMed

    von Arx, Thomas; Winzap-Kälin, Carmen; Hänni, Stefan

    2005-01-01

    Diagnostic and therapeutic interventions following dental injuries are not part of the routine practice in the dental office. Quite often, these patients are emergency cases who seek treatment after normal office hours. The objective of this and the future papers is to present the current treatment concepts in dental traumatology at the School of Dental Medicine, University of Berne. The fruitful cooperation in the field of dental traumatology between the Department of Oral Surgery and Stomatology, and the Department of Conservative Dentistry (including pediatric dentistry and endodontology), is based on the interdisciplinary approach that has been established four years ago. Following discussion and evaluation of such treated cases, and considering current clinical and experimental references, the said concepts have been worked out. The present paper describes the diagnostic measures following injuries to the permanent teeth. Subsequent papers will illustrate our therapeutic concepts of injuries to the periodontal and dental hard tissues of permanent teeth.

  16. Inherited retarded eruption in the permanent dentition.

    PubMed

    Rasmussen, P; Kotsaki, A

    1997-01-01

    The term retarded eruption, may be used in cases where eruption is inhibited, causing an interruption in the coordination of tooth formation and tooth eruption. The phenomenon may be local or general, and several etiological factors for retarded eruption have been listed, comprising a lack of space, ankylosis, cysts, supernumerary teeth, hormone and vitamin deficiencies and several developmental disturbances and syndromes. The present paper describes several cases of retarded eruption where no factors other than inheritance have been evident. So far 14 cases have been evaluated, 9 boys and 5 girls. In addition several cases have been registered among parents and grandparents of the probands. Typical features are: retarded eruption, defined as more than 3 SD beyond mean eruption figures, comprises all teeth in the permanent dentition, and in 5 cases also second primary molars. The chronology of tooth formation are within normal limits. Consequently the teeth finish development still laying deeply buried in the jaws, often in aberrant positions and with curves or hooks on the roots. When the teeth finally get the "signal" for eruption, 5-15 years beyond normal eruption time, they move rather quickly into right positions, despite the long eruption paths and the hooked roots. Permanent teeth without, as well as with predecessors, are affected. Extraction of predecessors does not seem to provoke eruption. The main features in management are to take care of the primary teeth, to improve-esthetics, and offer surgery and orthodontics when needed. Analyses of pedigrees indicates that the genetic transmittance may be autosomal dominant as both sexes are affected, about half of the siblings show the trait, and the trait shows continuity through generations.

  17. Frequency and variability of dental morphology in deciduous and permanent dentition of a Nasa indigenous group in the municipality of Morales, Cauca, Colombia

    PubMed Central

    Díaz, Eider; García, Lorena; Hernández, Michelle; Palacio, Lesly; Ruiz, Diana; Velandia, Nataly; Villavicencio, Judy

    2014-01-01

    Objectives: To determine the frequency, variability, sexual dimorphism and bilateral symmetry of fourteen dental crown traits in the deciduous and permanent dentition of 60 dental models (35 women and 25 men) obtained from a native, indigenous group of Nasa school children of the Musse Ukue group in the municipality of Morales, Department of Cauca, Colombia. Methods: This is a quantitative, descriptive, cross-sectional study that characterizes dental morphology by means of the systems for temporary dentition from Dahlberg (winging), and ASUDAS (crowding, reduction of hypocone, metaconule and cusp 6), Hanihara (central and lateral incisors in shovel-shape and cusp 7), Sciulli (double bit, layered fold protostylid, cusp pattern and cusp number) and Grine (Carabelli trait); and in permanent dentition from ASUDAS (Winging, crowding, central and lateral incisors in shovel-shape and double shovel-shape, Carabelli trait, hypocone reduction, metaconule, cusp pattern, cusp number, layered fold protostylid, cusp 6 and cusp 7). Results: The most frequent dental crown features were the shovel-shaped form, grooved and fossa forms of the Carabelli trait, metaconule, cusp pattern Y6, layered fold, protostylid (point P) and cusp 6. Sexual dimorphism was not observed and there was bilateral symmetry in the expression of these features. Conclusions: The sample studied presented a great affinity with ethnic groups belonging to the Mongoloid Dental Complex due to the frequency (expression) and variability (gradation) of the tooth crown traits, upper incisors, the Carabelli trait, the protostylid, cusp 6 and cusp 7. The influence of the Caucasoide Dental Complex associated with ethno-historical processes cannot be ruled out. PMID:24970955

  18. Occlusal glass ionomer cermet, resin sandwich and amalgam restorations: a 2-year clinical study.

    PubMed

    Lidums, A; Wilkie, R; Smales, R

    1993-08-01

    This study compared the clinical behavior of a glass ionomer silver cermet (Ketac-Silver), a posterior resin composite (Visio-Molar) used with the "sandwich" technique, and a high-copper amalgam (Dispersalloy) for restoring conventional Class I occlusal cavity preparations. Two dentists placed 116 restorations in the posterior permanent teeth of 35 adults treated at a dental hospital. Restorations were assessed at 6-month intervals over 2 years for bulk loss of material and occlusal wear, surface voids, roughness and cracking, surface and marginal staining, and marginal fracture. Losses of material and surface voids were obvious with the cermet material, with surface crazing or cracking being present in 33% of the restorations. The cermet cannot be recommended as a long-term permanent restorative material if the restorations are likely to be subjected to heavy occlusal stresses and abrasive wear.

  19. Surgical removal of coronal fragment of tooth embedded in lower lip and esthetic management of fractured crown segment.

    PubMed

    Avinash, Alok; Dubey, Alok; Singh, Rajeev Kumar; Prasad, Swati

    2014-01-01

    Dental fractures of the permanent maxillary anterior teeth are relatively frequent accidents during childhood. The Efficient diagnosis and treatment of dental injury are important elements in clinical dentistry. This article describes a case of trauma in permanent right central maxillary incisors with tooth fragments embedded in the lower lip. Thorough clinical examination followed by soft tissue radiographs confirmed the presence of a fractured incisal fragment, which was surgically retrieved under local anesthesia. Direct composite restoration was placed. After finishing and polishing, an esthetic and natural-looking restoration was achieved; this completely satisfied the functional and esthetic expectation of the patient and dental team. How to cite this article: Avinash A, Dubey A, Singh RK, Prasad S. Surgical Removal of Coronal Fragment of Tooth Embedded in Lower Lip and Esthetic Management of Fractured Crown Segment. Int J Clin Pediatr Dent 2014;7(1):65-68.

  20. Housing First and the Risk of Failure: A Comment on Westermeyer and Lee (2013).

    PubMed

    Kertesz, Stefan G; Austin, Erika Laine; Holmes, Sally K; Pollio, David E; VanDeusen Lukas, Carol

    2015-07-01

    Over the last 5 years, community policies in response to homelessness have shifted toward offering permanent housing accompanied by treatment supports, without requiring treatment success as a precondition. The US Department of Veterans Affairs (VA) has embraced this "Housing First" approach. A 2013 report sounds a contrarian note. In a 16-person quasi-experimental study, 8 veterans who entered VA's permanent supportive housing did poorly, whereas 8 veterans who remained in more traditional treatment did well. In this commentary, we suggest that the report was problematic in the conceptualization of the matters it sought to address and in its science. Nonetheless, it highlights challenges that must not be ignored. From this report and other research, we now know that even more attention is required to support clinical recovery for Housing First clients. Successful implementation of Housing First requires guidance from agency leaders, and their support for clinical staff when individual clients fare poorly.

  1. Organists and organ music composers.

    PubMed

    Foerch, Christian; Hennerici, Michael G

    2015-01-01

    Clinical case reports of patients with exceptional musical talent and education provide clues as to how the brain processes musical ability and aptitude. In this chapter, selected examples from famous and unknown organ players/composers are presented to demonstrate the complexity of modified musical performances as well as the capacities of the brain to preserve artistic abilities: both authors are active organists and academic neurologists with strong clinical experience, practice, and knowledge about the challenges to play such an outstanding instrument and share their interest to explore potentially instrument-related phenomena of brain modulation in specific transient or permanent impairments. We concentrate on the sites of lesions, suggested pathophysiology, separate positive (e.g., seizures, visual or auditory hallucinations, or synesthesia [an involuntary perception produced by stimulation of another sense]) and negative phenomena (e.g., amusia, aphasia, neglect, or sensory-motor deficits) and particularly address aspects of recent concepts of temporary and permanent network disorders. © 2015 Elsevier B.V. All rights reserved.

  2. Brainstem cavernous malformations: anatomical, clinical, and surgical considerations.

    PubMed

    Giliberto, Giuliano; Lanzino, Desiree J; Diehn, Felix E; Factor, David; Flemming, Kelly D; Lanzino, Giuseppe

    2010-09-01

    Symptomatic brainstem cavernous malformations carry a high risk of permanent neurological deficit related to recurrent hemorrhage, which justifies aggressive management. Detailed knowledge of the microscopic and surface anatomy is important for understanding the clinical presentation, predicting possible surgical complications, and formulating an adequate surgical plan. In this article the authors review and illustrate the surgical and microscopic anatomy of the brainstem, provide anatomoclinical correlations, and illustrate a few clinical cases of cavernous malformations in the most common brainstem areas.

  3. Rapid Characterization of Shorelines using a Georeferenced Video Mapping System

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

    Anderson, Michael G.; Judd, Chaeli; Marcoe, K.

    Increased understanding of shoreline conditions is needed, yet current approaches are limited in ability to characterize remote areas or document features at a finer resolution. Documentation using video mapping may provide a rapid and repeatable method for assessing the current state of the environment and determining changes to the shoreline over time. In this study, we compare two studies using boat-based, georeferenced video mapping in coastal Washington and the Columbia River Estuary to map and characterize coastal stressors and functional data. In both areas, mapping multiple features along the shoreline required approximation of the coastline. However, characterization of vertically orientedmore » features such as shoreline armoring and small features such as pilings and large woody debris was possible. In addition, end users noted that geovideo provides a permanent record to allow a user to examine recorded video anywhere along a transect or at discrete points.« less

  4. The role of optics in secure credentials

    NASA Astrophysics Data System (ADS)

    Lichtenstein, Terri L.

    2006-02-01

    The global need for secure ID credentials has grown rapidly over the last few years. This is evident both in government and commercial sectors. Governmental programs include national ID card programs, permanent resident cards for noncitizens, biometric visas or border crossing cards, foreign worker ID programs and secure vehicle registration programs. The commercial need for secure credentials includes secure banking and financial services, security and access control systems and digital healthcare record cards. All of these programs necessitate the use of multiple tamper and counterfeit resistant features for credential authentication and cardholder verification. It is generally accepted that a secure credential should include a combination of overt, covert and forensic security features. The LaserCard optical memory card is a proven example of a secure credential that uses a variety of optical features to enhance its counterfeit resistance and reliability. This paper will review those features and how they interact to create a better credential.

  5. The Four Forces Airpower Theory

    DTIC Science & Technology

    2011-05-19

    exported early B-17s to Great Britain to little tactical success. While British complaints led to improvements in the 0.3 and 0.5 inch guns, armor plating...civilians.64 Unfortunately, the tendency to predict unrestricted growth of friendly technology and lethality while denying the...reduced planned features. Competing defense priorities permanently stunted the program’s growth . Resource dollars may end up being one of the greatest

  6. Striking the Balance: The Role of English and German in a Multilingual English-Medium Degree Programme in German Higher Education

    ERIC Educational Resources Information Center

    Earls, Clive W.

    2014-01-01

    In 2002, English-medium degree programmes (EMDPs) became a permanent feature of German higher education (HE). While this action marked an important step towards government-supported institutionalisation of English in Germany, no formal strategy or guidelines governing the role of English in HE have been developed. To date, research in this area in…

  7. Oral rehabilitation of a patient with amelogenesis imperfecta using removable overlay denture: a clinical report.

    PubMed

    Ghodsi, S; Rasaeipour, S; Vojdani, M

    2012-03-01

    The aim of this study was oral rehabilitation of 17-year old patient with amelogenesis imperfecta using removable overlay denture in order to satisfy her esthetic and functional expectations and enhance her self-image. Amelogenesis imperfecta (AI) is a group of genetic disorders that primarily affect the quality and quantity of amelogenesis in both primary and permanent dentitions. The main clinical characteristics are severe attrition, tooth sensitivity and unesthetic appearance. This clinical report illustrates the oral rehabilitation of a 17-year-old girl with hypoplastic-hypomature type of AI with cobalt-chromium (Co-Cr) overlay removable partial denture (ORPD) that is one of the most economical and biocompatible replacements for noble metal and nickel-chromium (Ni-Cr) alloy. The presented case report suggests that Co-Cr ORPD can be a good temporary or even permanent treatment option for AI patients with limited budget, low esthetic concerns or medical limitations. There are major advantages in cast metal ORPDs; they are simpler, less traumatic and less expensive than fixed prosthetic options. This case report supports their use in patients with amelogenesis imperfecta.

  8. Gamma Knife radiosurgery for cerebral arteriovenous malformations in children/adolescents and adults. Part I: Differences in epidemiologic, morphologic, and clinical characteristics, permanent complications, and bleeding in the latency period

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

    Nicolato, Antonio; Lupidi, Francesco; Section of Stereotactic and Functional Neurosurgery, University of Verona and University Hospital, Verona

    Purpose: To compare the epidemiologic, morphologic, and clinical characteristics of 92 children/adolescents (Group A) and 362 adults (Group B) with cerebral arteriovenous malformations (cAVMs) considered suitable for radiosurgery; to correlate radiosurgery-related permanent complication and post-radiosurgery bleeding rates in the 75 children/adolescents and 297 adults available for follow-up. Methods and Materials: Radiosurgery was performed with a model C 201-source Co{sup 6} Leksell Gamma Unit (Elekta Instruments, Stockholm, Sweden). Fisher exact two-tailed, Wilcoxon rank-sum, and two-sample binomial exact tests were used for statistical analysis. Results: There were significant differences between the two populations in sex (p = 0.015), clinical presentation (p =more » 0.001), and location (p = 0.008). The permanent complication rate was lower in younger (1.3%) than in older patients (5.4%), although the difference was not significant (p = 0.213). The postradiosurgery bleeding rate was lower in Group A (1.3%) than in Group B (2.7%) (p = 0.694), with global actuarial bleeding rates of 0.56% per year and 1.15% per year, respectively. Conclusions: The different characteristics of child/adolescent and adult cAVMs suggest that they should be considered two distinct vascular disorders. The similar rates of radiosurgery-related complications and latency period bleeding in the two populations show that gamma knife radiosurgery does not expose young patients to a higher risk of sequelae than that for older patients.« less

  9. Primary Fused Teeth and Findings in Permanent Dentition.

    PubMed

    Açıkel, Hatice; İbiş, Sevgin; Şen Tunç, Emine

    2018-01-01

    The aim of this study was to investigate the characteristics of primary fused teeth (PFT) and their effect on permanent dentition in a group of Turkish children. Dental records of 13,450 pediatric patients who attended the Pediatric Dental Clinic in northern Turkey between 2015 and 2017 were reviewed. Forty patients had been diagnosed with PFT and were included in the study. Clinical and radiographic examinations were conducted, and the distribution of PFT was calculated by type, sex, affected jaw, associated dental anomalies, and clinical complications. Data analysis involved descriptive statistics. A total of 50 PFT were detected in the 40 patients. The mean age of patients was 6.7 ± 0.3 years (range 3-10 years). The most common PFT were the mandibular lateral incisors and canines (34, 68%). The most prevalent type of PFT was type III (20, 40%). Of the 40 patients with PFT, 34 (85%) also ex-hibited other dental anomalies such as tooth aplasia, peg-shaped incisors, talon cusps, ectopic eruption, and delayed eruption in both related and unrelated areas. The most common complications of PFT were fusion-related tooth aplasia (n = 26 [76%]) and caries formation in the affected teeth (24 [48%]). In this study, PFT were frequently observed in the mandibular anterior region. Caries formation and dental anomalies, especially permanent tooth aplasia, were often encountered in areas where PFT were seen. Hence, parents should be informed about possible dental problems associated with PFT and be encouraged to schedule regular follow-up appointments. ©2018 The Author(s) Published by S. Karger AG, Basel.

  10. Treatment of Mature Permanent Teeth with Necrotic Pulps and Apical Periodontitis Using Regenerative Endodontic Procedures: A Case Series.

    PubMed

    Saoud, Tarek Mohamed; Martin, Gabriela; Chen, Yea-Huey M; Chen, Kuang-Liang; Chen, Chao-An; Songtrakul, Kamolthip; Malek, Matthew; Sigurdsson, Asgeir; Lin, Louis M

    2016-01-01

    Regenerative endodontic procedures (REPs) are usually used to treat human immature permanent teeth with necrotic pulps and/or apical periodontitis. Successful REPs result in the elimination of clinical signs/symptoms, the resolution of apical periodontitis, and, in some cases, thickening of the canal walls and/or continued root development with or without apical closure. REPs can restore the vitality of tissue in the canals of immature permanent teeth previously destroyed by infection or trauma. Vital tissue is inherited with immune defense mechanisms to protect itself from foreign invaders. Recently, REPs have also been used to successfully treat human mature permanent teeth with necrotic pulps and apical periodontitis. The purpose of this case series was to present the potential of using REPs for mature permanent teeth with necrotic pulps and apical periodontitis. This case series consisted of 6 patients, 4 females and 2 males. The patients' ages ranged from 8-21 years old. Seven permanent teeth, 4 anterior and 3 molar teeth, with necrotic pulps and apical periodontitis were treated using REP. Radiographically, the root development of all teeth was almost completed except the apices of 2 molars, which showed slightly open. Complete chemomechanical debridement of the canals of the teeth was performed, and the canals were dressed with Metapaste (Meta Biomed Co, Ltd, Chungbuk, Korea) during treatment visits. Periapical bleeding into the canals was induced at the last treatment visit by placing a hand #20 or #25 K-file with the tip slightly bent through the apical foramina into the periapical tissues. A 3-mm thickness of mineral trioxide aggregate was placed into the coronal canals over semicoagulated blood. The access cavities were restored with either composite resin or amalgam. Follow-ups of the 7 teeth ranged from 8 to 26 months. The periapical lesions of 2 teeth were considered healed, and 5 teeth revealed healing. Clinical signs/symptoms were absent in all teeth at follow-up visits at different time points. None of the treated teeth responded to cold and electric pulp tests. This case series shows the potential of using REPs for mature teeth with necrotic pulp and apical periodontitis. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  11. Features of Synchronous Electronically Commutated Motors in Servomotor Operation Modes

    NASA Astrophysics Data System (ADS)

    Dirba, J.; Lavrinovicha, L.; Dobriyan, R.

    2017-04-01

    The authors consider the features and operation specifics of the synchronous permanent magnet motors and the synchronous reluctance motors with electronic commutation in servomotor operation modes. Calculation results show that mechanical and control characteristics of studied motors are close to a linear shape. The studied motor control is proposed to implement similar to phase control of induction servomotor; it means that angle θ (angle between vectors of the supply voltage and non-load electromotive force) or angle ɛ (angle between rotor direct axis and armature magnetomotive force axis) is changed. The analysis results show that synchronous electronically commutated motors could be used as servomotors.

  12. Inherited focal, episodic neuropathies: hereditary neuropathy with liability to pressure palsies and hereditary neuralgic amyotrophy.

    PubMed

    Chance, Phillip F

    2006-01-01

    Hereditary neuropathy with liability to pressure palsies (HNPP; also called tomaculous neuropathy) is an autosomal-dominant disorder that produces a painless episodic, recurrent, focal demyelinating neuropathy. HNPP generally develops during adolescence, and may cause attacks of numbness, muscular weakness, and atrophy. Peroneal palsies, carpal tunnel syndrome, and other entrapment neuropathies may be frequent manifestations of HNPP. Motor and sensory nerve conduction velocities may be reduced in clinically affected patients, as well as in asymptomatic gene carriers. The histopathological changes observed in peripheral nerves of HNPP patients include segmental demyelination and tomaculous or "sausage-like" formations. Mild overlap of clinical features with Charcot-Marie-Tooth (CMT) disease type 1 (CMT1) may lead patients with HNPP to be misdiagnosed as having CMT1. HNPP and CMT1 are both demyelinating neuropathies, however, their clinical, pathological, and electrophysiological features are quite distinct. HNPP is most frequently associated with a 1.4-Mb pair deletion on chromosome 17p12. A duplication of the identical region leads to CMT1A. Both HNPP and CMT1A result from a dosage effect of the PMP22 gene, which is contained within the deleted/duplicated region. This is reflected in reduced mRNA and protein levels in sural nerve biopsy samples from HNPP patients. Treatment for HNPP consists of preventative and symptom-easing measures. Hereditary neuralgic amyotrophy (HNA; also called familial brachial plexus neuropathy) is an autosomal-dominant disorder causing episodes of paralysis and muscle weakness initiated by severe pain. Individuals with HNA may suffer repeated episodes of intense pain, paralysis, and sensory disturbances in an affected limb. The onset of HNA is at birth or later in childhood with prognosis for recovery usually favorable; however, persons with HNA may have permanent residual neurological dysfunction following attack(s). Episodes are often triggered by infections, immunizations, the puerperium, and stress. Electrophysiological studies show normal or mildly prolonged motor nerve conduction velocities distal to the affected brachial plexus. Pathological studies have found axonal degeneration in nerves examined distal to the plexus abnormality. In some HNA pedigrees there are characteristic facial features, including hypotelorism. The prognosis for recovery of normal function of affected limbs in HNA is good, although recurrent episodes may cause residual deficits. HNA is genetically linked to chromosome 17q25, where mutations in the septin-9 (SEPT9) gene have been found.

  13. Zero-fluoroscopy permanent pacemaker implantation using Ensite NavX system: Clinical viability or fanciful technique?

    PubMed

    Guo, Ping; Qiu, Jie; Wang, Yan; Chen, Guangzhi; Proietti, Riccardo; Fadhle, Al-Selmi; Zhao, Chunxia; Wen Wang, Dao

    2018-02-01

    Fluoroscopy is the imaging modality routinely used for cardiac device implantation and electrophysiological procedures. Due to the rising concern regarding the harmful effects of radiation exposure to both the patients and operation staffs, novel 3D mapping systems have been developed and implemented in electrophysiological procedure for the navigation of catheters inside the heart chambers. Their applicability in cardiac device implantation has been rarely reported. Our aim is to evaluate the feasibility and safety of permanent pacemaker implantation without fluoroscopy. From January 2012 to June 2016, six patients (50 ± 15 years, four of six were female, one of who was at the 25th week of gestation) who underwent permanent pacemaker implantation were included (zero-fluoroscopy group). Data from 20 consecutive cases of implantation performed under fluoroscopy guidance were chosen as a control group (fluoroscopy group). Total implantation procedure time for single-chamber pacemaker was 51.3 ± 13.1 minutes in the zero-fluoroscopy group and 42.6 ± 7.4 minutes in the fluoroscopy group (P  =  0.155). The implantation procedural time for a dual-chamber pacemaker was 88.3 ± 19.6 minutes and 67.3 ± 7.6 minutes in the zero-fluoroscopy and fluoroscopy groups (P  =  0.013), respectively. No complications were observed during the procedure and the follow-up in the two groups, and all pacemakers worked with satisfactory parameters. Ensite NavX system can be used as a reliable and safe zero-fluoroscopy approach for the implantation of single- or dual-chamber permanent pacemakers in specific patients, such as pregnant women or in extreme situations when the x-ray machine is not available. © 2017 The Authors. Pacing and Clinical Electrophysiology published by Wiley Periodicals, Inc.

  14. Use of Oral Chroma™ in the assessment of volatile sulfur compounds in patients with fixed protheses.

    PubMed

    Sinjari, B; Murmura, G; Caputi, S; Ricci, L; Varvara, G; Scarano, A

    2013-01-01

    Prosthetic rehabilitation improves the patient's quality of life and oral health. The purpose of the present study was to assess the production of volatile sulfur compounds (VSCs) using Oral Chroma™ in patients wearing provisional and permanent fixed prosthesis, who were treated or not, with supportive non-surgical periodontal therapy. A total of 10 healthy patients not affected by periodontal disease and who needed the restoration of at least two edentulous single sites were included in the present study. Registrations of VSCs were carried out with a Gas Chromatograph OralChroma™ (Oral Chroma™, Abimedical, Abilit Corp., Osaka, Japan) one month after placement of the provisional restoration (group 1) and one month after placement of the final restoration (group 3). After each measurement, professional oral hygiene was carried out both on patients with provisional (group 2) and permanent prostheses (group 4) and VSC values were registered. The results showed that there were no statistical significant differences in the VSC quantity between groups with temporary or permanent prostheses. Meanwhile, statistically significant differences were found in VCS values between groups before and after the professional health care session (p less than 0.05). Also it was observed that dimethyl sulphide (CH3)2S was present in all the study groups. The present preliminary study suggests that OralChroma™ produce a comprehensive assessment of VSC in the clinical diagnosis of halitosis and that professional oral hygiene seems to influence VSC production. However, further clinical long-term studies with a larger sample size are necessary for a better understanding of halitosis manifestation in patients wearing provisional and permanent fixed prosthesis.

  15. Determination of prescription dose for Cs-131 permanent implants using the BED formalism including resensitization correction

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

    Luo, Wei, E-mail: wei.luo@uky.edu; Molloy, Janelle; Aryal, Prakash

    2014-02-15

    Purpose: The current widely used biological equivalent dose (BED) formalism for permanent implants is based on the linear-quadratic model that includes cell repair and repopulation but not resensitization (redistribution and reoxygenation). The authors propose a BED formalism that includes all the four biological effects (4Rs), and the authors propose how it can be used to calculate appropriate prescription doses for permanent implants with Cs-131. Methods: A resensitization correction was added to the BED calculation for permanent implants to account for 4Rs. Using the same BED, the prescription doses with Au-198, I-125, and Pd-103 were converted to the isoeffective Cs-131 prescriptionmore » doses. The conversion factor F, ratio of the Cs-131 dose to the equivalent dose with the other reference isotope (F{sub r}: with resensitization, F{sub n}: without resensitization), was thus derived and used for actual prescription. Different values of biological parameters such as α, β, and relative biological effectiveness for different types of tumors were used for the calculation. Results: Prescription doses with I-125, Pd-103, and Au-198 ranging from 10 to 160 Gy were converted into prescription doses with Cs-131. The difference in dose conversion factors with (F{sub r}) and without (F{sub n}) resensitization was significant but varied with different isotopes and different types of tumors. The conversion factors also varied with different doses. For I-125, the average values of F{sub r}/F{sub n} were 0.51/0.46, for fast growing tumors, and 0.88/0.77 for slow growing tumors. For Pd-103, the average values of F{sub r}/F{sub n} were 1.25/1.15 for fast growing tumors, and 1.28/1.22 for slow growing tumors. For Au-198, the average values of F{sub r}/F{sub n} were 1.08/1.25 for fast growing tumors, and 1.00/1.06 for slow growing tumors. Using the biological parameters for the HeLa/C4-I cells, the averaged value of F{sub r} was 1.07/1.11 (rounded to 1.1), and the averaged value of F{sub n} was 1.75/1.18. F{sub r} of 1.1 has been applied to gynecological cancer implants with expected acute reactions and outcomes as expected based on extensive experience with permanent implants. The calculation also gave the average Cs-131 dose of 126 Gy converted from the I-125 dose of 144 Gy for prostate implants. Conclusions: Inclusion of an allowance for resensitization led to significant dose corrections for Cs-131 permanent implants, and should be applied to prescription dose calculation. The adjustment of the Cs-131 prescription doses with resensitization correction for gynecological permanent implants was consistent with clinical experience and observations. However, the Cs-131 prescription doses converted from other implant doses can be further adjusted based on new experimental results, clinical observations, and clinical outcomes.« less

  16. Determination of prescription dose for Cs-131 permanent implants using the BED formalism including resensitization correction

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

    Luo, Wei, E-mail: wei.luo@uky.edu; Molloy, Janelle; Aryal, Prakash

    Purpose: The current widely used biological equivalent dose (BED) formalism for permanent implants is based on the linear-quadratic model that includes cell repair and repopulation but not resensitization (redistribution and reoxygenation). The authors propose a BED formalism that includes all the four biological effects (4Rs), and the authors propose how it can be used to calculate appropriate prescription doses for permanent implants with Cs-131. Methods: A resensitization correction was added to the BED calculation for permanent implants to account for 4Rs. Using the same BED, the prescription doses with Au-198, I-125, and Pd-103 were converted to the isoeffective Cs-131 prescriptionmore » doses. The conversion factor F, ratio of the Cs-131 dose to the equivalent dose with the other reference isotope (F{sub r}: with resensitization, F{sub n}: without resensitization), was thus derived and used for actual prescription. Different values of biological parameters such as α, β, and relative biological effectiveness for different types of tumors were used for the calculation. Results: Prescription doses with I-125, Pd-103, and Au-198 ranging from 10 to 160 Gy were converted into prescription doses with Cs-131. The difference in dose conversion factors with (F{sub r}) and without (F{sub n}) resensitization was significant but varied with different isotopes and different types of tumors. The conversion factors also varied with different doses. For I-125, the average values of F{sub r}/F{sub n} were 0.51/0.46, for fast growing tumors, and 0.88/0.77 for slow growing tumors. For Pd-103, the average values of F{sub r}/F{sub n} were 1.25/1.15 for fast growing tumors, and 1.28/1.22 for slow growing tumors. For Au-198, the average values of F{sub r}/F{sub n} were 1.08/1.25 for fast growing tumors, and 1.00/1.06 for slow growing tumors. Using the biological parameters for the HeLa/C4-I cells, the averaged value of F{sub r} was 1.07/1.11 (rounded to 1.1), and the averaged value of F{sub n} was 1.75/1.18. F{sub r} of 1.1 has been applied to gynecological cancer implants with expected acute reactions and outcomes as expected based on extensive experience with permanent implants. The calculation also gave the average Cs-131 dose of 126 Gy converted from the I-125 dose of 144 Gy for prostate implants. Conclusions: Inclusion of an allowance for resensitization led to significant dose corrections for Cs-131 permanent implants, and should be applied to prescription dose calculation. The adjustment of the Cs-131 prescription doses with resensitization correction for gynecological permanent implants was consistent with clinical experience and observations. However, the Cs-131 prescription doses converted from other implant doses can be further adjusted based on new experimental results, clinical observations, and clinical outcomes.« less

  17. Eligibility and FAQs | Center for Cancer Research

    Cancer.gov

    Eligibility for the Clinical Investigator Development Program Candidates may be U.S. citizens, permanent residents or possess (or be eligible for) the appropriate work visa, and must have completed subspecialty training at a U.S.-accredited institution in appropriate fields.

  18. Dynamics of slow-moving landslides from permanent scatterer analysis.

    PubMed

    Hilley, George E; Bürgmann, Roland; Ferretti, Alessandro; Novali, Fabrizio; Rocca, Fabio

    2004-06-25

    High-resolution interferometric synthetic aperture radar (InSAR) permanent scatterer data allow us to resolve the rates and variations in the rates of slow-moving landslides. Satellite-to-ground distances (range changes) on landslides increase at rates of 5 to 7 millimeters per year, indicating average downslope sliding velocities from 27 to 38 millimeters per year. Time-series analysis shows that displacement occurs mainly during the high-precipitation season; during the 1997-1998 El Niño event, rates of range change increased to as much as 11 millimeters per year. The observed nonlinear relationship of creep and precipitation rates suggests that increased pore fluid pressures within the shallow subsurface may initiate and accelerate these features. Changes in the slope of a hill resulting from increases in the pore pressure and lithostatic stress gradients may then lead to landslides.

  19. A tubular hybrid Halbach/axially-magnetized permanent-magnet linear machine

    NASA Astrophysics Data System (ADS)

    Sui, Yi; Liu, Yong; Cheng, Luming; Liu, Jiaqi; Zheng, Ping

    2017-05-01

    A single-phase tubular permanent-magnet linear machine (PMLM) with hybrid Halbach/axially-magnetized PM arrays is proposed for free-piston Stirling power generation system. Machine topology and operating principle are elaborately illustrated. With the sinusoidal speed characteristic of the free-piston Stirling engine considered, the proposed machine is designed and calculated by finite-element analysis (FEA). The main structural parameters, such as outer radius of the mover, radial length of both the axially-magnetized PMs and ferromagnetic poles, axial length of both the middle and end radially-magnetized PMs, etc., are optimized to improve both the force capability and power density. Compared with the conventional PMLMs, the proposed machine features high mass and volume power density, and has the advantages of simple control and low converter cost. The proposed machine topology is applicable to tubular PMLMs with any phases.

  20. Optimal tracking and second order sliding power control of the DFIG wind turbine

    NASA Astrophysics Data System (ADS)

    Abdeddaim, S.; Betka, A.; Charrouf, O.

    2017-02-01

    In the present paper, an optimal operation of a grid-connected variable speed wind turbine equipped with a Doubly Fed Induction Generator (DFIG) is presented. The proposed cascaded nonlinear controller is designed to perform two main objectives. In the outer loop, a maximum power point tracking (MPPT) algorithm based on fuzzy logic theory is designed to permanently extract the optimal aerodynamic energy, whereas in the inner loop, a second order sliding mode control (2-SM) is applied to achieve smooth regulation of both stator active and reactive powers quantities. The obtained simulation results show a permanent track of the MPP point regardless of the turbine power-speed slope moreover the proposed sliding mode control strategy presents attractive features such as chattering-free, compared to the conventional first order sliding technique (1-SM).

  1. Dorsal midbrain syndrome associated with persistent neck extension: Clinical and diagnostic imaging findings in 2 dogs

    PubMed Central

    Canal, Sara; Baroni, Massimo; Falzone, Cristian; De Benedictis, Giulia M.; Bernardini, Marco

    2015-01-01

    Two young dogs were evaluated for an acute onset of abnormal head posture and eye movement. Neurological examination was characterized mostly by permanent neck extension, abnormalities of pupils, and eye movement. A mesencephalic mass lesion was detected on magnetic resonance imaging in both cases. Neurophysiological pathways likely responsible for this peculiar clinical presentation are discussed. PMID:26663922

  2. An optimal design of coreless direct-drive axial flux permanent magnet generator for wind turbine

    NASA Astrophysics Data System (ADS)

    Ahmed, D.; Ahmad, A.

    2013-06-01

    Different types of generators are currently being used in wind power technology. The commonly used are induction generator (IG), doubly-fed induction generator (DFIG), electrically excited synchronous generator (EESG) and permanent magnet synchronous generator (PMSG). However, the use of PMSG is rapidly increasing because of advantages such as higher power density, better controllability and higher reliability. This paper presents an innovative design of a low-speed modular, direct-drive axial flux permanent magnet (AFPM) generator with coreless stator and rotor for a wind turbine power generation system that is developed using mathematical and analytical methods. This innovative design is implemented in MATLAB / Simulink environment using dynamic modelling techniques. The main focus of this research is to improve efficiency of the wind power generation system by investigating electromagnetic and structural features of AFPM generator during its operation in wind turbine. The design is validated by comparing its performance with standard models of existing wind power generators. The comparison results demonstrate that the proposed model for the wind power generator exhibits number of advantages such as improved efficiency with variable speed operation, higher energy yield, lighter weight and better wind power utilization.

  3. [Management of financial resources of permanent education in health: challenge of the in-service learning integration committees].

    PubMed

    Ferraz, Fabiane; Backes, Vânia Marli Schubert; Mercado-Martinez, Francisco Javier; Feuerwerker, Laura Camargo Macruz; Lino, Mônica Motta

    2013-06-01

    Despite adhering to the dynamics established in the Management Pact, the use of financial resources of Permanent Education in Health (PEH) still features as a problem in Brazil. This study analyzes how the management of these financial resources by two Permanent In-Service Learning Integration Committees (ICLS) evolves in the State of Santa Catarina, Brazil. It involves a qualitative, participatory research study adapted from Paulo Freire's Thematic Research conducted with 56 members from two ICLS between May and December 2009. After setting up the research groups, the members participated in the stages of theme generation surveys, encoding, decoding, and critical exposition of the reality. Participant observation and dialogue were the main data collection techniques. The results indicate that the two ICLS are not dissimilar in terms of issues of management of resources destined for policy, with bureaucracy, the indefinition of forms of financial management and delays that permeate regional structures responsible for resource management being the main factors detected. The participants considered the elaboration of PEH actions in the management of financial resources at state level to be the main opportunities for change.

  4. Long-term results after treatment of extensive odontogenic cysts of the jaws: a review.

    PubMed

    Wakolbinger, Robert; Beck-Mannagetta, Johann

    2016-01-01

    The aim was to perform a literature review concerning long-term results after treatment of extensive cysts of the jaws. The following databases were searched: MEDLINE, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, The Cochrane Library, and EMBASE. Case reports and abstracts were excluded. Three hundred fifty-six articles were found, of which 30 were included. Only the minority of the studies reported long-term results. Most authors did not distinguish between temporary complications and permanent deficiencies (incomplete bone healing, permanent sensory deficits). Based on this review, it is recommended to consider primary decompression or marsupialization ± later definitive surgery for the treatment of extensive jaw cysts in order to achieve satisfying clinical results. Complications (occurring within the first 6 months postoperatively, e.g., infection) and remaining deficits (after a minimum of 6 months and not changing over time, e.g., bony or sensory deficit) should be clearly separated from each other. Knowledge of permanent deficits and bone healing after different therapeutic approaches is important for decision making. Patients should be informed not only about complications but also about the risk of permanent deficits for each method.

  5. Investigating Mercury’s South Polar Deposits: Arecibo Radar Observations and High-resolution Determination of Illumination Conditions

    PubMed Central

    Chabot, Nancy L.; Shread, Evangela E.; Harmon, John K.

    2018-01-01

    There is strong evidence that Mercury’s polar deposits are water ice hosted in permanently shadowed regions. In this study, we present new Arecibo radar observations of Mercury’s south pole, which reveal numerous radar-bright deposits and substantially increase the radar imaging coverage. We also use images from MESSENGER’s full mission to determine the illumination conditions of Mercury’s south polar region at the same spatial resolution as the north polar region, enabling comparisons between the two poles. The area of radar-bright deposits in Mercury’s south is roughly double that found in the north, consistent with the larger permanently shadowed area in the older, cratered terrain at the south relative to the younger smooth plains at the north. Radar-bright features are strongly associated with regions of permanent shadow at both poles, consistent with water ice being the dominant component of the deposits. However, both of Mercury’s polar regions show that roughly 50% of permanently shadowed regions lack radar-bright deposits, despite some of these locations having thermal environments that are conducive to the presence of water ice. The observed uneven distribution of water ice among Mercury’s polar cold traps may suggest that the source of Mercury’s water ice was not a steady, regular process but rather that the source was an episodic event, such as a recent, large impact on the innermost planet. PMID:29552436

  6. 14 CFR 67.111 - Cardiovascular.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... diagnosis of any of the following: (1) Myocardial infarction; (2) Angina pectoris; (3) Coronary heart disease that has required treatment or, if untreated, that has been symptomatic or clinically significant; (4) Cardiac valve replacement; (5) Permanent cardiac pacemaker implantation; or (6) Heart replacement...

  7. 14 CFR 67.311 - Cardiovascular.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... diagnosis of any of the following: (a) Myocardial infarction; (b) Angina pectoris; (c) Coronary heart disease that has required treatment or, if untreated, that has been symptomatic or clinically significant; (d) Cardiac valve replacement; (e) Permanent cardiac pacemaker implantation; or (f) Heart replacement. ...

  8. 14 CFR 67.311 - Cardiovascular.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... diagnosis of any of the following: (a) Myocardial infarction; (b) Angina pectoris; (c) Coronary heart disease that has required treatment or, if untreated, that has been symptomatic or clinically significant; (d) Cardiac valve replacement; (e) Permanent cardiac pacemaker implantation; or (f) Heart replacement. ...

  9. 14 CFR 67.111 - Cardiovascular.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... diagnosis of any of the following: (1) Myocardial infarction; (2) Angina pectoris; (3) Coronary heart disease that has required treatment or, if untreated, that has been symptomatic or clinically significant; (4) Cardiac valve replacement; (5) Permanent cardiac pacemaker implantation; or (6) Heart replacement...

  10. 14 CFR 67.111 - Cardiovascular.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... diagnosis of any of the following: (1) Myocardial infarction; (2) Angina pectoris; (3) Coronary heart disease that has required treatment or, if untreated, that has been symptomatic or clinically significant; (4) Cardiac valve replacement; (5) Permanent cardiac pacemaker implantation; or (6) Heart replacement...

  11. 14 CFR 67.311 - Cardiovascular.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... diagnosis of any of the following: (a) Myocardial infarction; (b) Angina pectoris; (c) Coronary heart disease that has required treatment or, if untreated, that has been symptomatic or clinically significant; (d) Cardiac valve replacement; (e) Permanent cardiac pacemaker implantation; or (f) Heart replacement. ...

  12. 14 CFR 67.111 - Cardiovascular.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... diagnosis of any of the following: (1) Myocardial infarction; (2) Angina pectoris; (3) Coronary heart disease that has required treatment or, if untreated, that has been symptomatic or clinically significant; (4) Cardiac valve replacement; (5) Permanent cardiac pacemaker implantation; or (6) Heart replacement...

  13. 14 CFR 67.311 - Cardiovascular.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... diagnosis of any of the following: (a) Myocardial infarction; (b) Angina pectoris; (c) Coronary heart disease that has required treatment or, if untreated, that has been symptomatic or clinically significant; (d) Cardiac valve replacement; (e) Permanent cardiac pacemaker implantation; or (f) Heart replacement. ...

  14. Rolamite acceleration sensor

    DOEpatents

    Abbin, Joseph P.; Briner, Clifton F.; Martin, Samuel B.

    1993-01-01

    A rolamite acceleration sensor which has a failsafe feature including a housing, a pair of rollers, a tension band wrapped in an S shaped fashion around the rollers, wherein the band has a force-generation cut out and a failsafe cut out or weak portion. The failsafe cut out or weak portion breaks when the sensor is subjected to an excessive acceleration so that the sensor fails in an open circuit (non-conducting) state permanently.

  15. Address at the Opening Meeting of the Symposium on Books in the Service of Peace, Humanism and Progress, Moscow (USSR).

    ERIC Educational Resources Information Center

    Maheu, Rene

    The knowledge that books are still not a permanent feature of everyone's daily life in the developed nations of the world, and that many nations of the Third World are still experiencing a real book famine led to the Unesco declaration proclaiming 1972 International Book Year with its theme, "Books for All." This theme is reflected in…

  16. Eruption of the permanent maxillary canines in relation to mandibular second molar maturity.

    PubMed

    Perinetti, Giuseppe; Callovi, Marilena; Salgarello, Stefano; Biasotto, Matteo; Contardo, Luca

    2013-07-01

    To evaluate the timing of spontaneous maxillary canine eruption in relation to stages of mandibular second molar maturation. Potential confounding effects from such factors as age, growth phase, and facial features were also explored. A sample of 106 healthy subjects (48 females and 58 males; age range, 9.4-14.3 years) with both permanent maxillary canines during the final phase of intraoral eruption were included. Mandibular second molar maturation (stages E to H) was assessed according to the method of Demirjian. Skeletal maturity was determined using the cervical vertebral maturational (CVM) method. Facial vertical and sagittal relationships were evaluated by recording the Sella-Nasion/mandibular plane (SN/MP) angle and the ANB angle. An ordered multiple logistic regression was run to evaluate adjusted correlation of each parameter with the mandibular second molar maturational stage. Overall, the prevalence of the different second molar maturational stages was 36.8%, 37.8%, and 27.4% for stages E, F and G, respectively. According to the regression model, this relation was not influenced by sex, CVM stage, SN/MP angle, and ANB angle. Irrespective of sex, growth phase, and facial features, the maturational stage of the mandibular second molar may be a reliable indicator for the timing of spontaneous eruption of the maxillary canine.

  17. Effects of isopropanol on collagen fibrils in new parchment

    PubMed Central

    2012-01-01

    Background Isopropanol is widely used by conservators to relax the creases and folds of parchment artefacts. At present, little is known of the possible side effects of the chemical on parchments main structural component- collagen. This study uses X-ray Diffraction to investigate the effects of a range of isopropanol concentrations on the dimensions of the nanostructure of the collagen component of new parchment. Results It is found in this study that the packing features of the collagen molecules within the collagen fibril are altered by exposure to isopropanol. The results suggest that this chemical treatment can induce a loss of structural water from the collagen within parchment and thus a rearrangement of intermolecular bonding. This study also finds that the effects of isopropanol treatment are permanent to parchment artefacts and cannot be reversed with rehydration using deionised water. Conclusions This study has shown that isopropanol induces permanent changes to the packing features of collagen within parchment artefacts and has provided scientific evidence that its use to remove creases and folds on parchment artefacts will cause structural change that may contribute to long-term deterioration of parchment artefacts. This work provides valuable information that informs conservation practitioners regarding the use of isopropanol on parchment artefacts. PMID:22462769

  18. Clinical features of subepithelial layer irregularities of cornea.

    PubMed

    Lee, Yong Woo; Gye, Hyo Jung; Choi, Chul Young

    2015-07-01

    To illustrate surgical outcomes of subepithelial irregularities that were identified incidentally during laser refractive surgery. The study group consisted of 406 patients who underwent 787 surface ablation refractive surgeries. Ophthalmologic evaluations were performed before each procedure and at 1, 3 and 6 months post-operatively. Subepithelial irregularities were evaluated by analyzing still photographs captured from video recordings. Sizes and locations were determined by a calibrated scale located at the major axis of the tracking system's reticle. Subepithelial irregularities were identified in 27 eyes during 787 surface ablation refractive surgeries. Most of the subepithelial irregularities did not show any abnormalities in the wavefront aberrometer. However, one case with diameter greater than 1.00 mm and one case of clustered multiple subepithelial irregularities with moderate size were corresponded significant coma (Z31) and increased higher order aberration (HOA) in the HOA gradient map. Corneal subepithelial irregularities may be related to problems that include significantly increased localized HOA and remaining permanent subepithelial opacity. Subepithelial irregularity should be considered even if the surface of the cornea is intact and there are no specific findings measured by corneal topography.

  19. How implantable cardioverter-defibrillators work and simple programming.

    PubMed

    Bryant, Randall M

    2017-01-01

    Following the sudden death of a friend in 1966, Dr Michel Mirowski began pioneering work on the first implantable cardioverter-defibrillator. By 1969 he had developed an experimental model and performed the first transvenous defibrillation. In 1970 he reported on the use of a "standby automatic defibrillator" that was tested successfully in dogs. He postulated that such a device "when adapted for clinical use, might be implanted temporarily or permanently in selected patients particularly prone to develop ventricular fibrillation and thus provide them with some degree of protection from sudden coronary death". In 1980 he reported on the first human implants of an "electronic device designed to monitor cardiac electrical activity, to recognise ventricular fibrillation and ventricular tachyarrhythmias … and then to deliver corrective defibrillatory discharges". Through innovations in circuitry, battery, and capacitor technologies, the current implantable cardioverter-defibrillator is 10 times smaller and exponentially more sophisticated than that first iteration. This article will review the inner workings of the implantable cardioverter-defibrillator and outline several features that make it the wonder in technology that it has become.

  20. Leprosy in a patient infected with HIV.

    PubMed

    Galtrey, Clare M; Modarres, Hamid; Jaunmuktane, Zane; Brandner, Sebastian; Rossor, Alexander M; Lockwood, Diana Nj; Reilly, Mary M; Manji, Hadi; Schon, Fred

    2017-04-01

    A 60-year-old Nigerian man, who had lived in Europe for 30 years but had returned home frequently, presented with right frontalis muscle weakness and right ulnar nerve palsy, without skin lesions. Neurophysiology showed a generalised neuropathy with demyelinating features. Blood tests were positive for HIV, with a normal CD4 count. There was nerve thickening both clinically and on MRI. Nerve biopsy showed chronic endoneuritis and perineuritis (indicating leprosy) without visible mycobacteria. His neuropathy continued to deteriorate (lepra reaction) before starting treatment with WHO multidrug therapy, highly active antiretroviral therapy and corticosteroids. There are 10 new cases of leprosy diagnosed annually in the UK. Coinfection with HIV is rare but paradoxically does not usually adversely affect the outcome of leprosy or change treatment. However, permanent nerve damage in leprosy is common despite optimal therapy. Leprosy should be considered in patients from endemic areas who present with mononeuritis multiplex. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Intraoperative hypertensive crisis secondary to an undiagnosed pheochromocytoma during orthognathic surgery: a case report.

    PubMed

    Bouchard, Carl; Chiniara, Gilles; Valcourt, Annie-Claude

    2014-04-01

    Increased blood pressure (BP) during orthognathic surgery may result in excessive blood loss, poor surgical field visualization, and longer surgical time and require blood transfusion. When uncontrollable high BP is encountered in an otherwise healthy patient during orthognathic surgery, the diagnosis of pheochromocytoma should be considered. Pheochromocytomas are rare neuroendocrine tumors of the chromaffin cells of the adrenal medulla or extra-adrenal paraganglia (sympathetic ganglia) that secrete catecholamine. They are present in approximately 0.05 to 0.2% of hypertensive patients. Patients can present with hypertension, tachycardia, headaches, and diaphoresis. The clinical presentation may vary and a wide spectrum of nonspecific symptoms may be encountered. The elevated BP can be intermittent (40%) or permanent (60%). About 10% of pheochromocytomas are hereditary and they can be a feature of multiple endocrine neoplasia type 2. This report describes the case of a 29-year-old patient with a large pheochromocytoma of the right adrenal gland undiagnosed before orthognathic surgery. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Long-term survival and vitality outcomes of permanent teeth following deep caries treatment with step-wise and partial-caries-removal: A Systematic Review.

    PubMed

    Hoefler, Vaughan; Nagaoka, Hiroko; Miller, Craig S

    2016-11-01

    A systematic review was performed to compare the long-term survival of deep dentine caries-affected permanent teeth treated with partial-caries-removal (PCR) versus similar teeth treated with stepwise-caries-removal techniques (SWT). Clinical studies investigating long-term PCR and SWT outcomes in unrestored permanent teeth with deep dentine caries were evaluated. Failures were defined as loss of pulp vitality or restorative failures following treatment. PubMed, Web of Science, Dentistry and Oral Sciences Source, and Central databases were systematically searched. From 136 potentially relevant articles, 9 publications utilizing data from 5 studies (2 RCTs, and 3 observational case-series) reporting outcomes for 426 permanent teeth over two to ten years were analyzed. Regarding restorative failures, >88% success at two years for both techniques was reported. For loss of pulp vitality, observational studies reported >96% vitality at two years for each technique, while one RCT reported significantly higher vitality (p<0.05) at three years for PCR (96%) compared to SWT (83%). Risk of bias was high in all studies. Successful vitality and restorative outcomes for both PCR and SWT have been demonstrated at two years and beyond in permanent teeth with deep dentine caries. Partial-caries-removal may result in fewer pulpal complications over a three year period than SWT, although claims of a therapeutic advantage are based on very few, limited-quality studies. Partial-caries-removal and SWT are deep caries management techniques that reduce pulp exposure risk. Permanent teeth with deep dentine caries treated with either technique have a high likelihood for survival beyond two years. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Balance of autonomic nervous system in children having signs of endothelial dysfunction, that were born and are domiciled in contaminated territories.

    PubMed

    Kondrashova, V G; Kolpakov, I E; Vdovenko, V Yu; Leonovych, O S; Lytvynets, O M; Stepanova, E I

    2014-09-01

    Objective. The study examined the features of functional state of the autonomic nervous system in children having endothelial dysfunction and permanently residing in contaminated areas. Materials and methods. Clinical and instrumental examination of 101 children aged 7-18 years that were born and are domiciled in contaminated territories, including 37 persons with signs of endothelial dysfunction (subgroup IA) and 64 ones with no signs of endothelial dysfunction (IB subgroup) was conducted. The control group being comparable to the subgroups IA and IB by age, gender and clinical examination results included 37 children neither been domiciled in contaminated areas nor were belonging to the contingent of Chornobyl accident survivors. There were 20 apparently healthy children also examined. Results. Due to peculiarities of physiological pathways providing adaptive responses the children having signs of endothelial dysfunction are characterized by a more pronounced dysregulation of autonomous nervous system both in a resting state and under a functional load simulation, and also by a high strain of adaptation pathways. The lack of autonomous support of cardiovascular system is caused by inadequate adaptive responses of both central regulatory bodies (hypothalamus, vasomotor center) and peripheral receptors. Mainly the failure of segmental autonomous (parasympathetic) structures was revealed. The mode of their response to stress in this case corresponds to that in healthy individuals but at a lower functional level. There is a reduced aerobic capacity of the organism by the Robinson index, contributing to low adaptive range to non-specific stress in children being domiciled on contaminated territories including children having the endothelial dysfunction. Conclusions. Endothelial dysfunction was associated with more pronounced manifestations of autonomic dysregulation and reduced aerobic capacity of the organism being the risk factors of development of a range of somatic diseases requiring the development of prevention measures in children permanently residing in contaminated areas. autonomous nervous system balance, endothelial dysfunction, children, Chornobyl accident. V. G. Kondrashova, I. E. Kolpakov, V. Yu. Vdovenko, O. S. Leonovych, O. M. Lytvynets, E. I. Stepanova.

  4. Phase 2 Clinical Trials: D-Methionine to Reduce Noise-Induced Hearing Loss

    DTIC Science & Technology

    2016-07-01

    no lapses in regulatory reports or approvals (IRB, HRPO, FDA). KEYWORDS: D-methionine, noise, protection, hearing loss , antioxidant, free radicals...25, 2012 2012“D-methionine (D-met) Pre- Loading Prior to Noise Exposure Significantly Reduces Temporary and Permanent Noise-Induced Hearing Loss ...1 AWARD NUMBER: W81XWH-11-C-0033 TITLE: Phase 2 Clinical Trials: D-Methionine to Reduce Noise-induced Hearing Loss PRINCIPAL INVESTIGATOR

  5. Root anatomy and canal configuration of the permanent mandibular first molar: clinical implications and recommendations.

    PubMed

    de Pablo, Oliver Valencia; Estevez, Roberto; Heilborn, Carlos; Cohenca, Nestor

    2012-01-01

    Root canal anatomy may present clinicians with a complex clinical challenge that requires diagnostic approaches, access modification, and clinical skills to successfully localize, negotiate, disinfect, and seal the root canal system. This article discusses the clinical implications of endodontic therapy on permanent mandibular first molars. The number of roots on the mandibular first molar is directly related to ethnicity. Canal morphology has a significant effect on treatment protocol: Mesial roots present two canals on a regular basis, adopting 2-2 and 2-1 as the most common configurations. A third canal is present in 2.6% of the population. The most common configuration in the distal root is type I (62.7%), followed by type II (14.5%) and type IV (12.4%). Diagnosis and treatment of complex root canal systems often require specialized training that may be beyond the scope of the average general practitioner. Access modifications are required to find extra roots and/or canals. The instrumentation of the third root requires a different access and small, flexible instruments, given the curvature that is usually present buccally in the apical third. The incidence of isthmuses is 55% in the mesial root and 20% in the distal root. This anatomical configuration should be taken into consideration during endodontic treatment as well as during periapical surgery.

  6. Benefits of Permanent His Bundle Pacing Combined With Atrioventricular Node Ablation in Atrial Fibrillation Patients With Heart Failure With Both Preserved and Reduced Left Ventricular Ejection Fraction.

    PubMed

    Huang, Weijian; Su, Lan; Wu, Shengjie; Xu, Lei; Xiao, Fangyi; Zhou, Xiaohong; Ellenbogen, Kenneth A

    2017-04-01

    Clinical benefits from His bundle pacing (HBP) in heart failure patients with preserved and reduced left ventricular ejection fraction are still inconclusive. This study evaluated clinical outcomes of permanent HBP in atrial fibrillation patients with narrow QRS who underwent atrioventricular node ablation for heart failure symptoms despite rate control by medication. The study enrolled 52 consecutive heart failure patients who underwent attempted atrioventricular node ablation and HBP for symptomatic atrial fibrillation. Echocardiographic left ventricular ejection fraction and left ventricular end-diastolic dimension, New York Heart Association classification and use of diuretics for heart failure were assessed during follow-up visits after permanent HBP. Of 52 patients, 42 patients (80.8%) received permanent HBP and atrioventricular node ablation with a median 20-month follow-up. There was no significant change between native and paced QRS duration (107.1±25.8 versus 105.3±23.9 milliseconds, P =0.07). Left ventricular end-diastolic dimension decreased from the baseline ( P <0.001), and left ventricular ejection fraction increased from baseline ( P <0.001) in patients with a greater improvement in heart failure with reduced ejection fraction patients (N=20) than in heart failure with preserved ejection fraction patients (N=22). New York Heart Association classification improved from a baseline 2.9±0.6 to 1.4±0.4 after HBP in heart failure with reduced ejection fraction patients and from a baseline 2.7±0.6 to 1.4±0.5 after HBP in heart failure with preserved ejection fraction patients. After 1 year of HBP, the numbers of patients who used diuretics for heart failure decreased significantly ( P <0.001) when compared to the baseline diuretics use. Permanent HBP post-atrioventricular node ablation significantly improved echocardiographic measurements and New York Heart Association classification and reduced diuretics use for heart failure management in atrial fibrillation patients with narrow QRS who suffered from heart failure with preserved or reduced ejection fraction. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  7. Comparative Assessment of Conventional Composites and Coloured Compomers in Permanent Molars of Children with Mixed Dentition: A Pilot Study

    PubMed Central

    Kohli, Divyata; Badakar, Chandrashekhar M; Vyavahare, Supriya S; Shah, Parin P; Gokhale, Niraj S; Patel, Punit M; Mundada, Madhura V

    2017-01-01

    Introduction Early treatment of carious lesions in children is important for the maintenance of oral health. Multicoloured restorations could be the impetus for an extremely nervous or defiant child to take dental treatment. Aim The aim of this study was to assess and compare the clinical success of conventional composites and coloured compomer material in first permanent molars of children with mixed dentition. Materials and Methods A total of sixty sites, divided into two groups, with thirty subjects in each group using split mouth design were chosen amongst patients reporting to Department of Pedodontics and Preventive Dentistry. In control group conventional composites were placed, similarly coloured compomers were placed in experimental group under standard operating protocol. Patients were recalled for assessment of clinical success amongst control as well as experimental group at regular intervals of one; three and six months follow up based on Modified Ryge’s Criteria. Statistical analysis was done using Chi-square test using SPSS version 20.0 (Chicago, USA). Results Both conventional composites and coloured compomers had comparable retention rates in terms of anatomical form, marginal integrity, secondary caries and marginal discolouration. Conclusion The coloured compomer material showed promising results in this six month follow up study in permanent molars and had properties comparable to that of conventional composites. PMID:28764297

  8. Prevalence of venous obstruction in permanent endovenous pacing in newborns and infants: follow-up study.

    PubMed

    Stojanov, Petar; Vranes, Mile; Velimirovic, Dusan; Zivkovic, Mirjana; Kocica, Mladen J; Davidovic, Lazar; Neskovic, Voislava; Stajevic, Mila

    2005-05-01

    We examined the prevalence of venous obstruction in 12 newborns and infants with permanent endovenous ventricular pacing, clinically, and by ultrasonographic assessment of hemodynamics (spontaneity, phasicity, velocity, and turbulence of flow) and morphologic parameters (compressibility, wall thickness, and thrombus presence). All implantations of single ventricular unipolar endovenous steroid leads, were performed via cephalic vein, and pacemakers were placed in subcutaneous pocket in right prepectoral region. After the vascular surgeon has carefully examined all children for presence of venous collaterals in the chest wall, morphologic and hemodynamic parameters of the subclavian, axillary, and internal jugular veins, were assessed by linear-array color Doppler. Lead capacity (LC) was calculated for each patient. Mean age of patients at implant was 6.2 months (range 1 day-12 months), mean weight 6.5 kg (range 2.25-10 kg), and mean height 60.9 cm (range 48-78 cm). Mean LC was 1.99 (range 1.14-3.07). Total follow-up was 1023 and mean follow-up 85.2 pacing months (range 3-156). No clinical signs of venous obstruction were observed. Mild stenosis (20%) of subclavian vein was found by color Doppler in 2/12 patients. Both had adequate lead diameter for body surface. Permanent endovenous pacing is a feasible procedure, even in children of body weight less than 10 kg, with quite acceptable impact on venous system patency.

  9. Thermal and time-temperature index (TTI) patterns during geologic evolution of north and central Gulf of Mexico

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

    Lowrie, A.; Hamiter, R.; Fogarty, M.A.

    1996-09-01

    Regional thermal and Time-Temperature Index (TTI) contours were prepared for 12 dip paleo-tectonic reconstructions extending from central Arkansas to the central Gulf Basin. The first 9 reconstructions are based on back-stripping of Series-long sequences above the Louann Salt with the salt not restored. Additional reconstructions through Lower Jurassic set a geologic scenario prior to continental rifting. The reconstructions with salt not restored reveal a paleo-Sigsbee salt wedge, undergirding the Upper Jurassic to Pleistocene continental slope, has been a {open_quotes}permanent{close_quotes} ocean-side feature of the prograding margin, a salt-sediment geometry not in existent salt tectonic theories. Such a permanent and laterally migratingmore » {open_quotes}salt nose{close_quotes} provides an obstacle against which descending gravity-driven sediments can interact, creating reservoir-grade deposits against protruding salts features. The nose migration has left a lubricating layer of salt welds and other features. This salt-surrounded unit, beneath and downdip, may be termed a {open_quotes}salt-floored sub-basin{close_quotes} containing mostly {open_quotes}shallow{close_quotes} sediments of coastal plain, shelf, and slope genesis and growing through time. By Lower Cretaceous (131-96 mybp) times, the salt-floored basin updip from the then Sigsbee salt wedge was deep enough, approximately 5-7 km, that hydrocarbon maturation had begun. In the Upper Cretaceous (96-66 mybp), hydrocarbon maturation extended to sediments along flanks of the recently extinct mid-ocean ridge. From then to the present, ever more of the sedimentary volume has been subject to maturation.« less

  10. Perception of stochastically undersampled sound waveforms: a model of auditory deafferentation

    PubMed Central

    Lopez-Poveda, Enrique A.; Barrios, Pablo

    2013-01-01

    Auditory deafferentation, or permanent loss of auditory nerve afferent terminals, occurs after noise overexposure and aging and may accompany many forms of hearing loss. It could cause significant auditory impairment but is undetected by regular clinical tests and so its effects on perception are poorly understood. Here, we hypothesize and test a neural mechanism by which deafferentation could deteriorate perception. The basic idea is that the spike train produced by each auditory afferent resembles a stochastically digitized version of the sound waveform and that the quality of the waveform representation in the whole nerve depends on the number of aggregated spike trains or auditory afferents. We reason that because spikes occur stochastically in time with a higher probability for high- than for low-intensity sounds, more afferents would be required for the nerve to faithfully encode high-frequency or low-intensity waveform features than low-frequency or high-intensity features. Deafferentation would thus degrade the encoding of these features. We further reason that due to the stochastic nature of nerve firing, the degradation would be greater in noise than in quiet. This hypothesis is tested using a vocoder. Sounds were filtered through ten adjacent frequency bands. For the signal in each band, multiple stochastically subsampled copies were obtained to roughly mimic different stochastic representations of that signal conveyed by different auditory afferents innervating a given cochlear region. These copies were then aggregated to obtain an acoustic stimulus. Tone detection and speech identification tests were performed by young, normal-hearing listeners using different numbers of stochastic samplers per frequency band in the vocoder. Results support the hypothesis that stochastic undersampling of the sound waveform, inspired by deafferentation, impairs speech perception in noise more than in quiet, consistent with auditory aging effects. PMID:23882176

  11. Post-operative diffusion weighted imaging as a predictor of posterior fossa syndrome permanence in paediatric medulloblastoma.

    PubMed

    Chua, Felicia H Z; Thien, Ady; Ng, Lee Ping; Seow, Wan Tew; Low, David C Y; Chang, Kenneth T E; Lian, Derrick W Q; Loh, Eva; Low, Sharon Y Y

    2017-03-01

    Posterior fossa syndrome (PFS) is a serious complication faced by neurosurgeons and their patients, especially in paediatric medulloblastoma patients. The uncertain aetiology of PFS, myriad of cited risk factors and therapeutic challenges make this phenomenon an elusive entity. The primary objective of this study was to identify associative factors related to the development of PFS in medulloblastoma patient post-tumour resection. This is a retrospective study based at a single institution. Patient data and all related information were collected from the hospital records, in accordance to a list of possible risk factors associated with PFS. These included pre-operative tumour volume, hydrocephalus, age, gender, extent of resection, metastasis, ventriculoperitoneal shunt insertion, post-operative meningitis and radiological changes in MRI. Additional variables included molecular and histological subtypes of each patient's medulloblastoma tumour. Statistical analysis was employed to determine evidence of each variable's significance in PFS permanence. A total of 19 patients with appropriately complete data was identified. Initial univariate analysis did not show any statistical significance. However, multivariate analysis for MRI-specific changes reported bilateral DWI restricted diffusion changes involving both right and left sides of the surgical cavity was of statistical significance for PFS permanence. The authors performed a clinical study that evaluated possible risk factors for permanent PFS in paediatric medulloblastoma patients. Analysis of collated results found that post-operative DWI restriction in bilateral regions within the surgical cavity demonstrated statistical significance as a predictor of PFS permanence-a novel finding in the current literature.

  12. Statins Improve Long Term Patency of Arteriovenous Fistula for Hemodialysis

    PubMed Central

    Chang, Hao-Hsiang; Chang, Yu-Kang; Lu, Chia-Wen; Huang, Chi-Ting; Chien, Chiang-Ting; Hung, Kuan-Yu; Huang, Kuo-Chin; Hsu, Chih-Cheng

    2016-01-01

    The protective effects of statins against stenosis for permanent hemodialysis access have been repeatedly demonstrated in animal studies, but remain controversial in human studies. This study aims to evaluate the association between statin use and permanent hemodialysis access patency using a nationwide hemodialysis cohort. A total of 9862 pairs of statin users and non-users, matched by age and gender, were selected for investigation from 75404 new hemodialysis patients during 2000–2008. The effect of statins on permanent hemodialysis access patency was evaluated using Cox proportional hazards models. Compared with non-users, statin users had an overall 18% risk reduction in the composite endpoint in which angioplasty and recreation were combined (adjusted hazard ratio = 0.82 [95%CI, 0.78–0.87]) and 21% in recreation of permanent hemodialysis access (adjusted hazard ratio = 0.79 [95%CI, 0.69–0.80]). Specifically, the protective effect was found for arteriovenous fistula (adjusted hazard ratio = 0.78[95% CI, 0.73–0.82] for composite endpoint and 0.74 [95% CI, 0.69–0.80] for vascular recreation), but not for arteriovenous grafts (adjusted hazard ratio = 1.10 [95% CI, 0.98–1.24] and 0.94 [95% CI, 0.83–1.07]). Statins possess a protective effect for arteriovenous fistula against the recreation of permanent hemodialysis access. The results provide a pharmaco-epidemiologic link between basic research and clinical evidence. PMID:26902330

  13. Teaching of direct posterior resin composite restorations in UK dental therapy training programmes.

    PubMed

    Lynch, C D; Wilson, N H F

    2010-05-08

    With the numbers of dental therapists involved in the delivery of dental care within the UK on the increase, and the trend towards the use of direct resin composites (composites) for the restoration of posterior teeth, this study was undertaken to describe the teaching of posterior composites in dental therapy training programmes in the UK. A secondary aim was to identify differences in techniques for posterior composites taught within these dental therapy training programmes. In 2008/9, a questionnaire seeking information on the teaching of posterior composites was distributed by email to 13 centres with dental therapy training programmes in the UK. This questionnaire sought information relating to the teaching of direct posterior composites to dental therapy students, including the amounts of preclinical and clinical teaching in respect of deciduous and permanent teeth, numbers of restorations placed, contraindications to placement, and details in respect of operative techniques. Ten completed responses were received (response rate = 77%). In ten programmes, student dental therapists received clinical training in the placement of composite restorations in the occlusal surfaces of premolar and permanent molar teeth, and nine programmes included such training for two and three surface occlusoproximal restorations. The mean proportions of posterior restorations placed clinically by the trainee dental therapists in permanent teeth using dental amalgam and composite were 52% and 46% respectively (range: amalgam = 20-95%; composite = 5-70%). With the exception of one programme, the teaching of posterior composites is a well established element of dental therapy training. Some variations were noted in the teaching of clinical techniques between respondent training centres. It is suggested that to ensure harmony in approaches to treatments provided by graduated therapists that training centres look to relevant consensus documents, such as those of the British Association for the Teaching of Conservative Dentistry. The findings of our study are important for the future provision of oral healthcare, given the growing evidence base in favour of minimally invasive dentistry.

  14. Viral Characteristics Associated with the Clinical Nonprogressor Phenotype Are Inherited by Viruses from a Cluster of HIV-1 Elite Controllers

    PubMed Central

    2018-01-01

    ABSTRACT A small group of HIV-1-infected individuals, called long-term nonprogressors (LTNPs), and in particular a subgroup of LTNPs, elite controllers (LTNP-ECs), display permanent control of viral replication and lack of clinical progression. This control is the result of a complex interaction of host, immune, and viral factors. We identified, by phylogenetic analysis, a cluster of LTNP-ECs infected with very similar low-replication HIV-1 viruses, suggesting the contribution of common viral features to the clinical LTNP-EC phenotype. HIV-1 envelope (Env) glycoprotein mediates signaling and promotes HIV-1 fusion, entry, and infection, being a key factor of viral fitness in vitro, cytopathicity, and infection progression in vivo. Therefore, we isolated full-length env genes from viruses of these patients and from chronically infected control individuals. Functional characterization of the initial events of the viral infection showed that Envs from the LTNP-ECs were ineffective in the binding to CD4 and in the key triggering of actin/tubulin-cytoskeleton modifications compared to Envs from chronic patients. The viral properties of the cluster viruses result in a defective viral fusion, entry, and infection, and these properties were inherited by every virus of the cluster. Therefore, inefficient HIV-1 Env functions and signaling defects may contribute to the low viral replication capacity and transmissibility of the cluster viruses, suggesting a direct role in the LTNP-EC phenotype of these individuals. These results highlight the important role of viral characteristics in the LTNP-EC clinical phenotype. These Env viral properties were common to all the cluster viruses and thus support the heritability of the viral characteristics. PMID:29636433

  15. Failure Rate of Direct High-Viscosity Glass-Ionomer Versus Hybrid Resin Composite Restorations in Posterior Permanent Teeth - a Systematic Review

    PubMed Central

    Mickenautsch, Steffen; Yengopal, Veerasamy

    2015-01-01

    Purpose Traditionally, resin composite restorations are claimed by reviews of the dental literature as being superior to glass-ionomer fillings in terms of restoration failures in posterior permanent teeth. The aim of this systematic review is to answer the clinical question, whether conventional high-viscosity glass-ionomer restorations, in patients with single and/or multi-surface cavities in posterior permanent teeth, have indeed a higher failure rate than direct hybrid resin composite restorations. Methods Eight databases were searched until December 02, 2013. Trials were assessed for bias risks, in-between datasets heterogeneity and statistical sample size power. Effects sizes were computed and statistically compared. A total of 55 citations were identified through systematic literature search. From these, 46 were excluded. No trials related to high-viscosity glass-ionomers versus resin composite restorations for direct head-to-head comparison were found. Three trials related to high-viscosity glass-ionomers versus amalgam and three trials related to resin composite versus amalgam restorations could be included for adjusted indirect comparison, only. Results The available evidence suggests no difference in the failure rates between both types of restoration beyond the play of chance, is limited by lack of head-to-head comparisons and an insufficient number of trials, as well as by high bias and in-between-dataset heterogeneity risk. The current clinical evidence needs to be regarded as too poor in order to justify superiority claims regarding the failure rates of both restoration types. Sufficiently large-sized, parallel-group, randomised control trials with high internal validity are needed, in order to justify any clinically meaningful judgment to this topic. PMID:26962372

  16. A systematic map of systematic reviews in pediatric dentistry--what do we really know?

    PubMed

    Mejàre, Ingegerd A; Klingberg, Gunilla; Mowafi, Frida K; Stecksén-Blicks, Christina; Twetman, Svante H A; Tranæus, Sofia H

    2015-01-01

    To identify, appraise and summarize existing knowledge and knowledge gaps in practice-relevant questions in pediatric dentistry. A systematic mapping of systematic reviews was undertaken for domains considered important in daily clinical practice. The literature search covered questions in the following domains: behavior management problems/dental anxiety; caries risk assessment and caries detection including radiographic technologies; prevention and non-operative treatment of caries in primary and young permanent teeth; operative treatment of caries in primary and young permanent teeth; prevention and treatment of periodontal disease; management of tooth developmental and mineralization disturbances; prevention and treatment of oral conditions in children with chronic diseases/developmental disturbances/obesity; diagnosis, prevention and treatment of dental erosion and tooth wear; treatment of traumatic injuries in primary and young permanent teeth and cost-effectiveness of these interventions. Abstracts and full text reviews were assessed independently by two reviewers and any differences were solved by consensus. AMSTAR was used to assess the risk of bias of each included systematic review. Reviews judged as having a low or moderate risk of bias were used to formulate existing knowledge and knowledge gaps. Out of 81 systematic reviews meeting the inclusion criteria, 38 were judged to have a low or moderate risk of bias. Half of them concerned caries prevention. The quality of evidence was high for a caries-preventive effect of daily use of fluoride toothpaste and moderate for fissure sealing with resin-based materials. For the rest the quality of evidence for the effects of interventions was low or very low. There is an urgent need for primary clinical research of good quality in most clinically-relevant domains in pediatric dentistry.

  17. A Systematic Map of Systematic Reviews in Pediatric Dentistry—What Do We Really Know?

    PubMed Central

    Mejàre, Ingegerd A.; Klingberg, Gunilla; Mowafi, Frida K.; Stecksén-Blicks, Christina; Twetman, Svante H. A.; Tranæus, Sofia H.

    2015-01-01

    Objectives To identify, appraise and summarize existing knowledge and knowledge gaps in practice-relevant questions in pediatric dentistry. Methods A systematic mapping of systematic reviews was undertaken for domains considered important in daily clinical practice. The literature search covered questions in the following domains: behavior management problems/dental anxiety; caries risk assessment and caries detection including radiographic technologies; prevention and non-operative treatment of caries in primary and young permanent teeth; operative treatment of caries in primary and young permanent teeth; prevention and treatment of periodontal disease; management of tooth developmental and mineralization disturbances; prevention and treatment of oral conditions in children with chronic diseases/developmental disturbances/obesity; diagnosis, prevention and treatment of dental erosion and tooth wear; treatment of traumatic injuries in primary and young permanent teeth and cost-effectiveness of these interventions. Abstracts and full text reviews were assessed independently by two reviewers and any differences were solved by consensus. AMSTAR was used to assess the risk of bias of each included systematic review. Reviews judged as having a low or moderate risk of bias were used to formulate existing knowledge and knowledge gaps. Results Out of 81 systematic reviews meeting the inclusion criteria, 38 were judged to have a low or moderate risk of bias. Half of them concerned caries prevention. The quality of evidence was high for a caries-preventive effect of daily use of fluoride toothpaste and moderate for fissure sealing with resin-based materials. For the rest the quality of evidence for the effects of interventions was low or very low. Conclusion There is an urgent need for primary clinical research of good quality in most clinically-relevant domains in pediatric dentistry. PMID:25706629

  18. High-quality permanent draft genome sequence of the Lebeckia - nodulating Burkholderia dilworthii strain WSM3556T

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

    De Meyer, Sofie E.; Tian, Rui; Seshadri, Rekha

    Burkholderia dilworthii strain WSM3556T is an aerobic, motile, Gram-negative, non-spore-forming rod that was isolated from an effective N2-fixing root nodule of Lebeckia ambigua collected near Grotto Bay Nature Reserve, in the Western Cape of South Africa, in October 2004. This plant persists in infertile and deep sandy soils with acidic pH, and is therefore an ideal candidate for a perennial based agriculture system in Western Australia. WSM3556T thus represents a potential inoculant quality strain for L. ambigua for which we describe the general features, together with genome sequence and annotation. Lastly, the 7,679,067 bp high-quality permanent draft genome is arrangedmore » in 140 scaffolds of 141 contigs, contains 7,059 protein-coding genes and 64 RNA-only encoding genes, and is part of the GEBA-RNB project proposal.« less

  19. High-quality permanent draft genome sequence of the Lebeckia - nodulating Burkholderia dilworthii strain WSM3556T

    DOE PAGES

    De Meyer, Sofie E.; Tian, Rui; Seshadri, Rekha; ...

    2015-09-19

    Burkholderia dilworthii strain WSM3556T is an aerobic, motile, Gram-negative, non-spore-forming rod that was isolated from an effective N2-fixing root nodule of Lebeckia ambigua collected near Grotto Bay Nature Reserve, in the Western Cape of South Africa, in October 2004. This plant persists in infertile and deep sandy soils with acidic pH, and is therefore an ideal candidate for a perennial based agriculture system in Western Australia. WSM3556T thus represents a potential inoculant quality strain for L. ambigua for which we describe the general features, together with genome sequence and annotation. Lastly, the 7,679,067 bp high-quality permanent draft genome is arrangedmore » in 140 scaffolds of 141 contigs, contains 7,059 protein-coding genes and 64 RNA-only encoding genes, and is part of the GEBA-RNB project proposal.« less

  20. An adiabatic spectroscopic investigation of the CsRb system in ground and numerous excited states

    NASA Astrophysics Data System (ADS)

    Souissi, Hanen; Jellali, Soulef; Maha, Chaieb; Habli, Héla; Oujia, Brahim; Gadéa, Florent Xavier

    2017-10-01

    Via ab-initio approximations, we investigate the electronic and structural features of the CsRb molecule. Adiabatic potential energy curves of 261,3Σ+, 181,3Π and 61,3Δ electronic states with their derived spectroscopic constants as well as vibrational levels spacing have been carried out and well explained. Our approach is founded on an Effective Core Potential (ECP) describing the valence electrons of the system. Using a large Gaussian basis set, the full valence Configuration Interaction can be applied easily on the two-effective valence electrons of the CsRb system. Furthermore, a detailed analysis of the electric dipolar properties has been made through the investigation of both permanent and transition dipole moments (PDM and TDM). It is significant that the ionic character connected with electron transfer that is linked to Cs+ Rb- state has been clearly illustrated in the adiabatic permanent dipole moment.

  1. High-quality permanent draft genome sequence of Rhizobium leguminosarum bv. viciae strain GB30; an effective microsymbiont of Pisum sativum growing in Poland

    DOE PAGES

    Mazur, Andrzej; De Meyer, Sofie E.; Tian, Rui; ...

    2015-07-16

    We report that Rhizobium leguminosarum bv. viciae GB30 is an aerobic, motile, Gram-negative, non-spore-forming rod that can exist as a soil saprophyte or as a legume microsymbiont of Pisum sativum. GB30 was isolated in Poland from a nodule recovered from the roots of Pisum sativum growing at Janow. GB30 is also an effective microsymbiont of the annual forage legumes vetch and pea. Here we describe the features of R. leguminosarum bv. viciae strain GB30, together with sequence and annotation. The 7,468,464 bp high-quality permanent draft genome is arranged in 78 scaffolds of 78 contigs containing 7,227 protein-coding genes and 75more » RNA-only encoding genes, and is part of the GEBA-RNB project proposal.« less

  2. Geotechnical aspects of the January 2003 Tecoma'n, Mexico, earthquake

    USGS Publications Warehouse

    Wartman, Joseph; Rodriguez-Marek, Adrian; Macari, Emir J.; Deaton, Scott; Ramirez-Reynaga, Marti'n; Ochoa, Carlos N.; Callan, Sean; Keefer, David; Repetto, Pedro; Ovando-Shelley, Efrai'n

    2005-01-01

    Ground failure was the most prominent geotechnical engineering feature of the 21 January 2003 Mw 7.6 Tecoma´n earthquake. Ground failure impacted structures, industrial facilities, roads, water supply canals, and other critical infrastructure in the state of Colima and in parts of the neighboring states of Jalisco and Michoaca´n. Landslides and soil liquefaction were the most common type of ground failure, followed by seismic compression of unsaturated materials. Reinforced earth structures generally performed well during the earthquake, though some structures experienced permanent lateral deformations up to 10 cm. Different ground improvement techniques had been used to enhance the liquefaction resistance of several sites in the region, all of which performed well and exhibited no signs of damage or significant ground deformation. Earth dams in the region experienced some degree of permanent deformation but remained fully functional after the earthquake.

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

    Libkind, M.; Bertolini, L.; Duffy, P.

    As part of the research and development effort for a 4th generation light source, we have designed a 4-meter long Free-Electron Laser (FEL) undulator. The undulator will be installed at the Accelerator Test Facility (ATF) at Brookhaven National Laboratory to conduct a Self-Amplified Spontaneous Emission (SASE) demonstration. The demonstration is called VISA, which stands for "Visible to Infrared SASE Amplifier." The undulator consists of 440 permanent dipole magnets per meter which are supported and aligned on a precision strongback. Focusing and defocusing permanent quadrupole magnets are also supported by the strongback. Each of the 4 one-meter sections of undulator aremore » kinematically supported and housed within the vacuum vessel. The undulator and the vacuum vessel are supported independently to eliminate undulator misalignment during vacuum pump-down of the vessel. We describe the design requirements and features of the undulator, vacuum vessel and support system.« less

  4. High-quality permanent draft genome sequence of Rhizobium leguminosarum bv. viciae strain GB30; an effective microsymbiont of Pisum sativum growing in Poland

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

    Mazur, Andrzej; De Meyer, Sofie E.; Tian, Rui

    We report that Rhizobium leguminosarum bv. viciae GB30 is an aerobic, motile, Gram-negative, non-spore-forming rod that can exist as a soil saprophyte or as a legume microsymbiont of Pisum sativum. GB30 was isolated in Poland from a nodule recovered from the roots of Pisum sativum growing at Janow. GB30 is also an effective microsymbiont of the annual forage legumes vetch and pea. Here we describe the features of R. leguminosarum bv. viciae strain GB30, together with sequence and annotation. The 7,468,464 bp high-quality permanent draft genome is arranged in 78 scaffolds of 78 contigs containing 7,227 protein-coding genes and 75more » RNA-only encoding genes, and is part of the GEBA-RNB project proposal.« less

  5. Feasibility of feature-based indexing, clustering, and search of clinical trials: A case study of breast cancer trials from ClinicalTrials.gov

    PubMed Central

    Boland, Mary Regina; Miotto, Riccardo; Gao, Junfeng; Weng, Chunhua

    2013-01-01

    Summary Background When standard therapies fail, clinical trials provide experimental treatment opportunities for patients with drug-resistant illnesses or terminal diseases. Clinical Trials can also provide free treatment and education for individuals who otherwise may not have access to such care. To find relevant clinical trials, patients often search online; however, they often encounter a significant barrier due to the large number of trials and in-effective indexing methods for reducing the trial search space. Objectives This study explores the feasibility of feature-based indexing, clustering, and search of clinical trials and informs designs to automate these processes. Methods We decomposed 80 randomly selected stage III breast cancer clinical trials into a vector of eligibility features, which were organized into a hierarchy. We clustered trials based on their eligibility feature similarities. In a simulated search process, manually selected features were used to generate specific eligibility questions to filter trials iteratively. Results We extracted 1,437 distinct eligibility features and achieved an inter-rater agreement of 0.73 for feature extraction for 37 frequent features occurring in more than 20 trials. Using all the 1,437 features we stratified the 80 trials into six clusters containing trials recruiting similar patients by patient-characteristic features, five clusters by disease-characteristic features, and two clusters by mixed features. Most of the features were mapped to one or more Unified Medical Language System (UMLS) concepts, demonstrating the utility of named entity recognition prior to mapping with the UMLS for automatic feature extraction. Conclusions It is feasible to develop feature-based indexing and clustering methods for clinical trials to identify trials with similar target populations and to improve trial search efficiency. PMID:23666475

  6. Feasibility of feature-based indexing, clustering, and search of clinical trials. A case study of breast cancer trials from ClinicalTrials.gov.

    PubMed

    Boland, M R; Miotto, R; Gao, J; Weng, C

    2013-01-01

    When standard therapies fail, clinical trials provide experimental treatment opportunities for patients with drug-resistant illnesses or terminal diseases. Clinical Trials can also provide free treatment and education for individuals who otherwise may not have access to such care. To find relevant clinical trials, patients often search online; however, they often encounter a significant barrier due to the large number of trials and in-effective indexing methods for reducing the trial search space. This study explores the feasibility of feature-based indexing, clustering, and search of clinical trials and informs designs to automate these processes. We decomposed 80 randomly selected stage III breast cancer clinical trials into a vector of eligibility features, which were organized into a hierarchy. We clustered trials based on their eligibility feature similarities. In a simulated search process, manually selected features were used to generate specific eligibility questions to filter trials iteratively. We extracted 1,437 distinct eligibility features and achieved an inter-rater agreement of 0.73 for feature extraction for 37 frequent features occurring in more than 20 trials. Using all the 1,437 features we stratified the 80 trials into six clusters containing trials recruiting similar patients by patient-characteristic features, five clusters by disease-characteristic features, and two clusters by mixed features. Most of the features were mapped to one or more Unified Medical Language System (UMLS) concepts, demonstrating the utility of named entity recognition prior to mapping with the UMLS for automatic feature extraction. It is feasible to develop feature-based indexing and clustering methods for clinical trials to identify trials with similar target populations and to improve trial search efficiency.

  7. Intrasellar cysticercosis: a systematic review.

    PubMed

    Del Brutto, Oscar H; Del Brutto, Victor J

    2013-09-01

    The objective of this study was to review patients with intrasellar cysticercosis to outline the features of this form of neurocysticercosis. A MEDLINE and manual search of patients with intrasellar cysticercosis were done. Abstracted data included clinical manifestations, neuroimaging findings, therapy, and outcome. Twenty-three patients were reviewed. Ophthalmological disturbances, including diminution of visual acuity and visual field defects following a chiasmatic pattern, were recorded in 67 % of cases. Endocrine abnormalities were found in 56 % of patients (panhypopituitarism, hyperprolactinemia, diabetes insipidus, and isolated hypothyroidism). In addition, some patients complained of seizures or chronic headaches. Neuroimaging studies showed lesions confined to the sellar region in 47 % of cases. The remaining patients also had subarachnoid cysts associated or not with hydrocephalus, parenchymal brain cysts, or parenchymal brain calcifications. Thirteen patients underwent surgical resection of the sellar cyst through a craniotomy in nine cases and by the transsphenoidal approach in four. Visual acuity or visual field defects improved in only two of these patients. Five patients were treated with cysticidal drugs without improvement. Intrasellar cysticercosis is rare and probably under-recognized. Clinical manifestations resemble those caused by pituitary tumors, cysts, or other granulomatous lesions. Neuroimaging findings are of more value when intrasellar cysts are associated with other forms of neurocysticercosis, such as basal subarachnoid cysts or hydrocephalus. Prompt surgical resection is mandatory to reduce the risk of permanent loss of visual function. There seems to be no role for cysticidal drug therapy in these cases.

  8. Counseling Athletes on the Risk of Chronic Traumatic Encephalopathy

    PubMed Central

    Concannon, Leah G.; Kaufman, Marla S.; Herring, Stanley A.

    2014-01-01

    Context: Chronic traumatic encephalopathy (CTE) is a rare progressive neurologic disorder that can manifest as a combination of cognitive, mood and behavioral, and neurologic symptoms. Despite clinically apparent symptoms, there is no imaging or other diagnostic test that can confirm diagnosis in living subjects. Diagnosis can only be confirmed postmortem by specific histopathologic features within the brain tissue identified on autopsy. CTE represents a unique tauopathy that is distinct from other neurodegenerative diseases. Evidence Acquisition: PubMed was searched from 1990 to 2013 for sport concussion and chronic traumatic encephalopathy. Articles were also identified from bibliographies of recent reviews and consensus statements. Study Design: Clinical review. Level of Evidence: Level 5. Results: Although CTE is postulated to occur as a result of repetitive mild traumatic brain injury, the specific etiology and risk factors have not yet been elucidated, and postmortem diagnosis makes causality difficult to determine. Conclusion: When counseling athletes and families about the potential association of recurrent concussions and the development of CTE, discussion of proper management of concussion is cornerstone. Unfortunately, to date, there is no equipment that can prevent concussions; however, rule changes and legislation may decrease the risk. It is imperative that return to play is medically supervised by a provider trained in the management of concussion and begins only once symptoms have resolved. In addition, athletes with permanent symptoms should be retired from contact sport. PMID:25177414

  9. Tips for longwall conveyor chain

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

    Courtney, J.C.; Fortune, J.

    1977-03-01

    Mining chain must be capable of sustaining imposed loads of 80 or 90 percent of its minimum breaking strength, and still return to its original dimensions. This means that the chain should behave like an extremely sophisticated spring up to very high load levels, and return to its unloaded state without any plastic stretch or permanent dimensional deformation having taken place. This feature is absolutely essential, not only to enable repeat loadings to be made, but to ensure that constant, precise engagement of the drive and idler sprockets takes place. The mining chain production process, therefore, is carefully designed somore » that the last stage of manufacture introduces these necessary features.« less

  10. Cancelable biometrics realization with multispace random projections.

    PubMed

    Teoh, Andrew Beng Jin; Yuang, Chong Tze

    2007-10-01

    Biometric characteristics cannot be changed; therefore, the loss of privacy is permanent if they are ever compromised. This paper presents a two-factor cancelable formulation, where the biometric data are distorted in a revocable but non-reversible manner by first transforming the raw biometric data into a fixed-length feature vector and then projecting the feature vector onto a sequence of random subspaces that were derived from a user-specific pseudorandom number (PRN). This process is revocable and makes replacing biometrics as easy as replacing PRNs. The formulation has been verified under a number of scenarios (normal, stolen PRN, and compromised biometrics scenarios) using 2400 Facial Recognition Technology face images. The diversity property is also examined.

  11. Calcium-enriched mixture pulpotomy of a human permanent molar with irreversible pulpitis and condensing apical periodontitis

    PubMed Central

    Asgary, Saeed

    2011-01-01

    This case report describes a pulpotomy treatment of a permanent mature molar tooth with established irreversible pulpitis and condensing apical periodontitis, using calcium-enriched mixture (CEM) cement. Clinical examination revealed that the first right lower molar had a large carious lesion with history of spontaneous/lingering pain; radiographic examination showed condensing apical periodontitis. Pulpotomy was opted as the treatment; cervical pulpotomy was carried out. Following hemostasis, the radicular pulp stumps were covered with ~2-mm-thick layer of the prepared CEM cement; the tooth was restored with amalgam. Two-year follow-up showed that the treated tooth had been symptomless, and there were no clinical signs/symptoms of either inflammation or infection. Radiographically, the periradicular lesion was completely healed with reconstruction of bone structures to normal appearance; the root canals were not calcified. According to chemical, physical, and biological properties of the CEM cement, this novel biomaterial may be suitable for endodontic treatment. PMID:21691516

  12. Subacute Thyroiditis: Clinical Presentation and Long Term Outcome

    PubMed Central

    Alfadda, Assim A.; Sallam, Reem M.; Elawad, Ghadi E.; AlDhukair, Hisham; Alyahya, Mossaed M.

    2014-01-01

    Few studies have been reported from the Kingdom of Saudi Arabia (SA) to describe the clinical presentation and long term outcomes of subacute thyroiditis (SAT). Our aim was to review the demographic, anthropometric, clinical presentation, laboratory results, treatment, and disease outcome in Riyadh region and to compare those with results from different regions of the Kingdom and different parts of the world. We reviewed the medical files of patients who underwent thyroid uptake scan during an 8-year period in King Khalid University Hospital. Only 25 patients had confirmed diagnosis of thyroiditis. Age and gender distribution were similar to other studies. Most patients presented with palpitation, goiter, and weight change. Elevated thyroid hormones, suppressed thyroid-stimulating hormone, and elevated ESR were reported. Among those, 7 cases of SAT were recorded. β-Blockers were prescribed to 57% and nonsteroidal anti-inflammatory drugs to 29% of SAT. Long follow-up demonstrated that 85.7% of SAT cases recovered, while 14.3% developed permanent hypothyroidism. In conclusion, SAT is uncommon in the central region of SA. Compared to the western region, corticosteroid is not commonly prescribed, and permanent hypothyroidism is not uncommon. A nation-wide epidemiological study to explain these interprovincial differences is warranted. PMID:24803929

  13. Clinical evaluation of a composite resin system with a dentin bonding agent for restoration of permanent posterior teeth: a 3-year study.

    PubMed

    Roberts, M W; Folio, J; Moffa, J P; Guckes, A D

    1992-03-01

    This study evaluated the clinical performance of a visible light-cured small particle bimodally filled hybrid condensable composite resin system that included a dentin bonding agent compared with an amalgam alloy in class II restorations of permanent teeth. A total of 108 restorations were placed in 34 patients. Fifty-three composite resin and 55 amalgam restorations were inserted. Each restoration was evaluated immediately after placement and then on an annual basis for a 3-year period using the Public Health Service (PHS) criteria. In addition, the Moffa-Lugassy scale was used to measure the loss of material on the occlusal surface of these materials. One hundred percent of the resin and amalgam restorations were evaluated, measured, and reasons for replacement were recorded over the 3-year period. There was no significant difference (p greater than 0.05) in the clinical performance of the composite resin and the amalgam when evaluated by the PHS criteria. Analyses of wear at each of the three annual recall periods did not reveal any significant difference (p greater than 0.05) between the two restorative materials when measured by the Moffa-Lugassy scale.

  14. [The impact factor and those who dislike it].

    PubMed

    Schubert, András

    2015-06-28

    Since its introduction in 1976, the impact factor is permanently a subject of both criticism and glorification. This paper gives an overview on what actually the reservations and objections attack. A closer look often reveals that the criticisms are not against the specific substantial features of the impact factor. They may formulate much more general doubts or, on the other hand, superficial technical details, easily remediable flaws or inconsistensies resulting erroneous use.

  15. Rolamite acceleration sensor

    DOEpatents

    Abbin, J.P.; Briner, C.F.; Martin, S.B.

    1993-12-21

    A rolamite acceleration sensor is described which has a failsafe feature including a housing, a pair of rollers, a tension band wrapped in an S shaped fashion around the rollers, wherein the band has a force-generation cut out and a failsafe cut out or weak portion. The failsafe cut out or weak portion breaks when the sensor is subjected to an excessive acceleration so that the sensor fails in an open circuit (non-conducting) state permanently. 6 figures.

  16. Determinants of plasma NT-pro-BNP levels in patients with atrial fibrillation and preserved left ventricular ejection fraction.

    PubMed

    Letsas, Konstantinos P; Filippatos, Gerasimos S; Pappas, Loukas K; Mihas, Constantinos C; Markou, Virginia; Alexanian, Ioannis P; Efremidis, Michalis; Sideris, Antonios; Maisel, Alan S; Kardaras, Fotios

    2009-02-01

    The present study aimed to investigate the clinical and echocardiographic determinants of plasma NT-pro-BNP levels in patients with atrial fibrillation (AF) and preserved left ventricular ejection fraction (LVEF). NT-pro-BNP levels were measured in 45 patients with paroxysmal AF, 41 patients with permanent AF and 48 controls. NT-pro-BNP levels were found significantly elevated in patients with paroxysmal (215+/-815 pg/ml) and permanent AF (1,086+/-835 pg/ml) in relation to control population (86.3+/-77.9 pg/ml) (P<0.001). According to the univariate linear regression analysis, age, hypertension, beta-blocker use, left atrial diameter (LAD), LVEF and AF status (paroxysmal or permanent or both) were significantly associated with NT-pro-BNP levels (P<0.05). In multiple linear regression analysis, LVEF (B coefficient: -53.030; CI: -95.738 to -10.322; P: 0.015) and LAD (B coefficient: 285.858; CI: 23.731-547.986; P: 0.033) were significant and independent determinants of NT-pro-BNP levels. Plasma NT-pro-BNP levels were significantly higher in patients with paroxysmal and permanent AF compared to those with sinus rhythm in the setting of preserved left ventricular systolic function. LVEF and LAD were independent predictors of NT-pro-BNP levels.

  17. Transient Hypothyroidism after Radioiodine for Graves' Disease: Challenges in Interpreting Thyroid Function Tests.

    PubMed

    Sheehan, Michael T; Doi, Suhail A R

    2016-03-01

    Graves' disease is the most common cause of hyperthyroidism and is often managed with radioactive iodine (RAI) therapy. With current dosing schemes, the vast majority of patients develop permanent post-RAI hypothyroidism and are placed on life-long levothyroxine therapy. This hypothyroidism typically occurs within the first 3 to 6 months after RAI therapy is administered. Indeed, patients are typically told to expect life-long thyroid hormone replacement therapy to be required within this timeframe and many providers expect this post-RAI hypothyroidism to be complete and permanent. There is, however, a small subset of patients in whom a transient post-RAI hypothyroidism develops which, initially, presents exactly as the typical permanent hypothyroidism. In some cases the transient hypothyroidism leads to a period of euthyroidism of variable duration eventually progressing to permanent hypothyroidism. In others, persistent hyperthyroidism requires a second dose of RAI. Failure to appreciate and recognize the possibility of transient post-RAI hypothyroidism can delay optimal and appropriate treatment of the patient. We herein describe five cases of transient post-RAI hypothyroidism which highlight this unusual sequence of events. Increased awareness of this possible outcome after RAI for Graves' disease will help in the timely management of patients. © 2016 Marshfield Clinic.

  18. Vascular status in human primary and permanent teeth in health and disease.

    PubMed

    Rodd, Helen D; Boissonade, Fiona M

    2005-04-01

    The present study sought to compare the vascular status of human primary teeth with that of human permanent teeth, and to determine whether caries or painful pulpitis was associated with changes in vascularity. Coronal pulps were removed from 62 primary and 62 permanent mandibular molars with a known pain history. Teeth were categorized as intact, moderately carious or grossly carious. Pulp sections were labelled with Ulex europaeus I lectin (UEIL), which is a marker of human vascular endothelium. Image analysis was then used to quantify the percentage area of UEIL-labelled tissue (vascularity) and the number of blood vessels present within three regions: the pulp horn, the subodontoblastic region, and the mid-coronal pulp. Only the mid-coronal region of the primary tooth pulp was found to be significantly more vascular than the corresponding area of the permanent tooth pulp. Both dentitions showed a significant increase in vascularity within the pulp horn region with caries progression, but this was not accompanied by an increase in vessel number. There was no correlation between vascularity and pain symptoms. These findings suggest that the primary tooth pulp is more vascular than its successor within the mid-coronal region. However, the functional and clinical significance of this finding remains speculative.

  19. Regional early development and eruption of permanent teeth: case report.

    PubMed

    Al Mullahi, A M; Bakathir, A; Al Jahdhami, S

    2017-02-01

    Early development and eruption of permanent teeth are rarely reported in scientific literature. Early eruption of permanent teeth has been reported to occur due to local factors such as trauma or dental abscesses in primary teeth, and in systemic conditions. Congenital diffuse infiltrating facial lipomatosis (CDIFL) is a rare condition that belongs to a group of lipomatosis tumours. In this disorder, the mature adipocytes invade adjacent soft and hard tissues in the facial region. Accelerated tooth eruption is one of the dental anomalies associated with CDIFL. A 3-year-old boy presented with a swelling of the lower lip localised early development and eruption of permanent teeth and dental caries involving many primary teeth. The planned treatment included biopsy of the swollen lower lip to confirm the diagnosis, surgical reduction and reconstruction of lip aesthetics. The management of the carious primary teeth included preventative and comprehensive dental care and extractions. These procedures were completed under general anaesthesia due to the child's young age and poor cooperation. The lip biopsy showed features of CDIFL such as the presence of infiltrating adipose tissue, prominent number of nerve bundles and thickened vessels. The high recurrence rate of CDIFL mandates long-term monitoring during the facial growth period of the child. Follow-up care by the paediatric dentist and maxillofacial surgeon has been required to manage all aspects of this congenital malformation. This rare disorder has many implications affecting child's facial aesthetics, psychological well being, developing occlusion and risk of dental caries. A multi-disciplinary approach is needed for management of this condition.

  20. Space Place Prime

    NASA Technical Reports Server (NTRS)

    Fitzpatrick, Austin J.; Novati, Alexander; Fisher, Diane K.; Leon, Nancy J.; Netting, Ruth

    2013-01-01

    Space Place Prime is public engagement and education software for use on iPad. It targets a multi-generational audience with news, images, videos, and educational articles from the Space Place Web site and other NASA sources. New content is downloaded daily (or whenever the user accesses the app) via the wireless connection. In addition to the Space Place Web site, several NASA RSS feeds are tapped to provide new content. Content is retained for the previous several days, or some number of editions of each feed. All content is controlled on the server side, so features about the latest news, or changes to any content, can be made without updating the app in the Apple Store. It gathers many popular NASA features into one app. The interface is a boundless, slidable- in-any-direction grid of images, unique for each feature, and iconized as image, video, or article. A tap opens the feature. An alternate list mode presents menus of images, videos, and articles separately. Favorites can be tagged for permanent archive. Face - book, Twitter, and e-mail connections make any feature shareable.

  1. Estimated capacity of object files in visual short-term memory is not improved by retrieval cueing.

    PubMed

    Saiki, Jun; Miyatsuji, Hirofumi

    2009-03-23

    Visual short-term memory (VSTM) has been claimed to maintain three to five feature-bound object representations. Some results showing smaller capacity estimates for feature binding memory have been interpreted as the effects of interference in memory retrieval. However, change-detection tasks may not properly evaluate complex feature-bound representations such as triple conjunctions in VSTM. To understand the general type of feature-bound object representation, evaluation of triple conjunctions is critical. To test whether interference occurs in memory retrieval for complete object file representations in a VSTM task, we cued retrieval in novel paradigms that directly evaluate the memory for triple conjunctions, in comparison with a simple change-detection task. In our multiple object permanence tracking displays, observers monitored for a switch in feature combination between objects during an occlusion period, and we found that a retrieval cue provided no benefit with the triple conjunction tasks, but significant facilitation with the change-detection task, suggesting that low capacity estimates of object file memory in VSTM reflect a limit on maintenance, not retrieval.

  2. Impact of untreated dental caries and its clinical consequences on the oral health-related quality of life of schoolchildren aged 8-10 years.

    PubMed

    Mota-Veloso, Isabella; Soares, Maria Eliza C; Alencar, Bruna Mota; Marques, Leandro Silva; Ramos-Jorge, Maria Letícia; Ramos-Jorge, Joana

    2016-01-01

    This study aims to evaluate the impact of untreated dental caries and its clinical consequences on the quality of life of Brazilian schoolchildren aged 8-10 years. A randomly selected sample of 587 children underwent a clinical oral examination for the assessment of untreated dental caries and clinical consequences. The WHO criteria (decayed component of the decayed, missing, and filled teeth--D-DMFT in permanent teeth or d-dfmt in primary teeth) and the PUFA index, which records the presence of severely decayed permanent (upper case) and primary (lower case) teeth with visible pulpal involvement (P/p), as well as ulceration caused by dislocated tooth fragments (U/u), fistula (F/f), and abscesses (A/a), were used for the oral examination. Oral health-related quality of life (OHRQoL) was evaluated using the Child's Perception Questionnaire (CPQ8-10). Poisson regression was employed to test unadjusted and adjusted associations between untreated dental caries/clinical consequences and OHRQoL. The prevalence of untreated dental caries was 64.6% (D/d component of DMFT/dmft > 0) and 17.9% of children exhibited clinical consequences of caries (PUFA/pufa index >0). In the adjusted models, untreated caries was significantly associated with the total CPQ8-10 score and all subscale scores. The clinical consequences of dental caries (PUFA/pufa index >0) were significantly associated with the total CPQ8-10 as well as the oral symptoms and functional limitations' subscales. Untreated dental caries and its clinical consequences exerted a negative impact on the OHRQoL of the schoolchildren analyzed.

  3. Ocular toxocariasis: clinical features, diagnosis, treatment, and prevention

    PubMed Central

    Ahn, Seong Joon; Ryoo, Na-Kyung

    2014-01-01

    Despite being one of the most common zoonotic infections worldwide, human toxocariasis has been one of the neglected tropical diseases. Although most human infections are asymptomatic, two main syndromes of human toxocariasis are classically recognized: systemic toxocariasis, which encompasses diseases in major organs; and ocular toxocariasis (OT), disease in the eye or optic nerve, caused by the migration of Toxocara larvae into the eye. OT is usually a unilateral disease, which typically presents as retinal granuloma, a yellowish or whitish inflammatory mass, in the posterior pole or peripheral retina. Granuloma itself or other comorbid conditions such as epiretinal membrane, macular edema, and retinal detachment can lead to permanent retinal damage and visual loss in eyes with OT. OT is diagnosed clinically by identification of clinical signs on ophthalmologic examination. Serological tests, such as enzyme-linked immunosorbent assay (ELISA) for detection of serum antibody against the Toxocara larvae, can confirm the diagnosis. In addition, serum immunoglobulin E and detection of ocular fluid antitoxocara antibody by ELISA may give additional aid to the diagnosis. Standard treatment of OT is corticosteroid in patients with active intraocular inflammation. Although the role of anthelmintic therapy is unclear, favorable outcome has been reported by combined corticosteroid and albendazole therapy in eyes with active inflammation. Prevention, by increasing public awareness and reducing the risk of infection, is also important. Recently, the association between ingestion of uncooked meat or liver and toxocariasis was reported, especially in adult patients. Future research on the potential source of infection, diagnosis, and treatment should be performed. PMID:25097848

  4. Psychiatric aspects of herpes simplex encephalitis, tick-borne encephalitis and herpes zoster encephalitis among immunocompetent patients.

    PubMed

    Więdłocha, Magdalena; Marcinowicz, Piotr; Stańczykiewicz, Bartłomiej

    2015-01-01

    The psychopathological symptoms occurring in the course of diseases associated with infections are often initially isolated and non-characteristic, and may cause diagnostic difficulties. Moreover, such disorders tend to be less responsive to psychiatric management. Among possible causes such as trauma, neoplasm and vascular changes, inflammatory changes of the brain as a result of a viral infection should also be considered. There were 452 registered cases of viral encephalitis in Poland in 2010, and although not very prevalent they remain a severe and life-threatening condition. What is more, the frequently occurring neurological and psychiatric complications of viral encephalitis often result in permanent disabilities, causing a significant decrease in the quality of life. This article presents the three types of encephalitis that are most prevalent among immunocompetent patients in Poland, i.e. herpes simplex encephalitis (HSE), tick-borne encephalitis (TBE) and herpes zoster encephalitis (HZE). The psychopathology of the acute phase of the infection, the residual symptoms, features apparent in imaging studies and some neuropathological aspects are also presented. The paper also focuses on psychiatric aspects of the diagnostics and treatment of the described conditions. The clinical pictures of these infections are quite specific, although they cover a wide range of symptoms, and these characteristic features are described. The aim of this review is also to show the significance of thorough diagnostics and a multidisciplinary approach to patients with viral CNS infections.

  5. Outcomes of different vital pulp therapy techniques on symptomatic permanent teeth: a case series.

    PubMed

    Asgary, Saeed; Fazlyab, Mahta; Sabbagh, Sedigheh; Eghbal, Mohammad Jafar

    2014-01-01

    In modern endodontics, vital pulp therapy (VPT) has been considered an ultra-conservative treatment modality. Based on the level of pulp preservation, VPT includes stepwise excavation, indirect pulp capping (IDPC), direct pulp capping (DPC), miniature pulpotomy (MP), partial/Cvek pulpotomy and coronal/complete pulpotomy (CP). The present article reviews the treatment outcomes of 94 permanent teeth with irreversible pulpitis treated with either IDPC (n=28), DPC (n=28), MP (n=29) or CP (n=9) using calcium-enriched mixture (CEM) cement. After a mean follow-up time of 12.3 months, 93 treated teeth were radiographic/clinically successful; only one radiographic failure was observed in the DPC group.

  6. Outcomes of Different Vital Pulp Therapy Techniques on Symptomatic Permanent Teeth: A Case Series

    PubMed Central

    Asgary, Saeed; Fazlyab, Mahta; Sabbagh, Sedigheh; Eghbal, Mohammad Jafar

    2014-01-01

    In modern endodontics, vital pulp therapy (VPT) has been considered an ultra-conservative treatment modality. Based on the level of pulp preservation, VPT includes stepwise excavation, indirect pulp capping (IDPC), direct pulp capping (DPC), miniature pulpotomy (MP), partial/Cvek pulpotomy and coronal/complete pulpotomy (CP). The present article reviews the treatment outcomes of 94 permanent teeth with irreversible pulpitis treated with either IDPC (n=28), DPC (n=28), MP (n=29) or CP (n=9) using calcium-enriched mixture (CEM) cement. After a mean follow-up time of 12.3 months, 93 treated teeth were radiographic/clinically successful; only one radiographic failure was observed in the DPC group. PMID:25386213

  7. Permanent certification program for health information technology; revisions to ONC-Approved Accreditor processes. Final rule.

    PubMed

    2011-11-25

    Under the authority granted to the National Coordinator for Health Information Technology by section 3001(c)(5) of the Public Health Service Act (PHSA) as added by the Health Information Technology for Economic and Clinical Health (HITECH) Act, this final rule establishes a process for addressing instances where the ONC-Approved Accreditor (ONC-AA) engages in improper conduct or does not perform its responsibilities under the permanent certification program. This rule also addresses the status of ONC-Authorized Certification Bodies (ONC-ACBs) in instances where there may be a change in the accreditation organization serving as the ONC-AA and clarifies the responsibilities of the new ONC-AA.

  8. Which ante mortem clinical features predict progressive supranuclear palsy pathology?

    PubMed

    Respondek, Gesine; Kurz, Carolin; Arzberger, Thomas; Compta, Yaroslau; Englund, Elisabet; Ferguson, Leslie W; Gelpi, Ellen; Giese, Armin; Irwin, David J; Meissner, Wassilios G; Nilsson, Christer; Pantelyat, Alexander; Rajput, Alex; van Swieten, John C; Troakes, Claire; Josephs, Keith A; Lang, Anthony E; Mollenhauer, Brit; Müller, Ulrich; Whitwell, Jennifer L; Antonini, Angelo; Bhatia, Kailash P; Bordelon, Yvette; Corvol, Jean-Christophe; Colosimo, Carlo; Dodel, Richard; Grossman, Murray; Kassubek, Jan; Krismer, Florian; Levin, Johannes; Lorenzl, Stefan; Morris, Huw; Nestor, Peter; Oertel, Wolfgang H; Rabinovici, Gil D; Rowe, James B; van Eimeren, Thilo; Wenning, Gregor K; Boxer, Adam; Golbe, Lawrence I; Litvan, Irene; Stamelou, Maria; Höglinger, Günter U

    2017-07-01

    Progressive supranuclear palsy (PSP) is a neuropathologically defined disease presenting with a broad spectrum of clinical phenotypes. To identify clinical features and investigations that predict or exclude PSP pathology during life, aiming at an optimization of the clinical diagnostic criteria for PSP. We performed a systematic review of the literature published since 1996 to identify clinical features and investigations that may predict or exclude PSP pathology. We then extracted standardized data from clinical charts of patients with pathologically diagnosed PSP and relevant disease controls and calculated the sensitivity, specificity, and positive predictive value of key clinical features for PSP in this cohort. Of 4166 articles identified by the database inquiry, 269 met predefined standards. The literature review identified clinical features predictive of PSP, including features of the following 4 functional domains: ocular motor dysfunction, postural instability, akinesia, and cognitive dysfunction. No biomarker or genetic feature was found reliably validated to predict definite PSP. High-quality original natural history data were available from 206 patients with pathologically diagnosed PSP and from 231 pathologically diagnosed disease controls (54 corticobasal degeneration, 51 multiple system atrophy with predominant parkinsonism, 53 Parkinson's disease, 73 behavioral variant frontotemporal dementia). We identified clinical features that predicted PSP pathology, including phenotypes other than Richardson's syndrome, with varying sensitivity and specificity. Our results highlight the clinical variability of PSP and the high prevalence of phenotypes other than Richardson's syndrome. The features of variant phenotypes with high specificity and sensitivity should serve to optimize clinical diagnosis of PSP. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

  9. Atrial antitachycardia pacing and managed ventricular pacing in bradycardia patients with paroxysmal or persistent atrial tachyarrhythmias: the MINERVA randomized multicentre international trial.

    PubMed

    Boriani, Giuseppe; Tukkie, Raymond; Manolis, Antonis S; Mont, Lluis; Pürerfellner, Helmut; Santini, Massimo; Inama, Giuseppe; Serra, Paolo; de Sousa, João; Botto, Giovanni Luca; Mangoni, Lorenza; Grammatico, Andrea; Padeletti, Luigi

    2014-09-14

    Atrial fibrillation (AF) is a common comorbidity in bradycardia patients. Advanced pacemakers feature atrial preventive pacing and atrial antitachycardia pacing (DDDRP) and managed ventricular pacing (MVP), which minimizes unnecessary right ventricular pacing. We evaluated whether DDDRP and MVP might reduce mortality, morbidity, or progression to permanent AF when compared with standard dual-chamber pacing (Control DDDR). In a randomized, parallel, single-blind, multi-centre trial we enrolled 1300 patients with bradycardia and previous atrial tachyarrhythmias, in whom a DDDRP pacemaker had recently been implanted. History of permanent AF and third-degree atrioventricular block were exclusion criteria. After a 1-month run-in period, 1166 eligible patients, aged 74 ± 9 years, 50% females, were randomized to Control DDDR, DDDRP + MVP, or MVP. Analysis was intention-to-treat. The primary outcome, i.e. the 2-year incidence of a combined endpoint composed of death, cardiovascular hospitalizations, or permanent AF, occurred in 102/385 (26.5%) Control DDDR patients, in 76/383 (19.8%) DDDRP + MVP patients [hazard ratio (HR) = 0.74, 95% confidence interval 0.55-0.99, P = 0.04 vs. Control DDDR] and in 85/398 (21.4%) MVP patients (HR = 0.89, 95% confidence interval 0.77-1.03, P = 0.125 vs. Control DDDR). When compared with Control DDDR, DDDRP + MVP reduced the risk for AF longer than 1 day (HR = 0.66, 95% CI 0.52-0.85, P < 0.001), AF longer than 7 days (HR = 0.52, 95% CI 0.36-0.73, P < 0.001), and permanent AF (HR = 0.39, 95% CI 0.21-0.75, P = 0.004). In patients with bradycardia and atrial tachyarrhythmias, DDDRP + MVP is superior to standard dual-chamber pacing. The primary endpoint was significantly lowered through the reduction of the progression of atrial tachyarrhythmias to permanent AF. NCT00262119. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Cardiology.

  10. Metal Amorphous Nanocomposite Soft Magnetic Material-Enabled High Power Density, Rare Earth Free Rotational Machines [Metal Amorphous Nanocomposite (MANC) Soft Magnetic Material (SMM) Enabled High Power Density, Rare Earth Free Rotational Machines

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

    Simizu, Satoru; Ohodnicki, Paul R.; McHenry, Michael E.

    Metal amorphous nanocomposites (MANCs) are promising soft magnetic materials (SMMs) for power electronic applications offering low power loss at high frequency and maintaining a relatively high flux density. While applications in certain motor designs have been recently modeled, their widespread application awaits scaled manufacturing of MANC materials and proliferation of new higher speed motor designs. A hybrid motor design based on permanent magnets and doubly salient stator and rotor is reported here to develop a compact (a factor of 10 smaller than currently possible in Si steels), high-speed (>1 kHz, electrical), high-power (>2.5 kW) motor by incorporating low loss (<10more » W/kg at 1 kHz) MANCs such as recently reported Fe-Ni-based alloys. A feature of this motor design is flux focusing from the permanent magnet allowing use of lower energy permanent magnet chosen from among non-rare earth containing compositions and attractive due to constraints posed by rare earth criticality. A 2-D finite element analysis model reported here indicates that a 2.5 kW hybrid motor may be built with a permanent magnet with a 0.4 T remanence at a rotor speed of 6000 rpm. At a magnetic switching frequency of 1.4 kHz, the core loss may be limited to <3 W by selecting an appropriate MANC SMM. The projected efficiency exceeds 96% not including power loss in the controller. Under full load conditions, the flux density distributions for the SMM stay predominantly <1.3 T, the saturation magnetization of optimized FeNi-based MANC alloys. As a result, the maximum demagnetizing field in the permanent magnet is less than 2.2 × 10 5 A/m sustainable, for example, with a high-grade hard ferrite magnet.« less

  11. Metal Amorphous Nanocomposite Soft Magnetic Material-Enabled High Power Density, Rare Earth Free Rotational Machines [Metal Amorphous Nanocomposite (MANC) Soft Magnetic Material (SMM) Enabled High Power Density, Rare Earth Free Rotational Machines

    DOE PAGES

    Simizu, Satoru; Ohodnicki, Paul R.; McHenry, Michael E.

    2018-02-27

    Metal amorphous nanocomposites (MANCs) are promising soft magnetic materials (SMMs) for power electronic applications offering low power loss at high frequency and maintaining a relatively high flux density. While applications in certain motor designs have been recently modeled, their widespread application awaits scaled manufacturing of MANC materials and proliferation of new higher speed motor designs. A hybrid motor design based on permanent magnets and doubly salient stator and rotor is reported here to develop a compact (a factor of 10 smaller than currently possible in Si steels), high-speed (>1 kHz, electrical), high-power (>2.5 kW) motor by incorporating low loss (<10more » W/kg at 1 kHz) MANCs such as recently reported Fe-Ni-based alloys. A feature of this motor design is flux focusing from the permanent magnet allowing use of lower energy permanent magnet chosen from among non-rare earth containing compositions and attractive due to constraints posed by rare earth criticality. A 2-D finite element analysis model reported here indicates that a 2.5 kW hybrid motor may be built with a permanent magnet with a 0.4 T remanence at a rotor speed of 6000 rpm. At a magnetic switching frequency of 1.4 kHz, the core loss may be limited to <3 W by selecting an appropriate MANC SMM. The projected efficiency exceeds 96% not including power loss in the controller. Under full load conditions, the flux density distributions for the SMM stay predominantly <1.3 T, the saturation magnetization of optimized FeNi-based MANC alloys. As a result, the maximum demagnetizing field in the permanent magnet is less than 2.2 × 10 5 A/m sustainable, for example, with a high-grade hard ferrite magnet.« less

  12. Prevalence of radix entomolaris in mandibular permanent first molars: a study in a South Indian population.

    PubMed

    Chandra, Saurabh S; Chandra, Supriya; Shankar, Padmanabhan; Indira, Rajamani

    2011-09-01

    Anatomical racial variations are an acknowledged characteristic in permanent molars. Generally, mandibular first molars have 2 roots; however, the presence of a third root, radix entomolaris (RE), is a major anatomic variant among many population groups. This study evaluated the prevalence of permanent mandibular first molars featuring a distolingual root in a South Indian population. Five hundred patients of South Indian origin possessing bilateral mandibular first molars were selected. The radiographs of these patients were evaluated under optimal conditions. A total of 1000 mandibular first molars were screened and the incidence of 3-rooted mandibular first molars and the correlation between left and right side occurrence and between either gender was recorded. The prevalence of 3-rooted mandibular first molars was 18.6% of the patients examined and 13.3% of the teeth examined. There was no statistically significant difference between genders or side of occurrence (P > .05). The bilateral incidence of a symmetric distribution was 43.01%. RE is considered an Asiatic trait. The occurrence of this macrostructure in the South Indian population was 13.3%, which was lower than that of other patients of Mongoloid origin. The clinician must thoroughly examine the radiograph before initiation of endodontic therapy. Copyright © 2011 Mosby, Inc. All rights reserved.

  13. Design and analysis of a direct-drive wind power generator with ultra-high torque density

    NASA Astrophysics Data System (ADS)

    Jian, Linni; Shi, Yujun; Wei, Jin; Zheng, Yanchong

    2015-05-01

    In order to get rid of the nuisances caused by mechanical gearboxes, generators with low rated speed, which can be directly connected to wind turbines, are attracting increasing attention. The purpose of this paper is to propose a new direct-drive wind power generator (DWPG), which can offer ultra-high torque density. First, magnetic gear (MG) is integrated to achieve non-contact torque transmission and speed variation. Second, armature windings are engaged to achieve electromechanical energy conversion. Interior permanent magnet (PM) design on the inner rotor is adopted to boost the torque transmission capability of the integrated MG. Nevertheless, due to lack of back iron on the stator, the proposed generator does not exhibit prominent salient feature, which usually exists in traditional interior PM (IPM) machines. This makes it with good controllability and high power factor as the surface-mounted permanent magnet machines. The performance is analyzed using finite element method. Investigation on the magnetic field harmonics demonstrates that the permanent-magnetic torque offered by the MG can work together with the electromagnetic torque offered by the armature windings to balance the driving torque captured by the wind turbine. This allows the proposed generator having the potential to offer even higher torque density than its integrated MG.

  14. Clinical Features and Associated Likelihood of Primary Ciliary Dyskinesia in Children and Adolescents.

    PubMed

    Leigh, Margaret W; Ferkol, Thomas W; Davis, Stephanie D; Lee, Hye-Seung; Rosenfeld, Margaret; Dell, Sharon D; Sagel, Scott D; Milla, Carlos; Olivier, Kenneth N; Sullivan, Kelli M; Zariwala, Maimoona A; Pittman, Jessica E; Shapiro, Adam J; Carson, Johnny L; Krischer, Jeffrey; Hazucha, Milan J; Knowles, Michael R

    2016-08-01

    Primary ciliary dyskinesia (PCD), a genetically heterogeneous, recessive disorder of motile cilia, is associated with distinct clinical features. Diagnostic tests, including ultrastructural analysis of cilia, nasal nitric oxide measurements, and molecular testing for mutations in PCD genes, have inherent limitations. To define a statistically valid combination of systematically defined clinical features that strongly associates with PCD in children and adolescents. Investigators at seven North American sites in the Genetic Disorders of Mucociliary Clearance Consortium prospectively and systematically assessed individuals (aged 0-18 yr) referred due to high suspicion for PCD. The investigators defined specific clinical questions for the clinical report form based on expert opinion. Diagnostic testing was performed using standardized protocols and included nasal nitric oxide measurement, ciliary biopsy for ultrastructural analysis of cilia, and molecular genetic testing for PCD-associated genes. Final diagnoses were assigned as "definite PCD" (hallmark ultrastructural defects and/or two mutations in a PCD-associated gene), "probable/possible PCD" (no ultrastructural defect or genetic diagnosis, but compatible clinical features and nasal nitric oxide level in PCD range), and "other diagnosis or undefined." Criteria were developed to define early childhood clinical features on the basis of responses to multiple specific queries. Each defined feature was tested by logistic regression. Sensitivity and specificity analyses were conducted to define the most robust set of clinical features associated with PCD. From 534 participants 18 years of age and younger, 205 were identified as having "definite PCD" (including 164 with two mutations in a PCD-associated gene), 187 were categorized as "other diagnosis or undefined," and 142 were defined as having "probable/possible PCD." Participants with "definite PCD" were compared with the "other diagnosis or undefined" group. Four criteria-defined clinical features were statistically predictive of PCD: laterality defect; unexplained neonatal respiratory distress; early-onset, year-round nasal congestion; and early-onset, year-round wet cough (adjusted odds ratios of 7.7, 6.6, 3.4, and 3.1, respectively). The sensitivity and specificity based on the number of criteria-defined clinical features were four features, 0.21 and 0.99, respectively; three features, 0.50 and 0.96, respectively; and two features, 0.80 and 0.72, respectively. Systematically defined early clinical features could help identify children, including infants, likely to have PCD. Clinical trial registered with ClinicalTrials.gov (NCT00323167).

  15. Transient and sustained elementary flux mode networks on a catalytic string-based chemical evolution model.

    PubMed

    Pereira, José A

    2014-08-01

    Theoretical models designed to test the metabolism-first hypothesis for prebiotic evolution have yield strong indications about the hypothesis validity but could sometimes use a more extensive identification between model objects and real objects towards a more meaningful interpretation of results. In an attempt to go in that direction, the string-based model SSE ("steady state evolution") was developed, where abstract molecules (strings) and catalytic interaction rules are based on some of the most important features of carbon compounds in biological chemistry. The system is open with a random inflow and outflow of strings but also with a permanent string food source. Although specific catalysis is a key aspect of the model, used to define reaction rules, the focus is on energetics rather than kinetics. Standard energy change tables were constructed and used with standard formation reactions to track energy flows through the interpretation of equilibrium constant values. Detection of metabolic networks on the reaction system was done with elementary flux mode (EFM) analysis. The combination of these model design and analysis options enabled obtaining metabolic and catalytic networks showing several central features of biological metabolism, some more clearly than in previous models: metabolic networks with stepwise synthesis, energy coupling, catalysts regulation, SN2 coupling, redox coupling, intermediate cycling, coupled inverse pathways (metabolic cycling), autocatalytic cycles and catalytic cascades. The results strongly suggest that the main biological metabolism features, including the genotype-phenotype interpretation, are caused by the principles of catalytic systems and are prior to modern genetic systems principles. It also gives further theoretical support to the thesis that the basic features of biologic metabolism are a consequence of the time evolution of a random catalyst search working on an open system with a permanent food source. The importance of the food source characteristics and evolutionary possibilities are discussed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Effect of gestating sow body condition, feed refusals, and group housing on growth and feed intake in grower-finishing pigs.

    PubMed

    Sell-Kubiak, E; van der Waaij, E H; Bijma, P

    2013-08-01

    The main focus of this study was to identify sow gestation features that affect growth rate (GR) and feed intake (FI) of their offspring during grower-finishing stage. Because the sow provides a specific environment to her offspring during gestation, certain features (e.g., BW of the sow), feed refusals or gestation group, may affect her ability to deliver and feed a healthy litter. Data on 17,743 grower-finishing pigs, coming from 604 sires and 681 crossbred sows, were obtained from the Institute for Pigs Genetics. Sow gestation features were collected during multiple gestations and divided into 3 clusters describing i) sow body condition (i.e., BW, backfat, and gestation length), ii) sow feed refusals (FR), the difference between offered and eaten feed during 3 periods of gestation: 1 to 28, 25 to 50, 45 to 80 d, and iii) sow group features (i.e., number of sows, and average parity). Sow gestation features were added to the base model 1 at a time to study their effect on GR and FI. Significant gestation features (P < 0.1) were fitted simultaneously in animal model to investigate whether they could explain common litter and permanent sow effects. Gestation length had effect on GR [1.4 (g/d)/d; P = 0.04] and FI [6.8 (g/d)/d; P = 0.007]. Body weights of the sow at insemination [0.07 (g/d)/kg; P = 0.08], at farrowing [0.14 (g/d)/kg; P < 0.0001], and after lactation [0.1 (g/d)/kg; P = 0.003] had effect on GR. Sow parturition-lactation loss in backfat thickness and weight were not significant for GR and FI. Days with FR during 25 to 50 and 45 to 80 d of gestation and average FR during 45 to 80 d of gestation had negative effect on GR and when substantially increased had also a positive effect on FI. Sow FR from 1 to 28 d of gestation were not significant. Number of sows in gestation group had effect on FI [-9 (g/d)/group member; P = 0.04] and day sow entered group had an effect on GR [-0.9 (g/d)/day; P = 0.04]. Sow gestation features explained 1 to 3% of the total variance in grower-finishing pigs. Gestation features did explain phenotypic variance due to permanent sow and part of phenotypic variance due to common litter effects for FI but not for GR.

  17. The development of stromatolitic features from laminated microbial mats in the coastal sabkha of Abu Dhabi (UAE)

    NASA Astrophysics Data System (ADS)

    Paul, Andreas; Lessa Andrade, Luiza; Dutton, Kirsten E.; Sherry, Angela; Court, Wesley M.; Van der Land, Cees; Lokier, Stephen W.; Head, Ian M.

    2017-04-01

    Stromatolitic features are documented from both marine and terrestrial environments worldwide. These features form through a combination of trapping and binding of allochthonous grains, and through microbially mediated and/or controlled precipitation of carbonate minerals. The combined effects of these processes result in the continuous vertical and lateral growth of stromatolites. While the Abu Dhabi coastal sabkha is well known for a vast microbial mat belt that is dominated by continuous polygonal and internally-laminated microbial mats, no stromatolitic features have been reported from this area so far. In this study, we report evidence for stromatolitic features from the coastal sabkha of Abu Dhabi, based on observations in an intertidal but permanently submerged pool. This pool lies embedded within the laminated microbial mat zone, and is marked by the development of true laminated stromatolite at its margins and microbial build-ups at its centre. In order to characterise processes that lead to the formation of these stromatolitic features, and to develop a conceptual model that describes their development in the context of variations in sea level, tidal energy and other environmental factors, we employ a multitude of environmental, sedimentological, mineralogical and geochemical methods. These methods include the analysis of water data in terms of temporal variations in temperature, salinity, dissolved oxygen and water level, the analysis of petrographic thin sections of both lithified and unlithified features as well as an analysis of the stromatolites' mineralogical composition, and the amounts of incorporated organic carbon and calcium carbonate. Initial results suggest that the development of the observed stromatolitic features in the coastal sabkha of Abu Dhabi is the result of a complex interplay between simultaneous erosion of laminated microbial mat, and biotic/abiotic lithification processes. Initially, the location of this pool was characterised by a continuous laminated microbial mat. Through Recent changes in sea level and/or of the associated environmental conditions, this microbial mat was removed. At the same time as this erosion occurred, lithification processes set-in that continuously stabilised the extending pool margin. Through this extension, selected areas of the newly lithified mat were left behind, and formed the build-ups in the pool's centre that are observed today. This lithification might have been controlled by a change in the associated microbial mat communities from non-lithifying to lithifying, due to the permanent exposure to seawater by which this pool is characterised.

  18. Homozygous Mutations in NEUROD1 Are Responsible for a Novel Syndrome of Permanent Neonatal Diabetes and Neurological Abnormalities

    PubMed Central

    Rubio-Cabezas, Oscar; Minton, Jayne A.L.; Kantor, Iren; Williams, Denise; Ellard, Sian; Hattersley, Andrew T.

    2010-01-01

    OBJECTIVE NEUROD1 is expressed in both developing and mature β-cells. Studies in mice suggest that this basic helix-loop-helix transcription factor is critical in the development of endocrine cell lineage. Heterozygous mutations have previously been identified as a rare cause of maturity-onset diabetes of the young (MODY). We aimed to explore the potential contribution of NEUROD1 mutations in patients with permanent neonatal diabetes. RESEARCH DESIGN AND METHODS We sequenced the NEUROD1 gene in 44 unrelated patients with permanent neonatal diabetes of unknown genetic etiology. RESULTS Two homozygous mutations in NEUROD1 (c.427_ 428del and c.364dupG) were identified in two patients. Both mutations introduced a frameshift that would be predicted to generate a truncated protein completely lacking the activating domain. Both patients had permanent diabetes diagnosed in the first 2 months of life with no evidence of exocrine pancreatic dysfunction and a morphologically normal pancreas on abdominal imaging. In addition to diabetes, they had learning difficulties, severe cerebellar hypoplasia, profound sensorineural deafness, and visual impairment due to severe myopia and retinal dystrophy. CONCLUSIONS We describe a novel clinical syndrome that results from homozygous loss of function mutations in NEUROD1. It is characterized by permanent neonatal diabetes and a consistent pattern of neurological abnormalities including cerebellar hypoplasia, learning difficulties, sensorineural deafness, and visual impairment. This syndrome highlights the critical role of NEUROD1 in both the development of the endocrine pancreas and the central nervous system in humans. PMID:20573748

  19. Fireworks type, injury pattern, and permanent impairment following severe fireworks-related injuries.

    PubMed

    Sandvall, Brinkley K; Jacobson, Lauren; Miller, Erin A; Dodge, Ryan E; Alex Quistberg, D; Rowhani-Rahbar, Ali; Vavilala, Monica S; Friedrich, Jeffrey B; Keys, Kari A

    2017-10-01

    There is a paucity of clinical data on severe fireworks-related injuries, and the relationship between firework types, injury patterns, and magnitude of impairment is not well understood. Our objective was to describe the relationship between fireworks type, injury patterns, and impairment. Retrospective case series (2005-2015) of patients who sustained consumer fireworks-related injuries requiring hospital admission and/or an operation at a Level 1 Trauma/Burn Center. Fireworks types, injury patterns (body region, injury type), operation, and permanent impairment were examined. Data from 294 patients 1 to 61years of age (mean 24years) were examined. The majority (90%) were male. 119 (40%) patients were admitted who did not undergo surgery, 163 (55%) patients required both admission and surgery, and 12 (5%) patients underwent outpatient surgery. The greatest proportion of injuries was related to shells/mortars (39%). There were proportionally more rocket injuries in children (44%), more homemade firework injuries in teens (34%), and more shell/mortar injuries in adults (86%). Brain, face, and hand injuries were disproportionately represented in the shells/mortars group. Seventy percent of globe-injured patients experienced partial or complete permanent vision loss. Thirty-seven percent of hand-injured patients required at least one partial or whole finger/hand amputation. The greatest proportion of eye and hand injuries resulting in permanent impairment was in the shells/mortars group, followed by homemade fireworks. Two patients died. Severe fireworks-related injuries from homemade fireworks and shells/mortars have specific injury patterns. Shells/mortars disproportionately cause permanent impairment from eye and hand injury. Published by Elsevier Inc.

  20. Depth and Horizontal Distribution of Volatiles in Lunar Permanently Shadowed Regions

    NASA Astrophysics Data System (ADS)

    Hurley, D. M.; Bussey, B.; Lawrence, D. J.; Gladstone, R.; Elphic, R. C.; Vondrak, R. R.

    2011-12-01

    Neutron spectroscopy from Lunar Prospector returned data consistent with the presence of water ice in the near-subsurface of the Moon in permanently shadowed regions (PSRs) at low spatial resolution. Clementine and ground-based radar returned tantalizing, but inconclusive evidence of ice in lunar PSRs. Later, Mini-RF on Chandrayaan-1 and LRO detected a signature consistent with water ice in some polar craters on the Moon, but not all PSRs. Similarly, LEND on LRO detected a heterogeneous distribution of hydrogen among lunar PSRs. In addition, LAMP on LRO detected FUV spectra consistent with a heterogeneous distribution of frost on the surface of permanently shadowed regions. Yet the weakest spectral feature from LAMP was associated with the crater with the strongest hydrogen feature from LEND. The impact of LCROSS into Cabeus released water and other volatiles, but abundances were higher than the background amounts detected by neutron spectroscopy implying heterogeneity within that PSR. Data from any one instrument taken alone would lead one to a different conclusion about the distribution of volatiles than data taken from any other single instrument. Although the data from different instrumentation can seem to be disparate, the apparent discrepancy results from the different fields of view and sensitivities of the detection techniques. The complementary nature of these data can be exploited to provide a multi-dimensional view of volatiles in lunar PSRs. We apply a Monte Carlo model to describe the retention and redistribution of volatiles within lunar cold traps. The model runs constrain the coherence of volatile deposits with depth, area, and time, which allows us to examine how a given volatile distribution would appear to remote sensing experiments. This provides a big picture framework for integrating the observations of volatiles on the surface and at depth at the poles of the Moon with the goal of finding a distribution of volatiles in lunar PSRs consistent with all of the data.

  1. Radiographic and Clinical Outcomes of the Treatment of Immature Permanent Teeth by Revascularization or Apexification: A Pilot Retrospective Cohort Study

    PubMed Central

    Alobaid, Adel S.; Cortes, Lina M.; Lo, Jeffery; Nguyen, Thuan T.; Albert, Jeffery; Abu-Melha, Abdulaziz S; Lin, Louis M.; Gibbs, Jennifer L.

    2014-01-01

    Introduction This retrospective cohort study compared clinical and radiographic outcomes of endodontic treatment performed in immature non-vital permanent teeth, by apexification (calcium hydroxide or apical barrier with Mineral Trioxide Aggregate (MTA)), versus revascularization. Methods A comprehensive chart review was performed to obtain a cohort of sequential previously completed cases with recalls. Clinical and radiographic data were collected for 31 treated teeth (19 revascularization and 12 apexification) with an average follow up time of 17 months and a recall rate of 63%. Tooth survival, success rate, and adverse events were analyzed. Changes in radiographic root length, width and area were quantified. Results The majority of treated teeth survived throughout the study period with 30/31 (97%) teeth surviving (18/19 (95%) revascularization, 12/12 apexification). Most cases were also clinically successful with 27/31 (87%) meeting criteria for success, (15/19 (78%) revascularization and 12/12 apexification; non-significant difference). A greater incidence of adverse events was observed in the revascularization group (8/19 (42%) versus 1/12 (11%) in apexification (Risk Ratio= 5.1, p=0.04, 95%CI (0.719, 35.48)). Although more revascularization cases than apexification cases demonstrated an increase in radiographic root area and width, the effect was not statistically significant. Conclusion In this study, revascularization was not superior to other apexification techniques in either clinical or radiographic outcomes. Studies with large subject cohorts, and long follow up periods are needed to evaluate outcomes of revascularization and apexification, while accounting for important co-variants relevant to clinical success. PMID:25069909

  2. Regenerative endodontics: barriers and strategies for clinical translation.

    PubMed

    Mao, Jeremy J; Kim, Sahng G; Zhou, Jian; Ye, Ling; Cho, Shoko; Suzuki, Takahiro; Fu, Susan Y; Yang, Rujing; Zhou, Xuedong

    2012-07-01

    Regenerative endodontics has encountered substantial challenges toward clinical translation. The adoption by the American Dental Association of evoked pulp bleeding in immature permanent teeth is an important step for regenerative endodontics. However, there is no regenerative therapy for most endodontic diseases. Simple recapitulation of cell therapy and tissue engineering strategies that are under development for other organ systems has not led to clinical translation in regeneration endodontics. Recent work using novel biomaterial scaffolds and growth factors that orchestrate the homing of host endogenous cells represents a departure from traditional cell transplantation approaches and may accelerate clinical translation. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. Clinical course of infants with congenital heart disease who developed thyroid dysfunction within 100 days

    PubMed Central

    Lee, Hye Jin; Yu, Hyeoh Won; Kim, Gi Beom; Shin, Choong Ho; Yang, Sei Won

    2017-01-01

    Purpose We investigated the clinical course of infants with congenital heart disease (CHD) who experienced thyroid dysfunction within 100 days of birth. Methods We performed retrospective medical reviews of 54 CHD patients (24 male patients) who underwent a thyroid function test (TFT) between January 2007 and July 2016. Data were collected on birth history, diagnosis of CHD, underlying chromosomal or genetic abnormalities, medication history, surgery, ventilator care, and exposure to iodine contrast media (ICM). Results of neonatal screening tests (NSTs) and TFTs were reviewed. Results A total of 36 patients (29 transient, 7 permanent) showed thyroid dysfunction. Among the seven patients with permanent hypothyroidism, three had an underlying syndrome, three showed abnormal NST results, and one was admitted to the intensive care unit for macroglossia and feeding cyanosis. We found that infants with transient thyroid dysfunction had a lower birth weight and were more commonly exposed to thyroid disrupting medication and/or ICM. However, these risk factors were not significant. A total of 8 patients with a history of ICM exposure showed thyroid dysfunction. Excluding 3 patients with elevated thyroid stimulating hormone before ICM exposure, 5 patients recovered from transient thyroid dysfunction. Conclusions We observed thyroid dysfunction in two-thirds of CHD infants (53.7% transient, 13.0% permanent) who had risk factors and received TFT screening within 100 days, despite normal NSTs. Further studies with larger sample sizes are required to revise the criteria for TFT screening in CHD infants. PMID:29301186

  4. Birth asphyxia: pathophysiologic events and fetal adaptive changes.

    PubMed

    Woods, J R

    1983-06-01

    We have made significant advances toward understanding birth asphyxia and its effects upon neurologic development in the newborn and infant. The fetus is well adapted to compensate for moderate alterations in oxygen delivery. However, near lethal hypoxemia, prolonged exposure, and survival result in cell death and permanent neurologic sequelae. Neuroelectrical measurements such as the EEG and visual evoked potential provide insight into the acute alterations in nerve transmission during asphyxia, and in the recovery phase may ultimately provide information for long-term prognosis. These measurements are limited, however, by their inability once lost to distinguish cell inactivity from cell death. Permanent neurologic damage from asphyxia appears now to be a complex process in which severe hypoxemia precipitates a cascade of events leading to glycolysis, glycogenolysis, hypotension, and ultimately the accumulation of high concentrations of lactate at the cell level. As a consequence, cellular and extracellular fluid shifts produce cerebral edema, further impairment of cerebral circulation, and ultimately cell death. Clinical studies have helped to identify the newborn at high risk for neurologic impairment, but a cause-effect relationship remains unclear. That birth asphyxia can produce severe neurologic damage and death is generally accepted. Moreover, improper resuscitation of a severely depressed newborn increases the chance of permanent sequelae. The important clinical question is: Can one alter the natural course of asphyxia as has been alluded to through pharmacologic and ventilator manipulation? Answers to this question will depend upon continued study of the mechanisms of asphyctic damage in the central nervous system.

  5. A clinical trial to evaluate the retention of a silver cermet-ionomer cement used as a fissure sealant.

    PubMed

    Mills, R W; Ball, I A

    1993-01-01

    A randomized clinical trial was under-taken to compare the retention of a silver cermet-ionomer cement, Ketac Silver, with a conventional, autopolymerizing BIS-GMA resin sealant, Delton, using matched pairs of fissure sites within each subject's mouth. One hundred twenty matched contralateral pairs of fissure sites in first and second permanent molars of 53 school children were sealed with the two materials. The choice of site and material was selected at random. The ages of the children ranged from five to 16 years; first permanent molars were sealed in the five- to 10-year age group, and second permanent molars in the 11- to 16-year age group. Sealants were assessed as present, partly present, or absent at 6, 12, and 24 months. The number of pairs of sites available for reassessment declined from 102 at six months to 59 at 24 months as patients were lost to the study. Retention rates were higher for the Ketac Silver sealants at all three inspection intervals (P < 0.01): 93% compared with 74% at six months, 81% compared with 65% at 12 months, and 83% compared with 58% at 24 months. When analyzed according to age range, the difference between the retention rates was statistically significant in the five- to 10-year-olds but not significant in the 11- to 16-year-olds. The conclusion reached in this study was that cermet cement was better retained than conventional resin sealants in younger children.

  6. Permanent medialization of the paralyzed vocal fold utilizing botulinum toxin and Gelfoam.

    PubMed

    Rontal, Eugene; Rontal, Michael

    2003-09-01

    The clinical picture of a paralyzed vocal fold often has the same appearance as a subluxated arytenoid, with anterior and medial displacement of the arytenoid and a foreshortened and lax vocal fold. Previous work by the authors has shown that a subluxated arytenoid may be permanently repositioned by reduction and selective injection of the intrinsic laryngeal musculature with botulinum toxin. The injection changes the forces within the larynx, allowing the arytenoid to be brought back to proper position on the cricoid cartilage. This concept has been extended to the paralyzed vocal fold. It has been noted that even a clinically paralyzed vocal fold has voluntary motor units that may still act on the arytenoid through residual action from the interarytenoid and synkinesis. These forces are significant enough to manipulate the arytenoid and, thus, the vocal fold, into its correct, adducted position. In this paper, the arytenoid is mobilized to free any fibrosis. The thyroarytenoid and lateral cricoarytenoid muscles are then injected to prevent any forward synkinetic pull on the arytenoid. Next, a Gelfoam injection medializes the vocal fold to create glottic closure. This rebalancing sufficiently positions the arytenoid, so that valvular function is permanently restored. In the ten patients studied for over 1 year, there was a 90% success rate as measured by videostroboscopy, phonation time, and V-RQOL analysis. There were no untoward complications. All the materials used are nonpermanent. The procedure does not limit other techniques from being performed at a later time.

  7. The Role of Housing: A Comparison of Front-Line Provider Views in Housing First and Traditional Programs

    PubMed Central

    Stanhope, Victoria; Padgett, Deborah K.

    2011-01-01

    Purpose Within the mental health system, there are two distinct service models for adults who have severe mental illness and are homeless: one prioritizes treatment before accessing permanent housing (Treatment First) while the other provides permanent housing upfront followed by clinical support (Housing First). Investigating front-line providers working within these two models affords an opportunity to learn more about their implementation from an insider perspective, thus shedding light on whether actual practice is consistent with or contrary to these program models’ contrasting philosophical values. Methods Forty-one providers were recruited from four agencies as part of a NIMH funded qualitative study. Multiple, in-depth interviews lasting 30–45 min were conducted with providers that explored working within these agencies. Thematic analysis was utilized to compare the views of 20 providers working in Housing First versus the 21 providers working in Treatment First programs. Results Providers viewed housing as a priority but differences emerged between Treatment First and Housing First providers along three major themes: the centrality of housing, engaging consumers through housing, and (limits to…) a right to housing. Conclusion Ironically, this study revealed that providers working within Treatment First programs were consumed with the pursuit of housing, whereas Housing First providers focused more on clinical concerns since consumers already had housing. Clearly, how programs position permanent housing has very different implications for how providers understand their work, the pressures they encounter, and how they prioritize client goals. PMID:20521164

  8. Effects of a New Bleaching Gel on Tooth Whitening

    DTIC Science & Technology

    2016-05-17

    that claims "wow’’ results and permanent whiteness unaffected by consumption of coffee, tea, or red wine with low to no sensitivity. KOR has also...bleaching to result in greater lightness {delta L *)than Home bleaching, suggesting no overall benefit from either technique. Two recent clinical

  9. Effects of Early Seizures on Later Behavior and Epileptogenicity

    ERIC Educational Resources Information Center

    Holmes, Gregory L.

    2004-01-01

    Both clinical and laboratory studies demonstrate that seizures early in life can result in permanent behavioral abnormalities and enhance epileptogenicity. Understanding the critical periods of vulnerability of the developing nervous system to seizure-induced changes may provide insights into parallel or divergent processes in the development of…

  10. Environment and initial state engineered dynamics of quantum and classical correlations

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

    Wang, Cheng-Zhi, E-mail: czczwang@outlook.com; Li, Chun-Xian; Guo, Yu

    Based on an open exactly solvable system coupled to an environment with nontrivial spectral density, we connect the features of quantum and classical correlations with some features of the environment, initial states of the system, and the presence of initial system–environment correlations. Some interesting features not revealed before are observed by changing the structure of environment, the initial states of system, and the presence of initial system–environment correlations. The main results are as follows. (1) Quantum correlations exhibit temporary freezing and permanent freezing even at high temperature of the environment, for which the necessary and sufficient conditions are given bymore » three propositions. (2) Quantum correlations display a transition from temporary freezing to permanent freezing by changing the structure of environment. (3) Quantum correlations can be enhanced all the time, for which the condition is put forward. (4) The one-to-one dependency relationship between all kinds of dynamic behaviors of quantum correlations and the initial states of the system as well as environment structure is established. (5) In the presence of initial system–environment correlations, quantum correlations under local environment exhibit temporary multi-freezing phenomenon. While under global environment they oscillate, revive, and damp, an explanation for which is given. - Highlights: • Various interesting behaviors of quantum and classical correlations are observed in an open exactly solvable model. • The important effects of the bath structure on quantum and classical correlations are revealed. • The one-to-one correspondence between the type of dynamical behavior of quantum discord and the initial state is given. • Quantum correlations are given in the presence of initial qubits–bath correlations.« less

  11. Reinforced Concrete Modeling

    DTIC Science & Technology

    1982-07-01

    micro- cracks within the material . This microcracking causes permanent deformation and a loss in stiffness similar to the strain hardening seen in metals...approached. Dilatation is caused by the tendency of shear stresses to open cracks in a microcracked, brittle material . 10 1.2 I , e3 3 1.0 F i ,S22 e...situation would be for a user to compromise some accuracy based on what features of a material are of the most importance for the analysis involved

  12. Landforms of the United States

    USGS Publications Warehouse

    Hack, John T.

    1969-01-01

    The United States contains a great variety of landforms which offer dramatic contrasts to a crosscountry traveler. Mountains and desert areas, tropical jungles and areas of permanently frozen subsoil, deep canyons and broad plains are examples of the Nation's varied surface. The present-day landforms the features that make up the face of the earth are products of the slow, sculpturing actions of streams and geologic processes that have been at work throughout the ages since the earth's beginning.

  13. Landforms of the United States

    USGS Publications Warehouse

    Hack, John T.

    1988-01-01

    The United States contains a great variety of landforms which offer dramatic contrasts to a cross-country traveler. Mountains and desert areas, tropical jungles and areas of permanently frozen subsoil, and deep canyons and broad plains are examples of the Nation's varied surface. The presentday landforms the features that make up the face of the Earth are products of the slow sculpturing actions of streams and geologic processes that have been at work throughout the ages since the Earth's beginning.

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

    Agnew, Douglas W.; DiMucci, Ida M.; Arroyave, Alejandra

    A permanently porous, three-dimensional metal–organic material formed from zero-valent metal nodes is presented. Combination of ditopic m-terphenyl diisocyanide, [CNAr Mes2] 2, and the d 10 Ni(0) precursor Ni(COD) 2, produces a porous metal–organic material featuring tetrahedral [Ni(CNAr Mes2) 4] n structural sites. X-ray absorption spectroscopy provides firm evidence for the presence of Ni(0) centers, whereas gas-sorption and thermogravimetric analysis reveal the characteristics of a robust network with a microdomain N 2-adsorption profile.

  15. Open System Architecture design for planet surface systems

    NASA Technical Reports Server (NTRS)

    Petri, D. A.; Pieniazek, L. A.; Toups, L. D.

    1992-01-01

    The Open System Architecture is an approach to meeting the needs for flexibility and evolution of the U.S. Space Exploration Initiative program of the manned exploration of the solar system and its permanent settlement. This paper investigates the issues that future activities of the planet exploration program must confront, defines the basic concepts that provide the basis for establishing an Open System Architecture, identifies the appropriate features of such an architecture, and discusses examples of Open System Architectures.

  16. Renal histopathology features according to various warm ischemia times in porcine laparoscopic and open surgery model

    PubMed Central

    Sabbagh, Robert; Chawla, Arun; Tisdale, Britton; Kwan, Kevin; Chatterjee, Suman; Kwiecien, Jacek M.; Kapoor, Anil

    2011-01-01

    Background Thirty minutes has been considered as the threshold for tolerable warm ischemic time (WIT). Recent reports demonstrate recovery of renal function after longer WIT. We assessed renal histology according to different WIT in a 2-kidney porcine model. Methods Twelve female pigs were randomized to an open or laparoscopic group. Each pig was further randomized within each group to clamping the left renal artery for 5, 15, 30, 45, 60 or 180 minutes. Preclamping left renal biopsies were performed on each pig. The contralateral kidney in each animal was used as an individual control. On postoperative day 14, all animals underwent bilateral nephrectomies. Preclamping left renal biopsies and all renal specimens were evaluated by a blinded veterinary pathologist. Results One pig died in the open group after 180 minutes of clamping. Histopathology did not show any significant changes between the two groups and across clamp times from 5 to 60 minutes. After 180 minutes of laparoscopic clamping, there was evidence of diffuse necrosis. Interpretation Sixty minutes of ischemia did not show any permanent renal damage in both groups. Further studies are needed to verify these findings in humans. A prolonged ischemic time without permanent renal damage would be helpful in partial nephrectomy. Warm ischemic time of 180 minutes exceeded the renal ischemic burden based on histological features. PMID:21470513

  17. Identity and Its Construal: Learning from Luxembourg.

    PubMed

    Murdock, Elke

    2017-06-01

    This article examines national identity construal processes within the case study context of Luxembourg. Building on research highlighting the modalities of generalization from case studies, I present the country case that is Luxembourg. This social universe has a foreign population percentage of 47% and what is considered majority and minority becomes increasingly fluid. The migration process itself is fluid, ranging from daily migration, to medium-term stays, return visits and permanent immigration including uptake of citizenship. Within such a fluid environment, where national borders are permeable at the physical level of crossing borders and (national) societies are nested within societies, culture contact is a permanent feature in daily life. Nationality becomes a salient feature as culture contact tends to prompt reflection, resulting in questioning and (re-)negotiation of national identity. This affects the native population as well as the diverse immigrant population - with diversity going beyond the level of country of origin. Many individuals are also of mixed nationality and some examples for the construal process of national identity will be provided, illustrating how national identity is negotiated at individual level. Like a periscope, this country let s us adjust mirrors, permitting us to observe modes of identity construal which would otherwise be obstructed from the field of view. The case study that is Luxembourg allows us to look at the micro-setting of the construction, potentially of something new.

  18. Evaluation of a web based informatics system with data mining tools for predicting outcomes with quantitative imaging features in stroke rehabilitation clinical trials

    NASA Astrophysics Data System (ADS)

    Wang, Ximing; Kim, Bokkyu; Park, Ji Hoon; Wang, Erik; Forsyth, Sydney; Lim, Cody; Ravi, Ragini; Karibyan, Sarkis; Sanchez, Alexander; Liu, Brent

    2017-03-01

    Quantitative imaging biomarkers are used widely in clinical trials for tracking and evaluation of medical interventions. Previously, we have presented a web based informatics system utilizing quantitative imaging features for predicting outcomes in stroke rehabilitation clinical trials. The system integrates imaging features extraction tools and a web-based statistical analysis tool. The tools include a generalized linear mixed model(GLMM) that can investigate potential significance and correlation based on features extracted from clinical data and quantitative biomarkers. The imaging features extraction tools allow the user to collect imaging features and the GLMM module allows the user to select clinical data and imaging features such as stroke lesion characteristics from the database as regressors and regressands. This paper discusses the application scenario and evaluation results of the system in a stroke rehabilitation clinical trial. The system was utilized to manage clinical data and extract imaging biomarkers including stroke lesion volume, location and ventricle/brain ratio. The GLMM module was validated and the efficiency of data analysis was also evaluated.

  19. [Combined surgical-orthodontic therapy for compound odontoma].

    PubMed

    Dukić, Walter; Kuna, Tihomir; Lapter-Varga, Marina; Jurić, Hrvoje; Lulić-Dukić, Olga

    2007-09-01

    Odontogenic tumor is a rare condition in dental medicine that mostly proceeds unrecognized until the occurrence of clinical symptoms such as delayed eruption, or is incidentally detected on routine x-ray examination. The exact cause is not known, however, previous dental trauma and infection have been postulated as the potential factors in the development of odontogenic tumor. The earliest possible operative extirpation of the tumorous growth is recommended to eliminate permanent tooth impaction and to enable normal growth of the teeth. In some cases, corticotomy, including complete removal of the bony coat of the tooth, may be needed to additionally facilitate and precipitate its eruption. Orthodontic therapy is also of great importance in correct alignment of the teeth 'n the dental arch as well as in the management of other anomalies that may be associated with odontogenic tumor. A patient with compound odontoma is presented, along with the course of combined surgical-orthodontic therapy. The patient reported previous intrusion trauma that had occurred at the age of 4 years, which may have been the potential factor in the development of odontoma. In this case, there was a massive odontogenic tumor which had compromised the growth of permanent teeth, and the growth impulse was almost at the end since the patient was 11 years old and the apexes of the upper incisors were partially closed. The first operation included complete removal of the tumorous mass that had interrupted spontaneous eruption of the upper permanent incisors. It did not result in immediate spontaneous tooth eruption, so an additional operation was needed. The objective of the second operative procedure was complete removal of the covering bone over the unerupted upper permanent incisors in order to eliminate the physical barrier to tooth growth and eruption. The objective of fixed orthodontic therapy was full eruption of the partially erupted upper incisors. After 16 months, the upper incisors were regularly located in the dental arch. In this case, orthodontic therapy had another objective, i.e. to ensure rotation of the first upper premolar, to provide space for the upper permanent canine eruption and to establish regular intercuspidation after upper second premolar hypodontia. In colclusion, combined operative and orthodontic therapy can be recommended irrespective of the stage of the impacted tooth development because any treatment to precipitate tooth eruption has favorable effects. Impacted teeth should always be provided all treatment options for faster eruption, as demonstrated in our case where a good clinical result was achieved within 2.5 years. The role of regular clinical and x-ray controls for assessment of the impacted tooth eruption should also be emphasized.

  20. Bladder cancer treatment response assessment with radiomic, clinical, and radiologist semantic features

    NASA Astrophysics Data System (ADS)

    Gordon, Marshall N.; Cha, Kenny H.; Hadjiiski, Lubomir M.; Chan, Heang-Ping; Cohan, Richard H.; Caoili, Elaine M.; Paramagul, Chintana; Alva, Ajjai; Weizer, Alon Z.

    2018-02-01

    We are developing a decision support system for assisting clinicians in assessment of response to neoadjuvant chemotherapy for bladder cancer. Accurate treatment response assessment is crucial for identifying responders and improving quality of life for non-responders. An objective machine learning decision support system may help reduce variability and inaccuracy in treatment response assessment. We developed a predictive model to assess the likelihood that a patient will respond based on image and clinical features. With IRB approval, we retrospectively collected a data set of pre- and post- treatment CT scans along with clinical information from surgical pathology from 98 patients. A linear discriminant analysis (LDA) classifier was used to predict the likelihood that a patient would respond to treatment based on radiomic features extracted from CT urography (CTU), a radiologist's semantic feature, and a clinical feature extracted from surgical and pathology reports. The classification accuracy was evaluated using the area under the ROC curve (AUC) with a leave-one-case-out cross validation. The classification accuracy was compared for the systems based on radiomic features, clinical feature, and radiologist's semantic feature. For the system based on only radiomic features the AUC was 0.75. With the addition of clinical information from examination under anesthesia (EUA) the AUC was improved to 0.78. Our study demonstrated the potential of designing a decision support system to assist in treatment response assessment. The combination of clinical features, radiologist semantic features and CTU radiomic features improved the performance of the classifier and the accuracy of treatment response assessment.

  1. Body mass index, blood pressure, and glucose and lipid metabolism among permanent and fixed-term workers in the manufacturing industry: a cross-sectional study.

    PubMed

    Inoue, Mariko; Minami, Masahide; Yano, Eiji

    2014-02-27

    Temporary employment, a precarious form of employment, is recognized as social determinant of poor health. However, evidence supporting precarious employment as a risk factor for health is mainly obtained from subjective data. Studies using objective clinical measurement data in the assessment of health status are limited. This study compared body mass index (BMI), lipid and glucose metabolism, and health-related lifestyle factors between permanent workers and fixed-term workers employed in the manufacturing industry. Data of 1,701 male manufacturing industry workers <50 years old in Japan were collected and analyzed. Anthropometric data were BMI, calculated using measured height and weight of study participants, and blood pressure. For lipid metabolism, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride levels were determined. For glucose metabolism, fasting plasma glucose and hemoglobin A1c (HbA1c) levels were measured. Multiple regression analysis adjusted for age and lifestyle factors was performed. BMI was significantly higher in permanent workers (22.9 kg/m2) compared with fixed-term workers (22.4 kg/m2). The leaner population (BMI < 18.5) was greater among fixed-term workers (8.3%) compared with permanent workers (4.0%), whereas the overweight population (BMI ≥ 25.0) was greater among permanent workers (21.4%) compared with fixed-term workers (18.1%). Although fixed-term workers tended not to be overweight, regression analysis adjusted for age and lifestyle factors suggested that fixed-term employment was significantly associated with higher blood pressure (systolic β = 2.120, diastolic β = 2.793), triglyceride (β = 11.147), fasting blood glucose (β = 2.218), and HbA1c (β = 0.107) compared with permanent workers (all p < 0.01). Fixed-term workers showed more health risks, such as poorer blood pressure and lipid and glucose metabolism, even when adjusted for age and lifestyle variables, although BMI of fixed-term workers were lower than permanent workers. Precarious work might contribute to a deteriorating health status even among less overweight populations.

  2. Changes in deciduous and permanent dentinal tubules diameter after several conditioning protocols: In vitro study.

    PubMed

    de Los Angeles Moyaho-Bernal, María; Contreras-Bulnes, Rosalía; Rodríguez-Vilchis, Laura Emma; Rubio-Rosas, Efraín

    2018-05-08

    Innovators conditioning protocols are emerged in permanent dentin, however for deciduous dentin the information is limited; the aim of this study was to evaluate in vitro diameter of deciduous and permanent dentinal tubules after several conditioning protocols. Eighty dentin samples were distributed in sixteen groups (n = 5 p/g) and dentin surface was conditioned as follow: G1D/G1P acid etching; G2D/G2P, self-etch adhesive; G3D/G3P, G4D/G4P, Er: YAG laser irradiation at 200 mJ-25.5 J/cm 2 and 300 mJ-38.2 J/cm 2 , at 10 Hz under water spray respectively; G5D/G5P, G6D/G6P, G7D/G7P, and G8D/G8P were irradiated under the same energy densities followed phosphoric acid or self-etch adhesive conditioning. The sample dentin of deciduous and permanent teeth was analyzed with scanning electron microscopy and tubule diameter was evaluated by Image Tools Scandium program. Data were subjected to one-way analysis ANOVA to compare among groups with a level of significance at p ≤ .05. For deciduous dentin, diameters were from 1.52 ± 0.32 µm in G3D to 3.88 ± 0.37 µm in G1D; narrowest and widest diameter, respectively (p < .000). While permanent dentin tubules exhibited diameters from 1.16 ± 0.16/1.19 ± 0.12 µm in G7P/G8P to 2.76 ± 0.28 µm in G6P; narrowest and widest diameter, respectively (p < .000). All dentin conditioning protocols produced more open dentin tubules (diameter size) in deciduous dentin than permanent, specific conditioning protocols are required for each tissue (deciduous or permanent dentin), since same protocol produced stronger effects on primary dentin, which is important for dental clinical success in children and adolescents. © 2018 Wiley Periodicals, Inc.

  3. Neural basis for dynamic updating of object representation in visual working memory.

    PubMed

    Takahama, Sachiko; Miyauchi, Satoru; Saiki, Jun

    2010-02-15

    In real world, objects have multiple features and change dynamically. Thus, object representations must satisfy dynamic updating and feature binding. Previous studies have investigated the neural activity of dynamic updating or feature binding alone, but not both simultaneously. We investigated the neural basis of feature-bound object representation in a dynamically updating situation by conducting a multiple object permanence tracking task, which required observers to simultaneously process both the maintenance and dynamic updating of feature-bound objects. Using an event-related design, we separated activities during memory maintenance and change detection. In the search for regions showing selective activation in dynamic updating of feature-bound objects, we identified a network during memory maintenance that was comprised of the inferior precentral sulcus, superior parietal lobule, and middle frontal gyrus. In the change detection period, various prefrontal regions, including the anterior prefrontal cortex, were activated. In updating object representation of dynamically moving objects, the inferior precentral sulcus closely cooperates with a so-called "frontoparietal network", and subregions of the frontoparietal network can be decomposed into those sensitive to spatial updating and feature binding. The anterior prefrontal cortex identifies changes in object representation by comparing memory and perceptual representations rather than maintaining object representations per se, as previously suggested. Copyright 2009 Elsevier Inc. All rights reserved.

  4. Identification of symptom and functional domains that fibromyalgia patients would like to see improved: a cluster analysis.

    PubMed

    Bennett, Robert M; Russell, Jon; Cappelleri, Joseph C; Bushmakin, Andrew G; Zlateva, Gergana; Sadosky, Alesia

    2010-06-28

    The purpose of this study was to determine whether some of the clinical features of fibromyalgia (FM) that patients would like to see improved aggregate into definable clusters. Seven hundred and eighty-eight patients with clinically confirmed FM and baseline pain > or =40 mm on a 100 mm visual analogue scale ranked 5 FM clinical features that the subjects would most like to see improved after treatment (one for each priority quintile) from a list of 20 developed during focus groups. For each subject, clinical features were transformed into vectors with rankings assigned values 1-5 (lowest to highest ranking). Logistic analysis was used to create a distance matrix and hierarchical cluster analysis was applied to identify cluster structure. The frequency of cluster selection was determined, and cluster importance was ranked using cluster scores derived from rankings of the clinical features. Multidimensional scaling was used to visualize and conceptualize cluster relationships. Six clinical features clusters were identified and named based on their key characteristics. In order of selection frequency, the clusters were Pain (90%; 4 clinical features), Fatigue (89%; 4 clinical features), Domestic (42%; 4 clinical features), Impairment (29%; 3 functions), Affective (21%; 3 clinical features), and Social (9%; 2 functional). The "Pain Cluster" was ranked of greatest importance by 54% of subjects, followed by Fatigue, which was given the highest ranking by 28% of subjects. Multidimensional scaling mapped these clusters to two dimensions: Status (bounded by Physical and Emotional domains), and Setting (bounded by Individual and Group interactions). Common clinical features of FM could be grouped into 6 clusters (Pain, Fatigue, Domestic, Impairment, Affective, and Social) based on patient perception of relevance to treatment. Furthermore, these 6 clusters could be charted in the 2 dimensions of Status and Setting, thus providing a unique perspective for interpretation of FM symptomatology.

  5. Lingual eruption of mandibular permanent incisors: a space correlated phenomenon?

    PubMed

    Aminabadi, Naser Asl; Farahani, Ramin Mostofi Zadeh; Sohrabi, Aydin; Pouralibaba, Firuz

    2009-01-01

    The aim of the present study was to investigate the prevalence and distribution according to various arch length conditions of lingually erupted mandibular permanent incisors and the effect of space condition on this phenomenon with long-term follow-up of these teeth. A total of 105 children aged 5-7.5 years with one or more permanent mandibular incisors erupting lingual to the corresponding primary incisors were included in the study. A space analysis was performed. The subjects were divided into six groups according to various space conditions. The subjects were followed for 2 years. In this study the prevalence of lingual eruption was 18.4%. Eighty-three point seven percent of the subjects had either equivalent space, mild space excess, or a space deficiency (not more than 3 mm). No relationship was found between groups and clinical outcomes (P>.05). Follow up of the main three groups (according to the space analysis results) revealed in the adequate space group 75% of the children lost their primary incisors without any intervention. Similar outcomes occurred in 85.7% and 57.14% of cases in the mild space excess and space deficiency groups, respectively. Considering the three main groups combined, equivalent space, mild space excess, and mild space deficiency, 70.45% of children lost their primary incisors without any intervention and 14.8% needed primary incisor extraction (17.4%, 14.3%, and 10.7% in each group, respectively). There was no predisposition toward a space deficiency or excess found in these subjects so the wait-and-see policy versus early extraction can be considered for lingually erupting permanent mandibular incisors. Lingual eruption of mandibular incisors is a common clinical problem in the early mixed dentition period that is a source of discomfort for parents of patients with this condition. The present study provides a unique insight into the prevalence of the problem as well as the clinical decisions such as favoring retention of primary incisors as long as possible, the extraction of these primary teeth, placement of lower lingual holding arches, or referral for comprehensive orthodontic treatment. These types of data should not be regarded as standards but as illustrative of several key factors that are still not well-understood or which are still ignored.

  6. Clinical Features and Associated Likelihood of Primary Ciliary Dyskinesia in Children and Adolescents

    PubMed Central

    Ferkol, Thomas W.; Davis, Stephanie D.; Lee, Hye-Seung; Rosenfeld, Margaret; Dell, Sharon D.; Sagel, Scott D.; Milla, Carlos; Olivier, Kenneth N.; Sullivan, Kelli M.; Zariwala, Maimoona A.; Pittman, Jessica E.; Shapiro, Adam J.; Carson, Johnny L.; Krischer, Jeffrey; Hazucha, Milan J.

    2016-01-01

    Rationale: Primary ciliary dyskinesia (PCD), a genetically heterogeneous, recessive disorder of motile cilia, is associated with distinct clinical features. Diagnostic tests, including ultrastructural analysis of cilia, nasal nitric oxide measurements, and molecular testing for mutations in PCD genes, have inherent limitations. Objectives: To define a statistically valid combination of systematically defined clinical features that strongly associates with PCD in children and adolescents. Methods: Investigators at seven North American sites in the Genetic Disorders of Mucociliary Clearance Consortium prospectively and systematically assessed individuals (aged 0–18 yr) referred due to high suspicion for PCD. The investigators defined specific clinical questions for the clinical report form based on expert opinion. Diagnostic testing was performed using standardized protocols and included nasal nitric oxide measurement, ciliary biopsy for ultrastructural analysis of cilia, and molecular genetic testing for PCD-associated genes. Final diagnoses were assigned as “definite PCD” (hallmark ultrastructural defects and/or two mutations in a PCD-associated gene), “probable/possible PCD” (no ultrastructural defect or genetic diagnosis, but compatible clinical features and nasal nitric oxide level in PCD range), and “other diagnosis or undefined.” Criteria were developed to define early childhood clinical features on the basis of responses to multiple specific queries. Each defined feature was tested by logistic regression. Sensitivity and specificity analyses were conducted to define the most robust set of clinical features associated with PCD. Measurements and Main Results: From 534 participants 18 years of age and younger, 205 were identified as having “definite PCD” (including 164 with two mutations in a PCD-associated gene), 187 were categorized as “other diagnosis or undefined,” and 142 were defined as having “probable/possible PCD.” Participants with “definite PCD” were compared with the “other diagnosis or undefined” group. Four criteria-defined clinical features were statistically predictive of PCD: laterality defect; unexplained neonatal respiratory distress; early-onset, year-round nasal congestion; and early-onset, year-round wet cough (adjusted odds ratios of 7.7, 6.6, 3.4, and 3.1, respectively). The sensitivity and specificity based on the number of criteria-defined clinical features were four features, 0.21 and 0.99, respectively; three features, 0.50 and 0.96, respectively; and two features, 0.80 and 0.72, respectively. Conclusions: Systematically defined early clinical features could help identify children, including infants, likely to have PCD. Clinical trial registered with ClinicalTrials.gov (NCT00323167). PMID:27070726

  7. Reversible Lithium Neurotoxicity: Review of the Literature

    PubMed Central

    Netto, Ivan

    2012-01-01

    Objective: Lithium neurotoxicity may be reversible or irreversible. Reversible lithium neurotoxicity has been defined as cases of lithium neurotoxicity in which patients recovered without any permanent neurologic sequelae, even after 2 months of an episode of lithium toxicity. Cases of reversible lithium neurotoxicity differ in clinical presentation from those of irreversible lithium neurotoxicity and have important implications in clinical practice. This review aims to study the clinical presentation of cases of reversible lithium neurotoxicity. Data Sources: A comprehensive electronic search was conducted in the following databases: MEDLINE (PubMed), 1950 to November 2010; PsycINFO, 1967 to November 2010; and SCOPUS (EMBASE), 1950 to November 2010. MEDLINE and PsycINFO were searched by using the OvidSP interface. Study Selection: A combination of the following search terms was used: lithium AND adverse effects AND central nervous system OR neurologic manifestation. Publications cited include articles concerned with reversible lithium neurotoxicity. Data Extraction: The age, sex, clinical features, diagnostic categories, lithium doses, serum lithium levels, precipitating factors, and preventive measures of 52 cases of reversible lithium neurotoxicity were extracted. Data Synthesis: Among the 52 cases of reversible lithium neurotoxicity, patients ranged in age from 10 to 80 years and a greater number were female (P = .008). Most patients had affective disorders, schizoaffective disorders, and/or depression (P < .001) and presented mainly with acute organic brain syndrome. In most cases, the therapeutic serum lithium levels were less than or equal to 1.5 mEq/L (P < .001), and dosage regimens were less than 2,000 mg/day. Specific drug combinations with lithium, underlying brain pathology, abnormal tissue levels, specific diagnostic categories, and elderly populations were some of the precipitating factors reported for reversible lithium neurotoxicity. The preventive measures were also described. Conclusions: Reversible lithium neurotoxicity presents with a certain clinical profile and precipitating factors for which there are appropriate preventive measures. This recognition will help in early diagnosis and prompt treatment of lithium neurotoxicity. PMID:22690368

  8. Epidemiological study of 7316 patients on haemodialysis treated in FME clinics in Spain, using data from the EuCliD® database: results from years 2009-2010.

    PubMed

    Pérez-García, Rafael; Palomares-Sancho, Inés; Merello-Godino, José I; Aljama-García, Pedro; Bustamante-Bustamante, Jesús; Luño, José; Maduell-Canals, Francisco; Martín-de Francisco, Angel L; Martín-Malo, Alejandro; Mirapeix-i-Vicens, Eduard; Molina-Núñez, Manuel; Praga-Terente, Manuel; Tetta, Ciro; Marcelli, Daniele

    2012-01-01

    Observational study of patients on hemodialysis (HD) in FMC® Spain clinics over the years 2009 and 2010. The data were collected from the EuClid® database, implemented in the clinics of FMC®, which complies with the following feature: record online, compulsory, conducted in patients incidents and that it covers the entire population on HD in these clinics. Its aim is to understand the characteristics of patients and treatment patterns, comparing them with other studies described in the literature and in order to improve their prognosis and quality of life. Include 2637 incidents patients and 4679 prevalent, which makes a total of 7316 patients. In prevalent patients: 24.4% were diabetic; 76.3% had cardio-vascular disease (CVD) and 13.4% cancer. Among the incidents, these percentages were: 33.5% diabetic; 80.6% had CVD and 12.6% cancer. The prevalent patients had such as vascular access: FAV 68.5%, prosthesis 5.6%, permanent catheter 23.7% and 2.3% temporary catheter. The average of the duration of the sessions of HD was 230 minutes. 23.2% of the prevalent patients were on on-line hemodiafiltration. These patients hospitalization rates were 0.46 hospitalizations per incident patient per year and 0.52 per prevalent patient per year. The annual gross mortality rate was 12%. The mortality of the patients in this study HD is smaller than these of the Spanish Registry of Dialysis and Transplant (GRER). The result of morbidity and mortality of the FMC clinics of Spain can, therefore, be as good compared with these of the GRER and other international series. That does not mean that there are not areas of improvement as the increase in the time of dialysis, the percentage of patients on on-line hemodiafiltration convective techniques and the percentage of FAV.

  9. Misdiagnosis of cerebellar hemorrhage - features of 'pseudo-gastroenteritis' clinical presentations to the ED and primary care.

    PubMed

    Lee, Seung-Han; Stanton, Victoria; Rothman, Richard E; Crain, Barbara; Wityk, Robert; Wang, Zheyu; Newman-Toker, David E

    2017-03-01

    Early-stage cerebellar hemorrhage can present with nausea or vomiting absent other neurological symptoms or signs, potentially leading to an incorrect diagnosis of gastroenteritis. We sought to determine the frequency of gastroenteritis-like presentations and delayed or missed diagnoses among patients with spontaneous cerebellar hemorrhage. This is a retrospective, case-control analysis of atraumatic, primary cerebellar hemorrhages derived from a systematic search of surgical pathology and autopsy databases at two large urban, academic medical centers from 1984 to 2006. Hospital visit and clinical symptom data were abstracted from electronic and paper medical records for included patients. Delayed or missed diagnoses were defined as those at least one previous visit for relevant clinical symptoms in the 7 days prior to the correct diagnosis being confirmed. Among 254 records captured by our search filter, we identified 35 cases of pathologically proven primary cerebellar hemorrhage. Four patients (11%) were misdiagnosed initially - three with "gastroenteritis" and one with "hypertension". In this small sample, misdiagnosed patients presented more often with normal mental state (100% vs. 35%, p=0.07) and nausea/vomiting (100% vs. 58%, p=0.22). Although patients deteriorated clinically after the initial misdiagnosis, and potentially dangerous diagnostic tests and treatment strategies were instituted as a result of misdiagnosis, none of the misdiagnosed patients died or suffered major permanent harms due to diagnostic delay. Our study is limited by the small number of identified cases. Nevertheless, it appears that patients with cerebellar hemorrhages can present with relatively unimpressive clinical findings without obvious neurological manifestations. Such individuals are sometimes misdiagnosed with gastroenteritis or other benign disorders initially, possibly when neurologic examination, particularly gait testing, is omitted or abridged. A careful search for subtle cerebellar signs, including dysarthria, limb ataxia, nystagmus or tandem gait instability, absent in true gastroenteritis cases, could potentially reduce misdiagnosis.

  10. 12 years' preservation of maxillary permanent incisors with cervical root fractures adjacent to aggressive periodontitis: Report of a case.

    PubMed

    Tobiska, Sandra; Krastl, Gabriel

    2018-05-17

    This case report presents long-term results following horizontal root fracture of both maxillary central incisors in a 19-year-old woman with aggressive periodontitis. Due to extensive marginal bone loss and the close proximity of the fracture lines to the bottoms of the periodontal pockets, the prognosis of both teeth was uncertain at the time of the accident. Nevertheless, a conservative treatment strategy consisting of splinting and nonsurgical periodontal therapy was initiated. Follow-up at 12 years after the start of treatment revealed a stable situation from clinical and radiologic perspectives. Permanent fixation to the adjacent teeth and regular supportive periodontal care were the basis for a favorable long-term prognosis.

  11. Severe tricuspid regurgitation due to entrapment of the anterior leaflet of the valve by a permanent pacemaker lead: role of real time three-dimensional echocardiography.

    PubMed

    Nucifora, Gaetano; Badano, Luigi P; Allocca, Giuseppe; Gianfagna, Pasquale; Proclemer, Alessandro; Cinello, Margherita; Fioretti, Paolo M

    2007-07-01

    Pacemaker leads may impair tricuspid valve coaptation and they are a well-known cause of mild tricuspid regurgitation. Occasionally, right ventricular leads worsen tricuspid regurgitation over time and patients develop late-onset symptoms of right-sided heart failure. The exact mechanism of this clinical entity is rarely identifiable by 2D-echocardiography only. This case report details a patient with severe tricuspid regurgitation secondary to immobilization of the anterior leaflet of the tricuspid valve by a permanent ventricular pacing lead. The mechanism of regurgitation was clarified by real time three-dimensional echocardiography that showed the location of the ventricular lead and its interference with the tricuspid valve.

  12. Parotid tumours: clinical and oncologic outcomes after microscope-assisted parotidectomy with intraoperative nerve monitoring.

    PubMed

    Carta, F; Chuchueva, N; Gerosa, C; Sionis, S; Caria, R A; Puxeddu, R

    2017-10-01

    Temporary and permanent facial nerve dysfunctions can be observed after parotidectomy for benign and malignant lesions. Intraoperative nerve monitoring is a recognised tool for the preservation of the nerve, while the efficacy of the operative microscope has been rarely stated. The authors report their experience on 198 consecutive parotidectomies performed on 196 patients with the aid of the operative microscope and intraoperative nerve monitoring. 145 parotidectomies were performed for benign lesions and 53 for malignancies. Thirteen patients treated for benign tumours experienced temporary (11 cases) or permanent facial palsy (2 cases, both of House-Brackmann grade II). Ten patients with malignant tumour presented with preoperative facial nerve weakness that did not improve after treatment. Five and 6 patients with malignant lesion without preoperative facial nerve deficit experienced postoperative temporary and permanent weakness respectively (the sacrifice of a branch of the nerve was decided intraoperatively in 2 cases). Long-term facial nerve weakness after parotidectomy for lesions not directly involving or originating from the facial nerve (n = 185) was 2.7%. Patients treated for benign tumours of the extra facial portion of the gland without inflammatory behaviour (n = 91) had 4.4% facial nerve temporary weakness rate and no permanent palsy. The combined use of the operative microscope and intraoperative nerve monitoring seems to guarantee facial nerve preservation during parotidectomy. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

  13. Combination of Permanent Interstitial 125I-Seed Brachytherapy and Surgery for the Treatment of Large Hepatocellular Carcinoma

    PubMed Central

    Li, Xiaogang; Li, Bo; Yang, Rong; Luo, Kaiyuan

    2017-01-01

    The treatment methods available for large primary hepatocellular carcinomas (diameter >5 cm) are inadequate. Here, we report the successful management of 80 cases of large hepatocellular carcinoma, using a combination of custom-designed permanent interstitial iodine-125 seed brachytherapy and palliative surgery. Patients were enrolled in the study between 2011 and 2014. All patients underwent surgical treatment along with permanent interstitial iodine-125 seed brachytherapy; for the latter, patients received minimum doses covering 90% of the target (D90 s) of iodine-125 seeds ranging from 100 to 160 Gy (median: 110 Gy). All patients received 6 cycles of chemotherapy and were followed up at 6, 12, 24, and 36 months postoperatively. The clinical symptom remission rate was 95.3% (61 of 64). Alanine aminotransferase and aspartate aminotransferase levels decreased to normal in 80% (50 of 60) and 75% of the patients (45 of 60), respectively. The posttreatment alpha-fetoprotein levels decreased by 50% in 80% of the patients (40 of 50). The effective therapy rates were 80% (76 of 95) for 95 tumor nodules (diameters 5-10 cm) and 78.6% (33 of 42) for 42 tumor nodules (diameters >10 cm). The 3-year disease-free survival rate was 66.6%. Palliative surgery plus permanent interstitial iodine-125 seed brachytherapy appears to be a reasonable therapeutic alternative for large hepatocellular carcinoma. PMID:28585493

  14. Locum tenens consultant doctors in a rural general hospital - an essential part of the medical workforce or an expensive stopgap?

    PubMed

    Sim, Andrew Jw

    2011-01-01

    Maintaining hospital consultant staffing levels often requires the employment of locum tenens to meet service needs. This is particularly so in hospitals where core clinical services are run by a small number of permanently appointed consultants. The problems associated with locum employment are underestimated and little attention has been directed towards addressing the issue in the rural general hospitals of Scotland. This study looked at the permanent and short- and long-term locum consultant usage over an 8 year period in one Scottish rural general hospital, the Western Isles Hospital in Stornoway. Data were extracted from the Human Resources Department of NHS Western Isles' list of locum consultants for most weeks from the beginning of January 2002 to the end of December 2009. The Western Isles Hospital in Stornoway has an establishment of 17 permanent consultants. During the 8 year study period 239 different consultants were employed, 20 held substantive permanent positions, 31 were long-term locums (employed >3 months) and 188 were short-term locums. The short-term locums worked for 535 different locum episodes. The pattern of usage varied according to service configuration. Study data revealed the alarming scope of the locum tenens issue, which will increase unless action is taken. For sustainable medical services to continue in the rural general hospitals of Scotland, staffing models must minimise the need to employ locum consultants.

  15. Autologus Platelet Rich Fibrin aided Revascularization of an immature, non-vital permanent tooth with apical periodontitis: A case report.

    PubMed

    Jadhav, Ganesh Ranganath; Shah, Dipali; Raghvendra, Srinidhi Surya

    2015-01-01

    Caries or trauma induced non-vital immature permanent tooth with blunderbuss, thin root which are very common among childrens are corrected using regenerative endodontic (revascularization) procedures. In the presented case, a 16-year-old boy reported with chief complaint of pain in maxillary left central incisor (Tooth #21). Tooth #21 showed grade III mobility, draining labial sinus, and short blunderbuss root with diffuse periapical radiolucency. Patient was explained the treatment plan and written informed consent was taken. Platelet rich fibrin (PRF) was prepared according to standard protocol. Autologous PRF was carried to the apical portion of the root canal after inducing revascularization. Access opening was double sealed with MTA and resin modified glass ionomer cement (RMGI). Baseline, 12 month and 18 month follow-up intraoral radiographs were taken. Clinically case was asymptomatic with complete resolution of intraoral sinus. Periapical healing, apical closure, root lengthening and dentinal wall thickening were uneventful. Thus PRF supplementation hastens the predictability and rate of revascularization in non-vital immature permanent teeth.

  16. Topical Iodine And Fluoride Varnish Combined Is More Effective Than Fluoride Varnish Alone For Protecting Erupting First Permanent Molars: A Retrospective Cohort Study

    PubMed Central

    Tut, Ohnmar K.; Milgrom, Peter M.

    2010-01-01

    Objective This communication examines the combined effect of topical PVP-iodine plus fluoride varnish in prevention of tooth decay in erupting first permanent molars in an on-going public health program. Methods The evaluation employed a retrospective cohort design with two groups of children 60–83 months. Cohort 1 (2004–05) received three times per school year topical fluoride varnish, and Cohort 2 (2008–09) received topical application of 10% PVP-iodine followed at each visit with topical fluoride varnish. The children were examined clinically at the beginning and end of the school year. Results The proportion of children with caries-free first permanent molars in Cohort 2 (PVP-iodine plus fluoride varnish) was .883 and was greater than that in Cohort 1 (varnish), which was .785 (Chi-square=1.000E1, df 1, p<.002). Conclusions This evaluation of an on-going dental public health program adds evidence that topical antiseptics applied at the same time as fluoride varnish are more effective than varnish alone. Randomized trials are needed. PMID:20337902

  17. Permanent disability pension due to skin diseases in Denmark 2003-2008.

    PubMed

    Ibler, Kristina S; Jemec, Gregor B E

    2011-01-01

    Skin diseases are common in the society. The majority of papers published on the impact of skin diseases are focused on clinical consequences of the quality of life, depression and anxiety. The overall societal perspective on skin disease is only poorly described but is important in the understanding of how skin diseases affect patients and in arguments for continued specialist services. An approach to explore the societal impact of skin diseases is to investigate the incidence of permanent disability pensions granted due to skin diseases. The present study evaluated the number of permanent disability pensions granted due to skin diseases in Denmark during the 2003-2008 period and related them to previous findings. In view of the high prevalence of skin diseases in the society, and particularly their role in occupational medicine, only a low number of disability pensions are granted. This may reflect that skin diseases either have less impact on the individual or are not considered by the authorities as debilitating as other high prevalence diseases such as musculoskeletal, psychiatric or circulatory diseases.

  18. Potentiation of Chemical Ototoxicity by Noise

    PubMed Central

    Steyger, Peter S.

    2010-01-01

    High-intensity and/or prolonged exposure to noise causes temporary or permanent threshold shifts in auditory perception. Occupational exposure to solvents or administration of clinically important drugs, such as aminoglycoside antibiotics and cisplatin, also can induce permanent hearing loss. The mechanisms by which these ototoxic insults cause auditory dysfunction are still being unraveled, yet they share common sequelae, particularly generation of reactive oxygen species, that ultimately lead to hearing loss and deafness. Individuals are frequently exposed to ototoxic chemical contaminants (e.g., fuel) and noise simultaneously in a variety of work and recreational environments. Does simultaneous exposure to chemical ototoxins and noise potentiate auditory dysfunction? Exposure to solvent vapor in noisy environments potentiates the permanent threshold shifts induced by noise alone. Moderate noise levels potentiate both aminoglycoside- and cisplatin-induced ototoxicity in both rate of onset and in severity of auditory dysfunction. Thus, simultaneous exposure to chemical ototoxins and moderate levels of noise can potentiate auditory dysfunction. Preventing the ototoxic synergy of noise and chemical ototoxins requires removing exposure to ototoxins and/or attenuating noise exposure levels when chemical ototoxins are present. PMID:20523755

  19. A hand-held EPR scanner for transcutaneous oximetry

    NASA Astrophysics Data System (ADS)

    Wolfson, Helen; Ahmad, Rizwan; Twig, Ygal; Blank, Aharon; Kuppusamy, Periannan

    2015-03-01

    Cutaneous (skin) oxygenation is an important prognostic factor for the treatment of chronic wounds, skin cancer, diabetes side effects, and limb amputation. Currently, there are no reliable methods for measuring this parameter. Oximetry, using electron paramagnetic resonance (EPR) spectroscopy, is emerging as a potential tool for clinical oximetry, including cutaneous applications. The problem with EPR oximetry, however, is that the conventional EPR design requires the use of a large magnet that can generate homogeneous field across the sample, making it unattractive for clinical practice. We present a novel approach that makes use of a miniature permanent magnet, combined with a small microwave resonator, to enable the acquisition of EPR signals from paramagnetic species placed on the skin. The instrumentation consists of a hand-held, modular, cylindrical probehead with overall dimensions of 36-mm diameter and 24-mm height, with 150-g weight. The probehead includes a Halbach array of 16 pieces (4×4×8 mm3) of Sm-Co permanent magnet and a loop-gap resonator (2.24 GHz). Preliminary measurements using a Hahn-echo pulse sequence (800 echos in 20 ms) showed a signalto- noise ratio of ~70 compared to ~435 in a homogenous magnet under identical settings. Further work is in progress to improve the performance of the probehead and to optimize the hand-held system for clinical use

  20. Catatonia in Psychotic Patients: Clinical Features and Treatment Response

    PubMed Central

    England, Mary L.; Öngür, Dost; Konopaske, Glenn T.; Karmacharya, Rakesh

    2012-01-01

    We report clinical features and treatment response in 25 patients with catatonia admitted to an inpatient psychiatric unit specializing in psychotic disorders. ECT, benzodiazepines, and clozapine had beneficial effects on catatonic features, while typical antipsychotics resulted in clinical worsening. PMID:21677256

  1. Features of electric drive sucker rod pumps for oil production

    NASA Astrophysics Data System (ADS)

    Gizatullin, F. A.; Khakimyanov, M. I.; Khusainov, F. F.

    2018-01-01

    This article is about modes of operation of electric drives of downhole sucker rod pumps. Downhole oil production processes are very energy intensive. Oil fields contain many oil wells; many of them operate in inefficient modes with significant additional losses. Authors propose technical solutions to improve energy performance of a pump unit drives: counterweight balancing, reducing of electric motor power, replacing induction motors with permanent magnet motors, replacing balancer drives with chain drives, using of variable frequency drives.

  2. A system for programming experiments and for recording and analyzing data automatically1

    PubMed Central

    Herrick, Robert M.; Denelsbeck, John S.

    1963-01-01

    A system designed for use in complex operant conditioning experiments is described. Some of its key features are: (a) plugboards that permit the experimenter to change either from one program to another or from one analysis to another in less than a minute, (b) time-sharing of permanently-wired, electronic logic components, (c) recordings suitable for automatic analyses. Included are flow diagrams of the system and sample logic diagrams for programming experiments and for analyzing data. ImagesFig. 4. PMID:14055967

  3. Morphological studies on the infraciliature of a planktonic ciliate, Tintinnopsis brasiliensis (Ciliophora: Tintinina)

    NASA Astrophysics Data System (ADS)

    Cai, Shengfang; Song, Weibo; Xu, Dapeng; Chiang, Kuoping

    2006-01-01

    A poorly-described marine planktonic ciliate, Tintinnopsis brasiliensis Kofoid & Campbell, 1929, collected from the Taiping Cape of Qingdao, China, was morphologically investigated based on permanent preparation after protargol impregnation and was compared with other related congeners. According to the infraciliature, three ciliary groups can be recognized, which reveals a very stable structure among specimens and denotes that the pattern of infraciliature is, apart from the features of the lorica, a highly reliable criterion for species identification.

  4. SOME NEW PROCESSING TECHNIQUES FOR THE IMPERIAL VALLEY 1979 AFTERSHOCKS.

    USGS Publications Warehouse

    Brady, A. Gerald; ,

    1983-01-01

    This paper describes some of the features of the latest processing improvements that the U. S. Geological Survey (USGS) is currently applying to strong-motion accelerograms from the national network of permanent stations. At the same time it introduces the application of this processing to the set of Imperial Valley aftershocks recorded following the main shock of October 15, 1979. Earlier processing of the 22 main shock recordings provided corrected accelerations, velocity and displacement, response spectra, and Fourier spectra.

  5. A new magnesium alloy system: TEXAS

    NASA Astrophysics Data System (ADS)

    Wiese, Björn; Mendis, Chamini; Blawert, Carsten; Nyberg, Eric; Kainer, Karl Ulrich; Hort, Norbert

    A new TEXAS alloy system (Mg-Sn-Nd-Ca-Al-Si) is presented in order to extend the range of applications for magnesium alloys. The alloy has been produced by permanent mould direct chill casting, a process that provides a homogenous distribution of alloying elements throughout the entire casting. This work presents microstructural features and a new Mg-Sn-Ca phase with the morphology of hexagonal platelets. Additionally mechanical properties and the corrosion behaviour of TEXAS alloys are presented in as cast and heat treated conditions.

  6. Tracking problem for electromechanical system under influence of external perturbations

    NASA Astrophysics Data System (ADS)

    Kochetkov, Sergey A.; Krasnova, Svetlana A.; Utkin, Victor A.

    2017-01-01

    For electromechanical objects the new control algorithms (vortex algprithms) are developed on the base of discontinuous functions. The distinctive feature of these algorithms is providing of asymptotical convergence of the output variables to zero under influence of unknown bounded disturbances of prescribed class. The advantages of proposed approach is demonstrated for direct current motor with permanent excitation. It is shown that inner variables of the system converge to unknown bounded disturbances and guarantee asymptotical convergence of output variables to zero.

  7. Porous Structure Design of Polymeric Membranes for Gas Separation

    DOE PAGES

    Zhang, Jinshui; Schott, Jennifer Ann; Mahurin, Shannon Mark; ...

    2017-04-04

    High-performance polymeric membranes for gas separation are of interest for molecular-level separations in industrial-scale chemical, energy and environmental processes. To overcome the inherent trade-off relationship between permeability and selectivity, the creation of permanent microporosity in polymeric matrices is highly desirable because the porous structures can provide a high fractional free volume to facilitate gas transport through the dense layer. In this feature article, recent developments in the formation of porous polymeric membranes and potential strategies for pore structure design are reviewed.

  8. The design of a small linear-resonant, split Stirling cryogenic refrigerator compressor

    NASA Technical Reports Server (NTRS)

    Ackermann, R. A.

    1985-01-01

    The development of a small linear-resonant compressor for use in a 1/4-watt, 78K, split Stirling cryogenic refrigerator is discussed. The compressor contains the following special features: (1) a permanent-magnet linear motor; (2) resonant dynamics; (3) dynamic balancing; and (4) a close-clearance seal between the compressor piston and cylinder. This paper describes the design of the compressor, and presents component test data and system test data for the compressor driving a 1/4-watt expander.

  9. Alert 2002 Ground Truth Missions for Arctic Shoreline Delineation and Feature Extraction

    DTIC Science & Technology

    2002-12-01

    consid6r6e. DRDC Ottawa TM 2002-147 This page intentionally left blank. DRDC Ottawa TM 2002-147 Executive summary _ The current world vector shoreline...northern permanently inhabited settlement in the world . Alert was first settled in early 1950s as a joint Canada/US weather station. The Canadian...military station was established in 1958. During the Cold War it was Canada’s most important intercept station for monitoring the Soviet Union. There are

  10. A novel permanent maglev impeller TAH: most requirements on blood pumps have been satisfied.

    PubMed

    Qian, K X; Zeng, P; Ru, W M; Yuan, H Y

    2003-07-01

    Based on the development of an impeller total artificial heart (TAH) (1987) and a permanent maglev (magnetic levitation) impeller pump (2002), as well as a patented magnetic bearing and magnetic spring (1996), a novel permanent maglev impeller TAH has been developed. The device consists of a rotor and a stator. The rotor is driven radially. Two impellers with different dimensions are fixed at both the ends of the rotor. The levitation of the rotor is achieved by using two permanent magnetic bearings, which have double function: radial bearing and axial spring. As the rotor rotates at a periodic changing speed, two pumps deliver the pulsatile flow synchronously. The volume balance between the two pumps is realized due to self-modulation property of the impeller pumps, without need for detection and control. Because the hemo-dynamic force acting on the left impeller is larger than that on the right impeller, and this force during systole is larger than that during diastole, the rotor reciprocates axially once a cycle. This is beneficial to prevent the thrombosis in the pump. Furthermore, a small flow via the gap between stator and rotor from left pump into right pump comes to a full washout in the motor and the pumps. Therefore, it seems neither mechanical wear nor thrombosis could occur. The previously developed prototype impeller TAH had demonstrated that it could operate in animal experiments indefinitely, if the bearing would not fail to work. Expectantly, this novel permanent magnetic levitation impeller TAH with simplicity, implantability, pulsatility, compatibility and durability has satisfied the most requirements on blood pumps and will have more extensive applications in experiments and clinics.

  11. Incidence, predictors and early post-operative course of diabetes insipidus in paediatric craniopharygioma: a comparison with adults.

    PubMed

    Pratheesh, Ravindran; Swallow, Diane Margaret A; Rajaratnam, Simon; Jacob, K S; Chacko, Geeta; Joseph, Mathew; Chacko, Ari G

    2013-06-01

    This study aims to determine the incidence, predictors, early post-operative course of diabetes insipidus (DI) in paediatric craniopharyngiomas(CP) and compare the findings with adults. Retrospective analysis of clinical, biochemical, radiological and operative data for 102 consecutive CP surgeries (45 paediatric and 57 adult cases) was done. Bivariate and multivariate analyses were done to determine the predictors of DI. The incidence of the triphasic response and electrolyte abnormalities in the first post-operative week was compared between children and adults. Children had larger tumours and higher incidence of cystic tumours and hydrocephalus. Preoperative DI was close to 15 % in both the age groups. Radical/subtotal excision was achieved in 58 % of children and 53 % of adults. The incidence of post-operative DI was 80 % and 63 % in children and adults, respectively. Children had significantly higher incidence of permanent DI (55.6 %). Radical excision in children (p = 0.000); previous tumour surgery (p = 0.014) and new onset hypopituitarism (p = 0.019) in adults were associated with permanent DI. The triphasic response (23 %), wide intra-day serum sodium fluctuations and hyponatraemia were more common in children. Post-operative DI is a frequent and significant cause of morbidity in children undergoing surgery for CP. Children have a higher incidence of permanent DI. Radical excision is a predictor of permanent DI in children, whereas previous tumour excision and new onset hypopituitarism were predictors of permanent DI among adults. The management of post-operative DI is more difficult in children and the treating physician needs to be alert to detect the triphasic response.

  12. Management of a child with severe hypodontia in the mixed dentition stage of development.

    PubMed

    Tong, H J; Tahmassebi, J F

    2014-12-01

    Severe hypodontia is a condition characterized by developmental absence of six or more teeth and affects 0.14-0.3% of the overall population. Hypodontia can have a marked psychosocial effect and functional implications for a growing child. A 10-year-old girl with a medical history of hypothyroidism and repaired spinal bifida was referred to the Leeds Dental Institute as she was becoming increasingly concerned about her appearance. On clinical examination, the patient had severe wear of her over-retained maxillary primary central incisors, microdontia of mandibular anterior teeth (32, 34, 41, 42, 43), and loss of anterior vertical dimension. Radiographic examination revealed that the patient had 11 missing permanent teeth (14, 13, 12, 11, 21, 22, 23, 24, 31, 35, 44), an ectopic mandibular left canine and taurodontism of the permanent molars. Management of the patient included an intensive preventive programme with placement of fissure sealants; scaling of calculus deposition on microdont teeth; composite resin reconstruction of microdont teeth; fabrication of removable partial overdentures tailored aesthetically to match the patient's age; orthodontic consultation and monitoring for the eruption of ectopic canine and permanent dentition. The patient and her parents reported marked improvement in self-esteem following dental treatment. After 2 years of follow-up, a new pair of dentures were made and designed to allow ease of eruption of the existing permanent dentition. All permanent teeth have erupted. The patient is ready for further assessment and planning for future orthodontic and restorative/implant treatment. This case illustrates the essential role of the paediatric dentist in the management of hypodontia in the mixed dentition stage.

  13. Understanding Teenage Depression: A Guide to Diagnosis, Treatment, and Management.

    ERIC Educational Resources Information Center

    Empfield, Maureen; Bakalar, Nicholas

    The incidence of teenage depression has increased all over the world. In some populations it is has been accompanied by suicide, but suicide remains rare. Clinical depression, which entails many debilitating physical and psychological symptoms, is a serious disease that can do terrible and even permanent damage to a teenager's developmental…

  14. An Interpersonal Psychotherapy Approach to Counseling Student Athletes: Clinical Implications of Athletic Identity

    ERIC Educational Resources Information Center

    Heird, Emily Benton; Steinfeldt, Jesse A.

    2013-01-01

    Research has shown that disruptive circumstances in an athlete's career (temporary injury, permanent injury, retirement) can pose significant difficulties, especially if the athlete has developed a salient athletic identity at the expense of a multidimensional self-concept. The authors present an interpersonal psychotherapy approach to case…

  15. Endodontic treatment of an unusual connation of permanent mandibular molars: a case report.

    PubMed

    Liu, Shengbo; Fan, Bing; Peng, Bin; Fan, Mingwen; Bian, Zhuan

    2006-10-01

    A 27-year-old patient with an anomalous mandibular molar was referred for endodontic therapy. Clinical and radiographic examination revealed the connation of a second mandibular molar with a third molar. Challenging endodontic therapy was performed in the unusual connated molars. A 2-year recall showed good treatment result.

  16. SU-F-19A-11: Retrospective Evaluation of Thermal Coverage by Thermobrachytherapy Seed Arrangements of Clinical LDR Prostate Implants

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

    Warrell, G; Shvydka, D; Chen, C

    Purpose: The superiority of a properly-administered combination of radiation therapy and hyperthermia over radiation alone in treatment of human cancers has been demonstrated in multiple studies examining radiobiology, local control, and survival. Unfortunately, hyperthermia is not yet a common modality in oncology practice, due in part to the technical difficulty of heating a deep-seated target volume to sufficient temperature. To address this problem, our group has invented a thermobrachytherapy (TB) seed based on a commonly-used low dose-rate permanent brachytherapy seed for implant in solid tumors. Instead of the tungsten radiographic marker of the standard seed, the TB seed contains onemore » of a self-regulating ferromagnetic alloy. Placement of a patient implanted with such seeds in an oscillating magnetic field generates heat via induction of eddy currents. We present the results of studies of the capability of clinically-realistic TB seed arrangements to adequately heat defined target volumes. Methods: Seed distributions for several past LDR prostate permanent implant brachytherapy patients were reproduced in the finite element analysis software package COMSOL Multiphysics 4.4, with the difference that TB seeds were modelled, rather than the radiation-only seeds actually used for their treatments. The implant geometries were mainly of the modified peripheral loading type; a range of prostatic volumes and blood perfusion rates likely to be seen in a clinical setting were examined. Results: According to the simulations, when distributed to optimize radiation dose, TB seeds also produce sufficient heat to provide thermal coverage of the target given proper selection of the magnetic field strength. However, the thermal distributions may be improved by additional use of hyperthermia-only seeds. Conclusion: A dual-modality seed intended as an alternative to and using the same implantation apparatus and technique as the standard LDR permanent implant seed has been successfully evaluated for its ability to provide sufficient hyperthermia in clinically-realistic implants. This work was partially supported by the National Institutes of Health (NIH) STTR Grant No. R41 CA153631-01A1.« less

  17. Is non-cavitated proximal lesion sealing an effective method for caries control in primary and permanent teeth? A systematic review and meta-analysis.

    PubMed

    Ammari, Michelle Mikhael; Soviero, Vera Mendes; da Silva Fidalgo, Tatiana Kelly; Lenzi, Michele; Ferreira, Daniele Masterson T P; Mattos, Cláudia Trindade; de Souza, Ivete Pomarico Ribeiro; Maia, Lucianne Cople

    2014-10-01

    The aim of this study was to perform a systematic review and meta-analysis on the effectiveness of sealing non-cavitated proximal caries lesions in primary and permanent teeth. Only controlled clinical trials and randomized controlled clinical trials that evaluated the effectiveness of sealing on non-cavitated proximal caries with a minimum follow-up of 12 months were included in the study. The primary outcome should be arrestment/progression of proximal caries evaluated by bitewing radiographs. A risk of bias evaluation based on the Cochrane Collaboration common scheme for bias was carried out for each study. The meta-analysis was performed on the studies considered low risk of bias and with pair-wise visual reading results through RevMan software. A comprehensive search was performed in the Systematic Electronic Databases: Pubmed, Cochrane Library, Scopus, IBI Web of Science, Lilacs, SIGLE, and on website Clinical trials.gov, through until June 2013. From 967 studies identified, 10 articles and 3 studies with partial results were assessed for eligibility. However three articles were excluded and our final sample included 10 studies. According to the risk of bias evaluation, six studies were considered "high" risk of bias, and four "low" risk of bias. The forest plot of the meta-analysis showed low heterogeneity (I(2)=29%) and a favourable outcome for the Infiltrant. The chance of caries progression when this technique was used was significantly lower (p=0.002) compared with Placebo. Our results suggest that the technique of sealing non-cavitated proximal caries seems to be effective in controlling proximal caries in the short and medium term. Further long-term randomized clinical trials are still necessary to increase this evidence. Contemporary dentistry is focused in minimally invasive approaches that prevent the destruction of sound dental tissues next to carious lesions. This paper searches for evidence of the efficacy of sealing/infiltrating non-cavitated proximal caries in arresting caries progression both in permanent and primary teeth. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Amelogenesis imperfecta: therapeutic strategy from primary to permanent dentition across case reports.

    PubMed

    Toupenay, Steve; Fournier, Benjamin Philippe; Manière, Marie-Cécile; Ifi-Naulin, Chantal; Berdal, Ariane; de La Dure-Molla, Muriel

    2018-06-15

    Hereditary enamel defect diseases are regrouped under the name "Amelogenesis Imperfecta" (AIH). Both dentitions are affected. Clinical expression is heterogeneous and varies between patients. Mutations responsible for this multigene disease may alter various genes and the inheritance can be either autosomal dominant or recessive, or X-linked. Until now, no therapeutic consensus has emerged for this rare disease. The purpose of this article was to report treatments of AIH patients from childhood to early adulthood. Treatment of three patients of 3, 8 16 years old are described. Each therapeutic option was discussed according to patients' age and type of enamel alteration. Paediatric crowns and resin based bonding must be preferred in primary teeth. In permanent teeth, non-invasive or minimally invasive dentistry should be the first choice in order to follow a therapeutic gradient from the less invasive options to prosthodontic treatments. Functional and aesthetic issues require patients to be treated; this clinical care should be provided as early as possible to enable a harmonious growth of the maxillofacial complex and to prevent pain.

  19. Personality disorders and treatment drop out in the homeless

    PubMed Central

    Salavera, Carlos; Tricás, José M; Lucha, Orosia

    2013-01-01

    The homeless drop out of treatment relatively frequently. Also, prevalence rates of personality disorders are much higher in the homeless group than in the general population. We hypothesize that when both variables coexist — homelessness and personality disorders — the possibility of treatment drop out grows. The aim of this study was to analyze the hypotheses, that is, to study how the existence of personality disorders affects the evolution of and permanence in treatment. One sample of homeless people in a therapeutic community (N = 89) was studied. The structured clinical interview for the diagnostic and statistical manual of mental disorders (DSM-IV-TR) was administered and participants were asked to complete the Millon Clinical Multiaxial Inventory-II (MCMI-II). Cluster B personality disorders (antisocial, borderline, and narcissistic) avoided permanence in the treatment process while cluster C disorders, as dependent, favored adhesion to the treatment and improved the prognosis. Knowledge of these personality characteristics should be used to advocate for better services to support homeless people and prevent their dropping out before completing treatment. PMID:23569378

  20. 4.7-T diffusion tensor imaging of acute traumatic peripheral nerve injury

    PubMed Central

    Boyer, Richard B.; Kelm, Nathaniel D.; Riley, D. Colton; Sexton, Kevin W.; Pollins, Alonda C.; Shack, R. Bruce; Dortch, Richard D.; Nanney, Lillian B.; Does, Mark D.; Thayer, Wesley P.

    2015-01-01

    Diagnosis and management of peripheral nerve injury is complicated by the inability to assess microstructural features of injured nerve fibers via clinical examination and electrophysiology. Diffusion tensor imaging (DTI) has been shown to accurately detect nerve injury and regeneration in crush models of peripheral nerve injury, but no prior studies have been conducted on nerve transection, a surgical emergency that can lead to permanent weakness or paralysis. Acute sciatic nerve injuries were performed microsurgically to produce multiple grades of nerve transection in rats that were harvested 1 hour after surgery. High-resolution diffusion tensor images from ex vivo sciatic nerves were obtained using diffusion-weighted spin-echo acquisitions at 4.7 T. Fractional anisotropy was significantly reduced at the injury sites of transected rats compared with sham rats. Additionally, minor eigenvalues and radial diffusivity were profoundly elevated at all injury sites and were negatively correlated to the degree of injury. Diffusion tensor tractography showed discontinuities at all injury sites and significantly reduced continuous tract counts. These findings demonstrate that high-resolution DTI is a promising tool for acute diagnosis and grading of traumatic peripheral nerve injuries. PMID:26323827

  1. Regenerative Therapy of Type 1 Diabetes Mellitus: From Pancreatic Islet Transplantation to Mesenchymal Stem Cells

    PubMed Central

    Rekittke, Nadine E.; Ang, Meidjie; Rawat, Divya; Khatri, Rahul

    2016-01-01

    Type 1 diabetes is an autoimmune disease resulting in the permanent destruction of pancreatic islets. Islet transplantation to portal vein provides an approach to compensate for loss of insulin producing cells. Clinical trials demonstrated that even partial islet graft function reduces severe hypoglycemic events in patients. However, therapeutic impact is restrained due to shortage of pancreas organ donors and instant inflammation occurring in the hepatic environment of the graft. We summarize on what is known about regenerative therapy in type 1 diabetes focusing on pancreatic islet transplantation and new avenues of cell substitution. Metabolic pathways and energy production of transplanted cells are required to be balanced and protection from inflammation in their intravascular bed is desired. Mesenchymal stem cells (MSCs) have anti-inflammatory features, and so they are interesting as a therapy for type 1 diabetes. Recently, they were reported to reduce hyperglycemia in diabetic rodents, and they were even discussed as being turned into endodermal or pancreatic progenitor cells. MSCs are recognized to meet the demand of an individual therapy not raising the concerns of embryonic or induced pluripotent stem cells for therapy. PMID:27047547

  2. Ocular Jellyfish Stings: Report of 2 Cases and Literature Review.

    PubMed

    Mao, Chen; Hsu, Chien-Chin; Chen, Kuo-Tai

    2016-09-01

    An ocular jellyfish sting is an ophthalmic emergency and is rarely reported in the medical literature. With the evolution of aquatic activities and entertainment in recent decades, we anticipate that more patients with ocular jellyfish stings may be taken to the emergency department. However, most physicians are unaware of the typical presentations, suitable treatments, prognosis, and possible complications of ocular jellyfish stings. We reported 2 cases with ocular jellyfish stings and collected cases series from literature review. The most common clinical features of ocular jellyfish stings were pain, conjunctival injection, corneal lesion, and photophobia. All patients who sustained ocular stings did so during aquatic activities, and the best management at the scene was proper analgesics and copious irrigation of affected eyes with seawater or saline. The ocular lesions were treated with topical cycloplegics, topical steroids, topical antibiotics, topical antihistamines, and removal of nematocysts. The prognosis was good, and all patients recovered without any permanent sequelae. However, symptoms in some patients may last longer than 1 week. Reported complications included iritis, increased intraocular pressures, mydriasis, decreased accommodation, and peripheral anterior synechiae. Copyright © 2016 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  3. Advanced access: reducing waiting and delays in primary care.

    PubMed

    Murray, Mark; Berwick, Donald M

    2003-02-26

    Delay of care is a persistent and undesirable feature of current health care systems. Although delay seems to be inevitable and linked to resource limitations, it often is neither. Rather, it is usually the result of unplanned, irrational scheduling and resource allocation. Application of queuing theory and principles of industrial engineering, adapted appropriately to clinical settings, can reduce delay substantially, even in small practices, without requiring additional resources. One model, sometimes referred to as advanced access, has increasingly been shown to reduce waiting times in primary care. The core principle of advanced access is that patients calling to schedule a physician visit are offered an appointment the same day. Advanced access is not sustainable if patient demand for appointments is permanently greater than physician capacity to offer appointments. Six elements of advanced access are important in its application balancing supply and demand, reducing backlog, reducing the variety of appointment types, developing contingency plans for unusual circumstances, working to adjust demand profiles, and increasing the availability of bottleneck resources. Although these principles are powerful, they are counter to deeply held beliefs and established practices in health care organizations. Adopting these principles requires strong leadership investment and support.

  4. Safe discharge and outpatient investigation of ureteric colic: a retrospective analysis.

    PubMed

    Stewart, Michael

    2017-07-12

    Computed tomography of the kidneys, ureters and bladder is the recommended imaging modality for suspected urolithiasis. Early scanning is advised in guidelines, but there is limited published evidence to support this recommendation. In a retrospective study, we reviewed patients managed according to a local guideline. Patients without high-risk features were either imaged during their initial visit (if in the daytime) or discharged for outpatient scans. Complications, unplanned returns, final diagnosis, and intervention rates were compared between groups. Fifty-four patients were scanned during their initial visit and 151 were scanned as an outpatient at a median interval of 10 days. Unplanned return rates were lower in those scanned as outpatients (7.3 vs. 24.1%), with no significant difference in complications (2.0 vs. 3.7%; none leading to permanent harm). Those scanned as outpatients were less likely to have a stone proven by imaging (39.7 vs. 64.8%), but did not have a significantly higher rate of proven alternative diagnosis (9.3 vs. 13.0%). There is no evidence in this cohort that discharging patients for outpatient imaging is associated with poorer outcomes, provided that an appropriate clinical risk assessment is carried out.

  5. Rotor Position Sensorless Control and Its Parameter Sensitivity of Permanent Magnet Motor Based on Model Reference Adaptive System

    NASA Astrophysics Data System (ADS)

    Ohara, Masaki; Noguchi, Toshihiko

    This paper describes a new method for a rotor position sensorless control of a surface permanent magnet synchronous motor based on a model reference adaptive system (MRAS). This method features the MRAS in a current control loop to estimate a rotor speed and position by using only current sensors. This method as well as almost all the conventional methods incorporates a mathematical model of the motor, which consists of parameters such as winding resistances, inductances, and an induced voltage constant. Hence, the important thing is to investigate how the deviation of these parameters affects the estimated rotor position. First, this paper proposes a structure of the sensorless control applied in the current control loop. Next, it proves the stability of the proposed method when motor parameters deviate from the nominal values, and derives the relationship between the estimated position and the deviation of the parameters in a steady state. Finally, some experimental results are presented to show performance and effectiveness of the proposed method.

  6. Universal Parameter Measurement and Sensorless Vector Control of Induction and Permanent Magnet Synchronous Motors

    NASA Astrophysics Data System (ADS)

    Yamamoto, Shu; Ara, Takahiro

    Recently, induction motors (IMs) and permanent-magnet synchronous motors (PMSMs) have been used in various industrial drive systems. The features of the hardware device used for controlling the adjustable-speed drive in these motors are almost identical. Despite this, different techniques are generally used for parameter measurement and speed-sensorless control of these motors. If the same technique can be used for parameter measurement and sensorless control, a highly versatile adjustable-speed-drive system can be realized. In this paper, the authors describe a new universal sensorless control technique for both IMs and PMSMs (including salient pole and nonsalient pole machines). A mathematical model applicable for IMs and PMSMs is discussed. Using this model, the authors derive the proposed universal sensorless vector control algorithm on the basis of estimation of the stator flux linkage vector. All the electrical motor parameters are determined by a unified test procedure. The proposed method is implemented on three test machines. The actual driving test results demonstrate the validity of the proposed method.

  7. Spatial distribution, temporal variation and specificity of microhabitat of Tropisternus species (Coleoptera: Hydrophilidae) in permanent ponds.

    PubMed

    Gómez Lutz, M C; Kehr, A I; Fernández, L A

    2015-06-01

    The spatial distribution and temporal variation of 11 species of Tropisternus were analyzed in two permanent ponds located in the province of Corrientes, Argentina. Samples were collected every 15 days, between October 2010 and March 2011. The species recorded were Tropisternus collaris (Fabricius), Tropisternus ovalis Castelnau, Tropisternus laevis (Sturm), Tropisternus lateralis limbatus (Brullé), Tropisternus longispina Fernández & Bachmann, Tropisternus carinispina Orchymont, Tropisternus bourmeisteri Fernández & Bachmann, Tropisternus apicipalpis (Chevrolat), Tropisternus dilatatus Bruch, Tropisternus obesus Bruch, and Tropisternus ignoratus Knisch. The first four were present in higher proportions than the remaining during most of the study period. The spatial distribution of individuals was mostly related to the homogeneity or heterogeneity of the ecosystem in relation to microhabitats with aquatic vegetation: In ponds with different microhabitats, individuals were mainly aggregated, whereas in ponds with homogenous features, individuals were randomly distributed. However, when species were analyzed individually, the spatial distribution and the use of microhabitat by each species were different with respect to preference and behavior.

  8. Dissipation dynamics of field-free molecular alignment for symmetric-top molecules: Ethane (C2H6)

    NASA Astrophysics Data System (ADS)

    Zhang, H.; Billard, F.; Yu, X.; Faucher, O.; Lavorel, B.

    2018-03-01

    The field-free molecular alignment of symmetric-top molecules, ethane, induced by intense non-resonant linearly polarized femtosecond laser pulses is investigated experimentally in the presence of collisional relaxation. The dissipation dynamics of field-free molecular alignment are measured by the balanced detection of ultrafast molecular birefringence of ethane gas samples at high pressures. By separating the molecular alignment into the permanent alignment and the transient alignment, the decay time-constants of both components are quantified at the same pressure. It is observed that the permanent alignment always decays slower compared to the transient alignment within the measured pressure range. This demonstrates that the propensity of molecules to conserve the orientation of angular momentum during collisions, previously observed for linear species, is also applicable to symmetric-top molecules. The results of this work provide valuable information for further theoretical understanding of collisional relaxation within nonlinear polyatomic molecules, which are expected to present interesting and nontrivial features due to an extra rotational degree of freedom.

  9. High-quality permanent draft genome sequence of Bradyrhizobium sp. strain WSM1743 - an effective microsymbiont of an Indigofera sp. growing in Australia

    DOE PAGES

    Eshraghi, Leila; De Meyer, Sofie E.; Tian, Rui; ...

    2015-10-26

    Bradyrhizobium sp. strain WSM1743 is an aerobic, motile, Gram-negative, non-spore-forming rod that can exist as a soil saprophyte or as a legume microsymbiont of an Indigofera sp. WSM1743 was isolated from a nodule recovered from the roots of an Indigofera sp. growing 20 km north of Carnarvon in Australia. It is slow growing, tolerates up to 1 % NaCl and is capable of growth at 37 °C. Here we describe the features of Bradyrhizobium sp. strain WSM1743, together with genome sequence information and its annotation. Finally, the 8,341,956 bp high-quality permanent draft genome is arranged into 163 scaffolds and 167more » contigs, contains 7908 protein-coding genes and 75 RNA-only encoding genes and was sequenced as part of the Root Nodule Bacteria chapter of the Genomic Encyclopedia of Bacteria and Archaea project.« less

  10. High-quality permanent draft genome sequence of the Mimosa asperata - nodulating Cupriavidus sp. strain AMP6

    DOE PAGES

    De Meyer, Sofie E.; Parker, Matthew; Van Berkum, Peter; ...

    2015-10-16

    Cupriavidus sp. strain AMP6 is an aerobic, motile, Gram-negative, non-spore-forming rod that was isolated from a root nodule of Mimosa asperata collected in Santa Ana National Wildlife Refuge, Texas, in 2005. Mimosa asperata is the only legume described so far to exclusively associates with Cupriavidus symbionts. Furthermore, strain AMP6 represents an early-diverging lineage within the symbiotic Cupriavidus group and has the capacity to develop an effective nitrogen-fixing symbiosis with three other species of Mimosa. Here, we describe the genome of Cupriavidus sp. strain AMP6 which enables comparative analyses of symbiotic trait evolution in this genus; the general features, together withmore » sequence and annotation are further discussed. Finally, the 7,579,563 bp high-quality permanent draft genome is arranged in 260 scaffolds of 262 contigs, contains 7,033 protein-coding genes and 97 RNA-only encoding genes, and is part of the GEBA-RNB project proposal.« less

  11. Isolated Power Generation System Using Permanent Magnet Synchronous Generator with Improved Power Quality

    NASA Astrophysics Data System (ADS)

    Arya, Sabha Raj; Patel, Ashish; Giri, Ashutosh

    2018-06-01

    This paper deals wind energy based power generation system using Permanent Magnet Synchronous Generator (PMSG). It is controlled using advanced enhanced phase-lock loop for power quality features using distribution static compensator to eliminate the harmonics and to provide KVAR compensation as well as load balancing. It also manages rated potential at the point of common interface under linear and non-linear loads. In order to have better efficiency and reliable operation of PMSG driven by wind turbine, it is necessary to analyze the governing equation of wind based turbine and PMSG under fixed and variable wind speed. For handling power quality problems, power electronics based shunt connected custom power device is used in three wire system. The simulations in MATLAB/Simulink environment have been carried out in order to demonstrate this model and control approach used for the power quality enhancement. The performance results show the adequate performance of PMSG based power generation system and control algorithm.

  12. Development of a radio frequency ion source with multi-helicon plasma injectors for neutral beam injection system of Versatile Experiment Spherical Torus

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

    Choe, Kyumin; Jung, Bongki; Chung, Kyoung-Jae, E-mail: jkjlsh1@snu.ac.kr

    2014-02-15

    Despite of high plasma density, helicon plasma has not yet been applied to a large area ion source such as a driver for neutral beam injection (NBI) system due to intrinsically poor plasma uniformity in the discharge region. In this study, a radio-frequency (RF) ion source with multi-helicon plasma injectors for high plasma density with good uniformity has been designed and constructed for the NBI system of Versatile Experiment Spherical Torus at Seoul National University. The ion source consists of a rectangular plasma expansion chamber (120 × 120 × 120 mm{sup 3}), four helicon plasma injectors with annular permanent magnetsmore » and RF power system. Main feature of the source is downstream plasma confinement in the cusp magnetic field configuration which is generated by arranging polarities of permanent magnets in the helicon plasma injectors. In this paper, detailed design of the multi-helicon plasma injector and plasma characteristics of the ion source are presented.« less

  13. Development of a radio frequency ion source with multi-helicon plasma injectors for neutral beam injection system of Versatile Experiment Spherical Torus

    NASA Astrophysics Data System (ADS)

    Choe, Kyumin; Jung, Bongki; Chung, Kyoung-Jae; Hwang, Y. S.

    2014-02-01

    Despite of high plasma density, helicon plasma has not yet been applied to a large area ion source such as a driver for neutral beam injection (NBI) system due to intrinsically poor plasma uniformity in the discharge region. In this study, a radio-frequency (RF) ion source with multi-helicon plasma injectors for high plasma density with good uniformity has been designed and constructed for the NBI system of Versatile Experiment Spherical Torus at Seoul National University. The ion source consists of a rectangular plasma expansion chamber (120 × 120 × 120 mm3), four helicon plasma injectors with annular permanent magnets and RF power system. Main feature of the source is downstream plasma confinement in the cusp magnetic field configuration which is generated by arranging polarities of permanent magnets in the helicon plasma injectors. In this paper, detailed design of the multi-helicon plasma injector and plasma characteristics of the ion source are presented.

  14. Development of a radio frequency ion source with multi-helicon plasma injectors for neutral beam injection system of Versatile Experiment Spherical Torus.

    PubMed

    Choe, Kyumin; Jung, Bongki; Chung, Kyoung-Jae; Hwang, Y S

    2014-02-01

    Despite of high plasma density, helicon plasma has not yet been applied to a large area ion source such as a driver for neutral beam injection (NBI) system due to intrinsically poor plasma uniformity in the discharge region. In this study, a radio-frequency (RF) ion source with multi-helicon plasma injectors for high plasma density with good uniformity has been designed and constructed for the NBI system of Versatile Experiment Spherical Torus at Seoul National University. The ion source consists of a rectangular plasma expansion chamber (120 × 120 × 120 mm(3)), four helicon plasma injectors with annular permanent magnets and RF power system. Main feature of the source is downstream plasma confinement in the cusp magnetic field configuration which is generated by arranging polarities of permanent magnets in the helicon plasma injectors. In this paper, detailed design of the multi-helicon plasma injector and plasma characteristics of the ion source are presented.

  15. Statistical analysis of relationship between negative-bias temperature instability and random telegraph noise in small p-channel metal-oxide-semiconductor field-effect transistors

    NASA Astrophysics Data System (ADS)

    Tega, Naoki; Miki, Hiroshi; Mine, Toshiyuki; Ohmori, Kenji; Yamada, Keisaku

    2014-03-01

    It is demonstrated from a statistical perspective that the generation of random telegraph noise (RTN) changes before and after the application of negative-bias temperature instability (NBTI) stress. The NBTI stress generates a large number of permanent interface traps and, at the same time, a large number of RTN traps causing temporary RTN and one-time RTN. The interface trap and the RTN trap show different features in the recovery process. That is, a re-passivation of interface states is the minor cause of the recovery after the NBTI stress, and in contrast, rapid disappearance of the temporary RTN and the one-time RTN is the main cause of the recovery. The RTN traps are less likely to become permanent. This two-type trap, namely, the interface trap and RTN trap, model simply explains NBTI degradation and recovery in scaled p-channel metal-oxide-semiconductor field-effect transistors.

  16. Multiple-object permanence tracking: limitation in maintenance and transformation of perceptual objects.

    PubMed

    Saiki, Jun

    2002-01-01

    Research on change blindness and transsaccadic memory revealed that a limited amount of information is retained across visual disruptions in visual working memory. It has been proposed that visual working memory can hold four to five coherent object representations. To investigate their maintenance and transformation in dynamic situations, I devised an experimental paradigm called multiple-object permanence tracking (MOPT) that measures memory for multiple feature-location bindings in dynamic situations. Observers were asked to detect any color switch in the middle of a regular rotation of a pattern with multiple colored disks behind an occluder. The color-switch detection performance dramatically declined as the pattern rotation velocity increased, and this effect of object motion was independent of the number of targets. The MOPT task with various shapes and colors showed that color-shape conjunctions are not available in the MOPT task. These results suggest that even completely predictable motion severely reduces our capacity of object representations, from four to only one or two.

  17. A central role for the retrosplenial cortex in de novo environmental learning

    PubMed Central

    Auger, Stephen D; Zeidman, Peter; Maguire, Eleanor A

    2015-01-01

    With experience we become accustomed to the types of environments that we normally encounter as we navigate in the world. But how does this fundamental knowledge develop in the first place and what brain regions are involved? To examine de novo environmental learning, we created an ‘alien’ virtual reality world populated with landmarks of which participants had no prior experience. They learned about this environment by moving within it during functional MRI (fMRI) scanning while we tracked their evolving knowledge. Retrosplenial cortex (RSC) played a central and highly selective role by representing only the most stable, permanent features in this world. Subsequently, increased coupling was noted between RSC and hippocampus, with hippocampus then expressing knowledge of permanent landmark locations and overall environmental layout. Studying how environmental representations emerge from scratch provided a new window into the information processing underpinning the brain's navigation system, highlighting the key influence of the RSC. DOI: http://dx.doi.org/10.7554/eLife.09031.001 PMID:26284602

  18. A single-phase axially-magnetized permanent-magnet oscillating machine for miniature aerospace power sources

    NASA Astrophysics Data System (ADS)

    Sui, Yi; Zheng, Ping; Cheng, Luming; Wang, Weinan; Liu, Jiaqi

    2017-05-01

    A single-phase axially-magnetized permanent-magnet (PM) oscillating machine which can be integrated with a free-piston Stirling engine to generate electric power, is investigated for miniature aerospace power sources. Machine structure, operating principle and detent force characteristic are elaborately studied. With the sinusoidal speed characteristic of the mover considered, the proposed machine is designed by 2D finite-element analysis (FEA), and some main structural parameters such as air gap diameter, dimensions of PMs, pole pitches of both stator and mover, and the pole-pitch combinations, etc., are optimized to improve both the power density and force capability. Compared with the three-phase PM linear machines, the proposed single-phase machine features less PM use, simple control and low controller cost. The power density of the proposed machine is higher than that of the three-phase radially-magnetized PM linear machine, but lower than the three-phase axially-magnetized PM linear machine.

  19. Isolated Power Generation System Using Permanent Magnet Synchronous Generator with Improved Power Quality

    NASA Astrophysics Data System (ADS)

    Arya, Sabha Raj; Patel, Ashish; Giri, Ashutosh

    2018-03-01

    This paper deals wind energy based power generation system using Permanent Magnet Synchronous Generator (PMSG). It is controlled using advanced enhanced phase-lock loop for power quality features using distribution static compensator to eliminate the harmonics and to provide KVAR compensation as well as load balancing. It also manages rated potential at the point of common interface under linear and non-linear loads. In order to have better efficiency and reliable operation of PMSG driven by wind turbine, it is necessary to analyze the governing equation of wind based turbine and PMSG under fixed and variable wind speed. For handling power quality problems, power electronics based shunt connected custom power device is used in three wire system. The simulations in MATLAB/Simulink environment have been carried out in order to demonstrate this model and control approach used for the power quality enhancement. The performance results show the adequate performance of PMSG based power generation system and control algorithm.

  20. High-quality permanent draft genome sequence of the Mimosa asperata - nodulating Cupriavidus sp. strain AMP6

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

    De Meyer, Sofie E.; Parker, Matthew; Van Berkum, Peter

    Cupriavidus sp. strain AMP6 is an aerobic, motile, Gram-negative, non-spore-forming rod that was isolated from a root nodule of Mimosa asperata collected in Santa Ana National Wildlife Refuge, Texas, in 2005. Mimosa asperata is the only legume described so far to exclusively associates with Cupriavidus symbionts. Furthermore, strain AMP6 represents an early-diverging lineage within the symbiotic Cupriavidus group and has the capacity to develop an effective nitrogen-fixing symbiosis with three other species of Mimosa. Here, we describe the genome of Cupriavidus sp. strain AMP6 which enables comparative analyses of symbiotic trait evolution in this genus; the general features, together withmore » sequence and annotation are further discussed. Finally, the 7,579,563 bp high-quality permanent draft genome is arranged in 260 scaffolds of 262 contigs, contains 7,033 protein-coding genes and 97 RNA-only encoding genes, and is part of the GEBA-RNB project proposal.« less

  1. High-quality permanent draft genome sequence of Bradyrhizobium sp. strain WSM1743 - an effective microsymbiont of an Indigofera sp. growing in Australia

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

    Eshraghi, Leila; De Meyer, Sofie E.; Tian, Rui

    Bradyrhizobium sp. strain WSM1743 is an aerobic, motile, Gram-negative, non-spore-forming rod that can exist as a soil saprophyte or as a legume microsymbiont of an Indigofera sp. WSM1743 was isolated from a nodule recovered from the roots of an Indigofera sp. growing 20 km north of Carnarvon in Australia. It is slow growing, tolerates up to 1 % NaCl and is capable of growth at 37 °C. Here we describe the features of Bradyrhizobium sp. strain WSM1743, together with genome sequence information and its annotation. Finally, the 8,341,956 bp high-quality permanent draft genome is arranged into 163 scaffolds and 167more » contigs, contains 7908 protein-coding genes and 75 RNA-only encoding genes and was sequenced as part of the Root Nodule Bacteria chapter of the Genomic Encyclopedia of Bacteria and Archaea project.« less

  2. New Class of Type III Porous Liquids: A Promising Platform for Rational Adjustment of Gas Sorption Behavior

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

    Shan, Weida; Fulvio, Pasquale F.; Kong, Liyun

    Porous materials have already manifested their unique properties in a number of fields. Generally, all porous materials are in a solid state other than liquid, in which molecules are closely packed without porosity. “Porous” and “liquid” seem like antonyms. In this paper, we report a new class of Type 3 porous liquids based on rational coupling of microporous framework nanoparticles as porous hosts with a bulky ionic liquid as the fluid media. Positron annihilation lifetime spectroscopy (PALS) and CO 2 adsorption measurements confirm the successful engineering of permanent porosity into these liquids. Compared to common porous solid materials, as-synthesized porousmore » liquids exhibited pronounced hysteresis loops in the CO 2 sorption isotherms even at ambient conditions (298 K, 1 bar). Finally, the unique features of these novel porous liquids could bring new opportunities in many fields including gas separation and storage, air separation and regeneration, gas transport, and permanent gas storage at ambient conditions.« less

  3. New Class of Type III Porous Liquids: A Promising Platform for Rational Adjustment of Gas Sorption Behavior

    DOE PAGES

    Shan, Weida; Fulvio, Pasquale F.; Kong, Liyun; ...

    2017-12-26

    Porous materials have already manifested their unique properties in a number of fields. Generally, all porous materials are in a solid state other than liquid, in which molecules are closely packed without porosity. “Porous” and “liquid” seem like antonyms. In this paper, we report a new class of Type 3 porous liquids based on rational coupling of microporous framework nanoparticles as porous hosts with a bulky ionic liquid as the fluid media. Positron annihilation lifetime spectroscopy (PALS) and CO 2 adsorption measurements confirm the successful engineering of permanent porosity into these liquids. Compared to common porous solid materials, as-synthesized porousmore » liquids exhibited pronounced hysteresis loops in the CO 2 sorption isotherms even at ambient conditions (298 K, 1 bar). Finally, the unique features of these novel porous liquids could bring new opportunities in many fields including gas separation and storage, air separation and regeneration, gas transport, and permanent gas storage at ambient conditions.« less

  4. New Class of Type III Porous Liquids: A Promising Platform for Rational Adjustment of Gas Sorption Behavior.

    PubMed

    Shan, Weida; Fulvio, Pasquale F; Kong, Liyun; Schott, Jennifer A; Do-Thanh, Chi-Linh; Tian, Tao; Hu, Xunxiang; Mahurin, Shannon M; Xing, Huabin; Dai, Sheng

    2018-01-10

    Porous materials have already manifested their unique properties in a number of fields. Generally, all porous materials are in a solid state other than liquid, in which molecules are closely packed without porosity. "Porous" and "liquid" seem like antonyms. Herein, we report a new class of Type 3 porous liquids based on rational coupling of microporous framework nanoparticles as porous hosts with a bulky ionic liquid as the fluid media. Positron annihilation lifetime spectroscopy (PALS) and CO 2 adsorption measurements confirm the successful engineering of permanent porosity into these liquids. Compared to common porous solid materials, as-synthesized porous liquids exhibited pronounced hysteresis loops in the CO 2 sorption isotherms even at ambient conditions (298 K, 1 bar). The unique features of these novel porous liquids could bring new opportunities in many fields including gas separation and storage, air separation and regeneration, gas transport, and permanent gas storage at ambient conditions.

  5. Permanent magnets as biasing mechanism for improving the performance of circular dielectric elastomer out-of-plane actuators

    NASA Astrophysics Data System (ADS)

    Loew, P.; Rizzello, G.; Seelecke, S.

    2017-04-01

    Dielectric Elastomers (DE) represent an attractive technology for the realization of mechatronic actuators, due to their lightweight, high energy density, high energy efficiency, scalability, and low noise features. In order to produce a stroke, a DE membrane needs to be pre-loaded with a mechanical biasing mechanism. In our previous works, we compared the stroke achieved with different biasing mechanisms for a circular out-of-plane DE Actuator (DEA), i.e., hanging masses, linear and bi-stable springs. The novel contribution of this paper is the investigation of a biasing design approach based on permanent magnets. The resulting magnet-based actuators are usually more compact than the spring-based ones, allowing to obtain more compact systems. Two design solutions are proposed and compared, namely a first one characterized by a stable actuation, and a second one which permits to achieve a higher stroke, but it is intrinsically unstable. The effectiveness of the novel design solution is assessed by means of several experiments.

  6. Clinical and Molecular Characterization of Children with Neonatal Diabetes Mellitus at a Tertiary Care Center in Northern India.

    PubMed

    Jain, Vandana; Satapathy, Amit; Yadav, Jaivinder; Sharma, Rajni; Radha, Venkatesan; Mohan, Viswanathan; De Franco, Elisa; Ellard, Sian

    2017-06-15

    To study the genetic mutations and clinical profile in children with neonatal diabetes mellitus. Genetic evaluation, clinical management and follow-up of infants with neonatal diabetes. Eleven infants were studied of which eight had permanent neonatal diabetes. Median age at presentation was 8 weeks and mean (SD) birth weight was 2.4 (0.5) kg. Pathogenic genetic mutations were identified in 7 (63.6%) children; 3 infants with mutations in KCNJ11 gene and 1 in ABCC8 were switched to oral sulfonylureas; 2 infants had mutations in INS and 1 in ZFP57. Neonatal diabetes mellitus is a heterogeneous disorder. Identification of genetic cause guides clinical management.

  7. Neuropsychiatric autoimmune encephalitis without VGKC-complex, NMDAR, and GAD autoantibodies: case report and literature review.

    PubMed

    Najjar, Souhel; Pearlman, Daniel; Devinsky, Orrin; Najjar, Amanda; Nadkarni, Siddhartha; Butler, Tracy; Zagzag, David

    2013-03-01

    We report a patient with a seronegative autoimmune panencephalitis, adding a subtype to the emerging spectrum of seronegative autoimmune encephalitis, and we review the sparse literature on isolated psychiatric presentations of autoimmune encephalitis. (A PubMed search for "seronegative autoimmune encephalitis," "nonvasculitic autoimmune inflammatory meningoencephalitis," and related terms revealed <25 cases.) A 15-year-old girl developed an acute-onset isolated psychosis with prominent negative symptoms and intermittent encephalopathy. Despite clinical worsening, her brain magnetic resonance imaging (MRI) scans remained normal for 7 years. Serology was negative for voltage-gated potassium channel (VGKC)-complex, N-methyl-D-aspartate receptor (NMDAR), and glutamic acid decarboxylase (GAD) autoantibodies. We excluded genetic, metabolic, paraneoplastic, degenerative, and infectious etiologies. The patient's symptoms remitted fully with immune therapy, but recurred in association with widespread bihemispheric brain lesions. Brain biopsy revealed mild nonvasculitic inflammation and prominent vascular hyalinization. Immune therapy with plasma exchanges cleared the MRI abnormalities but, 10 years after onset, the patient still suffers neuropsychiatric sequelae. We conclude that autoimmune panencephalitis seronegative for VGKC-complex, NMDAR, and GAD autoantibodies is a subtype of autoimmune encephalitis that can present with pure neuropsychiatric features and a normal brain MRI. Immunologic mechanisms may account for psychiatric symptoms in a subset of patients now diagnosed with classical psychotic disorders. Delay in starting immune therapy can lead to permanent neuropsychiatric sequelae. We propose a standardized classification system for the autoimmune encephalitides, integrating earlier pathology-oriented terms with more recently defined serologic and clinical phenotypes.

  8. Optically Stimulated Luminescent Dosimetry for High Dose Rate Brachytherapy

    PubMed Central

    Tien, Christopher Jason; Ebeling, Robert; Hiatt, Jessica R.; Curran, Bruce; Sternick, Edward

    2012-01-01

    Purpose: The objective was to determine whether optically stimulated luminescent dosimeters (OSLDs) were appropriate for in vivo measurements in high dose rate brachytherapy. In order to make this distinction, three dosimetric characteristics were tested: dose linearity, dose rate dependence, and angular dependence. The Landauer nanoDot™ OSLDs were chosen due to their popularity and their availability commercially. Methods: To test the dose linearity, each OSLD was placed at a constant location and the dwell time was varied. Next, in order to test the dose rate dependence, each OSLD was placed at different OLSD-to-source distances and the dwell time was held constant. A curved geometry was created using a circular Accuboost® applicator in order to test angular dependence. Results: The OSLD response remained linear for high doses and was independent of dose rate. For doses up to 600 cGy, the linear coefficient of determination was 0.9988 with a response of 725 counts per cGy. The angular dependence was significant only in “edge-on” scenarios. Conclusion: OSLDs are conveniently read out using commercially available readers. OSLDs can be re-read and serve as a permanent record for clinical records or be annealed using conventional fluorescent light. Lastly, OSLDs are produced commercially for $5 each. Due to these convenient features, in conjunction with the dosimetric performance, OSLDs should be considered a clinically feasible and attractive tool for in vivo HDR brachytherapy measurements. PMID:22888476

  9. Permanent tooth mineralization in bonobos (Pan paniscus) and chimpanzees (P. troglodytes).

    PubMed

    Boughner, Julia C; Dean, M Christopher; Wilgenbusch, Chelsea S

    2012-12-01

    The timing of tooth mineralization in bonobos (Pan paniscus) is virtually uncharacterized. Analysis of these developmental features in bonobos and the possible differences with its sister species, the chimpanzee (P. troglodytes), is important to properly quantify the normal ranges of dental growth variation in closely related primate species. Understanding this variation among bonobo, chimpanzee and modern human dental development is necessary to better contextualize the life histories of extinct hominins. This study tests whether bonobos and chimpanzees are distinguished from each other by covariance among the relative timing and sequences of tooth crown initiation, mineralization, root extension, and completion. Using multivariate statistical analyses, we compared the relative timing of permanent tooth crypt formation, crown mineralization, and root extension between 34 P. paniscus and 80 P. troglodytes mandibles radiographed in lateral and occlusal views. Covariance among our 12 assigned dental scores failed to statistically distinguish between bonobos and chimpanzees. Rather than clustering by species, individuals clustered by age group (infant, younger or older juvenile, and adult). Dental scores covaried similarly between the incisors, as well as between both premolars. Conversely, covariance among dental scores distinguished the canine and each of the three molars not only from each other, but also from the rest of the anterior teeth. Our study showed no significant differences in the relative timing of permanent tooth crown and root formation between bonobos and chimpanzees. Copyright © 2012 Wiley Periodicals, Inc.

  10. Lithospheric Shear Stresses Over And Around Africa

    NASA Astrophysics Data System (ADS)

    Greff-Lefftz, M.; Jean, B.; Vicente De Gouveia, S.

    2017-12-01

    We use a simple model for mantle dynamics combining contributions of subducted lithosphere, domes at the bottom of the mantle and upwelling plumes. A dominant feature of plate tectonics is the quasi permanence of a girdle of subductions around the Pacific ocean (or its ancestor), which creates large-wavelength positive topography anomaly within the ring they form. The superimposition of the resultant extension with the one induced by the dome leads to a permanent extensional regime over Africa and the future Indian ocean which creates faults with azimuth directions depending on the direction of the most active part of the ring of subductions. We thus obtain fractures with NW-SE azimuth during the period 275-165 Ma parallel to the strike of the subduction zone of the West South American active margin, which appears to be very active during this period. Between 155-95 Ma, subduction became more active along the Eastern Australian coast involving a change in the direction of the faults toward an E-W direction, in agreement with the observed fault systems between Africa and India, Antartica and Australia. During the Mesozoic and the Cenozoic, we correlate the permanent extensional regime over Africa and Indian ocean with the observed rift systems.Finally we emphasize the role of three primary hotspots as local additional contributors to the stress field imposed by our proposed subduction-doming system, which help in the opening of Indian and South Atlantic oceans.

  11. ClinicalTrials.gov Turns 10! | NIH MedlinePlus the Magazine

    MedlinePlus

    ... please turn Javascript on. Feature: Clinical Trials ClinicalTrials.gov Turns 10! Past Issues / Fall 2010 Table of ... and whom to contact for more information. ClinicalTrials.gov's Helpful Features ClinicalTrials.gov has many helpful consumer ...

  12. Immune Dysregulation, Polyendocrinopathy, Enteropathy, X-Linked Syndrome: A Paradigm of Immunodeficiency with Autoimmunity

    PubMed Central

    Barzaghi, Federica; Passerini, Laura; Bacchetta, Rosa

    2012-01-01

    Immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome is a rare monogenic primary immunodeficiency (PID) due to mutations of FOXP3, a key transcription factor for naturally occurring (n) regulatory T (Treg) cells. The dysfunction of Treg cells is the main pathogenic event leading to the multi-organ autoimmunity that characterizes IPEX syndrome, a paradigm of genetically determined PID with autoimmunity. IPEX has a severe early onset and can become rapidly fatal within the first year of life regardless of the type and site of the mutation. The initial presenting symptoms are severe enteritis and/or type-1 diabetes mellitus, alone or in combination with eczema and elevated serum IgE. Other autoimmune symptoms, such as hypothyroidism, cytopenia, hepatitis, nephropathy, arthritis, and alopecia can develop in patients who survive the initial acute phase. The current therapeutic options for IPEX patients are limited. Supportive and replacement therapies combined with pharmacological immunosuppression are required to control symptoms at onset. However, these procedures can allow only a reduction of the clinical manifestations without a permanent control of the disease. The only known effective cure for IPEX syndrome is hematopoietic stem cell transplantation, but it is always limited by the availability of a suitable donor and the lack of specific guidelines for bone marrow transplant in the context of this disease. This review aims to summarize the clinical histories and genomic mutations of the IPEX patients described in the literature to date. We will focus on the clinical and immunological features that allow differential diagnosis of IPEX syndrome and distinguish it from other PID with autoimmunity. The efficacy of the current therapies will be reviewed, and possible innovative approaches, based on the latest highlights of the pathogenesis to treat this severe primary autoimmune disease of childhood, will be discussed. PMID:23060872

  13. Efficacy of postoperative prophylactic antibiotics in reducing permanent pacemaker infections.

    PubMed

    Lee, Wen-Huang; Huang, Ting-Chun; Lin, Li-Jen; Lee, Po-Tseng; Lin, Chih-Chan; Lee, Cheng-Han; Chao, Ting-Hsing; Li, Yi-Heng; Chen, Ju-Yi

    2017-08-01

    Despite limited evidence, postoperative prophylactic antibiotics are often used in the setting of permanent pacemaker implantation or replacement. The aim of this study is to investigate the efficacy of postoperative antibiotics. Postoperative prophylactic antibiotics may be not clinically useful. We recruited 367 consecutive patients undergoing permanent pacemaker implantation or generator replacement at a tertiary referral center. Baseline demographics, clinical characteristics, and procedure information were collected, and all patients received preoperative prophylactic antibiotics. Postoperative prophylactic antibiotics were administered at the discretion of the treating physician, and all patients were seen in follow-up every 3 to 6 months for an average follow-up period of 16 months. The primary endpoint was device-related infection. A total of 110 patients were treated with preoperative antibiotics only (group 1), whereas 257 patients received both preoperative and postoperative antibiotics (group 2). After a mean follow-up period of 16 months, 1 patient in group 1 (0.9%) and 4 patients in group 2 (1.5%) experienced a device-related infection. There was no significant difference in the rate of infection between the 2 groups (P = 0.624). In the univariate analysis, only the age (60 ± 11 vs 75 ± 12 years, P < 0.001) was significantly different between the infected and noninfected groups. In the multivariate analysis, younger age was an independent risk factor for infective complications (odds ratio = 1.08, P = 0.016). Patients treated with preoperative and postoperative antibiotics had a similar rate of infection as those treated with preoperative antibiotics alone. Further studies are needed to confirm these preliminary findings. © 2017 Wiley Periodicals, Inc.

  14. Clinical presentation, management, and outcomes in the Indian Heart Rhythm Society-Atrial Fibrillation (IHRS-AF) registry.

    PubMed

    Vora, A; Kapoor, A; Nair, M; Lokhandwala, Y; Narsimhan, C; Ravikishore, A G; Dwivedi, S K; Namboodiri, N; Hygriv, R; Saxena, A; Nabar, A; Garg, S; Bardoloi, N; Yadav, R; Nambiar, A; Pandurangi, U; Jhala, D; Naik, A; Nagmallesh; Rajagopal, S; Selvaraj, R; Arora, V; Thachil, A; Thomas, J; Panicker, G

    A national atrial fibrillation (AF) registry was conducted under the aegis of the Indian Heart Rhythm Society (IHRS), to capture epidemiological data-type of AF, clinical presentation and comorbidities, current treatment practices, and 1-year follow-up outcomes. A total of 1537 patients were enrolled from 24 sites in India in the IHRS-AF registry from July 2011 to August 2012. Their baseline characteristics and follow-up data were recorded in case report forms and subsequently analyzed. The average age of Indian AF patients was 54.7 years. There was a marginal female preponderance - 51.5% females and 48.5% males. At baseline, 20.4% had paroxysmal AF; 33% had persistent AF; 35.1% had permanent AF and 11% had first AF episode. At one-year follow-up, 45.6% patients had permanent AF. Rheumatic valvular heart disease (RHD) was present in 47.6% of patients. Hypertension, heart failure, coronary artery disease, and diabetes were seen in 31.4%, 18.7%, 16.2%, and 16.1%, respectively. Rate control was the strategy used in 75.2% patients, digoxin and beta-blockers being the most frequently prescribed rate-control drugs. Oral anticoagulation (OAC) drugs were used in 70% of patients. The annual mortality was 6.5%, hospitalization 8%, and incidence of stroke 1%. In India, AF patients are younger and RHD is still the most frequent etiology. Almost two-third of the patients have persistent/permanent AF. At one-year follow-up, there is a significant mortality and morbidity in AF patients in India. Copyright © 2016. Published by Elsevier B.V.

  15. Prevalence, Type and Etiology of Dental and Soft Tissue Injuries in Children in Croatia.

    PubMed

    Škaričić, Josip; Vuletić, Marko; Hrvatin, Sandra; Jeličić, Jesenka; Čuković-Bagić, Ivana; Jurić, Hrvoje

    2016-06-01

    The prevalence, type and etiology of dental and soft tissue injuries and relationship between the time of arrival and sustaining soft tissue injury were analyzed in this retrospective study conducted at the Department of Pediatric Dentistry, University Dental Clinic in Zagreb, Croatia, during the 2010-2014 period using documentation on 447 patients (264 male and 183 female) aged 1-16 years with injuries of primary and permanent teeth. The highest prevalence of traumatic dental injury (TDI) was found in the 7-12 age group and maxillary central incisors were most frequently affected (80.9%) in both primary and permanent dentitions. Enamel-dentin fracture without pulp exposure (31.9%) was the most common TDI of dental hard tissue in both dentitions, whereas subluxation (27.3%) was the most common periodontal tissue injury type. The most frequent location, cause and seasonal variation of trauma were at home, falling and spring. Soft tissue injuries were observed in 203 (45.4%) patients. Soft tissue injuries were less likely when fewer teeth were traumatized (p<0.001). Comparison of children with and without soft tissue injuries yielded a statistically significant difference in the time to arrival between primary and permanent teeth (p<0.01). Because soft tissue injuries include bleeding and clinical presentation appears more dramatic, the time elapsed between injury and initial treatment was shorter than in non-bleeding injuries, pointing to the need of education focused on parents and school teachers regarding the importance of immediate therapy for both bleeding and non-bleeding TDIs.

  16. TU-CD-BRB-01: Normal Lung CT Texture Features Improve Predictive Models for Radiation Pneumonitis

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

    Krafft, S; The University of Texas Graduate School of Biomedical Sciences, Houston, TX; Briere, T

    2015-06-15

    Purpose: Existing normal tissue complication probability (NTCP) models for radiation pneumonitis (RP) traditionally rely on dosimetric and clinical data but are limited in terms of performance and generalizability. Extraction of pre-treatment image features provides a potential new category of data that can improve NTCP models for RP. We consider quantitative measures of total lung CT intensity and texture in a framework for prediction of RP. Methods: Available clinical and dosimetric data was collected for 198 NSCLC patients treated with definitive radiotherapy. Intensity- and texture-based image features were extracted from the T50 phase of the 4D-CT acquired for treatment planning. Amore » total of 3888 features (15 clinical, 175 dosimetric, and 3698 image features) were gathered and considered candidate predictors for modeling of RP grade≥3. A baseline logistic regression model with mean lung dose (MLD) was first considered. Additionally, a least absolute shrinkage and selection operator (LASSO) logistic regression was applied to the set of clinical and dosimetric features, and subsequently to the full set of clinical, dosimetric, and image features. Model performance was assessed by comparing area under the curve (AUC). Results: A simple logistic fit of MLD was an inadequate model of the data (AUC∼0.5). Including clinical and dosimetric parameters within the framework of the LASSO resulted in improved performance (AUC=0.648). Analysis of the full cohort of clinical, dosimetric, and image features provided further and significant improvement in model performance (AUC=0.727). Conclusions: To achieve significant gains in predictive modeling of RP, new categories of data should be considered in addition to clinical and dosimetric features. We have successfully incorporated CT image features into a framework for modeling RP and have demonstrated improved predictive performance. Validation and further investigation of CT image features in the context of RP NTCP modeling is warranted. This work was supported by the Rosalie B. Hite Fellowship in Cancer research awarded to SPK.« less

  17. Contraction or expansion of the Moon's crust during magma ocean freezing?

    PubMed Central

    Elkins-Tanton, Linda T.; Bercovici, David

    2014-01-01

    The lack of contraction features on the Moon has been used to argue that the Moon underwent limited secular cooling, and thus had a relatively cool initial state. A cool early state in turn limits the depth of the lunar magma ocean. Recent GRAIL gravity measurements, however, suggest that dikes were emplaced in the lower crust, requiring global lunar expansion. Starting from the magma ocean state, we show that solidification of the lunar magma ocean would most likely result in expansion of the young lunar crust, and that viscous relaxation of the crust would prevent early tectonic features of contraction or expansion from being recorded permanently. The most likely process for creating the expansion recorded by the dikes is melting during cumulate overturn of the newly solidified lunar mantle. PMID:25114310

  18. The prognostic value of CT radiomic features for patients with pulmonary adenocarcinoma treated with EGFR tyrosine kinase inhibitors

    PubMed Central

    Kim, Hyungjin; Park, Sang Joon; Kim, Miso; Kim, Tae Min; Kim, Dong-Wan; Heo, Dae Seog; Goo, Jin Mo

    2017-01-01

    Purpose To determine if the radiomic features on CT can predict progression-free survival (PFS) in epidermal growth factor receptor (EGFR) mutant adenocarcinoma patients treated with first-line EGFR tyrosine kinase inhibitors (TKIs) and to identify the incremental value of radiomic features over conventional clinical factors in PFS prediction. Methods In this institutional review board–approved retrospective study, pretreatment contrast-enhanced CT and first follow-up CT after initiation of TKIs were analyzed in 48 patients (M:F = 23:25; median age: 61 years). Radiomic features at baseline, at 1st first follow-up, and the percentage change between the two were determined. A Cox regression model was used to predict PFS with nonredundant radiomic features and clinical factors, respectively. The incremental value of radiomic features over the clinical factors in PFS prediction was also assessed by way of a concordance index. Results Roundness (HR: 3.91; 95% CI: 1.72, 8.90; P = 0.001) and grey-level nonuniformity (HR: 3.60; 95% CI: 1.80, 7.18; P<0.001) were independent predictors of PFS. For clinical factors, patient age (HR: 2.11; 95% CI: 1.01, 4.39; P = 0.046), baseline tumor diameter (HR: 1.03; 95% CI: 1.01, 1.05; P = 0.002), and treatment response (HR: 0.46; 95% CI: 0.24, 0.87; P = 0.017) were independent predictors. The addition of radiomic features to clinical factors significantly improved predictive performance (concordance index; combined model = 0.77, clinical-only model = 0.69, P<0.001). Conclusions Radiomic features enable PFS estimation in EGFR mutant adenocarcinoma patients treated with first-line EGFR TKIs. Radiomic features combined with clinical factors provide significant improvement in prognostic performance compared with using only clinical factors. PMID:29099855

  19. [Clinical features of a Chinese pedigree with Waardenburg syndrome type 2].

    PubMed

    Yang, Shu-zhi; Yuan, Hui-jun; Bai, Lin-na; Cao, Ju-yang; Xu, Ye; Shen, Wei-dong; Ji, Fei; Yang, Wei-yan

    2005-10-12

    To investigate detailed clinical features of a Chinese pedigree with Waardenburg syndrome type 2. Members of this pedigree were interviewed to identify personal or family medical histories of hearing loss, the use of aminoglycosides, and other clinical abnormalities by filling questionnaire. The audiological and other clinical evaluations of the proband and other members of this family were conducted, including pure-tone audiometry, immittance and auditory brain-stem response and ophthalmological, dermatologic, hair, temporal bone CT examinations. This family is categorized as Waardenburg syndrome type 2 according to its clinical features. It's an autosomal dominant disorder with incomplete penetrance. The clinical features varied greatly among family members and characterized by sensorineural hearing loss, heterochromia irides, freckle on the face and premature gray hair. Hearing loss can be unilateral or bilateral, congenital or late onset in this family. This Chinese family has some unique clinical features comparing with the international diagnostic criteria for Waardenburg syndrome. This study may provide some evidences to amend the diagnostic criteria for Waardenburg syndrome in Chinese population.

  20. COMP report: CPQR technical quality control guidelines for low-dose-rate permanent seed brachytherapy.

    PubMed

    Beaulieu, Luc; Radford, Dee-Ann; Eduardo Villarreal-Barajas, J

    2018-03-14

    The Canadian Organization of Medical Physicists (COMP), in close partnership with the Canadian Partnership for Quality Radiotherapy (CPQR) has developed a series of Technical Quality Control (TQC) guidelines for radiation treatment equipment. These guidelines outline the performance objectives that equipment should meet in order to ensure an acceptable level of radiation treatment quality. The TQC guidelines have been rigorously reviewed and field tested in a variety of Canadian radiation treatment facilities. The development process enables rapid review and update to keep the guidelines current with changes in technology. This article contains detailed performance objectives and safety criteria for low-dose-rate (LDR) permanent seed brachytherapy. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  1. Dentinogenesis imperfecta associated with osteogenesis imperfecta

    PubMed Central

    Biria, Mina; Abbas, Fatemeh Mashhadi; Mozaffar, Sedighe; Ahmadi, Rahil

    2012-01-01

    This paper presents a case with dentinogenesis imperfecta (DI) associated with osteogenesis imperfecta. Systemic and dental manifestations of OI and its medical and dental treatments are discussed in this paper. A 5-year-old child with the diagnosis of OI was referred to the Dental School of Shaid Beheshti University of Medical Sciences. On clinical examination yellow/brown discoloration of primary teeth with the attrition of the exposed dentin and class III malocclusion was observed. Enamel of first permanent molars was hypoplastic. Radiographic examinations confirmed the diagnosis of DI. A histological study was performed on one of the exfoliating teeth, which showed abnormal dentin. Primary teeth with DI were more severely affected compared to permanent teeth; enamel disintegration occurred in teeth with DI, demonstrating the need for restricts recalls for these patients. PMID:23162594

  2. Using the Spatial Persistence of Soil Moisture Patterns to Estimate Catchment Soil Moisture in Semi-arid Areas

    NASA Astrophysics Data System (ADS)

    Willgoose, G. R.

    2006-12-01

    In humid catchments the spatial distribution of soil water is dominated by subsurface lateral fluxes, which leads to a persistent spatial pattern of soil moisture principally described by the topographic index. In contrast, semi-arid, and dryer, catchments are dominated by vertical fluxes (infiltration and evapotranspiration) and persistent spatial patterns, if they exist, are subtler. In the first part of this presentation the results of a reanalysis of a number of catchment-scale long-term spatially-distributed soil moisture data sets are presented. We concentrate on Tarrawarra and SASMAS, both catchments in Australia that are water-limited for at least part of the year and which have been monitored using a variety of technologies. Using the data from permanently installed instruments (neutron probe and reflectometry) both catchments show persistent patterns at the 1-3 year timescale. This persistent pattern is not evident in the field campaign data where field portable instruments (reflectometry) instruments were used. We argue, based on high-resolution soil moisture semivariograms, that high short-distance variability (100mm scale) means that field portable instrument cannot be replaced at the same location with sufficient accuracy to ensure deterministic repeatability of soil moisture measurements from campaign to campaign. The observed temporal persistence of the spatial pattern can be caused by; (1) permanent features of the landscape (e.g. vegetation, soils), or (2) long term memory in the soil moisture store. We argue that it is permanent in which case it is possible to monitor the soil moisture status of a catchment using a single location measurement (continuous in time) of soil moisture using a permanently installed reflectometry instrument. This instrument will need to be calibrated to the catchment averaged soil moisture but the temporal persistence of the spatial pattern of soil moisture will mean that this calibration will be deterministically stable with time. In the second part of this presentation we will explore aspects of the calibration using data from the SASMAS site using the multiscale spatial resolution data (100m to 10km) provided by permanently installed reflectometry instruments, and how this single site measurement technique may complement satellite data.

  3. Occupational noise exposure and age correction: the problem of selection bias.

    PubMed

    Dobie, Robert A

    2009-12-01

    Selection bias often invalidates conclusions about populations based on clinical convenience samples. A recent paper in this journal makes two surprising assertions about noise-induced permanent threshold shift (NIPTS): first, that there is more NIPTS at 2 kHz than at higher frequencies; second, that NIPTS declines with advancing age. Neither assertion can be supported with the data presented, which were obtained from a clinical sample; both are consistent with the hypothesis that people who choose to attend an audiology clinic have worse hearing, especially at 2 kHz, than people of the same age and gender who choose not to attend.

  4. Strategic Deployment of Clinical Models.

    PubMed

    Goossen, William

    2016-01-01

    The selection, implementation, and certification of electronic health records (EHR) could benefit from the required use of one of the established clinical model approaches. For the lifelong record of data about individuals, issues arise about the permanence and preservation of data during or even beyond a lifetime. Current EHR do not fully adhere to pertinent standards for clinical data, where it is known for some 20 plus years that standardization of health data is a cornerstone for patient safety, interoperability, data retrieval for various purposes and the lifelong preservation of such data. This paper briefly introduces the issues and gives a brief recommendation for future work in this area.

  5. EHR based Genetic Testing Knowledge Base (iGTKB) Development

    PubMed Central

    2015-01-01

    Background The gap between a large growing number of genetic tests and a suboptimal clinical workflow of incorporating these tests into regular clinical practice poses barriers to effective reliance on advanced genetic technologies to improve quality of healthcare. A promising solution to fill this gap is to develop an intelligent genetic test recommendation system that not only can provide a comprehensive view of genetic tests as education resources, but also can recommend the most appropriate genetic tests to patients based on clinical evidence. In this study, we developed an EHR based Genetic Testing Knowledge Base for Individualized Medicine (iGTKB). Methods We extracted genetic testing information and patient medical records from EHR systems at Mayo Clinic. Clinical features have been semi-automatically annotated from the clinical notes by applying a Natural Language Processing (NLP) tool, MedTagger suite. To prioritize clinical features for each genetic test, we compared odds ratio across four population groups. Genetic tests, genetic disorders and clinical features with their odds ratios have been applied to establish iGTKB, which is to be integrated into the Genetic Testing Ontology (GTO). Results Overall, there are five genetic tests operated with sample size greater than 100 in 2013 at Mayo Clinic. A total of 1,450 patients who was tested by one of the five genetic tests have been selected. We assembled 243 clinical features from the Human Phenotype Ontology (HPO) for these five genetic tests. There are 60 clinical features with at least one mention in clinical notes of patients taking the test. Twenty-eight clinical features with high odds ratio (greater than 1) have been selected as dominant features and deposited into iGTKB with their associated information about genetic tests and genetic disorders. Conclusions In this study, we developed an EHR based genetic testing knowledge base, iGTKB. iGTKB will be integrated into the GTO by providing relevant clinical evidence, and ultimately to support development of genetic testing recommendation system, iGenetics. PMID:26606281

  6. EHR based Genetic Testing Knowledge Base (iGTKB) Development.

    PubMed

    Zhu, Qian; Liu, Hongfang; Chute, Christopher G; Ferber, Matthew

    2015-01-01

    The gap between a large growing number of genetic tests and a suboptimal clinical workflow of incorporating these tests into regular clinical practice poses barriers to effective reliance on advanced genetic technologies to improve quality of healthcare. A promising solution to fill this gap is to develop an intelligent genetic test recommendation system that not only can provide a comprehensive view of genetic tests as education resources, but also can recommend the most appropriate genetic tests to patients based on clinical evidence. In this study, we developed an EHR based Genetic Testing Knowledge Base for Individualized Medicine (iGTKB). We extracted genetic testing information and patient medical records from EHR systems at Mayo Clinic. Clinical features have been semi-automatically annotated from the clinical notes by applying a Natural Language Processing (NLP) tool, MedTagger suite. To prioritize clinical features for each genetic test, we compared odds ratio across four population groups. Genetic tests, genetic disorders and clinical features with their odds ratios have been applied to establish iGTKB, which is to be integrated into the Genetic Testing Ontology (GTO). Overall, there are five genetic tests operated with sample size greater than 100 in 2013 at Mayo Clinic. A total of 1,450 patients who was tested by one of the five genetic tests have been selected. We assembled 243 clinical features from the Human Phenotype Ontology (HPO) for these five genetic tests. There are 60 clinical features with at least one mention in clinical notes of patients taking the test. Twenty-eight clinical features with high odds ratio (greater than 1) have been selected as dominant features and deposited into iGTKB with their associated information about genetic tests and genetic disorders. In this study, we developed an EHR based genetic testing knowledge base, iGTKB. iGTKB will be integrated into the GTO by providing relevant clinical evidence, and ultimately to support development of genetic testing recommendation system, iGenetics.

  7. [Rehabilitation by hollow obturator prosthesis immediately after total maxillectomy for malignant tumor].

    PubMed

    Li, Xiao-ye; Yan, Ai-hui; Hao, Shuai; Li, Wei; Jiang, Xue-jun; Lu, Li; Qin, Xing-jun; Yan, Hai-xin

    2011-05-01

    The feasibility and clinical effects of hollow obturator prosthesis for the repair of maxillofacial defect immediately after maxillectomy for cancer were assessed. Thirteen patients with T3-4aN0M0 maxillary neoplasm were treated by the prostheses immediately after maxillectomy. According to the 3D-CT reconstruction of nasal sinus, the 3D stereoscopic prototype was constructed before the surgery. Simulating surgery with Surgicare 5.0 software and then the prosthesis 3D stereoscopic model was shaped. The prosthesis was made quickly and precisely with methacrylate resins according to the model and the print mold before surgery, with supplementary tooth at the bottom of prosthesis. In the surgery, the prosthesis was installed instantly after maxillectomy. The patients were followed up at 1, 3 and 6 month after the surgery, respectively. The facial features and the pronunciation clarity were examined and the questionnaires were carried out in the patients, with comparation by paired t-test. The hollow obturator prosthesis would be replaced by permanent prosthesis made of methacrylate resins at 6 month after the surgery. The hollow obturator prostheses were installed accurately and maxillofacial defects were repaired immediately after maxillectomy in the 13 patients. Postoperative follow-up showed there were significant differences in eyeball sagging (t = 4.67, P < 0.05), mid-facial region collapse (t = 5.67, P < 0.05), and pronunciation clarity (t = 16.38, P < 0.05) between patients with and without prostheses. Questionnaires showed that all the patients were satisfied with the retention of prostheses, the improvement of appearance, the improvement of the symptom of water choking and speech definition. Six months after the surgery, the hollow obturator prostheses were replaced smoothly by permanent prostheses in 11 of the 13 patients. The precise and instant repair of maxillofacial defect by prosthesis after maxillectomy can improve survival quality of patient.

  8. Extrapyramidal signs in normal pressure hydrocephalus: an objective assessment

    PubMed Central

    Mandir, Allen S; Hilfiker, Jennifer; Thomas, George; Minahan, Robert E; Crawford, Thomas O; Williams, Michael A; Rigamonti, Daniele

    2007-01-01

    Background Beyond the classic Normal Pressure Hydrocephalus (NPH) triad of gait disturbance, incontinence, and dementia are characteristic signs of motor dysfunction in NPH patients. We used highly sensitive and objective methods to characterize upper limb extrapyramidal signs in a series of NPH subjects compared with controls. Concentrated evaluation of these profound, yet underappreciated movement disorders of NPH before and after techniques of therapeutic intervention may lead to improved diagnosis, insight into pathophysiology, and targeted treatment. Methods Twenty-two (22) consecutive NPH patients and 17 controls performed an upper limb motor task battery where highly sensitive and objective measures of akinesia/bradykinesia, tone, and tremor were conducted. NPH subjects performed this test battery before and more than 36 h after continuous CSF drainage via a spinal catheter over 72 h and, in those subjects undergoing permanent ventriculo-peritoneal shunt placement, at least 12 weeks later. Control subjects performed the task battery at the same dates as the NPH subjects. Statistical analyses were applied to group populations of NPH and control subjects and repeated measures for within subject performance. Results Twenty (20) NPH subjects remained in the study following CSF drainage as did 14 controls. NPH subjects demonstrated akinesia/bradykinesia (prolonged reaction and movement times) and increased resting tone compared with controls. Furthermore, the NPH group demonstrated increased difficulty with self-initiated tasks compared with stimulus-initiated tasks. Following CSF drainage, some NPH subjects demonstrated reduced movement times with greater improvement in self- versus stimulus-initiated tasks. Group reaction time was unchanged. Resting tremor present in one NPH subject resolved following shunt placement. Tone measures were consistent for all subjects throughout the study. Conclusion Clinical motor signs of NPH subjects extend beyond gait deficits and include extrapyramidal manifestations of bradykinesia, akinesia, rigidity, and propensity to perform more poorly when external cues to move are absent. Objective improvement of some but not all of these features was seen following temporary or permanent CSF diversion. PMID:17697324

  9. Dental Decay in Southern Illinois Migrant and Seasonal Farmworkers: An Analysis of Clinical Data

    ERIC Educational Resources Information Center

    Lukes, Sherri M.; Simon, Bret

    2005-01-01

    Context: Migrant and seasonal farmworkers are a population at risk for oral health problems. Data on the oral health conditions of migrant and seasonal farmworkers? permanent teeth are particularly lacking. Purpose: To document the relative rates of treated and untreated dental decay in a sample of southern Illinois migrant and seasonal…

  10. 76 FR 48058 - Effective Date of Requirement for Premarket Approval for Cardiovascular Permanent Pacemaker...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-08

    ... embolism, muscle/nerve stimulation, stenosis, and erosion/extrusion may occur as a result of the clinical... advises that to ensure timely filing of any such petition, any request should be submitted to the Division... timely request for a change in the classification of this device is submitted, the Agency will, within 60...

  11. Dental Decay in Southern Illinois Migrant and Seasonal Farmworkers: An Analysis of Clinical Data

    ERIC Educational Resources Information Center

    Lukes, Sherri M.; Simon, Bret

    2005-01-01

    Context: Migrant and seasonal farmworkers are a population at risk for oral health problems. Data on the oral health conditions of migrant and seasonal farmworkers' permanent teeth are particularly lacking. Purpose: To document the relative rates of treated and untreated dental decay in a sample of southern Illinois migrant and seasonal…

  12. [Moxiflaxin and iris transillumination].

    PubMed

    Broens, A; Collignon, N

    2016-07-01

    Bilateral Acute Iris Transillumination (BAIT) is a new clinical entity characterized by acute onset of pigment dispersion in the anterior chamber and angle, depigmentation of the iris stroma and permanent iris transillumination, masquerading as uveitis. An association with oral moxifloxacin is reported in some articles. We describe one case of bilateral acute iris transillumination, following the use of systemic moxifloxacin.

  13. Studies of the jet in BL Lacertae. I. Recollimation shock and moving emission features

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

    Cohen, M. H.; Hovatta, T.; Meier, D. L.

    2014-06-01

    Parsec-scale VLBA images of BL Lac at 15 GHz show that the jet contains a permanent quasi-stationary emission feature 0.26 mas (0.34 pc projected) from the core, along with numerous moving features. In projection, the tracks of the moving features cluster around an axis at a position angle of –166.°6 that connects the core with the standing feature. The moving features appear to emanate from the standing feature in a manner strikingly similar to the results of numerical two-dimensional relativistic magneto-hydrodynamic (RMHD) simulations in which moving shocks are generated at a recollimation shock (RCS). Because of this, and the closemore » analogy to the jet feature HST-1 in M87, we identify the standing feature in BL Lac as an RCS. We assume that the magnetic field dominates the dynamics in the jet, and that the field is predominantly toroidal. From this we suggest that the moving features are compressions established by slow and fast mode magneto-acoustic MHD waves. We illustrate the situation with a simple model in which the slowest moving feature is a slow-mode wave, and the fastest feature is a fast-mode wave. In the model, the beam has Lorentz factor Γ{sub beam}{sup gal}≈3.5 in the frame of the host galaxy and the fast mode wave has Lorentz factor Γ{sub Fwave}{sup beam}≈1.6 in the frame of the beam. This gives a maximum apparent speed for the moving features, β{sub app} = v{sub app}/c = 10. In this model the Lorentz factor of the pattern in the galaxy frame is approximately three times larger than that of the beam itself.« less

  14. Therapeutic decisions in the presence of decayed permanent first molars in young subjects: a descriptive inquiry.

    PubMed

    Sayagh, Millewa; Maniere-Ezvan, Armelle; Vernet, Cindy; Muller-Bolla, Michèle

    2012-09-01

    The aim of this exhaustive descriptive epidemiological study was to determine the clinical approach to be adopted by practitioners specializing exclusively in pediatric odontology and by orthodontists when confronted with decayed molars in children and adolescents. A questionnaire was sent out to all corresponding practitioners (n=2076). Six questions related to treatment decisions taken when faced with decayed permanent first molars (unfavorable short or middle-term prognosis) in patients needing, or not, orthodontic care. The Chi(2) test was used to compare responses. Thirty-eight per cent of pedodontists (n=38) and 12.5% (n=246) of orthodontists answered the questionnaire. Faced with a permanent first molar with an unfavorable middle-term prognosis, 75.7% needed criteria to help them reach their treatment decision. In decreasing order of importance, these criteria were: presence of the third molar, patient motivation, inter-arch relationship, patient's oral hygiene, facial type, anterior jaw-teeth discrepancy and the number of molars to be extracted. Faced with a permanent first molar requiring extraction and when orthodontic treatment was not required, 31.7% of practitioners decided to close the maxillary space immediately as opposed to 13.4% who closed the space at the mandible. In the presence of a single decayed first molar, 68.7% of practitioners did not extract the antagonist or contralateral first molars. These treatment decisions were not always unanimous and call for a combined approach between dental surgeon and orthodontist. Copyright © 2012. Published by Elsevier Masson SAS.

  15. Impact of bioresorbable versus permanent polymer on longterm vessel wall inflammation and healing: a comparative drug-eluting stent experimental study.

    PubMed

    Wilson, Gregory J; McGregor, Jennifer; Conditt, Gerard; Shibuya, Masahiko; Sushkova, Natalia; Eppihimer, Michael J; Hawley, Steven P; Rouselle, Serge D; Huibregtse, Barbara A; Dawkins, Keith D; Granada, Juan F

    2018-02-20

    Drug-eluting stents (DES) have evolved to using bioresorbable polymers as a method of drug delivery. The impact of bioresorbable polymer on long-term neointimal formation, inflammation, and healing has not been fully characterised. This study aimed to evaluate the biological effect of polymer resorption on vascular healing and inflammation. A comparative DES study was performed in the familial hypercholesterolaemic swine model of coronary stenosis. Permanent polymer DES (zotarolimus-eluting [ZES] or everolimus-eluting [EES]) were compared to bioresorbable polymer everolimus-eluting stents (BP-EES) and BMS. Post implantation in 29 swine, stents were explanted and analysed up to 180 days. Area stenosis was reduced in all DES compared to BMS at 30 days. At 180 days, BP-EES had significantly lower area stenosis than EES or ZES. Severe inflammatory activity persisted in permanent polymer DES at 180 days compared to BP-EES or BMS. Qualitative para-strut inflammation areas (graded as none to severe) were elevated but similar in all groups at 30 days, peaked at 90 days in DES compared to BMS (p<0.05) and, at 180 days, were similar between BMS and BP-EES but were significantly greater in DES. BP-EES resulted in a lower net long-term reduction in neointimal formation and inflammation compared to permanent polymer DES in an animal model. Further study of the long-term neointima formation deserves study in human clinical trials.

  16. Allogeneic stem cells derived from human exfoliated deciduous teeth (SHED) for the management of periapical lesions in permanent teeth: Two case reports of a novel biologic alternative treatment

    PubMed Central

    Prasad, Madu Ghana Shyam; Ramakrishna, Juvva; Babu, Duvvi Naveen

    2017-01-01

    Stem cells are the pluripotent cells that have the capacity to differentiate into other specialized cells. Recently, many experiments have been conducted to study the potentiality of stem cells in the tissue regeneration. We report two cases treated utilizing stem cells from human exfoliated deciduous teeth (SHED) in the management of periapical lesions in permanent teeth. Two normal human deciduous teeth from children, 7‒8 years of age, were collected to isolate stem cells. Two patients, one with periapical pathology alone and the other with periapical lesion along with an open apex in young permanent teeth, were selected for the study. After initial debridement of the root canals, homing of SHED was carried out and the access cavity was sealed using glass-ionomer cement. Clinical examination after 7 days, 30 days, 90 days, 180 days and 365 days revealed no symptoms. Closure of open apex and periapical tissue healing were observed radiographically at one-month review and maintained until 365-day review. Positive response to electric pulp testing was recorded for the treated teeth from the 3- to 12-month follow-ups. The treated cases demonstrated complete resolution of periapical radiolucency in a span of 30 days, which was faster than the conventional methods. SHED could be considred effective in treating the periapical lesions and open apex in permanent teeth. PMID:28748053

  17. Periodontal ligament injection versus routine local infiltration for nonsurgical single posterior maxillary permanent tooth extraction: comparative double-blinded randomized clinical study.

    PubMed

    Al-Shayyab, Mohammad H

    2017-01-01

    The aim of this study was to evaluate the efficacy of, and patients' subjective responses to, periodontal ligament (PDL) anesthetic injection compared to traditional local-anesthetic infiltration injection for the nonsurgical extraction of one posterior maxillary permanent tooth. All patients scheduled for nonsurgical symmetrical maxillary posterior permanent tooth extraction in the Department of Oral and Maxillofacial Surgery at the University of Jordan Hospital, Amman, Jordan over a 7-month period were invited to participate in this prospective randomized double-blinded split-mouth study. Every patient received the recommended volume of 2% lidocaine with 1:100,000 epinephrine for PDL injection on the experimental side and for local infiltration on the control side. A visual analog scale (VAS) and verbal rating scale (VRS) were used to describe pain felt during injection and extraction, respectively. Statistical significance was based on probability values <0.05 and measured using χ 2 and Student t -tests and nonparametric Mann-Whitney and Kruskal-Wallis tests. Of the 73 patients eligible for this study, 55 met the inclusion criteria: 32 males and 23 females, with a mean age of 34.87±14.93 years. Differences in VAS scores and VRS data between the two techniques were statistically significant ( P <0.001) and in favor of the infiltration injection. The PDL injection may not be the alternative anesthetic technique of choice to routine local infiltration for the nonsurgical extraction of one posterior maxillary permanent tooth.

  18. Classification of clinically useful sentences in clinical evidence resources.

    PubMed

    Morid, Mohammad Amin; Fiszman, Marcelo; Raja, Kalpana; Jonnalagadda, Siddhartha R; Del Fiol, Guilherme

    2016-04-01

    Most patient care questions raised by clinicians can be answered by online clinical knowledge resources. However, important barriers still challenge the use of these resources at the point of care. To design and assess a method for extracting clinically useful sentences from synthesized online clinical resources that represent the most clinically useful information for directly answering clinicians' information needs. We developed a Kernel-based Bayesian Network classification model based on different domain-specific feature types extracted from sentences in a gold standard composed of 18 UpToDate documents. These features included UMLS concepts and their semantic groups, semantic predications extracted by SemRep, patient population identified by a pattern-based natural language processing (NLP) algorithm, and cue words extracted by a feature selection technique. Algorithm performance was measured in terms of precision, recall, and F-measure. The feature-rich approach yielded an F-measure of 74% versus 37% for a feature co-occurrence method (p<0.001). Excluding predication, population, semantic concept or text-based features reduced the F-measure to 62%, 66%, 58% and 69% respectively (p<0.01). The classifier applied to Medline sentences reached an F-measure of 73%, which is equivalent to the performance of the classifier on UpToDate sentences (p=0.62). The feature-rich approach significantly outperformed general baseline methods. This approach significantly outperformed classifiers based on a single type of feature. Different types of semantic features provided a unique contribution to overall classification performance. The classifier's model and features used for UpToDate generalized well to Medline abstracts. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Using GIS for spatial analysis of rectal lesions in the human body.

    PubMed

    Garb, Jane L; Ganai, Sabha; Skinner, Ric; Boyd, Christopher S; Wait, Richard B

    2007-03-15

    Geographic Information Systems (GIS) have been used in a wide variety of applications to integrate data and explore the spatial relationship of geographic features. Traditionally this has referred to features on the surface of the earth. However, it is possible to apply GIS in medicine, at the scale of the human body, to visualize and analyze anatomic and clinical features. In the present study we used GIS to examine the findings of transanal endoscopic microsurgery (TEM), a minimally-invasive procedure to locate and remove both benign and cancerous lesions of the rectum. Our purpose was to determine whether anatomic features of the human rectum and clinical findings at the time of surgery could be rendered in a GIS and spatially analyzed for their relationship to clinical outcomes. Maps of rectal topology were developed in two and three dimensions. These maps highlight anatomic features of the rectum and the location of lesions found on TEM. Spatial analysis demonstrated a significant relationship between anatomic location of the lesion and procedural failure. This study demonstrates the feasibility of rendering anatomical locations and clinical events in a GIS and its value in clinical research. This allows the visualization and spatial analysis of clinical and pathologic features, increasing our awareness of the relationship between anatomic features and clinical outcomes as well as enhancing our understanding and management of this disease process.

  20. Using GIS for spatial analysis of rectal lesions in the human body

    PubMed Central

    Garb, Jane L; Ganai, Sabha; Skinner, Ric; Boyd, Christopher S; Wait, Richard B

    2007-01-01

    Background Geographic Information Systems (GIS) have been used in a wide variety of applications to integrate data and explore the spatial relationship of geographic features. Traditionally this has referred to features on the surface of the earth. However, it is possible to apply GIS in medicine, at the scale of the human body, to visualize and analyze anatomic and clinical features. In the present study we used GIS to examine the findings of transanal endoscopic microsurgery (TEM), a minimally-invasive procedure to locate and remove both benign and cancerous lesions of the rectum. Our purpose was to determine whether anatomic features of the human rectum and clinical findings at the time of surgery could be rendered in a GIS and spatially analyzed for their relationship to clinical outcomes. Results Maps of rectal topology were developed in two and three dimensions. These maps highlight anatomic features of the rectum and the location of lesions found on TEM. Spatial analysis demonstrated a significant relationship between anatomic location of the lesion and procedural failure. Conclusion This study demonstrates the feasibility of rendering anatomical locations and clinical events in a GIS and its value in clinical research. This allows the visualization and spatial analysis of clinical and pathologic features, increasing our awareness of the relationship between anatomic features and clinical outcomes as well as enhancing our understanding and management of this disease process. PMID:17362510

  1. The rapid formation of Sputnik Planitia early in Pluto's history.

    PubMed

    Hamilton, Douglas P; Stern, S A; Moore, J M; Young, L A

    2016-11-30

    Pluto's Sputnik Planitia is a bright, roughly circular feature that resembles a polar ice cap. It is approximately 1,000 kilometres across and is centred on a latitude of 25 degrees north and a longitude of 175 degrees, almost directly opposite the side of Pluto that always faces Charon as a result of tidal locking. One explanation for its location includes the formation of a basin in a giant impact, with subsequent upwelling of a dense interior ocean. Once the basin was established, ice would naturally have accumulated there. Then, provided that the basin was a positive gravity anomaly (with or without the ocean), true polar wander could have moved the feature towards the Pluto-Charon tidal axis, on the far side of Pluto from Charon. Here we report modelling that shows that ice quickly accumulates on Pluto near latitudes of 30 degrees north and south, even in the absence of a basin, because, averaged over its orbital period, those are Pluto's coldest regions. Within a million years of Charon's formation, ice deposits on Pluto concentrate into a single cap centred near a latitude of 30 degrees, owing to the runaway albedo effect. This accumulation of ice causes a positive gravity signature that locks, as Pluto's rotation slows, to a longitude directly opposite Charon. Once locked, Charon raises a permanent tidal bulge on Pluto, which greatly enhances the gravity signature of the ice cap. Meanwhile, the weight of the ice in Sputnik Planitia causes the crust under it to slump, creating its own basin (as has happened on Earth in Greenland). Even if the feature is now a modest negative gravity anomaly, it remains locked in place because of the permanent tidal bulge raised by Charon. Any movement of the feature away from 30 degrees latitude is countered by the preferential recondensation of ices near the coldest extremities of the cap. Therefore, our modelling suggests that Sputnik Planitia formed shortly after Charon did and has been stable, albeit gradually losing volume, over the age of the Solar System.

  2. The rapid formation of Sputnik Planitia early in Pluto's history

    NASA Astrophysics Data System (ADS)

    Hamilton, Douglas P.; Stern, S. A.; Moore, J. M.; Young, L. A.; Binzel, R. P.; Buie, M. W.; Buratti, B. J.; Cheng, A. F.; Ennico, K.; Grundy, W. M.; Linscott, I. R.; McKinnon, W. B.; Olkin, C. B.; Reitsema, H. J.; Reuter, D. C.; Schenk, P.; Showalter, M. R.; Spencer, J. R.; Tyler, G. L.; Weaver, H. A.

    2016-12-01

    Pluto's Sputnik Planitia is a bright, roughly circular feature that resembles a polar ice cap. It is approximately 1,000 kilometres across and is centred on a latitude of 25 degrees north and a longitude of 175 degrees, almost directly opposite the side of Pluto that always faces Charon as a result of tidal locking. One explanation for its location includes the formation of a basin in a giant impact, with subsequent upwelling of a dense interior ocean. Once the basin was established, ice would naturally have accumulated there. Then, provided that the basin was a positive gravity anomaly (with or without the ocean), true polar wander could have moved the feature towards the Pluto-Charon tidal axis, on the far side of Pluto from Charon. Here we report modelling that shows that ice quickly accumulates on Pluto near latitudes of 30 degrees north and south, even in the absence of a basin, because, averaged over its orbital period, those are Pluto's coldest regions. Within a million years of Charon's formation, ice deposits on Pluto concentrate into a single cap centred near a latitude of 30 degrees, owing to the runaway albedo effect. This accumulation of ice causes a positive gravity signature that locks, as Pluto's rotation slows, to a longitude directly opposite Charon. Once locked, Charon raises a permanent tidal bulge on Pluto, which greatly enhances the gravity signature of the ice cap. Meanwhile, the weight of the ice in Sputnik Planitia causes the crust under it to slump, creating its own basin (as has happened on Earth in Greenland). Even if the feature is now a modest negative gravity anomaly, it remains locked in place because of the permanent tidal bulge raised by Charon. Any movement of the feature away from 30 degrees latitude is countered by the preferential recondensation of ices near the coldest extremities of the cap. Therefore, our modelling suggests that Sputnik Planitia formed shortly after Charon did and has been stable, albeit gradually losing volume, over the age of the Solar System.

  3. Management of atrial fibrillation in Greece: the MANAGE-AF study.

    PubMed

    Andrikopoulos, George; Pastromas, Sokratis; Mantas, Ioannis; Sakellariou, Dimitris; Kyrpizidis, Christos; Makridis, Pantelis; Goumas, Georgios; Stakos, Dimitris; Gotsis, Alexandros; Kartalis, Athanasios; Kazianis, Georgios; Babalis, Dimitrios; Toli, Konstantina; Tzeis, Stylianos; Papavasileiou, Maria; Kalogeropoulos, Petros; Vardas, Panos

    2014-01-01

    Although atrial fibrillation (AF) is a highly prevalent health problem with high morbidity and mortality, data regarding the clinical characteristics and management of AF in the Greek population are scarce. The "Current Clinical Practice in the MANAGEment of Atrial Fibrillation in Greece" study (MANAGEAF) aimed to assess the epidemiological features as well as the daily clinical practice in the management of Greek patients with AF. Taking into consideration the distribution of the Greek population, 603 consecutive patients over 18 years of age, with any type of AF, presenting at the emergency departments or outpatient clinics of 27 different centers, were included in our study. The mean age of the patients was 68.5 ± 12.1 years, with male patients representing 52.5% of the study population. The most common AF type in our cohort was non-paroxysmal AF (60%), including the patients with permanent (24.1%), persistent (17.4%), long-standing (4.8%) and first diagnosed AF (13.8%). Hypertension was the most common comorbidity (70.3%). A history of stroke or transient ischemic attack was detected in 9.2% of the patients, while 6.2% had a history of gastrointestinal bleeding. About half of the patients (49.3%) were treated with anticoagulant drugs, mainly vitamin K antagonists (46.9%), while 34.2% were on antiplatelet drugs, aspirin and/or clopidogrel. The mean INR level (1.7 ± 0.8) was sub-therapeutic, although the mean values for CHADS2 and CHA2DS2-VASc scores were 1.6 ± 1.2 and 3.0 ± 1.7, respectively. The MANAGE-AF baseline results indicate unsatisfactory levels of compliance with the current guidelines for the management of AF in Greece. Considering the undisputed effectiveness of anticoagulant treatment for preventing AF-related strokes, MANAGE-AF demonstrates the need for optimization of our therapeutic strategies for the management of cardioembolic stroke risk.

  4. Clinical and radiological evaluation of inverse impaction of supernumerary teeth.

    PubMed

    Tuna, Elif-Bahar; Kurklu, Esma; Gencay, Koray; Ak, Gulsum

    2013-07-01

    To describe the clinical and radiological features of children with inverted supernumerary teeth. Thirty eight patients with inverted supernumerary teeth (ST) were enrolled in this descriptive and restrospective study. Data from patient records including age, gender, status of dentition, number of ST, number of ST in inverted position, coexistence of ST in inverted and normal direction of eruption, location, orientation, morphology, clinical complications, management and radiography were assessed during 3-years period. Thirty eight patients with a mean age of 9.10 ± 1.97 years (range:6-13) and a strong male preponderance of 3.7:1 (male:30, female:8) had a total of 69 ST, of which 41 were in inverted position. Thirty five patients had one (92.1%) inverted tooth, whereas 3 patients had two inverted teeth per case (7.9%). All cases were located in the maxilla. Midline was the most frequent site for the single inverted supernumerary tooth in 18 (47.4%) patients, followed equally by the right and left premaxillary region in 10 patients each (26.3%). Regarding morphology, 30 patients had conical (78.9%) and 8 (21.1%) had incisiform ST. No tuberculate shaped ST was detected. There was no statistically significant difference between number of inverted teeth and delayed tooth eruption, diastema, local malocclusion, palatinal swelling (p>0.05). There was no statistically significant difference between complications and age (p>0.05). Surgical removal at the time of diagnosis with subsequent follow-up during completion of permanent dentition was the treatment approach in all cases. Thorough clinical examination followed by a comprehensive radiographic screening is the crucial determinant of an accurate diagnosis of an impacted ST. Early diagnosis and timely management are key factors to prevent or minimize the complications, which may influence function and esthetics of the teeth and even psychological condition of the growing child.

  5. Clinical and radiological evaluation of inverse impaction of supernumerary teeth

    PubMed Central

    Kurklu, Esma; Gencay, Koray; Ak, Gulsum

    2013-01-01

    Objective: To describe the clinical and radiological features of children with inverted supernumerary teeth. Study Design: Thirty eight patients with inverted supernumerary teeth (ST) were enrolled in this descriptive and restrospective study. Data from patient records including age, gender, status of dentition, number of ST, number of ST in inverted position, coexistence of ST in inverted and normal direction of eruption, location, orientation, morphology, clinical complications, management and radiography were assessed during 3-years period. Results: Thirty eight patients with a mean age of 9.10±1.97 years (range:6-13) and a strong male preponderance of 3.7:1 (male:30, female:8) had a total of 69 ST, of which 41 were in inverted position. Thirty five patients had one (92.1%) inverted tooth, whereas 3 patients had two inverted teeth per case (7.9%). All cases were located in the maxilla. Midline was the most frequent site for the single inverted supernumerary tooth in 18 (47.4%) patients, followed equally by the right and left premaxillary region in 10 patients each (26.3%). Regarding morphology, 30 patients had conical (78.9%) and 8 (21.1%) had incisiform ST. No tuberculate shaped ST was detected. There was no statistically significant difference between number of inverted teeth and delayed tooth eruption, diastema, local malocclusion, palatinal swelling (p>0.05). There was no statistically significant difference between complications and age (p>0.05). Surgical removal at the time of diagnosis with subsequent follow-up during completion of permanent dentition was the treatment approach in all cases. Conclusions: Thorough clinical examination followed by a comprehensive radiographic screening is the crucial determinant of an accurate diagnosis of an impacted ST. Early diagnosis and timely management are key factors to prevent or minimize the complications, which may influence function and esthetics of the teeth and even psychological condition of the growing child. Key words:Supernumerary tooth, impaction, inverted. PMID:23722132

  6. Increased Heart Rate Is Associated With Higher Mortality in Patients With Atrial Fibrillation (AF): Results From the Outcomes Registry for Better Informed Treatment of AF (ORBIT-AF)

    PubMed Central

    Steinberg, Benjamin A; Kim, Sunghee; Thomas, Laine; Fonarow, Gregg C; Gersh, Bernard J; Holmqvist, Fredrik; Hylek, Elaine; Kowey, Peter R; Mahaffey, Kenneth W; Naccarelli, Gerald; Reiffel, James A; Chang, Paul; Peterson, Eric D; Piccini, Jonathan P

    2015-01-01

    Background Most patients with atrial fibrillation (AF) require rate control; however, the optimal target heart rate remains under debate. We aimed to assess rate control and subsequent outcomes among patients with permanent AF. Methods and Results We studied 2812 US outpatients with permanent AF in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation. Resting heart rate was measured longitudinally and used as a time-dependent covariate in multivariable Cox models of all-cause and cause-specific mortality during a median follow-up of 24 months. At baseline, 7.4% (n=207) had resting heart rate <60 beats per minute (bpm), 62% (n=1755) 60 to 79 bpm, 29% (n=817) 80 to 109 bpm, and 1.2% (n=33) ≥110 bpm. Groups did not differ by age, previous cerebrovascular disease, heart failure status, CHA2DS2-VASc scores, renal function, or left ventricular function. There were significant differences in race (P=0.001), sinus node dysfunction (P=0.004), and treatment with calcium-channel blockers (P=0.006) and anticoagulation (P=0.009). In analyses of continuous heart rates, lower heart rate ≤65 bpm was associated with higher all-cause mortality (adjusted hazard ratio [HR], 1.15 per 5-bpm decrease; 95% CI, 1.01 to 1.32; P=0.04). Similarly, increasing heart rate >65 bpm was associated with higher all-cause mortality (adjusted HR, 1.10 per 5-bpm increase; 95% CI, 1.05 to 1.15; P<0.0001). This relationship was consistent across endpoints and in a broader sensitivity analysis of permanent and nonpermanent AF patients. Conclusions Among patients with permanent AF, there is a J-shaped relationship between heart rate and mortality. These data support current guideline recommendations, and clinical trials are warranted to determine optimal rate control. Clinical Trial Registration URL: http://clinicaltrials.gov/. Unique identifier: NCT01165710. PMID:26370445

  7. Female pattern alopecia: current perspectives

    PubMed Central

    Levy, Lauren L; Emer, Jason J

    2013-01-01

    Hair loss is a commonly encountered problem in clinical practice, with men presenting with a distinctive pattern involving hairline recession and vertex balding (Norwood-Hamilton classification) and women exhibiting diffuse hair thinning over the crown (increased part width) and sparing of the frontal hairline (Ludwig classification). Female pattern hair loss has a strikingly overwhelming psychological effect; thus, successful treatments are necessary. Difficulty lies in successful treatment interventions, as only two medications – minoxidil and finasteride – are approved for the treatment of androgenetic alopecia, and these medications offer mediocre results, lack of a permanent cure, and potential complications. Hair transplantation is the only current successful permanent option, and it requires surgical procedures. Several other medical options, such as antiandrogens (eg, spironolactone, oral contraceptives, cyproterone, flutamide, dutasteride), prostaglandin analogs (eg, bimatoprost, latanoprost), and ketoconazole are reported to be beneficial. Laser and light therapies have also become popular despite the lack of a profound benefit. Management of expectations is crucial, and the aim of therapy, given the current therapeutic options, is to slow or stop disease progression with contentment despite patient expectations of permanent hair regrowth. This article reviews current perspectives on therapeutic options for female pattern hair loss. PMID:24039457

  8. Cerebral infarction caused by traumatic carotid artery dissection.

    PubMed

    Bayır, Ayşegül; Aydoğdu Kıreşi, Demet; Söylemez, Ali; Demirci, Osman

    2012-07-01

    Traumatic carotid artery dissection, if not diagnosed and treated early, is a serious problem with permanent neurological deficit and a high mortality rate of up to 40%. We present a case with delayed diagnosis of traumatic carotid artery dissection in a 21-year-old female. While there were no ischemic infarct findings on the admission cerebral computerized tomography (CT), such findings were observed on two cerebral CTs taken because of the left hemiplegia noticed seven days later when the patient regained consciousness. The patient was referred to our emergency service, and definitive diagnosis was achieved with arterial Doppler ultrasonography, cerebral magnetic resonance imaging (MRI), diffusion MRI, and MR angiography. We did not consider invasive treatment since the neurological damage was permanent and dissection grade was IV according to angiography findings. The case was discharged within a week and physiotherapy was advised. Despite the advances in diagnostic methods, diagnosis of traumatic carotid artery dissection is still missed or delayed, as in the case presented here. Early diagnosis can ameliorate permanent neurological damage or even prevent it. However, the vital factors for early diagnosis are the obtained anamnesis leading to appropriate radiological examinations, detailed physical examination and high clinical suspicion.

  9. Apical Closure in Apexification: A Review and Case Report of Apexification Treatment of an Immature Permanent Tooth with Biodentine.

    PubMed

    Vidal, Karla; Martin, Gabriela; Lozano, Oscar; Salas, Marco; Trigueros, Jaime; Aguilar, Gabriel

    2016-05-01

    Materials such as calcium hydroxide paste and mineral trioxide aggregate are used in apexification treatment of immature permanent teeth, but the search for improved materials with higher characteristics of biocompatibility results in different materials. Biodentine is a tricalcium silicate cement that possesses adequate handling characteristics and acceptable mechanical and bioactivity properties. This report describes the case of a 9-year-old boy who was referred to the Department of Dental Clinic of Querétaro Autonomous University of Mexico. One month prior the patient had suffered a dental trauma of his upper left central incisor and had been treated by another dentist. The clinical diagnosis was previously initiated therapy and symptomatic apical periodontitis. The treatment was apexification with Biodentine. At follow-ups performed at 3, 6, and 18 months after treatment the tooth was asymptomatic. The cone-beam computed tomography scan at 18-month postoperative follow-up revealed continuity of periodontal ligament space, absence of periapical rarefactions, and a thin layer of calcified tissue formed apical to the Biodentine barrier. On the basis of sealing ability and biocompatibility, apexification treatment with Biodentine was applied in the present case report. The favorable clinical and radiographic outcome in this case demonstrated that Biodentine may be an efficient alternative to the conventional apexification materials. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  10. Visual Aggregate Analysis of Eligibility Features of Clinical Trials

    PubMed Central

    He, Zhe; Carini, Simona; Sim, Ida; Weng, Chunhua

    2015-01-01

    Objective To develop a method for profiling the collective populations targeted for recruitment by multiple clinical studies addressing the same medical condition using one eligibility feature each time. Methods Using a previously published database COMPACT as the backend, we designed a scalable method for visual aggregate analysis of clinical trial eligibility features. This method consists of four modules for eligibility feature frequency analysis, query builder, distribution analysis, and visualization, respectively. This method is capable of analyzing (1) frequently used qualitative and quantitative features for recruiting subjects for a selected medical condition, (2) distribution of study enrollment on consecutive value points or value intervals of each quantitative feature, and (3) distribution of studies on the boundary values, permissible value ranges, and value range widths of each feature. All analysis results were visualized using Google Charts API. Five recruited potential users assessed the usefulness of this method for identifying common patterns in any selected eligibility feature for clinical trial participant selection. Results We implemented this method as a Web-based analytical system called VITTA (Visual Analysis Tool of Clinical Study Target Populations). We illustrated the functionality of VITTA using two sample queries involving quantitative features BMI and HbA1c for conditions “hypertension” and “Type 2 diabetes”, respectively. The recruited potential users rated the user-perceived usefulness of VITTA with an average score of 86.4/100. Conclusions We contributed a novel aggregate analysis method to enable the interrogation of common patterns in quantitative eligibility criteria and the collective target populations of multiple related clinical studies. A larger-scale study is warranted to formally assess the usefulness of VITTA among clinical investigators and sponsors in various therapeutic areas. PMID:25615940

  11. Visual aggregate analysis of eligibility features of clinical trials.

    PubMed

    He, Zhe; Carini, Simona; Sim, Ida; Weng, Chunhua

    2015-04-01

    To develop a method for profiling the collective populations targeted for recruitment by multiple clinical studies addressing the same medical condition using one eligibility feature each time. Using a previously published database COMPACT as the backend, we designed a scalable method for visual aggregate analysis of clinical trial eligibility features. This method consists of four modules for eligibility feature frequency analysis, query builder, distribution analysis, and visualization, respectively. This method is capable of analyzing (1) frequently used qualitative and quantitative features for recruiting subjects for a selected medical condition, (2) distribution of study enrollment on consecutive value points or value intervals of each quantitative feature, and (3) distribution of studies on the boundary values, permissible value ranges, and value range widths of each feature. All analysis results were visualized using Google Charts API. Five recruited potential users assessed the usefulness of this method for identifying common patterns in any selected eligibility feature for clinical trial participant selection. We implemented this method as a Web-based analytical system called VITTA (Visual Analysis Tool of Clinical Study Target Populations). We illustrated the functionality of VITTA using two sample queries involving quantitative features BMI and HbA1c for conditions "hypertension" and "Type 2 diabetes", respectively. The recruited potential users rated the user-perceived usefulness of VITTA with an average score of 86.4/100. We contributed a novel aggregate analysis method to enable the interrogation of common patterns in quantitative eligibility criteria and the collective target populations of multiple related clinical studies. A larger-scale study is warranted to formally assess the usefulness of VITTA among clinical investigators and sponsors in various therapeutic areas. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    PubMed

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

    2002-01-01

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

  13. Use of Retrievable Compared to Permanent Inferior Vena Cava Filters: A Single-Institution Experience

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

    Ha, Thuong G. Van; Chien, Andy S.; Funaki, Brian S.

    The purpose of this study was to review the use, safety, and efficacy of retrievable inferior vena cava (IVC) filters in their first 5 years of availability at our institution. Comparison was made with permanent filters placed in the same period. A retrospective review of IVC filter implantations was performed from September, 1999, to September, 2004, in our department. These included both retrievable and permanent filters. The Recovery nitinol and Guenther tulip filters were used as retrievable filters. The frequency of retrievable filter used was calculated. Clinical data and technical data related to filter placement were reviewed. Outcomes, including pulmonarymore » embolism, complications associated with placement, retrieval, or indwelling, were calculated. During the study period, 604 IVC filters were placed. Of these, 97 retrievable filters (16%) were placed in 96 patients. There were 53 Recovery filter and 44 Tulip filter insertions. Subjects were 59 women and 37 men; the mean age was 52 years, with a range of from 18 to 97 years. The placement of retrievable filters increased from 2% in year 1 to 32% in year 5 of the study period. The total implantation time for the permanent group was 145,450 days, with an average of 288 days (range, 33-1811 days). For the retrievable group, the total implantation time was 21,671 days, with an average of 226 days (range, 2-1217 days). Of 29 patients who returned for filter retrieval, the filter was successfully removed in 28. There were 14 of 14 successful Tulip filter retrievals and 14 of 15 successful Recovery filter retrievals. In one patient, after an indwelling period of 39 days, a Recovery nitinol filter could not be removed secondary to a large clot burden within the filter. For the filters that were removed, the mean dwell time was 50 days for the Tulip type and 20 days for the Recovery type. Over the follow-up period there was an overall PE incidence of 1.4% for the permanent group and 1% for the retrieval group. In conclusion, there was an increase in the use of retrievable filters over the study period and an overall increase in the total number of filters implanted. The increased use of these filters appeared to be due to expanded indications predicated by their retrievability. Placement and retrieval of these filters have a low risk of complications, and retrievable filters appeared effective, as there was low rate of clinically significant pulmonary embolism associated with these filters during their indwelling time.« less

  14. Direct Pulp Capping with Calcium Hydroxide, Mineral Trioxide Aggregate, and Biodentine in Permanent Young Teeth with Caries: A Randomized Clinical Trial.

    PubMed

    Brizuela, Claudia; Ormeño, Andrea; Cabrera, Carolina; Cabezas, Roxana; Silva, Carolina Inostroza; Ramírez, Valeria; Mercade, Montse

    2017-11-01

    Direct pulp capping treatment is intended to preserve pulp vitality, to avoid or retard root canal treatment, and, in cases with an open apex, to allow continued root development. Historically, calcium hydroxide (CH) was the gold standard material, but nowadays calcium silicate materials (CSMs) are displacing CH because of their high bioactivity, biocompatibility, sealing ability, and mechanical properties. However, more randomized clinical trials are needed to confirm the appropriateness of CSMs as replacement materials for CH in direct pulp capping procedures. A randomized clinical trial was conducted that included 169 patients (mean age, 11.3 years) from the Maipo district (Chile). The inclusion criterion was patients with 1 carious permanent tooth with pulpal exposure, a candidate for a direct pulp capping procedure. The patients were randomly allocated to one of the experimental groups (CH, Biodentine, or mineral trioxide aggregate [MTA]). Clinical follow-up examinations were performed at 1 week, 3 months, 6 months, and 1 year. The Fisher exact test was performed. At the follow-up examination at 1 week, the patients showed 100% clinical success. At 3 months, there was 1 failure in the CH group. At 6 months, there were 4 new failures (1 in the CH group and 3 in the MTA group). At 1 year, there was another failure in the CH group. There were no statistically significant differences among the experimental groups. CSMs appear to be suitable materials to replace CH. Although no significant differences were found among the materials studied, Biodentine and MTA offered some advantages over CH. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  15. Acquired bilateral telangiectatic macules: a distinct clinical entity.

    PubMed

    Park, Ji-Hye; Lee, Dong Jun; Lee, Yoo-Jung; Jang, Yong Hyun; Kang, Hee Young; Kim, You Chan

    2014-09-01

    We evaluated 13 distinct patients with multiple telangiectatic pigmented macules confined mostly to the upper arms to determine if the clinical and histopathological features of these cases might represent a specific clinical entity. We retrospectively investigated the clinical, histopathologic, and immunohistochemical features of 13 patients with multiple telangiectatic pigmented macules on the upper arms who presented between January 2003 and December 2012. Epidermal pigmentation, melanogenic activity, melanocyte number, vascularity, epidermal thickness, and perivascular mast cell number of the specimens were evaluated. Clinically, the condition favored middle-aged men. On histopathologic examination, the lesional skin showed capillary proliferation and telangiectasia in the upper dermis. Histochemical and immunohistochemical analysis revealed basal hyperpigmentation and increased melanogenic activity in the lesional skin (P < .05). No significant difference in epidermal thickness or mast cell number was observed between the normal perilesional skin and the lesional skin. The clinical and histopathologic features of these lesions were relatively consistent in all patients. In addition, the features are quite distinct from other diseases. Based on clinical and histologic features, we suggest the name acquired bilateral telangiectatic macules for this new entity.

  16. Chemical Synthesis of Next Generation High Energy Product Hybrid SmCo Permanent Magnets for High Temperature Applications

    DTIC Science & Technology

    2010-08-01

    among CoxC, AINiCo and Ba / Sr ferrite magnets. AINiCo is shown to exhibit high (BH)max, 35 kJmŗ, but a low intrinsic coercivity, mostly ə kOe...whereas Ba / Sr ferrite features high intrinsic coercivity, 3-4.5 kOe, but typical values of (BH)max below 25 kJm-3. However, the multiple...coercivity of cobalt carbide nanoparticles is compared with free powders of AINiCo and ceramic magnets of the Ba / Sr hexaferrite type. Curie temperatures near

  17. Detecting Low-Contrast Features in the Cosmic Ray Albedo Proton Map of the Moon

    NASA Technical Reports Server (NTRS)

    Wilson, J. K.; Schwadron, N.; Spence, H. E.; Golightly, M. J.; Case, A. W.; Smith, S.; Blake, J. B.; Kasper, J.; Looper, M. D.; Mazur, J. E.; hide

    2014-01-01

    High energy cosmic rays constantly bombard the lunar regolith, producing (via nuclear evaporation) secondary 'albedo' or 'splash' particles like protons and neutrons, some of which escape back to space. Lunar Prospector and the Lunar Reconnaissance Orbiter (LRO), have shown that the energy distribution of albedo neutrons is modulated by the elemental composition of the lunar regolith, and by ice deposits in permanently shadowed polar craters. Here we investigate an analogous phenomenon with high energy ((is) approximately 100 MeV) lunar albedo protons.

  18. Permanent draft genome sequence of Comamonas testosteroni KF-1

    PubMed Central

    Weiss, Michael; Kesberg, Anna I.; LaButti, Kurt M.; Pitluck, Sam; Bruce, David; Hauser, Loren; Copeland, Alex; Woyke, Tanja; Lowry, Stephen; Lucas, Susan; Land, Miriam; Goodwin, Lynne; Kjelleberg, Staffan; Cook, Alasdair M.; Buhmann, Matthias; Thomas, Torsten; Schleheck, David

    2013-01-01

    Comamonas testosteroni KF-1 is a model organism for the elucidation of the novel biochemical degradation pathways for xenobiotic 4-sulfophenylcarboxylates (SPC) formed during biodegradation of synthetic 4-sulfophenylalkane surfactants (linear alkylbenzenesulfonates, LAS) by bacterial communities. Here we describe the features of this organism, together with the complete genome sequence and annotation. The 6,026,527 bp long chromosome (one sequencing gap) exhibits an average G+C content of 61.79% and is predicted to encode 5,492 protein-coding genes and 114 RNA genes. PMID:23991256

  19. Effective assessments of electroencephalography during stroke recovery: contemporary approaches and considerations.

    PubMed

    Iyer, Kartik K

    2017-11-01

    Stroke is one of the leading causes of permanent disability worldwide, relying conventionally on extended periods of physiotherapy to recover functional ability. While neuroimaging techniques and emerging neurorehabilitation paradigms have advanced our understanding of pathophysiological mechanisms underlying stroke, recent evidence has renewed focus on quantifying features of cortical activity present in electroencephalography recordings to greatly enhance our understanding of stroke treatment and recovery. This Neuro Forum article reviews these key advances and discusses the importance of quantifying electroencephalography in future assessments of stroke survivors. Copyright © 2017 the American Physiological Society.

  20. Occupational absorption of tellurium: a report of two cases.

    PubMed Central

    Blackadder, E S; Manderson, W G

    1975-01-01

    Industrial uses of tellurium are limited, and reported cases of tellurium absorption of occupational origin are rare. Two such cases are reported here. Both showed typical signs and symptoms of intoxication; in particular, the stench of sour garlic was noted on breath and from excreta. An unusual feature was the bluish-black discoloration of the webs of the fingers and streaks on the face and neck. Full hospital investigation was negative. No permanent damage resulted and each patient made a spontaneous recovery without treatment. Images PMID:123755

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