Sample records for cold provocation test

  1. May nasal hyperreactivity be a sequela of recurrent common cold?

    PubMed

    Cassano, M; Cassano, P; Ciprandi, G

    2011-01-01

    Respiratory viral infections may worsen bronchial hyperreactivity. However, there is no data on the possible role of recurrent infectious rhinitis in nose hyperreactivity. This study was therefore designed to investigate whether subjects suffering from recurrent common cold have nasal hyperreactivity, assessed by histamine nasal challenge. This study included a group of 40 patients (19 males, mean age 34.1 years) with history of at least five episodes of common cold in the previous year, but without documented allergy, and twenty healthy subjects (8 males, mean age 32.3 years) were enrolled as control group, all of whom were non-allergic. Nasal provocation test with histamine was performed in all subjects. Nasal provocation test with histamine induced a 200% increase in nasal resistance after provocation in 24 (60%) patients suffering from recurrent viral rhinitis. No normal subject had an increase >180% in nasal resistance. There was a significant difference between the patient group and the control group (p<0.05). In conclusion, this study shows that nasal hyperreactivity might be a sequela of recurrent common cold. Further studies should be conducted to confirm this preliminary finding.

  2. Cutaneous microvascular response during local cold exposure - the effect of female sex hormones and cold perception.

    PubMed

    Cankar, Ksenija; Music, Mark; Finderle, Zare

    2016-11-01

    It is generally known that differences exist between males and females with regard to sensitivity to cold. Similar differences even among females in different hormonal balance might influence microvascular response during cold provocation testing. The aim of the present study was to measure sex hormone levels, cold and cold pain perception thresholds and compare them to cutaneous laser-Doppler flux response during local cooling in both the follicular and luteal phases of the menstrual cycle. In the luteal phase a more pronounced decrease in laser-Doppler flux was observed compared to follicular phase during local cooling at 15°C (significant difference by Dunnett's test, p<0.05). In addition, statistically significant correlations between progesterone level and laser-Doppler flux response to local cooling were observed during the follicular (R=-0.552, p=0.0174) and during the luteal phases (R=0.520, p=0.0271). In contrast, the correlation between estradiol level and laser-Doppler flux response was observed only in the follicular phase (R=-0.506, p=0.0324). Our results show that individual sensitivity to cold influences cutaneous microvascular response to local cooling; that microvascular reactivity is more pronounced during the luteal phase of the menstrual cycle; and that reactivity correlates with hormone levels. The effect of specific sex hormone levels is related to the cold-provocation temperature. Copyright © 2016. Published by Elsevier Inc.

  3. Cold-provocation testing for the vascular component of hand-arm vibration syndrome in health surveillance.

    PubMed

    Poole, Kerry; Elms, Joanne; Mason, Howard

    2006-10-01

    The aim was to investigate whether the use of infra-red thermography (I-R) and measurement of temperature gradients along the finger could improve the diagnostic accuracy of cold-provocation testing (15 degrees C for 5 min) in vascular hand-arm vibration syndrome (HAVS). Twenty-one controls and 33 individuals with stages 2/3V HAVS were studied. The standard measurement of time to rewarm by 4 degrees C (T4 degrees C) and temperature gradients between the finger tip, base and middle (measured using I-R) were calculated. Receiver Operating Characteristics (ROC) analysis to distinguish between the two groups revealed that for T4 degrees C the area under the ROC curve was not statistically significantly different from 0.5 (0.64 95% confidence interval 0.49-0.76). The difference between the tip and middle portion of the finger during the sixth minute of recovery was the most promising gradient with an area of 0.76 (95% confidence interval 0.62-0.87), and sensitivity and specificity of 57.6% and 85.7% respectively. However, this was not significantly different from that for the time to rewarm by 4 degrees C. In conclusion, the cold-provocation test used in this study does not appear to discriminate between individuals with stage 2/3V HAVS and controls and this is not improved by the measurement of temperature gradients along the fingers using I-R.

  4. The diagnostic value of finger systolic blood pressure and cold-provocation testing for the vascular component of hand-arm vibration syndrome in health surveillance.

    PubMed

    Poole, K; Elms, J; Mason, H J

    2004-12-01

    Hand-arm vibration syndrome (HAVS) is a complex condition with vascular, sensorineural and musculoskeletal components. A number of quantitative tests have been used for assisting in the diagnosis of HAVS and grading disease severity. To investigate and compare the diagnostic value of finger systolic blood pressure (FSBP) and rewarming of finger skin temperature (FST) following cold-provocation testing, in the assessment of vascular HAVS. Twenty-four individuals with vascular HAVS (Stockholm Workshop stage 2 or 3V) and 22 control subjects underwent FSBP measurements at 30, 15 and 10 degrees C and monitoring of FST following immersion of the hands in water at 15 degrees C for 5 min. There was a significant reduction in median FSBP% in the vascular HAVS group in the change in FSBP from 30 to 15 degrees C adjusted for brachial blood pressure (FSBPC%). There was no difference in the median time for FST to rewarm by 4 degrees C between HAVS cases and controls. The sensitivity and specificity of FSBP to discriminate between the groups varied between 44 and 61% and 91 and 95%, respectively. The sensitivity and specificity for the time for FST to rewarm by 4 degrees C were 71 and 77%. There is little evidence that the described form of finger rewarming after cold-provocation testing is a useful diagnostic test for vascular HAVS, although it may have some moderate influence in ruling out vascular problems. Based on our data, the FSBP may also have limited use in confirming a positive diagnosis of vibration-induced vascular problems. The higher specificity of the FSBP test suggests it may have some value in ruling out the vascular component of HAVS. The data from this study do not confirm the diagnostic power of FSBP for the vascular component of HAVS reported by a few other investigators.

  5. Histaminergic and cholinergic neuron systems in the impairment of human thermoregulation during motion sickness.

    PubMed

    Nobel, Gerard; Tribukait, Arne; Mekjavic, Igor B; Eiken, Ola

    2010-05-31

    Motion sickness (MS) exaggerates body cooling during cold-water immersion. The aim of the present study was to investigate whether such MS-induced predisposition to hypothermia is influenced by two anti-MS drugs: the histamine-receptor blocker dimenhydrinate (DMH) and the muscarine-receptor blocker scopolamine (Scop). Nine healthy male subjects were immersed in 15 degrees C water for a maximum of 90min in five conditions: (1) control (CN): no medication, no MS provocation; (2) MS-control (MS-CN): no medication, MS provocation; (3) MS-placebo (MS-P): placebo DMH and placebo Scop, MS provocation; (4) MS-DMH: DMH and placebo Scop, MS provocation; (5) MS-Scop: Scop and placebo DMH, MS provocation. MS was induced by use of a rotating chair. Throughout the experiments rectal temperature (T(re)), the difference in temperature between the non-immersed right forearm and third finger (T(ff)) as an index of peripheral vasoconstriction, and oxygen uptake (VO(2)) as a measure of shivering thermogenesis, were recorded. DMH and Scop were similarly efficacious in ameliorating nausea. The fall in T(re) was greater in the MS-CN and MS-P conditions than in the CN condition. DMH, but not Scop, prevented the MS-induced increase in body-core cooling. MS attenuated the cold-induced vasoconstriction, an effect which was fully prevented by DMH but only partially by Scop. MS provocation did not affect VO(2) in any condition. The results suggest that the MS-induced predisposition to hypothermia is predominantly mediated by histaminergic mechanisms and that DMH might be useful in conjunction with maritime accidents or other scenarios where exposure to cold and MS are imminent features. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  6. Assessment of vibration produced by the grinders used in the shipbuilding industry of Korea.

    PubMed

    Park, Hee-Sok; Yim, Sang-Hyuk

    2007-04-01

    The objective of this study is to estimate the prevalence of finger blanching among the workers in a shipyard of Korea using the dose-response relationship suggested by ISO 5349. The characteristics of vibration exposure produced by six types of grinders were investigated. Vibration measurement was made under the real work conditions. Exposure time was estimated by questionnaire and direct observation. In addition, cold provocation tests were performed, and the results from the tests were compared with the estimated prevalence. As a result, 4 hour-energy-equivalent frequency-weighted accelerations of the finishing grinding (FG) and the prepainting grinding (PG) jobs were 6.23 m/s(2) and 13.39 m/s(2), respectively. The mean exposure time for holding the grinders was 4.64 h per day. Using the ISO 5349 method, it was predicted that after exposure to vibration for 10.79 yr, about a half of the FG workers could develop finger blanching. For the PG workers, the corresponding predicted latency was 5.02 yr. A discrepancy was found between the results from the ISO relationship and those from the cold provocation tests. A linear regression model was suggested employing vibration acceleration and vibration exposure time as explanatory variables for vascular dysfunction.

  7. A critique of a UK standardized test of finger rewarming after cold provocation in the diagnosis and staging of hand-arm vibration syndrome.

    PubMed

    Mason, H J; Poole, K; Saxton, J

    2003-08-01

    Accurate diagnosis and staging of hand-arm vibration syndrome (HAVS) is important in health surveillance of vibration-exposed workers and the substantial number of related medico-legal cases. The measurement of the rewarming rate of fingers after cold provocation to the hands (CPT) has been suggested as a useful test in diagnosing HAVS. To investigate the diagnostic value of a standardized version of the CPT test using a 15 degrees C cold challenge for 5 min applied in the recent compensation assessment of UK miners. Analysis of a subset of UK miners assessed at our unit, together with data from a small repeatability study of the standardized CPT in normal subjects. Rewarming time in the CPT was significantly lower in those subjects classified as vascular Stockholm stage 0 compared with Stockholm stages 1-3 combined, but did not discriminate between the stages of abnormality. Using the suggested cut-off in the CPT test, the sensitivity and specificity were calculated as 43 and 78%, respectively. Receiver operator characteristic analysis suggested that the rewarming time of highest accuracy gave a sensitivity of 66% and specificity of 59%. In 10 miners who reported unilateral hand blanching, there was no significant difference in CPT measurements between blanching and non-blanching hands. Repeat CPT measurements in normal subjects suggested mean differences of 52 and 107 s for each hand, and the Bland-Altman coefficient of repeatability was approximately 600 s for all fingers. Single application of this standardized CPT test may have limited value in diagnosing the vascular component of HAVS in an individual.

  8. [Clinical evaluation of Olbas oil effect on nasal mucosa in acute rhinitis patients during common cold].

    PubMed

    Zalewski, P; Olszewski, J; Olszewska-Ziaber, A; Zielińska-Bliźniewska, H; Pietkiewicz, P

    1997-01-01

    The aim of the study was the clinical evaluation of the effect of Olbas oil on nasal mucosa in patients with acute rhinitis during common cold. 15 patients with 2-3 days history of acute rhinitis during common cold, both sexes, in the age between 23-47 were investigated. All the examinations were done before using, after the first inhalation, and after 7 days of Olbas oil administration. The investigation before using Olbas oil was comprised of: history data, general and otorhinolaryngological examination with particular evaluation of nasal mucosa, anterior rhinomanometry, saccharin translocation time, olfactometry, microbiological cultures, histamine nasal provocation test. At the end, after 7 days of Olbas oil inhalation 3 times a day for 4 minutes 4 drops of Olbas oil applied into a handkerchief, all the test were done again, as at the beginning. The study showed a good of the effect of Olbas oil on nasal mucosa in patients with acute rhinitis during common cold.

  9. Hyperventilation and cold-pressor stress echocardiography combined with automated functional imaging non-invasively detected vasospastic angina

    PubMed Central

    Suzuki, Kengo; Akashi, Yoshihiro J; Mizukoshi, Kei; Kou, Seisyou; Takai, Manabu; Izumo, Masaki; Shimozato, Takashi; Hayashi, Akio; Ohtaki, Eiji; Nobuoka, Sachihiko; Miyake, Fumihiko

    2010-01-01

    A 47-year-old male presented with chest discomfort while sleeping. The patient was suspected of having vasospastic angina (VSA) and underwent hyperventilation and cold-pressor stress echocardiography. No chest pain, ECG changes or decreased wall motion was found. However, automated function imaging (AFI) showed decreased peak systolic strain at the apex and postsystolic shortening at both the apex and inferior wall, which was not found before the test. The provocation test revealed 99% stenosis in the right coronary artery #2 at a dose of 50 μg acetylcholine and 90% stenosis in the left coronary artery #8 at a dose of 100 μg. The patient was thus diagnosed as having VSA. The present case demonstrates the usefulness of AFI combined with hyperventilation and cold-pressor stress echocardiography as a screening examination for VSA. PMID:22798093

  10. Immersion in Cold-Water Evaluation (ICE) and self-reported cold intolerance are reliable but unrelated measures.

    PubMed

    Traynor, Robyn; MacDermid, Joy C

    2008-09-01

    Intolerance to the cold is common following peripheral nerve injury and surgery of the upper extremity. Despite its prevalence, the exact pathophysiology and natural history of this condition are not well understood. Subjective, self-report questionnaires have been created and validated as reliable measures of post-traumatic cold intolerance. The difficulty currently lies in assigning an objective measure to this predominantly subjective phenomenon. The present study evaluated the test-retest reliability of a proposed objective measure of cold intolerance, the Immersion in Cold-water Evaluation (ICE), and its correlation with subjective measures in healthy control subjects. Two age groups were also compared to investigate the effect of age on cold intolerance and temperature recovery. On two separate testing days, subjects completed three health-related questionnaires and submersed their dominant hands in cold water. The temperature of their second and fifth digits was monitored during recovery. Both the objective cold-provocation testing and the subjective self-report questionnaires were highly reliable albeit not significantly correlated. No significant temperature recovery trend was noted between the age groups. Post-traumatic cold intolerance is postulated to have both a vascular and neural etiology among other contributing causes. The protocol studied here was centered predominantly on the former etiology, examining peripheral blood flow and associated temperature recovery. This study established ICE as a reliable means to objectively measure cold response, supplementing information provided by previously validated self-report methods.

  11. Occupational hand-arm vibration syndrome in Korea.

    PubMed

    Yoo, Cheolin; Lee, Ji-Ho; Lee, Choong-Ryeol; Kim, Yangho; Lee, Hun; Choi, Younghee; Kim, Young Wook; Chae, Chang Ho; Kim, Hyokyoung; Koh, Sang Baek; Kim, Euna; Lee, Lu Jin; Lee, Kiyoung

    2005-06-01

    It is suspected that there is a large number of patients suffering from hand-arm vibration syndrome (HAVS) in Korea. However, no cases have been reported since 1992. This study was conducted to identify HAVS cases and determine the characteristics of the syndrome. In April 2001, the Busan, Ulsan, and Gyeong-Nam Province Occupational Disease Surveillance System (BUGODSS) was established to identify work-related HAVS and other occupational diseases. In the 2 years of this project, occupational physicians from five hospitals in these provinces collected information by way of interviews and questionnaires during mandatory occupational medical examinations. Among the initial 189 suspected HAVS cases, 58 volunteers were given cold-water provocation tests in order to diagnose the vascular component of the disorder. One hundred fifty-four approximately occupational HAVS cases were identified from ca. 21,000 workers. One hundred fifty about of these cases were male. The cases were most often found in workers from the shipbuilding industry, and the grinder was the most common source of vibration exposure. Cases of sensorineural disorder (SD) were more common than cases of vascular disorder (VD). The mean values of the finger skin temperature and its recovery rate at 5 min and 10 min after cold-water provocation were significantly lower in the group with the VD than in the group with the SD. We identified 154 occupational HAVS cases, although no cases have been reported during the occupational medical examinations mandated by the state. The majority of the cases were in workers that used grinders in the shipbuilding industry. We determined that peripheral VD and peripheral SD can progress independently of each other. We conclude that exposure to hand-transmitted vibration (HTV) and HAVS cases are common in shipbuilding industry in Korea. The recovery rate of finger skin temperature after cold-water provocation is one of the useful methods for diagnosing the vascular component of HAVS.

  12. Direct oral provocation tests in non-immediate mild cutaneous reactions related to beta-lactam antibiotics.

    PubMed

    Vezir, Emine; Dibek Misirlioglu, Emine; Civelek, Ersoy; Capanoglu, Murat; Guvenir, Hakan; Ginis, Tayfur; Toyran, Muge; Kocabas, Can N

    2016-02-01

    Skin testing has a limited role in the diagnosis of non-immediate beta-lactam hypersensitivity in children. The aim of this study was to report the results of oral provocation tests performed without skin tests in children with non-immediate mild cutaneous reactions without systemic symptoms caused by beta-lactam antibiotics. Oral provocation tests with suspected antibiotics were performed to patients with non-immediate mild cutaneous reactions without systemic symptoms caused by beta-lactam antibiotics. Skin tests were not performed before provocation tests. A total of five doses were administered with half-an-hour intervals in increasing doses. Provocation was continued for 5 days. A total of 119 patients with a median age of 4.3 (IQR: 2-7.5) years, of whom 58% were males, were included in the study. Amoxicillin-clavulanic acid was the most frequently responsible agent in 87 (73.1%) patients, and most common type of rash was maculopapular in 74 (62.2%) patients. Four patients (3.4%) had an urticarial reaction during the provocation test. We did not experience any severe reactions during oral provocation test without previous skin tests performed to children with non-immediate mild cutaneous reactions without systemic symptoms. Omitting skin tests before oral provocation test in this group of children can help decreasing the burden of allergy clinics and alleviating the discomfort of children. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. To Be Black, & Gifted & Red: Cold War Period Yields New, Provocative Ground for Contemporary Scholars

    ERIC Educational Resources Information Center

    Keels, Crystal L.

    2004-01-01

    Today's climate of supercharged patriotism and apparent intolerance for comment or critique calls to mind an earlier period of U.S. history. The Cold War that began in the mid-to late-1940s, along with McCarthyism and the anti-communist movement in the early 1950s, created an atmosphere of national hysteria and paranoia. For the past decade,…

  14. Association between composites of selected motion palpation and pain provocation tests for sacroiliac joint disorders.

    PubMed

    Soleimanifar, Manijeh; Karimi, Noureddin; Arab, Amir Massoud

    2017-04-01

    The sacroiliac joint (SIJ) has been implicated as a potential source of low back and buttock pain. Several types of motion palpation and pain provocation tests are used to evaluate SIJ dysfunction. The purpose of this study was to investigate the relationship between motion palpation and pain provocation tests in assessment of SIJ problems. This study is Descriptive Correlation. 50 patients between the ages of 20 and 65 participated. Four motion palpation tests (Sitting flexion, Standing flexion, Prone knee flexion, Gillet test) and three pain provocation tests (FABER, Posterior shear, Resisted abduction test) were examined. Chi-square analysis was used to assess the relationship between results of the individuals and composites of these two groups of tests. No significant relationship was found between these two groups of tests. It seems that motion palpation tests assess SIJ dysfunction and provocative tests assessed SIJ pain which do not appear to be related. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. A cross sectional study on hand-arm vibration syndrome among a group of tree fellers in a tropical environment.

    PubMed

    Su, Anselm Ting; Maeda, Setsuo; Fukumoto, Jin; Miyai, Nobuyuki; Isahak, Marzuki; Yoshioka, Atsushi; Nakajima, Ryuichi; Bulgiba, Awang; Miyashita, Kazuhisa

    2014-01-01

    This study aimed to explore the clinical characteristics of hand arm vibration syndrome (HAVS) in a group of tree fellers in a tropical environment. We examined all tree fellers and selected control subjects in a logging camp of central Sarawak for vibration exposure and presence of HAVS symptoms utilizing vibrotactile perception threshold test (VPT) and cold water provocation test (CWP). None of the subjects reported white finger. The tree fellers reported significantly higher prevalence of finger coldness as compared to the control subjects (OR=10.32, 95%CI=1.21-87.94). A lower finger skin temperature, longer fingernail capillary return time and higher VPT were observed among the tree fellers as compared to the control subjects in all fingers (effect size >0.5). The VPT following CWP of the tree fellers was significantly higher (repeated measures ANOVA p=0.002, partial η(2)=0.196) than the control subject. The A (8) level was associated with finger tingling, numbness and dullness (effect size=0.983) and finger coldness (effect size=0.524) among the tree fellers. Finger coldness and finger tingling, numbness and dullness are important symptoms for HAVS in tropical environment that may indicate vascular and neurological damage due to hand-transmitted vibration exposure.

  16. Quantitative skin prick and bronchial provocation tests with platinum salt.

    PubMed Central

    Merget, R; Schultze-Werninghaus, G; Bode, F; Bergmann, E M; Zachgo, W; Meier-Sydow, J

    1991-01-01

    Occupational asthma due to platinum salts is a frequent disease in platinum refineries. The diagnosis is based upon a history of work related symptoms and a positive skin prick test with platinum salts. Bronchial provocation tests have not been performed in epidemiological studies because the skin test is believed to be highly specific and sensitive. As no reliable data about this issue currently exist, this study assesses the use of skin prick and bronchial provocation tests with methacholine and platinum salt in platinum refinery workers. Twenty seven of 35 workers, who were referred to our clinic with work related symptoms and nine control subjects with bronchial hyperreactivity underwent a skin prick test and bronchial provocation with methacholine and platinum salt. For skin prick and bronchial provocation tests with platinum salt a 10(-2)-10(-8) mol/l hexachloroplatinic acid solution, in 10-fold dilutions was used. Four of the 27 subjects and all controls showed neither a bronchial reaction nor a skin reaction. Twenty three subjects were considered allergic to platinum salt; 22 of these showed a fall of 50% or more in specific airway conductance after inhalation of the platinum salt solution. Four workers experienced a positive bronchial reaction despite a negative skin prick test. No correlation of responsiveness to methacholine with responsiveness to platinum salt was found, but the skin prick test correlated with the bronchial reaction to platinum salt (rs = 0.50, p less than 0.023, n = 22). One dual reaction was seen in bronchial provocation tests. Side effects of both skin tests and bronchial provocation tests with platinum salt were rare and were not encountered in workers without a skin reaction to platinum salt. It is concluded that bronchial provocation tests with platinum salts should be performed on workers with work related symptoms but negative skin tests with platinum salts. PMID:1772797

  17. Ultra-long acting calcium channel blockers may decrease accuracy of the acetylcholine provocation test.

    PubMed

    Kurabayashi, Manabu; Asano, Mitsutoshi; Shimura, Tsukasa; Suzuki, Hidetoshi; Aoyagi, Hideshi; Yamauchi, Yasuteru; Okishige, Kaoru; Ashikaga, Takashi; Isobe, Mitsuaki

    2017-06-01

    When drug-induced coronary spasm provocation tests are performed, a washout period of >48h for calcium channel blockers (CCBs) is uniformly recommended. However, each CCB has a distinct half-life, and little is known about the influence of prior oral administration of CCBs on acetylcholine provocation test to evaluate coronary vasomotor reaction. We examined 245 consecutive patients with suspected vasospastic angina who had undergone acetylcholine provocation test. Of those patients, 29 patients had been on amlodipine, an ultra-long term acting CCB (group A), 34 on other CCBs (group O), and 182 patients on no CCB (group N). After CCBs had been withheld > 48h, we performed acetylcholine provocation, which resulted in 152 positive, 36 intermediate, and 57 negative reactions. We evaluated coronary artery tone calculated as follows: (luminal diameter after nitrate-baseline luminal diameter)÷(luminal diameter after nitrate)×100 (%). In group A patients, coronary artery tone was lower (A:9.1±6.9% vs. O:11.7±8.3% vs. N:12.1±8.5%, p=0.0011) and the positive rate of acetylcholine provocation test was lower than group O and group N (A:41% vs. O:68% vs. N:64%, p=0.047). Multivariate logistic analysis showed that taking amlodipine until 2days before acetylcholine provocation test was a significant inverse predictor for acetylcholine-provoked coronary spasm (odds ratio 0.327; 95% confidence interval 0.125-0.858, p=0.023). Residual vasodilatory effects of ultra-long acting CCB may decrease coronary artery tone and the vasoconstrictive reaction to acetylcholine suggesting that a 2-day pre-test drug holiday may not be long enough. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Lymphocyte blastogenic responses to inciting food allergens in dogs with food hypersensitivity.

    PubMed

    Ishida, Rinei; Masuda, Kenichi; Kurata, Keigo; Ohno, Koichi; Tsujimoto, Hajime

    2004-01-01

    Lymphocyte blastogenic responses against food allergens in dogs with food hypersensitivity were evaluated in this study. Eleven dogs with food hypersensitivity, based on food elimination and oral food provocation tests and allergic responses to food allergens, were examined by various tests such as intradermal testing, antigen-specific IgE testing, and lymphocyte blastogenic responses. The number and kinds of food allergens identified as positive by these tests were compared with the offending food allergens that were found in an oral food provocation test. In 9 (82%) of the 11 dogs with food hypersensitivity, there was close agreement for positive allergens between the results of lymphocyte blastogenic responses and oral food provocation test; however, there was little agreement for intradermal and IgE testing of the positive allergens with those of the oral food provocation test (11% and 31%, respectively). In the 9 dogs, the stimulation indices of lymphocyte blastogenic responses increased to 2.0-10.1 upon food provocation but decreased significantly to 0.7-1.4 upon feeding the elimination diet until clinical signs disappeared. These results indicate that lymphocyte blastogenic responses may fluctuate because of exposure to offending food allergens in dogs with food hypersensitivity. Lymphocytes reactive to food allergens may play an important role in the pathogenesis of food hypersensitivity in dogs.

  19. Impact of tachycardia and sympathetic stimulation by cold pressor test on cardiac diastology and arterial function in elderly females.

    PubMed

    Johnson, Jonas; Håkansson, Felicia; Shahgaldi, Kambiz; Manouras, Aristomenis; Norman, Mikael; Sahlén, Anders

    2013-04-01

    Abnormal vascular-ventricular coupling has been suggested to contribute to heart failure with preserved ejection fraction in elderly females. Failure to increase stroke volume (SV) during exercise occurs in parallel with dynamic changes in arterial physiology leading to increased afterload. Such adverse vascular reactivity during stress may reflect either sympathoexcitation or be due to tachycardia. We hypothesized that afterload elevation induces SV failure by transiently attenuating left ventricular relaxation, a phenomenon described in animal research. The respective roles of tachycardia and sympathoexcitation were investigated in n = 28 elderly females (70 ± 4 yr) carrying permanent pacemakers. At rest, during atrial tachycardia pacing (ATP; 100 min(-1)) and during cold pressor test (hand immersed in ice water), we performed Doppler echocardiography (maximal untwist rate analyzed by speckle tracking imaging of rotational mechanics) and arterial tonometry (arterial stiffness estimated as augmentation index). Estimation of arterial compliance was based on an exponential relationship between arterial pressure and volume. We found that ATP produced central hypovolemia and a reduction in SV which was larger in patients with stiffer arteries (higher augmentation index). There was an associated adverse response of arterial compliance and vascular resistance during ATP and cold pressor test, causing an overall increase in afterload, but nonetheless enhanced maximal rate of untwist and no evidence of afterload-dependent failure of relaxation. In conclusion, tachycardia and cold provocation in elderly females produces greater vascular reactivity and SV failure in the presence of arterial stiffening, but SV failure does not arise secondary to afterload-dependent attenuation of relaxation.

  20. Airway hyperresponsiveness, peak flow variability and inflammatory markers in non-asthmatic subjects with respiratory infections.

    PubMed

    Björnsson, Eythór; Lúdvíksdóttir, Dóra; Hedenström, Hans; Eriksson, Britt-Marie; Högman, Marieann; Venge, Per; Janson, Christer

    2007-07-01

    The aim of this study was to characterise non-asthmatic subjects with asthma-like symptoms during a common cold, particularly in relation to airway hyperresponsiveness (AHR). Subjects with acute respiratory infections and a group of controls (n = 20 + 20), age 20-65 years, underwent bronchial provocations with methacholine, adenosine and cold air. All were non-smokers and had no history of asthma or heart disease. Those with infection had asthma-like symptoms (>2). Measurements of exhaled nitric oxide (eNO), serum levels of eosinophil cationic protein (ECP), eosinophil peroxidase, myeloperoxidase and human neutrophil lipocalin were made at each provocation. A 17-day symptom and peak flow diary was calculated. No differences between the two groups were found, regarding responsiveness to methacholine, adenosine or cold air challenge, as well as the inflammatory markers measured. In the infected group, the mean (standard deviation) ECP was higher in those with AHR to methacholine or cold air [15.7 (6.5) and 11.4 (4.2) microg/L, respectively; P < 0.05]; furthermore, eNO was higher in the infected group [116 (54) and 88 (52) nL/min, respectively; P = 0.055]. The infected group had, at all times, more symptoms and higher peak flow, with a decrease in the symptoms (P = 0.02) and a tendency to change in peak flow variation (P = 0.06). AHR does not seem to be the main cause of asthma-like symptoms in adults with infectious wheezing. Peak flow variation and symptom prevalence during the post-infection period may imply airway pathology different from AHR.

  1. The Importance of Prolonged Provocation in Drug Allergy - Results From a Danish Allergy Clinic.

    PubMed

    Fransson, Sara; Mosbech, Holger; Kappel, Mogens; Hjortlund, Janni; Poulsen, Lars K; Kvisselgaard, Ask D; Garvey, Lene H

    Drug provocation is the "Gold Standard" in drug allergy investigation. Recent studies suggest that a negative drug provocation on first dose should be followed by a prolonged provocation over several days. To evaluate drug allergy investigations on the basis of drug provocation, including prolonged provocation. Data from adult patients investigated for drug allergy in a Danish Allergy Clinic during the period 2010 to 2014 were entered into a database. Data included clinical details and results of provocations with suspected culprit drug (for penicillins performed only in specific IgE-negative patients). If provocation was negative on first dose, treatment was continued for 3 to 10 days. A total of 1,913 provocations were done in 1,659 patients, median age 46 years, of whom 1,237 (74.6%) were females. Drugs investigated were antibiotics, 1,776 (92.8%), of which 1,590 (89.5%) were penicillins; analgesics, 59 (3.1%); local anesthetics, 33 (1.7%); and other drugs, 45 (2.4%). In total, 211 of 1,913 (11.0%) provocations were positive. Causes were antibiotics, 198 (93.8%), of which 167 (84.3%) were penicillins; analgesics, 7 (3.3%); local anesthetics, 0; and other drugs, 6 (2.8%). Only 43 (20.4%) provocations were positive on first dose, whereas 95 (45.0%) turned positive more than 3 days later. Only 11.0% of the provocations were positive. Importantly, only 1 of 5 patients tested positive on the first dose, indicating that prolonged exposure should always be considered when drug provocation is included in allergy investigations. Most provocations were with penicillins, reflecting the pattern of antibiotic use in Denmark, which differs from that in other countries, especially outside Northern Europe. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  2. The value and safety of specific nasal provocation in the diagnosis of allergic rhinitis in mild persistent asthma under inhaled steroid therapy.

    PubMed

    Tuskan, Tansu Cengiz; Gemicioglu, Bilun; Ikitimur, Hande; Yilmaz, Nail; Tuskan, Kemal; Oz, Ferhan; Can, Gunay

    2010-01-01

    Although specific nasal provocation is an objective diagnostic test for allergic rhinitis, it can also increase the lower airway responsiveness in asthmatic patients. Our goal was to determine the value and safety of specific nasal provocation test for the diagnosis of allergic rhinitis in mild persistent asthmatic patients under low-dose inhaled steroid therapy. The study was performed on 32 mild persistent, stable, mite-sensitive allergic asthmatics (group 1), 9 mild persistent nonallergic asthmatics (group 2) and 9 healthy non-smokers (group 3). Nasal symptoms were noted, paranasal sinus computerized tomography (PNCT) and rhinoscopic evaluations were performed. Cases with pathologic-anatomic changes in PNCT and rhinoscopy were excluded. Symptom scoring, flow-volume, peak expiratory flow (PEF), serum and nasal lavage eosinophil cationic protein (ECP) and nasal lavage eosinophil counts were performed before mite specific nasal provocation test and at the 0th, 4th and 24th hours following the test. No adverse effects were observed in all diagnostic procedures. Total diagnostic value of nasal symptoms were found to be at 92%, while being 70% for rhinoscopy and 88% for specific nasal provocation test respectively in the diagnosis of allergic rhinitis in group 1. Statistically significant differences were found between basal nasal lavage eosinophil values (p < 0.001) and ECP levels (p < 0.05) when group 1 was compared with both group 2 and group 3. In the remaining measured values between three groups, no statistically significant differences were found. Specific nasal provocation test is a safe method for mild house dust mite allergic asthma cases under low-dose inhaled steroid therapy, but history of rhinitis might be sufficient for the diagnosis of allergic rhinitis.

  3. The effect of levocabastine and furosemide pretreatment on hyperreactive response after nasal provocation with hypotonic aerosol in subjects with allergic rhinitis.

    PubMed

    Anzic, Srdjan Ante; Dzepina, Davor; Kalogjera, Livije

    2007-11-01

    Patients with allergic rhinitis demonstrate hyperreactive response in distilled water nasal provocation, shown by significant increase in nasal airway resistance (NAR). Antihistamines, including topical antihistamine, levocabastine, reduce response in non-specific nasal provocation tests. Furosemide is a diuretic which reduces hyperreactivity in lower airways, but the mode of its action is not yet fully understood. In this study, we hypothesized that either levocabastine or furosemide pre-treatment in allergic rhinitis patients reduced response to nasal challenge with non-isotonic aerosol. To test the hypothesis, we measured the effect of pre-treatment with levocabastine and furosemide in topical application on suppression of hyperreactive response to distilled water nasal inhalation. Nasal resistance was measured, prior to and after the provocation, by active anterior rhinomanometry in two randomized groups of patients, according to pre-treatment, either by levocabastine or furosemide, 20 patients in each group, respectively. Nasal airflow resistance and level of hyperreactive response considering nasal eosinophilia were tested. Significant increase in nasal resistance following provocation was found at baseline conditions (without pre-medication); pre-treatment with levocabastine and furosemide has suppressed such response. Patients with positive nasal eosinophilia showed a significantly higher increase in nasal resistance compared to those with negative smears. Furosemide has shown significantly better protective effect on nasal resistance increase in patients with positive eosinophils nasal smears. Levocabastine and furosemide pre-treatment suppress hyperreactive response to distilled water nasal provocation. Comparison of resistances (pre-treatment vs. without) showed more protective effect of furosemide, measured on both better and worse patent side of nose, in contrast to levocabastine group for which it was shown only on better patent side prior to provocation. Protection of furosemide was significantly more pronounced in patients with significant nasal eosinophilia.

  4. Provocation testing to assist craniomandibular pain diagnosis.

    PubMed

    DuPont, John S; Brown, Christopher E

    2010-04-01

    Patients with TMD often present with complex pain symptoms, which can make it difficult to reach a diagnosis. Usually palpation of the masticatory muscles and TM joints, range of motion testing and imaging are used in the diagnostic process. Sometimes it is necessary to evaluate the jaw moving muscles from a functional prospective because they cannot be palpated due to inaccessibility or because they have other structures that are more superficial to them. In these instances, provocation testing can be a helpful adjunct in providing some insight into what is occurring in the area being tested and localizing a suspected source of pain. Anesthesia blocking can be used to confirm any positive findings. This article explores several provocation tests that can be used to evaluate conditions of the masticatory musculature, the TM joints and the stylomandibular ligament.

  5. Manifestation of J wave induced by acetylcholine applied for a coronary spasm provocation test in a patient with aborted sudden cardiac death.

    PubMed

    Kodama, Hiroyuki; Fujita, Kazumasa; Moriyama, Shouhei; Irie, Kei; Noda, Hirotaka; Yokoyama, Taku; Fukata, Mitsuhiro; Arita, Takeshi; Odashiro, Keita; Maruyama, Toru; Akashi, Koichi

    2017-06-01

    A 51-year-old man with a resuscitation episode was referred to our hospital. Coronary angiography revealed a focal spasm overlapped with organic stenosis where a bare metal stent was implanted. Acetylcholine (ACh) provocation test did not induce chest pain. It revealed no discernible ST-T changes but unmasked a J wave at the end of the QRS complex, which was associated with short-coupled repetitive premature ventricular beats. A J wave reportedly appears immediately before the onset of ventricular fibrillation caused by vasospastic angina. However, a J wave observed newly after a coronary spasm provocation test using ACh without ST-T changes is informative when considering the mechanisms of the J wave.

  6. Statistical prediction of space motion sickness

    NASA Technical Reports Server (NTRS)

    Reschke, Millard F.

    1990-01-01

    Studies designed to empirically examine the etiology of motion sickness to develop a foundation for enhancing its prediction are discussed. Topics addressed include early attempts to predict space motion sickness, multiple test data base that uses provocative and vestibular function tests, and data base subjects; reliability of provocative tests of motion sickness susceptibility; prediction of space motion sickness using linear discriminate analysis; and prediction of space motion sickness susceptibility using the logistic model.

  7. Can conjunctival provocation test facilitate the diagnosis of food allergy in children?

    PubMed

    Krane Kvenshagen, B; Jacobsen, M; Halvorsen, R

    2010-01-01

    Food allergy is common in children, occurring in 5-7.5%. The diagnosis may, however, be difficult. Elevated IgE or positive skin prick test to a food allergen is often considered proof of allergy, but may represent sensitisation without clinical manifestations. For a precise diagnosis oral challenge is necessary, but this is often not performed because of risk of serious allergic reactions. The aim of this study was to evaluate whether conjunctival provocation test would facilitate the diagnosis of IgE-mediated food allergy. One hundred and forty-nine children with 174 possible diagnoses of food allergy were included. General examination, skin prick test and specific IgE were performed, as well as conjunctival provocation test of the suspected food allergen. Open food challenges and double-blind placebo controlled tests were performed in order to diagnose possible food allergy. Forty-six children with strongly positive conjunctival reactions (rubor, itching, oedema) to fifty food allergens were all proven to have allergy to the food in question. The children with negative conjunctival provocation tests showed no allergic reactions when challenged. We find that a strongly positive conjunctival reaction to a food allergen correlates well with true allergy. An oral challenge should be carefully performed. With a negative conjunctival test an oral challenge may safely be performed. Copyright © 2009 SEICAP. Published by Elsevier Espana. All rights reserved.

  8. Influence of body mass index on the growth hormone response to provocative testing in short children without growth hormone deficiency.

    PubMed

    Lee, Jieun; Yoon, Juyoung; Kang, Min Jae; Lee, Young Ah; Lee, Seong Yong; Shin, Choong Ho; Yang, Sei Won

    2013-09-01

    Obesity and its related factors are known to suppress the secretion of growth hormone (GH). We aimed to evaluate the influence of body mass index (BMI) on the peak GH response to provocative testing in short children without GH deficiency. We conducted a retrospective review of medical records of 88 children (2-15 yr old) whose height was less than 3 percentile for one's age and sex, with normal results (peak GH level > 10 ng/mL) of GH provocative testing with clonidine and dopamine. Peak stimulated GH level, height, weight, pubertal status and serum IGF-1 level were measured. Univariate analysis showed that the BMI standard deviation score (SDS) correlated negatively with the natural log (ln) of the peak stimulated GH level (ln peak GH). BMI SDS did not correlate significantly with sex, age, pubertal status, or ln IGF-1 level. BMI SDS correlated negatively with ln peak GH level induced by clonidine but not by dopamine. In stepwise multivariate regression analysis, BMI SDS was the only significant predictor of ln peak GH level in the combination of tests and the clonidine test, but not in the dopamine test. In children without GH deficiency, BMI SDS correlates negatively with the peak GH level. BMI SDS should be included in the analysis of the results of GH provocation tests, especially tests with clonidine.

  9. Experimental provocation of 'ice-cream headache' by ice cubes and ice water.

    PubMed

    Mages, Stephan; Hensel, Ole; Zierz, Antonia Maria; Kraya, Torsten; Zierz, Stephan

    2017-04-01

    Background There are various studies on experimentally provoked 'ice-cream headache' or 'headache attributed to ingestion or inhalation of a cold stimulus' (HICS) using different provocation protocols. The aim of this study was to compare two provocation protocols. Methods Ice cubes pressed to the palate and fast ingestion of ice water were used to provoke HICS and clinical features were compared. Results The ice-water stimulus provoked HICS significantly more often than the ice-cube stimulus (9/77 vs. 39/77). Ice-water-provoked HICS had a significantly shorter latency (median 15 s, range 4-97 s vs. median 68 s, range 27-96 s). There was no difference in pain localisation. Character after ice-cube stimulation was predominantly described as pressing and after ice-water stimulation as stabbing. A second HICS followed in 10/39 (26%) of the headaches provoked by ice water. Lacrimation occurred significantly more often in volunteers with than in those without HICS. Discussion HICS provoked by ice water was more frequent, had a shorter latency, different pain character and higher pain intensity than HICS provoked by ice cubes. The finding of two subsequent HICS attacks in the same volunteers supports the notion that two types of HICS exist. Lacrimation during HICS indicates involvement of the trigeminal-autonomic reflex.

  10. Immediate hypersensitivity to iodinated contrast media: diagnostic accuracy of skin tests and intravenous provocation test with low dose.

    PubMed

    Sesé, L; Gaouar, H; Autegarden, J-E; Alari, A; Amsler, E; Vial-Dupuy, A; Pecquet, C; Francès, C; Soria, A

    2016-03-01

    The diagnosis of HSR to iodinated contrast media (ICM) is challenging based on clinical history and skin tests. This study evaluates the negative predictive value (NPV) of skin tests and intravenous provocation test (IPT) with low-dose ICM in patients with suspected immediate hypersensitivity reaction (HSR) to ICM. Thirty-seven patients with suspected immediate hypersensitivity reaction to ICM were included retrospectively. Skin tests and a single-blind placebo-controlled intravenous provocation test (IPT) with low-dose iodinated contrast media (ICM) were performed. Skin tests with ICM were positive in five cases (one skin prick test and five intradermal test). Thirty-six patients were challenged successfully by IPT, and only one patient had a positive challenge result, with a grade I reaction by the Ring and Messmer classification. Ten of 23 patients followed up by telephone were re-exposed to a negative tested ICM during radiologic examination; two experienced a grade I immediate reaction. For immediate hypersensitivity reaction to ICM, the NPV for skin tests and IPT with low dose was 80% (95% CI 44-97%). © 2016 John Wiley & Sons Ltd.

  11. Reproducibility of manual pressure force on provocation of the sacroiliac joint.

    PubMed

    Levin, U; Nilsson-Wikmar, L; Stenström, C H; Lundeberg, T

    1998-01-01

    Previous studies of pain-provocation sacroiliac (SI) joint tests have revealed conflicting results. The aim of the present study was to evaluate the intra- and inter-test reliability of pressure force applied during distraction test, compression test and pressure on the apex sacralis. Seventeen physiotherapists (PTs), median age 43 years and median clinical experience 11 years, all experienced in musculoskeletal evaluation and therapy, participated in the study. Each PT performed each test on the same healthy volunteer for 20 s, on three separate occasions, at intervals of one week using a specially constructed examination table which registered pressure force. The PTs were capable of maintaining a relatively constant pressure force for 20 s. The intra-test reliability was acceptable even though there were individual differences on different occasions between those PTs who used the SI joint tests often and those who seldom or never used them. The inter-test reliability was insufficient. The findings indicate the advantage of registering pressure force as a complement for standardized methods for pain-provoking tests and when learning provocation tests, since individual variability was considerable.

  12. Food hypersensitivity reactions in Soft Coated Wheaten Terriers with protein-losing enteropathy or protein-losing nephropathy or both: gastroscopic food sensitivity testing, dietary provocation, and fecal immunoglobulin E.

    PubMed

    Vaden, S L; Hammerberg, B; Davenport, D J; Orton, S M; Trogdon, M M; Melgarejo, L T; VanCamp, S D; Williams, D A

    2000-01-01

    The purpose of this study was to evaluate Soft Coated Wheaten Terriers (SCWTs) affected with protein-losing enteropathy (PLE) or protein-losing nephropathy (PLN) or both for allergy to food. We performed gastroscopic food-sensitivity testing, a provocative dietary trial, and measurement of fecal immunoglobulin E (IgE) in 6 SCWTs affected with PLE or PLN or both. Positive gastroscopic food-sensitivity test reactions were noted in 5 of 6 dogs. Positive reactions were found to milk in 4 dogs, to lamb in 2 dogs, and to wheat and chicken each in 1 dog. Adverse reactions to food (diarrhea, vomiting, or pruritus) were detected in all 6 dogs during the provocative dietary trial. Adverse reactions were found to corn in 5 dogs, to tofu in 3 dogs, to cottage cheese in 2 dogs, to milk in 2 dogs, to farina cream of wheat in 2 dogs, and to lamb in 2 dogs. Serum albumin concentrations significantly decreased and fecal alpha1-protease inhibitor concentration significantly increased 4 days after the provocative trial when compared with baseline values. Antigen-specific fecal IgE varied throughout the provocative trial, with peak levels following ingestion of test meals. We conclude that food hypersensitivities are present in SCWTs affected with the syndrome of PLE/PLN. Mild inflammatory bowel disease was already established in the 6 SCWTs of this report at the time of study, making it impossible to determine if food allergies were the cause or result of the enteric disease.

  13. Eucapnic voluntary hyperventilation in diagnosing exercise-induced laryngeal obstructions.

    PubMed

    Christensen, Pernille M; Rasmussen, Niels

    2013-11-01

    Exercise-induced laryngeal obstructions (EILOs) cause exercise-related respiratory symptoms (ERRS) and are important differential diagnoses to exercise-induced asthma. The diagnostic method for EILOs includes provocation to induce the obstruction followed by a verification of the obstruction and the degree thereof. The objective of the present study was to examine if a eucapnic voluntary hyperventilation (EVH) test could induce laryngeal obstructions laryngoscopically identical in subtypes and development as seen during an exercise test. EVH and exercise testing with continuous laryngoscopy were performed during a screening of two national athletic teams (n = 67). The laryngoscopic recordings were examined for usability, abnormalities and maximal supraglottic and glottic obstruction using two currently available methods (Eilomea and CLE-score). The participants were asked questions on ERRS, and whether the symptoms experienced during each provocation matched those experienced during regular training. A total of 39 completed both tests. There were no significant differences in subtypes and development thereof, the experience of symptoms, and specificity and sensitivity between the methods. Significantly more recordings obtained during the exercise test were usable for evaluation primarily due to resilient mucus on the tip of the fiber-laryngoscope in the EVH test. Only recordings of six athletes from both provocation methods were usable for evaluation using the Eilomea method (high-quality demand). Amongst these, a linear correlation was found for the glottic obstruction. EVH tests can induce EILOs. However, the present test protocol needs adjustments to secure better visualisation of the larynx during provocation.

  14. Hip range of motion and provocative physical examination tests reliability and agreement in asymptomatic volunteers

    PubMed Central

    Prather, H; Harris-Hayes, M; Hunt, D; Steger-May, K; Mathew, V; Clohisy, JC

    2012-01-01

    Objective The objectives of this study are the following: 1) report passive hip ROM in asymptomatic young adults, 2) report the intra-tester and inter-tester reliability of hip ROM measurements among testers of multiple disciplines, 3) report the results of provocative hip tests and tester agreement. Design descriptive epidemiology study Setting tertiary university Participants Twenty-eight young adult volunteers without musculoskeletal symptoms, history of disorder or surgery involving the lumbar spine or lower extremities were enrolled and completed the study. Methods Asymptomatic young adult volunteers completed questionnaires and were examined by two blinded examiners during a single session. The testers were physical therapists and physicians. Hip range of motion and provocative tests were completed by both examiners on each hip. Main Outcome Measurements Inter and intra-rater reliability for ROM and agreement for provocative tests was determined. Results Twenty-eight asymptomatic adults with mean age 31 years old (range 18–51 years) and mean modified Harris Hip Score of 99.5 ± 1.5 and UCLA Activity score of 8.8 ± 1.2 completed the study. Intra-rater agreement was excellent for all hip range of motion measurements, with intraclass correlation coefficients (ICCs) ranging from 0.76 to 0.97 with similar agreement if the examiner was a physical therapist or a physician. Excellent inter-rater reliability was found for hip flexion ICC 0.87 (95% CI 0.78 to 0.92), supine internal rotation ICC 0.75 (95% CI 0.60 to 0.84) and prone internal rotation ICC 0.79 (95% CI 0.66 to 0.87). The least reliable measurements were supine hip abduction (ICC 0.34) and supine external rotation (ICC 0.18). Agreement between examiners ranged from 96–100% for provocative hip tests which included the hip impingement, resisted straight leg raise, FABER/Patrick’s and log roll tests. Conclusions Specific hip ROM measures show excellent inter-rater reliability and provocative hip tests show good agreement among multiple examiners and medical disciplines. Further studies are needed to assess the utilization of these measurements and tests as a part of a hip screening examination to assess for young adults at risk intra-articular hip disorders prior to the onset of degenerative changes. PMID:20970757

  15. [Correlation of brain electrical activity and motivation in healthy people].

    PubMed

    Bogovin, L V; Nakhamchen, D L; Kolosov, V P; Perel'man, Iu M

    2014-01-01

    Motivation dominates in the structure of the personality and is one of the basic notions which explains the dynamics of the behavior. The literature has little data about neurophysiology of motivation. The aim of the research was to study the correlation between the motivational sphere and electrical activity of the brain at the influence of different provocations. 24 healthy people at the age of 26-36 years were examined. The results of motivation tests turned out to be uniform (the motivation to success was of a moderate or high level, there were mean values of readiness to risk and low motivation to achievement and approval). Multiple correlations between different types of motivation and electrical activity of the brain at rest, at hyperventilation with room temperature air and at isocapnic cold air hyperventilation were revealed.

  16. [Clinical features of the hand-arm vibration syndrome in miners].

    PubMed

    Kákosy, Tibor; Németh, László; Kiss, Gábor; Lászlóffy, Marianna; Kardos, Kálmán

    2006-05-07

    It is well known that the vibrating tools used by the miners can cause hand-arm vibration syndrome. However no detailed reports on this field could be found in the Hungarian literature. The aim of this study was to clarify the clinical features of the hand-arm vibration syndrome of the miners. The circulation, the peripheral nerves and the osteoarticular system of the upper extremities of 152 miners were examined by means of cold provocation test, Allen-test, measurement of systolic blood pressure performed by Doppler flowmeter, clinical neurological and neurographic examination and X-ray investigation of the bones and joints. Hand-arm vibration syndrome was diagnosed in 87 patients (57.2%). The most common symptom was the lesion of the circulation which occurred in 78 patients (89.6%). The peripheral nerves were affected in 44 cases (50.5%). Radiological alteration of the bones and joints of the upper extremities was observed in 32 patients (36.8%). Out of 78 damaged cases the frequency of the vascular diseases was as follows: angiopathy (diminished systolic blood pressure in the fingers): 66 patient (84.6%), occlusion of the hand arteries (positive Allen-test) and arterial form of the thoracic outlet syndrome (positive elevation-test) respectively: 28 and 28 cases (35.9%), Raynaud phenomenon (positive cold-provocation test): 26 cases (33.3%). The peripheral nerves were examined in detail in 141 cases. Pathological alterations were observed in 78 patients (55.3%) in the following forms: carpal tunnel syndrome: 66 cases (84.6%), peripheral neuropathy of the upper limbs: 20 patients (25.6%), lesion of the ulnar nerve: 3 cases (3.8%), brachial plexus lesion: one patient (1.3%). Radiological alteration was most common in the carpal region (87 cases, 57.2%). The frequency of the lesion of cubital (40.4%) and shoulder region (40.7%) was practically the same. In the carpal region the most common alterations were the degenerative processes (23 cases, 15.1%) followed by the aseptic osteonecroses (22 patients, 14.5%). In the cubital region the periarticular changes (31 patients, 23.9%) were most common followed by degenerative changes (21 cases, 16.2%) and the osteochondrosis dissecans (13 cases, 10.1%). In the shoulder region the degenerative processes were the most common changes (41 patients, 34.7%), first of all in the acromioclavicular joint (21 cases, 17.8%). Aseptic necrosis was observed in two patients. The miners are professionally exposed not only to hand-arm vibration, but also to increased physical stress. The symptoms on the upper limbs can develop as the result of both exposures.

  17. Reliability and validity of three pain provocation tests used for the diagnosis of chronic proximal hamstring tendinopathy.

    PubMed

    Cacchio, Angelo; Borra, Fabrizio; Severini, Gabriele; Foglia, Andrea; Musarra, Frank; Taddio, Nicola; De Paulis, Fosco

    2012-09-01

    The clinical assessment of chronic proximal hamstring tendinopathy (PHT) in athletes is a challenge to sports medicine. To be able to compare the results of research and treatments, the methods used to diagnose and evaluate PHT must be clearly defined and reproducible. To assess the reliability and validity of three pain provocation tests used for the diagnosis of PHT. Ninety-two athletes with (N=46) and without (N=46) PHT were examined by one physician and two physiotherapists, who were trained in the examination techniques before the study. The examiners were blinded to the symptoms and identity of the athletes. The three pain provocation tests examined were the Puranen-Orava, bent-knee stretch and modified bent-knee stretch tests. Intraclass correlation coefficients (ICCs) based on the repeated measures analysis of variance were used to analyse the intraexaminer and interexaminer reliability, while sensitivity, specificity, predictive values and likelihood ratios were used to determine the validity of the three tests. The ICC values in all three tests revealed a high correlation (range 0.82 to 0.88) for the interexaminer reliability and a high-to-very high correlation (range 0.87 to 0.93) for the intraexaminer reliability. All three tests displayed a moderate-to-high validity, with the highest degree of validity being yielded by the modified bent-knee stretch test. All three pain provocation tests proved to be of potential value in assessing chronic PHT in athletes. However, we recommend that they be used in conjunction with other objective measures, such as MRI.

  18. Muscle Weakness in the Empty and Full Can Tests Cannot Differentiate Rotator Cuff Tear from Cervical Spondylotic Amyotrophy: Pain Provocation is a Useful Finding.

    PubMed

    Iwata, Eiichiro; Shigematsu, Hideki; Inoue, Kazuya; Egawa, Takuya; Sakamoto, Yoshihiro; Tanaka, Yasuhito

    2017-01-01

    Rotator cuff tears and cervical spondylotic amyotrophy (CSA) are often confused as the main symptom in those with difficulty in shoulder elevation. Empty and full can tests are frequently used for the clinical diagnosis of rotator cuff tears. The aim of the present study was to investigate whether the empty and full can test results can help differentiate rotator cuff tears from CSA. Twenty-seven consecutive patients with rotator cuff tears and 25 with CSA were enrolled. We prospectively performed empty and full can tests in patients with rotator cuff tears and CSA. The following signs were considered positive: (a) muscle weakness during the empty can test, (b) muscle weakness during the full can test, (c) pain provocation during the empty can test, and (d) pain provocation during the full can test. We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of rotator cuff tears for each positive finding. The sensitivity and specificity of each index were as follows (sensitivity, specificity, PPV, NPV): (a) 77.8%, 0%, 45.7%, 0%; (b) 66.7%, 4.0%, 42.9%, 10.0%; (c) 88.9%, 96.0%, 96.0%, 88.9%; and (d) 74.1%, 96.0%, 95.2%, 77.4%. There were significant differences for each index. Muscle weakness during the empty and full can tests was not useful in differentiating rotator cuff tears from CSA because of low specificity and PPV. However, pain provocation was useful in differentiating these two conditions because of high specificity and PPV.

  19. Diagnostic Accuracy of the Neck Tornado Test as a New Screening Test in Cervical Radiculopathy.

    PubMed

    Park, Juyeon; Park, Woo Young; Hong, Seungbae; An, Jiwon; Koh, Jae Chul; Lee, Youn-Woo; Kim, Yong Chan; Choi, Jong Bum

    2017-01-01

    The Spurling test, although a highly specific provocative test of the cervical spine in cervical radiculopathy (CR), has low to moderate sensitivity. Thus, we introduced the neck tornado test (NTT) to examine the neck and the cervical spine in CR. The aim of this study was to introduce a new provocative test, the NTT, and compare the diagnostic accuracy with a widely accepted provocative test, the Spurling test. Retrospective study. Medical records of 135 subjects with neck pain (CR, n = 67; without CR, n = 68) who had undergone cervical spine magnetic resonance imaging and been referred to the pain clinic between September 2014 and August 2015 were reviewed. Both the Spurling test and NTT were performed in all patients by expert examiners. Sensitivity, specificity, and accuracy were compared for both the Spurling test and the NTT. The sensitivity of the Spurling test and the NTT was 55.22% and 85.07% ( P < 0.0001); specificity, 98.53% and 86.76% ( P = 0.0026); accuracy, 77.04% and 85.93% ( P = 0.0423), respectively. The NTT is more sensitive with superior diagnostic accuracy for CR diagnosed by magnetic resonance imaging than the Spurling test.

  20. Retrospective Comparison of Cardiac Testing and Results on Inpatients with Low Pretest Probability Compared with Moderate/High Pretest Probability for Coronary Artery Disease.

    PubMed

    Lear, Aaron; Huber, Merritt; Canada, Amy; Robertson, Jessica; Bosman, Evan; Zyzanski, Stephen

    2018-01-01

    To determine whether admission, and provocative stress testing of patients who have ruled out for acute coronary syndrome put patients with low-risk category for coronary artery disease (CAD) at risk for false-positive provocative stress testing and unnecessary coronary angiogram/imaging. A retrospective chart review was performed on patients between 30 and 70 years old, with no pre-existing diagnosis of CAD, admitted to observation or inpatient status chest pain or related complaints. Included patients were categorized based on Duke Clinical Score for pretest probability for CAD into either low-risk group, or moderate/high-risk group. The inpatient course was compared including whether provocative stress testing was performed; results of stress testing; whether patients underwent further coronary imaging; and what the results of the further imaging showed. 543 patients were eligible: 305 low pretest probability, and 238 moderate/high pretest probability. No difference was found in rate of stress testing relative risk (RR) = 1.01 (95% CI, 0.852 to 1.192; P = 0); rate of positive or equivocal stress tests between the 2 groups: RR = 0.653 (95% CI, 0.415 to 1.028; P = .07,). Low-pretest-probability patients had a lower likelihood of positive coronary imaging after stress test, RR = 0.061 (95% CI, 0.004 to 0.957; P = .001). Follow-up provocative testing of all patients admitted/observed after emergency department presentation with chest pain is unlikely to find CAD in patients with low pretest probability. Testing all low-probability patients puts them at increased risk for unnecessary invasive confirmatory testing. Further prospective testing is needed to confirm these retrospective results. © Copyright 2018 by the American Board of Family Medicine.

  1. U.S. Military Arms Sales to Taiwan: Deterrent or Provocation?

    DTIC Science & Technology

    2002-03-01

    de facto Sino-U.S. alliance could provide a means of containing the USSR.” See Derek McDougall, The International Politics of the New Asia Pacific...Survey, July/August 2000, vol. 40, no. 4, pp. 622-640. McDougall, Derek . The International Politics of the New Asia Pacific. Boulder: Lynne Rienner...Corporation. E-mail correspondence on 25 & 31 January 2002. Ong , R.C.M. “Japan and China: Security Interest in the Post-Cold War Era.” East Asia

  2. A commercially available immunoglobulin E-based test for food allergy gives inconsistent results in healthy ponies.

    PubMed

    Dupont, S; De Spiegeleer, A; Liu, D J X; Lefère, L; van Doorn, D A; Hesta, M

    2016-01-01

    Commercial immunoglobulin E (IgE)-based tests are available for diagnosis of food allergies and are commonly used in equine practice. However, these tests have been proven unreliable as a screening method in man and other species, but not critically evaluated in equids. Therefore, a commercially available IgE-based test for horses was evaluated. To evaluate the consistency of the results obtained with a commercially available IgE-based test for food allergy diagnosis in ponies (Phase I) and to subject ponies to a provocation trial with the presumed allergens (Phase II). Allergen screening followed by experimental food provocation trials in healthy ponies. Blood samples of 17 healthy Shetland ponies were taken at 2 different time points, sent blinded to a commercial laboratory for screening of common food allergens and the results were evaluated for consistency (Phase I). Ponies that were positive for food allergens were consecutively challenged orally with each allergen separately for 14 days (Phase II). A washout period of one week was applied in ponies with multiple positive results. Clinical parameters and serum amyloid A were monitored during the provocation trial. Only 7/17 ponies were negative on the IgE-based test at the 2 time points, 3 had positive results twice but only one tested positive twice for the same food allergen. No abnormalities were noted during the provocation trials. This study demonstrated that this IgE-based test is not a reliable screening tool for food allergy in healthy equids. © 2015 EVJ Ltd.

  3. Overview of the pharmacological spasm provocation test: Comparisons between acetylcholine and ergonovine.

    PubMed

    Sueda, Shozo; Kohno, Hiroaki; Ochi, Takaaki; Uraoka, Tadao; Tsunemitsu, Kensuke

    2017-01-01

    The spasm provocation tests of ergonovine and acetylcholine have been employed in the cardiac catheterization laboratory. Ergonovine acts through the serotogenic receptors, while acetylcholine acts through the muscarinic cholinergic receptors. Different mediators may have the potential to cause different coronary responses. However, there are few reports concerning the coronary response between ergonovine and acetylcholine in the same patients. Acetylcholine is supersensitive for females; spasm provoked by ergonovine is focal and proximal, whereas provoked spasm by acetylcholine is diffuse and distal. We should use both tests as supplementary in the clinic because ergonovine and acetylcholine have self-limitations to induce coronary spasms during daily life. The maximal pharmacological doses, administration methods, and the angiographical positive definition are remarkably different for each institution in the world. We recommend the pharmacological spasm provocation tests as Class I in the guidelines in patients with vasospastic angina throughout the world. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  4. Inhaled Mannitol as a Laryngeal and Bronchial Provocation Test.

    PubMed

    Tay, Tunn Ren; Hoy, Ryan; Richards, Amanda L; Paddle, Paul; Hew, Mark

    2017-03-01

    Timely diagnosis of vocal cord dysfunction (VCD), more recently termed "inducible laryngeal obstruction," is important because VCD is often misdiagnosed as asthma, resulting in delayed diagnosis and inappropriate treatment. Visualization of paradoxical vocal cord movement on laryngoscopy is the gold standard for diagnosis, but is limited by poor test sensitivity. Provocation tests may improve the diagnosis of VCD, but the diagnostic performance of current tests is less than ideal. Alternative provocation tests are required. This pilot study demonstrates the feasibility of using inhaled mannitol for concurrent investigation of laryngeal and bronchial hyperresponsiveness. Consecutive patients with suspected VCD seen at our institution's asthma clinic underwent flexible laryngoscopy at baseline and following mannitol challenge. VCD was diagnosed on laryngoscopy based on inspiratory adduction, or >50% expiratory adduction of the vocal cords. Bronchial hyperresponsiveness after mannitol challenge was also assessed. We evaluated the interrater agreement of postmannitol laryngoscopy between respiratory specialists and laryngologists. Fourteen patients with suspected VCD in the context of asthma evaluation were included in the study. Mannitol provocation demonstrated VCD in three of the seven patients with normal baseline laryngoscopy (42.9%). Only two patients had bronchial hyperresponsiveness. There was substantial interrater agreement between respiratory specialists and laryngologists, kappa = 0.696 (95% confidence interval: 0.324-1) (P = 0.006). Inhaled mannitol can be used to induce VCD. It is well tolerated and can evaluate laryngeal and bronchial hyperresponsiveness at the same setting. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  5. [Safety and efficacy of a new preservative-free levocabastine ophthalmic solution (Levofree®) using the conjunctival provocation test].

    PubMed

    Allaire, C; Siou-Mermet, R; Bassols, A

    2012-09-01

    To evaluate the safety and efficacy of preservative-free levocabastine 0.05 % ophthalmic solution compared to placebo (vehicle) and to preserved levocabastine 0.05 % ophthalmic suspension in the prevention of allergic conjunctivitis induced by a conjunctival provocation test. Ninety-two subjects (18-50 years) with a previous history of allergic conjunctivitis to pollen were randomised to receive either preservative-free levocabastine solution in one eye and preserved levocabastine suspension in the fellow eye (n=69), or preservative-free levocabastine in one eye and placebo in the fellow eye (n=23). One drop of each product was administered 10 minutes (visit 3) and 4 hours (visit 4) prior to the provocation test. The primary efficacy criterion was the sum of the itching and conjunctival hyperemia scores assessed at 3, 5 and 10 minutes after the provocation test. The safety evaluation included adverse events, visual acuity, intra-ocular pressure and study drug drop sensation. The efficacy of the preservative-free solution was significantly higher than that of placebo at all time points (P≤0.01) with one exception at visit 4 (3 minutes after the provocation test). It was significantly higher than that of the preserved suspension at visit 3, and equivalent at visit 4. The incidence of adverse events was lower with the preservative-free solution than with the preserved suspension. 94.2 % and 95.7 % subjects rated preservative-free levocabastine drop sensation as "good" or "very good" at visits 3 and 4 respectively, whereas these rates were 68.1 % and 63.8 % with preserved levocabastine. This difference between the two formulations was highly statistically significant (P<0.001). The efficacy of preservative-free levocabastine was superior to that of the placebo and of the preserved suspension at visit 3, at least as effective as the preserved suspension at visit 4, and better tolerated at each visit. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  6. A practical guide and perspectives on the use of experimental pain modalities with children and adolescents

    PubMed Central

    Birnie, Kathryn A; Caes, Line; Wilson, Anna C; Williams, Sara E; Chambers, Christine T

    2014-01-01

    SUMMARY Use of experimental pain is vital for addressing research questions that would otherwise be impossible to examine in the real world. Experimental induction of pain in children is highly scrutinized given the potential for harm and lack of direct benefit to a vulnerable population. However, its use has critically advanced our understanding of the mechanisms, assessment and treatment of pain in both healthy and chronically ill children. This article introduces various experimental pain modalities, including the cold pressor task, the water load symptom provocation test, thermal pain, pressure pain and conditioned pain modulation, and discusses their application for use with children and adolescents. It addresses practical implementation and ethical issues, as well as the advantages and disadvantages offered by each task. The incredible potential for future research is discussed given the array of experimental pain modalities now available to pediatric researchers. PMID:24641434

  7. The pleasure of revenge: retaliatory aggression arises from a neural imbalance toward reward

    PubMed Central

    DeWall, C. Nathan

    2016-01-01

    Most of daily life hums along peacefully but provocations tip the balance toward aggression. Negative feelings are often invoked to explain why people lash out after an insult. Yet people might retaliate because provocation makes aggression hedonically rewarding. To test this alternative hypothesis, 69 participants underwent functional neuroimaging while they completed a behavioral aggression task that repeatedly manipulated whether aggression was preceded by an instance of provocation or not. After provocation, greater activity in the nucleus accumbens (NAcc) (a brain region reliably associated with reward) during aggressive decisions predicted louder noise blasts administered in retaliation. Greater NAcc activation was also associated with participants’ history of real-world violence. Functional connectivity between the NAcc and a regulatory region in the lateral prefrontal cortex related to lower retaliatory aggression. These findings suggest that provocation tips the neural balance towards hedonic reward, which fosters retaliatory aggression. Although such pleasure of inflicting pain may promote retaliatory aggression, self-regulatory processes can keep such aggressive urges at bay. Implications for theory and violence reduction are discussed. PMID:26117504

  8. Diagnostic Accuracy of the Neck Tornado Test as a New Screening Test in Cervical Radiculopathy

    PubMed Central

    Park, Juyeon; Park, Woo Young; Hong, Seungbae; An, Jiwon; Koh, Jae Chul; Lee, Youn-Woo; Kim, Yong Chan; Choi, Jong Bum

    2017-01-01

    Background: The Spurling test, although a highly specific provocative test of the cervical spine in cervical radiculopathy (CR), has low to moderate sensitivity. Thus, we introduced the neck tornado test (NTT) to examine the neck and the cervical spine in CR. Objectives: The aim of this study was to introduce a new provocative test, the NTT, and compare the diagnostic accuracy with a widely accepted provocative test, the Spurling test. Design: Retrospective study. Methods: Medical records of 135 subjects with neck pain (CR, n = 67; without CR, n = 68) who had undergone cervical spine magnetic resonance imaging and been referred to the pain clinic between September 2014 and August 2015 were reviewed. Both the Spurling test and NTT were performed in all patients by expert examiners. Sensitivity, specificity, and accuracy were compared for both the Spurling test and the NTT. Results: The sensitivity of the Spurling test and the NTT was 55.22% and 85.07% (P < 0.0001); specificity, 98.53% and 86.76% (P = 0.0026); accuracy, 77.04% and 85.93% (P = 0.0423), respectively. Conclusions: The NTT is more sensitive with superior diagnostic accuracy for CR diagnosed by magnetic resonance imaging than the Spurling test. PMID:28824298

  9. Comorbid Latent Adrenal Insufficiency with Autoimmune Thyroid Disease.

    PubMed

    Yamamoto, Toshihide

    2015-09-01

    Autoimmune thyroid disease (ATD) has been occasionally observed in patients with primary adrenal insufficiency (PAI). In contrast, less than 20 cases of comorbid PAI with ATD have been found in the English literature. One conceivable reason is difficulty in detecting latent PAI. Information of clinical presentation and diagnostics is sought to facilitate diagnosis of latent PAI. Latent PAI was pursued in 11 patients among 159 ATD patients. All of them were maintained in a euthyroid state. Except for one patient with nonrheumatic musculoskeletal symptoms, the other patients, who were asymptomatic in their daily lives, presented with recurrent nonspecific gastrointestinal symptoms or fatigue in stress-associated circumstances. Morning cortisol level <303 nmol/l was used as an inclusion criterion. Their basal adrenocorticotropic hormone levels were normal. The adrenal status was examined by a provocation test, either an insulin-induced hypoglycemia test or a 1-μg intravenous corticotrophin test. Eleven patients showed subnormal cortisol response. They were supplemented with hydrocortisone of doses ≤15 mg/day. After a few months of supplementation, PAI was confirmed by another provocation test. Three patients were excluded because of dissociation of two provocation tests. Comorbid latent PAI with ATD was pursued from the symptoms stated above and proven by two provocation tests; it was found in 5% (8/159) of the patients. When patients with ATD are troubled by recurrent stress-associated gastrointestinal or constitutional symptoms or nonrheumatic musculoskeletal symptoms which have remained unrelieved by adjustment of thyroid medication, these symptoms may be a manifestation of comorbid latent PAI. It is worth investigating such patients for latent PAI.

  10. Test-retest Reliability in Reporting the Pain Induced by a Pain Provocation Test: Further Validation of a Novel Approach for Pain Drawing Acquisition and Analysis.

    PubMed

    Leoni, Diego; Falla, Deborah; Heitz, Carolin; Capra, Gianpiero; Clijsen, Ron; Egloff, Michele; Cescon, Corrado; Baeyens, Jean-Pierre; Barbero, Marco

    2017-02-01

    Pain drawings (PD) are frequently used in research to illustrate the pain response to pain provocation tests. However, there is a lack of data on the reliability in defining the extent and location of pain. We investigated the test-retest reliability in reporting an acute painful sensation induced by a pain provocation test using a novel approach for PD acquisition and analysis in healthy volunteers. Forty healthy volunteers participated. Each participant underwent 2 upper limb neurodynamic tests 1 (ULNT1), once to the point of pain onset (PO) and once until the point of submaximal pain (SP). After each ULNT1, participants completed 2 consecutive PD with an interval of 1 minute. Custom software was used to quantify the pain extent and analyze the pain overlap. The test-retest reliability of pain extent was examined using Intraclass Correlation Coefficient (ICC 2,1 ) and Bland-Altman plots. Pain location reliability was examined using the Jaccard similarity coefficient (JSC). The ICC values for PO and SP were 0.98 (95% CI: 0.96-0.99) and 0.97 (95% CI: 0.95-0.98), respectively. The mean difference and 95% limits of agreement (± 1.96 SD) in the Bland-Altman plots were 14 pixels (-1080;1110) for PO, and 145 (-1610;1900) for SP. The median JSCs (Q1;Q3) were 0.73 (0.64;0.80) for PO and 0.76 (0.65;0.79) for SP. Pain drawings is a reliable instrument to investigate pain extent and pain location in healthy individuals experiencing an acute painful sensation induced by a pain provocation test. © 2016 World Institute of Pain.

  11. A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy

    PubMed Central

    Pool, Jan J. M.; van Tulder, Maurits W.; Riphagen, Ingrid I.; de Vet, Henrica C. W.

    2006-01-01

    Clinical provocative tests of the neck, which position the neck and arm inorder to aggravate or relieve arm symptoms, are commonly used in clinical practice in patients with a suspected cervical radiculopathy. Their diagnostic accuracy, however, has never been examined in a systematic review. A comprehensive search was conducted in order to identify all possible studies fulfilling the inclusion criteria. A study was included if: (1) any provocative test of the neck for diagnosing cervical radiculopathy was identified; (2) any reference standard was used; (3) sensitivity and specificity were reported or could be (re-)calculated; and, (4) the publication was a full report. Two reviewers independently selected studies, and assessed methodological quality. Only six studies met the inclusion criteria, which evaluated five provocative tests. In general, Spurling’s test demonstrated low to moderate sensitivity and high specificity, as did traction/neck distraction, and Valsalva’s maneuver. The upper limb tension test (ULTT) demonstrated high sensitivity and low specificity, while the shoulder abduction test demonstrated low to moderate sensitivity and moderate to high specificity. Common methodological flaws included lack of an optimal reference standard, disease progression bias, spectrum bias, and review bias. Limitations include few primary studies, substantial heterogeneity, and numerous methodological flaws among the studies; therefore, a meta-analysis was not conducted. This review suggests that, when consistent with the history and other physical findings, a positive Spurling’s, traction/neck distraction, and Valsalva’s might be indicative of a cervical radiculopathy, while a negative ULTT might be used to rule it out. However, the lack of evidence precludes any firm conclusions regarding their diagnostic value, especially when used in primary care. More high quality studies are necessary in order to resolve this issue. PMID:17013656

  12. Elevated anticardiolipin antibodies in a patient with vibration-white-finger, valvular heart disease and psoriatic arthritis.

    PubMed

    McHugh, N J; Elvins, D M; Ring, E F

    1993-03-01

    We describe a case of irreversible severe vibration-white-finger (VWF) occurring in a male who used a compression-hammer daily at work for a 20-year period. Infra-red thermography following either a cold provocation or a vibratory stress was a sensitive objective method of documenting the condition. Persistent elevation of IgG anticardiolipin antibodies (aCL) was found in his serum and may be a marker of endothelial damage associated with either VWF or the patient's coincidental valvular heart disease.

  13. Retrieval and sleep both counteract the forgetting of spatial information.

    PubMed

    Antony, James W; Paller, Ken A

    2018-06-01

    Repeatedly studying information is a good way to strengthen memory storage. Nevertheless, testing recall often produces superior long-term retention. Demonstrations of this testing effect, typically with verbal stimuli, have shown that repeated retrieval through testing reduces forgetting. Sleep also benefits memory storage, perhaps through repeated retrieval as well. That is, memories may generally be subject to forgetting that can be counteracted when memories become reactivated, and there are several types of reactivation: (i) via intentional restudying, (ii) via testing, (iii) without provocation during wake, or (iv) during sleep. We thus measured forgetting for spatial material subjected to repeated study or repeated testing followed by retention intervals with sleep versus wake. Four groups of subjects learned a set of visual object-location associations and either restudied the associations or recalled locations given the objects as cues. We found the advantage for restudied over retested information was greater in the PM than AM group. Additional groups tested at 5-min and 1-wk retention intervals confirmed previous findings of greater relative benefits for restudying in the short-term and for retesting in the long-term. Results overall support the conclusion that repeated reactivation through testing or sleeping stabilizes information against forgetting. © 2018 Antony and Paller; Published by Cold Spring Harbor Laboratory Press.

  14. Examination of patients for carpal tunnel syndrome sensibility, provocative, and motor testing.

    PubMed

    Palumbo, Carl F; Szabo, Robert M

    2002-05-01

    The value of a test for carpal tunnel syndrome (CTS) depends on the purpose of performing the test. When screening a large population with a low prevalence for CTS, a test with a high sensitivity is needed so that no possible case goes undetected. However, in order to establish a diagnosis, a more specific test is required. Using a combination of physical examination techniques, including sensibility and provocative testing, the probability of correctly diagnosing CTS without relying on electrodiagnostic studies can be very high. Because CTS is a clinical syndrome, the diagnosis should be made on clinical grounds. Electrodiagnosis is extremely important, however, in its ability to objectively document median nerve slowing and eliminate other competing differential diagnoses.

  15. A Case of Cardiac Cephalalgia Showing Reversible Coronary Vasospasm on Coronary Angiogram

    PubMed Central

    Yang, YoungSoon; Jin, Dong Gyu; Jang, Il Mi; Jang, YoungHee; Na, Hae Ri; Kim, SanYun

    2010-01-01

    Background Under certain conditions, exertional headaches may reflect coronary ischemia. Case Report A 44-year-old woman developed intermittent exercise-induced headaches with chest tightness over a period of 10 months. Cardiac catheterization followed by acetylcholine provocation demonstrated a right coronary artery spasm with chest tightness, headache, and ischemic effect of continuous electrocardiography changes. The patient's headache disappeared following intra-arterial nitroglycerine injection. Conclusions A coronary angiogram with provocation study revealed variant angina and cardiac cephalalgia, as per the International Classification of Headache Disorders (code 10.6). We report herein a patient with cardiac cephalalgia that manifested as reversible coronary vasospasm following an acetylcholine provocation test. PMID:20607049

  16. Correcting for possible tissue distortion between provocation and assessment in skin testing: the divergent beam UVB photo-test.

    PubMed

    O'Doherty, Jim; Henricson, Joakim; Falk, Magnus; Anderson, Chris D

    2013-11-01

    In tissue viability imaging (TiVi), an assessment method for skin erythema, correct orientation of skin position from provocation to assessment optimizes data interpretation. Image processing algorithms could compensate for the effects of skin translation, torsion and rotation realigning assessment images to the position of the skin at provocation. A reference image of a divergent, UVB phototest was acquired, as well as test images at varying levels of translation, rotation and torsion. Using 12 skin markers, an algorithm was applied to restore the distorted test images to the reference image. The algorithm corrected torsion and rotation up to approximately 35 degrees. The radius of the erythemal reaction and average value of the input image closely matched that of the reference image's 'true value'. The image 'de-warping' procedure improves the robustness of the response image evaluation in a clinical research setting and opens the possibility of the correction of possibly flawed images performed away from the laboratory setting by the subject/patient themselves. This opportunity may increase the use of photo-testing and, by extension, other late response skin testing where the necessity of a return assessment visit is a disincentive to performance of the test. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Vitamin C and common cold-induced asthma: a systematic review and statistical analysis.

    PubMed

    Hemilä, Harri

    2013-11-26

    Asthma exacerbations are often induced by the common cold, which, in turn, can be alleviated by vitamin C. To investigate whether vitamin C administration influences common cold-induced asthma. Systematic review and statistical analysis of the identified trials. Medline, Scopus and Cochrane Central were searched for studies that give information on the effects of vitamin C on common cold-induced asthma. All clinically relevant outcomes related to asthma were included in this review. The estimates of vitamin C effect and their confidence intervals [CI] were calculated for the included studies. Three studies that were relevant for examining the role of vitamin C on common cold-induced asthma were identified. The three studies had a total of 79 participants. Two studies were randomized double-blind placebo-controlled trials. A study in Nigeria on asthmatics whose asthma attacks were precipitated by respiratory infections found that 1 g/day vitamin C decreased the occurrence of asthma attacks by 78% (95% CI: 19% to 94%). A cross-over study in former East-Germany on patients who had infection-related asthma found that 5 g/day vitamin C decreased the proportion of participants who had bronchial hypersensitivity to histamine by 52 percentage points (95% CI: 25 to 71). The third study did not use a placebo. Administration of a single dose of 1 gram of vitamin C to Italian non-asthmatic common cold patients increased the provocative concentration of histamine (PC20) 3.2-fold (95% CI: 2.0 to 5.1), but the vitamin C effect was significantly less when the same participants did not suffer from the common cold. The three reviewed studies differed substantially in their methods, settings and outcomes. Each of them found benefits from the administration of vitamin C; either against asthma attacks or against bronchial hypersensitivity, the latter of which is a characteristic of asthma. Given the evidence suggesting that vitamin C alleviates common cold symptoms and the findings of this systematic review, it may be reasonable for asthmatic patients to test vitamin C on an individual basis, if they have exacerbations of asthma caused by respiratory infections. More research on the role of vitamin C on common cold-induced asthma is needed.

  18. Vitamin C and common cold-induced asthma: a systematic review and statistical analysis

    PubMed Central

    2013-01-01

    Background Asthma exacerbations are often induced by the common cold, which, in turn, can be alleviated by vitamin C. Objective To investigate whether vitamin C administration influences common cold-induced asthma. Methods Systematic review and statistical analysis of the identified trials. Medline, Scopus and Cochrane Central were searched for studies that give information on the effects of vitamin C on common cold-induced asthma. All clinically relevant outcomes related to asthma were included in this review. The estimates of vitamin C effect and their confidence intervals [CI] were calculated for the included studies. Results Three studies that were relevant for examining the role of vitamin C on common cold-induced asthma were identified. The three studies had a total of 79 participants. Two studies were randomized double-blind placebo-controlled trials. A study in Nigeria on asthmatics whose asthma attacks were precipitated by respiratory infections found that 1 g/day vitamin C decreased the occurrence of asthma attacks by 78% (95% CI: 19% to 94%). A cross-over study in former East-Germany on patients who had infection-related asthma found that 5 g/day vitamin C decreased the proportion of participants who had bronchial hypersensitivity to histamine by 52 percentage points (95% CI: 25 to 71). The third study did not use a placebo. Administration of a single dose of 1 gram of vitamin C to Italian non-asthmatic common cold patients increased the provocative concentration of histamine (PC20) 3.2-fold (95% CI: 2.0 to 5.1), but the vitamin C effect was significantly less when the same participants did not suffer from the common cold. Conclusions The three reviewed studies differed substantially in their methods, settings and outcomes. Each of them found benefits from the administration of vitamin C; either against asthma attacks or against bronchial hypersensitivity, the latter of which is a characteristic of asthma. Given the evidence suggesting that vitamin C alleviates common cold symptoms and the findings of this systematic review, it may be reasonable for asthmatic patients to test vitamin C on an individual basis, if they have exacerbations of asthma caused by respiratory infections. More research on the role of vitamin C on common cold-induced asthma is needed. PMID:24279478

  19. Approach to the pediatric athlete with back pain: more than just the pars.

    PubMed

    Dizdarevic, Ismar; Bishop, Meghan; Sgromolo, Nicole; Hammoud, Sommer; Atanda, Alfred

    2015-11-01

    Back pain in a pediatric patient can present a worrisome and challenging diagnostic dilemma for any physician. Although most back pain can be attributed to muscle strains and poor mechanics, it is necessary to appreciate the full differential of etiologies causing back pain in the pediatric population. The physician must recognize areas of mechanical weakness in the skeletally immature spine and the sport specific forces that can predispose a patient to injury. A comprehensive history involves determining the onset, chronicity, and location of the pain. A focused physical exam includes a neurological exam as well as provocative testing. The combination of a thorough history and focused physical exam should guide appropriate imaging. Radiographic tests are instrumental in narrowing the differential, making a diagnosis, and uncovering associated pathology. Treatment modalities such as activity modification, heat/cold compresses, and NSAIDs can provide pain relief and allow for effective physical therapy. In most cases nonoperative methods are successful in providing a safe and quick return to activities. Failure of conservative measures requires referral to an orthopedic surgeon, as surgical intervention may be warranted.

  20. Assessment of coarse and fine hand motor performance in asymptomatic subjects exposed to hand-arm vibration.

    PubMed

    Popević, Martin B; Janković, Srđan M; Borjanović, Srđan S; Jovičić, Slavica R; Tenjović, Lazar R; Milovanović, Aleksandar P S; Bulat, Petar

    2014-03-01

    A frequently encountered exposure profile for hand-arm vibration in contemporary occupational setting comprises workers with a long history of intermittent exposure but without detectable signs of hand-arm vibration syndrome (HAVS). Yet, most of the published studies deal with developed HAVS cases, rarely discussing the biological processes that may be involved in degradation of manual dexterity and grip strength when it can be most beneficial - during the asymptomatic stage. In the present paper, a group of 31 male asymptomatic vibration-exposed workers (according to the Stockholm Workshop Scale) were compared against 30 male controls. They were tested using dynamometry and dexterimetry (modelling coarse and fine manual performance respectively) and cold provocation was done to detect possible differences in manual performance drop on these tests. The results showed reduced manual dexterity but no significant degradation in hand grip strength in the exposed subjects. This suggests that intermittent exposure profile and small cumulative vibration dose could only lead to a measurable deficit in manual dexterity but not hand grip strength even at non-negligible A(8) levels and long term exposures.

  1. Impulsivity and suicidality: the mediating role of painful and provocative experiences.

    PubMed

    Bender, Theodore W; Gordon, Kathryn H; Bresin, Konrad; Joiner, Thomas E

    2011-03-01

    Multiple studies have reported a link between high levels of impulsivity and suicidal behavior. Joiner's (2005) explanation for this link is that impulsive individuals have a greater tendency to experience painful and provocative events that habituate them to fear and pain, which leads to an acquired capability for engaging in suicidal behavior. Study 1 tested Joiner's (2005) hypothesis in a sample of 182 undergraduate students who completed self-report questionnaires on impulsivity, frequency of painful and provocative events, and acquired capability for suicide. In addition to self-report, pain tolerance (an aspect of acquired capability for suicide) was measured with a pressure algometer. Study 2 sought to replicate our findings from Study 1 in a sample of 516 clinical outpatients using a multi-faceted measure of impulsivity. Consistent with prediction, product of coefficients tests for mediation (MacKinnon et al., 2002) revealed that impulsivity has an indirect relationship with acquired capability for suicidal behavior, and that this relationship is mediated by painful and provocative events. Data from our studies are cross-sectional in nature, which does not allow for conclusions about the temporal ordering of our variables. In addition, self-report was used to measure most variables. Future research may benefit from a longitudinal design and the inclusion of other modes of assessment (e.g., behavioral measures of impulsivity). Our findings suggest that the link between impulsivity and suicidal behavior occurs because impulsive people tend to have a greater capability for suicidal behavior, which they have acquired through experiencing painful and provocative events. Copyright © 2010 Elsevier B.V. All rights reserved.

  2. Testosterone reactivity to provocation mediates the effect of early intervention on aggressive behavior.

    PubMed

    Carré, Justin M; Iselin, Anne-Marie R; Welker, Keith M; Hariri, Ahmad R; Dodge, Kenneth A

    2014-05-01

    We tested the hypotheses that the Fast Track intervention program for high-risk children would reduce adult aggressive behavior and that this effect would be mediated by decreased testosterone responses to social provocation. Participants were a subsample of males from the full trial sample, who during kindergarten had been randomly assigned to the 10-year Fast Track intervention or to a control group. The Fast Track program attempted to develop children's social competencies through child social-cognitive and emotional-coping skills training, peer-relations coaching, academic tutoring, and classroom management, as well as training for parents to manage their child's behavior. At a mean age of 26 years, participants responded to laboratory provocations. Results indicated that, relative to control participants, men assigned to the intervention demonstrated reduced aggression and testosterone reactivity to social provocations. Moreover, reduced testosterone reactivity mediated the effect of intervention on aggressive behavior, which provides evidence for an enduring biological mechanism underlying the effect of early psychosocial intervention on aggressive behavior in adulthood.

  3. Aminopenicillin-associated exanthem: lymphocyte transformation testing revisited.

    PubMed

    Trautmann, A; Seitz, C S; Stoevesandt, J; Kerstan, A

    2014-12-01

    The lymphocyte transformation test (LTT) has been promoted as in-vitro test for diagnosis of drug hypersensitivity. For determination of statistical LTT sensitivity, series of patients with clinically uniform reactions followed by complete drug hypersensitivity work-up are mandatory. Assessment of LTT specificity requires control patients who tolerated exposure to the drug studied. To prospectively determine the diagnostic value of the LTT in a clinically and diagnostically well-defined series of patients. Patients with exanthematous skin eruptions after ampicillin (AMP) intake were included in this study. After exclusion or confirmation of delayed-onset allergic AMP hypersensitivity by skin and provocation testing, two independent LTTs were performed: one standard LTT and a modified LTT with additional anti-CD3/anti-CD28 monoclonal antibody stimulation. By testing, delayed-onset allergic AMP hypersensitivity was diagnosed in 11 patients and definitely ruled out in 26. The standard LTT reached a diagnostic sensitivity of 54.5% while the modified LTT yielded 72.7%. However, the methodical test modification resulted in a decline of specificity from 92.3% (standard LTT) to 76.9%. In cases of AMP-associated exanthems, the diagnostic value of the LTT compared with routine allergy testing is limited. When evaluating such exanthems, provocation testing remains the gold standard. Delayed reading of intradermal skin tests remains most useful to avoid positive provocation reactions. © 2014 John Wiley & Sons Ltd.

  4. Does short-term exposure to mobile phone base station signals increase symptoms in individuals who report sensitivity to electromagnetic fields? A double-blind randomized provocation study.

    PubMed

    Eltiti, Stacy; Wallace, Denise; Ridgewell, Anna; Zougkou, Konstantina; Russo, Riccardo; Sepulveda, Francisco; Mirshekar-Syahkal, Dariush; Rasor, Paul; Deeble, Roger; Fox, Elaine

    2007-11-01

    Individuals with idiopathic environmental illness with attribution to electromagnetic fields (IEI-EMF) believe they suffer negative health effects when exposed to electromagnetic fields from everyday objects such as mobile phone base stations. This study used both open provocation and double-blind tests to determine if sensitive and control individuals experience more negative health effects when exposed to base station-like signals compared with sham. Fifty-six self-reported sensitive and 120 control participants were tested in an open provocation test. Of these, 12 sensitive and 6 controls withdrew after the first session. The remainder completed a series of double-blind tests. Subjective measures of well-being and symptoms as well as physiological measures of blood volume pulse, heart rate, and skin conductance were obtained. During the open provocation, sensitive individuals reported lower levels of well-being in both the global system for mobile communication (GSM) and universal mobile telecommunications system (UMTS) compared with sham exposure, whereas controls reported more symptoms during the UMTS exposure. During double-blind tests the GSM signal did not have any effect on either group. Sensitive participants did report elevated levels of arousal during the UMTS condition, whereas the number or severity of symptoms experienced did not increase. Physiological measures did not differ across the three exposure conditions for either group. Short-term exposure to a typical GSM base station-like signal did not affect well-being or physiological functions in sensitive or control individuals. Sensitive individuals reported elevated levels of arousal when exposed to a UMTS signal. Further analysis, however, indicated that this difference was likely to be due to the effect of order of exposure rather than the exposure itself.

  5. Abnormal hip physical examination findings in asymptomatic female soccer athletes

    PubMed Central

    Hunt, Devyani; Rho, Monica; Yemm, Ted; Fong, Kathryn; Brophy, Robert H.

    2016-01-01

    Purpose Examination of the hip provides information regarding risk for pre-arthritic hip disorders, knee injuries, and low back pain. The purpose of this study was to report a hip screening examination of asymptomatic female soccer athletes and to test the hypothesis that these findings vary by competition experience. Methods Asymptomatic females from a youth soccer club, a college, and a professional team were evaluated. Passive hip range of motion, hip abduction strength, and hip provocative tests were assessed. Data were compared for the grade/middle school, high school, college, and professional athletes. Results One hundred and seventy-two athletes with a mean age of 16.7 ± 5 years (range 10–30) participated. Professional athletes had less flexion (HF) for both hips (p < 0.0001) and less internal rotation (IR) for the preferred kicking leg (p < 0.05) compared to all other groups. Grade/middle school athletes had more external rotation in both hips as compared to all other groups (p < 0.0001). For the preferred kicking leg, collegiate athletes had less hip abduction strength as compared to other groups (p < 0.01). Positive provocative hip tests were found in 22 % of all players and 36 % of the professionals. In professionals, a positive provocative test was associated with ipsilateral decreased HF (p = 0.04). Conclusion Asymptomatic elite female soccer athletes with the most competition experience had less bilateral hip flexion and preferred kicking leg IR than less-experienced athletes. Positive provocative hip tests were found in 22 % of athletes. Future studies are needed to show whether these findings link to risk for intra-articular hip or lumbar spine and knee disorders. Level of evidence III. PMID:24150125

  6. Does Short-Term Exposure to Mobile Phone Base Station Signals Increase Symptoms in Individuals Who Report Sensitivity to Electromagnetic Fields? A Double-Blind Randomized Provocation Study

    PubMed Central

    Eltiti, Stacy; Wallace, Denise; Ridgewell, Anna; Zougkou, Konstantina; Russo, Riccardo; Sepulveda, Francisco; Mirshekar-Syahkal, Dariush; Rasor, Paul; Deeble, Roger; Fox, Elaine

    2007-01-01

    Background Individuals with idiopathic environmental illness with attribution to electromagnetic fields (IEI-EMF) believe they suffer negative health effects when exposed to electromagnetic fields from everyday objects such as mobile phone base stations. Objectives This study used both open provocation and double-blind tests to determine if sensitive and control individuals experience more negative health effects when exposed to base station-like signals compared with sham. Methods Fifty-six self-reported sensitive and 120 control participants were tested in an open provocation test. Of these, 12 sensitive and 6 controls withdrew after the first session. The remainder completed a series of double-blind tests. Subjective measures of well-being and symptoms as well as physiological measures of blood volume pulse, heart rate, and skin conductance were obtained. Results During the open provocation, sensitive individuals reported lower levels of well-being in both the global system for mobile communication (GSM) and universal mobile telecommunications system (UMTS) compared with sham exposure, whereas controls reported more symptoms during the UMTS exposure. During double-blind tests the GSM signal did not have any effect on either group. Sensitive participants did report elevated levels of arousal during the UMTS condition, whereas the number or severity of symptoms experienced did not increase. Physiological measures did not differ across the three exposure conditions for either group. Conclusions Short-term exposure to a typical GSM base station-like signal did not affect well-being or physiological functions in sensitive or control individuals. Sensitive individuals reported elevated levels of arousal when exposed to a UMTS signal. Further analysis, however, indicated that this difference was likely to be due to the effect of order of exposure rather than the exposure itself. PMID:18007992

  7. Evaluation of colonoscopic allergen provocation as a diagnostic tool in dogs with proven food hypersensitivity reactions.

    PubMed

    Allenspach, K; Vaden, S L; Harris, T S; Gröne, A; Doherr, M G; Griot-Wenk, M E; Bischoff, S C; Gaschen, F

    2006-01-01

    To evaluate the colonoscopic allergen provocation (COLAP) test as a new tool for the diagnosis of IgE-mediated food allergy. Oral food challenges as well as COLAP testing were performed in a colony of nine research dogs with proven immediate-type food allergic reactions. In addition, COLAP was performed in five healthy dogs. When compared with the oral challenge test, COLAP accurately determined 18 of 23 (73 per cent) positive oral challenge reactions (73 per cent) in dogs with food allergies and was negative in the healthy dogs. The accuracy of this new test may be higher than that for gastric sensitivity testing. Therefore, COLAP holds promise as a new test to confirm the diagnosis of suspect IgE-mediated food allergy in dogs.

  8. Oxytocin strengthens the link between provocation and aggression among low anxiety people.

    PubMed

    Pfundmair, Michaela; Reinelt, Annika; DeWall, C Nathan; Feldmann, Lisa

    2018-07-01

    Oxytocin (OT) not only modulates positive social interactions but also affects negative ones. Several studies have established a link between OT and aggression. However, they also resulted in an inconsistent picture and showed methodological issues. The current studies aimed to address these lacks and test the hypothesis that OT increases provocation-induced aggression in people low in anxiety. Therefore, two studies with 56 males (Study 1) as well as 40 females and 24 males (Study 2) were conducted. After responding to a trait anxiety questionnaire, participants self-administered OT or a placebo. Thereafter, provocation was manipulated by rejecting vs. accepting (Study 1) or insulting vs. accepting (Study 2) the participants by real human counterparts. Aggressive behavior was quantified by measuring how much hot sauce (Study 1) or unpleasant blasts of white noise (Study 2) participants delivered to their opponents, using two classic aggression paradigms. Both studies provided evidence that OT promotes aggression in response to provocation in low anxiety people which was not the case with no provocation or in high anxiety people. These findings confirm the idea that OT can be involved in the creation of aggressive behavior when accounting for situational and dispositional features. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Localized periorbital edema as a clinical manifestation of sulfite sensitivity.

    PubMed

    Park, H S; Nahm, D

    1996-08-01

    Sulfite is commonly used in pharmaceuticals as a preservative. We report a unique clinical presentation of localized periorbital edema on the left eye after administration of sulfite-containing dexamethasone. The patient's sulfite sensitivity was confirmed by sulfite oral provocation test: periorbital edema on the same site developed after ingestion of 200 mg sodium bisulfite. She was non-atopic and did not complain of any respiratory symptoms. Allergy skin prick test with 100 mg/ml sodium bisulfite showed a negative result. She also has aspirin-sensitive urticaria which was confirmed by oral provocation test. In conclusion, sulfite can induce a localized periorbital edema, an uncommon manifestation in sensitive patients. Further investigations are needed to clarify the pathogenetic mechanisms.

  10. Difference Between Dormant Conduction Sites Revealed by Adenosine Triphosphate Provocation and Unipolar Pace-Capture Sites Along the Ablation Line After Pulmonary Vein Isolation.

    PubMed

    Kogawa, Rikitake; Okumura, Yasuo; Watanabe, Ichiro; Sonoda, Kazumasa; Sasaki, Naoko; Takahashi, Keiko; Iso, Kazuki; Nagashima, Koichi; Ohkubo, Kimie; Nakai, Toshiko; Kunimoto, Satoshi; Hirayama, Atsushi

    2016-01-01

    Dormant pulmonary vein (PV) conduction revealed by adenosine/adenosine triphosphate (ATP) provocation test and exit block to the left atrium by pacing from the PV side of the ablation line ("pace and ablate" method) are used to ensure durable pulmonary vein isolation (PVI). However, the mechanistic relation between ATP-provoked PV reconnection and the unexcitable gap along the ablation line is unclear.Forty-five patients with atrial fibrillation (AF) (paroxysmal: 31 patients, persistent: 14 patients; age: 61.1 ± 9.7 years) underwent extensive encircling PVI (EEPVI, 179 PVs). After completion of EEPVI, an ATP provocation test (30 mg, bolus injection) and unipolar pacing (output, 10 mA; pulse width, 2 ms) were performed along the previous EEPVI ablation line to identify excitable gaps. Dormant conduction was revealed in 29 (34 sites) of 179 PVs (16.2%) after EEP-VI (22/45 patients). Pace capture was revealed in 59 (89 sites) of 179 PVs (33.0%) after EEPVI (39/45 patients), and overlapping sites, ie, sites showing both dormant conduction and pace capture, were observed in 22 of 179 (12.3%) PVs (17/45 patients).Some of the ATP-provoked dormant PV reconnection sites were identical to the sites with excitable gaps revealed by pace capture, but most of the PV sites were differently distributed, suggesting that the main underling mechanism differs between these two forms of reconnection. These findings also suggest that performance of the ATP provocation test followed by the "pace and ablate" method can reduce the occurrence of chronic PV reconnections.

  11. Exogenous Testosterone Enhances the Reactivity to Social Provocation in Males

    PubMed Central

    Wagels, Lisa; Votinov, Mikhail; Kellermann, Thilo; Eisert, Albrecht; Beyer, Cordian; Habel, Ute

    2018-01-01

    Testosterone affects human social behavior in various ways. While testosterone effects are generally associated with muscular strength and aggressiveness, human studies also point towards enhanced status–seeking motives after testosterone administration. The current study tested the causal influence of exogenous testosterone on male behavior during a competitive provocation paradigm. In this double blind, randomized, placebo (PL)-controlled study, 103 males were assigned to a PL or testosterone group receiving a colorless PL or testosterone gel. To induce provocation, males played a rigged reaction time game against an ostensible opponent. When participants lost, the opponent subtracted money from the participant who in return could subtract money from the ostensible opponent. Participants subjectively indicated anger and self-estimated treatment affiliation (testosterone or PL administration). A trial-by-trial analysis demonstrated that provocation and success during the repeated games had a stronger influence on participants’ choice to reduce money from the opponent if they had received testosterone. Participants who believed to be in the testosterone group were angrier after the experiment and increased monetary reductions during the task course. In line with theories about mechanisms of testosterone in humans, provocation is shown to be necessary for the agency of exogenous testosterone. Thus, testosterone reinforces the conditional adjustment of aggressive behavior but not aggressive behavior per se. In contrast undirected frustration is not increased by testosterone but probably interferes with cognitive appraisals about biological mechanisms of testosterone. PMID:29551966

  12. Exogenous Testosterone Enhances the Reactivity to Social Provocation in Males.

    PubMed

    Wagels, Lisa; Votinov, Mikhail; Kellermann, Thilo; Eisert, Albrecht; Beyer, Cordian; Habel, Ute

    2018-01-01

    Testosterone affects human social behavior in various ways. While testosterone effects are generally associated with muscular strength and aggressiveness, human studies also point towards enhanced status-seeking motives after testosterone administration. The current study tested the causal influence of exogenous testosterone on male behavior during a competitive provocation paradigm. In this double blind, randomized, placebo (PL)-controlled study, 103 males were assigned to a PL or testosterone group receiving a colorless PL or testosterone gel. To induce provocation, males played a rigged reaction time game against an ostensible opponent. When participants lost, the opponent subtracted money from the participant who in return could subtract money from the ostensible opponent. Participants subjectively indicated anger and self-estimated treatment affiliation (testosterone or PL administration). A trial-by-trial analysis demonstrated that provocation and success during the repeated games had a stronger influence on participants' choice to reduce money from the opponent if they had received testosterone. Participants who believed to be in the testosterone group were angrier after the experiment and increased monetary reductions during the task course. In line with theories about mechanisms of testosterone in humans, provocation is shown to be necessary for the agency of exogenous testosterone. Thus, testosterone reinforces the conditional adjustment of aggressive behavior but not aggressive behavior per se . In contrast undirected frustration is not increased by testosterone but probably interferes with cognitive appraisals about biological mechanisms of testosterone.

  13. Localized periorbital edema as a clinical manifestation of sulfite sensitivity.

    PubMed Central

    Park, H. S.; Nahm, D.

    1996-01-01

    Sulfite is commonly used in pharmaceuticals as a preservative. We report a unique clinical presentation of localized periorbital edema on the left eye after administration of sulfite-containing dexamethasone. The patient's sulfite sensitivity was confirmed by sulfite oral provocation test: periorbital edema on the same site developed after ingestion of 200 mg sodium bisulfite. She was non-atopic and did not complain of any respiratory symptoms. Allergy skin prick test with 100 mg/ml sodium bisulfite showed a negative result. She also has aspirin-sensitive urticaria which was confirmed by oral provocation test. In conclusion, sulfite can induce a localized periorbital edema, an uncommon manifestation in sensitive patients. Further investigations are needed to clarify the pathogenetic mechanisms. PMID:8878807

  14. Assessment of Social Information Processing in early childhood: development and initial validation of the Schultz Test of Emotion Processing-Preliminary Version.

    PubMed

    Schultz, David; Ambike, Archana; Logie, Sean Kevin; Bohner, Katherine E; Stapleton, Laura M; Vanderwalde, Holly; Min, Christopher B; Betkowski, Jennifer A

    2010-07-01

    Crick and Dodge's (Psychological Bulletin 115:74-101, 1994) social information processing model has proven very useful in guiding research focused on aggressive and peer-rejected children's social-cognitive functioning. Its application to early childhood, however, has been much more limited. The present study responds to this gap by developing and validating a video-based assessment tool appropriate for early childhood, the Schultz Test of Emotion Processing-Preliminary Version (STEP-P). One hundred twenty-five Head Start preschool children participated in the study. More socially competent children more frequently attributed sadness to the victims of provocation and labeled aggressive behaviors as both morally unacceptable and less likely to lead to positive outcomes. More socially competent girls labeled others' emotions more accurately. More disruptive children more frequently produced physically aggressive solutions to social provocations, and more disruptive boys less frequently interpreted social provocations as accidental. The STEP-P holds promise as an assessment tool that assesses knowledge structures related to the SIP model in early childhood.

  15. Optical measurements of microvascular circulatory function in the foot for detection of peripheral neuropathy

    NASA Astrophysics Data System (ADS)

    Zamora, G.; Chekh, V.; Burge, M.; Barriga, E. S.; Luan, S.; Heintz, P.; Edwards, A.; McGrew, E.; Soliz, P.

    2012-03-01

    The purpose of this research is to quantify functional signals in the microvascular circulation of the plantar. Our device is based on thermal and spectral technologies that can be easily adopted in clinical and tele-screening settings. Eightytwo thousand amputations are performed annually on diabetics in the US. The cost of foot disorder diagnosis and management are estimated at $10.9 billion dollars annually. Our experiments on normal controls and diabetics assess the temperature recovery time characteristics due to cold provocation to the bottom of the foot (plantar). A difference in the nature of the recovery time between normal controls and diabetics was observed.

  16. Self-reported dietary fructose intolerance in irritable bowel syndrome: Proposed diagnostic criteria.

    PubMed

    Berg, Leif Kyrre; Fagerli, Erik; Myhre, Arnt-Otto; Florholmen, Jon; Goll, Rasmus

    2015-05-14

    To study the criteria for self-reported dietary fructose intolerance (DFI) and to evaluate subjective global assessment (SGA) as outcome measure. Irritable bowel syndrome (IBS) patients were randomized in an open study design with a 2 wk run-in on a habitual IBS diet, followed by 12 wk with/without additional fructose-reduced diet (FRD). Daily registrations of stool frequency and consistency, and symptoms on a visual analog scale (VAS) were performed during the first 4 wk. SGA was used for weekly registrations during the whole study period. Provocation with high-fructose diet was done at the end of the registration period. Fructose breath tests (FBTs) were performed. A total of 182 subjects performed the study according to the protocol (88 FRD, 94 controls). We propose a new clinically feasible diagnostic standard for self-reported fructose intolerance. The instrument is based on VAS registrations of symptom relief on FRD combined with symptom aggravation upon provocation with fructose-rich diet. Using these criteria 43 of 77 patients (56%) in the present cohort of IBS patients had self-reported DFI. To improve the concept for clinical evaluation, we translated the SGA scale instrument to Norwegian and validated it in the context of the IBS diet regimen. The validation procedures showed a sensitivity, specificity and κ value for SGA detecting the self-reported DFI group by FRD response within the IBS patients of 0.79, 0.75 and 0.53, respectively. Addition of the provocation test yielded values of 0.84, 0.76 and 0.61, respectively. The corresponding validation results for FBT were 0.57, 0.34 and -0.13, respectively. FRD improves symptoms in a subgroup of IBS patients. A diet trial followed by a provocation test evaluated by SGA can identify most responders to FRD.

  17. Comparison of capnovolumetry-derived dead space parameters with pulmonary function test in normal adults using histamine provocation.

    PubMed

    Sun, Xiaoli; Zhang, Yan; Yang, Wenlan; Liu, Jinming

    2015-04-01

    This study in healthy adults was conducted to explore the clinical application of capnovolumetric indices as compared to lung function parameters using histamine provocation. Forty healthy subjects received aerosol histamine or salbutamol in an automatic stimulation system with escalating doses of histamine. Dead space volumes of capnovolumetry and lung function parameters were examined with increased concentrations of histamine at a fixed time interval. The doses of histamine were selected from 0.0562 mg-2.2 mg and 0.1 mg salbutamol was inhaled when a maximal dose of histamine was reached. Baseline values in each group were calculated prior to histamine inhalation. Fowler dead space (VDF), Wolff dead space (VDW), threshold dead space (VDT), Bohr dead space (VDB), forced expiratory volume in 1 s (FEV1 ) and peak expiratory flow (PEF) showed a dose-dependent reduction following histamine provocation, but there were no statistical differences in the measurements at baseline and post S6 provocation. The value of dC3/DV at the maximal dose was significantly increased over its baseline value (P < 0.05). VDF, VDT and VDW were significantly increased after bronchodilator use (P < 0.05 or <0.01). The changes in capnovolumetry did not correspond with the results of lung function test. The dC3/DV and airway dead spaces of capnovolumetry in healthy adults are significantly increased compared to lung function parameters before or after bronchodilator use, suggesting that capnovolumetry is feasible in diagnostic evaluation of airway reactivity, especially for persons who are unable to undertake lung function test. © 2014 John Wiley & Sons Ltd.

  18. De-labelling self-reported penicillin allergy within the emergency department through the use of skin tests and oral drug provocation testing.

    PubMed

    Marwood, Joseph; Aguirrebarrena, Gonzalo; Kerr, Stephen; Welch, Susan A; Rimmer, Janet

    2017-10-01

    Self-reported penicillin allergy is common among patients attending the ED, but is a poor predictor of true immunoglobulin E-mediated hypersensitivity to penicillin. We hypothesise that with a combination of skin testing and drug provocation testing, selected patients can be safely de-labelled of their allergy. This prospective study enrolled a sample of patients presenting to an urban academic ED between 2011 and 2016 with a self-reported allergy to penicillin. Standardised skin prick and intradermal testing with amoxicillin and both major and minor determinants of penicillin was performed in the department. If negative, testing was followed by a graded oral challenge of amoxicillin over 9 days. The primary end point was the allergy status of participants at the end of the study. A total of 100 patients (mean age 42; standard deviation 14 years; 54% women) completed the testing. Of these, 81% (95% confidence interval 71.9-88.2) showed no hypersensitivity to penicillin and were labelled non-allergic. The majority (16/19) of allergies were confirmed by skin testing, with three suspected allergies detected by the oral challenge. Women were more likely than men to have a true penicillin allergy, with odds ratio of 4.0 (95% confidence interval 1.23-13.2). There were no serious adverse events. Selected patients in the ED who self-report an allergy to penicillin can be safely tested there for penicillin allergy, using skin tests and oral drug provocation testing. This testing allows a significant de-labelling of penicillin allergy, with the majority of these patients able to tolerate penicillin without incident. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  19. Hand-arm vibration syndrome: clinical characteristics, conventional electrophysiology and quantitative sensory testing.

    PubMed

    Rolke, Roman; Rolke, Silke; Vogt, Thomas; Birklein, Frank; Geber, Christian; Treede, Rolf-Detlef; Letzel, Stephan; Voelter-Mahlknecht, Susanne

    2013-08-01

    Workers exposed to vibrating tools may develop hand-arm vibration syndrome (HAVS). We assessed the somatosensory phenotype using quantitative sensory testing (QST) in comparison to electrophysiology to characterize (1) the most sensitive QST parameter for detecting sensory loss, (2) the correlation of QST and electrophysiology, and (3) the frequency of a carpal tunnel syndrome (CTS) in HAVS. QST, cold provocation tests, fine motor skills, and median nerve neurography were used. QST included thermal and mechanical detection and pain thresholds. Thirty-two patients were examined (54 ± 11 years, 91% men) at the more affected hand compared to 16 matched controls. Vibration detection threshold was the most sensitive parameter to detect sensory loss that was more pronounced in the sensitivity range of Pacinian (150 Hz, x12) than Meissner's corpuscles (20 Hz, x3). QST (84% abnormal) was more sensitive to detect neural dysfunction than conventional electrophysiology (37% abnormal). Motor (34%) and sensory neurography (25%) were abnormal in HAVS. CTS frequency was not increased (9.4%). Findings are consistent with a mechanically-induced, distally pronounced motor and sensory neuropathy independent of CTS. HAVS involves a neuropathy predominantly affecting large fibers with a sensory damage related to resonance frequencies of vibrating tools. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  20. Evidence-Based Diagnosis and Treatment of the Painful Sacroiliac Joint

    PubMed Central

    Laslett, Mark

    2008-01-01

    Sacroiliac joint (SIJ) pain refers to the pain arising from the SIJ joint structures. SIJ dysfunction generally refers to aberrant position or movement of SIJ structures that may or may not result in pain. This paper aims to clarify the difference between these clinical concepts and present current available evidence regarding diagnosis and treatment of SIJ disorders. Tests for SIJ dysfunction generally have poor inter-examiner reliability. A reference standard for SIJ dysfunction is not readily available, so validity of the tests for this disorder is unknown. Tests that stress the SIJ in order to provoke familiar pain have acceptable inter-examiner reliability and have clinically useful validity against an acceptable reference standard. It is unknown if provocation tests can reliably identify extra-articular SIJ sources of pain. Three or more positive pain provocation SIJ tests have sensitivity and specificity of 91% and 78%, respectively. Specificity of three or more positive tests increases to 87% in patients whose symptoms cannot be made to move towards the spinal midline, i.e., centralize. In chronic back pain populations, patients who have three or more positive provocation SIJ tests and whose symptoms cannot be made to centralize have a probability of having SIJ pain of 77%, and in pregnant populations with back pain, a probability of 89%. This combination of test findings could be used in research to evaluate the efficacy of specific treatments for SIJ pain. Treatments most likely to be effective are specific lumbopelvic stabilization training and injections of corticosteroid into the intra-articular space. PMID:19119403

  1. Ondansetron and promethazine have differential effects on hypothermic responses to lithium chloride administration and to provocative motion in rats

    PubMed Central

    Guimaraes, Drielle D; Andrews, Paul L R; Rudd, John A; Braga, Valdir A; Nalivaiko, Eugene

    2015-01-01

    We recently reported that provocative motion (rotation in a home cage) causes hypothermic responses in rats, similar to the hypothermic responses associated with motion sickness in humans. Many stimuli inducing emesis in species with an emetic reflex also provoke hypothermia in the rat, therefore we hypothesized that a fall in body temperature may reflect a “nausea-like” state in these animals. As rats do not possess an emetic reflex, we employed a pharmacological approach to test this hypothesis. In humans, motion- and chemically-induced nausea have differential sensitivity to anti-emetics. We thus tested whether the hypothermia induced in rats by provocative motion (rotation at 0.7 Hz) and by the emetic LiCl (63 mg/kg i.p.) have a similar differential pharmacological sensitivity. Both provocations caused a comparable robust fall in core body temperature (−1.9 ± 0.3°C and −2.0 ± 0.2°C for chemical and motion provocations, respectively). LiCl−induced hypothermia was completely prevented by ondansetron (2mg/kg, i.p., a 5-HT3 receptor antagonist that reduces cancer chemotherapy-induced nausea and vomiting), but was insensitive to promethazine (10 mg/kg, i.p., a predominantly histamine-H1 and muscarinic receptor antagonist that is commonly used to treat motion sickness). Conversely, motion-induced hypothermia was unaffected by ondansetron but promethazine reduced the rate of temperature decline from 0.20 ± 0.02 to 0.11 ± 0.03°C/min (P < 0.05) with a trend to decrease the magnitude. We conclude that this differential pharmacological sensitivity of the hypothermic responses of vestibular vs. chemical etiology in rats mirrors the observations in other pre-clinical models and humans, and thus supports the idea that a “nausea-like” state in rodents is associated with disturbances in thermoregulation. PMID:27227074

  2. Scopolamine provocation-based pharmacological MRI model for testing procognitive agents.

    PubMed

    Hegedűs, Nikolett; Laszy, Judit; Gyertyán, István; Kocsis, Pál; Gajári, Dávid; Dávid, Szabolcs; Deli, Levente; Pozsgay, Zsófia; Tihanyi, Károly

    2015-04-01

    There is a huge unmet need to understand and treat pathological cognitive impairment. The development of disease modifying cognitive enhancers is hindered by the lack of correct pathomechanism and suitable animal models. Most animal models to study cognition and pathology do not fulfil either the predictive validity, face validity or construct validity criteria, and also outcome measures greatly differ from those of human trials. Fortunately, some pharmacological agents such as scopolamine evoke similar effects on cognition and cerebral circulation in rodents and humans and functional MRI enables us to compare cognitive agents directly in different species. In this paper we report the validation of a scopolamine based rodent pharmacological MRI provocation model. The effects of deemed procognitive agents (donepezil, vinpocetine, piracetam, alpha 7 selective cholinergic compounds EVP-6124, PNU-120596) were compared on the blood-oxygen-level dependent responses and also linked to rodent cognitive models. These drugs revealed significant effect on scopolamine induced blood-oxygen-level dependent change except for piracetam. In the water labyrinth test only PNU-120596 did not show a significant effect. This provocational model is suitable for testing procognitive compounds. These functional MR imaging experiments can be paralleled with human studies, which may help reduce the number of false cognitive clinical trials. © The Author(s) 2015.

  3. Outcomes of a pilates-based intervention for individuals with lateral epicondylosis: A pilot study.

    PubMed

    Dale, Lucinda M; Mikuski, Connie; Miller, Jacqueline

    2015-01-01

    Core stability and flexibility, features of Pilates exercise, can reduce loads to the upper extremities. Reducing loads is essential to improve symptoms for individuals with lateral epicondylosis. Although Pilates exercise has gained popularity in healthy populations, it has not been studied for individuals with lateral epicondylosis. The purpose of this study was to determine if adding Pilates-based intervention to standard occupational therapy intervention improved outcomes as measured by the Patient-Rated Tennis Elbow Evaluation (PRTEE) more than standard intervention for individuals with lateral epicondylosis. Participants (N= 17) were randomized to the standard intervention group or Pilates-based intervention group. All participants received standard intervention. The Pilates-based intervention group additionally completed abdominal strengthening, postural correction, and flexibility. For both groups, paired t-tests showed significantly improved PRTEE scores, 38.1 for the Pilates-based intervention group, and 22.9 for the standard intervention group. Paired t-test showed significantly improved provocative grip strength and pain for both groups. Independent t-tests showed no significant difference between groups in improved scores of PRTEE, pain, and provocative grip. Although the Pilates-based intervention group showed greater improvement in PRTEE outcome, provocative grip, and pain, scores were not significantly better than those of the standard intervention group, warranting further research.

  4. Serotonin Augmentation Reduces Response to Attack in Aggressive Individuals

    PubMed Central

    Berman, Mitchell E.; McCloskey, Michael S.; Fanning, Jennifer R.; Schumacher, Julie A.; Coccaro, Emil F.

    2009-01-01

    We tested the theory that central serotonin (5- hydroxytryptamine, or 5-HT) activity regulates aggression by modulating response to provocation. Eighty men and women (40 with and 40 without a history of aggression) were randomly assigned to receive either 40 mg of paroxetine (to acutely augment serotonergic activity) or a placebo, administered using double-blind procedures. Aggression was assessed during a competitive reaction time game with a fictitious opponent. Shocks were selected by the participant and opponent before each trial, with the loser on each trial receiving the shock set by the other player. Provocation was manipulated by having the opponent select increasingly intense shocks for the participant and eventually an ostensibly severe shock toward the end of the trials. Aggression was measured by the number of severe shocks set by the participant for the opponent. As predicted, aggressive responding after provocation was attenuated by augmentation of serotonin in individuals with a pronounced history of aggression. PMID:19422623

  5. The situation specificity of youth responses to peer provocation.

    PubMed

    Dirks, Melanie A; Treat, Teresa A; Weersing, V Robin

    2007-01-01

    Previous studies have identified peer provocation as a challenging class of situations for youth. The work presented here builds on previous methods of assessing peer provocation by (a) increasing the contextual detail of the vignettes; (b) developing a reliable, descriptive coding system of the range of youth responses to physical, verbal, and relational provocation; and (c) assessing the relevance of these situations for a sample (N = 76) of ethnically diverse, economically disadvantaged youth ages 12 to 14. The vignettes were used to examine the situation specificity of youth responses to provocation. Situation and identity of aggressor were both predictors of youth responses. For example, participants "matched" physical aggression to physical provocation. These findings are consistent with previous studies demonstrating the situation specificity of social information processing, even within the relatively homogeneous category of peer provocations.

  6. Natural History of Benign Nonimmediate Allergy to Beta-Lactams in Children: A Prospective Study in Retreated Patients After a Positive and a Negative Provocation Test.

    PubMed

    Tonson la Tour, Aude; Michelet, Marine; Eigenmann, Philippe A; Caubet, Jean-Christoph

    2017-11-23

    The drug provocation test (DPT) is considered as the gold standard to diagnose drug allergy and is particularly important in the diagnosis of nonimmediate beta-lactam (BL) allergy in children. The natural history of BL allergy remains unknown. Our main aim was to evaluate the natural history of nonimmediate BL hypersensitivity and the long-term tolerance acquisition, and our secondary objective was to determine the negative predictive value (NPV) of the DPT following a 2-day protocol. Children developing a benign rash while treated by BL were prospectively recruited at the Emergency Department of the Geneva University Hospital from 2006 to 2011 and challenged with the incriminated BL (initial diagnostic drug provocation test [idDPT]) following a 2-day protocol. In case of a positive idDPT, the patients underwent a follow-up drug provocation test (fuDPT) 3 years later. In case of a negative idDPT, we sent a questionnaire to assess tolerance of a subsequent treatment with the incriminated BL. Among the 18 children with a positive idDPT, 16 children (89%) had a negative fuDPT and 2 children developed a benign exanthema. Among those 16 children, 11 tolerated a subsequent treatment with the incriminated BL without any reaction, suggesting natural antibiotic tolerance acquisition. From another point of view, we found that the NPV of the DPT following a 2-day protocol was excellent at 96.7%. Our data strongly suggest that a fuDPT is safe and useful to assess tolerance acquisition in children with a confirmed benign nonimmediate BL allergy. In addition, our results support the use of a short DPT protocol (2 days), which led to a high NPV of 96.7% in our population, with a favorable benefit-risk balance. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  7. Empathy Inhibits Aggression in Competition: The Role of Provocation, Emotion, and Gender.

    PubMed

    Stanger, Nicholas; Kavussanu, Maria; McIntyre, David; Ring, Christopher

    2016-02-01

    Although the empathy-aggression relationship has been well documented, research has yet to establish whether emotions mediate and gender moderates this relationship in athletes, under conditions of low and high provocation. In this experiment, we assigned team-sport athletes to either a high (n = 40) or a low (n = 40) empathy group, and asked them to compete in a reaction-time task against a (fictitious) opponent, under conditions of low and high provocation. Empathy reduced aggression (i.e., intensity of electrical shock administered to the opponent) at low provocation in men, and at both low and high provocation in women. Guilt mediated the effect of empathy on aggression at low provocation in men; anger did not mediate any effects of empathy on aggression. Our findings indicate that the inhibitory effect of empathy on aggression and the mediating role of guilt are moderated by provocation and gender.

  8. The susceptibility of rhesus monkeys to motion sickness

    NASA Technical Reports Server (NTRS)

    Corcoran, Meryl L.; Daunton, Nancy G.; Fox, Robert A.

    1990-01-01

    The susceptibility of rhesus monkeys to motion sickness was investigated using test conditions that are provocative for eliciting motion sickness in squirrel monkeys. Ten male rhesus monkeys and ten male Bolivian squirrel monkeys were rotated in the vertical axis at 150 deg/s for a maximum duration of 45 min. Each animal was tested in two conditions, continuous rotation and intermittent rotation. None of the rhesus monkeys vomited during the motion tests but all of the squirrel monkeys did. Differences were observed between the species in the amount of activity that occurred during motion test, with the squirrel monkeys being significantly more active than the rhesus monkeys. These results, while substantiating anecdotal reports of the resistance of rhesus monkeys to motion sickness, should be interpreted with caution because of the documented differences that exist between various species with regard to stimuli that are provocative for eliciting motion sickness.

  9. The time course of brief and prolonged topical 8% capsaicin-induced desensitization in healthy volunteers evaluated by quantitative sensory testing and vasomotor imaging.

    PubMed

    Lo Vecchio, Silvia; Andersen, Hjalte Holm; Arendt-Nielsen, Lars

    2018-05-29

    Topically applied high-concentration capsaicin induces reversible dermo-epidermal denervation and depletion of capsaicin-sensitive nociceptors. This causes desensitization of distinct sensory modalities and is used to treat peripheral neuropathic pain and itch. For high-concentration capsaicin, the selectivity of loss of function and functional recovery rates of various afferent fibers subpopulations are unknown. This study used comprehensive quantitative sensory testing and vasomotor imaging to assess effectiveness, duration and sensory selectivity of high-concentration 8% capsaicin-ablation. Skin areas in 14 healthy volunteers were randomized to treatment with 8% capsaicin/vehicle patches for 1 and 24 h and underwent comprehensive sensory and vasomotor testing at 1, 7 and 21 days postpatch removal. Tests consisted of thermal detection and pain thresholds, tactile and vibration detection thresholds, mechanical pain threshold and mechanical pain sensitivity as well as micro-vascular and itch reactivity to histamine provocations. The 24 h capsaicin drastically inhibited warmth detection (P < 0.001), heat pain (P < 0.001) as well as histamine-induced itch (P < 0.05) and neurogenic flare (P < 0.001), but had no impact on tactile sensitivity, cold detection and cold pain. A marginal decrease in mechanical pain sensitivity was observed (P < 0.05). Capsaicin for 1 h had limited and transient sensory effects only affecting warmth and heat sensations. Time-dependent functional recovery was almost complete 21 days after the 24 h capsaicin exposure, while recovery of neurogenic inflammatory responsiveness remained partial. The psychophysically assessed sensory deficiencies induced by the used 8% capsaicin-ablation correspond well with a predominant effect on TRPV1 + -cutaneous fibers. The method is easy to apply, well tolerated, and utilizable for studies on, e.g., interactions between skin barrier, inflammation and capsaicin-sensitive afferents.

  10. Treatment of pregnancy-related lumbar and pelvic girdle pain by the yoga method: a randomized controlled study.

    PubMed

    Martins, Roseny Flávia; Pinto e Silva, João Luiz

    2014-01-01

    Pregnancy-related lumbopelvic pain is a major problem for the majority of pregnant women. Complementary medicine has been used to alleviate pain, and yoga is one of the most commonly chosen alternative methods. The objective of this study was to assess the effectiveness of Hatha yoga in the reduction of lumbopelvic pain in pregnancy. A randomized controlled trial with 60 pregnant women (age range, 14-40 years) who reported lumbopelvic pain at 12 to 32 weeks of gestation was conducted from June 2009 to June 2011. Pregnant women who had twin pregnancies, had medical restrictions for exercise, used analgesics, and participated in physical therapy were excluded from the study. Pregnant women were divided into two groups: the yoga group, practicing exercises guided by this method, and the postural orientation group, performing standardized posture orientation according to instructions provided in a pamphlet. Treatment in each group lasted 10 weeks. A visual analog scale (VAS) was used to measure pain intensity. Lumbar pain and posterior pelvic pain provocation tests were used to confirm the presence of pain. Statistical analysis included the Mann-Whitney test, the McNemar test, a paired Wilcoxon test, and analysis of covariance. The median pain score was lower in the yoga group (p<.0058) than the postural orientation group. Lumbar pain provocation tests showed a decreased response in relation to posterior pelvic pain provocation tests and a gradual reduction in pain intensity during 10 yoga sessions (p<.024). The yoga method was more effective at reducing lumbopelvic pain intensity compared with postural orientation.

  11. Neural response in obsessive-compulsive washers depends on individual fit of triggers

    PubMed Central

    Baioui, Ali; Pilgramm, Juliane; Merz, Christian J.; Walter, Bertram; Vaitl, Dieter; Stark, Rudolf

    2013-01-01

    Background: Patients with obsessive-compulsive disorder (OCD) have highly idiosyncratic triggers. To fully understand which role this idiosyncrasy plays in the neurobiological mechanisms behind OCD, it is necessary to elucidate the impact of individualization regarding the applied investigation methods. This functional magnetic resonance imaging (fMRI) study explores the neural correlates of contamination/washing-related OCD with a highly individualized symptom provocation paradigm. Additionally, it is the first study to directly compare individualized and standardized symptom provocation. Methods: Nineteen patients with washing compulsions created individual OCD hierarchies, which later served as instructions to photograph their own individualized stimulus sets. The patients and 19 case-by-case matched healthy controls participated in a symptom provocation fMRI experiment with individualized and standardized stimulus sets created for each patient. Results: OCD patients compared to healthy controls displayed stronger activation in the basal ganglia (nucleus accumbens, nucleus caudatus, pallidum) for individualized symptom provocation. Using standardized symptom provocation, this group comparison led to stronger activation in the nucleus caudatus. The direct comparison of between-group effects for both symptom provocation approaches revealed stronger activation of the orbitofronto-striatal network for individualized symptom provocation. Conclusions: The present study provides insight into the differential impact of individualized and standardized symptom provocation on the orbitofronto-striatal network of OCD washers. Behavioral and neural responses imply a higher symptom-specificity of individualized symptom provocation. PMID:23630478

  12. Intimate partner violence perpetration corresponds to a dorsal-ventral gradient in medial PFC reactivity to interpersonal provocation.

    PubMed

    Chester, David S; DeWall, C Nathan

    2018-01-22

    Intimate partner violence (IPV) perpetration is often preceded by perceived interpersonal provocations such as slights, insults, and rejections. Yet the neural mechanisms that link provocation to IPV remain unclear. In the context of interactions with strangers, the medial prefrontal cortex (MPFC) has been repeatedly shown to respond to provocation, with more dorsal activation associated with more aggressive reactions and more ventral activation associated with less aggressive reactions. We used functional brain imaging to test whether this dorsal-ventral MPFC reactivity gradient would also correlate with greater aggression towards an unexamined target: intimate partners. To do so, 61 undergraduates (27.87% male, age range: 18-22) reported whether they had ever committed various acts of IPV perpetration (e.g., punching, hitting, shoving) and then were repeatedly provoked by a stranger while undergoing functional MRI (fMRI) scanning. Individuals with a disproportionately dorsal, rather than ventral, MPFC response were more likely to have perpetrated IPV and had perpetrated more kinds of IPV, even when controlling for gender. These findings provide further evidence that the dorsal-ventral MPFC gradient is a critical, biological indicator of whether an individual is more or less likely to react aggressively and suggest new avenues for understanding and potentially preventing IPV perpetration.

  13. Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders.

    PubMed

    Ong, Peter; Athanasiadis, Anastasios; Sechtem, Udo

    2016-08-18

    Intracoronary acetylcholine provocation testing (ACH-test) is an established method for assessment of epicardial coronary artery spasm in the catheterization laboratory which was introduced more than 30 years ago. Due to the short half-life of acetylcholine it can only be applied directly into the coronary arteries. Several studies have demonstrated the safety and clinical usefulness of this test. However, acetylcholine testing is only rarely applied in the U.S. or Europe. Nevertheless, it has been shown that 62% of Caucasian patients with stable angina and unobstructed coronary arteries on coronary angiography suffer from coronary vasomotor disorders that can be diagnosed with acetylcholine testing. In recent years it has been appreciated that the ACH-test not only assesses the presence of epicardial spasm but that it can also be useful for the detection of coronary microvascular spam. In such cases no epicardial spasm is seen after injection of acetylcholine but ischemic ECG shifts are present together with a reproduction of the patient's symptoms during the test. This article describes the experience with the ACH-test and its implementation in daily clinical routine.

  14. Occupational allergic rhinitis from guar gum.

    PubMed

    Kanerva, L; Tupasela, O; Jolanki, R; Vaheri, E; Estlander, T; Keskinen, H

    1988-05-01

    Three cases of allergic rhinitis from a vegetable gum, guar gum, have been detected. Two subjects were exposed to fine guar gum powder (Emco Gum 563, Meyhall Chemical AG, Switzerland), an insulator in rubber cables, when opening cables in a power cable laboratory. After 1-2 years' exposure the patients developed rhinitis. Scratch-chamber tests, nasal provocation tests, nasal eosinophilia and a RAST test proved their allergy. A third subject developed allergic rhinitis from another guar gum product (Meyproid 5306, Meyhall Chemical AG) after 2 years' exposure in a paper factory. A positive skin test and nasal provocation test confirmed the diagnosis. A fourth case of possible allergy to guar gum after exposure to Meyproid 5306 in a paper factory is also presented. No final diagnosis was reached in this case (in 1974). The present subjects, only one of whom was atopic, developed allergy within 2 years, although their exposure to guar gum was not especially heavy. Therefore, when handling guar, adequate ventilation facilities should be provided and protective clothing, including a respiratory mask, should be worn.

  15. Respiratory allergy to fungi in Barcelona, Spain: clinical aspects, diagnosis and specific treatment in a general allergy unit.

    PubMed

    Torres-Rodríguez, Josep M; Pulido-Marrero, Zeida; Vera-García, Yolanda

    2012-01-01

    The importance of hypersensitivity to fungal allergens is a relatively unknown and somewhat controversial subject. An open prospective study was carried out in just one centre to determine the clinical and epidemiological characteristics as well as the diagnostic usefulness of skin prick and conjunctiva provocation tests, associated with total and specific IgE determination in two groups of patients, one of which was monosensitised to fungi and the other of which had multiple sensitisations, including fungi. Rhinitis, exclusive or associated with asthma, was the main consultation cause (88% in monosensitised patients). Severe asthma was rarely found. In the polysensitised group, 64% were simultaneously allergic to moulds and mites. Alternaria alternata was the most common sensitising fungus, although a considerable number of cases were associated with other species such as Cladosporium, Penicillium and/or Aspergillus. The skin prick test gave the highest sensitivity and specificity. In 67% of the cases, the specific IgE was found between classes 3 and 4. The conjunctival provocation test was an innocuous and highly useful method for verifying the diagnosis and determining the degree of clinical sensitisation. A large number of patients exclusively allergic to fungi received specific immunotherapy, and it was generally well tolerated. This protocolised study shows the importance of Alternaria and other fungi sensitisations in rhinitis alone or associated with asthma. Combined diagnosis of prick test, specific IgE and conjunctiva provocation test is very useful for deciding specific immunotherapy. Copyright © 2011 SEICAP. Published by Elsevier Espana. All rights reserved.

  16. Pro and Contra: Provocation Tests in Drug Hypersensitivity

    PubMed Central

    Soyer, Ozge; Sahiner, Umit Murat; Sekerel, Bulent Enis

    2017-01-01

    Drug provocation test (DPT) is the controlled administration of a drug to diagnose immune- or non-immune-mediated drug hypersensitivity and the last step for accurate recognition of drug hypersensitivity reactions when the previous diagnostic evaluations are negative or unavailable. A DPT is performed only if other conventional tests fail to yield conclusive results. In each clinical presentation, “to provoke or not to provoke” a patient should be decided after careful assessment of the risk–benefit ratio. Well-defined benefits of DPT include confirmative exclusion of diagnoses of drug hypersensitivity and provision of safe alternatives. However, disadvantages such as safety, difficulty in interpretations of results, lack of objective biomarkers, risks of resensitization, efficiency in daily practice, and lack of standardized protocols, are poorly debated. This review summarizes the current published research concerning DPT, with particular emphasis on the advantages and disadvantages of DPT in an evidence-based manner. PMID:28677662

  17. Self-reported dietary fructose intolerance in irritable bowel syndrome: Proposed diagnostic criteria

    PubMed Central

    Berg, Leif Kyrre; Fagerli, Erik; Myhre, Arnt-Otto; Florholmen, Jon; Goll, Rasmus

    2015-01-01

    AIM: To study the criteria for self-reported dietary fructose intolerance (DFI) and to evaluate subjective global assessment (SGA) as outcome measure. METHODS: Irritable bowel syndrome (IBS) patients were randomized in an open study design with a 2 wk run-in on a habitual IBS diet, followed by 12 wk with/without additional fructose-reduced diet (FRD). Daily registrations of stool frequency and consistency, and symptoms on a visual analog scale (VAS) were performed during the first 4 wk. SGA was used for weekly registrations during the whole study period. Provocation with high-fructose diet was done at the end of the registration period. Fructose breath tests (FBTs) were performed. A total of 182 subjects performed the study according to the protocol (88 FRD, 94 controls). RESULTS: We propose a new clinically feasible diagnostic standard for self-reported fructose intolerance. The instrument is based on VAS registrations of symptom relief on FRD combined with symptom aggravation upon provocation with fructose-rich diet. Using these criteria 43 of 77 patients (56%) in the present cohort of IBS patients had self-reported DFI. To improve the concept for clinical evaluation, we translated the SGA scale instrument to Norwegian and validated it in the context of the IBS diet regimen. The validation procedures showed a sensitivity, specificity and κ value for SGA detecting the self-reported DFI group by FRD response within the IBS patients of 0.79, 0.75 and 0.53, respectively. Addition of the provocation test yielded values of 0.84, 0.76 and 0.61, respectively. The corresponding validation results for FBT were 0.57, 0.34 and -0.13, respectively. CONCLUSION: FRD improves symptoms in a subgroup of IBS patients. A diet trial followed by a provocation test evaluated by SGA can identify most responders to FRD. PMID:25987795

  18. Reliability of provocative tests of motion sickness susceptibility

    NASA Technical Reports Server (NTRS)

    Calkins, D. S.; Reschke, M. F.; Kennedy, R. S.; Dunlop, W. P.

    1987-01-01

    Test-retest reliability values were derived from motion sickness susceptibility scores obtained from two successive exposures to each of three tests: (1) Coriolis sickness sensitivity test; (2) staircase velocity movement test; and (3) parabolic flight static chair test. The reliability of the three tests ranged from 0.70 to 0.88. Normalizing values from predictors with skewed distributions improved the reliability.

  19. ERS technical standard on bronchial challenge testing: general considerations and performance of methacholine challenge tests.

    PubMed

    Coates, Allan L; Wanger, Jack; Cockcroft, Donald W; Culver, Bruce H; Diamant, Zuzana; Gauvreau, Gail; Hall, Graham L; Hallstrand, Teal S; Horvath, Ildiko; de Jongh, Frans H C; Joos, Guy; Kaminsky, David A; Laube, Beth L; Leuppi, Joerg D; Sterk, Peter J

    2017-05-01

    This international task force report updates general considerations for bronchial challenge testing and the performance of the methacholine challenge test. There are notable changes from prior recommendations in order to accommodate newer delivery devices. Rather than basing the test result upon a methacholine concentration (provocative concentration (PC 20 ) causing a 20% fall in forced expiratory volume in 1 s (FEV 1 )), the new recommendations base the result upon the delivered dose of methacholine causing a 20% fall in FEV 1 (provocative dose (PD 20 )). This end-point allows comparable results from different devices or protocols, thus any suitable nebuliser or dosimeter may be used, so long as the delivery characteristics are known. Inhalation may be by tidal breathing using a breath-actuated or continuous nebuliser for 1 min (or more), or by a dosimeter with a suitable breath count. Tests requiring maximal inhalations to total lung capacity are not recommended because the bronchoprotective effect of a deep breath reduces the sensitivity of the test. Copyright ©ERS 2017.

  20. [The ice water test and bladder cooling reflex. Physiology, pathophysiology and clinical importance].

    PubMed

    Hüsch, T; Neuerburg, T; Reitz, A; Haferkamp, A

    2016-04-01

    Urodynamic studies are utilised for identification and follow-up of functional disorders of the lower urinary tract. Provocation tests are used to determine disorders which could not be revealed in standard cystometry. The ice water test is a simple test to identify neurogenic bladder dysfunction and to screen the integrity of the upper motor neuron in neurogenic bladder dysfunction. Development and significance of the ice water test is presented in this review against the background of physiology and pathophysiology of the lower urinary tract. A systematic review of PubMed and ScienceDirect databases was performed in April 2015. No language or time limitation was applied. The following key words and Medical Subject Heading terms were used to identify relevant studies: "ice water test", "bladder cooling reflex", "micturition" and "neuronal control". Review articles and bibliographies of other relevant studies identified were hand searched to find additional studies. The ice water test is performed by rapid instillation of 4-8 °C cold fluid into the urinary bladder. Hereby, afferent C fibers are activated by cold receptors in the bladder leading to the bladder cooling reflex. It is a spinal reflex which causes an involuntarily contraction of the urinary bladder. The test is normally positive in young infants during the first 4 years of life and become negative with maturation of the central nervous system afterwards by inhibition of the reflex. The damage of the upper motor neuron causes the recurrence of the reflex in the adulthood and indicates spinal and cerebral lesions. The ice water test is utilised to identify lesions of the upper motor neuron. However, in the case of detrusor acontractility the test will always be negative and can not be utilized to distinguish between neurogenic or muscular causes. Furthermore, the test is also positive in a small percentage of cases of non-neurogenic diseases, e.g. in prostate-related bladder outlet obstruction or idiopathic overactive bladder. Although no clear explanation exists, a positive ice water test could be the first sign of an otherwise asymptomatic neurological disease. Due to the simple procedure, the ice water test is a reliable possibility to identify neurologic bladder hyperactivity subsequent to standard cystometry.

  1. Manual unloading of the lumbar spine: can it identify immediate responders to mechanical traction in a low back pain population? A study of reliability and criterion referenced predictive validity

    PubMed Central

    Swanson, Brian T.; Riley, Sean P.; Cote, Mark P.; Leger, Robin R.; Moss, Isaac L.; Carlos,, John

    2016-01-01

    Background To date, no research has examined the reliability or predictive validity of manual unloading tests of the lumbar spine to identify potential responders to lumbar mechanical traction. Purpose To determine: (1) the intra and inter-rater reliability of a manual unloading test of the lumbar spine and (2) the criterion referenced predictive validity for the manual unloading test. Methods Ten volunteers with low back pain (LBP) underwent a manual unloading test to establish reliability. In a separate procedure, 30 consecutive patients with LBP (age 50·86±11·51) were assessed for pain in their most provocative standing position (visual analog scale (VAS) 49·53±25·52 mm). Patients were assessed with a manual unloading test in their most provocative position followed by a single application of intermittent mechanical traction. Post traction, pain in the provocative position was reassessed and utilized as the outcome criterion. Results The test of unloading demonstrated substantial intra and inter-rater reliability K = 1·00, P = 0·002, K = 0·737, P = 0·001, respectively. There were statistically significant within group differences for pain response following traction for patients with a positive manual unloading test (P<0·001), while patients with a negative manual unloading test did not demonstrate a statistically significant change (P>0·05). There were significant between group differences for proportion of responders to traction based on manual unloading response (P = 0·031), and manual unloading response demonstrated a moderate to strong relationship with traction response Phi = 0·443, P = 0·015. Discussion and conclusion The manual unloading test appears to be a reliable test and has a moderate to strong correlation with pain relief that exceeds minimal clinically important difference (MCID) following traction supporting the validity of this test. PMID:27559274

  2. Dispositional anger and the resolution of the approach-avoidance conflict.

    PubMed

    Robinson, Michael D; Boyd, Ryan L; Persich, Michelle R

    2016-09-01

    The approach-avoidance conflict is one in which approaching reward brings increased threat while avoiding threat means forgoing reward. This conflict can be uniquely informative because it will be resolved in different ways depending on whether approach (toward) or avoidance (away from) is the stronger motive. Two studies (total N = 191) created a computerized version of this conflict and used the test to examine questions of motivational direction in anger. In Study 1, noise blast provocations increased the frequency of approach behaviors at high levels of trait anger, but decreased their frequency at low levels. In Study 2, a simpler version of the conflict test was used to predict anger in daily life. As hypothesized, greater approach frequencies in the test predicted greater anger reactivity to daily provocations and frustrations. The discussion focuses on the utility of the approach-avoidance conflict test and on questions of motivational direction in anger. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  3. Bronchial provocation tests in clinical practice.

    PubMed

    Borges, Marcos de Carvalho; Ferraz, Erica; Vianna, Elcio Oliveira

    2011-01-01

    Bronchial hyperresponsiveness, which consists of an exaggerated response of the airways to bronchoconstrictor stimuli, is one of the main characteristics of asthma, presented in nearly all asthmatic patients. Bronchial hyperresponsiveness may also be present in other diseases, such as allergic rhinitis, chronic obstructive pulmonary disease, cystic fibrosis, heart failure and respiratory infection, and with some medications, such as β-blockers. Bronchial provocation tests (also known as bronchial challenges) are used to evaluate bronchial responsiveness. These tests have become increasingly used over the last 20 years, with the development and validation of accurate, safe and reproducible tests, and with the publication of well-detailed protocols. Several stimuli can be used in a bronchial challenge, and they are classified as direct and indirect stimuli. There are many indications for a bronchial challenge. In this review, we discuss the main differences between direct and indirect stimuli, and the use of bronchial challenges in clinical practice, especially for confirming diagnoses of asthma, exercise-induced bronchoconstriction and cough-variant asthma, and for use among elite-level athletes.

  4. Risk Factors for Gastrointestinal Leak after Bariatric Surgery: MBASQIP Analysis.

    PubMed

    Alizadeh, Reza Fazl; Li, Shiri; Inaba, Colette; Penalosa, Patrick; Hinojosa, Marcelo W; Smith, Brian R; Stamos, Michael J; Nguyen, Ninh T

    2018-03-30

    Gastrointestinal leak remains one of the most dreaded complications in bariatric surgery. We aimed to evaluate risk factors and the impact of common perioperative interventions on the development of leak in patients who underwent laparoscopic bariatric surgery. Using the 2015 database of accredited centers, data were analyzed for patients who underwent laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass (LRYGB). Emergent, revisional, and converted cases were excluded. Multivariate logistic regression was used to analyze risk factors for leak, including provocative testing of anastomosis, surgical drain placement, and use of postoperative swallow study. Data from 133,478 patients who underwent laparoscopic sleeve gastrectomy (n = 92,495 [69.3%]) and LRYGB (n = 40,983 [30.7%]) were analyzed. Overall leak rate was 0.7% (938 of 133,478). Factors associated with increased risk for leak were oxygen dependency (adjusted odds ratio [AOR] 1.97), hypoalbuminemia (AOR 1.66), sleep apnea (AOR 1.52), hypertension (AOR 1.36), and diabetes (AOR 1.18). Compared with LRYGB, laparoscopic sleeve gastrectomy was associated with a lower risk of leak (AOR 0.52; 95% CI 0.44 to 0.61; p < 0.01). Intraoperative provocative test was performed in 81.9% of cases and the leak rate was higher in patients with vs without a provocative test (0.8% vs 0.4%, respectively; p < 0.01). A surgical drain was placed in 24.5% of cases and the leak rate was higher in patients with vs without a surgical drain placed (1.6% vs 0.4%, respectively; p < 0.01). A swallow study was performed in 41% of cases and the leak rate was similar between patients with vs without swallow study (0.7% vs 0.7%; p = 0.50). The overall rate of gastrointestinal leak in bariatric surgery is low. Certain preoperative factors, procedural type (LRYGB), and interventions (intraoperative provocative test and surgical drain placement) were associated with a higher risk for leaks. Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Height velocity and IGF-I assessment in the diagnosis of childhood onset GH insufficiency: do we still need a second GH stimulation test?

    PubMed

    Cianfarani, Stefano; Tondinelli, Tiziana; Spadoni, Gian Luigi; Scirè, Giuseppe; Boemi, Sergio; Boscherini, Brunetto

    2002-08-01

    The diagnosis of GH insufficiency (GHI) in childhood is not straightforward. Our aim was to test the sensitivity and specificity of height velocity (HV), IGF-I, IGFBP-3 and GH stimulation tests alone or in combination in the diagnosis of GHI. A retrospective review of patients with GHI and idiopathic short stature (ISS) diagnosed in our centre and followed up to the completion of linear growth. Thirty-three GHI children and 56 children with ISS were evaluated. GHI diagnosis was based on fulfilment of anthropometric, endocrine and neuroradiological criteria: stature < or = -2 z-score, delayed bone age (at least 1 year), GH peak response to at least two different provocative tests < 10 micro g/l (20 mU/l), brain MRI positive for hypothalamus-pituitary abnormalities, catch-up growth during the first year of GH replacement therapy > or = 75th centile, peak GH response to a third provocative test after growth completion < 10 micro g/l (20 mU/l). Children with anthropometry resembling that of GHI but with peak GH responses > 10 micro g/l (20 mU/l) were diagnosed as ISS. All subjects underwent standard anthropometry. GH secretory status was assessed by clonidine, arginine and GHRH plus arginine stimulation tests. IGF-I and IGFBP-3 circulating levels were measured by immunoradiometric assay (IRMA). The following cut-off values were chosen to discriminate between GHI and nonGHI short children: HV < 25th centile over the 6-12 months prior to the initiation of GH therapy, peak GH responses < 10 or < 7 micro g/l (< 20 or < 14 mU/l) and IGF-I and IGFBP-3-values < -1.9 z-score. Sensitivity (true positive ratio) and specificity (true negative ratio) were evaluated. Taking 10 micro g/l (20 mU/l) as the cut-off value, sensitivity was 100% and specificity 57% for GH provocative tests, whereas taking 7 as the cut-off value, sensitivity was 66% and specificity rose to 78%. Sensitivity was 73% for IGF-I and 30% for IGFBP-3 measurement, whilst specificity was 95% for IGF-I and 98% for IGFBP-3 evaluation. HV assessment revealed a sensitivity of 82% and a specificity of 43%. When HV and IGF-I evaluations were used in combination, sensitivity reached 95% and specificity 96%. When both HV and IGF-I are normal (26% of our subjects) GHI may be ruled out, whereas when both the indices are subnormal (23%) GHI is so highly likely that the child may undergo only one GH provocative test and brain MRI and, thereafter, may begin GH therapy without any further test. In case of discrepancy, when IGF-I is normal and HV < 25th centile (44% of children), due to the relatively low sensitivity of IGF-I assessment and low specificity of HV, the patient should undergo GH tests and brain MRI. Finally, in the rare case of HV > 25th centile and subnormal IGF-I-values (7%), due to the high specificity of IGF-I measurement, the child should undergo one provocative test and brain MRI for the high suspicion of GHI. Our results suggest that a simple assessment of HV and basal IGF-I may exclude or, in association with only one stimulation test, confirm the diagnosis of GH insufficiency in more than half of patients with short stature.

  6. Collateral Damage: How High-Stakes Testing Corrupts America's Schools

    ERIC Educational Resources Information Center

    Nichols, Sharon L.; Berliner, David C.

    2007-01-01

    Drawing on their extensive research, Nichols and Berliner document and categorize the ways that high-stakes testing threatens the purposes and ideals of the American education system. For more than a decade, the debate over high-stakes testing has dominated the field of education. This passionate and provocative book provides a fresh perspective…

  7. Ergonovine-induced changes of coronary artery diameter in patients with nonsignificant coronary artery stenosis : relation with lipid profile.

    PubMed

    Nedeljkovic, Milan A; Ostojic, Miodrag C; Beleslin, Branko D; Nedeljkovic, Ivana; Milic, Natasa; Vukcevic, Vladan; Stojkovic, Sinisa; Saponjski, Jovica; Orlic, Dejan; Djordjevic-Dikic, Ana; Stepanovic, Jelena; Giga, Vojislav; Petrasinovic, Zorica; Arandjelovic, Aleksandra; Beleslin, Biljana; Kanjuh, Vladimir

    2007-06-01

    Serum cholesterol is positively associated with the risk of developing coronary heart disease. The aim of this study was to determine the relation between response of coronary arteries to ergonovine provocation and lipid profile in patients with nonsignificant coronary artery disease. 105 patients (46 male, 59 female, mean age 52 +/- 8 years) with chest pain syndrome and nonsignificant coronary artery stenosis (< 50% diameter stenosis) were analyzed. Ergonovine test was performed at the end of diagnostic catheterization. Coronary spasm was defined as total or near total obstruction of the coronary artery. By quantitative coronary arteriography, changes of minimal luminal diameter (MLD) during ergonovine provocation were evaluated. Total cholesterol, LDL and HDL cholesterol, and triglycerides were measured. There was a significant negative correlation between resting MLD and LDL cholesterol (r = -0.215; p = 0.034), and a significant positive correlation between MLD decrease provoked by ergonovine and total cholesterol (r = 0.275; p = 0.006), as well as LDL cholesterol (r = 0.284; p = 0.004), but not for HDL cholesterol and triglycerides (p = NS [not significant]). In patients with nonsignificant coronary artery stenosis evaluated by ergonovine provocation, there was not only a significant negative correlation between MLD and LDL cholesterol, but also a positive correlation between coronary vasoconstriction induced by ergonovine provocation and both total and LDL cholesterol.

  8. Bite by a dog under provocation: is it free from risk?

    PubMed

    Dutta, J K

    2002-05-01

    There is a common belief that rabid dogs bite without provocation, hence a dog bite under provocation is free from the risk of rabies. This is not always true as is evident from the case report narrated below. Here in this article, a man of 38 years was bitten by a dog under provocation. He developed rabies 4 months after the bite and subsequently died. Autopsy revealed Negri bodies from the brain tissue.

  9. Dissociation between history and challenge in patients with physical urticaria.

    PubMed

    Komarow, Hirsh D; Arceo, Sarah; Young, Michael; Nelson, Celeste; Metcalfe, Dean D

    2014-01-01

    Physical urticaria is a subtype of chronic urticaria induced by a physical stimulus. To evaluate the consistency between a history of physical urticaria and results of challenge testing. Seventy-six subjects, ages 3 to 77 years old, were referred with the diagnosis of a physical urticaria and were evaluated by using challenge testing directed toward the presenting diagnosis, yet included other stimuli based on history. The majority of subjects were tested to 3 or more stimuli, thus 294 provocation tests were performed. Fifty-seven subjects were surveyed for the status of their physical urticaria at least 1 year after initial evaluation. Of the 76 subjects with a positive history of a physical urticaria, 38% (n = 29) were challenge negative to the presenting diagnosis. Eight subjects within the challenge negative group reacted positively to additional testing, thus 28% (n = 21) remained negative to all challenge testing, which allowed discontinuation of medications and avoidance behavior. A negative challenge result was less likely with subjects who presented with cold-induced urticaria (25%), delayed pressure urticaria (25%), and dermatographism (29%), yet more common with cholinergic (65%) and solar urticaria (67%). A 1-year follow-up survey of 57 subjects was consistent with initial results. Nineteen of this subgroup were rechallenged for the presenting diagnosis, and the outcome was unchanged in 17 subjects and, in 2 subjects the urticaria had resolved. The diagnosis by history of a physical urticaria should be verified by testing whenever possible and particularly if the condition is judged as severe and thus requires both significant life-style changes and pharmacologic intervention. Published by Elsevier Inc.

  10. Provocative questions in cancer epidemiology in a time of scientific innovation and budgetary constraints.

    PubMed

    Lam, Tram Kim; Schully, Sheri D; Rogers, Scott D; Benkeser, Rachel; Reid, Britt; Khoury, Muin J

    2013-04-01

    In a time of scientific and technological developments and budgetary constraints, the National Cancer Institute's (NCI) Provocative Questions Project offers a novel funding mechanism for cancer epidemiologists. We reviewed the purposes underlying the Provocative Questions Project, present information on the contributions of epidemiologic research to the current Provocative Questions portfolio, and outline opportunities that the cancer epidemiology community might capitalize on to advance a research agenda that spans a translational continuum from scientific discoveries to population health impact.

  11. Occupational formalin asthma.

    PubMed Central

    Hendrick, D J; Lane, D J

    1977-01-01

    Hypersensitivity to formalin used to sterilise artificial kidney machines was shown by inhalation provocation tests to be responsible for attacks of wheezing accompanied by productive cough in two members of the nursing staff of a haemodialysis unit. Three further members of the staff of 28 who were continually exposed to this substance occupationally had developed similar recurrent but less frequent episodes since joining the unit. Two underwent inhalation provocation tests with formalin which did not reproduce these symptoms.Single episodes of these symptoms had been noted by three additional staff members so that altogether eight (29%) had experienced attacks described as bronchitic since becoming exposed to formalin. We suggest that, while exposure to formalin did not seem to be directly responsible in all cases, it might have increased susceptibility to other provoking agents or induced a hyper-reactive responsiveness of the airways. The responses observed in the two nurses after inhalation provocation tests with fromalin were predominantly of airways obstruction. Wheezing began between two and three hours after exposure, and peak expiratory flow rates fell maximally by approximately 50%. Reactions persisted for 10 hours to 10 days depending on the exposure dose. A productive cough was a prominent feature. The sputum appeared to be mucopurulent, but culture produced a scanty growth of Haemophilus influenzae only, together with upper respiratory tract commensals. The cellular content was not homogeneous, neutrophil leucocytes and eosinophil leucocoytes variably dominating. Variable responses of neutrophil and eosinophil leucocytes were also seen in the peripheral blood. PMID:557329

  12. Distilled water nasal provocation in hyperreactive patients.

    PubMed

    Baudoin, T; Anzic, S A; Kalogjera, L

    1999-01-01

    Nonisotonic aerosol may act as a provocation agent in the upper and lower airways of hyperreactive individuals. The purpose of the study was to compare the results of nasal challenge with distilled water in patients with allergic rhinitis to those with noninfective nonallergic rhinitis (NINAR), with respect to the potential clinical use of the obtained data. A group of 68 ambulatory patients with allergic rhinitis or NINAR (39 perennial allergic, 6 seasonal, 23 NINAR) were challenged with 10 mL of distilled water aerosol after the baseline active anterior rhinomanometry. Patients with nasal polyposis at endoscopy, significant unilateral septal deviation, positive bacteriologic swab, recent nasal surgery, and uncertain anamnestic data about the medication taken 6 weeks before the provocation were excluded from the study. After 10 minutes of nasal provocation, rhinomanometry was repeated to assess the response. In 15 patients of the perennial allergic group, the same measurements were performed after a 2-week oral antihistamine and topical steroid therapy. Nasal resistance was significantly increased on the more patent side of the nose after nasal provocation with distilled water aerosol in allergic patients in comparison to the nasal resistance before provocation. In the patients with NINAR, the provocation resulted in a significant rise on the more patent side, but the total nasal airway resistance (NAR) levels were also significantly increased. The systemic antihistamine and topical steroid 2-week therapy in patients with perennial allergic rhinitis significantly reduced the response to nasal distilled water provocation. Nasal provocation with distilled water aerosol is a cheap, simple, and acceptable method that provides useful clinical data on the level of nonspecific nasal hyperreactivity and the therapy success.

  13. The relationship between clinical and standardized tests for hand-arm vibration syndrome.

    PubMed

    Poole, C J M; Mason, H; Harding, A-H

    2016-06-01

    Standardized laboratory tests are undertaken to assist the diagnosis and staging of hand-arm vibration syndrome (HAVS), but the strength of the relationship between the tests and clinical stages of HAVS is unknown. To assess the relationship between the results of thermal aesthesiometry (TA), vibrotactile (VT) thresholds and cold provocation (CP) tests with the modified Stockholm scales for HAVS and to determine whether the relationship is affected by finger skin temperature. Consecutive records of workers referred to a Tier 5 HAVS assessment centre from 2006 to 2015 were identified. The diagnosis and staging of cases was undertaken from the clinical information contained in the records. Cases with alternative or mixed diagnoses were excluded and staging performed according to the modified Stockholm scale without knowledge of the results of the standardized laboratory tests. A total of 279 cases of HAVS were analysed. Although there was a significant trend for sensorineural (SN) and vascular scores to increase with clinical stage (P < 0.01), there was no significant difference in scores between 2SN early and 2SN late or between 2SN late and 3SN. There was moderate correlation between the TA and VT scores and the clinical SN stages (r = 0.6). This correlation did not change when subjects were divided into those with a finger skin temperature <30 and >30°C. CP scores distributed bimodally and correlated poorly with clinical staging (r = 0.2). Standardized SN tests distinguish between the lower Stockholm stages, but not above 2SN early. This has implications for health surveillance and UK policy. © Crown copyright 2016.

  14. Angular velocities, angular accelerations, and coriolis accelerations

    NASA Technical Reports Server (NTRS)

    Graybiel, A.

    1975-01-01

    Weightlessness, rotating environment, and mathematical analysis of Coriolis acceleration is described for man's biological effective force environments. Effects on the vestibular system are summarized, including the end organs, functional neurology, and input-output relations. Ground-based studies in preparation for space missions are examined, including functional tests, provocative tests, adaptive capacity tests, simulation studies, and antimotion sickness.

  15. The object of my aggression: Sexual objectification increases physical aggression toward women.

    PubMed

    Vasquez, Eduardo A; Ball, Louisa; Loughnan, Steve; Pina, Afroditi

    2018-01-01

    Objectification involves reducing someone to a sexual object, rather than seeing them as a full person. Despite numerous theoretical claims that people are more aggressive toward the objectified, and empirical evidence that objectification is linked to high willingness to aggress, rape proclivity, and aggressive attitudes, no research has examined a causal link between objectification and physical aggression, particularly in the context of provocation. In two experiments, we examined this predicted link. In Experiment 1, using a 2 (objectification: no/yes) × 2 (provocation: no/yes) factorial between-subjects design, we investigated the effects of objectification, induced via body focus during a face-to-face interaction, and provocation on physical aggression toward a female confederate. Our results revealed a significant main effect of provocation, a marginal main effect of objectification, and a significant interaction between these variables. In the absence of a provocation, focusing on a woman's body increased aggression toward her. Experiment 2 replicated Experiment 1 using a video of a target woman instead of a face-to-face interaction. Again, our results showed a significant two-way interaction between objectification and provocation, wherein objectification increased aggression in the absence of provocation. Overall, this research indicates that objectification can lead to heightened physical aggression toward objectified women. © 2017 Wiley Periodicals, Inc.

  16. Sensitivity to tomato and peanut allergens in children monosensitized to grass pollen.

    PubMed

    de Martino, M; Novembre, E; Cozza, G; de Marco, A; Bonazza, P; Vierucci, A

    1988-04-01

    Possible associations between allergy to grass pollen and positive skin tests to food allergens were studied in 102 children monosensitized (as to inhalant allergens) to grass pollen, and in 117 children monosensitized (as to inhalant allergens) to Dermatophagoides. Thirty-two foods were tested by an epicutaneous method. Positive skin tests to food allergens were more frequent in children with allergy to grass pollen (59.8%) than in children with allergy to Dermatophagoides (9.4%). A considerably high frequency of positive reactions to tomato (39.2%), peanut (22,5%), green pea (13.7%), and wheat (11.7%) was observed in children with allergy to grass pollen. Positive skin tests to peanut closely correlated with positive RAST results and nasal provocation tests, whereas in children with skin test positivity to tomato a close correlation with nasal provocation tests but a 45% correlation with a positive RAST result were observed. RAST inhibition experiments were carried out, and the results may suggest the presence of cross-reacting IgE to grass pollen, tomato, and peanut antigens. Clinical implications of these findings are discussed in the light of histories of food hypersensitivity, urticaria-angioedema, and atopic dermatitis in children with allergy to grass pollen.

  17. Nonimmediate hypersensitivity reactions to iodinated contrast media.

    PubMed

    Gómez, Enrique; Ariza, Adriana; Blanca-López, Natalia; Torres, Maria J

    2013-08-01

    To provide a detailed analysis of the latest findings on the mechanisms underlying the nonimmediate reactions to iodinated contrast media and comment on the recent advances in diagnosis, focusing on the roles of the skin test, drug provocation test (DPT), and lymphocyte transformation test (LTT). Several studies have reported new findings supporting an important role for T-lymphocytes in the nonimmediate reactions to iodinated contrast media. The LTT has been used as an in-vitro tool for diagnosis, but with variable results. However, the inclusion of autologous monocyte-derived dendritic cells as professional antigen-presenting cells has improved the sensitivity of this test. Regarding in-vivo diagnosis, although skin testing has been routine, it has now been shown that its sensitivity and negative predictive value are low. Recent studies have demonstrated that the DPT is a well tolerated and useful procedure that is necessary to confirm the diagnosis of nonimmediate hypersensitivity reactions to iodinated contrast media. Nonimmediate reactions to contrast media are usually T-cell mediated. Diagnosis is based on skin testing, although its sensitivity and negative predictive value are not optimal. Consequently, drug provocation testing is often needed to confirm the diagnosis and also to seek alternative contrast media that can be tolerated.

  18. `Blame' Hawaii for Extreme Cold Air Outbreaks on the US West Coast?

    NASA Astrophysics Data System (ADS)

    Grotjahn, R.; Zhang, R.

    2017-12-01

    Short term extreme cold events punctuate the climate record. Though not always captured by monthly or seasonal means, they can have impacts lasting months. Extreme cold air outbreaks affecting the US West Coast are associated with a specific large scale meteorological pattern (LSMP). The LSMP has large meridional displacements of warm and cold air that create a ridge over and south of western Alaska, then a trough downstream moving with the cold air of the CAO, and finally another ridge over the southeastern US. These three features form in that order over several days leading up to the CAO onset. The warm advection creating the Alaskan ridge displaces cold air which is then advected southward along the North American west coast. Our recent work shows that both advections are driven by a lower level highly unusual high pressure center near the Gulf of Alaska. The cold air advection includes a continental interior portion (which sets up an offshore pressure gradient) and a portion off the west coast (air parcels high enough to be little modified before sinking over the US West Coast). In the mid to upper troposphere there are additional cyclonic centers to the south of the Alaskan ridge. Depending on the region compared, the LSMP has notable pattern correlation (up to 0.7) with the Pacific-North American teleconnection (PNA) negative phase pattern. (Others have shown a link between the PNA negative phase and unusual cold over northwestern North America on longer time scales. Here we find a higher frequency LSMP having centers offset from corresponding centers in the negative phase PNA loading pattern.) Even earlier before onset, we find a connection to a stream function structure straddling the equator that shares properties with slow moving equatorial Rossby waves; this pattern includes a trough near Hawaii that appears linked to the Alaskan ridge building that initiates the CAO. Hence, we arrive at our provocative title. All these features in the geopotential and stream function fields are highly significant from bootstrap statistics. The presentation will emphasize the time evolution of these significant features.

  19. Provocation of Symmetry/Ordering Symptoms in Anorexia nervosa: A Functional Neuroimaging Study

    PubMed Central

    Giampietro, Vincent; Uher, Rudolf; Mataix-Cols, David; Brammer, Michael J.; Williams, Steven C. R.; Treasure, Janet; Campbell, Iain C.

    2014-01-01

    Anorexia nervosa (AN), obsessive–compulsive disorder (OCD), and obsessive–compulsive personality disorder (OCPD) are often co-morbid; however, the aetiology of such co-morbidity has not been well investigated. This study examined brain activation in women with AN and in healthy control (HC) women during the provocation of symmetry/ordering-related anxiety. During provocation, patients with AN showed more anxiety compared to HCs, which was correlated with the severity of symmetry/ordering symptoms. Activation in the right parietal lobe and right prefrontal cortex (rPFC) in response to provocation was reduced in the AN group compared with the HC group. The reduced right parietal activation observed in the AN group is consistent with parietal lobe involvement in visuospatial cognition and with studies of OCD reporting an association between structural abnormalities in this region and the severity of ‘ordering’ symptoms. Reduced rPFC activation in response to symmetry/ordering provocation has similarities with some, but not all, data collected from patients with AN who were exposed to images of food and bodies. Furthermore, the combination of data from the AN and HC groups showed that rPFC activation during symptom provocation was inversely correlated with the severity of symmetry/ordering symptoms. These data suggest that individuals with AN have a diminished ability to cognitively deal with illness-associated symptoms of provocation. Furthermore, our data also suggest that symptom provocation can progressively overload attempts by the rPFC to exert cognitive control. These findings are discussed in the context of the current neurobiological models of AN. PMID:24844926

  20. Provocation of symmetry/ordering symptoms in Anorexia nervosa: a functional neuroimaging study.

    PubMed

    Suda, Masashi; Brooks, Samantha J; Giampietro, Vincent; Uher, Rudolf; Mataix-Cols, David; Brammer, Michael J; Williams, Steven C R; Treasure, Janet; Campbell, Iain C

    2014-01-01

    Anorexia nervosa (AN), obsessive-compulsive disorder (OCD), and obsessive-compulsive personality disorder (OCPD) are often co-morbid; however, the aetiology of such co-morbidity has not been well investigated. This study examined brain activation in women with AN and in healthy control (HC) women during the provocation of symmetry/ordering-related anxiety. During provocation, patients with AN showed more anxiety compared to HCs, which was correlated with the severity of symmetry/ordering symptoms. Activation in the right parietal lobe and right prefrontal cortex (rPFC) in response to provocation was reduced in the AN group compared with the HC group. The reduced right parietal activation observed in the AN group is consistent with parietal lobe involvement in visuospatial cognition and with studies of OCD reporting an association between structural abnormalities in this region and the severity of 'ordering' symptoms. Reduced rPFC activation in response to symmetry/ordering provocation has similarities with some, but not all, data collected from patients with AN who were exposed to images of food and bodies. Furthermore, the combination of data from the AN and HC groups showed that rPFC activation during symptom provocation was inversely correlated with the severity of symmetry/ordering symptoms. These data suggest that individuals with AN have a diminished ability to cognitively deal with illness-associated symptoms of provocation. Furthermore, our data also suggest that symptom provocation can progressively overload attempts by the rPFC to exert cognitive control. These findings are discussed in the context of the current neurobiological models of AN.

  1. Hemodynamic changes in systolic and diastolic function during isoproterenol challenge predicts symptomatic response to myectomy in hypertrophic cardiomyopathy with labile obstruction.

    PubMed

    Prasad, Megha; Geske, Jeffrey B; Sorajja, Paul; Ommen, Steve R; Schaff, Hartzell V; Gersh, Bernard J; Nishimura, Rick A

    2016-11-15

    We aimed to assess the utility of changes in systolic and diastolic function by isoproterenol challenge in predicting symptom resolution post-myectomy in selected patients with hypertrophic cardiomyopathy (HCM) and labile obstruction. In a subset of symptomatic HCM patients without resting/provocable obstruction on noninvasive assessment, isoproterenol challenge during hemodynamic catheterization may elicit labile left ventricular outflow tract (LVOT) obstruction, and demonstrate the effect of obstruction on diastolic function. These changes may determine whether patients achieve complete symptom resolution post-myectomy. Between February 2003 and April 2009, 18 symptomatic HCM patients without LVOT obstruction on noninvasive testing underwent isoproterenol provocation and septal myectomy due to presence of provocable gradient and were followed for 4 (IQR 3-7) years. Thirteen (72.2%) had complete symptom resolution, while 5 (27.8%) had improved, but persistent symptoms. Those with provoked gradient >100 mm Hg or increase in left atrial pressure (LAP) with isoproterenol had symptom resolution. Symptomatic HCM patients without LVOT gradient on noninvasive testing may demonstrate labile obstruction with isoproterenol. With isoproterenol, patients with high LVOT gradient or increase in LAP concomitant with an increase in gradient achieved complete symptom resolution post-myectomy. Thus, improved diastolic filling as well as outflow gradient production in patients with HCM may predict symptom response to myectomy. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  2. Gender Differences in Intended Escalatory Tendencies among Marital Partners

    ERIC Educational Resources Information Center

    Winstok, Zeev; Straus, Murray A.

    2011-01-01

    This study addresses the intended escalatory tendency in eight hypothetical situations in which the provocator's identity (partner or stranger, male or female) and the provocation form (verbal or physical aggression) were manipulated. The research question is "how does the identity of the provocator and the form of his or her provocation…

  3. The Power of the Provocative: Exploring World History Content

    ERIC Educational Resources Information Center

    Ashkettle, Bryan L.

    2013-01-01

    This study addresses how my freshman world history students come to understand controversial issues as provocative within the secondary social studies classroom, and in what ways does their engagement with provocative issues influence their understanding of the content and the world around them. In addition, this research study seeks to discover…

  4. Rational ideation and empiric validation of an innovative digital dermographic tester.

    PubMed

    Lembo, C; Patruno, C; Balato, N; Ayala, F; Balato, A; Lembo, S

    2018-04-01

    Dermographism is a condition characterized by a weal response to a combination of pressure and traction on skin surface, and its diagnosis is based on medical history, clinical criteria and provocation test. The Dermographic Tester ® , a pen-sized tool containing a spring-loaded blunt tip, is the most widely used instrument for the provocation test, and it exerts increasing pressures on the skin surface according to an arbitrary units (AU) scale. Analysing the mechanism of function and trying to convert the AUs to SI units (g/mm 2 ), we found that this instrument had some defects and limits that would compromise a true and repeatable quantification of the weal response threshold. Consequently, we decided to develop a new instrument, the Digital Dermographic Tester (DDT), which is engineered with an inside force sensor to implement features lacking in the current tools, in the hope of enhancing the precision of the provocation test. To validate the effectiveness and accuracy of the DDT. We tested the DDT on 213 participants purposely sampled to obtain three groups, each with a different pattern of reaction to mechanical stimuli. Based on anamnestic, diagnostic and symptomatic criteria, patients were divided into dermographic urticaria (DU), spontaneous urticaria (SU) and healthy control (HC) groups. The DDT was used to apply 12 levels of pressure to the skin surface, and a frequency distribution of positive reactions was displayed for each group. A force of 36-40 g/mm 2 appropriately differentiated physiological from pathological conditions with high sensitivity and specificity. The DDT was found to be capable of differentiating patients with DU patients from those with SU and from HCs, and was able to precisely identify the weal elicitation threshold. © 2017 British Association of Dermatologists.

  5. Cardiovascular and cortisol reactivity and habituation to a virtual reality version of the Trier Social Stress Test: a pilot study.

    PubMed

    Jönsson, Peter; Wallergård, Mattias; Osterberg, Kai; Hansen, Ase Marie; Johansson, Gerd; Karlson, Björn

    2010-10-01

    The Trier Social Stress Test (TSST) is a widely used protocol to induce stress in laboratory settings. Briefly, in the TSST, the test participant is asked to hold a speech and to do an arithmetic task in front of an audience. In the present pilot study, we examined endocrine and autonomic reactivity and habituation to repeated stress provocations using a virtual reality (VR) version of TSST. The VR system was a CAVE™ system with three rear projected walls (4 m×3 m), and one floor projection. The system also included a head tracking system and passive stereoscopy. The virtual audience consisted of one woman, and two men. Ten healthy men, mean age 28.3 years (24-38 years), were confronted with the test twice (1 week between sessions), during which salivary cortisol, heart rate (HR), high frequency heart rate variability (HF-HRV, parasympathetic activity), and T-wave amplitude (TWA, suggested to be related to sympathetic influence on myocardial performance) were assessed. Cortisol secretion showed a marked increase (88% vs. baseline) during the first stress provocation, but habituated in the second session. The magnitude of HR and TWA reactivity during stress provocation was approximately the same at both sessions, implying a stable increase in sympathetic activity. Heart rate showed a maximum increase of 40% at the first session, and 32% at the second. TWA showed a maximum decrease of 42% at the first session, and 39% at the second. The results resemble those obtained in prior studies using the real-life TSST. If these results can be replicated with larger samples, VR technology may be used as a simple and standardized tool for social stress induction in experimental settings. Copyright © 2010 Elsevier Ltd. All rights reserved.

  6. Adenosine bronchial provocation with computerized wheeze detection in young infants with prolonged cough: correlation with long-term follow-up.

    PubMed

    Bentur, Lea; Beck, Raphael; Berkowitz, Drora; Hasanin, Jamal; Berger, Irit; Elias, Nael; Gavriely, Noam

    2004-10-01

    Chronic cough in babies is often associated with bronchial hyperreactivity (BHR). The objective documentation of BHR in babies is difficult, and acoustic methods have been described (provocative concentration of a substance causing wheeze) for conducting bronchial provocation tests (BPTs). We conducted a study to evaluate automatic computerized wheeze detection (CWD) in determining BHR in young infants with prolonged cough, and its correlation with the subsequent development of wheezing. Infants aged < 24 months with prolonged cough (ie, > 2 months) underwent acoustic BPTs with the response determined by CWD and auscultation by a physician. Telephone interviews with parents were conducted after 1 month and yearly for the next 3 years. A total of 28 infants who were 4 to 24 months old with prolonged cough were included in the study. Twenty of these infants (71.4%) had BHR as determined by a positive acoustic BPT result. In 11 of these 20 tests, the CWD occurred earlier, and in 9 tests it occurred at the same step as auscultation by a physician. Rhonchi or whistles often preceded wheezes. Seventeen of the 20 patients with BHR completed 3 years of follow-up. Of these, 14 had recurrent episodes of wheezing and shortness of breath, and 3 were well. Six of the eight adenosine-negative patients completed 3 years of follow-up and had no symptoms of BHR. Acoustic BPT is a technically feasible test for the detection of BHR in young infants. CWD provides an earlier detection of wheeze than stethoscope auscultation. In our group of infants, a positive acoustic BPT result had high correlation with symptoms compatible with BHR over the next 3 years.

  7. Pain referral and regional deep tissue hyperalgesia in experimental human hip pain models.

    PubMed

    Izumi, Masashi; Petersen, Kristian Kjær; Arendt-Nielsen, Lars; Graven-Nielsen, Thomas

    2014-04-01

    Hip disorder patients typically present with extensive pain referral and hyperalgesia. To better understand underlying mechanisms, an experimental hip pain model was established in which pain referrals and hyperalgesia could be studied under standardized conditions. In 16 healthy subjects, pain was induced by hypertonic saline injection into the gluteus medius tendon (GMT), adductor longus tendon (ALT), or gluteus medius muscle (GMM). Isotonic saline was injected contralaterally as control. Pain intensity was assessed on a visual analogue scale (VAS), and subjects mapped the pain distribution. Before, during, and after injections, passive hip joint pain provocation tests were completed, together with quantitative sensory testing as follows: pressure pain thresholds (PPTs), cuff algometry pain thresholds (cuff PPTs), cutaneous pin-prick sensitivity, and thermal pain thresholds. Hypertonic saline injected into the GMT resulted in higher VAS scores than hypertonic injections into the ALT and GMM (P<.05). Referred pain areas spread to larger parts of the leg after GMT and GMM injections compared with more regionalized pain pattern after ALT injections (P<.05). PPTs at the injection site were decreased after hypertonic saline injections into GMT and GMM compared with baseline, ALT injections, and isotonic saline. Cuff PPTs from the thigh were decreased after hypertonic saline injections into the ALT compared with baseline, GMT injections, and isotonic saline (P<.05). More subjects had positive joint pain provocation tests after hypertonic compared with isotonic saline injections (P<.05), indicating that this provocation test also assessed hyperalgesia in extra-articular soft tissues. The experimental models may open for better understanding of pain mechanisms associated with painful hip disorders. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  8. Diagnosis of mold allergy by RAST and skin prick testing.

    PubMed

    Nordvall, S L; Agrell, B; Malling, H J; Dreborg, S

    1990-11-01

    Sera from 33 patients with mold allergy proven by bronchial provocation were analyzed for specific IgE against six mold species comparing an improved Phadebas RAST with four other techniques. The new method was more sensitive and gave significantly higher IgE antibody concentrations for all tested molds except Cladosporium herbarum.

  9. Standardization of motion sickness induced by left-right and up-down reversing prisms

    NASA Technical Reports Server (NTRS)

    Reschke, M. F.; Vanderploeg, J. M.; Brumley, E. A.; Kolafa, J. J.; Wood, S. J.

    1990-01-01

    Reversing prisms are known to produce symptoms of motion sickness, and have been used to provide a chronic stimulus for training subjects on symptom recognition and regulation. However, testing procedures with reversing prisms have not been standardized. A set of procedures were evaluated which could be standardized using prisms for provocation and to compare the results between Right/Left Reversing Prisms (R/L-RP) and Up/Down Reversing Prisms (U/D-RP). Fifteen subjects were tested with both types of prisms using a self paced walking course throughout the laboratory with work stations established at specified intervals. The work stations provided tasks requiring eye-hand-foot coordination and various head movements. Comparisons were also made between these prism tests and two other standardized susceptibility tests, the KC-135 parabolic static chair test and the Staircase Velocity Motion Test (SVMT). Two different types of subjective symptom reports were compared. The R/L-RP were significantly more provocative than the U/D-RP. The incidence of motion sickness symptoms for the R/L-RP was similar to the KC-135 parabolic static chair test. Poor correlations were found between the prism tests and the other standardized susceptibility tests, which might indicate that different mechanisms are involved in provoking motion sickness for these different tests.

  10. Painful and provocative events scale and fearlessness about death among Veterans: Exploratory factor analysis.

    PubMed

    Poindexter, Erin K; Nazem, Sarra; Forster, Jeri E

    2017-01-15

    The interpersonal theory of suicide suggests three proximal risk factors for suicide: perceived burdensomeness, thwarted belongingness, and acquired capability. Previous literature indicates that repetitive exposure to painful and provocative events is related to increased acquired capability for suicide. Despite this, research related to the assessment of painful and provocative events has been insufficient. Research has inconsistently administered the Painful and Provocative Events Scale (PPES; a painful and provocative events assessment), and no study has examined the factor structure of the English PPES. This study explored the factor structure of the PPES and the relation between factors and fearlessness about death. The sample was a cross-sectional, self-report study comprised of 119 Veterans (Mage = 46.5, SD = 13.5). Findings from an exploratory factor analysis indicated a four-factor solution for the PPES; however, no factor from the PPES significantly related to fearlessness about death (measured by the Acquired Capability for Suicide Scale - Fearlessness About Death Scale; all p >.21). Cross-sectional, small Veteran sample. Findings suggest that the PPES lacks the psychometric properties necessary to reliably investigate painful and provocative factors. Consequently, this measure may not reliably capture and explain how painful and provocative events relate to fearlessness about death, which is a barrier to improving suicide risk assessment and prediction. Recommendations for the construction of a new PPES are offered. Published by Elsevier B.V.

  11. Gullies and Bedrock in Nirgal Vallis

    NASA Image and Video Library

    2015-02-11

    The gullies in this image are within the valley wall of an ancient channel-Nirgal Vallis-a testament to flowing water in Mars' ancient past. However, the formation of gullies are still the subject of much debate with respect to their formation: "wet" vs. "dry" or even "dry" with the aid of some lubricating fluid. Gullies most commonly form in the steep walls of simple craters. Gullies are common even in cold arctic deserts on Earth (e.g., the Haughton impact structure on Devon Island). This suggests that these provocative features can form on a mostly dry Mars that is only sporadically wet. Regardless, these features bear a remarkable resemblance to flowers, including the blossom, petals, stem, and roots. Can you see it too? http://photojournal.jpl.nasa.gov/catalog/PIA19294

  12. North Korea’s Choice of the Types of Provocation Against South Korea

    DTIC Science & Technology

    2013-12-01

    DISTRIBUTION CODE A 13. ABSTRACT (maximum 200 words) This research starts from the question of how North Korea decides upon the types of its provocations...INTENTIONALLY LEFT BLANK iv ABSTRACT This research starts from the question of how North Korea decides upon the types of its provocations...1 A. MAJOR RESEARCH QUESTION................................................................1 B

  13. [The health condition of forest workers exposed to noise and vibration produced by chain saws].

    PubMed

    Malinowska-Borowska, Jolanta; Socholik, Violetta; Harazin, Barbara

    2012-01-01

    Lumberjacks' working conditions are difficult due to the presence of numerous occupational hazards. Physical factors that pose a health risk are noise and vibration produced by chain saws. Excessive exposure of lumberjacks to noise and vibration can lead to the development of hand-arm vibration syndrome and hearing loss. The aim of the work was to analyze the health condition of forestry workers exposed to occupational physical hazards. A preliminary, questionnaire-based assessment of health status was conducted in 22 chain saw operators. In a group of 15 forestry workers audiometry, vibrotactile perception thresholds and cold provocation test were performed. X-ray diagnostic imaging of upper limbs was also done. At the same time noise and vibration produced by chain saws used in forestry was measured. Vascular or neurological disorders were found in nearly half of tested workers with seniority from 2 to 20 years; 40% of the surveyed was diagnosed with hearing impairment. An 8-hour energy equivalent vibration level measured on chain saws was 4.6 m/s2. An 8-hour equivalent sound pressure level was 99.1 dB(A). The threshold limit values for noise and vibration are exceeded at woodcutters' posts. There are changes in lumberjacks' health resulting from exposure to harmful physical agents. Preventive actions are urgently needed to be addressed, especially to people employed in single-handed forestry companies.

  14. Provocative work experiences predict the acquired capability for suicide in physicians.

    PubMed

    Fink-Miller, Erin L

    2015-09-30

    The interpersonal psychological theory of suicidal behavior (IPTS) offers a potential means to explain suicide in physicians. The IPTS posits three necessary and sufficient precursors to death by suicide: thwarted belongingness, perceived burdensomeness, and acquired capability. The present study sought to examine whether provocative work experiences unique to physicians (e.g., placing sutures, withdrawing life support) would predict levels of acquired capability, while controlling for gender and painful and provocative experiences outside the work environment. Data were obtained from 376 of 7723 recruited physicians. Study measures included the Acquired Capability for Suicide Scale, the Interpersonal Needs Questionnaire, the Painful and Provocative Events Scale, and the Life Events Scale-Medical Doctors Version. Painful and provocative events outside of work predicted acquired capability (β=0.23, t=3.82, p<0.001, f(2)=0.09) as did provocative work experiences (β=0.12, t=2.05, p<0.05, f(2)=0.07). This represents the first study assessing the potential impact of unique work experiences on suicidality in physicians. Limitations include over-representation of Caucasian participants, limited representation from various specialties of medicine, and lack of information regarding individual differences. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. [Gold salt alveolitis in 3 patients with rheumatoid arthritis].

    PubMed

    Music, E; Tomsic, M; Logar, D

    1995-06-01

    When the characteristic symptoms for an interstitial pulmonary disease arise in patients with rheumatoid arthritis, a drug-induced alveolitis should be considered in the differential diagnosis. In such cases, the administration of the drug and gold salts should be stopped. The cases of three patients with rheumatoid arthritis (RA) who had been treated with gold salts for 2 months (A), 23 months (B), and 36 months (C) are presented. The total dose of sodium aureothiomalate amounted to 280 mg for patient A, 1150 mg for patient B, and 2190 mg for patient C. Clinical signs, X-rays of the lungs, pulmonary function tests, and laboratory tests were evaluated for the three patients while, for patient A BAL as well as provocation tests were additionally performed before and after therapy. In this case, the histological picture of the lungs is presented; biopsies were taken during the first BAL. The clinical complaints of all 3 patients were similar, with the alveolitis being observed as diffuse in one case and above all in the upper regions in two cases on radiology. This led to differing degrees of diffusion disorders in the lungs. In patient A, the diagnosis was made in the stage of progressive fibrotic alveolitis and was treated with D-penicillamine. All 3 patients received steroids over 3-6 months and the gold salts were stopped. Because of the long duration and doubtful differential diagnosis for patient A with either rheumatoid lung or gold salt alveolitis, a provocation test with sodium aureothiomalate was performed. All 3 patients had blood eosinophilia while, in case A, a thrombopenia was also found. A gold salt alveolitis can occur as a side effect of gold salts in addition to skin vasculitis and hematological disorders. When the gold salt administration is not stopped a fibrotic alveolitis can develop. The provocation test can be diagnostically useful to distinguish between a rheumatoid lung and gold salt alveolitis.

  16. Diagnostic testing of dogs for food hypersensitivity.

    PubMed

    Jeffers, J G; Shanley, K J; Meyer, E K

    1991-01-15

    Thirteen food-allergic dogs were studied to evaluate the efficacy of feeding a commercially available egg and rice diet, intradermal skin testing, and serologic testing by ELISA for diagnosing and/or characterizing food hypersensitivity. Feeding of a home-cooked whole lamb meat and rice diet for 3 weeks, followed by challenge with each dog's regular diet, served as the standard for diagnosing food hypersensitivity. Each dog underwent provocative testing with 6 individual ingredients to determine as many of its dietary allergens as possible. Prior to skin testing and serologic testing by ELISA, most dogs had been recently exposed to the offending diet and subsequently manifested clinical signs of allergy. All dogs that tolerated the aforementioned commercial diet were exposed to it for at least 7 weeks; 84.6% of food-hypersensitive dogs ate the commercial diet with impunity. Of the 2 reactors to the commercial diet, only 1 became pruritic in response to provocation testing with chicken eggs. Low sensitivity and high specificity were found for skin testing and the ELISA, indicating a lack of true- and false-positive reactions. Neither the positive nor negative predictive values adequately predicted positive and negative reactions, respectively, for either test. On the basis of these results, the commercial diet, skin testing, and anti-IgE ELISA cannot replace an owner-prepared food elimination diet for food hypersensitivity testing in dogs.

  17. Exogenous cortisol facilitates responses to social threat under high provocation.

    PubMed

    Bertsch, Katja; Böhnke, Robina; Kruk, Menno R; Richter, Steffen; Naumann, Ewald

    2011-04-01

    Stress is one of the most important promoters of aggression. Human and animal studies have found associations between basal and acute levels of the stress hormone cortisol and (abnormal) aggression. Irrespective of the direction of these changes--i.e., increased or decreased aggressive behavior--the results of these studies suggest dramatic alterations in the processing of threat-related social information. Therefore, the effects of cortisol and provocation on social information processing were addressed by the present study. After a placebo-controlled pharmacological manipulation of acute cortisol levels, we exposed healthy individuals to high or low levels of provocation in a competitive aggression paradigm. Influences of cortisol and provocation on emotional face processing were then investigated with reaction times and event-related potentials (ERPs) in an emotional Stroop task. In line with previous results, enhanced early and later positive, posterior ERP components indicated a provocation-induced enhanced relevance for all kinds of social information. Cortisol, however, reduced an early frontocentral bias for angry faces and--despite the provocation-enhancing relevance--led to faster reactions for all facial expressions in highly provoked participants. The results thus support the moderating role of social information processing in the 'vicious circle of stress and aggression'. Copyright © 2010 Elsevier Inc. All rights reserved.

  18. Affective and Cognitive Orientations in Intergroup Perception

    PubMed Central

    Wolf, Lukas J.; von Hecker, Ulrich; Maio, Gregory R.

    2017-01-01

    Three studies examined the role of need for affect (NFA) and need for cognition (NFC) in intergroup perception. We hypothesized that NFA predicts a preference for stereotypically warm groups over stereotypically cold groups, whereas NFC predicts a preference for stereotypically competent groups over stereotypically incompetent groups. Study 1 supported these hypotheses for attitudes toward stereotypically ambivalent groups, which are stereotyped as high on one of the trait dimensions (e.g., high warmth) and low on the other (e.g., low competence), but not for stereotypically univalent groups, which are seen as high or low on both dimensions. Studies 2 and 3 replicated this pattern for stereotypically ambivalent groups, and yielded provocative evidence regarding several putative mechanisms underlying these associations. Together, these findings help integrate and extend past evidence on attitude-relevant individual differences with research on intergroup perception. PMID:28903673

  19. Effects of individual strengthening exercises for the stabilization muscles on the nutation torque of the sacroiliac joint in a sedentary worker with nonspecific sacroiliac joint pain.

    PubMed

    Yoo, Won-Gyu

    2015-01-01

    [Purpose] We investigated the effects of individual strengthening exercises for the stabilization muscles on the nutation torque of the sacroiliac joint in a sedentary worker with nonspecific sacroiliac joint pain. [Subject] A 36-year-old female complained of pain in the sacroiliac joints. [Methods] The subject performed individual strengthening exercises for the stabilization muscles for nutation torque of the sacroiliac joint for 3 weeks. Pain-provocation tests and visual analog scale (VAS) scores were evaluated before and after the exercises. [Results] After performing the individual strengthening exercises for the erector spinae, rectus abdominis, and biceps femoris muscles for 3 weeks, the subject displayed no pain in the pain provocation tests, and the VAS score was 2/10. [Conclusion] The individual strengthening exercises for the stabilization muscles of the sacroiliac joint performed in the present study appear to be effective for sedentary workers with sacroiliac joint pain.

  20. Administration of arginine plus growth hormone releasing hormone to evaluate growth hormone (GH) secretory status in children with GH deficiency.

    PubMed

    Keller, A; Donaubauer, J; Kratzsch, J; Pfaeffle, R; Hirsch, W; Kiess, W; Keller, E

    2007-12-01

    Diagnosis of growth hormone deficiency (GHD) in childhood is usually based on growth hormone (GH) response to at least two provocative stimuli. The aim of this study was to determine whether sequential administration of arginine (Arg) plus GH releasing hormone (GHRH) could be a useful tool in evaluating GHD in children. Thirty patients with short stature (mean age 9.0 years) with decreased growth rate were tested for GHD with Arg and the insulin tolerance test (ITT). Patients with confirmed GHD (peak GH <8 ng/ml) were subsequently tested with Arg + GHRH. Maximum GH stimulation for Arg and ITT was 6.3 (1.0-7.8) and 6.7 (0.5-7.7) ng/ml, respectively. Peak GH for the Arg + GHRH test was 36.3 (4.3-84.5) ng/ml and significantly different from the other provocative tests. Peak GH values for the three tests were not significantly correlated between tests or with clinical parameters. There were no significant differences in Arg + GHRH results between children with or without abnormal hypothalamic-pituitary MRI scans. Arg + GHRH gave higher GH levels than insulin or Arg alone. Because of the different causes of childhood GHD (hypothalamic and/or pituitary dysfunction), the Arg + GHRH test is unsuitable .for evaluating GHD and deciding whether GH replacement therapy is indicated.

  1. Provocation of left ventricular outflow tract obstruction using nitrate inhalation in hypertrophic cardiomyopathy: Relation to electromechanical delay.

    PubMed

    Badran, Hala Mahfouz; Ibrahim, Waleed Abdou; Faheem, Naglaa; Yassin, Rehab; Alashkar, Tamer; Yacoub, Magdi

    2015-01-01

    Left ventricular outflow tract obstruction (LVOT) is an independent predictor of adverse outcome in hypertrophic cardiomyopathy (HCM). It is of major importance that the provocation modalities used are validated against each other. To define the magnitude of LVOT gradients provocation during both isosorbide dinitrate (ISDN) inhalation and treadmill exercise in non-obstructive HCM and analyze the correlation to the electromechanical delay using speckle tracking. We studied 39 HCM pts (64% males, mean age 38 ± 13 years) regional LV longitudinal strain and electromechanical delay (TTP) was analyzed at rest using speckle tracking. LVOT gradient was measured at rest and after ISDN then patients underwent a treadmill exercise echocardiography (EE) and LVOT gradient was measured at peak exercise. The maximum effect of ISDN on LVOT gradient was obtained at 5 minutes, it increased to a significant level in 12 (31%) patients, and in 14 (36%) patients using EE, with 85.6% sensitivity & 100% specificity. Patients with latent obstruction had larger left atrial volume and lower E/A ratio compared to the non-obstructive group (p < 0.01). LVOTG using ISDN was significantly correlated with that using EE (p < 0.0001), resting LVOTG (p < 0.0001), SAM (p < 0.0001), EF% (p < 0.02) and regional electromechanical delay but not related to global LV longitudinal strain. Using multivariate regression, resting LVOTG (p = 0.006) & TTP mid septum (p = 0.01) were found to be independent predictors of latent LVOT obstruction using ISDN. There is a comparable diagnostic value of nitrate inhalation to exercise testing in provocation of LVOT obstruction in HCM. Latent obstruction is predominantly dependent on regional electromechanical delay.

  2. Provocation of left ventricular outflow tract obstruction using nitrate inhalation in hypertrophic cardiomyopathy: Relation to electromechanical delay

    PubMed Central

    Badran, Hala Mahfouz; Ibrahim, Waleed Abdou; Faheem, Naglaa; Yassin, Rehab; Alashkar, Tamer; Yacoub, Magdi

    2015-01-01

    Background: Left ventricular outflow tract obstruction (LVOT) is an independent predictor of adverse outcome in hypertrophic cardiomyopathy (HCM). It is of major importance that the provocation modalities used are validated against each other. Aim: To define the magnitude of LVOT gradients provocation during both isosorbide dinitrate (ISDN) inhalation and treadmill exercise in non-obstructive HCM and analyze the correlation to the electromechanical delay using speckle tracking. Methods: We studied 39 HCM pts (64% males, mean age 38 ± 13 years) regional LV longitudinal strain and electromechanical delay (TTP) was analyzed at rest using speckle tracking. LVOT gradient was measured at rest and after ISDN then patients underwent a treadmill exercise echocardiography (EE) and LVOT gradient was measured at peak exercise. Results: The maximum effect of ISDN on LVOT gradient was obtained at 5 minutes, it increased to a significant level in 12 (31%) patients, and in 14 (36%) patients using EE, with 85.6% sensitivity & 100% specificity. Patients with latent obstruction had larger left atrial volume and lower E/A ratio compared to the non-obstructive group (p < 0.01). LVOTG using ISDN was significantly correlated with that using EE (p < 0.0001), resting LVOTG (p < 0.0001), SAM (p < 0.0001), EF% (p < 0.02) and regional electromechanical delay but not related to global LV longitudinal strain. Using multivariate regression, resting LVOTG (p = 0.006) & TTP mid septum (p = 0.01) were found to be independent predictors of latent LVOT obstruction using ISDN. Conclusion: There is a comparable diagnostic value of nitrate inhalation to exercise testing in provocation of LVOT obstruction in HCM. Latent obstruction is predominantly dependent on regional electromechanical delay. PMID:26779503

  3. Psychophysical and vasomotor evidence for interdependency of TRPA1 and TRPV1 nociceptive responses in human skin: an experimental study.

    PubMed

    Nielsen, Thomas Arendt; Eriksen, Matilde Alida; Gazerani, Parisa; Andersen, Hjalte Holm

    2018-05-25

    The TRPA1 and TRPV1 receptors are important pharmaceutical targets for antipruritic and analgesic therapy. Obtaining further knowledge on their roles and inter-relationship in humans is therefore crucial. Preclinical results are contradictory concerning co-expression and functional interdependency of TRPV1 and TRPA1 but no human evidence exists. This human experimental study investigated whether functional responses from the subpopulation of TRPA1-nociceptors could be evoked following defunctionalization of TRPV1-nociceptors by cutaneous application of high-concentration capsaicin. Two quadratic areas on each forearm were randomized to pretreatment with an 8% topical capsaicin patch or vehicle for 24h. Subsequently, areas were provoked by transdermal 1% topical capsaicin (TRPV1 agonist) or 10% topical allyl-isothiocyanate ('AITC', a TRPA1-agonist), delivered by 12mm Finn chambers. Evoked pain intensities were recorded during pretreatments and chemical provocations. Quantitative sensory tests were performed before and after provocations to assess changes of heat pain sensitivity. Imaging of vasomotor responses was used to assess neurogenic inflammation after the chemical provocations. In the capsaicin-pretreated areas both the subsequent 1% capsaicin- and 10% AITC-provoked pain intensities were inhibited by 92.9±2.5% and 86.9±5.0% (both: P<0.001), respectively. The capsaicin-ablated skin areas showed significant heat hypoalgesia at baseline (P<0.001) as well as heat antihyperalgesia, and inhibition of neurogenic inflammation evoked by both 1% capsaicin- and 10% AITC provocations (both: P<0.001). Ablation of capsaicin-sensitive afferents caused consistent and equal inhibition of both TRPV1 and TRPA1-provoked responses assessed psychophysically and by imaging of vasomotor responses. The present study suggests that TRPA1 nociceptive responses in human skin strongly depend on intact capsaicin-sensitive, TPRV1 fibers.

  4. Validity and Measurement

    ERIC Educational Resources Information Center

    Maraun, Michael D.

    2012-01-01

    As illuminated forcefully by Professor Newton's provocative analytical and historical excursion, as long as tests are employed to practical ends (prediction, selection, etc.) there is little cause for the metatheoretic angst that occasions rounds of papers on the topic of validity. But then, also, there seems little need, within this context of…

  5. [Growth rate and bone maturation in celiac disease (author's transl)].

    PubMed

    Martínez Sopena, M J; Calvo Romero, M C; Bedate Calderón, P; Alonso Franch, M; Sánchez Villares, E

    1978-05-01

    The growth and bone maturation of 43 celiac patients were analyzed. A significant correlation between gluten intake and growth rate was found. The authors suggest this is a good parameter to advise the best moment to make the control biopsie and the provocation test.

  6. Does muscle creatine phosphokinase have access to the total pool of phosphocreatine plus creatine?

    PubMed

    Hochachka, P W; Mossey, M K

    1998-03-01

    Two fundamental assumptions underlie currently accepted dogma on creatine phosphokinase (CPK) function in phosphagen-containing cells: 1) CPK always operates near equilibrium and 2) CPK has access to, and reacts with, the entire pool of phosphocreatine (PCr) and creatine (Cr). We tested the latter assumption in fish fast-twitch or white muscle (WM) by introducing [14C]Cr into the WM pool in vivo. To avoid complications arising from working with muscles formed from a mixture of fast and slow fibers, it was advantageous to work with fish WM because it is uniformly fast twitch and is anatomically separated from other fiber types. According to current theory, at steady state after [14C]Cr administration, the specific activities of PCr and Cr should be the same under essentially all conditions. In contrast, we found that, in various metabolic states between rest and recovery from exercise, the specific activity of PCr greatly exceeds that of Cr. The data imply that a significant fraction of Cr is not free to rapidly exchange with exogenously added [14C]Cr. Releasing of this unlabeled or "cold" Cr on acid extraction accounts for lowered specific activities. This unexpected and provocative result is not consistent with traditional models of phosphagen function.

  7. Aggression in Children with Conduct Problems and Callous-Unemotional Traits: Social Information Processing and Response to Peer Provocation.

    PubMed

    Helseth, Sarah A; Waschbusch, Daniel A; King, Sara; Willoughby, Michael T

    2015-11-01

    Callous/unemotional traits (CU) moderate children's conduct problems (CP) in numerous domains, including social functioning. The present study examined whether CU traits also moderate the aggressiveness of children's social information processing (SIP) and responses to varying intensities of peer provocation. Sixty elementary school-age children (46 males) were grouped into those without CP or CU (controls, n = 32), those with CP but not CU (CP-only; n = 14), and those with both CP and CU (CPCU, n = 14). Participants completed a task that measured two aspects of SIP (response generation and hostile attribution bias) and a computerized reaction time task (CRTT) that measured behavior, affect, and communication before and after provocation under instrumental and hostile aggressive conditions. Children with CPCU generated more aggressive responses than controls on measures of SIP. On the CRTT, all children exhibited reactive aggression following high provocation, but only children with CPCU exhibited proactive aggression, and reactive aggression following low provocation; no differences in affect were found. In a series of exploratory analyses, CPCU children communicated antisocially, while CP-only communicated prosocially. Finally, children with CPCU did not seem to hold a grudge following the final instance of provocation, instead gradually returning to baseline like their non-CU peers. These distinct social cognitive and behavioral profiles hint at different etiologies of CP and CPCU, underscoring the variability of aggression in these populations.

  8. Standing Vs Supine; Does it Matter in Cough Stress Testing?

    PubMed

    Patnam, Radhika; Edenfield, Autumn L; Swift, Steven E

    The aim of this study was to compare the sensitivity of cough stress test in the standing versus supine position in the evaluation of incontinent females. We performed a prospective observational study of women with the chief complaint of urinary incontinence (UI) undergoing a provocative cough stress test (CST). Subjects underwent both a standing and a supine CST. Testing order was randomized via block randomization. Cough stress test was performed in a standard method via backfill of 200 mL or until the subject described strong urge. The subjects were asked to cough, and the physician documented urine leakage by direct observation. The gold standard for stress UI diagnosis was a positive CST in either position. Sixty subjects were enrolled, 38 (63%) tested positive on any CST, with 38 (63%) positive on standing compared with 29 (28%) positive on supine testing. Nine women (15%) had positive standing and negative supine testing. No subjects had negative standing with positive supine testing. There were no significant differences in positive tests between the 2 randomized groups (standing first and supine second vs. supine first and standing second). When compared with the gold standard of any positive provocative stress test, the supine CST has a sensitivity of 76%, whereas the standing CST has a sensitivity of 100%. The standing CST is more sensitive than the supine CST and should be performed in any patient with a complaint of UI and negative supine CST. The order of testing either supine or standing first does not affect the results.

  9. Physical aggression as a function of perceived fighting ability and provocation: an experimental investigation.

    PubMed

    Archer, John; Benson, David

    2008-01-01

    In three studies, Resource Holding Power (RHP) and provocation were manipulated in scenarios involving a young person in a bar with friends. In Study 1, teenage men reported lower likelihood of responding with physical aggression when insulted as levels of three RHP cues (size, allies and reputation) increased, effects that were accentuated by combinations of high-RHP cues; in the second part of this study, they consistently rated an insult to their girlfriend as the most provoking from a range of possible provocations, chosen on theoretical and empirical grounds. Study 2 replicated the results of the first part of Study 1 in samples of men and women in their twenties, although the effects were weaker at low levels of RHP. Study 3 combined a high- or low-provoking event, with low, medium or high RHP, and a wider range of response choices. As expected, direct aggression increased as provocation increased and RHP decreased. Delayed aggressive responses, including revenge fantasies, were highest in response to high provocation and high RHP. Findings are discussed in relation to theoretical models of aggressive motivation. (c) 2007 Wiley-Liss, Inc.

  10. [Adrenomedullin--the link between the sympathetic nervous system activation and peripheral vasodilatation in some patients with vasovagal syncope].

    PubMed

    Gajek, Jacek; Zyśko, Dorota; Halawa, Bogumił

    2004-09-01

    Adrenomedullin (ADM) is a potent vasodilator playing role in regulation of central hemodynamic. The concentration of plasma ADM in healthy people increases under the influence of orthostatic stress. In patients with vasovagal syncope (VS) the changes in ADM concentration could be responsible either for syncope provocation or prevention. The aim of the study was to assess the influence of phase of the head-up tilt test (HUTT) in which the syncope occurred on the plasma concentration of ADM. The study was performed in 25 patients (pts) (18 women and 7 men), mean age 45.0+/-16.1 years with cardiodepressive reactions during HUTT according to the Italian protocol with nitroglycerine (NTG) provocation if necessary: Syncope was caused in 23 pts due to vasovagal reaction: in 17 pts syncope occurred after NTG provocation (group 1), and in 6 pts occurred in the passive phase of tilt (group 2a), in 2 pts due to dysautonomic reactions (group 2b). The head-up tilt test was performed according to ESC guidelines. The blood for ADM concentration was drawn after 30 min supine rest (ADM 1) and immediately after syncope (ADM 2). ADM level was measured using radioimmunological method. The results. In group 1 plasma level of ADM significantly decreased after the HUTT (3.2+/-3.4 vs 1.7+/-1,4 pg/0.1 ml; p<0.05) and in group 2a increased significantly (1.3+/-0.8 vs 2.7+/-1.3 pg/0.1 ml; p<0.05) comparing to baseline values. The ADM concentration did not differ between the groups in baseline conditions and was significantly higher after the syncope in group 2a (p<0.05). Conclusions. The excessive increase of ADM concentration during the passive phase of HUTT could play the causative role in pathogenesis of VS occurring early during the HUTT. In patients with VS after NTG provocation the decrease of ADM concentration can be the result of hemodynamic changes in the presence of vasodilating drug and may be the mechanism that could prevent the syncope.

  11. Measures of central hyperexcitability in chronic whiplash associated disorder--a systematic review and meta-analysis.

    PubMed

    Stone, Andrew M; Vicenzino, Bill; Lim, Edwin C W; Sterling, Michele

    2013-04-01

    To synthesise the evidence for central hyperexcitability in Chronic WAD (whiplash associated disorders) with meta-analysis, and review test protocols. Chronic WAD was compared to healthy controls. Studies were eligible if they used measures of central hyperexcitability with standardised procedure. Meta-analyses (where possible) were conducted. The search yielded 27 trials of good quality and 13 were suitable for meta-analyses. Individuals with chronic WAD showed heightened sensitivity to the following tests (p < 0.05): Pressure Pain Thresholds at Head/Neck/Upper Thoracic area (H/N/UT) (SMD (Standardised mean differences) -1.36, 95% CI (confidence intervals) -1.89 to -0.82), Upper Limb (UL) (-1.33, 95% CI -2.50 to -0.16), Lower Limb (LL) (-1.01, 95% CI -1.70 to -0.33), flexor withdrawal (-0.73, 95% CI -1.11 to -0.35), Cold Pain Threshold at H/N/UT (0.91, 95% CI 0.66-1.17) and UL (0.66, 95% CI 0.37-0.94), Heat Pain Threshold at H/N/UT (-0.58, 95% CI -0.88 to -0.28), Electrocutaneous Stimulation at H/N/UT (-1.04, 95% CI -1.63 to -0.45) and LL (-0.85, 95% CI -1.67 to -0.03), and elbow extension with the Brachial Plexus Provocation Test (SMD -0.55, 95% CI -0.76 to -0.35). There is compelling evidence for central hyperexcitability in chronic WAD. This should be considered in the management of chronic WAD. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Esophageal motor function: technical aspects of manometry.

    PubMed

    Gyawali, C Prakash; Patel, Amit

    2014-10-01

    High-resolution manometry (HRM) has advanced the understanding of esophageal peristaltic mechanisms and has simplified esophageal motor testing. In this article the technical aspects of HRM are addressed, focusing on test protocols, in addition to concerns and pitfalls in performing esophageal motor studies. Specifically, catheter positioning, equipment-related artifacts, basal data acquisition, adequate swallows, and provocative maneuvers are discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Metabolic myopathies

    NASA Technical Reports Server (NTRS)

    Martin, A.; Haller, R. G.; Barohn, R.; Blomqvist, C. G. (Principal Investigator)

    1994-01-01

    Metabolic myopathies are disorders of muscle energy production that result in skeletal muscle dysfunction. Cardiac and systemic metabolic dysfunction may coexist. Symptoms are often intermittent and provoked by exercise or changes in supply of lipid and carbohydrate fuels. Specific disorders of lipid and carbohydrate metabolism in muscle are reviewed. Evaluation often requires provocative exercise testing. These tests may include ischemic forearm exercise, aerobic cycle exercise, and 31P magnetic resonance spectroscopy with exercise.

  14. Evaluation of canine adverse food reactions by patch testing with single proteins, single carbohydrates and commercial foods.

    PubMed

    Johansen, Cornelia; Mariani, Claire; Mueller, Ralf S

    2017-10-01

    Adverse food reaction (AFR) is an important differential diagnosis for the pruritic dog. It is usually diagnosed by feeding an elimination diet with a novel protein and carbohydrate source for eight weeks followed by subsequent food provocation. A previous study demonstrated that patch testing dogs with foods had a high sensitivity and negative predictability for selection of elimination diet ingredients. The aim of this study was to investigate patch testing with proteins, carbohydrates and dry commercial dog food in dogs to determine whether there was value in patch testing to aid the diagnosis of canine adverse food reaction. Twenty five privately owned dogs, with confirmed AFR, underwent provocation trials with selected food antigens and patch testing. For proteins, carbohydrates and dry dog food the sensitivity of patch testing was 100%, 70% and 22.2%, respectively; the negative predictive values of patch testing were 100%, 79% and 72%. The positive predictive values of patch testing for proteins and carbohydrates were 75% and 74%, respectively. This study confirmed that patch testing may be useful for the selection of a suitable protein source for an elimination diet in dogs with suspected AFR, but not as a diagnostic tool for canine AFR. Results for proteins are more reliable than for carbohydrates and the majority of positive patch test reactions were observed with raw protein. Patch testing with commercial dog food does not seem to be useful. © 2017 ESVD and ACVD.

  15. Gender differences in the effect of visual sexual stimulation on the perceived covariation between freedom and responsibility.

    PubMed

    Nevala, James D; Gray, Nicholas J; McGahan, Joseph R; Minchew, Teresa

    2006-03-01

    The authors replicated and extended a test of Epstein's cognitive-experiential self-theory (CEST; S. Epstein, 1973, 1980, 1985, 1994, 2003) regarding subjective estimates of the relationship between freedom and responsibility. CEST predicts that information in the form of sexually provocative images is likely to be processed by the experiential system. The authors' hypothesis was that such experiential processing would cause an increase in the likelihood of participants endorsing as true a statement that proposed a negative correlation between freedom and responsibility. University students (N = 97) in introductory psychology classes viewed 25 images of either men or women in provocative clothing, or a control consisting of academic journal covers, after which they responded to 24 statements proposing either a positive, negative, or noncontingent relationship between freedom and responsibility. Judgments were analyzed according to perceiver gender and target gender, as well as the framing of the proposition and its contingency category. The hypothesis was supported for the men and to a lesser extent for the women. Although priming the experiential system by exposing participants to sexually provocative images did not change endorsement rates of positive contingencies, it did lead to an increase in the likelihood of simultaneously endorsing negative contingencies.

  16. Provocative Questions in Cancer: NCI Seminar

    Cancer.gov

    science writers' seminar to discuss various aspects of one of NCI’s signature efforts -- the Provocative Questions project. Discussion will focus on the scientific research that surrounds some of these questions.

  17. Occupational asthma due to polyethylene shrink wrapping (paper wrapper's asthma).

    PubMed Central

    Gannon, P F; Burge, P S; Benfield, G F

    1992-01-01

    Occupational asthma due to the pyrolysis products of polyvinyl chloride (PVC) produced by shrink wrapping processes has previously been reported. The first case of occupational asthma in a shrink wrap worker using a different plastic, polyethylene, is reported; the association was confirmed by specific bronchial provocation testing. PMID:1440477

  18. Do You Have to be Angry to be Aggressive?

    ERIC Educational Resources Information Center

    Wienir, Paul L.

    Seven hypotheses regarding the role of anger for aggressive behavior were testes in an experimental exchange situation using male children as subjects. In previous studies, anger had not actually been employed as the intervening variable in a provocation/aggressive cue-aggression model. The results indicate a strong relationship between…

  19. Novel hybrid technology for early diagnostics of sepsis

    NASA Astrophysics Data System (ADS)

    Saknite, Inga; Grabovskis, Andris; Kazune, Sigita; Rubins, Uldis; Marcinkevics, Zbignevs; Volceka, Karina; Kviesis-Kipge, Edgars; Spigulis, Janis

    2017-02-01

    Sepsis is a potentially fatal disease with mortality rate as high as 50% in patients with septic shock; mortality rate can increase by 7.6% per hour if appropriate treatment is not started. Internationally accepted guidelines for diagnosis of sepsis rely on vital sign monitoring and laboratory tests in order to recognize organ failure. This pilot study aims to explore the potential of hyperspectral and thermal imaging techniques to identify and quantify early alterations in skin oxygenation and perfusion induced by sepsis. The study comprises both physiological model experiments on healthy volunteers in a laboratory environment, as well as screening case series of patients with septic shock in the intensive care department. Hyperspectral imaging is used to determine one of the main characteristic visual signs of skin oxygenation abnormalities - skin mottling, whereas changes in peripheral perfusion have been visualized by thermal imaging as heterogeneous skin temperature areas. In order to mimic septic skin mottling in a reproducible way in laboratory environment, arterial occlusion provocation test was utilized on healthy volunteers. Visualization of oxygen saturation by hyperspectral imaging allows diagnosing microcirculatory alterations induced by sepsis earlier than visual assessment of mottling. Thermal images of sepsis patients in the clinic clearly reveal hotspots produced by perforating arteries, as well as cold regions of low blood supply. The results of this pilot study show that thermal imaging in combination with hyperspectral imaging allows the determination of oxygen supply and utilization in critically ill septic patients.

  20. Diagnostic tools for post-gastric bypass hypoglycaemia.

    PubMed

    Emous, M; Ubels, F L; van Beek, A P

    2015-10-01

    In spite of its evident success, several late complications can occur after gastric bypass surgery. One of these is post-gastric bypass hypoglycaemia. No evidence-based guidelines exist in the literature on how to confirm the presence of this syndrome. This study aims to describe and compare the tests aimed at making a diagnosis of post-gastric bypass hypoglycaemia and to provide a diagnostic approach based upon the available evidence. A search was conducted in PubMed, Cochrane and Embase. A few questionnaires have been developed to measure the severity of symptoms in post-gastric bypass hypoglycaemia but none has been validated. The gold standard for provocation of a hypoglycaemic event is the oral glucose tolerance test or the liquid mixed meal tolerance test. Both show a high prevalence of hypoglycaemia in post-gastric bypass patients with and without hypoglycaemic complaints as well as in healthy volunteers. No uniformly established cut-off values for glucose concentrations are defined in the literature for the diagnosis of post-gastric bypass hypoglycaemia. For establishing an accurate diagnosis of post-gastric bypass hypoglycaemia, a validated questionnaire, in connection with the diagnostic performance of provocation tests, is the most important thing missing. Given these shortcomings, we provide recommendations based upon the current literature. © 2015 World Obesity.

  1. 391 Description of Drug Allergy Study Conducted in a Teaching Hospital between October 2007 and March 2011

    PubMed Central

    Rodríguez Martínez, Consuelo Fernanda; Rubio, Alicia Sciaraffia

    2012-01-01

    Background The World Allergy Organization (WAO) in 2003 defined ‘drug allergy’ as an immunologically mediated drug hypersensitivity reaction. The mechanism of drug allergy may be either IgE or non-IgE mediated. The true incidence of drug allergy is not known. There are only few studies/datasets using standardized clinical questionnaires and validated in vivo or in vitro tests to confirm the diagnosis of drug allergy. Here we have analyzed the obtained results of in vivo test in suspected drug allergy patients. Methods Data from the Centre of Allergies of the Clinical Hospital of the Universidad de Chile between the months of October 2007 and March 2011 was obtained. The information of the protocols of drug executed, by defining as Protocol the study of a probable allergy by 2 or more procedures, which can be: Prick Test, intradermal reaction, specific IgE and/or Test Patch. Results For a total of 126 drug protocols, 25% of them were trivírica vaccine, 24% β-lactams, 21% local anaesthetics and 10% to general anesthesia (inductors, muscle relaxants and Latex). Of the total of patients undergoing protocols the most of them were women, there is no clear difference between the number of children and adults. The temporal distribution of protocols was stable between the months of October 2007 and March 2009 (15 protocols/semester), to then become variable, reaching values between 10 and 29 every 6 months. Of total protocols, 30.1% were positive; only one patient presented a mild adverse reaction (local welt). The β-lactams being most often the positive drugs. Protocols involving pethidine 100% was positive, diclofenac 33%, dipyrone, ketoprofen and hydrocortisone each one 25%. The most accomplished protocol was trivírica vaccine, resulting in 100% negative. Of all negative protocols 58% went to provocation, resulting in a 8% positive, including one provocation to the trívirica vaccine. Conclusions Methodologicall study is very important for a possible drug allergy, because history is not enough to certify the diagnosis. To do a provocation test to a negative protocol is crucial.

  2. Influence of tilt training on activation of the autonomic nervous system in patients with vasovagal syncope.

    PubMed

    Gajek, Jacek; Zyśko, Dorota; Halawa, Bogumił; Mazurek, Walentyna

    2006-04-01

    Tilt training is a new treatment for vasovagal syncope. Its therapeutic efficacy is thought to be the result of the desensitization of cardiopulmonary receptors, but it could be the influence of the tilt training on the activation of the autonomic nervous system as well. The study group consisted of 24 vasovagal patients (17 women and 7 men) aged 32.5 +/- 11.8 years. The diagnostic head-up tilt test was performed according to the Italian protocol with nitroglycerin if necessary. The monitoring head-up tilt test was performed according to the Westminster protocol without provocation, after 1 to 3 months of tilt training. Holter ECG recordings for HRV parameters (time and frequency domain) were obtained from selected 2-min intervals before, during and after the diagnostic and monitoring tilt test. The diagnostic test was positive in the passive phase in 6 and after provocation in 18 patients. During the training period no syncope occurred. Analysing the HRV parameters we demonstrated the following findings: I. mRR decreases immediately after assumption of a vertical position in both tests (diagnostic and monitoring) but in the diagnostic test its further decrease occurs earlier than in the monitoring test; 2. the absolute power of the HF component is greater in the early phase of tilt after tilt training than in the corresponding period in the diagnostic test. After a longer period of tilt training the activation of the sympathetic nervous system in response to the erect position is diminished.

  3. Effects on skin blood flow by provocation during local analgesia.

    PubMed

    Arildsson, M; Nilsson, G E; Strömberg, T

    2000-01-01

    Although topical analgesia cream has been used for several years, little is known about its effects on the microcirculation. Previous studies have shown a vasoconstrictive effect after short application times and a vasodilatation after longer application. It has also been shown that vasomotion does not occur in the analgesized skin. The present study was undertaken to investigate the alterations in skin blood perfusion following local cooling, local heating and pin-pricking after the establishment of analgesia. In 11 healthy volunteers, skin analgesia was attained by use of a eutectic mixture of lidocaine and prilocaine (EMLA, Astra Pain Control AB, Sweden) applied to the skin three hours prior to provocation. The changes in skin blood perfusion, after applying three different provocation methods, were studied using the laser Doppler technique. Local cooling and heating to temperatures of +10 and +45 degrees C, respectively, were applied for 9 s by use of a copper probe (O12 mm). In the pin-prick provocation method, a combined effect of deflection and penetration of the skin to in total 3 mm was attained. Identical provocation methods were applied to placebo treated and untreated skin areas. After heat provocation, significant differences in the perfusion response between the treatments were seen (P < 0.0001). Skin areas treated with analgesia cream responded with a slow increase in perfusion that persisted beyond the four minute measurement period. Placebo and untreated areas decreased their perfusion over time. After cooling a significant reduction in skin perfusion was seen, irrespective of the treatment. Similarly, after pin-pricking a perfusion increase was seen for all treatments. The findings indicate that topical analgesia influences the myogenic control of the blood flow in those vascular plexa measured by laser Doppler following heat provocation. No differences could be seen in the response to pin-pricking and cooling for the different treatments. Copyright 2000 Academic Press.

  4. Face-Emotion Processing in Offspring at Risk for Panic Disorder.

    ERIC Educational Resources Information Center

    Pine, Daniel S.; Klein, Rachel G.; Mannuzza, Salvatore; Moulton, John L., III; Lissek, Shmuel; Guardino, Mary; Woldehawariat, Girma

    2005-01-01

    Objective: Panic disorder (PD) has been linked to perturbed processing of threats. This study tested the hypotheses that offspring of parents with PD and offspring with anxiety disorders display relatively greater sensitivity and attention allocation to fear provocation. Method: Offspring of adults with PD, major depressive disorder (MDD), or no…

  5. Rapid Detection of Visually Provocative Animals by Preschool Children and Adults

    ERIC Educational Resources Information Center

    Penkunas, Michael J.; Coss, Richard G.

    2013-01-01

    The ability to detect dangerous animals rapidly in complex landscapes has been historically important during human evolution. Previous research has shown that snake images are more readily detected than images of benign animals. To provide a stringent test of superior snake detection in preschool children and adults, Experiment 1 consisted of two…

  6. Growth hormone: its measurement and the need for assay harmonization.

    PubMed

    Wood, P

    2001-09-01

    Serum human growth hormone (hGH) assays show a wide range in bias and in cut-off values for provocative tests, which vary from 13.5 to 35-40 mU/L when they have been established. Studies using novel hGH assays show that methods that are absolutely specific for 22-kDa hGH may not identify bioactive hGH peaks and that 20:22-kDa hGH ratios are increased in acromegaly. Greater harmonization of serum hGH methods can be achieved by: changing from IS 80/505 to IS 98/574, which is calibrated in mass units of recombinant 22-kDa hGH; using monoclonal/polyclonal or polyclonal/polyclonal antibody combinations that measure both 20-kDa and 22-kDa hGH; the development of assays such as the immunofunctional hGH assay which has the convenience of an immunometric assay but gives results that correlate better with bioassays collaboration between manufacturers and laboratories to establish method-related cut-off limits for provocative tests of hGH status.

  7. Domestic Violence and Vagal Reactivity to Peer Provocation

    PubMed Central

    Katz, Lynn Fainsilber

    2007-01-01

    This paper examined whether individual differences in children’s vagal reactivity to peer provocation was related to domestic violence within the family. It also examined the question of whether conduct-problem children who show vagal augmentation to peer provocation come from families with high levels of domestic violence. During the peer provocation, children were expecting to interact with a difficult peer while vagal reactivity was assessed. Groups were divided into children who showed vagal augmentation and vagal suppression to the stressful peer interaction. Findings indicated that conduct-problem children who showed vagal augmentation to interpersonal challenge came from families with the highest levels of domestic violence. Vagal augmentation was also associated with a greater number of conduct-related problems for those children exposed to high levels of domestic violence. Discussion highlights the role of individual differences in physiological reactivity in understanding children’s behavior problems in relation to domestic violence. PMID:17118516

  8. Perpetrators and targets of bullying at work: role stress and individual differences.

    PubMed

    Matthiesen, Stig Berge; Einarsen, Ståle

    2007-01-01

    A workplace survey study (N = 2215, response rate 47%) revealed that about 16% of the sample may be categorized as either perpetrators (5.4%), provocative victims (2.1%), or as targets of bullying (8.3%). Targets of bullying, provocative victims, and bullies were compared with those 84% who do not report any involvement with respect to bullying at work, self-esteem, aggressive tendencies, prior experiences of bullying, or experiences of role stress. Perpetrators were found to have a higher level of aggression than did the comparison group and the targets. Provocative victims manifested a low level of self-esteem and social competency combined with a high level of aggressiveness. Targets of bullying revealed low levels of self-esteem and social competency. Targets, provocative victims, and perpetrators reported elevated levels of role stress in the form of unclear or conflicting demands and expectations around work tasks and daily work.

  9. Clinical tube weaning supported by hunger provocation in fully-tube-fed children.

    PubMed

    Hartdorff, Caroline M; Kneepkens, C M Frank; Stok-Akerboom, Anita M; van Dijk-Lokkart, Elisabeth M; Engels, Michelle A H; Kindermann, Angelika

    2015-04-01

    Children with congenital malformations, mental retardation, and complex early medical history frequently have feeding problems. Although tube feeding is effective in providing the necessary energy and nutrients, it decreases the child's motivation to eat and may lead to oral aversion. In this study, we sought to confirm our previous results, showing that a multidisciplinary clinical hunger provocation program may lead to quick resumption of oral feeding. In a crossover study, 22 children of 9 to 24 months of age who were fully dependent on tube feeding were randomly assigned to one of two groups: group A, intervention group (2-week multidisciplinary clinical hunger provocation program); and group B, control group (4-week outpatient treatment by the same multidisciplinary team). Patients failing one treatment were reassigned to the other treatment group. Primary outcome measures were at least 75% orally fed at the conclusion of the intervention and fully orally fed and gaining weight 6 months after the intervention. In group A, 9/11 patients were successfully weaned from tube feeding (2 failures: 1 developed ulcerative colitis, 1 drop-out). In group B, only 1 patient was weaned successfully; 10/11 were reassigned to the clinical hunger provocation program, all being weaned successfully. Six months after the intervention, 1 patient had to resume tube feeding. In total, in the control group, 1/11 (9%) was weaned successfully as compared with 18/21 (86%) in the hunger provocation group (P < 0.001). Multidisciplinary clinical hunger provocation is an effective short-term intervention for weaning young children from tube feeding.

  10. Do TETRA (Airwave) base station signals have a short-term impact on health and well-being? A randomized double-blind provocation study.

    PubMed

    Wallace, Denise; Eltiti, Stacy; Ridgewell, Anna; Garner, Kelly; Russo, Riccardo; Sepulveda, Francisco; Walker, Stuart; Quinlan, Terence; Dudley, Sandra; Maung, Sithu; Deeble, Roger; Fox, Elaine

    2010-06-01

    "Airwave" is the new communication system currently being rolled out across the United Kingdom for the police and emergency services, based on the Terrestrial Trunked Radio Telecommunications System (TETRA). Some police officers have complained about skin rashes, nausea, headaches, and depression as a consequence of using their Airwave handsets. In addition, a small subgroup in the population self-report being sensitive to electromagnetic fields (EMFs) in general. We conducted a randomized double-blind provocation study to establish whether short-term exposure to a TETRA base station signal has an impact on the health and well-being of individuals with self-reported "electrosensitivity" and of participants who served as controls. Fifty-one individuals with self-reported electrosensitivity and 132 age- and sex-matched controls participated in an open provocation test; 48 sensitive and 132 control participants went on to complete double-blind tests in a fully screened semianechoic chamber. Heart rate, skin conductance, and blood pressure readings provided objective indices of short-term physiological response. Visual analog scales and symptom scales provided subjective indices of well-being. We found no differences on any measure between TETRA and sham (no signal) under double-blind conditions for either controls or electrosensitive participants, and neither group could detect the presence of a TETRA signal at rates greater than chance (50%). When conditions were not double blind, however, the self-reported electrosensitive individuals did report feeling worse and experienced more severe symptoms during TETRA compared with sham. Our findings suggest that the adverse symptoms experienced by electrosensitive individuals are due to the belief of harm from TETRA base stations rather than to the low-level EMF exposure itself.

  11. Do TETRA (Airwave) Base Station Signals Have a Short-Term Impact on Health and Well-Being? A Randomized Double-Blind Provocation Study

    PubMed Central

    Wallace, Denise; Eltiti, Stacy; Ridgewell, Anna; Garner, Kelly; Russo, Riccardo; Sepulveda, Francisco; Walker, Stuart; Quinlan, Terence; Dudley, Sandra; Maung, Sithu; Deeble, Roger; Fox, Elaine

    2010-01-01

    Background “Airwave” is the new communication system currently being rolled out across the United Kingdom for the police and emergency services, based on the Terrestrial Trunked Radio Telecommunications System (TETRA). Some police officers have complained about skin rashes, nausea, headaches, and depression as a consequence of using their Airwave handsets. In addition, a small subgroup in the population self-report being sensitive to electromagnetic fields (EMFs) in general. Objectives We conducted a randomized double-blind provocation study to establish whether short-term exposure to a TETRA base station signal has an impact on the health and well-being of individuals with self-reported “electrosensitivity” and of participants who served as controls. Methods Fifty-one individuals with self-reported electrosensitivity and 132 age- and sex-matched controls participated in an open provocation test; 48 sensitive and 132 control participants went on to complete double-blind tests in a fully screened semianechoic chamber. Heart rate, skin conductance, and blood pressure readings provided objective indices of short-term physiological response. Visual analog scales and symptom scales provided subjective indices of well-being. Results We found no differences on any measure between TETRA and sham (no signal) under double-blind conditions for either controls or electrosensitive participants, and neither group could detect the presence of a TETRA signal at rates greater than chance (50%). When conditions were not double blind, however, the self-reported electrosensitive individuals did report feeling worse and experienced more severe symptoms during TETRA compared with sham. Conclusions Our findings suggest that the adverse symptoms experienced by electrosensitive individuals are due to the belief of harm from TETRA base stations rather than to the low-level EMF exposure itself. PMID:20075020

  12. An Apparatus to Deliver Mannitol Powder for Bronchial Provocation in Children Under Six Years Old.

    PubMed

    Tang, Patricia; Leung, Sharon S Y; Hor, Eleanor; Ruzycki, Conor A; Carrigy, Nicholas B; Finlay, Warren H; Brannan, John D; Devadason, Sunalene; Anderson, Sandra D; Sly, Peter D; Samnick, Kevin; Chan, Hak-Kim

    2015-12-01

    Currently bronchial provocation testing (BPT) using mannitol powder cannot be performed in children under 6 years. A primary reason is it is challenging for children at this age to generate a consistent inspiratory effort to inhale mannitol efficiently from a dry powder inhaler. A prototype system, which does not require any inhalation training from the pediatric subject, is reported here. It uses an external source of compressed air to disperse mannitol powder into a commercial holding chamber. Then the subject uses tidal breathing to inhale the aerosol. The setup consists of a commercially available powder disperser and Volumatic™ holding chamber. Taguchi experimental design was used to identify the effect of dispersion parameters (flow rate of compressed air, time compressed air is applied, mass of powder, and the time between dispersion and inhalation) on the fine particle dose (FPD). The prototype was tested in vitro using a USP throat connected to a next generation impactor. The aerosols from the holding chamber were drawn at 10 L/min. A scaling factor for estimating the provoking dose to induce a 15% reduction in forced expiratory volume in 1 second (FEV1) (PD15) was calculated using anatomical dimensions of the human respiratory tract at various ages combined with known dosing values from the adult BPT. Consistent and doubling FPDs were successfully generated based on the Taguchi experimental design. The FPD was reliable over a range of 0.8 (±0.09) mg to 14 (±0.94) mg. The calculated PD15 for children aged 1-6 years ranged from 7.1-30 mg. The FPDs generated from the proposed set up are lower than the calculated PD15 and therefore are not expected to cause sudden bronchoconstriction. A prototype aerosol delivery system has been developed that is consistently able to deliver doubling doses suitable for bronchial provocation testing in young children.

  13. Noninvasive ergonovine maleate provocative testing for coronary artery spasm: the need for routine thallium-201 imaging

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

    Shanes, J.G.; Krone, R.J.; Fisher, K.

    1983-01-01

    We administered ergonovine and used both electrocardiographic monitoring and thallium-/sup 201/ (/sup 201/Tl) imaging to detect reversible ischemia in 100 patients. Patients already established as having coronary artery spasm and those with nonbypassed, proximal, high-grade coronary artery stenosis were excluded. No complication occurred in any patient. The use of thallium imaging in addition to electrocardiographic monitoring resulted in a higher degree of sensitivity than did ECG monitoring alone. Fourteen patients demonstrated evidence of coronary artery spasm as documented by /sup 201/Tl imaging but of the 14, significant ECG changes occurred in only 50%, and classic ST segment elevation in 21%.more » Thus, in carefully selected patients the noninvasive provocation of coronary spasm can be accomplished safely, but ECG monitoring must be combined with thallium-/sup 201/ imaging to achieve an acceptable degree of sensitivity.« less

  14. Aggregated data from two double-blind base station provocation studies comparing individuals with idiopathic environmental intolerance with attribution to electromagnetic fields and controls.

    PubMed

    Eltiti, Stacy; Wallace, Denise; Russo, Riccardo; Fox, Elaine

    2015-02-01

    Data from two previous studies were aggregated to provide a statistically powerful test of whether exposure to electromagnetic fields (EMFs) produced by telecommunication base stations negatively affects well-being in individuals who report idiopathic environmental illness with attribution to electromagnetic fields (IEI-EMF) and control participants. A total of 102 IEI-EMF and 237 controls participated in open provocation trials and 88 IEI-EMF and 231 controls went on to complete double-blind trials in which they were exposed to EMFs from a base station emitting either a Global System for Mobile Communication and Universal Mobile Telecommunications System or a Terrestrial Trunked Radio Telecommunications System signal. Both experiments included a comparison sham condition. Visual analog and symptom scales measured subjective well-being. Results showed that IEI-EMF participants reported lower levels of well-being during real compared to sham exposure during open provocation, but not during double-blind trials. Additionally, participants reported lower levels of well-being during high compared to low load trials and this did not interact with radiofrequency-EMF exposure. These findings are consistent with a growing body of literature indicating there is no causal relationship between short-term exposure to EMFs and subjective well-being in members of the public whether or not they report perceived sensitivity to EMFs. © 2015 Wiley Periodicals, Inc.

  15. In vivo diagnosis of allergic diseases--allergen provocation tests.

    PubMed

    Agache, I; Bilò, M; Braunstahl, G-J; Delgado, L; Demoly, P; Eigenmann, P; Gevaert, P; Gomes, E; Hellings, P; Horak, F; Muraro, A; Werfel, T; Jutel, M

    2015-04-01

    The allergen challenge test has been the mainstay of diagnosis of allergic diseases for a long time since it offers a direct proof of the clinical relevance of a particular allergen for the allergic disease symptoms and severity. Standardisation and availability for daily practice (including safety issues) are still to be refined but most of the challenge tests have safely crossed the border from research tools to diagnostic tests available for daily practice for a well trained clinical staff. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Comparison of shoulder internal rotation test with the elbow flexion test in the diagnosis of cubital tunnel syndrome.

    PubMed

    Ochi, Kensuke; Horiuchi, Yukio; Tanabe, Aya; Morita, Kozo; Takeda, Kentaro; Ninomiya, Ken

    2011-05-01

    To compare the shoulder internal rotation test-a new, provocative test-with the elbow flexion test in the diagnosis of cubital tunnel syndrome (CubTS). Twenty-five patients with CubTS were examined before and after surgery with 10 seconds each of the elbow flexion and shoulder internal rotation tests. Fifty-four asymptomatic individuals and 14 neuropathy patients with a diagnosis other than CubTS were also examined as control cases. For the shoulder internal rotation test, the patient's upper extremity was kept at 90° abduction, maximum internal rotation, and 10° flexion at the shoulder, with 90° elbow flexion and neutral position of the forearm and wrist, with finger extension. Test results were considered positive if any slight symptom attributable to CubTS occurred within 10 seconds. Extraneural pressure inside the cubital tunnel was intraoperatively measured with the positions of both the elbow flexion and shoulder internal rotation tests, in 15 of the CubTS cases. Statistical analyses were performed using Student's t-test with a confidence level of 95%. The preoperative sensitivity in CubTS cases was 80% in the 10-second shoulder internal rotation test and 36% in the 10-second elbow flexion test, and these differences were significant. None of the control cases had positive results in either test. All the CubTS cases improved with surgery; after surgery, neither test provoked symptoms in any surgical patient. The extraneural pressure increased in both provocative positions with no significant difference. Positive results for the 10-second shoulder internal rotation test were more sensitive than that for the elbow flexion test of the same duration and seemed specific to CubTS. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  17. ALLERGEN PROVOCATION AUGMENTS ENDOTOXIN-INDUCED NASAL INFLAMMATION IN ATOPIC ASTHMATICS

    EPA Science Inventory

    Background: Recent epidemiologic and in vivo studies have suggested that inhaled endotoxin plays an important role in asthma pathogenesis.
    Objective: The present study examines the effect of nasal allergen provocation on subsequent endotoxin challenges in subjects with atopi...

  18. Alcohol's effect on triggered displaced aggression.

    PubMed

    Aviles, Fredy; Earleywine, Mitchell; Pollock, Vicki; Stratton, Joy; Miller, Norman

    2005-03-01

    The authors examined alcohol's effect on triggered displaced aggression, the hostile reaction to a second provoking person after provocation from a first. Participants consumed an alcoholic or a nonalcoholic beverage. Subsequently, one individual provoked all of them with moderate intensity. Then, 2 groups were studied: those who received or who failed to receive a second provocation of minimal intensity. Consistent with prior research, participants who received a second, minimal provocation displayed more aggression than those who did not. After participants drank alcohol, the magnitude of this difference was significantly greater, indicating that alcohol increases triggered displaced aggression. Copyright (c) 2005 APA, all rights reserved.

  19. Social provocation modulates decision making and feedback processing: Examining the trajectory of development in adolescent participants.

    PubMed

    Pincham, Hannah L; Wu, Claire; Killikelly, Clare; Vuillier, Laura; Fearon, R M Pasco

    2015-10-01

    Increasingly, research is turning to the ways in which social context impacts decision making and feedback processing in adolescents. The current study recorded electroencephalography to examine the trajectory of development across adolescence, with a focus on how social context impacts cognition and behaviour. To that end, younger (10-12 years) and older (14-16 years) adolescents played a modified Taylor Aggression Paradigm against two virtual opponents: a low-provoker and a high-provoker. During the task's decision phase (where participants select punishment for their opponent), we examined two event-related potentials: the N2 and the late positive potential (LPP). During the outcome phase (where participants experience win or loss feedback), we measured the feedback related negativity (FRN). Although N2 amplitudes did not vary with provocation, LPP amplitudes were enhanced under high provocation for the younger group, suggesting that emotional reactivity during the decision phase was heightened for early adolescents. During the outcome phase, the FRN was reduced following win outcomes under high provocation for both groups, suggesting that a highly provocative social opponent may influence the reward response. Collectively, the data argue that social context is an important factor modulating neural responses in adolescent behavioural and brain development. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. Shoulder internal rotation elbow flexion test for diagnosing cubital tunnel syndrome.

    PubMed

    Ochi, Kensuke; Horiuchi, Yukio; Tanabe, Aya; Waseda, Makoto; Kaneko, Yasuhito; Koyanagi, Takahiro

    2012-06-01

    Shoulder internal rotation enhances symptom provocation attributed to cubital tunnel syndrome. We present a modified elbow flexion test--the shoulder internal rotation elbow flexion test--for diagnosing cubital tunnel syndrome. Fifty-five ulnar nerves in cubital tunnel syndrome patients and 123 ulnar nerves in controls were examined with 5 seconds each of elbow flexion, shoulder internal rotation, and shoulder internal rotation elbow flexion tests before and after treatment (surgery in 18; conservative in others). For the shoulder internal rotation elbow flexion test position, 90° abduction, maximum internal rotation, and 10° flexion of the shoulder were combined with the elbow flexion test position. The test was considered positive if any symptom for cubital tunnel syndrome developed <5 seconds. Influence of the shoulder internal rotation elbow flexion test was evaluated by nerve conduction studies in 10 cubital tunnel syndrome nerves and 7 control nerves. The sensitivities/specificities of the 5-second elbow flexion, shoulder internal rotation, and shoulder internal rotation elbow flexion tests were 25%/100%, 58%/100%, and 87%/98%, respectively. Sensitivity differences between the shoulder internal rotation elbow flexion test and the other two tests were significant. Shoulder internal rotation elbow flexion test results and cubital tunnel syndrome symptoms were significantly correlated. Influence of the shoulder internal rotation elbow flexion test on the ulnar nerve was seen in 8 of 10 cubital tunnel syndrome nerves but not in controls. The 5-second shoulder internal rotation elbow flexion test is specific, easy and quick provocative test for diagnosing cubital tunnel syndrome. Copyright © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  1. Developing biologically-based assessment tools for physical therapy management of neck pain.

    PubMed

    MacDermid, Joy C; Gross, Anita R; Galea, Victoria; McLaughlin, Laurie M; Parkinson, William L; Woodhouse, Linda J

    2009-05-01

    Neck pain is a common and episodic condition that is treated using a spectrum of interventions known to be moderately effective but is associated with a significant incidence of chronic pain. Recently, there has been increased focus on defining biological aspects of neck pain. Studies have indicated that neurophysiological, biomechanical, and motor control abnormalities are present and may be useful either in prognosis or classification. We review some of these findings in the context of our own work defining biological markers that may form the basis for clinical tests that can be used for prognosis, classification, or outcome evaluation in patients with neck pain. We have identified abnormalities in neurophysiology using quantitative sensory testing (vibration, touch, and current perception) and response to cold provocation that are related to neck disability. We have identified altered muscle biochemistry by measuring circulating muscle proteins in a lumbar surgery model and are now applying those methods to whiplash injury. We have incorporated capnography into treatment to address central physiological changes present in some patients by monitoring and training CO2 levels. We have developed an innovative new test, the Neck Walk Index, that captures abnormal control of head movement during slow gait as a means of differentiating patients with neck pain from either unaffected controls or individuals with other pathologies. We have used time-varying 3-dimensional joint orientation kinematics to assess deficits in motor control during an upper extremity reach task, the results showing that poor coordination and control of the shoulder girdle leads to shoulder guarding and inconsistencies in elbow joint movement. Despite some promising early results, future research is needed to determine how these measures help clinicians to diagnose, evaluate, and forecast future outcome for patients who present with neck pain. Diagnosis, level 5.

  2. Clothing and Attributions Concerning Sexual Harassment.

    ERIC Educational Resources Information Center

    Johnson, Kim K. P.; Workman, Jane E.

    1992-01-01

    Photographs shown to 98 male and 102 female students illustrated provocative versus nonprovocative clothing on both men and women. Subjects rated provocative clothing more likely to induce sexual harassment. Females who had not experienced harassment rated those wearing nonprovocative clothing unlikely to be harassed. (SK)

  3. Inspiring Reading Success: Interest and Motivation in an Age of High-Stakes Testing

    ERIC Educational Resources Information Center

    Fink, Rosalee, Ed.; Samuels, S. Jay, Ed.

    2007-01-01

    Although recent U.S. legislation has had a profound impact on reading instruction and student achievement, some students continue to fall behind. This provocative text addresses this gap with a new perspective on reading instruction that goes beyond the realms of teacher content knowledge and methodology. The book shows how motivation and interest…

  4. Centralization as a predictor of provocation discography results in chronic low back pain, and the influence of disability and distress on diagnostic power.

    PubMed

    Laslett, Mark; Oberg, Birgitta; Aprill, Charles N; McDonald, Barry

    2005-01-01

    The "centralization phenomenon" (CP) is the progressive retreat of referred pain towards the spinal midline in response to repeated movement testing (a McKenzie evaluation). A previous study suggested that it may have utility in the clinical diagnosis of discogenic pain and may assist patient selection for discography and specific treatments for disc pain. Estimation of the diagnostic predictive power of centralization and the influence of disability and patient distress on diagnostic performance, using provocation discography as a criterion standard for diagnosis, in chronic low back pain patients. This study was a prospective, blinded, concurrent, reference standard-related validity design carried out in a private radiology clinic specializing in diagnosis of chronic spinal pain. Consecutive patients with persistent low back pain were referred to the study clinic by orthopedists and other medical specialists for interventional radiological diagnostic procedures. Patients were typically disabled and displayed high levels of psychosocial distress. The sample included patients with previous lumbar surgery, and most had unsuccessful conservative therapies previously. results of provocation discography. The CP. Psychometric evaluation: Roland-Morris, Zung, Modified Somatic Perception questionnaires, Distress Risk Assessment Method, and 100-mm visual analog scales for pain intensity. Patients received a single physical therapy examination, followed by lumbar provocation discography. Sensitivity, specificity, and likelihood ratios of the CP were estimated in the group as a whole and in subgroups defined by psychometric measures. A total of 107 patients received the clinical examination and discography at two or more levels and post-discography computed tomography. Thirty-eight could not tolerate a full physical examination and were excluded from the main analysis. Disability and pain intensity ratings were high, and distress was common. Sensitivity, specificity, and positive likelihood ratios for centralization observed during repeated movement testing for pain distribution and intensity changes were 40%, 94%, and 6.9 respectively. In the presence of severe disability, sensitivity, specificity, and positive likelihood ratios were 46%, 80%, 3.2 and for distress, 45%, 89%, 4.1. In the subgroups with moderate, minimal, or no disability, sensitivity and specificity were 37%, 100% and for no or minimal distress 35%, 100%. Centralization is highly specific to positive discography but specificity is reduced in the presence of severe disability or psychosocial distress.

  5. Rhinoconjunctivitis and asthma caused by vine pollen: a case report.

    PubMed

    Feo Brito, F; Martínez, A; Palacios, R; Mur, P; Gómez, E; Galindo, P A; Borja, J; Martínez, J

    1999-02-01

    The vine (Vitis vinifera) is a cultivated plant that is found in some European and American countries. Its pollen gathers in small quantities during a short pollination period in the months of May and June. Allergy to vine pollen has not been previously documented. We sought to describe a case report of allergy to vine pollen documented on the basis of anamnesis, cutaneous, provocation, and specific IgE determination tests. An allergenic extract was obtained from collected V vinifera pollens by aqueous standard procedures. Pollen counts and pollination periods of this and other common pollens in the area where the patient became symptomatic were studied. Cutaneous tests and the presence of specific IgE to the pollen extracts were performed by prick, CAP, and RAST techniques. Bronchial and conjunctival tests with the involved pollen extracts were also carried out to identify the sensitizing allergens. Five healthy subjects and 5 pollinic patients were used as control subjects and underwent the same tests. Skin prick test responses with vine pollen at different concentrations were positive for the studied patient and negative for the control subjects. Patient serum revealed a total IgE titer of 334 IU/mL and a specific IgE value of 1.3 PRU/mL (RAST class 2) to vine pollen. Bronchial and conjunctival provocation test responses were also positive when the patient was challenged with V vinifera extract. Exposure to the pollen of the vineyard plants (V vinifera) can induce immunologic sensitization and rhinoconjunctivitis/asthma.

  6. Methacholine challenge testing: improved patient comfort with a 2-tiered protocol.

    PubMed

    Segel, Michael J; Rabinovich, Einat; Schwarz, Yehuda; Ben-Dov, Issahar

    2013-06-01

    The methacholine challenge test (MCT) is a test of bronchial hyperreactivity used as an aid in the diagnosis of asthma. MCT results are reported as the provocation concentration at which the forced expiratory volume in 1 second (FEV1) decreases 20% (PC20). The requirement for a 20% or greater decrease in FEV1 results in precipitous decreases in FEV1 in some patients. To improve MCT safety without compromising accuracy. We performed a retrospective analysis of 879 consecutive MCTs (derivation cohort). A novel protocol for MCT was developed and validated in a cohort of 564 MCTs performed in a second institution. In comparison with a PC20 cutoff of less than 8 mg/mL, a provocation concentration at which the FEV1 decreases 10% (PC10) cutoff of 1 mg/mL or less has a sensitivity of 86%, a specificity of 98%, a positive predictive value (PPV) of 97%, and a negative predictive value (NPV) of 91%. We propose a novel 2-tiered protocol for MCT. If the PC10 is 1 mg/mL or less, bronchial hyperreactivity is present; if the PC10 is greater than 1 mg/mL, the test is continued until the provocative concentration is 8 mg/mL or a 20% decrease in FEV1 is achieved. Compared with the standard protocol, the proposed protocol has a sensitivity, specificity, PPV, NPV, and overall accuracy of 100%, 98%, 97.6%, 100%, and 99%, respectively. The modified protocol would have enabled us to avoid 26 of 42 cases (62%) in which a 40% or greater decrease in FEV1 occurred and would save 0.65 dose for every MCT performed. The 2-tiered protocol performed well in the validation cohort; sensitivity, specificity, PPV, NPV, and overall accuracy were 100%, 98%, 87%, 100%, and 98%, respectively. The proposed 2-tiered protocol is accurate, saves time, and avoids precipitous decreases in FEV1. Copyright © 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  7. Asthma-like symptoms, atopy, and bronchial responsiveness in furniture workers.

    PubMed

    Talini, D; Monteverdi, A; Benvenuti, A; Petrozzino, M; Di Pede, F; Lemmi, M; Carletti, A; Macchioni, P; Serretti, N; Viegi, G; Paggiaro, P

    1998-11-01

    To study the role of individual and occupational risk factors for asthma in furniture workers. 296 workers were examined (258 men, 38 women) with a questionnaire of respiratory symptoms and diseases, baseline spirometry, bronchial provocative test with methacholine, and skin prick tests. Non-specific bronchial hyperreactivity was defined as when a provocative dose with a fall of 20% in forced expiratory volume in 1 second (PD20FEV1) was < 0.8 mg and atopy in the presence of at least one positive response to skin prick tests. Workers were subdivided into spray painters (exposed to low concentrations of diisocyanates and solvents), woodworkers (exposed to wood dusts), and assemblers (control group). The prevalences of attacks of shortness of breath with wheezing and dyspnoea were higher in spray painters (13.5% and 11.5% respectively) than in woodworkers (7.7% and 6.3%) or in assemblers (1.6% and 1.6%); prevalences of chronic cough, asthma, and rhinitis were also slightly but not significantly higher in spray painters and in woodworkers than in assemblers. The difference in the prevalence of respiratory symptoms among the job titles was due to the atopic subjects, who showed a higher prevalence of chronic cough, wheeze, shortness of breath with wheeze, dyspnoea, and asthma in spray painters than in the other groups. The prevalence of non-specific bronchial hyperreactivity in subjects who performed bronchial provocative tests was 17.7%, with no significant difference among groups. Asthma symptoms were significantly associated with non-specific bronchial hyperreactivity. Asthma-like symptoms plus non-specific bronchial hyperreactivity was found in 4% of assemblers, 10% of woodworkers, and 13.3% of spray painters (chi 2 = 2.6, NS). Multiple logistic analysis taking into account individual (smoke, atopy, age) and occupational (job titles) risk factors confirmed that spray painters had higher prevalence of chronic cough than assemblers, and a trend in increasing the prevalence of shortness of breath with wheeze, dyspnoea, and asthma. Painters in the furniture industry, particularly atopic subjects, are at higher risk of asthma-like symptoms than other job titles. In these workers asthma-like symptoms are more sensitive than non-specific bronchial hyperreactivity in detecting a negative effect of the occupational exposure.

  8. Detection of Growth Hormone Deficiency in Adults with Chronic Traumatic Brain Injury

    PubMed Central

    Griesbach, Grace S.; Ashley, Mark J.

    2016-01-01

    Abstract This study examined the prevalence of growth hormone deficiency (GHD) in patients with traumatic brain injury (TBI) during the post-acute phase of recovery and whether GHD was associated with increased disability, decreased independence, and depression. A secondary objective was to determine the accuracy of insulin-like growth factor-1 (IGF-1) levels in predicting GHD in patients with TBI. Anterior pituitary function was assessed in 235 adult patients with TBI through evaluation of fasting morning hormone levels. GH levels were assessed through provocative testing, specifically the glucagon stimulation test. GHD was diagnosed in a significant number of patients, with 45% falling into the severe GHD (≤3 μg/L) category. IGF-1 levels were not predictive of GHD. Patients with GHD were more disabled and less independent compared with those patients who were not GHD. Those patients with more severe GHD also showed decreased levels of cortisol and testosterone. Symptoms of depression were also more prevalent in this group. In addition, patients with severe GHD had delayed admission to post-acute rehabilitation. This study confirms the high prevalence of GHD in patients with TBI and the necessity to monitor clinical symptoms and perform provocative testing to definitively diagnose GHD. PMID:26414093

  9. Role of motivation to respond to provocation, the social environment, and trait aggression in alcohol-related aggression.

    PubMed

    Tremblay, Paul F; Mihic, Ljiljana; Graham, Kathryn; Jelley, Jennifer

    2007-01-01

    Little attention has been paid to the motivation to respond to provocation and to the interaction between this motivation, alcohol, the drinking environment, and individual characteristics. Undergraduates at six Canadian universities (N = 1,232) read three vignettes describing conflict situations with social environmental manipulations while imagining themselves as either sober or intoxicated. Self-ratings assessed likelihood of assertive and aggressive responses and motivational indices of anger, offensiveness of the instigator's actions, and importance to respond to the provocation. Respondents also completed a measure of trait aggression. Multi-group structural equation models supported the hypothesis that perceived likelihood of reactive aggression is influenced by perceived alcohol intoxication, gender, trait aggression, social environmental factors, and motivation to respond to the provocation. In addition, a number of interactions were found among the predictors. These results provide insight into the types of factors that may influence aggression in drinking situations. Copyright 2007 Wiley-Liss, Inc.

  10. Diagnostic methods for insect sting allergy.

    PubMed

    Hamilton, Robert G

    2004-08-01

    This review overviews advances from mid-2002 to the present in the validation and performance methods used in the diagnosis of Hymenoptera venom-induced immediate-type hypersensitivity. The general diagnostic algorithm for insect sting allergy is initially discussed with an examination of the AAAAI's 2003 revised practice parameter guidelines. Changes as a result of a greater recognition of skin test negative systemic reactors include repeat analysis of all testing and acceptance of serology as a complementary diagnostic test to the skin test. Original data examining concordance of venom-specific IgE results produced by the second-generation Pharmacia CAP System with the Johns Hopkins University radioallergosorbent test are presented. Diagnostic performance of honeybee venom-specific IgE assays used in clinical laboratories in North America is discussed using data from the Diagnostic Allergy Proficiency Survey conducted by the College of American Pathologists. Validity of venom-specific IgE antibody in postmortem blood specimens is demonstrated. The utility of alternative in-vivo (provocation) and in-vitro (basophil-based) diagnostic testing methods is critiqued. This overview supports the following conclusions. Improved practice parameter guidelines include serology and skin test as complementary in supporting a positive clinical history during the diagnostic process. Data are provided which support the analytical performance of commercially available venom-specific IgE antibody serology-based assays. Intentional sting challenge in-vivo provocation, in-vitro basophil flow cytometry (CD63, CD203c) based assays, and in-vitro basophil histamine and sulfidoleukotriene release assays have their utility in the study of difficult diagnostic cases, but their use will remain as supplementary, secondary diagnostic tests.

  11. Cervical radiofrequency neurotomy reduces central hyperexcitability and improves neck movement in individuals with chronic whiplash.

    PubMed

    Smith, Ashley Dean; Jull, Gwendolen; Schneider, Geoff; Frizzell, Bevan; Hooper, Robert Allen; Sterling, Michele

    2014-01-01

    This study aims to determine if cervical medial branch radiofrequency neurotomy reduces psychophysical indicators of augmented central pain processing and improves motor function in individuals with chronic whiplash symptoms. Prospective observational study of consecutive patients with healthy control comparison. Tertiary spinal intervention centre in Calgary, Alberta, Canada. Fifty-three individuals with chronic whiplash associated disorder symptoms (Grade 2); 30 healthy controls. Measures were made at four time points: two prior to radiofrequency neurotomy, and 1- and 3-months post-radiofrequency neurotomy. Measures included: comprehensive quantitative sensory testing (including brachial plexus provocation test), nociceptive flexion reflex, and motor function (cervical range of movement, superficial neck flexor activity during the craniocervical flexion test). Self-report pain and disability measures were also collected. One-way repeated measures analysis of variance and Friedman's tests were performed to investigate the effect of time on the earlier measures. Differences between the whiplash and healthy control groups were investigated with two-tailed independent samples t-test or Mann-Whitney tests. Following cervical radiofrequency neurotomy, there were significant early (within 1 month) and sustained (3 months) improvements in pain, disability, local and widespread hyperalgesia to pressure and thermal stimuli, nociceptive flexor reflex threshold, and brachial plexus provocation test responses as well as increased neck range of motion (all P < 0.0001). A nonsignificant trend for reduced muscle activity with the craniocervical flexion test (P > 0.13) was measured. Attenuation of psychophysical measures of augmented central pain processing and improved cervical movement imply that these processes are maintained by peripheral nociceptive input. Wiley Periodicals, Inc.

  12. The 'think test': a further technique to elicit hyperventilation.

    PubMed Central

    Nixon, P G; Freeman, L J

    1988-01-01

    Hyperventilation can undermine cardiovascular homeostasis by generating autonomic imbalance, sympathetic dominance, hypokalaemia, and intracellular alkalosis with calcium ion shifts. The role of hyperventilation in episodic disorders such as arrhythmia and coronary vasospasm can be difficult to identify if the patient does not present in an attack and so a provocation challenge is required. Today, the standard challenge is the forced hyperventilation provocation test (FHPT). A capnograph enables the resting end-tidal PCO2 to be compared with the level 3 min after the period of overbreathing. We report the use of a patient-specific challenge. After the FHPT, the subject is invited to close his eyes and think about the circumstances of an attack, feelings and sensations experienced (breathing is not mentioned) or topics that were seen to disturb the rhythm of breathing when the medical history was taken. A fall of end-tidal PCO2 of 10 mmHg or more lasting at least one minute was taken as a positive response. Out of 57 patients with cardiovascular symptoms suggesting a hypocapnic influence, resting hypocapnia (end-tidal PCO2 = 30 mmHg) was present in 3 (5%). Of the remaining 54, the FHPT was positive in 16 (30%) and the 'think test' in 33 (61%). This suggests that patient-specific stimulation has advantages over an unspecific challenge in testing for episodic hypocapnia. PMID:3133476

  13. 389 Allergic Reactions to Local Anesthetics: Detection by Skin Tests and Subcutaneous Provocation. Analysis of 160 Cases

    PubMed Central

    Arcanjo, Luiz; Gonçalves Tavares, Tania Maria; Delcourt, Nathalia; Baroni, Juliana; Rios, João; Rios, José Luiz

    2012-01-01

    Background Adverse reactions to local anesthetics (LA) are frequent and often referred to as allergic. Although immune-mediated reactions are rare, it should be investigated for suspected cases. The objective of this study was to determine the frequency of positive skin test to these drugs in patients with a suspected history of allergic reactions and describe the main socio-demographic characteristics of these individuals. Methods Retrospective study of medical records of patients attended at Policlínica Geral do Rio de Janeiro Allergic Clinic, between 2008 and 2011. The parameters evaluated were the test indication and the patient ages and gender. The drug tested was that the patient had a history of suspicion. Patients underwent skin prick and intradermal tests and subcutaneous provocation. Descriptive statistical analysis of the data was performed. Results It was performed 160 tests (125 female). Three of this total was excluded due to inconclusive results. In women, the highest proportion of tests was in the age group from 41 to 60 years (43%), while in males the higher concentration was at a youngest age group: 21 to 40 years (41%). The most common indication (103 cases, 65%) for the tests was a previous suspected anaphylactic reaction by LA. Seven of 157 tests had a positive result (4.4%), 6 of them occurred in women (4.8%). Only one test resulted in a type of anaphylactic reaction response (0.67%). All patients who presented positive response to the test had a history of per-anesthetic reaction that suggested an immune-mediated mechanism. Conclusions In patients with a history of previous reaction to local anesthetics, the skin tests with these drugs have a key role in the prevention of anaphylaxis, and on guidance for adequate anesthetic procedures.

  14. A double-blind, placebo-controlled clinical trial of the effect of chlorpheniramine on the response of the nasal airway, middle ear and eustachian tube to provocative rhinovirus challenge.

    PubMed

    Doyle, W J; McBride, T P; Skoner, D P; Maddern, B R; Gwaltney, J M; Uhrin, M

    1988-03-01

    This paper presents the results of a randomized, double-blind, placebo-controlled study of the efficacy of chlorpheniramine in relieving the symptoms and attenuating the pathophysiologic correlates of a rhinovirus "common cold." Forty healthy, adult, nonatopic subjects were randomly assigned to one of two treatment groups: active drug and placebo. On study Day 0, all subjects were challenged intranasally with rhinovirus type 39 (dose = 100 TCID50). Subjects were cloistered from Day 2 to Day 7, at which time they were treated with either chlorpheniramine or placebo. From 3 days before challenge to study Day 19, subjects had nasal patency assessed by rhinomanometry, eustachian tube function assessed by the 9-step test and sonotubometry, middle ear pressure assessed by tympanometry and nasal clearance assessed by the dyed-saccharin technique. Symptom diaries were maintained throughout the period of follow-up. During cloister, symptoms also were scored by interview, nasal secretions were quantified and nasal washings were performed for viral culture. Results showed that 19 (95%) subjects in the active-treatment group and 18 (90%) subjects in the placebo-treatment group shed virus. Symptomatic colds were observed in 63% of the active-treated and 83% of the placebo-treated subjects. Symptoms increased on Day 1 and peaked at Days 4 to 5. Detrimental changes in other measured functions consistent with those previously reported were observed. During the period of treatment, significant differences in the average symptom scores favoring the active-treatment group were observed for sneezing. Also, weight of expelled secretions was greater and mucociliary clearance rate less on some cloister days for the placebo-treated group. No significant differences between treatment groups in the objective measures of nasal congestion or the response of the middle ear and eustachian tube were documented.

  15. Human Correlates of Provocative Questions in Pancreatic Pathology

    PubMed Central

    McDonald, Oliver G.; Maitra, Anirban; Hruban, Ralph H.

    2012-01-01

    Studies of cell lines and of animal models of pancreatic cancer have raised a number of provocative questions about the nature and origins of human pancreatic cancer and have provided several leads into exciting new approaches for the treatment of this deadly cancer. In addition, clinicians with little or no contact with human pathology have challenged the way that pancreatic pathology is practiced, suggesting that “genetic signals” may be more accurate than today’s multi-modal approach to diagnoses. In this review we consider eight provocative issues in pancreas pathology, with an emphasis on “the evidence derived from man.” PMID:23060061

  16. 1. VIEW NORTHEAST, LEFT TO RIGHT COLD CALIBRATION TEST STAND ...

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

    1. VIEW NORTHEAST, LEFT TO RIGHT COLD CALIBRATION TEST STAND COLD CALIBRATION BLOCKHOUSE IN FOREGROUND. - Marshall Space Flight Center, East Test Area, Cold Calibration Test Stand, Huntsville, Madison County, AL

  17. Emotional reactivity to threat modulates activity in mentalizing network during aggression.

    PubMed

    Beyer, Frederike; Münte, Thomas F; Erdmann, Christian; Krämer, Ulrike M

    2014-10-01

    Aggression is a common response to provocation, albeit with considerable interindividual differences. In this fMRI study, we investigated emotional reactivity to threat as possible link between provocation and aggression, as well as the neural correlates of this relationship. We hypothesized that emotional reactivity, measured as fear potentiation (FP) of the startle response, would be negatively associated with aggressive behavior and would modulate neural activity during an aggressive interaction. In 30 healthy female participants, FP was measured as the difference between blink amplitudes while watching threatening vs neutral pictures. Participants subsequently engaged in a variant of the Taylor Aggression Paradigm (TAP), while being scanned. During the TAP, participants selected a punishment level for either a highly provoking or a nonprovoking opponent. There was no difference in aggressive behavior between participants high and low in FP. However, we found a negative correlation between FP and the neural provocation effect in several regions of a network previously associated with mentalizing including the medial prefrontal cortex, precuneus and the temporo-parietal junction. Independently of the FP variability, aggressive behavior correlated with the provocation effect on activity in the caudate nucleus. Our results indicate that during a provocative confrontation, high emotional reactivity to threat suppresses recruitment of the mentalizing network. © The Author (2013). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  18. Peer Provocation in Physical Education: Experiences of Botswana Adolescents

    ERIC Educational Resources Information Center

    Shehu, Jimoh

    2009-01-01

    Critical incidents of peer provocation in physical education were investigated among 675 junior secondary school students in Botswana. Data were generated through a brief, open-ended questionnaire requesting the students to narrate their experiences of bad, hurtful and offensive peer behaviours during physical education classes. Six overlapping…

  19. Bullying by Definition: An Examination of Definitional Components of Bullying

    ERIC Educational Resources Information Center

    Goldsmid, Susan; Howie, Pauline

    2014-01-01

    Lack of definitional consensus remains an important unresolved issue within bullying research. This study examined the ability of definitional variables to predict overall level of victimisation (distress, power inequity, and provocation as predictors) and bullying (intention to harm, power inequity, and provocation as predictors) in 246…

  20. 78 FR 48216 - Culturally Significant Objects Imported for Exhibition Determinations: “Balthus: Cats and Girls...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-07

    ... DEPARTMENT OF STATE [Public Notice 8410] Culturally Significant Objects Imported for Exhibition Determinations: ``Balthus: Cats and Girls--Paintings and Provocations'' SUMMARY: Notice is hereby given of the... that the objects to be included in the exhibition ``Balthus: Cats and Girls--Paintings and Provocations...

  1. Familial Brugada syndrome uncovered by hyperkalaemic diabetic ketoacidosis.

    PubMed

    Postema, Pieter G; Vlaar, Alexander P J; DeVries, J Hans; Tan, Hanno L

    2011-10-01

    We describe a case of diabetic ketoacidosis with concomitant hyperkalaemia that uncovered a typical Brugada syndrome electrocardiogram (ECG). Further provocation testing in the patient and his son confirmed familial Brugada syndrome. Diabetic ketoacidosis with hyperkalaemia may uncover an inheritable arrhythmia syndrome that may put the patient and his/her next of kin at risk for a sudden death, irrespective of diabetes mellitus.

  2. Routine Leak Testing in Colorectal Surgery in the Surgical Care and Outcomes Assessment Program

    PubMed Central

    Kwon, Steve; Morris, Arden; Billingham, Richard; Frankhouse, Joseph; Horvath, Karen; Johnson, Morrie; McNevin, Shane; Simons, Anthony; Symons, Rebecca; Steele, Scott; Thirlby, Richard; Whiteford, Mark; Flum, David R.

    2014-01-01

    Objective To evaluate the effect of routine anastomotic leak testing (performed to screen for leaks) vs selective testing (performed to evaluate for a suspected leak in a higher-risk or technically difficult anastomosis) on outcomes in colorectal surgery because the value of provocative testing of colorectal anastomoses as a quality improvement metric has yet to be determined. Design Observational, prospectively designed cohort study. Setting Data from Washington state’s Surgical Care and Outcomes Assessment Program (SCOAP). Patients Patients undergoing elective left-sided colon or rectal resections at 40 SCOAP hospitals from October 1, 2005, to December 31, 2009. Interventions Use of leak testing, distinguishing procedures that were performed at hospitals where leak testing was selective (<90% use) or routine (≥90% use) in a given calendar quarter. Main Outcome Measure Adjusted odds ratio of a composite adverse event (CAE) (unplanned postoperative intervention and/or in-hospital death) at routine testing hospitals. Results Among 3449 patients (mean [SD] age, 58.8[14.8] years; 55.0% women), the CAE rate was 5.5%. Provocative leak testing increased (from 56% in the starting quarter to 76% in quarter 16) and overall rates of CAE decreased (from 7.0% in the starting quarter to 4.6% in quarter 16; both P ≤ .01) over time. Among patients at hospitals that performed routine leak testing, we found a reduction of more than 75% in the adjusted risk of CAEs (odds ratio, 0.23; 95% CI, 0.05–0.99). Conclusion Routine leak testing of left-sided colorectal anastomoses appears to be associated with a reduced rate of CAEs within the SCOAP network and meets many of the criteria of a worthwhile quality improvement metric. PMID:22508778

  3. Routine leak testing in colorectal surgery in the Surgical Care and Outcomes Assessment Program.

    PubMed

    Kwon, Steve; Morris, Arden; Billingham, Richard; Frankhouse, Joseph; Horvath, Karen; Johnson, Morrie; McNevin, Shane; Simons, Anthony; Symons, Rebecca; Steele, Scott; Thirlby, Richard; Whiteford, Mark; Flum, David R

    2012-04-01

    To evaluate the effect of routine anastomotic leak testing (performed to screen for leaks) vs selective testing (performed to evaluate for a suspected leak in a higher-risk or technically difficult anastomosis) on outcomes in colorectal surgery because the value of provocative testing of colorectal anastomoses as a quality improvement metric has yet to be determined. Observational, prospectively designed cohort study. Data from Washington state's Surgical Care and Outcomes Assessment Program (SCOAP). Patients undergoing elective left-sided colon or rectal resections at 40 SCOAP hospitals from October 1, 2005, to December 31, 2009. Use of leak testing, distinguishing procedures that were performed at hospitals where leak testing was selective (<90% use) or routine (≥ 90% use) in a given calendar quarter. Adjusted odds ratio of a composite adverse event (CAE) (unplanned postoperative intervention and/or in-hospital death) at routine testing hospitals. Among 3449 patients (mean [SD] age, 58.8 [14.8] years; 55.0% women), the CAE rate was 5.5%. Provocative leak testing increased (from 56% in the starting quarter to 76% in quarter 16) and overall rates of CAE decreased (from 7.0% in the starting quarter to 4.6% in quarter 16; both P ≤ .01) over time. Among patients at hospitals that performed routine leak testing, we found a reduction of more than 75% in the adjusted risk of CAEs (odds ratio, 0.23; 95% CI, 0.05-0.99). Routine leak testing of left-sided colorectal anastomoses appears to be associated with a reduced rate of CAEs within the SCOAP network and meets many of the criteria of a worthwhile quality improvement metric.

  4. A study to derive a clinical decision rule for triage of emergency department patients with chest pain: design and methodology

    PubMed Central

    Hess, Erik P; Wells, George A; Jaffe, Allan; Stiell, Ian G

    2008-01-01

    Background Chest pain is the second most common chief complaint in North American emergency departments. Data from the U.S. suggest that 2.1% of patients with acute myocardial infarction and 2.3% of patients with unstable angina are misdiagnosed, with slightly higher rates reported in a recent Canadian study (4.6% and 6.4%, respectively). Information obtained from the history, 12-lead ECG, and a single set of cardiac enzymes is unable to identify patients who are safe for early discharge with sufficient sensitivity. The 2007 ACC/AHA guidelines for UA/NSTEMI do not identify patients at low risk for adverse cardiac events who can be safely discharged without provocative testing. As a result large numbers of low risk patients are triaged to chest pain observation units and undergo provocative testing, at significant cost to the healthcare system. Clinical decision rules use clinical findings (history, physical exam, test results) to suggest a diagnostic or therapeutic course of action. Currently no methodologically robust clinical decision rule identifies patients safe for early discharge. Methods/design The goal of this study is to derive a clinical decision rule which will allow emergency physicians to accurately identify patients with chest pain who are safe for early discharge. The study will utilize a prospective cohort design. Standardized clinical variables will be collected on all patients at least 25 years of age complaining of chest pain prior to provocative testing. Variables strongly associated with the composite outcome acute myocardial infarction, revascularization, or death will be further analyzed with multivariable analysis to derive the clinical rule. Specific aims are to: i) apply standardized clinical assessments to patients with chest pain, incorporating results of early cardiac testing; ii) determine the inter-observer reliability of the clinical information; iii) determine the statistical association between the clinical findings and the composite outcome; and iv) use multivariable analysis to derive a highly sensitive clinical decision rule to guide triage decisions. Discussion The study will derive a highly sensitive clinical decision rule to identify low risk patients safe for early discharge. This will improve patient care, lower healthcare costs, and enhance flow in our busy and overcrowded emergency departments. PMID:18254973

  5. Can hip abduction and external rotation discriminate sacroiliac joint pain?

    PubMed

    Adhia, Divya Bharatkumar; Tumilty, Steve; Mani, Ramakrishnan; Milosavljevic, Stephan; Bussey, Melanie D

    2016-02-01

    The primary aim of the study is to determine if Hip Abduction and External Rotation (HABER) test is capable of reproducing familiar pain in individuals with low back pain (LBP) of sacroiliac joint (SIJ) origin (SIJ-positive) when compared with LBP of Non-SIJ origin (SIJ-negative). If so, the secondary aim is to determine the diagnostic accuracy of HABER test against the reference standard of pain provocation tests, and to determine which increments of the HABER test has highest sensitivity and specificity for identifying SIJ-positive individuals. Single-blinded diagnostic accuracy study. Participants [n(122)] between ages of 18-50 y, suffering from chronic non-specific LBP (≥3 months) volunteered in the study. An experienced musculoskeletal physiotherapist evaluated and classified participants into either SIJ-positive [n(45)] or SIJ-negative [n(77)], based on reference standard of pain provocation tests [≥3 positive tests = SIJ-positive]. Another musculoskeletal physiotherapist, blinded to clinical groups, evaluated participants for reproduction of familiar pain during each increment (10°, 20°, 30°, 40°, and 50°) of HABER test. The HABER test reproduced familiar pain in SIJ-positive individuals when compared with SIJ-negative individuals [p (0.001), R(2) (0.38), Exp(β) (5.95-10.32)], and demonstrated moderate level of sensitivity (67%-78%) and specificity (71%-72%) for identifying SIJ-positive individuals. Receiver operator curve analysis demonstrated that the HABER increments of ≥30° have the highest sensitivity (83%-100%) and specificity (52%-64%). The HABER test is capable of reproducing familiar pain in SIJ-positive LBP individuals and has moderate levels of sensitivity and specificity for identifying SIJ-positive LBP individuals. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. The Novaco Anger Scale--Provocation Inventory (1994 Version) in Dutch Forensic Psychiatric Patients

    ERIC Educational Resources Information Center

    Hornsveld, Ruud H. J.; Muris, Peter; Kraaimaat, Floris W.

    2011-01-01

    We examined the psychometric properties of the Novaco Anger Scale--Provocation Inventory (NAS-PI, 1994 version) in Dutch violent forensic psychiatric patients and secondary vocational students. A confirmatory factor analysis of the subscale structure of the NAS was carried out, reliability was investigated, and relations were calculated between…

  7. Creating Crossroads for Self-Authorship: Investigating the Provocative Moment

    ERIC Educational Resources Information Center

    Pizzolato, Jane Elizabeth

    2005-01-01

    Through examination of 613 students' narratives about self-selected important decisions, I investigated the student and situation characteristics related to provocation and use of self authored ways of knowing. The findings gesture toward both particular skills students may need to develop in order to self-author, as well as suggest that movement…

  8. Children's Moral Reasoning about Family and Peer Violence: The Role of Provocation and Retribution.

    ERIC Educational Resources Information Center

    Astor, Ron A.

    1994-01-01

    Examined violent and nonviolent inner-city children's moral reasoning about violence in family and peer situations. All of the children condemned unprovoked violence. With provoked situations, the violent group focused more on the immorality of the provocation and perceived force akin to reciprocal justice, whereas the nonviolent group perceived…

  9. Provocative Pedagogies in e-Learning: Making the Invisible Visible

    ERIC Educational Resources Information Center

    Sinclair, Anne

    2009-01-01

    The purpose of this case study was to explore the experiences of participants (practicing teachers) involved in an online course entitled: "Reflective Practice for Teachers." Using a provocative pedagogy in the course, the teachers were challenged to confront beliefs and assumptions about teaching and learning and become active participants in the…

  10. Making Choices: Simultaneous Report and Provocative Statements, Tools for Appreciative Inquiry

    ERIC Educational Resources Information Center

    Nelson, Eric M.; Wright, Christine M.

    2011-01-01

    Many educators find that students do not participate actively in class, and are constantly seeking a variety of techniques to encourage student participation. The focus of this paper is to show how simultaneous report and provocative statements can be combined to foster appreciative inquiry, thereby, creating a learning environment with greater…

  11. Azithromycin is more allergenic than clarithromycin in children with suspected hypersensitivity reaction to macrolides.

    PubMed

    Barni, S; Butti, D; Mori, F; Pucci, N; Rossi, M E; Cianferoni, A; Novembre, E

    2015-01-01

    Macrolides are considered safe antibiotics with reduced allergenic activity. However, studies on the safety of macrolides are scarce, particularly in children. The aim of this study was to assess the frequency of hypersensitivity reactions to clarithromycin and azithromycin in a group of children referred to our allergy unit for suspected macrolide allergy. We retrospectively reviewed the charts of 90 children aged 1-17 years with symptoms suggestive of hypersensitivity reaction to clarithromycin or azithromycin between December 31, 2008 and December 31, 2013. The allergy workup included skin tests (ie, skin prick tests and/or intradermal tests), determination of serum specific IgE (sIgE) to clarithromycin and azithromycin, and, if necessary to reach a diagnosis, oral provocation tests. Seventy-seven children completed the allergy workup. A reaction to clarithromycin was recorded in 58 children (75.3%): 21 (36.2%) had a history of immediate reactions, and 37 (63.8%) had a history of nonimmediate reactions. A reaction to azithromycin was recorded in 19 children (24.6%): 6 (31.5%) had a history of immediate reaction, and 13 (68.42%) had a history of nonimmediate reaction. Positive results in skin tests and oral provocation tests with the suspect drug confirmed the diagnosis in 15.5% of reactions to clarithromycin (9 of 58) and in 47.3% of reactions to azithromycin (9 of 19) (P = .004). A complete allergy workup enabled us to confirm a diagnosis of clarithromycin and azithromycin allergy in 15.5% and 47.3% of cases, respectively. Azithromycin was more allergenic than clarithromycin in children.

  12. The Novaco Anger Scale-Provocation Inventory (1994 version) in Dutch forensic psychiatric patients.

    PubMed

    Hornsveld, Ruud H J; Muris, Peter; Kraaimaat, Floris W

    2011-12-01

    We examined the psychometric properties of the Novaco Anger Scale-Provocation Inventory (NAS-PI, 1994 version) in Dutch violent forensic psychiatric patients and secondary vocational students. A confirmatory factor analysis of the subscale structure of the NAS was carried out, reliability was investigated, and relations were calculated between NAS-PI scores and other measures of personality traits and problem behaviors. The 3-subscale structure of the original NAS could not be confirmed. However, the internal consistency of the NAS and the PI was excellent, and the test-retest reliability of the NAS was good. The validity of the NAS and the PI was supported by a meaningful pattern of correlations with alternative measures of anger and personality traits. Forensic psychiatric outpatients displayed higher NAS scores than secondary vocational students, but inpatients scored even lower than this nonclinical control group. Our preliminary conclusion is that the NAS-PI is a valuable instrument for the assessment of anger in Dutch violent forensic psychiatric patients.

  13. Does response evaluation and decision (RED) mediate the relation between hostile attributional style and antisocial behavior in adolescence?

    PubMed

    Fontaine, Reid Griffith; Tanha, Marieh; Yang, Chongming; Dodge, Kenneth A; Bates, John E; Pettit, Gregory S

    2010-07-01

    The role of hostile attributional style (HAS) in antisocial development has been well-documented. We analyzed longitudinal data on 585 youths (48% female; 19% ethnic minority) to test the hypothesis that response evaluation and decision (RED) mediates the relation between HAS and antisocial behavior in adolescence. In Grades 10 and 12, adolescent participants and their parents reported participants' antisocial conduct. In Grade 11, participants were asked to imagine themselves in videotaped ambiguous-provocation scenarios. Segment 1 of each scenario presented an ambiguous provocation, after which participants answered HAS questions. In segment 2, participants were asked to imagine themselves responding aggressively to the provocateur, after which RED was assessed. Structural equation modeling indicated that RED mediates the relation between HAS and subsequent antisocial conduct, controlling for previous misconduct. Findings are consistent with research on the development of executive function processes in adolescence, and suggest that the relation between HAS and RED changes after childhood.

  14. Does Response Evaluation and Decision (RED) Mediate the Relation between Hostile Attributional Style and Antisocial Behavior in Adolescence?

    PubMed Central

    Tanha, Marieh; Yang, Chongming; Dodge, Kenneth A.; Bates, John E.; Pettit, Gregory S.

    2013-01-01

    The role of hostile attributional style (HAS) in antisocial development has been well-documented. We analyzed longitudinal data on 585 youths (48% female; 19% ethnic minority) to test the hypothesis that response evaluation and decision (RED) mediates the relation between HAS and antisocial behavior in adolescence. In Grades 10 and 12, adolescent participants and their parents reported participants’ antisocial conduct. In Grade 11, participants were asked to imagine themselves in videotaped ambiguous-provocation scenarios. Segment 1 of each scenario presented an ambiguous provocation, after which participants answered HAS questions. In segment 2, participants were asked to imagine themselves responding aggressively to the provocateur, after which RED was assessed. Structural equation modeling indicated that RED mediates the relation between HAS and subsequent antisocial conduct, controlling for previous misconduct. Findings are consistent with research on the development of executive function processes in adolescence, and suggest that the relation between HAS and RED changes after childhood. PMID:20186477

  15. Comparison of Valsalva Maneuver, Amyl Nitrite, and Exercise Echocardiography to Demonstrate Latent Left Ventricular Outflow Obstruction in Hypertrophic Cardiomyopathy.

    PubMed

    Ayoub, Chadi; Geske, Jeffrey B; Larsen, Carolyn M; Scott, Christopher G; Klarich, Kyle W; Pellikka, Patricia A

    2017-12-15

    Guidelines recommend exercise stress echocardiogram (ESE) for patients with hypertrophic cardiomyopathy (HC) if a 50 mm Hg gradient is not present at rest or provoked with Valsalva or amyl nitrite, to direct medical and surgical management. However, no study has directly compared all 3 methods. We sought to evaluate efficacy and degree of provocation of left ventricular outflow gradients by ESE, and compare with Valsalva and amyl nitrite. In patients with HC between 2002 and 2015, resting echocardiograms and ESEs within 1 year were retrospectively reviewed. Gradients elicited by each provocation method were compared. Rest and ESE were available in 97 patients (mean age 54 ± 18 years, 57% male); 78 underwent Valsalva maneuver and 41 amyl nitrite provocation. Median gradients (interquartile range) were 10 mm Hg (7,19) at rest, 16 mm Hg (9,34) with Valsalva, 23 mm Hg (13,49) with amyl nitrite, and 26 mm Hg (13,58) with ESE. ESE and amyl nitrite were able to provoke obstruction (≥30 mm Hg) and severe obstruction (≥50 mm Hg) more frequently than Valsalva. In patients with resting gradient <30 mm Hg (n = 83), provocation maneuvers demonstrated dynamic obstruction in 51%; in those with Valsalva gradient <30 mm Hg (n = 57), ESE or amyl nitrite provoked a gradient in 44%; and in those with amyl nitrite gradient <30 mm Hg (n = 20), ESE provoked a gradient in 29%. No demographic or baseline echocardiographic parameter predicted provocable obstruction. In conclusion, ESE is clinically useful; however, different provocation maneuvers may be effective in different patients with HC, and all maneuvers may be required to provoke dynamic obstruction in symptomatic patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Non-immediate reactions to beta-lactams: diagnostic value of skin testing and drug provocation test.

    PubMed

    Padial, A; Antunez, C; Blanca-Lopez, N; Fernandez, T D; Cornejo-Garcia, J A; Mayorga, C; Torres, M J; Blanca, M

    2008-05-01

    beta-Lactam (BL) antibiotics can induce non-immediate skin reactions, frequently manifested as exanthema or urticaria. The time between drug intake and the reaction appearance is generally 24-48 h. Because the mechanisms involved are not completely understood, diagnostic tests for these reactions have still to be fully validated. To evaluate the role of skin and drug provocation tests (DPTs) in the diagnosis of patients with non-immediate reactions to BL. We evaluated a group of 22 patients who developed maculopapular exanthema or urticarial exanthema after BL intake. Diagnosis was confirmed by DPT with BL. Intradermal/patch testing was performed with benzylpenicilloyl, minor determinant mixture, amoxicillin (AX), ampicillin (AMP) and the culprit drug in patients and in 22 negative controls. Immunohistochemical studies were done in the affected skin at the acute phase of the reaction and after a delayed positive skin test/DPT. IFN-gamma and IL-4 were quantified in peripheral mononuclear cells, obtained during the positive response to DPT and after resolution of the symptoms. From the total number of cases, 12 patients developed urticarial exanthema and 10 maculopapular exanthema after DPT. Only two of the 22 patients (9%) had a positive delayed intradermal skin test: one to AX/AMP and the other to cloxacillin. Biopsies showed a mononuclear CD4, CD8 infiltrate and activated and memory cells. The cytokine expression showed a Th1 pattern in patients, in contrast with the Th0 pattern in controls. In patients with non-immediate reactions to BLs (maculopapular exathema or urticarial exanthema), the sensitivity of skin testing is low and DPT may be required to establish the diagnosis. The reproducibility of the reactions and the cytokine pattern expressed during the acute episode support a T cell-induced non-immediate response.

  17. A comparison of skin endpoint titration and skin-prick testing in the diagnosis of allergic rhinitis.

    PubMed

    Gungor, Anil; Houser, Steven M; Aquino, Benjamin F; Akbar, Imran; Moinuddin, Rizwan; Mamikoglu, Bulent; Corey, Jacquelynne P

    2004-01-01

    Among the many methods of allergy diagnosis are intradermal testing (IDT) and skin-prick testing (SPT). The usefulness of IDT has been called into question by some authors, while others believe that studies demonstrating that SPT was superior might have been subject to bias. We conducted a study to compare the validity of SPT and IDT--specifically, the skin endpoint titration (SET) type of IDT--in diagnosing allergic rhinitis. We performed nasal provocation testing on 62 patients to establish an unbiased screening criterion for study entry. Acoustic rhinometric measurements of the nasal responses revealed that 34 patients tested positive and 28 negative. All patients were subsequently tested by SET and SPT. We found that SPT was more sensitive (85.3 vs 79.4%) and more specific (78.6 vs 67.9%) than SET as a screening procedure. The positive predictive value of SPT was greater than that of SET (82.9 vs 75.0%), as was the negative predictive value (81.5 vs 73.0%). None of these differences was statistically significant; because of the relatively small sample size, our study was powered to show only equivalency. The results of our study suggest that the information obtained by the SET method of IDT is comparable to that obtained by SPT in terms of sensitivity, specificity, and overall performance and that both SET and SPT correlate well with nasal provocation testing for ragweed. Therefore, the decision as to which to use can be based on other factors, such as the practitioner's training, the desire for quantitative results, the desire for rapid results, and the type of treatment (i.e., immunotherapy or pharmacotherapy) that is likely to be chosen on the basis of test results.

  18. Ranitidine-induced anaphylaxis: clinical features, cross-reactivity, and skin testing.

    PubMed

    Park, K H; Pai, J; Song, D-G; Sim, D W; Park, H J; Lee, J-H; Jeong, K Y; Pan, C-H; Shin, I; Park, J-W

    2016-04-01

    Histamine H2 receptor antagonists are commonly prescribed medications and are known to be well tolerated. However, 99 cases of ranitidine-induced anaphylaxis occurred in Korea from 2007 to 2014. The purpose of this study was to determine the incidence, clinical features, and diagnostic methods for ranitidine-induced anaphylaxis. Ranitidine-related pharmacovigilance data from 2007 to 2014 were reviewed. Adverse drug reactions with causal relationships were selected, and clinical manifestations, outcomes, and drug-related information were assessed. For further investigation, 8 years of pharmacovigilance data were collected at a single centre. Twenty-three patients participated in in vivo and in vitro studies. Skin tests, oral provocation tests, and laboratory tests were performed, including tests using other kinds of histamine H2 receptor antagonists. Over 7 years, 584 patients suffered adverse reactions to ranitidine. The most common manifestation was cutaneous symptoms. Among them, 99 patients (17.0%) experienced anaphylaxis. In a single-centre study, skin prick tests were positive in 91.7% of ranitidine-induced anaphylaxis patients (11/12); the optimal concentration was 20 mg/mL. Detection of ranitidine-specific immunoglobulin E failed. Cimetidine and proton pump inhibitors showed no cross-reactivity with ranitidine based on the skin prick test, oral provocation test, or clinical determination. Surprisingly, 82.6% of patients reintroduced ranitidine and re-experienced the same adverse reactions because ranitidine was not considered the culprit drug. Although ranitidine is known as a safe drug, it can also cause diverse adverse reactions, including anaphylaxis. This study demonstrates the need to pay attention to adverse reactions to ranitidine and consider ranitidine as a cause of anaphylaxis. © 2016 John Wiley & Sons Ltd.

  19. 40 CFR 86.213-11 - Fuel specifications.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...-Duty Passenger Vehicles; Cold Temperature Test Procedures § 86.213-11 Fuel specifications. (a) Gasoline... the text in this section follows: Table—Cold CO Fuel Specifications Item ASTM test Cold CO low octane.... Diesel test fuel used for cold temperature FTP testing under part 600 of this chapter must be a winter...

  20. 40 CFR 86.213-11 - Fuel specifications.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...-Duty Passenger Vehicles; Cold Temperature Test Procedures § 86.213-11 Fuel specifications. (a) Gasoline... the text in this section follows: Table—Cold CO Fuel Specifications Item ASTM test Cold CO low octane.... Diesel test fuel used for cold temperature FTP testing under part 600 of this chapter must be a winter...

  1. 40 CFR 86.213-11 - Fuel specifications.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...-Duty Passenger Vehicles; Cold Temperature Test Procedures § 86.213-11 Fuel specifications. (a) Gasoline... the text in this section follows: Table—Cold CO Fuel Specifications Item ASTM test Cold CO low octane.... Diesel test fuel used for cold temperature FTP testing under part 600 of this chapter must be a winter...

  2. 40 CFR 86.213-11 - Fuel specifications.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...-Duty Passenger Vehicles; Cold Temperature Test Procedures § 86.213-11 Fuel specifications. (a) Gasoline... the text in this section follows: Table—Cold CO Fuel Specifications Item ASTM test Cold CO low octane.... Diesel test fuel used for cold temperature FTP testing under part 600 of this chapter must be a winter...

  3. Occupational asthma due to soft corrosive soldering fluxes containing zinc chloride and ammonium chloride.

    PubMed Central

    Weir, D C; Robertson, A S; Jones, S; Burge, P S

    1989-01-01

    Two cases of occupational asthma due to soft corrosive soldering fluxes used in metal jointing are described in which the diagnosis was based on work related deterioration in daily peak expiratory flow rate and positive responses in bronchial provocation tests. Both fluxes contained ammonium chloride and zinc chloride. Occupational asthma provoked by these agents has not previously been reported. PMID:2705153

  4. In silico screening of the impact of hERG channel kinetic abnormalities on channel block and susceptibility to acquired long QT syndrome

    PubMed Central

    Romero, Lucia; Trenor, Beatriz; Yang, Pei-Chi; Saiz, Javier; Clancy, Colleen E.

    2014-01-01

    Accurate diagnosis of predisposition to long QT syndrome is crucial for reducing the risk of cardiac arrhythmias. In recent years, drug-induced provocative tests have proved useful to unmask some latent mutations linked to cardiac arrhythmias. In this study we expanded this concept by developing a prototype for a computational provocative screening test to reveal genetic predisposition to acquired Long-QT Syndrome (aLTQS). We developed a computational approach to reveal the pharmacological properties of IKr blocking drugs that are most likely to cause aLQTS in the setting of subtle alterations in IKr channel gating that would be expected to result from benign genetic variants. We used the model to predict the most potentially lethal combinations of kinetic anomalies and drug properties. In doing so, we also implicitly predicted ideal inverse therapeutic properties of K channel openers that would be expected to remedy a specific defect. We systematically performed “in silico mutagenesis” by altering discrete kinetic transition rates of the Fink et al. Markov model of human IKr channels, corresponding to activation, inactivation, deactivation and recovery from inactivation of IKr channels. We then screened and identified the properties of IKr blockers that caused acquired Long QT and therefore unmasked mutant phenotypes for mild, moderate and severe variants. Mutant IKr channels were incorporated into the O’Hara et al. human ventricular action potential (AP) model and subjected to simulated application of a wide variety of IKr-drug interactions in order to identify the characteristics that selectively exacerbate the AP duration (APD) differences between wild-type and IKr mutated cells. Our results show that drugs with disparate affinities to conformation states of the IKr channel are key to amplify variants underlying susceptibility to acquired Long QT Syndrome, an effect that is especially pronounced at slow frequencies. Finally, we developed a mathematical formulation of the M54T MiRP1 latent mutation and simulated a provocative test. In this setting, application of dofetilide dramatically amplified the predicted QT interval duration in the M54T hMiRP1 mutation compared to wild-type. PMID:24631769

  5. Experimental pain in the groin may refer into the lower abdomen: Implications to clinical assessments.

    PubMed

    Drew, M K; Palsson, T S; Hirata, R P; Izumi, M; Lovell, G; Welvaert, M; Chiarelli, P; Osmotherly, P G; Graven-Nielsen, T

    2017-10-01

    To investigate the effects of experimental adductor pain on the pain referral pattern, mechanical sensitivity and muscle activity during common clinical tests. Repeated-measures design. In two separate sessions, 15 healthy males received a hypertonic (painful) and isotonic (control) saline injection to either the adductor longus (AL) tendon to produce experimental groin pain or into the rectus femoris (RF) tendon as a painful control. Pain intensity was recorded on a visual analogue scale (VAS) with pain distribution indicated on body maps. Pressure pain thresholds (PPT) were assessed bilaterally in the groin area. Electromyography (EMG) of relevant muscles was recorded during six provocation tests. PPT and EMG assessment were measured before, during and after experimental pain. Hypertonic saline induced higher VAS scores than isotonic saline (p<0.001), and a local pain distribution in 80% of participants. A proximal pain referral to the lower abdominal region in 33% (AL) and 7% (RF) of participants. Experimental pain (AL and RF) did not significantly alter PPT values or the EMG amplitude in groin or trunk muscles during provocation tests when forces were matched with baseline. This study demonstrates that AL tendon pain was distributed locally in the majority of participants but may refer to the lower abdomen. Experimental adductor pain did not significantly alter the mechanical sensitivity or muscle activity patterns. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  6. Correlation of clinical examination characteristics with three sources of chronic low back pain.

    PubMed

    Young, Sharon; Aprill, Charles; Laslett, Mark

    2003-01-01

    Research has demonstrated some progress in using a clinical examination to predict discogenic or sacroiliac (SI) joint sources of pain. No clear predictors of symptomatic lumbar zygapophysial joints have yet been demonstrated. To identify significant components of a clinical examination that are associated with symptomatic lumbar discs, zygapophysial joints and SI joints. A prospective, criterion-related concurrent validity study performed at a private radiology practice specializing in spinal diagnostics. The sample consisted of 81 patients with chronic lumbopelvic pain referred for diagnostic injections. Contingency tables were constructed for nine features of the clinical evaluation compared with the results of diagnostic injections. Statistical analysis included chi-squared test for independence, phi and odds ratios with confidence intervals. Patients received blinded clinical examinations by physical therapists, and diagnostic injections were used as the criterion standard. Significant relationships were found between discogenic pain and centralization of pain during repeated movement testing, and pain when rising from sitting. Lumbar zygapophysial joint pain was associated with absence of pain when rising from sitting. Sacroiliac joint pain was related to three or more positive pain provocation tests, pain when rising from sitting, unilateral pain and absence of lumbar pain. Significant correlations exist between clinical examination findings and symptomatic lumbar discs, zygapophysial and SI joints. The strongest relationships were seen between SI joint pain and three or more positive pain provocation tests, centralization of pain for symptomatic discs and absence of pain when rising from sitting for symptomatic lumbar zygapophysial joints.

  7. The Oral Provocation Test for Raw Egg in Patients with Hen Egg Allergy.

    PubMed

    Kido, Jun; Nishi, Natsuko; Matsumoto, Tomoaki

    2018-06-06

    Many researchers have made efforts to develop diagnostic tools for predicting the outcome of oral food challenges (OFCs). The aim of this study was to assess the diagnostic value of the skin prick test (SPT) and blood-specific IgE concentrations based on the outcome of the OFCs for heated and raw hen egg. This study included 103 children with suspected hen egg allergy (HEA; median age 23 months, range 10-155; 72 boys, 31 girls). Forty-three patients were diagnosed with HEA by OFC. Of 60 patients who tolerated heated egg white (HEW), 22 underwent the OFC for raw hen egg and 7 developed adverse reactions after ingesting raw egg. Their wheal diameters and specific IgE levels for egg white and ovomucoid were determined. Wheal diameters as well as blood-specific IgE levels for egg white and ovomucoid were significantly larger in children with positive OFC results for HEW than in those with negative results. However, there were no significant differences between the positive and negative test results for raw hen egg white (REW) in wheal diameter or blood-specific IgE levels. The SPT and blood-specific IgE can be used to diagnose HEA. However, the provocation test for REW in children without HEW allergy is important because the values of SPT and specific IgE were not significantly different between children with and without raw egg allergy. © 2018 S. Karger AG, Basel.

  8. Return to Flying Duties Following Centrifuge or Vibration Exposures

    NASA Technical Reports Server (NTRS)

    Scheuring, Richard A.; Clarke, Jonathan; Jones, Jeffrey A.

    2009-01-01

    Introduction: In an effort to determine the human performance limits for vibration in spacecraft being developed by NASA, astronauts were evaluated during a simulated launch profile in a centrifuge/vibration environment and separate vibration-only simulation. Current USAF and Army standards for return to flight following centrifuge exposures require 12-24 hours to pass before a crewmember may return to flying duties. There are no standards on vibration exposures and return to flying duties. Based on direct observation and provocative neurological testing of the astronauts, a new standard for return to flying duties following centrifuge and/or vibration exposures was established. Methods: 13 astronaut participants were exposed to simulated launch profiles in a + 3.5 Gx bias centrifuge/vibration environment and separately on a vibration table at the NASA-Ames Research Center. Each subject had complete neurological evaluations pre- and post-exposure for the centrifuge/vibration runs with the NASA neurological function rating scale (NFRS). Subjects who participated in the vibration-only exposures had video oculography performed with provocative maneuvers in addition to the NFRS. NFRS evaluations occurred immediately following each exposure and at 1 hour post-run. Astronauts who remained symptomatic at 1 hour had repeat NFRS performed at 1 hour intervals until the crewmember was asymptomatic. Results: Astronauts in the centrifuge/vibration study averaged a 3-5 point increase in NFRS scores immediately following exposure but returned to baseline 3 hours post-run. Subjects exposed to the vibration-only simulation had a 1-3 point increase following exposure and returned to baseline within 1-2 hours. Pre- and post- vibration exposure video oculography did not reveal any persistent ocular findings with provocative testing 1 hour post-exposure. Discussion: Based on direct observations and objective measurement of neurological function in astronauts following simulated launch profiles, asymptomatic individuals are allowed to return to flying duties within 3 hours following centrifuge/vibration and 2 hours after vibration-only exposures.

  9. Clinical relevance of syncope and presyncope induced by tilt testing.

    PubMed

    Zyśko, Dorota; Gajek, Jacek; Koźluk, Edward; Agrawal, Anil Kumar; Smereka, Jacek; Checiński, Igor

    2009-08-01

    The authors investigated the relation between presyncope and syncope induced by tilt testing (HUTT) and demographics, medical history and HUTT data.The demographics, syncopal burden, data regarding the spontaneous syncope and reproduction of symptoms during HUTT were compared among patients with induced syncope and presyncope. The study group consisted of 574 patients (371 women, 203 men), aged 43.7 +/- 18.5 years. Patients with syncope induced by HUTT (418 patients, 63.9% women) had a higher number of syncopal episodes in their medical history. Stepwise logistic regression revealed that syncope provocation was independently related to the cardiodepressive type of neurocardiogenic reaction (OR 7.8, CI 4.2-14.4, P < 0.001), NTG use (OR 1.7, CI: 1.0-2.7, P < 0.05), the reproduction of the symptoms during HUTT (OR 2.0, CI: 1.3-3.1, P < 0.01) and the higher number of syncopal episodes (OR 2.0, CI: 1.3-3.0, P < 0.01). In patients with positive HUTT during a passive phase it was related to the cardiodepressive type of reaction (OR 26.5, CI: 5.9-118.5, P < 0.001). In the group with positive HUTT after NTG syncope was related to the cardiodepressive type (OR 5.7, CI: 2.9-11.2, P < 0.001), vasovagal history (OR 2.0, CI: 1.2-3.3, P < 0.01), reproduction of the spontaneous symptoms (OR 1.9, CI: 1.1-3.1, P < 0.05) and higher number of syncopal episodes (OR 2.1, CI: 1.3-3.3, P < 0.01). Syncope is more frequently a HUTT outcome than presyncope. The provocation of syncope in the passive phase of HUTT depends only on the cardiodepressive type of neurocardiogenic reaction. The induction of presyncope after nitroglycerin provocation is related to the possibility of a false positive reaction.

  10. Individual Differences in Responses to Provocation and Frequent Victimization by Peers

    ERIC Educational Resources Information Center

    Champion, Kelly M.; Clay, Daniel L.

    2007-01-01

    This study examined associations between victimization by peers and intention to respond to provocative events as a function of anger arousal and motivation to improve the situation in a cross-sectional sample of school-age children (N = 506, 260 males, 246 females). Results demonstrated that more intense anger and more retaliatory motivation were…

  11. Children's Emotion Regulation: Self-Report and Physiological Response to Peer Provocation

    ERIC Educational Resources Information Center

    Hessler, Danielle M.; Katz, Lynn Fainsilber

    2007-01-01

    The authors examined the notion that children's emotion regulation (ER) is a uniform skill by (a) investigating the concordance between self-report of ER and physiological measures and by (b) examining ER in a specific context (e.g., peer provocation) and context-free manner (e.g., during a semistructured interview of ER abilities). Seventy-two…

  12. The Photomontages of John Heartfield: A Provocative Teaching Tool for "Landeskunde."

    ERIC Educational Resources Information Center

    Mathieu, Gustave Bording

    1992-01-01

    A case is made for the use of the politically provocative photomontages of Heartfield (a.k.a. Berlin-born Helmut Herzfeld) in the German classroom. The interplay of language, art, culture, and history makes them especially useful as realia. A model for teaching them is presented, including a chronology and nine reproductions. (Author/LB)

  13. 13. VIEW FROM COLD CALIBRATION BLOCKHOUSE LOOKING DOWN CONNECTING TUNNEL ...

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

    13. VIEW FROM COLD CALIBRATION BLOCKHOUSE LOOKING DOWN CONNECTING TUNNEL TO COLD CALIBRATION TEST STAND BASEMENT, SHOWING HARD WIRE CONNECTION (INSTRUMENTATION AND CONTROL). - Marshall Space Flight Center, East Test Area, Cold Calibration Test Stand, Huntsville, Madison County, AL

  14. 2. VIEW NORTHWEST FROM LEFT TO RIGHT: COLD CALIBRATION BLOCKHOUSE, ...

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

    2. VIEW NORTHWEST FROM LEFT TO RIGHT: COLD CALIBRATION BLOCKHOUSE, COLD CALIBRATION TEST STAND FOR FL ENGINE FOR SATURN V. EXHAUST DUCT IN FOREGROUND. - Marshall Space Flight Center, East Test Area, Cold Calibration Test Stand, Huntsville, Madison County, AL

  15. Effects of tryptophan depletion on selective serotonin reuptake inhibitor-remitted patients with obsessive compulsive disorder.

    PubMed

    Hood, Sean D; Broyd, Annabel; Robinson, Hayley; Lee, Jessica; Hudaib, Abdul-Rahman; Hince, Dana A

    2017-12-01

    Serotonergic antidepressants are first-line medication therapies for obsessive-compulsive disorder, however it is not known if synaptic serotonin availability is important for selective serotonin reuptake inhibitor efficacy. The present study tested the hypothesis that temporary reduction in central serotonin transmission, through acute tryptophan depletion, would result in an increase in anxiety in selective serotonin reuptake inhibitor-remitted obsessive-compulsive disorder patients. Eight patients (four males) with obsessive-compulsive disorder who showed sustained clinical improvement with selective serotonin reuptake inhibitor treatment underwent acute tryptophan depletion in a randomized, double-blind, placebo-controlled, within-subjects design, over two days one week apart. Five hours after consumption of the depleting/sham drink the participants performed a personalized obsessive-compulsive disorder symptom exposure task. Psychological responses were measured using the Spielberger State Anxiety Inventory, Yale-Brown Obsessive Compulsive Scale and Visual Analogue Scales. Free plasma tryptophan to large neutral amino acid ratio decreased by 93% on the depletion day and decreased by 1% on the sham day, as anticipated. Psychological rating scores as measured by Visual Analogue Scale showed a significant decrease in perceived control and increase in interfering thoughts at the time of provocation on the depletion day but not on the sham day. A measure of convergent validity, namely Visual Analogue Scale Similar to past, was significantly higher at the time of provocation on both the depletion and sham days. Both the depletion and time of provocation scores for Visual Analogue Scale Anxiety, Spielberger State Anxiety Inventory, Yale-Brown Obsessive Compulsive Scale and blood pressure were not significant. Acute tryptophan depletion caused a significant decrease in perceived control and increase in interfering thoughts at the time of provocation. Acute tryptophan depletion had no effect on the Spielberger State Anxiety Inventory or Visual Analogue Scale Anxiety measures, which suggests that the mechanism of action of selective serotonin reuptake inhibitors may be different to that seen in panic, social anxiety and post-traumatic stress disorder. Successful selective serotonin reuptake inhibitor treatment of obsessive-compulsive disorder may involve the ability of serotonin to switch habitual responding to goal-directed behaviour.

  16. Systemic Allergy to Corticosteroids: Clinical Features and Cross Reactivity.

    PubMed

    Barbaud, Annick; Waton, Julie

    2016-01-01

    Systemic hypersensitivity (HS) to corticosteroids (CS) is paradoxical but does exist. Some patients with a previous contact allergy to topical CS may develop a systemic contact dermatitis (SCD) while receiving CS orally or intravenously. However, a previous contact sensitization is not mandatory for developing a systemic HS to CS. Acute or delayed urticaria can occur in immediate HS. Immediate HS can be due to excipients, mainly carboxymethylcellulose or to CS themselves. Delayed reactions, mainly maculopapular rash and acute generalized exanthematous pustulosis can occur. Skin tests with systemic CS have to be standardized. It is necessary to determine if IDT with CS frequently induce skin atrophy or not and if such skin atrophy is transient by doing prospective studies using an standardized method and a limited injected volume (0.02 ml). Patch tests can be done in delayed HS, with readings at day 2, 4 and 7. In SCD, the Baeck's classification of CS in 3 chemical groups could explain cross reactivity between systemic CS. However, this classification is not applicable to explain cross-reactions between in systemic HS. According to the literature, 52/79 patients had a HS reaction to a group confirmed by a positive allergological investigations, but had a negative provocation test with another CS belonging to the same group. In case of non-severe cutaneous adverse reactions and when skin tests are negative, provocation tests have to be performed to find an alternative CS, even if it belongs to the same chemical group as those responsible for the initial reaction. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  17. Asthma-like symptoms, atopy, and bronchial responsiveness in furniture workers

    PubMed Central

    Talini, D.; Monteverdi, A.; Benvenuti, A.; Petrozzino, M.; Di, P; Lemmi, M.; Carletti, A.; Macchioni, P.; Serretti, N.; Viegi, G.; Paggiaro, P.

    1998-01-01

    OBJECTIVES: To study the role of individual and occupational risk factors for asthma in furniture workers. METHODS: 296 workers were examined (258 men, 38 women) with a questionnaire of respiratory symptoms and diseases, baseline spirometry, bronchial provocative test with methacholine, and skin prick tests. Non-specific bronchial hyperreactivity was defined as when a provocative dose with a fall of 20% in forced expiratory volume in 1 second (PD20FEV1) was < 0.8 mg and atopy in the presence of at least one positive response to skin prick tests. Workers were subdivided into spray painters (exposed to low concentrations of diisocyanates and solvents), woodworkers (exposed to wood dusts), and assemblers (control group). RESULTS: The prevalences of attacks of shortness of breath with wheezing and dyspnoea were higher in spray painters (13.5% and 11.5% respectively) than in woodworkers (7.7% and 6.3%) or in assemblers (1.6% and 1.6%); prevalences of chronic cough, asthma, and rhinitis were also slightly but not significantly higher in spray painters and in woodworkers than in assemblers. The difference in the prevalence of respiratory symptoms among the job titles was due to the atopic subjects, who showed a higher prevalence of chronic cough, wheeze, shortness of breath with wheeze, dyspnoea, and asthma in spray painters than in the other groups. The prevalence of non-specific bronchial hyperreactivity in subjects who performed bronchial provocative tests was 17.7%, with no significant difference among groups. Asthma symptoms were significantly associated with non-specific bronchial hyperreactivity. Asthma-like symptoms plus non-specific bronchial hyperreactivity was found in 4% of assemblers, 10% of woodworkers, and 13.3% of spray painters (chi 2 = 2.6, NS). Multiple logistic analysis taking into account individual (smoke, atopy, age) and occupational (job titles) risk factors confirmed that spray painters had higher prevalence of chronic cough than assemblers, and a trend in increasing the prevalence of shortness of breath with wheeze, dyspnoea, and asthma. CONCLUSIONS: Painters in the furniture industry, particularly atopic subjects, are at higher risk of asthma-like symptoms than other job titles. In these workers asthma-like symptoms are more sensitive than non-specific bronchial hyperreactivity in detecting a negative effect of the occupational exposure.   PMID:9924457

  18. Adolescents' responses to online peer conflict: How self‐evaluation and ethnicity matter

    PubMed Central

    Bos, Marieke G.N.; Stevenson, Claire E.

    2017-01-01

    Abstract For parents, online platforms where their children interact with others often feel like a “black box” in terms of what exactly is happening. In this study, we developed an ecologically valid online computer game in which a (computer‐generated) peer teammate tried to provoke frustration, in order to examine (a) adolescents' responses and (b) how indices of self‐evaluation (i.e., sense of coherence and self‐esteem) and demographic variables (i.e., gender and ethnicity) matter to these responses. Like gender, being a member of a minority or majority group may influence how provocations by peers are interpreted, influencing how one responds. Fifteen‐year‐old Dutch and Moroccan‐Dutch adolescents (N = 167) completed self‐reports and played the online computer game. The game indeed elicited frustration, with increased self‐reported anger. Moreover, expressions of displeasure were much more common during and after provocation than before provocation. Crucially, perceived self‐evaluation mattered; higher levels of sense of coherence but lower levels of self‐esteem (only in Moroccan‐Dutch group) contributed to fewer expressions of displeasure. Gender did not play a moderating role. Our findings provide initial insights into individual differences in adolescents' responses in an online peer‐conflict situation. Highlights We studied Dutch and Moroccan-Dutch adolescents' responses during online peer provocation and how self-evaluation and demographic variables matter.Provocation by the (computer-generated) peer teammate increased expressions of displeasure.More sense of coherence but less self-esteem was associated with fewer expressions of displeasure, but ethnicity moderated the effect with self-esteem. PMID:29780286

  19. Adolescents' responses to online peer conflict: How self-evaluation and ethnicity matter.

    PubMed

    Novin, Sheida; Bos, Marieke G N; Stevenson, Claire E; Rieffe, Carolien

    2018-01-01

    For parents, online platforms where their children interact with others often feel like a "black box" in terms of what exactly is happening. In this study, we developed an ecologically valid online computer game in which a (computer-generated) peer teammate tried to provoke frustration, in order to examine (a) adolescents' responses and (b) how indices of self-evaluation (i.e., sense of coherence and self-esteem) and demographic variables (i.e., gender and ethnicity) matter to these responses. Like gender, being a member of a minority or majority group may influence how provocations by peers are interpreted, influencing how one responds. Fifteen-year-old Dutch and Moroccan-Dutch adolescents (N = 167) completed self-reports and played the online computer game. The game indeed elicited frustration, with increased self-reported anger. Moreover, expressions of displeasure were much more common during and after provocation than before provocation. Crucially, perceived self-evaluation mattered; higher levels of sense of coherence but lower levels of self-esteem (only in Moroccan-Dutch group) contributed to fewer expressions of displeasure. Gender did not play a moderating role. Our findings provide initial insights into individual differences in adolescents' responses in an online peer-conflict situation. We studied Dutch and Moroccan-Dutch adolescents' responses during online peer provocation and how self-evaluation and demographic variables matter.Provocation by the (computer-generated) peer teammate increased expressions of displeasure.More sense of coherence but less self-esteem was associated with fewer expressions of displeasure, but ethnicity moderated the effect with self-esteem.

  20. Testosterone causes both prosocial and antisocial status-enhancing behaviors in human males

    PubMed Central

    Dreher, Jean-Claude; Pazderska, Agnieszka; Frodl, Thomas; Nolan, John J.; O’Doherty, John P.

    2016-01-01

    Although popular discussion of testosterone’s influence on males often centers on aggression and antisocial behavior, contemporary theorists have proposed that it instead enhances behaviors involved in obtaining and maintaining a high social status. Two central distinguishing but untested predictions of this theory are that testosterone selectively increases status-relevant aggressive behaviors, such as responses to provocation, but that it also promotes nonaggressive behaviors, such as generosity toward others, when they are appropriate for increasing status. Here, we tested these hypotheses in healthy young males by injecting testosterone enanthate or a placebo in a double-blind, between-subjects, randomized design (n = 40). Participants played a version of the Ultimatum Game that was modified so that, having accepted or rejected an offer from the proposer, participants then had the opportunity to punish or reward the proposer at a proportionate cost to themselves. We found that participants treated with testosterone were more likely to punish the proposer and that higher testosterone levels were specifically associated with increased punishment of proposers who made unfair offers, indicating that testosterone indeed potentiates aggressive responses to provocation. Furthermore, when participants administered testosterone received large offers, they were more likely to reward the proposer and also chose rewards of greater magnitude. This increased generosity in the absence of provocation indicates that testosterone can also cause prosocial behaviors that are appropriate for increasing status. These findings are inconsistent with a simple relationship between testosterone and aggression and provide causal evidence for a more complex role for testosterone in driving status-enhancing behaviors in males. PMID:27671627

  1. Intra- and inter-rater reliability of 3D passive intervertebral motion in subjects with nonspecific neck pain assessed by physical therapy students: A pilot study.

    PubMed

    Rossettini, Giacomo; Rondoni, Angie; Lovato, Tommaso; Strobe, Marco; Verzè, Elisa; Vicentini, Marco; Testa, Marco

    2016-06-03

    Passive Intervertebral Movements (PIVMs) are commonly used to assess and treat patients with nonspecific neck pain. Only very few studies have investigated 3D movements until now. This study assessed intra- and inter-rater reliability of three-dimensional (3D) cervical PIVMs performed by physical therapy students in patients with nonspecific neck pain. Thirty-one patients, mean age 47.2 ± 7.2 years, were independently evaluated by 2 physical therapy students. The raters (A and B) assessed mobility, end-feel and pain provocation performing bilaterally the 3D cervical segmental side-bending test (3D CSSB) from levels C2-C3 to C6-C7. Percentage agreement (raw, positive and negative), Cohen's kappa (95% CI), prevalence index and bias index were calculated to estimate intra- and inter-reliability. Intra-rater reliability showed kappa values ranging between fair and substantial (k 0.29-0.80) for pain provocation, mobility and end-feel, with percentage agreements between 61%-90%. Inter-rater reliability presented kappa values ranging between fair and substantial (k 0.22-0.62) for pain provocation, mobility and end-feel, with percentage agreements between 61% and 80%. Intra-rater reliability of 3D PIVMs was superior to inter-rater reliability in patients with nonspecific neck pain. The most repeatable evaluation parameter was pain. However overall poor reliability suggests avoiding the use of these techniques alone to examine patients and measure their outcome. Further studies are needed to investigate PIVMs reliability in combination with other assessment procedure in symptomatic patients.

  2. MAOA-uVNTR genotype predicts interindividual differences in experimental aggressiveness as a function of the degree of provocation.

    PubMed

    Kuepper, Yvonne; Grant, Phillip; Wielpuetz, Catrin; Hennig, Juergen

    2013-06-15

    The MAOA-uVNTR has been suggested to play a role regarding aggression, however, results are inconsistent. We aimed at further elucidating potential effects of the MAOA-uVNTR on aggressiveness with respect to potential modulators: sex, experimental vs. trait aggressiveness and type of aggressiveness (proactive vs. reactive aggressiveness). We tested 239 healthy young adults (88 men/151 women). Participants were genotyped for the MAOA-uVNTR and performed a modified version of a competitive reaction time task - a commonly used and well established tool to elicit and measure aggressiveness. Furthermore, they completed a self-report scale measuring trait aggressiveness. We found a main effect of MAOA-uVNTR on a measure of reactive aggressiveness for both men and women, whereby the low-activity alleles of the MAOA-uVNTR were associated with substantially increased aggressive reactions (p<.05). This effect was unique for reactive aggressiveness. Measures of proactive aggressiveness or self reports were not associated with the MAOA-uVNTR-genotype. Our data are in line with earlier studies and indicate the MAOA-uVNTR-genotype to be specifically associated with measures of reactive impulsive experimental aggressiveness in healthy men and women. Furthermore the association between the MAOA-uVNTR genotype and aggressive responses increases in a fashion linear to the degree of provocation. This indicates that the low-functional alleles of the MAOA-uVNTR are not associated with increased aggressive behavior per se, but rather with an increased aggressive reactivity to provocation. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. Seeing the World through Mortal Kombat-Colored Glasses: Violent Video Games and the Development of a Short-Term Hostile Attribution Bias.

    ERIC Educational Resources Information Center

    Kirsh, Steven J.

    1998-01-01

    Investigated the effects of playing violent versus non-violent video games on the interpretation of ambiguous provocation situation. Found that children playing a violent video game responded more negatively to three of six ambiguous provocation story questions than children playing the non-violent video game. Data suggest that playing violent…

  4. Brain responses to symptom provocation and trauma-related short-term memory recall in coal mining accident survivors with acute severe PTSD.

    PubMed

    Hou, Cailan; Liu, Jun; Wang, Kun; Li, Lingjiang; Liang, Meng; He, Zhong; Liu, Yong; Zhang, Yan; Li, Weihui; Jiang, Tianzi

    2007-05-04

    Functional neuroimaging studies have largely been performed in patients with longstanding chronic posttraumatic stress disorder (PTSD). Additionally, memory function of PTSD patients has been proved to be impaired. We sought to characterize the brain responses of patients with acute PTSD and implemented a trauma-related short-term memory recall paradigm. Individuals with acute severe PTSD (n=10) resulting from a mining accident and 7 men exposed to the mining accident without PTSD underwent functional magnetic resonance imaging (fMRI) while performing the symptom provocation and trauma-related short-term memory recall paradigms. During symptom provocation paradigm, PTSD subjects showed diminished responses in right anterior cingulate gyrus, left inferior frontal gyrus and bilateral middle frontal gyrus and enhanced left parahippocampal gyrus response compared with controls. During the short-term memory recall paradigm, PTSD group showed diminished responses in right inferior frontal gyrus, right middle frontal and left middle occipital gyrus in comparison with controls. PTSD group exhibited diminished right parahippocampal gyrus response during the memory recall task as compared to the symptom provocation task. Our findings suggest that neurophysiological alterations and memory performance deficit have developed in acute severe PTSD.

  5. P3 and provoked aggressive behavior.

    PubMed

    Fanning, Jennifer R; Berman, Mitchell E; Long, James M

    2014-01-01

    Cognitive and biological processes play a role in human aggression. However, relatively little is known about the neural correlates of cognitive processes in aggressive individuals, particularly as they unfold during an aggressive encounter. We investigated whether the P3 event-related potential (ERP) discriminates aggressive versus nonaggressive individuals during a provocative, aggressive encounter. Forty-eight participants (23 men and 25 women) were classified as aggressive or nonaggressive based on self-reported life history of aggression. Aggressive behavior was assessed using a modification of a well-validated laboratory task during which the participant and a fictitious opponent ostensibly delivered and received noise blasts of low, medium, and high intensity. Provocation was manipulated by altering the level of noise set by the opponent. Aggression was defined as the number of high-intensity noise blasts the participant set for the opponent. As predicted, P3 amplitude in response to provocation differed as a function of aggressive history. Nonaggressive individuals showed enhanced P3 when provoked by the opponent relative to low provocation, but this effect was absent in aggressive individuals. The results suggest that aggressive individuals engage fewer neural processing resources in response to provoking social cues, which may reflect aberrant cognitive and emotional processes.

  6. 9. COLD CALIBRATION TEST STAND (H1) FROM LEFT TO RIGHT ...

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

    9. COLD CALIBRATION TEST STAND (H-1) FROM LEFT TO RIGHT - WORK BENCH, CONTROL PANEL, CHEMICAL TANK. - Marshall Space Flight Center, East Test Area, Cold Calibration Test Stand, Huntsville, Madison County, AL

  7. Critically appraised topic on adverse food reactions of companion animals (4): can we diagnose adverse food reactions in dogs and cats with in vivo or in vitro tests?

    PubMed

    Mueller, Ralf S; Olivry, Thierry

    2017-08-30

    The gold standard to diagnose adverse food reactions (AFRs) in the dog and cat is currently an elimination diet with subsequent provocation trials. However, those trials are inconvenient and client compliance can be low. Our objective was to systematically review the literature to evaluate in vivo and in vitro tests used to diagnose AFR in small animals. We searched three databases (CAB Abstracts, MEDLINE and Web of Science) for pertinent references on September 16, 2016. Among 71, 544 and 41 articles found in the CAB Abstract, MEDLINE and Web of Science databases, respectively, we selected 22 articles and abstracts from conference proceedings that reported data usable for evaluation of tests for AFR. Serum tests for food-specific IgE and IgG, intradermal testing with food antigens, lymphocyte proliferation tests, fecal food-specific IgE, patch, gastroscopic, and colonoscopic testing were evaluated. Testing for serum food-specific IgE and IgG showed low repeatability and, in dogs, a highly variable accuracy. In cats, the accuracy of testing for food-specific IgE was low. Lymphocyte proliferation tests were more frequently positive and more accurate in animals with AFR, but, as they are more difficult to perform, they remain currently a research tool. All other reported tests were only evaluated by individual studies with small numbers of animals. Negative patch test reactions have a very high negative predictability in dogs and could enable a choice of ingredients for the elimination diet in selected patients. Gastroscopic and colonoscopic testing as well as food-specific fecal IgE or food-specific serum IgG measurements appear less useful. Currently, the best diagnostic procedure to identify AFRs in small animals remains an elimination diet with subsequent provocation trials.

  8. On the Rebound: The Alliance Faces New Tests

    DTIC Science & Technology

    2012-06-01

    alliance. After several tumultuous years, the two countries regained their footing when responding to the March 11 triple catastrophe, moving forward...Japan after March 11. In the aftermath of the triple tragedy, some believed that the scale of the disaster would force change on Japan. The...provocations. If correct, this analysis has profound implications for bilateral relations, because it means that key to extended deterrence after the Nuclear

  9. Cutaneous adverse reactions to amoxicillin-clavulanic acid suspension in children: the role of sodium benzoate.

    PubMed

    Mori, Francesca; Barni, Simona; Pucci, Neri; Rossi, Maria Elisabetta; de Martino, Maurizio; Novembre, Elio

    2012-04-01

    In Europe amoxicillin plus clavulanic acid is the most commonly prescribed antibiotic and sodium benzoate is contained in the suspension formulation as a preservative. We studied the relevance of sodium benzoate as the culprit agent. In a group of children with a history of adverse reactions to amoxicillin plus clavulanic acid suspension. A total of 89 children were enrolled over a period of 3 years (2006 - 2009). Single blind oral provocation tests (OPTs) with amoxicillin plus clavulanic acid, sodium benzoate and placebo were performed. 20 children with recurrent idiopathic urticaria were investigated as a control group. according to personal history: 70% of reactions were late in developing while 23% of reactions were immediate and for 5% of the cases it was not possible to define the timing. 8 children (8/89=9%) resulted positive to the provocation tests with amoxicillin plus clavulanic acid; ten children (10/89=11%) had positive results with sodium benzoate; 3% had a double positivity (i.e. excipient and active drug). The timing of reactions significantly differs between the Amoxicillin plus clavulanic acid and sodium benzoate groups (p=0.002). Sodium benzoate probably acts through a non-immunologic mechanism and care should be given to children allergic to sodium benzoate containing pharmaceutical formulations.

  10. Influence of headache frequency on clinical signs and symptoms of TMD in subjects with temple headache and TMD pain

    PubMed Central

    Anderson, Gary C.; John, Mike T.; Ohrbach, Richard; Nixdorf, Donald R.; Schiffman, Eric L.; Truelove, Edmond S.; List, Thomas

    2011-01-01

    The relationship of the frequency of temple headache to signs and symptoms of temporomandibular disorders (TMD) was investigated in a subset of a larger convenience sample of community TMD cases. The study sample included: 86 painful TMD, non-headache subjects; 309 painful TMD subjects with varied frequency of temple headaches; and 149 subjects without painful TMD or headache for descriptive comparison. Painful TMD included Research Diagnostic Criteria (RDC) diagnoses of myofascial pain, TMJ arthralgia and TMJ osteoarthritis. Mild to moderate intensity temple headaches were classified by frequency using criteria based on the ICHD-II classification of TTH. Outcomes included TMD signs and symptoms (pain duration, pain intensity, number of painful masticatory sites on palpation, mandibular range of motion), PPTs and temple headache resulting from masticatory provocation tests. Trend analyses across the painful TMD groups showed a substantial trend for aggravation of all of the TMD signs and symptoms associated with increased frequency of the temple headaches. In addition, increased headache frequency showed significant trends associated with reduced PPTs and reported temple headache with masticatory provocation tests. In conclusion, these findings suggest that these headaches may be TMD-related, as well as a possible role for peripheral and central sensitization in TMD patients. PMID:21196079

  11. Assaultive behavior. Does provocation begin in the front office?

    PubMed

    Blair, D T

    1991-05-01

    1. Provocation is an important risk predictor because these issues can be recognized, assessed, and appropriate interventions can be implemented to reduce the associated risks. It is only by the reduction of such "non-fixed" risk factors that any reduction of assaults can be accomplished. 2. Involuntary admission, patients with dementia or organic brain disorder, physical or verbal limits, staff attitude, denial of the possibility of assaults, and the educational level and clinical experience of the staff may help provoke an assaultive episode. 3. An important step is assessing the assault to identify provocation due to certain medical causes, and to document the extent of degeneration in patients with dementia or organic brain disorder. Medical intervention would be indicated and would appropriately address the causes of some violent episodes.

  12. 5. VIEW NORTHWEST FROM LEFT TO RIGHT: COLD CALIBRATION OBSERVATION ...

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

    5. VIEW NORTHWEST FROM LEFT TO RIGHT: COLD CALIBRATION OBSERVATION BUNKER BACKGROUND, COLD CALIBRATION TOWER. - Marshall Space Flight Center, East Test Area, Cold Calibration Test Stand, Huntsville, Madison County, AL

  13. Impact of vasomotion type on prognosis of coronary artery spasm induced by acetylcholine provocation test of left coronary artery.

    PubMed

    Lee, Eun Mi; Choi, Man Ho; Seo, Hong Seog; Kim, Hyun Ki; Kim, Nam-Ho; Choi, Cheol Ung; Kim, Jin Won; Lim, Hong Euy; Kim, Eung Ju; Rha, Seung-Woon; Park, Chang Gyu; Oh, Dong Joo

    2017-02-01

    The impact of vasomotion types on long-term clinical outcomes in patients with coronary artery spasm (CAS) induced by the acetylcholine provocation test (ACH-test) remains unclear. We evaluated 4644 consecutive patients with typical resting chest pain (CP), but no angiographically significant coronary artery lesion (<50% stenosis), who underwent an ACH-test. According to their vasomotor response, patients were categorized into four types: normal vasomotion (no CP, no ischemic electrocardiographic changes, and no vasoconstriction), microvascular spasm (CP with <75% vasoconstriction but with CP relief after nitroglycerin infusion), epicardial spasm (CP with ≥75% vasoconstriction), and ACH-test inconclusive (vasoconstriction and/or electrocardiographic changes, but no CP). We investigated CP recurrence requiring follow-up angiography and major adverse cardiovascular events (MACEs) during 5 years. CP recurred in 7.9% of patients and was more frequent in abnormal vasomotion types (normal vasomotion, microvascular spasm, epicardial spasm, and inconclusive type: 5.4%, 9.8%, 10.9%, and 8.2%, respectively, log-rank p = 0.009). In multivariate analysis adjusted for medication use after the ACH-test, vasomotion subtype was not an independent predictor, whereas male sex, fixed lesion on baseline angiography, and medications including calcium channel blockers (CCBs), nitrates, and statins were independent positive predictors for recurrent CP. Alcohol consumption at the initial interview was a negative predictor. MACEs were observed in 1.6%, and the incidence was similar among subtypes (p = 0.421). Recurrent CP and long-term outcomes are independent of vasomotion subtypes, but long-term use of CCBs, nitrates, and statins is a significant predictor for recurrent CP. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. The prevalence of tarsal tunnel syndrome in patients with lumbosacral radiculopathy.

    PubMed

    Zheng, Chaojun; Zhu, Yu; Jiang, Jianyuan; Ma, Xiaosheng; Lu, Feizhou; Jin, Xiang; Weber, Robert

    2016-03-01

    Tarsal tunnel syndrome (TTS) is a painful foot condition. Lumbosacral radiculopathy (LR) may also present with symptoms occurring in TTS. However, no studies have been reported to determine the possible coexistence of these two conditions. The aim of our study was to identify the prevalence of TTS in patients with confirmed LR and to analyze the clinical and electrodiagnostic features of patients with both TTS and LR. Medial and lateral plantar nerve mixed studies, peroneal motor studies and deep peroneal sensory studies were performed in 81 normal subjects and 561 patients with LR. The Tinel's test and other provocative tests were performed in the LR patient group, and the clinical symptoms of TTS were also analyzed. The frequency of TTS was investigated in all radiculopathy group patients with different nerve root lesions. Concomitant TTS was found in 27 (4.8%) patients with LR. Abnormal results of sensory/mixed conduction tests were observed in 25/27 (92.6%) patients, and 11/27 (40.7%) patients had abnormal results of motor conduction tests. Positivity for the Tinel's test and special provocative tests was found in 15/27 (55.6%) and 17/27 (63.0%) patients, respectively. Overall, 9/27 (33.3%) patients had typical symptoms, and suspicious clinical symptoms were found in the other 14/27 (51.9%) patients. The frequency of coexisting TTS was not statistically different among the single-level L4, L5 or S1 radiculopathy, or between the single-level and multi-level radiculopathies (P > 0.05). The findings suggest that the prevalence of TTS is significant in patients with LR. Thus, more caution should be paid when diagnosing and managing patients with LR due to the possible existence of TTS, as their management strategies are quite different.

  15. Analysis of responses of cold pressor tests on pilots and executives

    NASA Technical Reports Server (NTRS)

    Swaroop, R.

    1977-01-01

    Statistical analyses were performed to study the relationship between cold pressor test responses and certain medical attributes of a group of 81 pilots and a group of 466 executives. The important results of this study were as follows: There was a significant relationship between a subject's cold pressor test response and his profession (that is, pilot or executive). The executives' diastolic cold pressor test responses were significantly related to their medical conditions, and their families' medical conditions. Significant relationships were observed between executives' diastolic and systolic cold pressor test responses and their history of tranquilizer and cardiac drug use.

  16. Cold Stress and the Cold Pressor Test

    ERIC Educational Resources Information Center

    Silverthorn, Dee U.; Michael, Joel

    2013-01-01

    Temperature and other environmental stressors are known to affect blood pressure and heart rate. In this activity, students perform the cold pressor test, demonstrating increased blood pressure during a 1- to 2-min immersion of one hand in ice water. The cold pressor test is used clinically to evaluate autonomic and left ventricular function. This…

  17. Fluorescence lifetime spectroscopy: potential for in-vivo estimation of skin fluorophores changes after low power laser treatment

    NASA Astrophysics Data System (ADS)

    Ferulova, Inesa; Lihachev, Alexey; Spigulis, Janis

    2013-11-01

    The impact of visible cwlaser irradiation on skin autofluorescence lifetimes was investigated in spectral range from 450 nm to 600 nm. Skin optical provocations were performed during 1 min by 405 nm low power cw laser with power density up to 20 mW/cm2. Autofluorescence lifetimes were measured before and immediately after the optical provocation.

  18. The Relation between Early Adolescents' Trust Beliefs in Peers and Reactions to Peer Provocation: Attributions of Intention and Retaliation

    ERIC Educational Resources Information Center

    Rotenberg, Ken J.; Betts, Lucy R.; Moore, Jolene

    2013-01-01

    The authors examined the relation between early adolescents' trust beliefs in peers and both their attributions for, and retaliatory aggression to, peer provocation. One hundred and eight-five early adolescents (102 male) from the United Kingdom (M age = 12 years, 2 months, SD = 3 months) completed the Children's Generalized Trust Beliefs in peer…

  19. Abnormal flexor carpi radialis H-reflex as a specific indicator of C7 as compared with C6 radiculopathy.

    PubMed

    Zheng, Chaojun; Zhu, Yu; Lv, Feizhou; Ma, Xiaosheng; Xia, Xinlei; Wang, Lixun; Jin, Xiang; Weber, Robert; Jiang, Jianyuan; Anuvat, Kevin

    2014-12-01

    The H-reflex of the flexor carpi radialis (FCR H-reflex) has not been commonly used for the diagnosis of cervical radiculopathy when compared with the routinely tested soleus H-reflex. Although both S1 and S2 roots innervate the soleus, the H-reflex is selectively related to S1 nerve root function clinically. Flexor carpi radialis is also innervated by two nerve roots which are C6 and C7. Although they are among the most common roots involved in cervical radiculopathy, few studies reported if the attenuation of the FCR H-reflex is caused by lesions affecting C7 or C6 nerve roots, or both. We aimed to identify whether an abnormal FCR H-reflex was attributed to the C7 or C6 nerve root lesion, or both. The sensitivities of needle electromyography, FCR H-reflex, and provocative tests in unilateral C7 or C6 radiculopathy were also compared in this study. A concentric needle electrode recorded bilateral FCR H-reflexes in 41 normal subjects (control group), 51 patients with C7 radiculopathy, and 54 patients with C6 radiculopathy. Clinical, radiological, and surgical approaches identified the precise single cervical nerve root involved in all patient groups. The H-reflex and M-wave latencies were measured and compared bilaterally. Abnormal FCR H-reflex was defined as the absence of the H-reflex or a side-to-side difference over 1.5 milliseconds which was based on the normal side-to-side difference of the H-reflex latency of 16.9 milliseconds (SD = 1.7 milliseconds) from the control group. We also determined standard median and ulnar conduction and needle electromyography. The provocative tests included bilateral determination of the Shoulder Abduction and Spurling's tests in all radiculopathy group patients. Abnormal FCR H-reflexes were recorded in 45 (88.2%) of C7 radiculopathy group patients, and 2 (3.7%) of C6 radiculopathy group patients (P < 0.05). Needle electromyography was abnormal in 41 (80.4%) of C7 radiculopathy patients and 43 (79.6%) of C6 radiculopathy patients. Provocative tests were positive in 15 (29.4%) of C7 radiculopathy patients and 25 (46.3%) of C6 radiculopathy patients. Flexor carpi radialis H-Reflex provides a sensitive assessment of evaluating the C7 spinal reflex pathway. Clinically, a combination of the FCR H-reflex with needle electromyography may yield the highest level of diagnostic information for evaluating clinical cases of C7 radiculopathy.

  20. Does the medical diagnosis of occupational asthma coincide with the legal diagnosis?

    PubMed

    Çelebi Sözener, Zeynep; Aydın, Ömür; Demirel, Yavuz Selim; Soyyiğit, Şadan; Çerçi, Pamir; Kendirlinan, Reşat; Bavbek, Sevim; Çelik, Gülfem Elif; Misirligil, Zeynep; Sin, Betül Ayşe; Keleşoğlu, Arif; Mungan, Dilşad

    2017-11-01

    The incidence of occupational asthma (OA) is increasing worldwide. In this study, we first aimed to document the rate of diagnosis of OA among patients who were referred to our clinic from the Social Security Institution and the factors that affected diagnosis; secondly, we aimed to assess the consistency of the medical and legal diagnoses. The study involved 132 consecutive patients who were referred to our clinic for the evaluation of OA between 2010 and 2015. Detailed workplace history, the tools used in the diagnosis such as peak expiratory flow (PEF) monitoring and bronchial provocation tests, and the final medical diagnosis were recorded from case files. Asthma was diagnosed in 75% (n = 99) of the patients. Among them, 22.2% were diagnosed as having OA. The diagnosis was confirmed by serial PEF measurements, non-specific bronchial hyperreactivity assessment or both of the tests both at work and off-work periods. OA diagnosis was mostly established in active workers (72.7%). The legal diagnosis period was completed in 54.5% of these 22 patients, and 50% (n = 11) were officially diagnosed as having OA with a 91.6% concordance with medical diagnosis. This study verifies the importance of diagnosing asthma correctly as a first step in the evaluation of OA. Diagnostic tests other than specific provocation tests could be preferential in patients who still work in the same field. We believe that cooperation with the patient's occupational physician and adequate recognition of the work environment will improve the consistency of legal and medical diagnoses.

  1. Individual differences in responses to provocation and frequent victimization by peers.

    PubMed

    Champion, Kelly M; Clay, Daniel L

    2007-02-01

    This study examined associations between victimization by peers and intention to respond to provocative events as a function of anger arousal and motivation to improve the situation in a cross-sectional sample of school-age children (N = 506, 260 males, 246 females). Results demonstrated that more intense anger and more retaliatory motivation were positively associated with intentions to aggress and with frequency of victimization. The association between aggressive intentions to respond to anger provocation and victimization could be accounted for by subjective feelings of anger and motivation to retaliate. The contribution of emotion processes was stronger for boys than for girls. A post hoc examination of non-bullying participants revealed that motivation accounted for aggressive intentions among the non-bullies. Results support including anger management programs in prevention efforts that target the school climate and victims' risk for psychopathology.

  2. Does acetaminophen/hydrocodone affect cold pulpal testing in patients with symptomatic irreversible pulpitis? A prospective, randomized, double-blind, placebo-controlled study.

    PubMed

    Fowler, Sara; Fullmer, Spencer; Drum, Melissa; Reader, Al

    2014-12-01

    The purpose of this prospective randomized, double-blind, placebo-controlled study was to determine the effects of a combination dose of 1000 mg acetaminophen/10 mg hydrocodone on cold pulpal testing in patients experiencing symptomatic irreversible pulpitis. One hundred emergency patients in moderate to severe pain diagnosed with symptomatic irreversible pulpitis of a mandibular posterior tooth randomly received, in a double-blind manner, identical capsules of either a combination of 1000 mg acetaminophen/10 hydrocodone or placebo. Cold testing with Endo-Ice (1,1,1,2 tetrafluoroethane; Hygenic Corp, Akron, OH) was performed at baseline and every 10 minutes for 60 minutes. Pain to cold testing was recorded by the patient using a Heft-Parker visual analog scale. Patients' reaction to the cold application was also rated. Cold testing at baseline and at 10 minutes resulted in severe pain for both the acetaminophen/hydrocodone and placebo groups. Although pain ratings decreased from 20-60 minutes, the ratings still resulted in moderate pain. Patient reaction to cold testing showed that 56%-62% had a severe reaction. Although the reactions decreased in severity over the 60 minutes, 20%-34% still had severe reactions at 60 minutes. Regarding pain and patients' reactions to cold testing, there were no significant differences between the combination acetaminophen/hydrocodone and placebo groups at any time period. A combination dose of 1000 mg of acetaminophen/10 mg of hydrocodone did not statistically affect cold pulpal testing in patients presenting with symptomatic irreversible pulpitis. Patients experienced moderate to severe pain and reactions to cold testing. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  3. Biochemical correlates of neurosensory changes in weightlessness

    NASA Technical Reports Server (NTRS)

    Leach, Carolyn S.; Reschke, Millard F.

    1989-01-01

    The possible existence of a relationship between space motion sickness and chemical and biochemical variables measured in body fluids is studied. Clinical chemistry and endocrine measurements from blood and urine samples taken before and after Space Shuttle flights were analyzed along with the occurrence of SMS during flight and provocative testing before flight. Significant positive correlations were observed with serum chloride and significant negative correlations with serum phosphate, serum uric acid, and plasma thyroid stimulating hormone.

  4. Televised relational and physical aggression and children's hostile intent attributions.

    PubMed

    Martins, Nicole

    2013-12-01

    An experiment was conducted with 150 children (mean age=10.1years) in third to fifth grades to test whether exposure to different forms of aggression in the media affected hostile attributional biases in response to different forms of provocation scenarios. Children were randomly assigned to watch a clip containing physical aggression, relational aggression, or no aggression. After exposure, children were asked to respond to a series of written provocation scenarios where a character caused some form of harm (instrumental or relational) to a target person, but the intent of the provocateur was ambiguous. Results revealed that exposure to relationally aggressive portrayals resulted in a hostile attributional bias in response to relational scenarios, whereas exposure to portrayals of physical aggression was associated with a hostile attributional bias in response to instrumental scenarios. Moreover, these biases were shown to be specific to the exposure condition (physical or relational) and not simply associated with exposure to aggression in general. The findings are discussed in terms of the general aggression model and children's social information processing. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Determining predictability and accuracy of thermal and electrical dental pulp tests: An in vivo study.

    PubMed

    Salgar, Avinash Ramchandra; Singh, Shishir H; Podar, Rajesh S; Kulkarni, Gaurav P; Babel, Shashank N

    2017-01-01

    Pulp sensitivity testing, even with its limitations and shortcomings, has been and still remains a very helpful aid in endodontic diagnosis. Pulp sensitivity tests extrapolate pulpal health from the sensory response. The aim of the present study was to identify the sensitivity, specificity, positive and negative predictive values (NPVs) of thermal and electrical tests of pulp sensitivity. Pulp tests studied were two cold and heat tests respectively and electrical test. A total of 330 teeth were tested: 198 teeth with vital pulp and 132 teeth with necrotic pulps (disease prevalence of 40%). The ideal standard was established by observing bleeding within the pulp chamber. Sensitivity values of the diagnostic tests were 0.89 and 0.94 for cold test, 0.84 and 0.87 for the heat tests, and 0.75 for electrical pulp test and the specificity values of the diagnostic tests were 0.91 and 0.93 for the cold tests, 0.86 and 0.84 for the heat tests, and 0.90 for electrical pulp test. The NPVs were 0.91 and 0.96 for the cold tests, 0.89 and 0.91 for the heat tests, and 0.84 for electrical pulp test. The positive predictive values were 0.89 and 0.90 for the cold tests, 0.80 and 0.79 for the heat tests and 0.88 for electrical pulp test. The highest accuracy (0.9393) was observed with cold test (icy spray). The cold test done with icy spray was the most accurate method for sensitivity testing.

  6. Mobile kidney pain provocation ultrasonography before surgery for symptomatic mobile kidney: A prospective study of 43 consecutive patients.

    PubMed

    Arnerlöv, Conny; Söderström, Minette; Öhberg, Lars

    2016-01-01

    The aim of this study was to evaluate whether mobile kidney pain provocation ultrasonography together with intravenous pyelography in supine and standing positions and a full medical history can confirm the diagnosis of the clinical condition of symptomatic mobile kidney and aid the selection of patients for surgical treatment. In a consecutive study, 43 patients with the clinical picture of symptomatic mobile kidney, a positive mobile kidney pain provocation ultrasonography and a renal descent of at least 2 lumbar vertebral heights on intravenous pyelography in the standing position, were operated on with nephropexy. Patients' pain relief after nephropexy was evaluated by clinical follow-up, a questionnaire and visual analogue scale (VAS) scoring. Reduction of pain after nephropexy was associated with a significant decrease in VAS scoring from a median of 8 (range 4-10) preoperatively to a median of 0 (range 0-7) postoperatively (p < 0.001). Thirty-four patients (79%) were cured of their pain and seven patients (16%) experienced substantial relief from their pain symptoms. In two patients (5%) the symptoms were unchanged. The results indicate that mobile kidney pain provocation ultrasonography and intravenous pyelography in supine and standing positions can verify the diagnosis of symptomatic mobile kidney and aid the selection of patients who will benefit from nephropexy.

  7. State narcissism and aggression: The mediating roles of anger and hostile attributional bias.

    PubMed

    Li, Caina; Sun, Ying; Ho, Man Yee; You, Jin; Shaver, Phillip R; Wang, Zhenhong

    2016-07-01

    Prior research has documented a relationship between narcissism and aggression but has focused only on dispositional narcissism without considering situational factors that may increase narcissism temporarily. This study explored the possibility that an increase in state narcissism would foster aggressive responding by increasing anger and hostile attributional bias following unexpected provocation among 162 college students from China. We created a guided-imagination manipulation to heighten narcissism and investigated its effects on anger, aroused hostile attribution bias, and aggressive responses following a provocation with a 2 (narcissism/neutral manipulation) × 2 (unexpected provocation/positive evaluation condition) between-subjects design. We found that the manipulation did increase self-reported state narcissism. The increase in state narcissism in turn heightened aggression, and this relation was mediated by increased anger. Regardless of the level of state narcissism, individuals were more aggressive after being provoked and this effect of provocation was mediated by hostile attributional bias. The findings indicate that narcissism can be temporarily heightened in a nonclinical sample of individuals, and that the effect of state narcissism on aggression is mediated by anger. Differences between state and trait narcissism and possible influences of culture are discussed. Aggr. Behav. 42:333-345, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  8. Colonoscopic allergen provocation test with rBet v 1 in patients with pollen-associated food allergy.

    PubMed

    Pickert, C N; Lorentz, A; Manns, M P; Bischoff, S C

    2012-10-01

    After consumption of fruits, nuts, and vegetables, several patients with pollen allergy experience gastrointestinal (GI) tract symptoms that are possibly caused by pollen-associated food allergy. The aim of this study was to evaluate the colonoscopic allergen provocation (COLAP) test using the recombinant birch pollen allergen Bet v 1 (rBet v 1) for in vivo diagnosis of pollen-associated food allergy manifesting in the GI tract. Thirty-four patients with a history of adverse reactions to food, GI tract symptoms, and birch pollen pollinosis and five healthy controls underwent COLAP test. Twenty minutes after endoscopic challenge of the cecal mucosa with rBet v 1, the mucosal wheal and flare reaction was registered semiquantitatively, and tissue biopsy specimens were examined for eosinophil mucosal activation. The mucosal reaction to rBet v 1 was correlated with the presence of pollinosis (P = 0.004), history of adverse reaction to Bet v 1-associated food allergens (P = 0.001), and tissue eosinophils' activation (P < 0.001). A wheal and flare reaction in the COLAP test was observed in 13 of 16 patients (81%) with a history of GI tract symptoms associated with the ingestion of Bet v 1-related foods and in four of 18 (22%) patients with a negative history (P < 0.001). The control group did not develop visible mucosal reactions to rBet v 1. Systemic anaphylactic reactions did not occur. The mucosal administration of rBet v 1 by COLAP test provides a new diagnostic tool that might support the diagnosis of Bet v 1-associated food allergy manifesting in the GI tract. © 2012 John Wiley & Sons A/S.

  9. Prospective assessment of diagnostic tests for pediatric penicillin allergy, from clinical history to challenge tests✰,✰✰,✰✰✰.

    PubMed

    Ibáñez, María Dolores; Del Río, Pablo Rodríguez; Lasa, Eva Maria; Joral, Alejandro; Ruiz-Hornillos, Javier; Muñoz, Candelaria; Traseira, Carmen Gómez; Escudero, Carmelo; Olaguibel Rivera, Jose María; Garriga-Baraut, Teresa; González-de-Olano, David; Rosado, Ana; Sanchez-García, Silvia; Bustamante, Socorro Pérez; Vilchez, Maria Antonia Padial; Montaño, Patricia Prieto; Morillo, Rocío Candón; Iglesia, Eva Macías; Vila, Angélica Feliú; Valbuena, Teresa; Lopez-Patiño, Ana; Martorell, Antonio; Sastre, Joaquín; Audícana, María Teresa

    2018-05-24

    Diagnostic guidelines for penicillin allergy in children recommend cumbersome protocols based partially on data from adults, which may be suboptimal for pediatric use. To assess the accuracy of tools for diagnosis of penicillin allergy in children. A prospective multicenter study was conducted in children with reported adverse events related to penicillin, excluding severe reactions. All patients underwent a uniform diagnostic protocol consisting of clinical history, skin tests, serum specific IgE, and, regardless of these results, drug provocation tests (DPT). 732 children (mean 5.5 years; 51.2% males) completed the allergy work-up, including DPT. Amoxicillin triggered 96.9% of all reactions. None of the patients with an immediate index reaction (IR) developed a reaction on DPT. Penicillin allergy was confirmed in 35 subjects (4.8%): 6(17%) immediate and 29(83%) non-immediate reactions in the DPT. No severe reactions were recorded. The allergist diagnosis based upon the clinical history was not associated with the final outcome at DPT. In 30 of 33(91%) allergic patients, all skin tests and sIgE were negative. A logistic regression model identified the following to be associated with PNC allergy (p<0.05): a family history of drug allergy (OR=3.03; 95% confidence interval (CI): 1.33-6.89), an IR lasting >3 days vs ≤24 hours (OR=8.96; 95% CI: 2.01-39.86), and IR while receiving corticosteroids (OR=2.68; 95% CI: 1.30-5.54). Conventional predictors of allergy to penicillin performed weakly. The authors propose straightforward penicillin provocation testing in controlled, experienced centers for the diagnosis of non-severe penicillin allergy in children. Copyright © 2018. Published by Elsevier Inc.

  10. Responses of dogs with food allergies to single-ingredient dietary provocation.

    PubMed

    Jeffers, J G; Meyer, E K; Sosis, E J

    1996-08-01

    To characterize specific food ingredients causing allergic reactions in dogs and to assess cross-reactivity between proteins derived from a single animal source or from different plant products. Prospective study. 25 dogs with histories and cutaneous signs consistent with food-allergic dermatitis. Dogs were fed a food-elimination diet until resolution of clinical signs and then challenged with their original diet. A diagnosis of food allergy was made if there was complete return of pruritus within 14 days of challenge exposure. After diagnosis, dogs were fed the food-elimination diet until signs related to dietary challenge abated. The dogs then were fed beef, chicken, chicken eggs, cows' milk, wheat, soy, and corn in single-ingredient provocation trials for 1 week. Any cutaneous reactions to these food ingredients were recorded by their owners. Beef and soy most often caused adverse cutaneous reactions, although all ingredients induced clinical signs in at least 1 dog. Mean number of allergens per dog was 2.4, with 80% reacting to 1 or 2 proteins and 64% reacting to 2 or more of the proteins tested. A significant difference was found between dogs reacting to beef versus cows' milk and between dogs reacting to soy versus wheat; thus, the hypothesis of cross-reactivity to ingredients derived from a single animal source or to different plant products was not supported. Similar differences between chicken meat and eggs were not identified. Long-term management of dogs with food allergies is facilitated by identification of the most commonly encountered food allergens. Because cross-reactivity cannot be verified, each protein source should be included separately in food-provocation trials.

  11. Cybersickness provoked by head-mounted display affects cutaneous vascular tone, heart rate and reaction time.

    PubMed

    Nalivaiko, Eugene; Davis, Simon L; Blackmore, Karen L; Vakulin, Andrew; Nesbitt, Keith V

    2015-11-01

    Evidence from studies of provocative motion indicates that motion sickness is tightly linked to the disturbances of thermoregulation. The major aim of the current study was to determine whether provocative visual stimuli (immersion into the virtual reality simulating rides on a rollercoaster) affect skin temperature that reflects thermoregulatory cutaneous responses, and to test whether such stimuli alter cognitive functions. In 26 healthy young volunteers wearing head-mounted display (Oculus Rift), simulated rides consistently provoked vection and nausea, with a significant difference between the two versions of simulation software (Parrot Coaster and Helix). Basal finger temperature had bimodal distribution, with low-temperature group (n=8) having values of 23-29 °C, and high-temperature group (n=18) having values of 32-36 °C. Effects of cybersickness on finger temperature depended on the basal level of this variable: in subjects from former group it raised by 3-4 °C, while in most subjects from the latter group it either did not change or transiently reduced by 1.5-2 °C. There was no correlation between the magnitude of changes in the finger temperature and nausea score at the end of simulated ride. Provocative visual stimulation caused prolongation of simple reaction time by 20-50 ms; this increase closely correlated with the subjective rating of nausea. Lastly, in subjects who experienced pronounced nausea, heart rate was elevated. We conclude that cybersickness is associated with changes in cutaneous thermoregulatory vascular tone; this further supports the idea of a tight link between motion sickness and thermoregulation. Cybersickness-induced prolongation of reaction time raises obvious concerns regarding the safety of this technology. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Teens With Heavy Prenatal Cocaine Exposure Respond to Experimental Social Provocation with Escape Not Aggression

    PubMed Central

    Greenwald, M.K.; Chiodo, L.M.; Hannigan, J.H.; Sokol, R.J.; Janisse, J.; Delaney-Black, V.

    2010-01-01

    Preclinical data show that, compared to no exposure, prenatal cocaine exposure (PCE) has age-dependent effects on social interaction and aggression. The aim of this clinical study was to determine how heavy/persistent PCE – after controlling for other prenatal drug exposures, sex and postnatal factors – predicts behavioral sensitivity to provocation (i.e., reactive aggression) using a well-validated human laboratory model of aggression. African American teens (mean = 14.2 yrs old) with histories of heavy/persistent PCE (maternal cocaine use ≥ 2 times/week during pregnancy, or positive maternal or infant urine/meconium test at delivery; n = 86) or none/some exposure (NON: maternal cocaine use < 2 times/week during pregnancy; n = 330) completed the Point Subtraction Aggression Paradigm. In this task, teens competed in a computer game against a fictitious opponent. There were three possible responses: (a) earn points, to exchange for money later; or (b) “aggress” against the fictitious opponent by subtracting their points; or (c) escape temporarily from point subtraction perpetrated by the fictitious opponent. The PCE group responded significantly more frequently on the escape option than the NON group, but did not differ in aggressive or money-earning responses. These data indicate that PCE-teens provoked with a social stressor exhibit a behavioral preference for escape (negative reinforcement) more than for aggressive (retaliatory) or appetitive (point- or money-reinforced) responses. These findings are consistent with preclinical data showing that social provocation of adolescent or young adult offspring after PCE is associated with greater escape behavior, inferring greater submission, social withdrawal, or anxiety, as opposed to aggressive behavior. PMID:20600841

  13. The Combined Effect of Cold and Moisture on Manual Performance.

    PubMed

    Ray, Matthew; Sanli, Elizabeth; Brown, Robert; Ennis, Kerri Ann; Carnahan, Heather

    2018-02-01

    Objective The aim of this study was to investigate the combined effect of cold and moisture on manual performance and tactile sensitivity. Background People working in the ocean environment often perform manual work in cold and wet conditions. Although the independent effects of cold and moisture on hand function are known, their combined effect has not been investigated. Method Participants completed sensory (Touch-Test, two-point discrimination) and motor (Purdue Pegboard, Grooved Pegboard, reef knot untying) tests in the following conditions: dry hand, wet hand, cold hand, and cold and wet hand. Results For the Purdue Pegboard and knot untying tasks, the greatest decrement in performance was observed in the cold-and-wet-hand condition, whereas the decrements seen in the cold-hand and wet-hand conditions were similar. In the Grooved Pegboard task, the performance decrements exhibited in the cold-and-wet-hand condition and the cold-hand condition were similar, whereas no decrement was observed in the wet-hand condition. Tactile sensitivity was reduced in the cold conditions for the Touch-Test but not the two-point discrimination test. The combined effect of cold and moisture led to the largest performance decrements except when intrinsic object properties helped with grasp maintenance. The independent effects of cold and moisture on manual performance were comparable. Application Tools and equipment for use in the cold ocean environment should be designed to minimize the effects of cold and moisture on manual performance by including object properties that enhance grasp maintenance and minimize the fine-dexterity requirements.

  14. Cold Regions - Environmental Testing of Individual Soldier Clothing

    DTIC Science & Technology

    2011-10-17

    Individual Soldier Clothing 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHORS 5d. PROJECT NUMBER 5e. TASK...This Test Operations Procedure (TOP) provides testing guidelines for individual Soldier cold weather clothing and footwear in a cold regions...Soldier clothing , along with its safety, reliability, durability, and performance when exposed to a cold regions environment. 15. SUBJECT TERMS

  15. Hostile attribution biases for relationally provocative situations and event-related potentials.

    PubMed

    Godleski, Stephanie A; Ostrov, Jamie M; Houston, Rebecca J; Schlienz, Nicolas J

    2010-04-01

    This exploratory study investigates how hostile attribution biases for relationally provocative situations may be related to neurocognitive processing using the P300 event-related potential. Participants were 112 (45 women) emerging adults enrolled in a large, public university in upstate New York. Participants completed self-report measures on relational aggression and hostile attribution biases and performed an auditory perseveration task to elicit the P300. It was found that hostile attribution biases for relational provocation situations was associated with a larger P300 amplitude above and beyond the role of hostile attribution biases for instrumental situations, relational aggression, and gender. Larger P300 amplitude is interpreted to reflect greater allocation of cognitive resources or enhanced "attending" to salient stimuli. Implications for methodological approaches to studying aggression and hostile attribution biases and for theory are discussed, as well as implications for the fields of developmental psychology and psychopathology. Copyright 2010 Elsevier B.V. All rights reserved.

  16. A-1 Test Stand modifications

    NASA Image and Video Library

    2011-09-14

    Team members check the progress of a liquid nitrogen cold shock test on the A-1 Test Stand at Stennis Space Center on Sept. 15. The cold shock test is used to confirm the test stand's support system can withstand test conditions, when super-cold rocket engine propellant is piped. The A-1 Test Stand is preparing to conduct tests on the powerpack component of the J-2X rocket engine, beginning in early 2012.

  17. Carpal tunnel syndrome – Part I (anatomy, physiology, etiology and diagnosis)☆☆☆

    PubMed Central

    Chammas, Michel; Boretto, Jorge; Burmann, Lauren Marquardt; Ramos, Renato Matta; dos Santos Neto, Francisco Carlos; Silva, Jefferson Braga

    2014-01-01

    Carpal tunnel syndrome (CTS) is defined by compression of the median nerve in the wrist. It is the commonest of the compressive syndromes and its most frequent cause is idiopathic. Even though spontaneous regression is possible, the general rule is that the symptoms will worsen. The diagnosis is primarily clinical, from the symptoms and provocative tests. Electroneuromyographic examination may be recommended before the operation or in cases of occupational illnesses. PMID:26229841

  18. M.I.T./Canadian vestibular experiments on the Spacelab-1 mission: 4. Space motion sickness: symptoms, stimuli, and predictability

    NASA Technical Reports Server (NTRS)

    Oman, C. M.; Lichtenberg, B. K.; Money, K. E.; McCoy, R. K.

    1986-01-01

    Space sickness symptoms were observed by 4 specially trained observers on Spacelab-1. Three reported persistent symptoms, and vomited repeatedly during the first and/or second day of flight. Head movements on all axes were provocative, particularly in pitch and roll. Head acceleration data recorded from 2 symptomatic crewmen showed that after several hours of physical activity in orbit, symptoms appeared, and thereafter both crewmen were compelled to limit head movements. Firm body contact with motionless surfaces helped alleviate symptoms. When crewmembers floated into unfamiliar body orientations in the cabin, inherent ambiguities in static visual orientation cues sometimes produced spatial reorientation episodes which were also provocative. Symptoms largely resembled those of other forms of prolonged motion sickness, superimposed upon other symptoms attributable to fluid shift. All 4 eventually used anti-motion sickness drugs. When they did, vomiting frequency was reduced. By the 4th day, symptoms subsided, and head accelerations again increased in magnitude and variability. Sickness intensity in orbit was not predicted by statistically concordant results of 6 acute preflight susceptibility tests. However, results from a longer duration preflight prism goggles test showed an apparent correlation. All subjects were asymptomatic making head movements in parabolic flight 4 days after the mission, but not 1 year later. Overall, results support the view that space sickness is a motion sickness.

  19. Effect of two doses of carbamylated allergoid extract of dust mite on nasal reactivity.

    PubMed

    Scalone, G; Compalati, E; Bruno, M E; Mistrello, G

    2013-11-01

    Background and Objective. Single SLIT studies with native allergen extracts support a dose-response effect for clinical and immunological outcomes. Conversely for carbamylated allergoids this dose-response effects is less evident, likely because the threshold for efficacy is more easily reached through the enhanced bioavailability of the extract consequent to the selective chemical modification. Thus this pilot study investigates the dose-response effect on nasal specific reactivity and safety of two unusual doses of carbamylated allergoid in patients mono-sensitized to house dust mites. Methods. A prospective open randomized study involved 6-65 year-old Italian patients with clinically relevant sensitization to house dust mites and positive response to nasal provocation challenge. Monomeric carbamylated allergoid was delivered once daily at the dose of 1000 AU or 2000 AU from June to September 2009, during the lowest level of mites exposure. Primary outcomes were the change of the threshold of allergen concentration for a positive nasal provocation test (NPT) before and after the treatment and the product safety. Secondary outcome was the change  in the mean percentage fall of peak nasal inspiratory flow (PNIF) following nasal challenge. Results. Thirty-four patients were enrolled. Fifteen in group 1 and 14 in group 2 concluded the study. After 12 weeks all patients treated in group 1 and all but one in group 2 showed an increase in the threshold dose provoking a positive NPT. Those with no symptoms onset with the highest dose delivered were 80% in group 1 and 78.6% in group 2 (p=0.92). From first to second challenge, the mean percentage fall of PNIF  was reduced with no statistical difference between groups (p=0.95), and with no difference between the final mean percentage falls (p=0.65). No serious adverse reactions occurred and the frequency of events, all mild, was similar in the two groups. Conclusions. Twelve weeks of carbamylated sublingual allergoid delivered at 1000AU or 2000AU once daily appear equally safe and show comparable effect in increasing  the threshold of allergen concentration for a positive nasal provocation test, confirming the apparent absence of a dose response effect for the used doses.

  20. Impact of climate change on cold hardiness of Douglas-fir (Pseudotsuga menziesii): environmental and genetic considerations.

    PubMed

    Bansal, Sheel; St Clair, J Bradley; Harrington, Constance A; Gould, Peter J

    2015-10-01

    The success of conifers over much of the world's terrestrial surface is largely attributable to their tolerance to cold stress (i.e., cold hardiness). Due to an increase in climate variability, climate change may reduce conifer cold hardiness, which in turn could impact ecosystem functioning and productivity in conifer-dominated forests. The expression of cold hardiness is a product of environmental cues (E), genetic differentiation (G), and their interaction (G × E), although few studies have considered all components together. To better understand and manage for the impacts of climate change on conifer cold hardiness, we conducted a common garden experiment replicated in three test environments (cool, moderate, and warm) using 35 populations of coast Douglas-fir (Pseudotsuga menziesii var. menziesii) to test the hypotheses: (i) cool-temperature cues in fall are necessary to trigger cold hardening, (ii) there is large genetic variation among populations in cold hardiness that can be predicted from seed-source climate variables, (iii) observed differences among populations in cold hardiness in situ are dependent on effective environmental cues, and (iv) movement of seed sources from warmer to cooler climates will increase risk to cold injury. During fall 2012, we visually assessed cold damage of bud, needle, and stem tissues following artificial freeze tests. Cool-temperature cues (e.g., degree hours below 2 °C) at the test sites were associated with cold hardening, which were minimal at the moderate test site owing to mild fall temperatures. Populations differed 3-fold in cold hardiness, with winter minimum temperatures and fall frost dates as strong seed-source climate predictors of cold hardiness, and with summer temperatures and aridity as secondary predictors. Seed-source movement resulted in only modest increases in cold damage. Our findings indicate that increased fall temperatures delay cold hardening, warmer/drier summers confer a degree of cold hardiness, and seed-source movement from warmer to cooler climates may be a viable option for adapting coniferous forest to future climate. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

  1. Reaching Out to Problem Anger: Assessing the Effectiveness of One-Day Cognitive Behavioural Workshops in a Community Setting in the UK.

    PubMed

    Illman, Nathan A; Brown, June S L

    2016-09-01

    Problem anger is frequently experienced by the general population and is known to cause significant problems for the individual and those around them. Whilst psychological treatments for problem anger are becoming increasingly established, this is still an under-researched area of mental health. We present an evaluation of a series of one-day anger management workshops for the public, targeting problem anger with a cognitive-behavioural approach. The main aim was to evaluate the effectiveness of a brief group-based anger intervention in terms of subjectively reported anger provocation levels and of depression and anxiety. Workshop participants completed a number of questionnaire measures at baseline before the intervention and at 1 month follow-up. The key questionnaires measured self-reported anger provocation levels (Novaco Anger Scale-Provocation Inventory), depressive symptomatology (PHQ-9) and symptoms of generalized anxiety (GAD-7). Change scores were analysed using repeated measures analyses. We found a significant reduction in anger provocation among workshop participants at 1 month follow-up (p = .03). Reductions in depression and anxiety were not statistically significant. We conclude that this brief psychoeducational anger intervention was effective in a small community sample and suggest future work should assess the effectiveness on similar brief interventions using a larger client group and examine outcomes on a broader range of anger measures.

  2. 12. COLD CALIBRATION BLOCKHOUSE BASEMENT VIEW FROM LEFT TO RIGHT, ...

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

    12. COLD CALIBRATION BLOCKHOUSE BASEMENT VIEW FROM LEFT TO RIGHT, CABLE TRAYS, RACKS, CABLE CONNECTION TERMINALS. - Marshall Space Flight Center, East Test Area, Cold Calibration Test Stand, Huntsville, Madison County, AL

  3. Usefulness of In Vivo and In Vitro Diagnostic Tests in the Diagnosis of Hypersensitivity Reactions to Quinolones and in the Evaluation of Cross-Reactivity: A Comprehensive Study Including the Latest Quinolone Gemifloxacin

    PubMed Central

    Gelincik, Asli; Akdeniz, Nilgun; Aktas-Cetin, Esin; Olgac, Muge; Unal, Derya; Ertek, Belkis; Coskun, Raif; Colakoğlu, Bahattin; Deniz, Gunnur; Buyukozturk, Suna

    2017-01-01

    Purpose Reports evaluating diagnosis and cross reactivity of quinolone hypersensitivity have revealed contradictory results. Furthermore, there are no reports investigating the cross-reactivity between gemifloxacin (GFX) and the others. We aimed to detect the usefulness of diagnostic tests of hypersensitivity reactions to quinolones and to evaluate the cross reactivity between different quinolones including the latest quinolone GFX. Methods We studied 54 patients (mean age 42.31±10.39 years; 47 female) with 57 hypersensitivity reactions due to different quinolones and 10 nonatopic quinolone tolerable control subjects. A detailed clinical history, skin test (ST), and single-blind placebo-controlled drug provocation test (SBPCDPT), as well as basophil activation test (BAT) and lymphocyte transformation test (LTT) were performed with the culprit and alternative quinolones including ciprofloxacin (CFX), moxifloxacin (MFX), levofloxacin (LFX), ofloxacin (OFX), and GFX. Results The majority (75.9%) of the patients reported immediate type reactions to various quinolones. The most common culprit drug was CFX (52.6%) and the most common reaction type was urticaria (26.3%). A quarter of the patients (24.1%) reacted to SBPCDPTs, although their STs were negative; while false ST positivity was 3.5% and ST/SBPCDPTs concordance was only 1.8%. Both BAT and LTT were not found useful in quinolone hypersensitivity. Cross-reactivity was primarily observed between LFX and OFX (50.0%), whereas it was the least between MFX and the others, and in GFX hypersensitive patients the degree of cross-reactivity to the other quinolones was 16.7%. Conclusions These results suggest that STs, BAT, and LTT are not supportive in the diagnosis of a hypersensitivity reaction to quinolone as well as in the prediction of cross-reactivity. Drug provocation tests (DPTs) are necessary to identify both culprit and alternative quinolones. PMID:28497922

  4. Gum Arabic as a Cause of Occupational Allergy

    PubMed Central

    Viinanen, Arja; Salokannel, Maija; Lammintausta, Kaija

    2011-01-01

    Background. Gum arabic is a potential sensitizer in food industry. Methods. We examined 11 candy factory workers referred to examinations due to respiratory and skin symptoms paying attention to exposure and sensitization to gum arabic. Skin tests, pulmonary function tests, and respiratory provocation tests were carried out as indicated by the symptoms and findings. Results. Occupational asthma, caused by gum arabic was diagnosed in 4/11 candy factory workers and two of them had also occupational contact urticaria and one had occupational rhinitis. One of them had oral symptoms associated with ingestion of products containing gum arabic. Conclusions. Airborne exposure to gum arabic may cause sensitization leading to allergic rhinitis, asthma, and urticaria. PMID:21747872

  5. 40 CFR 86.1432 - Vehicle preparation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... cold temperature compliance pathway, the temperature of the fuel prior to its delivery to the fuel tank... is the Cold CO Test Procedure, performed in accordance with subpart C of this part. (ii) Testing by...). (C) Cold CO Test Procedure, in accordance with subpart C of this part. (c) Soak—(1) Manufacturer's...

  6. 40 CFR 86.1432 - Vehicle preparation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... cold temperature compliance pathway, the temperature of the fuel prior to its delivery to the fuel tank... is the Cold CO Test Procedure, performed in accordance with subpart C of this part. (ii) Testing by...). (C) Cold CO Test Procedure, in accordance with subpart C of this part. (c) Soak—(1) Manufacturer's...

  7. Occupational rhinitis in the Slovak Republic--a long-term retrospective study.

    PubMed

    Perečinský, Slavomir; Legáth, L'ubomír; Varga, Marek; Javorský, Martin; Bátora, Igor; Klimentová, Gabriela

    2014-12-01

    Allergic and non-allergic rhinitis ranks among the common occupational health problems. However, data on the incidence of occupational rhinitis are lacking, since comprehensive studies are rare. The study includes a group of patients in the Slovak Republic who were reported as having occupational rhinitis in the years 1990-2011. The following parameters were tracked in the investigated sample: age, gender, number of cases by individual years, occupations, causative factors and the length of exposure to the given agent. Possible progression of rhinitis to bronchial asthma was evaluated as well. The diagnostic algorithm was also analysed retrospectively, which included skin tests, the examination of specific IgE antibodies and nasal provocation tests. A total of 70 cases of occupational rhinitis were reported. The disease most often occurred in food industry workers (50% of cases). The most common aetiological factor was flour. Among other relatively common allergens were synthetic textile, wool, cotton and different types of moulds. Significant agents were also different chemical factors causing allergic and irritant rhinitis. The average length of exposure was 14.8 years. Exposure was shorter in men than in women (11 years vs. 16 years) (p = 0.04). Bronchial asthma as a comorbidity was diagnosed in 13 patients (19.7%). The critical diagnostic method on the basis of which the causal association between rhinitis and work environments was confirmed in 59% of cases was skin test; confirmation of the occupational cause using nasal provocation test was less frequent (18%). Food industry, textile industry and agriculture were the most risky occupational environments. Workers in these sectors require preventive intervention. In case of showing rhinitis symptoms it is necessary to confirm the occupational aetiology of the disease by the objective diagnostic methods. Since occupational rhinitis mostly precedes the occupational asthma, the elimination from the workplace is necessary.

  8. Selective immediate responders to amoxicillin and clavulanic acid tolerate penicillin derivative administration after confirming the diagnosis.

    PubMed

    Blanca-Lopez, N; Perez-Alzate, D; Ruano, F; Garcimartin, M; de la Torre, V; Mayorga, C; Somoza, M L; Perkins, J; Blanca, M; Canto, M G; Torres, M J

    2015-08-01

    An increasing number of patients show immediate selective hypersensitivity reactions to clavulanic acid (CLV) and amoxicillin (AX), probably due to their increased prescription. The maintenance of this response should be established. To assess that the immediate hypersensitivity selective response to AX or to CLV is maintained after repeated administration of penicillin G (PG)/penicillin V (PV) and AX. Patients with proven immediate hypersensitivity to AX (Group A) or CLV (Group B) were included. Diagnosis was performed using skin tests with major and minor determinants of PG (PPL/MDM), AX and CLV and by drug provocation test (DPT) if required. Selectivity was established by confirming tolerance to PG/PV (Group A) and to PG/PV and AX (Group B). The maintenance of the selective response was verified by repeating DPT, 15 days after the initial investigation, with the same procedure. Of 51 patients, 78% belonged to Group A and 22% to Group B. Most had anaphylaxis. In Group A, 72% were skin test positive; 28% required DPT. In Group B, 63% were skin test positive; 37% required DPT. Only two AX-selective cases developed positive responses after re-provocation with PG/PV. No cases selective for CLV developed a positive response to PG, PV or AX. The selective response to AX appears consistent, and a response to penicillin determinants only develops in a minority of cases. For the case of CLV, the selective response appears not to be modified by exposure to penicillin determinants, meaning that patients with CLV allergy can take penicillin derivatives safely. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Design, rationale and feasibility of a multidimensional experimental protocol to study early life stress.

    PubMed

    Bartholomeusz, M Dillwyn; Bolton, Philip S; Callister, Robin; Skinner, Virginia; Hodgson, Deborah

    2017-09-01

    There is a rapidly accumulating body of evidence regarding the influential role of early life stress (ELS) upon medical and psychiatric conditions. While self-report instruments, with their intrinsic limitations of recall, remain the primary means of detecting ELS in humans, biological measures are generally limited to a single biological system. This paper describes the design, rationale and feasibility of a study to simultaneously measure neuroendocrine, immune and autonomic nervous system (ANS) responses to psychological and physiological stressors in relation to ELS. Five healthy university students were recruited by advertisement. Exclusion criteria included chronic medical conditions, psychotic disorders, needle phobia, inability to tolerate pain, and those using anti-inflammatory medications. They were clinically interviewed and physiological recordings made over a two-hour period pre, during and post two acute stressors: the cold pressor test and recalling a distressing memory. The Childhood Trauma Questionnaire and the Parental Bonding Index were utilised to measure ELS. Other psychological measures of mood and personality were also administered. Measurements of heart rate, blood pressure, respiratory rate, skin conductance, skin blood flow and temporal plasma samples were successfully obtained before, during and after acute stress. Participants reported the extensive psychological and multisystem physiological data collection and stress provocations were tolerable. Most (4/5) participants indicated a willingness to return to repeat the protocol, indicating acceptability. Our protocol is viable and safe in young physically healthy adults and allows us to assess simultaneously neuroendocrine, immune and autonomic nervous system responses to stressors in persons assessed for ELS.

  10. Three-dimensional simulation of helix traveling-wave tube cold-test characteristics using MAFIA

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

    Kory, C.L.

    1996-12-31

    A critically important step in the traveling-wave tube (TWT) design process is the cold-testing of the slow-wave circuit for dispersion, beam interaction impedance and RF losses. Experimental cold-tests can be very time-consuming and expensive, thus limiting the freedom to examine numerous variations to the test circuit. This makes the need for computational methods crucial as they can lower cost, reduce tube development time and allow the freedom to introduce novel and improved designs. The cold-test parameters have been calculated for a C-Band Northrop-Grumman helix TWT slow-wave circuit using MAFIA, the three-dimensional electromagnetic finite-integration computer code. Measured and simulated cold-test datamore » for the Northrop-Grumman helix TWT including dispersion, impedance and attenuation will be presented. Close agreement between simulated and measured values of the dispersion, impedance and attenuation has been obtained.« less

  11. Provocative Endoscopy to Identify Bleeding Site in Upper Gastrointestinal Bleeding: A Novel Approach in Transarterial Embolization.

    PubMed

    Kamo, Minobu; Fuwa, Sokun; Fukuda, Katsuyuki; Fujita, Yoshiyuki; Kurihara, Yasuyuki

    2016-07-01

    This report describes a novel approach to endoscopically induce bleeding by removing a clot from the bleeding site during angiography for upper gastrointestinal (UGI) hemorrhage. This procedure enabled accurate identification of the bleeding site, allowing for successful targeted embolization despite a negative initial angiogram. Provocative endoscopy may be a feasible and useful option for angiography of obscure bleeding sites in patients with UGI arterial hemorrhage. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

  12. Ankle pain and peroneal tendon pathology.

    PubMed

    Baumhauer, Judith F; Nawoczenski, Deborah A; DiGiovanni, Benedict F; Flemister, A Samuel

    2004-01-01

    Chronic ankle pain can be due to multiple causes. A thorough review of the patient's history with a physical examination concentrating on anatomic structures surrounding the ankle is imperative. The most common of causes have been presented. The addition of provocative testing and radiographic examinations can aid in elucidating the pathology. After treatment of the injury, attention to training technique, shoe and insert usage as well as individual gait abnormalities are integrated into global patient education to decrease the incidence of injury recurrence.

  13. Relationships of self-identified cold tolerance and cold-induced vasodilatation in the finger

    NASA Astrophysics Data System (ADS)

    Park, Joonhee; Lee, Joo-Young

    2016-04-01

    This study was conducted to investigate relationships of self-identified cold tolerance and cold-induced vasodilatation (CIVD) in the finger. Nine males and 34 females participated in the following 2 tests: a CIVD test and a self-reported survey. The CIVD test was conducted 30-min cold-water immersion (3.8 ± 0.3 °C) of the middle finger at an air temperature of 27.9 ± 0.1 °C. The self-reported questionnaire consisted of 28 questions about whole and local body cold and heat tolerances. By a cluster analysis on the survey results, the participants were divided into two groups: high self-identified cold tolerance (HSCT, n = 25) and low self-identified cold tolerance (LSCT, n = 18). LSCT had lower self-identified cold tolerance ( P < 0.001), preferred hot thermal stimulation ( P = 0.006), and wore heavier clothing during daily life ( P < 0.001) than HSCT. LSCT had significantly lower maximal finger temperatures ( T max) ( P = 0.040), smaller amplitude ( P = 0.029), and delayed onset time of CIVD ( P = 0.080) when compared to HSCT. Some questions examining the self-identified cold or heat tolerance had relationships with cold tolerance index, T max, and amplitude ( P < 0.1). These results indicate that self-identified cold tolerance classified through a standardized survey could be a good index to predict physiological cold tolerance.

  14. Relationships of self-identified cold tolerance and cold-induced vasodilatation in the finger.

    PubMed

    Park, Joonhee; Lee, Joo-Young

    2016-04-01

    This study was conducted to investigate relationships of self-identified cold tolerance and cold-induced vasodilatation (CIVD) in the finger. Nine males and 34 females participated in the following 2 tests: a CIVD test and a self-reported survey. The CIVD test was conducted 30-min cold-water immersion (3.8 ± 0.3 °C) of the middle finger at an air temperature of 27.9 ± 0.1 °C. The self-reported questionnaire consisted of 28 questions about whole and local body cold and heat tolerances. By a cluster analysis on the survey results, the participants were divided into two groups: high self-identified cold tolerance (HSCT, n = 25) and low self-identified cold tolerance (LSCT, n = 18). LSCT had lower self-identified cold tolerance (P < 0.001), preferred hot thermal stimulation (P = 0.006), and wore heavier clothing during daily life (P < 0.001) than HSCT. LSCT had significantly lower maximal finger temperatures (T max) (P = 0.040), smaller amplitude (P = 0.029), and delayed onset time of CIVD (P = 0.080) when compared to HSCT. Some questions examining the self-identified cold or heat tolerance had relationships with cold tolerance index, T max, and amplitude (P < 0.1). These results indicate that self-identified cold tolerance classified through a standardized survey could be a good index to predict physiological cold tolerance.

  15. High outgroup entitativity can inhibit intergroup retribution.

    PubMed

    Newheiser, Anna-Kaisa; Dovidio, John F

    2015-06-01

    Understanding the psychological processes that are involved in the perpetuation and escalation of intergroup conflict remains an important goal for intergroup relations research. In the present research, we examined perceived outgroup entitativity as a potential determinant of intergroup hostility. In intergroup conflict situations, high-entitative outgroups are perceived as particularly deserving of retribution; however, high-entitative outgroups are also perceived as efficacious and capable of retaliating successfully, suggesting that people may inhibit hostility against high-entitative (vs. low-entitative) outgroups that are in a position to retaliate. We tested this prediction in two studies. In Study 1, we manipulated intergroup provocation and outgroup entitativity, and found that higher negative mood predicted greater aggression against a low-entitative provoker outgroup, but failed to predict aggression against a high-entitative provoker outgroup that was plausibly in a position to retaliate. In Study 2, we held provocation constant while manipulating outgroup entitativity and the possibility of retaliation by the outgroup, and found that people acted in a retributive manner against a high-entitative provoker outgroup only when the outgroup was not in a position to retaliate. Implications for intergroup conflict are discussed. © 2014 The British Psychological Society.

  16. Neuromodulation of detrusor hyper-reflexia by functional magnetic stimulation of the sacral roots.

    PubMed

    Sheriff, M K; Shah, P J; Fowler, C; Mundy, A R; Craggs, M D

    1996-07-01

    To investigate the acute effects of functional magnetic stimulation (FMS) on detrusor hyper-reflexia using a multi-pulse magnetic stimulator. Seven male patients with established and intractable detrusor hyper-reflexia following spinal cord injury were studied. No patient was on medication and none had had previous surgery for detrusor hyper-reflexia. After optimization of magnetic stimulation of S2-S4 sacral anterior roots by recording toe flexor electromyograms, unstable detrusor activity was provoked during cystometry by rapid infusion of fluid into the bladder. The provocation test produced consistent and predictable detrusor hyper-reflexia. On some provocations, supramaximal FMS at 20 pulses/s for 5 s was applied at detrusor pressures which were > 15 cmH2O. Following FMS there was an obvious acute suppression of detrusor hyper-reflexia. There was a profound reduction in detrusor contraction, as assessed by the area under the curves of detrusor pressure with time. Functional magnetic stimulation applied over the sacrum can profoundly suppress detrusor hyper-reflexia in man. It may provide a non-invasive method of assessing patients for implantable electrical neuromodulation devices and as a therapeutic option in its own right.

  17. Verbal ability and delinquency: testing the moderating role of psychopathic traits.

    PubMed

    Muñoz, Luna C; Frick, Paul J; Kimonis, Eva R; Aucoin, Katherine J

    2008-04-01

    Impaired verbal abilities are one of the most consistent risk factors for serious antisocial and delinquent behavior. However, individuals with psychopathic traits often show serious antisocial behavior, despite showing no impairment in their verbal abilities. Thus, the aim of the current study was to examine whether psychopathy moderates the relationship between verbal abilities and delinquent behavior in a sample of detained youth. The sample included 100 detained adolescent boys who were assessed on self-reported delinquent acts and psychopathic traits, as well as their age at first offense based on official records. Participants also completed a competitive computer task involving two levels of provocation, during which skin conductance was measured. A standard measure of receptive vocabulary was individually administered. As predicted, there was a significant interaction between callous-unemotional (CU) traits (a critical dimension of psychopathy) and verbal ability when predicting violent delinquency. Individuals who were high on CU traits with higher scores on the measure of verbal abilities reported the greatest violent delinquency. These individuals also showed the lowest level of skin conductance reactivity during the provocation task. The results suggest CU traits are an important moderator of the relation between verbal abilities and violent delinquency.

  18. Self-regulatory failure and intimate partner violence perpetration.

    PubMed

    Finkel, Eli J; DeWall, C Nathan; Slotter, Erica B; Oaten, Megan; Foshee, Vangie A

    2009-09-01

    Five studies tested the hypothesis that self-regulatory failure is an important predictor of intimate partner violence (IPV) perpetration. Study 1 participants were far more likely to experience a violent impulse during conflictual interaction with their romantic partner than they were to enact a violent behavior, suggesting that self-regulatory processes help individuals refrain from perpetrating IPV when they experience a violent impulse. Study 2 participants high in dispositional self-control were less likely to perpetrate IPV, in both cross-sectional and residualized-lagged analyses, than were participants low in dispositional self-control. Study 3 participants verbalized more IPV-related cognitions if they responded immediately to partner provocations than if they responded after a 10-s delay. Study 4 participants whose self-regulatory resources were experimentally depleted were more violent in response to partner provocation (but not when unprovoked) than were nondepleted participants. Finally, Study 5 participants whose self-regulatory resources were experimentally bolstered via a 2-week training regimen exhibited less violent inclinations than did participants whose self-regulatory resources had not been bolstered. These findings hint at the power of incorporating self-regulation dynamics into predictive models of IPV perpetration. (c) 2009 APA, all rights reserved).

  19. Repetitive transcranial magnetic stimulation modulates the impact of a negative mood induction

    PubMed Central

    Lacomblé, Lylis; Meyer, Thomas; Schutter, Dennis J.L.G.; Gielkens, Tom; Becker, Eni S.; Tendolkar, Indira; van Eijndhoven, Philip

    2017-01-01

    Abstract High frequency repetitive Transcranial Magnetic Stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) has been found to alleviate depressive symptoms. However, the mechanisms driving these effects are still poorly understood. In the current study, we tested the idea that this intervention protects against negative mood shifts following emotional provocation. We furthermore explored changes in EEG activity (frontal alpha asymmetry) and effects on attentional processing (emotional Stroop). To this end, 23 healthy individuals participated in two sessions separated by one week, whereby they once received 15 min of 10Hz rTMS stimulation (1500 pulses) at 110% of the individual motor threshold, and once sham stimulation. Then, negative mood was induced using sad movie clips. The results revealed a significantly stronger mood decline following rTMS compared to sham stimulation. No changes were observed in frontal alpha asymmetry and attentional processing. Our findings are at odds with the view that high frequency rTMS over the left DLPFC directly protects against the induction of negative mood, but rather suggest that it enhances the effects of emotional provocation. Possibly, in healthy young individuals, this stimulation protocol heightens susceptibility to mood induction procedures in general. PMID:28008080

  20. 40 CFR 1060.515 - How do I test EPA Nonroad Fuel Lines and EPA Cold-Weather Fuel Lines for permeation emissions?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... and EPA Cold-Weather Fuel Lines for permeation emissions? 1060.515 Section 1060.515 Protection of... Nonroad Fuel Lines and EPA Cold-Weather Fuel Lines for permeation emissions? Measure emission as follows for EPA Nonroad Fuel Lines and EPA Cold-Weather Fuel Lines: (a) Prior to permeation testing, use good...

  1. 40 CFR 1060.515 - How do I test EPA Nonroad Fuel Lines and EPA Cold-Weather Fuel Lines for permeation emissions?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... and EPA Cold-Weather Fuel Lines for permeation emissions? 1060.515 Section 1060.515 Protection of... Nonroad Fuel Lines and EPA Cold-Weather Fuel Lines for permeation emissions? Measure emission as follows for EPA Nonroad Fuel Lines and EPA Cold-Weather Fuel Lines: (a) Prior to permeation testing, use good...

  2. 40 CFR 1060.515 - How do I test EPA Nonroad Fuel Lines and EPA Cold-Weather Fuel Lines for permeation emissions?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... and EPA Cold-Weather Fuel Lines for permeation emissions? 1060.515 Section 1060.515 Protection of... Nonroad Fuel Lines and EPA Cold-Weather Fuel Lines for permeation emissions? Measure emission as follows for EPA Nonroad Fuel Lines and EPA Cold-Weather Fuel Lines: (a) Prior to permeation testing, use good...

  3. 40 CFR 1060.515 - How do I test EPA Nonroad Fuel Lines and EPA Cold-Weather Fuel Lines for permeation emissions?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... and EPA Cold-Weather Fuel Lines for permeation emissions? 1060.515 Section 1060.515 Protection of... Nonroad Fuel Lines and EPA Cold-Weather Fuel Lines for permeation emissions? Measure emission as follows for EPA Nonroad Fuel Lines and EPA Cold-Weather Fuel Lines: (a) Prior to permeation testing, use good...

  4. 40 CFR 1060.515 - How do I test EPA Nonroad Fuel Lines and EPA Cold-Weather Fuel Lines for permeation emissions?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... and EPA Cold-Weather Fuel Lines for permeation emissions? 1060.515 Section 1060.515 Protection of... Nonroad Fuel Lines and EPA Cold-Weather Fuel Lines for permeation emissions? Measure emission as follows for EPA Nonroad Fuel Lines and EPA Cold-Weather Fuel Lines: (a) Prior to permeation testing, use good...

  5. Baroreflex modulation of muscle sympathetic nerve activity during cold pressor test in humans

    NASA Technical Reports Server (NTRS)

    Cui, Jian; Wilson, Thad E.; Crandall, Craig G.

    2002-01-01

    The purpose of this project was to test the hypothesis that baroreceptor modulation of muscle sympathetic nerve activity (MSNA) and heart rate is altered during the cold pressor test. Ten subjects were exposed to a cold pressor test by immersing a hand in ice water for 3 min while arterial blood pressure, heart rate, and MSNA were recorded. During the second and third minute of the cold pressor test, blood pressure was lowered and then raised by intravenous bolus infusions of sodium nitroprusside and phenylephrine HCl, respectively. The slope of the relationship between MSNA and diastolic blood pressure was more negative (P < 0.005) during the cold pressor test (-244.9 +/- 26.3 units x beat(-1) x mmHg(-1)) when compared with control conditions (-138.8 +/- 18.6 units x beat(-1) x mmHg(-1)), whereas no significant change in the slope of the relationship between heart rate and systolic blood pressure was observed. These data suggest that baroreceptors remain capable of modulating MSNA and heart rate during a cold pressor test; however, the sensitivity of baroreflex modulation of MSNA is elevated without altering the sensitivity of baroreflex control of heart rate.

  6. [Automobile tyre colloidal particle induced allergic damage of respiratory system in traffic policemen and its allergenicity].

    PubMed

    Zhang, Yong-xing; Wei, Qing-yu; Wang, Juan; Qiao, Ting-hui; Bai, Hong-bing; Cai, Li-na

    2007-06-01

    To explore the damage of respiratory system in the traffic policemen induced by automobile tyre colloidal particle and its allergenicity. The respiratory system symptoms in 445 traffic policemen working outside their offices and 243 controls were investigated and their pulmonary ventilation function index such as FVC, FEV(1.0), MMF and V(50) were determined. The specific IgE antibody of automobile tyre colloidal particle of their serum was determined and the skin-prick test of automobile tyre colloidal particle antigen was performed. Sixty-six traffic policemen working outside their offices and 5 controls with the positive of IgE antibody among them were detected by nasal mucosa provocation test. Sixty-six traffic policemen working outside their offices with the positive of IgE antibody were determined by Terbutaline inhalation test. The positive rate of respiratory system symptoms of traffic policemen such as cough, stethocatharsis, short breath, nasal obstruction, sneeze and nose running was 38.02%, 27.03%, 20.00%, 23.08%, 27.47%, 32.09% and 34.95% respectively and significantly higher than those of the control with significant difference (P < 0.01) or (P < 0.05). The positive rate of specific IgE antibody of automobile tyre colloidal particle, skin- prick test and nasal mucosa provocation test was 14.51%, 23.73% and 54.55% respectively with significant difference (P < 0.01) and (P < 0.05). The percentage, the actual figure compared with the prediction figure, of the index of pulmonary ventilation function (FVC, FEV(1.0) MMF and V(50)) of traffic policemen were significantly lower than those of the control. Terbutaline inhalation test in 66 positive subjects of specific IgE antibody of automobile tyre colloidal particle was positive in 44 subjects, accounting for 9.67% in all policemen investigated. The automobile tyre colloidal particle is one of etiological factors that induce pulmonary ventilation function damage and could result in allergic asthma of traffic police.

  7. A Rare Non-Hemolytic Case of Idiopathic Cold Agglutinin Disease.

    PubMed

    Erkus, Edip; Kocak, Mehmet Z; Aktas, Gulali; Ozen, Mehmet; Atak, Burcin M; Duman, Tuba T; Tekce, Buket K; Savli, Haluk

    2018-06-01

    Cold agglutinin disease is a very rare condition associated with agglutination of erythrocytes in cold environment usually due to IgM type antibodies. Other than hemolytic anemias, it may interfere with routine hemogram tests due to miscalculation of red blood cell count (RBC) and other hemogram parameters calculated with involvement of RBC. Awareness of the condition is important to overcome laboratory errors. We studied a peripheral blood smear and repeated the hemogram test at 37°C to establish the diagnosis of cold agglutinin disease. Initial hemogram test results of the fifty-eight year-old man was as follows: RBC: 1.34 M/µL, hemoglobin (Hb): 12.4 g/dL, hematocrit (Htc): 11.8%, mean corpuscular hemoglobin (MCH): 92.4 pg, and mean corpuscular hemoglobin concentration (MCHC): 105 gr/dL. Despite the standard indirect Coombs test being negative, repeated tests at room temperature was 4+. We suspected cold agglutinin disease and repeated the hemogram test using the Bain-Marie method at 37°C and the test results showed RBC: 3.4 M/µL, hemoglobin: 12.6 g/dL, hematocrit: 30.2%, MCH: 31.7 pg, and MCHC: 41.8 g/dL. Inappropriate hemogram results may be a sign of underlying cold agglutinin disease. Hemolytic anemia not always accompanies the disease; however, cold exposure may trigger erythrocyte agglutination in vitro and may cause erratic laboratory results.

  8. Cognitive impairment and olfactory panic from occupational exposure to VOCs.

    PubMed

    Reinhartz, Abe

    2006-10-01

    A Canadian government clerical worker in her early thirties developed frontal lobe dysfunction from inhalation of volatile organic compounds off-gassed during an office renovation. Pulmonary function, bronchial provocation, allergy testing, and a brain (SPECT) scan were performed. SPECT scanning showed frontotemporal hypoperfusion and neuropsychologic testing revealed deficits in verbal learning and poor organizational memory. A significant component of this worker's impairment was the development of "olfactory panic," a debilitating aversion to odor accompanied by symptoms of panic. The Ontario Workplace Safety and Insurance Appeals Tribunal granted entitlement for her cognitive difficulties and olfactory panic as a result of her toxic exposure.

  9. Surface electromyography of myopotential oversensing provoked by simultaneous straining and leftward twisting in a patient with an implantable cardioverter defibrillator.

    PubMed

    Ajiro, Yoichi; Shiga, Tsuyoshi; Shoda, Morio; Hagiwara, Nobuhisa

    2017-03-01

    An important step in diagnosing myopotential oversensing is to confirm its reproducibility using specific provocation maneuvers. Although most maneuvers involve the co-contraction of many muscles, no attempt has been made to assess relevant muscle activities by electromyography. We describe a case with an implantable cardioverter defibrillator (ICD) whose myopotential oversensing was provoked by simultaneous straining and leftward twisting. Simultaneous recordings from real-time ICD telemetry and myopotentials of the rectus abdominis, oblique abdominis, and diaphragm on electromyography during the provocation maneuvers were conducted. It was shown that all three muscles contracted simultaneously during the provocation maneuvers; the diaphragm activity was the main source of noise oversensing, and the twist itself caused oversensing possibly due to the change in the position of the lead. In conclusion, the electromyographic assessment of relevant muscle activities may be useful in assessing each muscle's role and its contribution to myopotential oversensing, especially in a patient whose myopotential oversensing requires complex maneuvers to be provoked.

  10. Philosophical Provocation: The Lifeblood of Clinical Ethics.

    PubMed

    McCullough, Laurence B

    2017-02-01

    The daily work of the clinical ethics teacher and clinical ethics consultant falls into the routine of classifying clinical cases by ethical type and proposing ethically justified alternatives for the professionally responsible management of a specific type of case. Settling too far into this routine creates the risk of philosophical inertia, which is not good either for the clinical ethicist or for the field of clinical ethics. The antidote to this philosophical inertia and resultant blinkered vision of clinical ethics is sustained, willing exposure to philosophical provocation. The papers in this clinical ethics issue of the Journal of Medicine and Philosophy provide just such philosophical provocation related to core topics in clinical ethics: the distinction between clinical practice and clinical research; telemedicine, or medicine at a distance; illness narratives; the concept of the placebo effect; and sex reassignment. © The Author 2017. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Experimental panic provocation in healthy man—a translational role in anti-panic drug development?

    PubMed Central

    Kellner, Michael

    2011-01-01

    Experimental neurochemical provocation of panic attacks in susceptible human subjects has considerably expanded our knowledge of the pathophysiology and psychopharmacology of panic disorder. Some panicogens also elicit short-lived panic-like states in healthy man. This offers the opportunity to assess the anti-panic action of drugs in proof-of-concept studies. However, from current data it is still unclear whether experimental panic in healthy man is a valid translational model. Most such studies in healthy volunteers have been performed using a cholecystokinin tetrapeptide (CCK-4) challenge. While CCK-4 panic was blocked by alprazolam pretreatment, escitalopram showed negative results in healthy man. Preliminary findings on novel investigational drugs and a few problematic results will be reviewed. Small sample sizes in many panic provocation studies, lack of dose-response aspects, and still-insufficient knowledge about the biological underpinning of experimental and spontaneous panic limit the interpretation of existing findings and should inspire further research. PMID:22275853

  12. Cold Regions Test of Indirect Fire Weapons Ammunition

    DTIC Science & Technology

    1983-03-08

    COLD REGIONS TEST OF INDIRECT FIRE WEAPONS AMMUNITION Paragraph 1 . SCOPE. 1 2. FACILITIES AND INSTRUMENTATION .......... 3. PREPARATION FOR TEST...A- 1 B. Data Collection Sheets ..... .............. B- 1 C. References ..... .................... ... C- 1 D. Cold-Dry...Uniform .D...... .. ... .. ... 0- 1 1 . SCOPE. The procedures outlined in this TOP are designed to determine the c-h-arac-teristics of indirect artillery

  13. Networks of phobic fear: Functional connectivity shifts in two subtypes of specific phobia.

    PubMed

    Stefanescu, Maria R; Endres, Ralph J; Hilbert, Kevin; Wittchen, Hans-Ulrich; Lueken, Ulrike

    2018-01-01

    Anxiety disorders can be conceptualized by an abnormal interplay of emotion-processing brain circuits; however, knowledge of brain connectivity measures in specific phobia is still limited. To explore functional interactions within selected fear-circuitry structures (anterior cingulate cortex (ACC), amygdala, insula), we re-examined three task-based fMRI studies using a symptom provocation approach (n=94 subjects in total) on two different phobia subtypes (animal subtype as represented by snake phobia (SP) and blood-injection-injury subtype as represented by dental phobia (DP)), and a non-phobic healthy control group (HC). Functional connectivity (FC) analyses detected a negative coupling between the amygdala and the ACC in HC for both classes of phobic stimuli, while SP and DP lacked this inhibitory relationship during visual stimulus presentation. However, a negative FC between the insula and the amygdala was observed in DP during visual symptom provocation, which reversed to a positive FC under auditory symptom provocation pointing to effects depending on stimulus modality in DP. SP showed significantly higher FC towards snake-anxiety eliciting stimuli than HC on an average measure of FC, while DP showed a similar pattern under auditory stimulation only. These findings altogether indicate FC shifts during symptom provocation in specific phobia possibly reflecting impaired emotion regulation processes within fear-circuitry networks. FC hence could represent a prime target for neuroscience-informed augmentation strategies when treating pathological forms of fear. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Trait aggressiveness modulates neurophysiological correlates of laboratory-induced reactive aggression in humans.

    PubMed

    Krämer, Ulrike M; Büttner, Sarah; Roth, Gerhard; Münte, Thomas F

    2008-08-01

    Reactive aggression following provocation is a frequent form of human social behavior. The neural basis of reactive aggression, especially its control, remains poorly understood, however. We conducted an event-related potential (ERP) study using a competitive reaction time task that elicits aggression through provocation. Participants were selected from a larger sample because of extreme scores in trait aggressiveness, yielding high and low trait aggressive groups. As each trial in the task is separated into a decision phase, during which the punishment level for the opponent is set, and an outcome phase, during which the punishment is applied or received, we were able to disentangle provocation-related and evaluation-related modulations of the ERPs during the aggressive interaction. Specifically, we observed an enhanced frontal negativity during the decision phase under high provocation that was positively correlated with the participants' ability to refrain from retaliation. This held true for high trait aggressive participants only, pointing to a higher need for inhibitory and control processes in these people when provoked. During the outcome phase, we detected a mediofrontal negativity in loss compared to win trials, resembling previous ERP findings to negative feedback stimuli, which have been linked to the evaluation of an outcome's valence. This mediofrontal negativity was differentially pronounced in aggressive and nonaggressive participants: Nonaggressive participants showed only a slightly smaller mediofrontal negativity in win than in loss trials, suggesting that for them punishing the opponent had a similar negative valence as being punished.

  15. Wire and Cable Cold Bending Test

    NASA Technical Reports Server (NTRS)

    Colozza, Anthony

    2010-01-01

    One of the factors in assessing the applicability of wire or cable on the lunar surface is its flexibility under extreme cold conditions. Existing wire specifications did not address their mechanical behavior under cold, cryogenic temperature conditions. Therefore tests were performed to provide this information. To assess this characteristic 35 different insulated wire and cable pieces were cold soaked in liquid nitrogen. The segments were then subjected to bending and the force was recorded. Any failure of the insulation or jacketing was also documented for each sample tested. The bending force tests were performed at room temperature to provide a comparison to the change in force needed to bend the samples due to the low temperature conditions. The results from the bending tests were plotted and showed how various types of insulated wire and cable responded to bending under cold conditions. These results were then used to estimate the torque needed to unroll the wire under these low temperature conditions.

  16. Natural rubber latex skin testing reagents: safety and diagnostic accuracy of nonammoniated latex, ammoniated latex, and latex rubber glove extracts.

    PubMed

    Hamilton, R G; Adkinson, N F

    1996-11-01

    Nonammoniated latex, ammoniated latex, and rubber glove extracts are the only sources of natural rubber (Hevea brasiliensis) latex that have potential for use as skin testing reagents in the diagnosis of latex allergy. Their diagnostic sensitivity and specificity as skin test reagents are unknown. We conducted a phase 1/2 clinical study to examine the safety and diagnostic accuracy (sensitivity and specificity) of nonammoniated latex, ammoniated latex, and rubber glove extracts as skin test extracts to identify the most efficacious source material for future skin test reagent development. Twenty-four adults not allergic to latex, 19 adults with hand dermatitis or pruritus, and 59 adults with a latex allergy were identified by clinical history. All provided blood and then received puncture skin tests and intradermal skin tests with nonammoniated latex, ammoniated latex, and rubber glove extracts from Malaysian H. brasiliensis latex by use of sequential titration. A glove provocation test and IgE anti-latex RAST were used to clarify positive history-negative skin test response and negative history-positive skin test response mismatches. All three extracts were biologically safe and sterile. After normalization to 1 mg/ml of total protein, all three extracts produced equivalent diagnostic sensitivity and specificity in puncture skin tests and intradermal skin tests at various extract concentrations. Optimal diagnostic accuracy was safely achieved at 100 micrograms/ml for intradermal skin tests (e.g., nonammoniated latex: puncture skin test sensitivity 96%, specificity 100%; intradermal skin test sensitivity 93%, specificity 96%). The presence of IgE antibody in skin was highly correlated with IgE anti-latex in serum (nonammoniated latex: r = 0.98, p < 0.001; ammoniated latex: r = 0.94, p < 0.001; rubber glove extract: r = 0.96, p < 0.001). All five available subjects with a positive history, negative skin test response, and absence of IgE antibody in serum had a negative glove provocation test response, indicating no clinical evidence of latex allergy. No systemic or large local allergic reactions were observed with puncture skin tests or intradermal skin tests. Equivalent diagnostic sensitivity and specificity were observed with the nonammoniated latex, ammoniated latex, and rubber glove extract skin test reagents after normalization for total protein; nonammoniated latex may be considered the reagent of choice on the basis of practical quality control and reproducibility considerations.

  17. Accurate Cold-Test Model of Helical TWT Slow-Wave Circuits

    NASA Technical Reports Server (NTRS)

    Kory, Carol L.; Dayton, James A., Jr.

    1997-01-01

    Recently, a method has been established to accurately calculate cold-test data for helical slow-wave structures using the three-dimensional electromagnetic computer code, MAFIA. Cold-test parameters have been calculated for several helical traveling-wave tube (TWT) slow-wave circuits possessing various support rod configurations, and results are presented here showing excellent agreement with experiment. The helical models include tape thickness, dielectric support shapes and material properties consistent with the actual circuits. The cold-test data from this helical model can be used as input into large-signal helical TWT interaction codes making it possible, for the first time, to design a complete TWT via computer simulation.

  18. Cold Regions Environmental Protection and Durability Test of Clothing.

    DTIC Science & Technology

    1983-07-08

    17 AD-A130 482 COLD REGIONS ENVIRONMENTAL PROTECTION AND DURABILITY 1 / TEST OF CLDTHING(U) *ARMY TEST AND EVALGATION COMMAND ABERDEEN PROVING GROUND...MD 08 JUL 83 TOP-10-2510 UNCLASSIFIED FDA 6/7 -Lm U= 1,2 2 340 12.0IIHI . 1 L1.8 j$jfLi25 .411 .6 MICROCOPY RESOLUTION TEST CHART NT’NL BUREAU C’ N j...July 1983 AD NO. COLD REGIONS ENVIRONMENTAL PROTECTION AND DURABILITY TEST OF CLOTHING Page 1 SCOPE .................................. 1 2 FACILITIES

  19. Resource Prospector Propulsion Cold Flow Test

    NASA Technical Reports Server (NTRS)

    Williams, Hunter; Pederson, Kevin; Dervan, Melanie; Holt, Kimberly; Jernigan, Frankie; Trinh, Huu; Flores, Sam

    2014-01-01

    For the past year, NASA Marshall Space Flight Center and Johnson Space Center have been working on a government version of a lunar lander design for the Resource Prospector Mission. A propulsion cold flow test system, representing an early flight design of the propulsion system, has been fabricated. The primary objective of the cold flow test is to simulate the Resource Prospector propulsion system operation through water flow testing and obtain data for anchoring analytical models. This effort will also provide an opportunity to develop a propulsion system mockup to examine hardware integration to a flight structure. This paper will report the work progress of the propulsion cold flow test system development and test preparation. At the time this paper is written, the initial waterhammer testing is underway. The initial assessment of the test data suggests that the results are as expected and have a similar trend with the pretest prediction. The test results will be reported in a future conference.

  20. Correlation of skin test results and specific immunoglobulin E blood levels with nasal provocation testing for house-dust mite allergies.

    PubMed

    Haxel, Boris R; Huppertz, Tilman; Boessert, Patrick; Bast, Florian; Fruth, Kai

    2016-01-01

    Allergen-specific immunotherapy for house-dust mite (HDM) allergies is associated with lower success rates when compared with similar treatments for other inhalant allergens, such as grass or birch. One reason might be the greater difficulty in diagnosing patients with assumed HDM allergies because symptoms occur perennially and may differ from those of a conventional allergic rhinitis. The aim of the study was to compare the different methods of diagnosis in patients with assumed HDM allergy. We performed a retrospective analysis of nasal provocation tests (NPT) from patients (n = 161) evaluated for Dermatophagoides pteronyssinus (n = 127) and Dermatophagoides farinae (n = 104) allergies, and compared the results with other allergen testing methods (skin-prick test [SPT], intracutaneous test, and allergen specific immunoglobulin E levels [sIgE] to detect sensitization). Receiver operating characteristic curves were used for the analyses and the areas under the curve were calculated. For D. pteronyssinus and D. farinae, 86 and 70 complete data files, respectively, were available. For both tested HDMs, the results of the receiver operating characteristic curves showed a significant correlation for SPT and sIgE, with the results of the NPT (area under the curve, 0.742 to 0.763) but not for the intracutaneous test. In patients with a positive SPT (≥3 mm), an allergy was confirmed by the NPT in 69% of cases for D. pteronyssinus and 71% for D. farinae. A positive sIgE result (ImmunoCAP class of ≥2) was verified by the NPT in 69% of cases (D. pteronyssinus) and 70% (D. farinae). The predictability value for a positive NPT result is best for SPT and sIgE. Nevertheless, even if the results of both test systems are combined, the positive predictive value that was achieved was only 0.77 for D. pteronyssinus and 0.69 for D. farinae. Therefore, in patients eligible for immunotherapy for HDM, an NPT should be performed before the start of the therapy to verify a clinically relevant allergy.

  1. [Cold-induced urticaria].

    PubMed

    Delorme, N; Drouet, M; Thibaudeau, A; Verret, J L

    2002-09-01

    Cold urticaria is characterized by the development of urticaria, usually superficial and/or angioedematous reaction after cold contact. It was found predominantly in young women. The diagnosis is based on the history and ice cube test. Patients with a negative ice cube test may have represented systemic cold urticaria (atypical acquired cold urticaria) induced by general body cooling. The pathogenesis is poorly understood. Cold urticaria can be classified into acquired and familial disorders, with an autosomal dominant inheritance. Idiopathic cold urticaria is most common type but the research of a cryopathy is necessary. Therapy is often difficult. It is essential that the patient be warned of the dangers of swimming in cold water because systemic hypotension can occur. H1 antihistamines can be used for treatment of cold urticaria but the clinical responses are highly variable. The combination with an H2 antagonists is more effective. Doxepin may be useful in the treatment. Leukotriene receptor antagonists may be a novel, promising drug entity. In patients who do not respond to previous treatments, induction of cold tolerance may be tried.

  2. Hypothermic general cold adaptation induced by local cold acclimation.

    PubMed

    Savourey, G; Barnavol, B; Caravel, J P; Feuerstein, C; Bittel, J H

    1996-01-01

    To study relationships between local cold adaptation of the lower limbs and general cold adaptation, eight subjects were submitted both to a cold foot test (CFT, 5 degrees C water immersion, 5 min) and to a whole-body standard cold air test (SCAT, 1 degree C, 2 h, nude at rest) before and after a local cold acclimation (LCA) of the lower limbs effected by repeated cold water immersions. The LCA induced a local cold adaptation confirmed by higher skin temperatures of the lower limbs during CFT and a hypothermic insulative general cold adaptation (decreased rectal temperature and mean skin temperature P < 0.05) without a change either in metabolic heat production or in lower limb skin temperatures during SCAT after LCA. It was concluded that local cold adaptation was related to the habituation process confirmed by decreased plasma concentrations of noradrenaline (NA) during LCA (P < 0.05). However, the hypothermic insulative general cold adaptation was unrelated either to local cold adaptation or to the habituation process, because an increased NA during SCAT after LCA (P < 0.05) was observed but was rather related to a "T3 polar syndrome" occurring during LCA.

  3. Growth retardation and reduced growth hormone secretion in cystic fibrosis. Clinical observations from three CF centers.

    PubMed

    Ciro, D'Orazio; Padoan, Rita; Blau, Hannah; Marostica, Anna; Fuoti, Maurizio; Volpi, Sonia; Pilotta, Alba; Meyerovitch, Joseph; Sher, Daniel; Assael, Baroukh M

    2013-03-01

    Growth delay in cystic fibrosis is frequent and is usually the result of several interacting causes. It most often derives from severe respiratory impairment and severe malabsorption. There are however patients whose clinical condition is not severe enough to be held accountable for this phenomenon. We aimed at describing patients who showed growth delay, who were not affected by severe pulmonary disease or malabsorption and who, when tested, showed a reduced GH secretion after stimulation with conventional agents. We noticed a disproportionately large prevalence of growth hormone (GH) release deficit (GHRD) in pediatric cystic fibrosis (CF) patients. We examined all patients under our care in the period 2006-11, who were older than 5 and younger than 16 years old. We focussed on those who fell below the 3rd height percentile, or whose growth during the previous 18 months faltered by >2SD, and who did not present clinical conditions that could reasonably explain their failure to thrive. These patients were subjected to standard GH provocative tests. Out of 285 who matched the age criterion, 33 patients also matched the height percentile criterion. While 15/33 suffered clinical conditions that could reasonably explain their failure to thrive, 18/33 underwent GH release provocative tests and 12/18 showed a release deficit. We conclude that impaired GH secretion is more frequent among CF patients compared to the prevalence of GH deficiency in the general population and that GH release impairment may be an independent cause of growth delay in CF. Our findings are in agreement with recent studies that have described low GH levels in CF piglets and in neonates with CF [1]. Copyright © 2012 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  4. Children's self reported discomforts as participants in clinical research.

    PubMed

    Staphorst, Mira S; Hunfeld, Joke A M; van de Vathorst, Suzanne; Passchier, Jan; van Goudoever, Johannes B

    2015-10-01

    There is little empirical evidence on children's subjective experiences of discomfort during clinical research procedures. Therefore, Institutional Review Boards have limited empirical information to guide their decision-making on discomforts for children in clinical research. To get more insight into what children's discomforts are during clinical research procedures, we interviewed a group of children on this topic and also asked for suggestions to reduce possible discomforts. Forty-six children (aged 6-18) participating in clinical research studies (including needle-related procedures, food provocation tests, MRI scans, pulmonary function tests, questionnaires) were interviewed about their experiences during the research procedures. Thematic analysis was used to analyze the interviews. The discomforts of the interviewed children could be divided into two main groups: physical and mental discomforts. The majority experienced physical discomforts during the research procedures: pain, shortness of breath, nausea, itchiness, and feeling hungry, which were often caused by needle procedures, some pulmonary procedures, and food provocation tests. Mental discomforts included anxiousness because of anticipated pain and not knowing what to expect from a research procedure, boredom and tiredness during lengthy research procedures and waiting, and embarrassment during Tanner staging. Children's suggestions to reduce the discomforts of the research procedures were providing distraction (e.g. watching a movie or listening to music), providing age-appropriate information and shortening the duration of lengthy procedures. Our study shows that children can experience various discomforts during research procedures, and it provides information about how these discomforts can be reduced according to them. Further research is needed with larger samples to study the number of children that experience these mentioned discomforts during research procedures in a quantitative way. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Development of Hot and Cold Executive Function in Boys and Girls With ADHD.

    PubMed

    Skogli, Erik Winther; Andersen, Per Normann; Hovik, Kjell Tore; Øie, Merete

    2017-02-01

    To investigate the development of executive function with pronounced emotional salience (hot EF) and less pronounced emotional salience (cold EF) in boys and girls with ADHD relative to typically developing (TD) children. Seventy-five children with ADHD and 47 TD children were assessed with hot and cold EF tests at baseline and after 2 years. Despite considerable maturation, the ADHD group remained impaired on all cold EF tests relative to TD children after 2 years. There was no effect of gender on cold EF test results. Females with ADHD outperformed TD counterparts on hot EF at baseline. Females with ADHD showed deteriorating hot EF performance, while TD counterparts showed improved hot EF performance across time. Enduring cold EF impairments after 2 years may reflect stable phenotypic traits in children with ADHD. Results indicate divergent developmental trajectories of hot EF in girls with ADHD relative to TD counterparts.

  6. Cold-end Subsystem Testing for the Fission Power System Technology Demonstration Unit

    NASA Technical Reports Server (NTRS)

    Briggs, Maxwell; Gibson, Marc; Ellis, David; Sanzi, James

    2013-01-01

    The Fission Power System (FPS) Technology Demonstration Unit (TDU) consists of a pumped sodium-potassium (NaK) loop that provides heat to a Stirling Power Conversion Unit (PCU), which converts some of that heat into electricity and rejects the waste heat to a pumped water loop. Each of the TDU subsystems is being tested independently prior to full system testing at the NASA Glenn Research Center. The pumped NaK loop is being tested at NASA Marshall Space Flight Center; the Stirling PCU and electrical controller are being tested by Sunpower Inc.; and the pumped water loop is being tested at Glenn. This paper describes cold-end subsystem setup and testing at Glenn. The TDU cold end has been assembled in Vacuum Facility 6 (VF 6) at Glenn, the same chamber that will be used for TDU testing. Cold-end testing in VF 6 will demonstrate functionality; validated cold-end fill, drain, and emergency backup systems; and generated pump performance and system pressure drop data used to validate models. In addition, a low-cost proof-of concept radiator has been built and tested at Glenn, validating the design and demonstrating the feasibility of using low-cost metal radiators as an alternative to high-cost composite radiators in an end-to-end TDU test.

  7. Development and Analysis of Cold Trap for Use in Fission Surface Power-Primary Test Circuit

    NASA Technical Reports Server (NTRS)

    Wolfe, T. M.; Dervan, C. A.; Pearson, J. B.; Godfroy, T. J.

    2012-01-01

    The design and analysis of a cold trap proposed for use in the purification of circulated eutectic sodium potassium (NaK-78) loops is presented. The cold trap is designed to be incorporated into the Fission Surface Power-Primary Test Circuit (FSP-PTC), which incorporates a pumped NaK loop to simulate in-space nuclear reactor-based technology using non-nuclear test methodology as developed by the Early Flight Fission-Test Facility. The FSP-PTC provides a test circuit for the development of fission surface power technology. This system operates at temperatures that would be similar to those found in a reactor (500-800 K). By dropping the operating temperature of a specified percentage of NaK flow through a bypass containing a forced circulation cold trap, the NaK purity level can be increased by precipitating oxides from the NaK and capturing them within the cold trap. This would prevent recirculation of these oxides back through the system, which may help prevent corrosion.

  8. Experimentally Assessed Reactive Aggression in Borderline Personality Disorder

    PubMed Central

    Kogan-Goloborodko, Olga; Brügmann, Elisabeth; Repple, Jonathan; Habel, Ute; Clemens, Benjamin

    2016-01-01

    Approximately 73% of patients suffering from Borderline personality disorder (BPD) exhibit aggressive behaviour, which severely hinders therapeutic work and clinical improvement. Because the underlying mechanisms of aggression in BPD are not yet completely understood, additional research in this domain has a high clinical and scientific relevance. We employed a modified version of the Taylor Aggression Paradigm (mTAP), in order to examine for the first time whether this task can be used to differentiate between BPD patients and healthy controls with regard to reactive aggression. In the mTAP, the amount of money subtracted by a virtual opponent was categorized into ‘low’ (10–20 cents) and ‘high’ (80–100 cents) provocations, enabling us to compare how much money BPD patients and healthy controls subtracted (i.e., how aggressively participants responded) following high and low provocation trials. Our results showed that, compared to healthy controls, BPD patients showed higher overall aggression, higher aggression after high provocation trials, as well as a larger difference between high and low provocation trials. This finding was corroborated by a neuropsychological assessment, demonstrating higher levels of aggression and impulsivity in BPD patients. Interestingly, reactive aggression in the mTAP was positively correlated with symptom severity and impulsivity in BPD patients. We suggest that the mTAP provides a valuable tool allowing psychiatrists to quantify reactive aggression in BPD. Therefore, clinicians and researchers might consider this task, as a short experimental measure of reactive aggression, either in future studies or to aid diagnostic assessment during clinical practice. PMID:27851804

  9. Predictive values of thermal and electrical dental pulp tests: a clinical study.

    PubMed

    Villa-Chávez, Carlos E; Patiño-Marín, Nuria; Loyola-Rodríguez, Juan P; Zavala-Alonso, Norma V; Martínez-Castañón, Gabriel A; Medina-Solís, Carlo E

    2013-08-01

    For a diagnostic test to be useful, it is necessary to determine the probability that the test will provide the correct diagnosis. Therefore, it is necessary to calculate the predictive value of diagnostics. The aim of the present study was to identify the sensitivity, specificity, positive and negative predictive values, accuracy, and reproducibility of thermal and electrical tests of pulp sensitivity. The thermal tests studied were the 1, 1, 1, 2-tetrafluoroethane (cold) and hot gutta-percha (hot) tests. For the electrical test, the Analytic Technology Pulp Tester (Analytic Technology, Redmond, WA) was used. A total of 110 teeth were tested: 60 teeth with vital pulp and 50 teeth with necrotic pulps (disease prevalence of 45%). The ideal standard was established by direct pulp inspection. The sensitivities of the diagnostic tests were 0.88 for the cold test, 0.86 for the heat test, and 0.76 for the electrical test, and the specificity was 1.0 for all 3 tests. The negative predictive value was 0.90 for the cold test, 0.89 for the heat test, and 0.83 for the electrical test, and the positive predictive value was 1.0 for all 3 tests. The highest accuracy (0.94) and reproducibility (0.88) were observed for the cold test. The cold test was the most accurate method for diagnostic testing. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  10. Traveling-Wave Tube Cold-Test Circuit Optimization Using CST MICROWAVE STUDIO

    NASA Technical Reports Server (NTRS)

    Chevalier, Christine T.; Kory, Carol L.; Wilson, Jeffrey D.; Wintucky, Edwin G.; Dayton, James A., Jr.

    2003-01-01

    The internal optimizer of CST MICROWAVE STUDIO (MWS) was used along with an application-specific Visual Basic for Applications (VBA) script to develop a method to optimize traveling-wave tube (TWT) cold-test circuit performance. The optimization procedure allows simultaneous optimization of circuit specifications including on-axis interaction impedance, bandwidth or geometric limitations. The application of Microwave Studio to TWT cold-test circuit optimization is described.

  11. 40 CFR 600.107-08 - Fuel specifications.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Exhaust Emission Test Procedures § 600.107-08 Fuel specifications. (a) The test fuel specifications for... given in paragraph (b) of this section. (b)(1) Diesel test fuel used for cold temperature FTP testing... alternative fuel for cold temperature FTP testing. (c) Test fuels representing fuel types for which there are...

  12. 40 CFR 600.107-08 - Fuel specifications.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Exhaust Emission Test Procedures § 600.107-08 Fuel specifications. (a) The test fuel specifications for... given in paragraph (b) of this section. (b)(1) Diesel test fuel used for cold temperature FTP testing... alternative fuel for cold temperature FTP testing. (c) Test fuels representing fuel types for which there are...

  13. 40 CFR 600.107-08 - Fuel specifications.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Exhaust Emission Test Procedures § 600.107-08 Fuel specifications. (a) The test fuel specifications for... given in paragraph (b) of this section. (b)(1) Diesel test fuel used for cold temperature FTP testing... alternative fuel for cold temperature FTP testing. (c) Test fuels representing fuel types for which there are...

  14. Testing of materials from the Minnesota Cold Regions pavement research test facility

    DOT National Transportation Integrated Search

    1996-09-01

    The U.S. Army Cold Regions Research and Engineering Laboratory (CRREL) conducted various laboratory tests on pavement materials from the Mn/ ROAD facility. The tests helped to characterize the behavior of materials under season frost conditions, and ...

  15. Pacifists and Revenge-Seekers in Response to Unambiguous Peer Provocation.

    PubMed

    McDonald, Kristina L; Asher, Steven R

    2018-01-19

    In order to better understand why some children retaliate when they feel provoked and others do not, the present study identified "pacifistically-oriented" children who made negative interpretations in response to unambiguous provocations, yet did not endorse revenge goals, and compared them to "revenge-seeking" children who also made negative interpretations but did endorse revenge goals. Groups were identified based on seventh graders' (N = 367; 54.77% male; 22.89% racial/ethnic minority) responses to hypothetical situations in which a peer excluded and insulted them. Comparing these groups revealed that Pacifists endorsed relationship-maintaining goals and emotion regulation goals more highly than Revenge-Seekers. Revenge-Seekers reported more anger and endorsed beliefs about negative reciprocity and aggression being legitimate more highly than Pacifists. Additionally, Revenge-Seekers were more disrespect sensitive than were Pacifists, based on a measure of vigilance for signs of disrespect and expectations that others would disrespect them. Together these findings point to social-cognitive and emotion-related processes that may inhibit revenge-seeking in unambiguous provocation situations, even when children interpret the peer's behavior quite negatively.

  16. Use of Provocative Angiography to Localize Site in Recurrent Gastrointestinal Bleeding

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

    Johnston, Ciaran, E-mail: ciaranjohnston@yahoo.co.uk; Tuite, David; Pritchard, Ruth

    2007-09-15

    Background. While the source of most cases of lower gastrointestinal bleeding may be diagnosed with modern radiological and endoscopic techniques, approximately 5% of patients remain who have negative endoscopic and radiological investigations.Clinical Problem. These patients require repeated hospital admissions and blood transfusions, and may proceed to exploratory laparotomy and intraoperative endoscopy. The personal and financial costs are significant. Method of Diagnosis and Decision Making. The technique of adding pharmacologic agents (anticoagulants, vasodilators, fibrinolytics) during standard angiographic protocols to induce a prohemorrhagic state is termed provocative angiography. It is best employed when significant bleeding would otherwise necessitate emergency surgery. Treatment. Thismore » practice frequently identifies a bleeding source (reported success rates range from 29 to 80%), which may then be treated at the same session. We report the case of a patient with chronic lower gastrointestinal hemorrhage with consistently negative endoscopic and radiological workup, who had an occult source of bleeding identified only after a provocative angiographic protocol was instituted, and who underwent succeeding therapeutic coil embolization of the bleeding vessel.« less

  17. Interrelations of Justice, Rejection, Provocation, and Moral Disgust Sensitivity and Their Links with the Hostile Attribution Bias, Trait Anger, and Aggression

    PubMed Central

    Bondü, Rebecca; Richter, Philipp

    2016-01-01

    Several personality dispositions with common features capturing sensitivities to negative social cues have recently been introduced into psychological research. To date, however, little is known about their interrelations, their conjoint effects on behavior, or their interplay with other risk factors. We asked N = 349 adults from Germany to rate their justice, rejection, moral disgust, and provocation sensitivity, hostile attribution bias, trait anger, and forms and functions of aggression. The sensitivity measures were mostly positively correlated; particularly those with an egoistic focus, such as victim justice, rejection, and provocation sensitivity, hostile attributions and trait anger as well as those with an altruistic focus, such as observer justice, perpetrator justice, and moral disgust sensitivity. The sensitivity measures had independent and differential effects on forms and functions of aggression when considered simultaneously and when controlling for hostile attributions and anger. They could not be integrated into a single factor of interpersonal sensitivity or reduced to other well-known risk factors for aggression. The sensitivity measures, therefore, require consideration in predicting and preventing aggression. PMID:27303351

  18. Repeatability of a cold stress test to assess cold sensitization.

    PubMed

    House, C M; Taylor, R J; Oakley, E H N

    2015-10-01

    Non-freezing cold injury (NFCI) is a syndrome in which damage to peripheral tissues occurs without the tissues freezing following exposure to low ambient temperatures. To assess the test-retest reliability of a cold stress test (CST) used to assess cold sensitization. Volunteers with no self-reported history of NFCI undertook the CST on three occasions. Thermal images were taken of the foot and hand before, immediately after and 5min after immersion of the limb in cold water for 2min. Cold sensitization was graded by the two clinicians and the lead author. Spot temperatures from the toe and finger pads were recorded. There were 30 white and 19 black male participants. The ratings indicated substantial agreement [a Cohen's kappa (κ) value of 0.61-0.8] to within ± one grading category for the hands and feet of the white volunteers and the hands of the black volunteers. Limits of agreement (LoA) analysis for toe and finger pad temperatures indicated high agreement (absolute 95% LoA < 5.5°C). Test-retest reliability for the feet of the black volunteers was not supported by the gradings (κ = 0.38) and toe pad temperatures (absolute 95% LoA = 9.5°C and coefficient of variation = 11%). The test-retest reliability of the CST is considered adequate for the assessment of the cold sensitization of the hands and feet of white and the hands of black healthy non-patients. The study should be repeated with patients who have suffered a NFCI. © Crown copyright 2015.

  19. Selection of Environmentally Friendly Solvents for the Extravehicular Mobility Unit Secondary Oxygen Pack Cold Trap Testing

    NASA Technical Reports Server (NTRS)

    Steele, John; Chullen, Cinda; Morenz, Jesse; Stephenson, Curtis

    2010-01-01

    Freon-113(TradeMark) has been used as a chemistry lab sampling solvent at NASA/JSC for EMU (extravehicular Mobility Unit) SOP (Secondary Oxygen Pack) oxygen testing Cold Traps utilized at the USA (United Space Alliance) Houston facility. Similar testing has occurred at the HSWL (Hamilton Sundstrand Windsor Locks) facility. A NASA Executive Order bans the procurement of all ODS (ozone depleting substances), including Freon-113 by the end of 2009. In order to comply with NASA direction, HSWL began evaluating viable solvents to replace Freon-113 . The study and testing effort to find Freon-113 replacements used for Cold Trap sampling is the subject of this paper. Test results have shown HFE-7100 (a 3M fluorinated ether) to be an adequate replacement for Freon-113 as a solvent to remove and measure the non-volatile residue collected in a Cold Trap during oxygen testing. Furthermore, S-316 (a Horiba Instruments Inc. high molecular weight, non-ODS chlorofluorocarbon) was found to be an adequate replacement for Freon-113 as a solvent to reconstitute non-volatile residue removed from a Cold Trap during oxygen testing for subsequent HC (hydrocarbon) analysis via FTIR (Fourier Transform Infrared Spectroscopy).

  20. 40 CFR 86.1343-88 - Calculations; particulate exhaust emissions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... cold-start test, grams. (3) PH = Mass particulate measured during the hot-start test, grams. (4) BHP-hr..., grams per test phase. (PH = Pmass for the hot-start test and PC = Pmass for the cold-start test. (2... Exhaust Test Procedures § 86.1343-88 Calculations; particulate exhaust emissions. (a) The final reported...

  1. 40 CFR 86.1343-88 - Calculations; particulate exhaust emissions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... cold-start test, grams. (3) PH = Mass particulate measured during the hot-start test, grams. (4) BHP-hr..., grams per test phase. (PH = Pmass for the hot-start test and PC = Pmass for the cold-start test. (2... Exhaust Test Procedures § 86.1343-88 Calculations; particulate exhaust emissions. (a) The final reported...

  2. Preliminary criteria for the definition of allergic rhinitis: a systematic evaluation of clinical parameters in a disease cohort (I).

    PubMed

    Ng, M L; Warlow, R S; Chrishanthan, N; Ellis, C; Walls, R

    2000-09-01

    The aim of this study is to formulate criteria for the definition of allergic rhinitis. Other studies have sought to develop scoring systems to categorize the severity of allergic rhinitis symptoms but it was never used for the formulation of diagnostic criteria. These other scoring systems were arbitrarily chosen and were not derived by any statistical analysis. To date, a study of this kind has not been performed. The hypothesis of this study is that it is possible to formulate criteria for the definition of allergic rhinitis. This is the first study to systematically examine and evaluate the relative importance of symptoms, signs and investigative tests in allergic rhinitis. We sought to statistically rank, from the most to the least important, the multiplicity of symptoms, signs and test results. Forty-seven allergic rhinitis and 23 normal subjects were evaluated with a detailed questionnaire and history, physical examination, serum total immunoglobulin E, skin prick tests and serum enzyme allergosorbent tests (EAST). Statistical ranking of variables indicated rhinitis symptoms (nasal, ocular and oronasal) were the most commonly occurring, followed by a history of allergen provocation, then serum total IgE, positive skin prick tests and positive EAST's to house dust mite, perennial rye and bermuda/couch grass. Throat symptoms ranked even lower whilst EAST's to cat epithelia, plantain and cockroach were the least important. Not all symptoms, signs and tests evaluated proved to be statistically significant when compared to a control group; this included symtoms and signs which had been considered historically to be traditionally associated with allergic rhinitis, e.g. sore throat and bleeding nose. In performing statistical analyses, we were able to rank from most to least important, the multiplicity of symptoms signs and test results. The most important symptoms and signs were identified for the first time, even though some of these were not included in our original selection criteria for defining the disease cohort i.e. sniffing, postnasal drip, oedematous nasal mucosa, impaired sense of smell, mouth breathing, itchy nose and many of the specific provocation factors.

  3. Cold Antimatter Plasmas, and Aspirations for Cold Antihydrogen

    DTIC Science & Technology

    2002-06-24

    comparison of any baryon and antibaryon by almost a factor of CP606, Non-Neutral Plasma Physics IV, edited by F. Anderegg et al. © 2002 American...antiprotons 3 _one-electron .1 eV quantum cyclotron 0.001 K FIGURE 1. Particle energies a million. An improved baryon CPT test (e.g. involving cold...more precise tests of CPT invariance with baryons and leptons than have been realized so far. The pursuit of cold antihydrogen thus began some time ago

  4. Effects of Cold Temperature and Ethanol Content on VOC Emissions from Light-Duty Gasoline Vehicles.

    PubMed

    George, Ingrid J; Hays, Michael D; Herrington, Jason S; Preston, William; Snow, Richard; Faircloth, James; George, Barbara Jane; Long, Thomas; Baldauf, Richard W

    2015-11-03

    Emissions of speciated volatile organic compounds (VOCs), including mobile source air toxics (MSATs), were measured in vehicle exhaust from three light-duty spark ignition vehicles operating on summer and winter grade gasoline (E0) and ethanol blended (E10 and E85) fuels. Vehicle testing was conducted using a three-phase LA92 driving cycle in a temperature-controlled chassis dynamometer at two ambient temperatures (-7 and 24 °C). The cold start driving phase and cold ambient temperature increased VOC and MSAT emissions up to several orders of magnitude compared to emissions during other vehicle operation phases and warm ambient temperature testing, respectively. As a result, calculated ozone formation potentials (OFPs) were 7 to 21 times greater for the cold starts during cold temperature tests than comparable warm temperature tests. The use of E85 fuel generally led to substantial reductions in hydrocarbons and increases in oxygenates such as ethanol and acetaldehyde compared to E0 and E10 fuels. However, at the same ambient temperature, the VOC emissions from the E0 and E10 fuels and OFPs from all fuels were not significantly different. Cold temperature effects on cold start MSAT emissions varied by individual MSAT compound, but were consistent over a range of modern spark ignition vehicles.

  5. Validation of the Novaco Anger Scale-Provocation Inventory (Danish) With Nonclinical, Clinical, and Offender Samples.

    PubMed

    Moeller, Stine Bjerrum; Novaco, Raymond W; Heinola-Nielsen, Vivian; Hougaard, Helle

    2016-10-01

    Anger has high prevalence in clinical and forensic settings, and it is associated with aggressive behavior and ward atmosphere on psychiatric units. Dysregulated anger is a clinical problem in Danish mental health care systems, but no anger assessment instruments have been validated in Danish. Because the Novaco Anger Scale and Provocation Inventory (NAS-PI) has been extensively validated with different clinical populations and lends itself to clinical case formulation, it was selected for translation and evaluation in the present multistudy project. Psychometric properties of the NAS-PI were investigated with samples of 477 nonclinical, 250 clinical, 167 male prisoner, and 64 male forensic participants. Anger prevalence and its relationship with other anger measures, anxiety/depression, and aggression were examined. NAS-PI was found to have high reliability, concurrent validity, and discriminant validity, and its scores discriminated the samples. High scores in the offender group demonstrated the feasibility of obtaining self-report assessments of anger with this population. Retrospective and prospective validity of the NAS were tested with the forensic patient sample regarding physically aggressive behavior in hospital. Regression analyses showed that higher scores on NAS increase the risk of having acted aggressively in the past and of acting aggressively in the future. © The Author(s) 2015.

  6. PCR analysis of a prescription vegetarian diet and use in three dogs with cutaneous adverse food reactions.

    PubMed

    Aufox, Erin E; May, Elizabeth R; Frank, Linda A; Kania, Stephen A

    2018-04-24

    Cutaneous adverse food reaction (CAFR) is diagnosed by performing an elimination diet trial utilizing prescription or home-cooked diets followed by provocative challenge. To report findings of PCR analysis of a prescription vegetarian diet (RCV) for undeclared proteins of animal origin, as well as to describe its utilization for diagnosis and management of dogs suspected of having CAFR. Three client-owned dogs. PCR analysis of RCV for 11 mammalian species and poultry. In three dogs, clinical examination, cytology, aerobic culture (if indicated) and at least one elimination diet trial with RCV. In our case series, all dogs had a history of pruritus and recurrent pyoderma that resolved with infection control and an elimination diet trial. In cases 1 and 2, a diagnosis of CAFR was made following an elimination trial with RCV and provocative challenge. Case 3 had a previously confirmed diagnosis of CAFR and RCV was successfully used to maintain remission of CAFR-related signs. PCR testing of RCV was negative for 11 mammalian species and poultry. The RCV diet was found not to contain any undeclared mammalian or avian proteins. In this case series, the RCV was successfully used to diagnose and maintain three dogs with CAFR. © 2018 ESVD and ACVD.

  7. Repetitive transcranial magnetic stimulation modulates the impact of a negative mood induction.

    PubMed

    Möbius, Martin; Lacomblé, Lylis; Meyer, Thomas; Schutter, Dennis J L G; Gielkens, Tom; Becker, Eni S; Tendolkar, Indira; van Eijndhoven, Philip

    2017-04-01

    High frequency repetitive Transcranial Magnetic Stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) has been found to alleviate depressive symptoms. However, the mechanisms driving these effects are still poorly understood. In the current study, we tested the idea that this intervention protects against negative mood shifts following emotional provocation. We furthermore explored changes in EEG activity (frontal alpha asymmetry) and effects on attentional processing (emotional Stroop). To this end, 23 healthy individuals participated in two sessions separated by one week, whereby they once received 15 min of 10Hz rTMS stimulation (1500 pulses) at 110% of the individual motor threshold, and once sham stimulation. Then, negative mood was induced using sad movie clips. The results revealed a significantly stronger mood decline following rTMS compared to sham stimulation. No changes were observed in frontal alpha asymmetry and attentional processing. Our findings are at odds with the view that high frequency rTMS over the left DLPFC directly protects against the induction of negative mood, but rather suggest that it enhances the effects of emotional provocation. Possibly, in healthy young individuals, this stimulation protocol heightens susceptibility to mood induction procedures in general. © The Author (2016). Published by Oxford University Press.

  8. Enzyme potentiated desensitisation in treatment of seasonal allergic rhinitis: double blind randomised controlled study.

    PubMed

    Radcliffe, Michael J; Lewith, George T; Turner, Richard G; Prescott, Philip; Church, Martin K; Holgate, Stephen T

    2003-08-02

    To assess the efficacy of enzyme potentiated desensitisation in the treatment of severe summer hay fever poorly controlled by pharmacotherapy. Double blind randomised placebo controlled parallel group study. Hospital in Hampshire. 183 participants aged between 18 and 64 with a history of severe summer hay fever for at least two years; all were skin prick test positive to timothy grass pollen. 90 randomised to active treatment; 93 randomised to placebo. Active treatment: two injections of enzyme potentiated desensitisation, given between eight and 11 weeks apart, each comprising 200 Fishman units of beta glucuronidase, 50 pg 1,3-cyclohexanediol, 50 ng protamine sulphate, and a mixed inhaled allergen extract (pollen mixes for trees, grasses, and weeds; allergenic fungal spores; cat and dog danders; dust and storage mites) in a total volume of 0.05 ml of buffered saline. Placebo: two injections of 0.05 ml buffered saline solution. Proportion of problem-free days; global rhinoconjunctivitis quality of life scores assessed weekly during pollen season. The active treatment group and the placebo group did not differ in the proportion of problem-free days, quality of life scores, symptom severity scores, change in quantitative skin prick provocation threshold, or change in conjunctival provocation threshold. No clinically significant adverse reactions occurred. Enzyme potentiated desensitisation showed no treatment effect in this study.

  9. Cold adaptation increases rates of nutrient flow and metabolic plasticity during cold exposure in Drosophila melanogaster

    PubMed Central

    McCue, Marshall D.; Sunny, Nishanth E.; Szejner-Sigal, Andre; Morgan, Theodore J.; Allison, David B.; Hahn, Daniel A.

    2016-01-01

    Metabolic flexibility is an important component of adaptation to stressful environments, including thermal stress and latitudinal adaptation. A long history of population genetic studies suggest that selection on core metabolic enzymes may shape life histories by altering metabolic flux. However, the direct relationship between selection on thermal stress hardiness and metabolic flux has not previously been tested. We investigated flexibility of nutrient catabolism during cold stress in Drosophila melanogaster artificially selected for fast or slow recovery from chill coma (i.e. cold-hardy or -susceptible), specifically testing the hypothesis that stress adaptation increases metabolic turnover. Using 13C-labelled glucose, we first showed that cold-hardy flies more rapidly incorporate ingested carbon into amino acids and newly synthesized glucose, permitting rapid synthesis of proline, a compound shown elsewhere to improve survival of cold stress. Second, using glucose and leucine tracers we showed that cold-hardy flies had higher oxidation rates than cold-susceptible flies before cold exposure, similar oxidation rates during cold exposure, and returned to higher oxidation rates during recovery. Additionally, cold-hardy flies transferred compounds among body pools more rapidly during cold exposure and recovery. Increased metabolic turnover may allow cold-adapted flies to better prepare for, resist and repair/tolerate cold damage. This work illustrates for the first time differences in nutrient fluxes associated with cold adaptation, suggesting that metabolic costs associated with cold hardiness could invoke resource-based trade-offs that shape life histories. PMID:27605506

  10. Hallermann-Streiff syndrome with hypopituitarism contributing to growth failure.

    PubMed

    Pivnick, E K; Burstein, S; Wilroy, R S; Kaufman, R A; Ward, J C

    1991-12-15

    A 35-month-old black boy with Hallermann-Streiff syndrome (HSS) was evaluated for anterior hypopituitarism when he presented with ketotic hypoglycemia, microgenitalia, and short stature. Endocrine evaluation showed a low T4 and TSH levels, suggesting hypothalamic hypothyroidism; this was confirmed by TRH stimulation. Metyrapone test confirmed ACTH deficiency as a contributing factor to the ketotic hypoglycemia. A superagonist GnRH test suggested hypothalamic GnRH deficiency. Growth hormone provocative testing conclusively demonstrated complete growth hormone deficiency. MRI investigation of the brain suggested hypopituitarism. Although facial findings were not completely classical of the HSS, we suggest these may be somewhat altered due to his racial back-ground. We recommend endocrine evaluation of HSS patients with manifestations suggesting hypopituitarism since treatment of this condition will improve the quality of life of these patients.

  11. Impact of cold climates on vehicle emissions: the cold start air toxics pulse : final report.

    DOT National Transportation Integrated Search

    2016-09-21

    This project measured cold start emissions from four vehicles in winter using fast response instrumentation to accurately measure the : time variation of the cold start emission pulse. Seventeen successful tests were conducted over a temperature rang...

  12. The effect of ethnicity on the vascular responses to cold exposure of the extremities.

    PubMed

    Maley, Matthew J; Eglin, Clare M; House, James R; Tipton, Michael J

    2014-11-01

    Cold injuries are more prevalent in individuals of African descent (AFD). Therefore, we investigated the effect of extremity cooling on skin blood flow (SkBF) and temperature (T sk) between ethnic groups. Thirty males [10 Caucasian (CAU), 10 Asian (ASN), 10 AFD] undertook three tests in 30 °C air whilst digit T sk and SkBF were measured: (i) vasomotor threshold (VT) test--arm immersed in 35 °C water progressively cooled to 10 °C and rewarmed to 35 °C to identify vasoconstriction and vasodilatation; (ii) cold-induced vasodilatation (CIVD) test--hand immersed in 8 °C water for 30 min followed by spontaneous warming; (iii) cold sensitivity (CS) test--foot immersed in 15 °C water for 2 min followed by spontaneous warming. Cold sensory thresholds of the forearm and finger were also assessed. In the VT test, vasoconstriction and vasodilatation occurred at a warmer finger T sk in AFD during cooling [21.2 (4.4) vs. 17.0 (3.1) °C, P = 0.034] and warming [22.0 (7.9) vs. 12.1 (4.1) °C, P = 0.002] compared with CAU. In the CIVD test, average SkBF during immersion was greater in CAU [42 (24) %] than ASN [25 (8) %, P = 0.036] and AFD [24 (13) %, P = 0.023]. Following immersion, SkBF was higher and rewarming faster in CAU [3.2 (0.4) °C min(-1)] compared with AFD [2.5 (0.7) °C min(-1), P = 0.037], but neither group differed from ASN [3.0 (0.6) °C min(-1)]. Responses to the CS test and cold sensory thresholds were similar between groups. AFD experienced a more intense protracted finger vasoconstriction than CAU during hand immersion, whilst ASN experienced an intermediate response. This greater sensitivity to cold may explain why AFD are more susceptible to cold injuries.

  13. Gas-Centered Swirl Coaxial Liquid Injector Evaluations

    NASA Technical Reports Server (NTRS)

    Cohn, A. K.; Strakey, P. A.; Talley, D. G.

    2005-01-01

    Development of Liquid Rocket Engines is expensive. Extensive testing at large scales usually required. In order to verify engine lifetime, large number of tests required. Limited Resources available for development. Sub-scale cold-flow and hot-fire testing is extremely cost effective. Could be a necessary (but not sufficient) condition for long engine lifetime. Reduces overall costs and risk of large scale testing. Goal: Determine knowledge that can be gained from sub-scale cold-flow and hot-fire evaluations of LRE injectors. Determine relationships between cold-flow and hot-fire data.

  14. Pelvic girdle pain--associations between risk factors in early pregnancy and disability or pain intensity in late pregnancy: a prospective cohort study.

    PubMed

    Robinson, Hilde Stendal; Veierød, Marit B; Mengshoel, Anne Marit; Vøllestad, Nina K

    2010-05-13

    Recent studies have shown high prevalence rates for pelvic girdle pain (PGP) in pregnancy. Some risk factors for developing PGP have been suggested, but the evidence is weak. Furthermore there is almost no data on how findings from clinical examinations are related to subsequent PGP. The main purpose for this study was to study the associations between socio-demographical, psychological and clinical factors measured at inclusion in early pregnancy and disability or pain intensity in gestation week 30. This is a prospective cohort study following women from early to late pregnancy. Eligible women were recruited at their first attendance at the maternity care unit. 268 pregnant women answered questionnaires and underwent clinical examinations in early pregnancy and in gestation week 30. We used scores on disability and pain intensity in gestation week 30 as outcome measures to capture the affliction level of PGP. Multiple linear regression analysis was used to study the associations between potential risk factors measured in early pregnancy and disability or pain intensity in gestation week 30. Self-reported pain locations in the pelvis, positive posterior pelvic pain provocation (P4) test and a sum of pain provocation tests in early pregnancy were significantly associated with disability and pain intensity in gestation week 30 in a multivariable statistic model. In addition, distress was significantly associated with disability. The functional active straight leg raise (ASLR) test, fear avoidance beliefs and the number of pain sites were not significantly associated with either disability or pain intensity. The results suggest that a clinical examination, including a few tests, performed in early pregnancy may identify women at risk of a more severe PGP late in pregnancy. The identification of clinical risk factors may provide a foundation for development of targeted prevention strategies.

  15. Allergy to chironomid larvae (red migde larvae) in non professional handlers of fish food.

    PubMed

    Cabrerizo Ballesteros, S; de Barrio, M; Baeza, M L; Rubio Sotés, M

    2006-01-01

    Chironomids are insects which inhabit wetlands. In countries such as Sudan, The United States. Egypt and Japan they are the cause of serious environmental allergy. In Europe, and particularly in Spain, allergy to Chironomids is infrequent and has only been described in patients who handle Chironomid larvae which form part of certain fish foods. We report a case of hypersensitivity to the Chironomid Midge (Chironomus thummi thummi) in a 23-year-old patient who on two occasions, after being in contact with fishfood, suffered rash, rhinoconjunctivitis, dyspnea and dysphagia. A Prick test was carried out with the habitual pneumoallergens, Chironomid Midge extract (PBS: 1.3 mg/ml), Common Mosquito (Culex pipiens), Squid, Mussel, Prawn and Anisakis. Conjunctival provocation was also carried out with Chironomid Midge extract; detection of specific IgE for Chironomid Midge, Common Mosquito (Aedes comunis), Mussel, Squid, Shrimp, Anisakis, house dust and house mites by means of the CAP technique; detection of IgE by means of ELISA in response to Chironomid Midge, Aedes mosquito, Squid, Prawn, Mussel and Anisakis; ELISA-inhibition and Immunoblott-inhibition. The positive results of the cutaneous tests, the detection of specific IgE and conjunctival provocation confirmed the existence of an IgE-mediated mechanism. In our patient, the in vitro techniques demonstrated cross reactivity with the Common Mosquito. We report on a patient with a case history of rhinoconjunctivitis, rash, dyspnea, and dysphagia after handling fish food. The etiological agent was the Chironomid larvae. The sensitization of our patient has been demonstrated by means of in vivo and in vitro techniques.

  16. Exercise-induced airway obstruction in young asthmatics measured by impulse oscillometry.

    PubMed

    Lee, J H; Lee, Y W; Shin, Y S; Jung, Y H; Hong, C S; Park, J W

    2010-01-01

    Impulse oscillometry (IOS) is a good method for measuring airway resistance. It does not require special breathing skills and it can reflect different aspects of airway obstruction to those revealed by spirometry, which is an effort-dependent maneuver. To evaluate the characteristics of airway obstruction in young asthmatics after an exercise bronchial provocation test (EBPT) using IOS. Forty-seven young adults were enrolled in the study. All the participants underwent a methacholine bronchial provocation test (MBPT) and an EBPT for the evaluation of their asthma. IOS and spirometric parameters were collected at baseline and at 0, 5, 10, 20, and 30 minutes post-EBPT.The participants were divided into 2 groups according to MBPT positivity: an airway hyperresponsiveness (AHR) group and a no-AHR group. There were differences in the percent decrease in forced expiratory volume in the first second (FEV1) between the 2 groups at 5, 10, and 20 minutes after exercise. Resistance at 5 Hz (R5) increased in the AHR group but not in the no-AHR group at 5 and 10 minutes after exercise. Integration of reactance from 5 Hz to resonance frequency (area of reactance, AX) was also increased in the AHR group at only 5 and 10 minutes post-EBPT. Delta R5 and delta AX at 5 and 10 minutes post-exercise were well correlated with the percent decrease in FEV1. IOS parameters, especially delta R5 and delta AX, may be useful for performing objective evaluations and improving our understanding of exercise-induced airway obstruction in young asthmatics.

  17. Provocative discography screening improves surgical outcome.

    PubMed

    Margetic, Petra; Pavic, Roman; Stancic, Marin F

    2013-10-01

    The objective of this study was to compare the surgical outcomes of patients operated on, with or without discography prior to operation. The study was designed as a randomized controlled trial, using power analysis with McNemar's test on two correlated proportions. The study comprised of 310 patients divided into trial (207) and control (103) groups. Inclusion criteria were low back pain resistant to nonsurgical treatment for more than 6 months and conventional radiological findings showing degenerative changes without a clear generator of pain. Exclusion criteria were red flags (tumor, trauma, and infection). After standard radiological diagnostic imaging (X-ray, CT, and MR), patients filled in the Oswestry Disability Index (ODI), SF-36, Zung, and MSP questionnaires. Depending on their radiological findings, patients were included and randomly placed in the trial or control group. At the 1-year follow-up examination, patients filled in the ODI, SF-36, and Likert scale questionnaires. The difference between preoperative and postoperative ODI in the control group degenerative disc disease (DDD) subgroup was 22.07 %. The difference between preoperative and postoperative ODI in the trial group DDD subgroup was 35.04 %. Differences between preoperative and postoperative ODI in the control group other indications subgroup was 26.13 %. Differences between preoperative and postoperative ODI in the trial group other indications subgroup was 28.42 %. DDD treated surgically without discography did not reach the clinically significant improvement of 15 ODI points for the patients treated with fusion. Provocative discography screening with psychological testing in the trial group made improvement following fusion clinically significant.

  18. Cold adaptation, aging, and Korean women divers haenyeo.

    PubMed

    Lee, Joo-Young; Park, Joonhee; Kim, Siyeon

    2017-08-08

    We have been studying the thermoregulatory responses of Korean breath-hold women divers, called haenyeo, in terms of aging and cold adaptation. During the 1960s to the 1980s, haenyeos received attention from environmental physiologists due to their unique ability to endure cold water while wearing only a thin cotton bathing suit. However, their overall cold-adaptive traits have disappeared since they began to wear wetsuits and research has waned since the 1980s. For social and economic reasons, the number of haenyeos rapidly decreased to 4005 in 2015 from 14,143 in 1970 and the average age of haenyeos is about 75 years old at present. For the past several years, we revisited and explored older haenyeos in terms of environmental physiology, beginning with questionnaire and field studies and later advancing to thermal tolerance tests in conjunction with cutaneous thermal threshold tests in a climate chamber. As control group counterparts, older non-diving females and young non-diving females were compared with older haenyeos in the controlled experiments. Our findings were that older haenyeos still retain local cold tolerance on the extremities despite their aging. Finger cold tests supported more superior local cold tolerance for older haenyeos than for older non-diving females. However, thermal perception in cold reflected aging effects rather than local cold acclimatization. An interesting finding was the possibility of positive cross-adaptation which might be supported by greater heat tolerance and cutaneous warm perception thresholds of older haenyeos who adapted to cold water. It was known that cold-adaptive traits of haenyeos disappeared, but we confirmed that cold-adaptive traits are still retained on the face and hands which could be interpreted by a mode switch to local adaptation from the overall adaptation to cold. Further studies on cross-adaptation between chronic cold stress and heat tolerance are needed.

  19. 40 CFR 86.208-94 - Dynamometer.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Passenger Vehicles; Cold Temperature Test Procedures § 86.208-94 Dynamometer. (a) For testing that is... the manufacturer, a dynamometer with different characteristics may be used provided cold CO emissions...

  20. 40 CFR 86.208-94 - Dynamometer.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Passenger Vehicles; Cold Temperature Test Procedures § 86.208-94 Dynamometer. (a) For testing that is... the manufacturer, a dynamometer with different characteristics may be used provided cold CO emissions...

  1. 40 CFR 86.208-94 - Dynamometer.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Passenger Vehicles; Cold Temperature Test Procedures § 86.208-94 Dynamometer. (a) For testing that is... the manufacturer, a dynamometer with different characteristics may be used provided cold CO emissions...

  2. LADEE Propulsion System Cold Flow Test

    NASA Technical Reports Server (NTRS)

    Williams, Jonathan Hunter; Chapman, Jack M.; Trinh, Hau, P.; Bell, James H.

    2013-01-01

    Lunar Atmosphere and Dust Environment Explorer (LADEE) is a NASA mission that will orbit the Moon. Its main objective is to characterize the atmosphere and lunar dust environment. The spacecraft development is being led by NASA Ames Research Center and scheduled for launch in 2013. The LADEE spacecraft will be operated with a bi-propellant hypergolic propulsion system using MMH and NTO as the fuel and oxidizer, respectively. The propulsion system utilizes flight-proven hardware on major components. The propulsion layout is composed of one 100-lbf main thruster and four 5-lbf RCS thrusters. The propellants are stored in four tanks (two parallel-connected tanks per propellant component). The propellants will be pressurized by regulated helium. A simulated propulsion system has been built for conducting cold flow test series to characterize the transient fluid flow of the propulsion system feed lines and to verify the critical operation modes, such as system priming, waterhammer, and crucial mission duty cycles. Propellant drainage differential between propellant tanks will also be assessed. Since the oxidizer feed line system has a higher flow demand than the fuel system does, the cold flow test focuses on the oxidizer system. The objective of the cold flow test is to simulate the LADEE propulsion fluid flow operation through water cold flow test and to obtain data for anchoring analytical models. The models will be used to predict the transient and steady state flow behaviors in the actual flight operations. The test activities, including the simulated propulsion test article, cold flow test, and analytical modeling, are being performed at NASA Marshall Space Flight Center. At the time of the abstract submission, the test article checkout is being performed. The test series will be completed by November, 2012

  3. Comparison of the efficacy of a custom-made pulse oximeter probe with digital electric pulp tester, cold spray, and rubber cup for assessing pulp vitality.

    PubMed

    Dastmalchi, Nafiseh; Jafarzadeh, Hamid; Moradi, Saeed

    2012-09-01

    The ideal technique for the evaluation of pulp vitality should be noninvasive, painless, objective, reliable, and reproducible. To achieve this, the most routine tests are sensitivity tests. However, a major shortcoming with these tests is that they indirectly indicate pulp vitality by measuring a neural response. Pulse oximetry is a well-established oxygen saturation monitoring technique broadly used in medicine. However, its efficacy as the pulp vitality test should be evaluated. The aim of this study was to design and build a custom-made pulse oximeter dental probe and to evaluate its efficacy in comparison with electric pulp tester, cold spray, and a rubber cup in pulp vitality testing. Twenty-four single-canal mandibular premolars needing endodontic treatment were selected. The patients did not have systemic disease and did not consume drugs. Also, they had no clinically relevant signs of necrosis. The selected teeth were pulpally tested with 4 kinds of tests including pulse oximetry, the electric test, cold spray, and the rubber cup. After endodontic treatment of these teeth, which revealed the actual status of the pulp, the results were analyzed by the kappa test to show the efficacy of these tests. When comparing electric, cold, heat, and pulse oximeter tests with the gold standard, the kappa agreement coefficient was 18%, 18%, 14%, and 91%, respectively. The sensitivity of pulse oximetry, a rubber cup, electric test, and cold spray was 0.93, 0.60, 0.60, and 0.53, respectively. The specificity of these tests was 1.00, 0.55, 0.22, and 0.66, respectively. Pulp testing by using pulse oximetry is more reliable than the electric test, rubber cup, and cold spray. The custom-made pulse oximeter dental probe is an effective and objective method for pulp vitality assessment. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  4. Insulation Test Cryostat with Lift Mechanism

    NASA Technical Reports Server (NTRS)

    Dokos, Adam G. (Inventor); Fesmire, James E. (Inventor)

    2014-01-01

    A multi-purpose, cylindrical thermal insulation test apparatus is used for testing insulation materials and systems of materials using a liquid boil-off calorimeter system for absolute measurement of the effective thermal conductivity (k-value) and heat flux of a specimen material at a fixed environmental condition (cold-side temperature, warm-side temperature, vacuum pressure level, and residual gas composition). The apparatus includes an inner vessel for receiving a liquid with a normal boiling point below ambient temperature, such as liquid nitrogen, enclosed within a vacuum chamber. A cold mass assembly, including the upper and lower guard chambers and a middle test vessel, is suspended from a lid of the vacuum canister. Each of the three chambers is filled and vented through a single feedthrough. All fluid and instrumentation feedthroughs are mounted and suspended from a top domed lid to allow easy removal of the cold mass. A lift mechanism allows manipulation of the cold mass assembly and insulation test article.

  5. Insulation Test Cryostat with Lift Mechanism

    NASA Technical Reports Server (NTRS)

    Fesmire, James E. (Inventor); Dokos, Adam G. (Inventor)

    2016-01-01

    A multi-purpose, cylindrical thermal insulation test apparatus is used for testing insulation materials and systems of materials using a liquid boil-off calorimeter system for absolute measurement of the effective thermal conductivity (k-value) and heat flux of a specimen material at a fixed environmental condition (cold-side temperature, warm-side temperature, vacuum pressure level, and residual gas composition). An inner vessel receives liquid with a normal boiling point below ambient temperature, such as liquid nitrogen, enclosed within a vacuum chamber. A cold mass assembly, including upper and lower guard chambers and middle test vessel, is suspended from a lid of the vacuum canister. Each of the three chambers is filled and vented through a single feedthrough. All fluid and instrumentation feedthroughs are mounted and suspended from a top domed lid allowing easy removal of the cold mass. A lift mechanism allows manipulation of the cold mass assembly and insulation test article.

  6. Do mitochondrial properties explain intraspecific variation in thermal tolerance?

    PubMed

    Fangue, Nann A; Richards, Jeffrey G; Schulte, Patricia M

    2009-02-01

    As global temperatures rise, there is a growing need to understand the physiological mechanisms that determine an organism's thermal niche. Here, we test the hypothesis that increases in mitochondrial capacity with cold acclimation and adaptation are associated with decreases in thermal tolerance using two subspecies of killifish (Fundulus heteroclitus) that differ in thermal niche. We assessed whole-organism metabolic rate, mitochondrial amount and mitochondrial function in killifish acclimated to several temperatures. Mitochondrial enzyme activities and mRNA levels were greater in fish from the northern subspecies, particularly in cold-acclimated fish, suggesting that the putatively cold-adapted northern subspecies has a greater capacity for increases in mitochondrial amount in response to cold acclimation. When tested at the fish's acclimation temperature, maximum ADP-stimulated (State III) rates of mitochondrial oxygen consumption in vitro were greater in cold-acclimated northern fish than in southern fish but did not differ between subspecies at higher acclimation temperatures. Whole-organism metabolic rate was greater in fish of the northern subspecies at all acclimation temperatures. Cold acclimation also changed the response of mitochondrial respiration to acute temperature challenge. Mitochondrial oxygen consumption was greater in cold-acclimated northern fish than in southern fish at low test temperatures, but the opposite was true at high test temperatures. These differences were reflected in whole-organism oxygen consumption. Our data indicate that the plasticity of mitochondrial function and amount differs between killifish subspecies, with the less high-temperature tolerant, and putatively cold adapted, northern subspecies having greater ability to increase mitochondrial capacity in the cold. However, there were few differences in mitochondrial properties between subspecies at warm acclimation temperatures, despite differences in both whole-organism oxygen consumption and thermal tolerance at these temperatures.

  7. Effects of Controlled Cooling-Induced Ferrite-Pearlite Microstructure on the Cold Forgeability of XC45 Steel

    NASA Astrophysics Data System (ADS)

    Hu, Chengliang; Chen, Lunqiang; Zhao, Zhen; Gong, Aijun; Shi, Weibing

    2018-05-01

    The combination of hot/warm and cold forging with an intermediate controlled cooling process is a promising approach to saving costs in the manufacture of automobile parts. In this work, the effects of the ferrite-pearlite microstructure, which formed after controlled cooling, on the cold forgeability of a medium-carbon steel were investigated. Different specimens for both normal and notched tensile tests were directly heated to high temperature and then cooled down at different cooling rates, producing different ferrite volume fractions, ranging from 6.69 to 40.53%, in the ferrite-pearlite microstructure. The yield strength, ultimate tensile strength, elongation rate, percentage reduction of area, and fracture strain were measured by tensile testing. The yield strength, indicating deformation resistance, and fracture strain, indicating formability, were used to evaluate the cold forgeability. As the ferrite volume fraction increased, the cold forgeability of the dual-phase ferritic-pearlitic steel improved. A quantitatively relationship between the ferrite volume fraction and the evaluation indexes of cold forgeability for XC45 steel was obtained from the test data. To validate the mathematical relationship, different tensile specimens machined from real hot-forged workpieces were tested. There was good agreement between the predicted and measured values. Our predictions from the relationship for cold forgeability had an absolute error less than 5%, which is acceptable for industrial applications and will help to guide the design of combined forging processes.

  8. Cold adaptation shapes the robustness of metabolic networks in Drosophila melanogaster

    PubMed Central

    Williams, CM; Watanabe, M; Guarracino, MR; Ferraro, MB; Edison, AS; Morgan, TJ; Boroujerdi, AFB; Hahn, DA

    2015-01-01

    When ectotherms are exposed to low temperatures, they enter a cold-induced coma (chill coma) that prevents resource acquisition, mating, oviposition, and escape from predation. There is substantial variation in time taken to recover from chill coma both within and among species, and this variation is correlated with habitat temperatures such that insects from cold environments recover more quickly. This suggests an adaptive response, but the mechanisms underlying variation in recovery times are unknown, making it difficult to decisively test adaptive hypotheses. We use replicated lines of Drosophila melanogaster selected in the laboratory for fast (hardy) or slow (susceptible) chill-coma recovery times to investigate modifications to metabolic profiles associated with cold adaptation. We measured metabolite concentrations of flies before, during, and after cold exposure using NMR spectroscopy to test the hypotheses that hardy flies maintain metabolic homeostasis better during cold exposure and recovery, and that their metabolic networks are more robust to cold-induced perturbations. The metabolites of cold-hardy flies were less cold responsive and their metabolic networks during cold exposure were more robust, supporting our hypotheses. Metabolites involved in membrane lipid synthesis, tryptophan metabolism, oxidative stress, energy balance, and proline metabolism were altered by selection on cold tolerance. We discuss the potential significance of these alterations. PMID:25308124

  9. 40 CFR 86.1413 - Fuel specifications.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Trucks; Certification Short Test Procedures § 86.1413 Fuel specifications. (a) The test fuel to be used... section. (b) CST test fuels by option. (1) Test Option 1: Use Cold CO fuel as specified in the table in § 86.213-94. (2) Test Option 2: Use Cold CO fuel, as specified in the table in § 86.213-94; optionally...

  10. 40 CFR 86.1413 - Fuel specifications.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Trucks; Certification Short Test Procedures § 86.1413 Fuel specifications. (a) The test fuel to be used... section. (b) CST test fuels by option. (1) Test Option 1: Use Cold CO fuel as specified in the table in § 86.213-94. (2) Test Option 2: Use Cold CO fuel, as specified in the table in § 86.213-94; optionally...

  11. 40 CFR 86.1413 - Fuel specifications.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Trucks; Certification Short Test Procedures § 86.1413 Fuel specifications. (a) The test fuel to be used... section. (b) CST test fuels by option. (1) Test Option 1: Use Cold CO fuel as specified in the table in § 86.213-94. (2) Test Option 2: Use Cold CO fuel, as specified in the table in § 86.213-94; optionally...

  12. 40 CFR 86.1413 - Fuel specifications.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Trucks; Certification Short Test Procedures § 86.1413 Fuel specifications. (a) The test fuel to be used... section. (b) CST test fuels by option. (1) Test Option 1: Use Cold CO fuel as specified in the table in § 86.213-94. (2) Test Option 2: Use Cold CO fuel, as specified in the table in § 86.213-94; optionally...

  13. 2. COLD FLOW LABORATORY, VIEW TOWARDS NORTH. Glenn L. ...

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

    2. COLD FLOW LABORATORY, VIEW TOWARDS NORTH. - Glenn L. Martin Company, Titan Missile Test Facilities, Cold Flow Laboratory Building B, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

  14. 1. COLD FLOW LABORATORY, VIEW TOWARDS EAST. Glenn L. ...

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

    1. COLD FLOW LABORATORY, VIEW TOWARDS EAST. - Glenn L. Martin Company, Titan Missile Test Facilities, Cold Flow Laboratory Building B, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

  15. Head movements in low and high gravitoinertial force environments elicit motion sickness - Implications for space motion sickness

    NASA Technical Reports Server (NTRS)

    Lackner, James R.; Graybiel, Ashton

    1987-01-01

    Astronauts report that head movements in flight tend to bring on symptoms of space motion sickness (SMS). The effects of head movements in pitch, yaw, and roll (made both with normal vision and with eyes occluded) on susceptibility to motion sickness in the zero G phase of parabolic flight maneuvers were evaluated. The findings are clear-cut: pitch head movements are most provocative, yaw least provocative, and roll intermediate. These experiments suggest that SMS is not a unique nosological entity, but is the consequence of exposure to nonterrestrial force levels. Head movements during departures in either direction from 1 G elicit symptoms.

  16. 8-OH-DPAT does not interfere with habituation to motion-induced emesis in cats

    NASA Technical Reports Server (NTRS)

    Lucot, James B.; Crampton, George H.

    1991-01-01

    Experiments were performed to determine if suppression of motion-induced emesis (motion sickness) by 8-OH-DPAT altered the development or retention of habituation to the motion stimulus. Cats received 8-OH-DPAT followed by provocative motion on three consecutive treatment days. A drug-free test on the fourth day resulted in an incidence of emesis that was not different from that obtained on the fourth consecutive day of drug-free motion testing. Three consecutive days of treatment with 8-OH-DPAT without motion had no effect on the incidence of motion sickness on the fourth day. It was concluded that suppression of motion sickness by 8-OH-DPAT does not alter the acquisition or retention of habituation.

  17. Reactor Simulator Testing Overview

    NASA Technical Reports Server (NTRS)

    Schoenfeld, Michael P.

    2013-01-01

    OBJECTIVE: Integrated testing of the TDU components TESTING SUMMARY: a) Verify the operation of the core simulator, the instrumentation and control system, and the ground support gas and vacuum test equipment. b) Thermal test heat regeneration design aspect of a cold trap purification filter. c) Pump performance test at pump voltages up to 150 V (targeted mass flow rate of 1.75 kg/s was not obtained in the RxSim at the originally constrained voltage of 120 V). TESTING HIGHLIGHTS: a) Gas and vacuum ground support test equipment performed effectively for NaK fill, loop pressurization, and NaK drain operations. b) Instrumentation and control system effectively controlled loop temperature and flow rates or pump voltage to targeted settings. c) Cold trap design was able to obtain the targeted cold temperature of 480 K. An outlet temperature of 636 K was obtained which was lower than the predicted 750 K but 156 K higher than the cold temperature indicating the design provided some heat regeneration. d) ALIP produce a maximum flow rate of 1.53 kg/s at 800 K when operated at 150 V and 53 Hz.

  18. 40 CFR 1066.701 - Applicability and general provisions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... POLLUTION CONTROLS VEHICLE-TESTING PROCEDURES Cold Temperature Test Procedures § 1066.701 Applicability and...) temperature range. (b) Do not apply the humidity correction factor in § 1066.615(a) for cold temperature...

  19. Design and cold test of S-BAND cavity BPM for HLS

    NASA Astrophysics Data System (ADS)

    Luo, Qing; Sun, BaoGen; Jia, QiKa; He, DuoHui; Fang, Jia

    2011-12-01

    An S-band cavity BPM is designed for a new injector in National Synchrotron Radiation Laboratory. A re-entrant position cavity is tuned to the TM110 mode as position cavity. Cut-through waveguides are used as pickups to suppress the monopole signal. Theoretical resolution of this design is 31 nm. A prototype cavity BPM system is manufactured for off-line cold tests. The wire scanning method is used to calibrate the BPM and estimate the performance of the on-line BPM system. A cross-talk problem has been detected during the cold test. Racetrack cavity BPM design can be used to suppress the cross-talk. With the nonlinear effect being ignored, transform matrix can be used to correct cross-talk. Analysis of cold test results shows that the position resolution of prototype BPM is better than 3 μm.

  20. Evaluation of pediatric upper extremity peripheral nerve injuries.

    PubMed

    Ho, Emily S

    2015-01-01

    The evaluation of motor and sensory function of the upper extremity after a peripheral nerve injury is critical to diagnose the location and extent of nerve injury as well as document functional recovery in children. The purpose of this paper is to describe an approach to the evaluation of the pediatric upper extremity peripheral nerve injuries through a critical review of currently used tests of sensory and motor function. Outcome studies on pediatric upper extremity peripheral nerve injuries in the Medline database were reviewed. The evaluation of the outcome in children less than 10 years of age with an upper extremity peripheral nerve injury includes careful observation of preferred prehension patterns, examination of muscle atrophy and sudomotor function, provocative tests, manual muscle testing and tests of sensory threshold and tactile gnosis. The evaluation of outcome in children with upper extremity peripheral nerve injuries warrants a unique approach. Copyright © 2015 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  1. [Food hypersensitivity dermatitis in the dog: diagnostic possibilities].

    PubMed

    Wilhelm, S; Favrot, C

    2005-04-01

    Dogs with food hypersensitivity usually develop chronic pruritic dermatoses virtually indistinguishable from atopic dermatitis. These reactions are often called food allergy but the pathogenesis is poorly characterized. Several studies have addressed the incidence of canine adverse reactions to food but the outcomes were conflicting. The gold standard for the diagnosis of such a condition is the restricted dietary trial and the subsequent provocation challenge. Some attempts have been made to develop serological tests but none of these tests accurately predicted canine food sensitivity. The aim of the present study was to determine the incidence of food hypersensitivity dermatitis and to evaluate a newly developed serological test for the diagnosis of food allergy in dogs. Only 9% of 55 dogs with dermatological signs compatible with food hypersensitivity or atopic dermatitis have been diagnosed as food hypersensitive dogs. The repeatability of the serological test has shown to be insufficient.

  2. Minimal pneumothorax with dynamic changes in ST segment similar to myocardial infarction.

    PubMed

    Yeom, Seok-Ran; Park, Sung-Wook; Kim, Young-Dae; Ahn, Byung-Jae; Ahn, Jin-Hee; Wang, Il-Jae

    2017-08-01

    Pneumothorax can cause a variety of electrocardiographic changes. ST segment elevation, which is mainly observed in myocardial infarction, can also be induced by pneumothorax. The mechanism is presumed to be a decrease in cardiac output, due to increased intra-thoracic pressure. We encountered a patient with ST segment elevation with minimal pneumothorax. Coronary angiography with ergonovine provocation test and echocardiogram had normal findings. The ST segment elevation was normalized by decreasing the amount of pneumothorax. We reviewed the literature and present possible mechanisms for this condition. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Acute Heart Failure Triggered by Coronary Spasm With Transient Left Ventricular Dysfunction.

    PubMed

    Adachi, Yusuke; Sakakura, Kenichi; Ibe, Tatsuro; Yoshida, Nanae; Wada, Hiroshi; Fujita, Hideo; Momomura, Shin-Ichi

    2017-04-06

    Coronary spasm is abnormal contraction of an epicardial coronary artery resulting in myocardial ischemia. Coronary spasm induces not only depressed myocardial contractility, but also incomplete myocardial relaxation, which leads to elevated ventricular filling pressure. We herein report the case of a 55-year-old woman who had repeated acute heart failure caused by coronary spasm. Acetylcholine provocation test with simultaneous right heart catheterization was useful for the diagnosis of elevated ventricular filling pressure as well as coronary artery spasm. We should add coronary spasm to a differential diagnosis for repeated acute heart failure.

  4. Biorhythms and space experiments with nonhuman primates

    NASA Technical Reports Server (NTRS)

    Winget, C. M.

    1977-01-01

    Man's response to exposure to spaceflight and weightlessness is expressed in physiological adjustments which involve his health and ability to function. The amplitude and periodicity of fluctuations in biological processes affect various functions and responses to provocative stimuli. Primates and other species are subjected to tests to determine the consequences of an altered biorhythm on work and performance, emotional stability, biomedical evaluation in space, the ability to cope with the unexpected, and susceptibility to infection, toxicity, radiation, drugs, and stress. Factors in the environment or operational setup which can change the physiological baseline must be determined and controlled.

  5. Effects of cold temperature and ethanol content on VOC ...

    EPA Pesticide Factsheets

    Emissions of speciated volatile organic compounds (VOCs), including mobile source air toxics (MSATs), were measured in vehicle exhaust from three light-duty spark ignition vehicles operating on summer and winter grade gasoline (E0) and ethanol blended (E10 and E85) fuels. Vehicle testing was conducted using a three-phase LA92 driving cycle in a temperature-controlled chassis dynamometer at two ambient temperatures (-7 °C and 24 °C). The cold start phase and cold ambient temperature increased VOC and MSAT emissions dramatically by up to several orders of magnitude compared to emissions during other phases and warm ambient temperature testing, respectively. As a result, calculated ozone formation potentials during the cold starts were significantly higher during cold temperature tests by 7 to 21 times the warm temperature values. The use of E85 fuel generally led to substantial reductions in hydrocarbons and increases in oxygenates such as ethanol and acetaldehyde compared to E0 and E10 fuels. However, the VOC emissions from E0 and E10 fuels were not significantly different. Cold temperature effects on cold start MSAT emissions varied by individual MSAT compound, but were consistent over a range of modern spark ignition vehicles. This manuscript communicates APPCD research activities on air toxics VOC emissions from mobile sources from the EPAct dynamometer study. Speciated VOC emissions from light-duty vehicles running on gasoline and ethanol blends at cold tem

  6. The effect of a simple annealing heat treatment on the mechanical properties of cold-sprayed aluminum

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

    Hall, Aaron Christopher; Roemer, Timothy John; Hirschfeld, Deidre A.

    2004-11-01

    Cold spray, a new member of the thermal spray process family, can be used to prepare dense, thick metal coatings. It has tremendous potential as a spray-forming process. However, it is well known that significant cold work occurs during the cold spray deposition process. This cold work results in hard coatings but relatively brittle bulk deposits. This work investigates the mechanical properties of cold-sprayed aluminum and the effect of annealing on those properties. Cold spray coatings approximately 1 cm thick were prepared using three different feedstock powders: Valimet H-10; Valimet H-20; and Brodmann Flomaster. ASTM E8 tensile specimens were machinedmore » from these coatings and tested using standard tensile testing procedures. Each material was tested in two conditions: as-sprayed; and after a 300 C, 22 h air anneal. The as-sprayed material showed high ultimate strength and low ductility, with <1% elongation. The annealed samples showed a reduction in ultimate strength but a dramatic increase in ductility, with up to 10% elongation. The annealed samples exhibited mechanical properties that were similar to those of wrought 1100 H14 aluminum. Microstructural examination and fractography clearly showed a change in fracture mechanism between the as-sprayed and annealed materials. These results indicate good potential for cold spray as a bulk-forming process.« less

  7. The effect of a simple annealing heat treatement on the mechanical properties of cold-sprayed aluminium.

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

    Hall, Aaron Christopher; Roemer, Timothy John; Hirschfeld, Deidre A.

    2005-08-01

    Cold spray, a new member of the thermal spray process family, can be used to prepare dense, thick metal coatings. It has tremendous potential as a spray-forming process. However, it is well known that significant cold work occurs during the cold spray deposition process. This cold work results in hard coatings but relatively brittle bulk deposits. This work investigates the mechanical properties of cold-sprayed aluminum and the effect of annealing on those properties. Cold spray coatings approximately 1 cm thick were prepared using three different feedstock powders: Valimet H-10: Valimet H-20: and Brodmann Flomaster. ASTM E8 tensile specimens were machinedmore » from these coatings and tested using standard tensile testing procedures. Each material was tested in two conditions: as-sprayed; and after a 300 C, 22h air anneal. The as-sprayed material showed high ultimate strength and low ductility, with <1% elongation. The annealed samples showed a reduction in ultimate strength but a dramatic increase in ductility, with up to 10% elongation. The annealed samples exhibited mechanical properties that were similar to those of wrought 1100 H14 aluminum. Microstructural examination and fractography clearly showed a change in fracture mechanism between the as-sprayed and annealed materials. These results indicate good potential for cold spray as a bulkforming process.« less

  8. Operational experience with the supercritical helium during the TF coils tests campaign of SST-1

    NASA Astrophysics Data System (ADS)

    Panchal, Rohitkumar Natvarlal; Patel, Rakesh; Tank, Jignesh; Mahesuria, Gaurang; Sonara, Dashrath; Tanna, Vipul; Patel, Jayant; Srikanth, G. L. N.; Singh, Manoj; Patel, Ketan; Christian, Dikens; Garg, Atul; Bairagi, Nitn; Gupta, Manoj Kumar; Nimavat, Hiren; Shah, Pankil; Sharma, Rajiv; Pradhan, Subrata

    2012-06-01

    Under the 'SST-1 mission mandate' recently, all the sixteen Steady State Superconducting Tokamak (SST-1) Toroidal Field (TF) magnets have been successfully tested at their nominal currents of 10000 A in cold under supercritical helium (SHe) flow conditions. The TF magnets test campaign have begun in an experimental cryostat since June 2010 with the SST-1 Helium cryogenics facility, which is a 1.3 kW at 4.5 K helium refrigerator-cum-liquefier (HRL) system. The HRL provides ~300 g-s-1supercritical helium (SHe) with cold circulator (CC) as well as ~ 60 g-s-1 without cold circulator to fulfill the forced flow cooling requirements of SST- 1 magnets. In case of single TF coil tests, we can adjust HRL process parameters such that an adequate amount of required supercritical helium is available without the cold circulator. In this paper, the complete process is describing the Process Flow Diagram (PFD) of 1.3 kW at 4.5 K HRL, techniques to generate supercritical helium without using the cold-circulator and the results of the cooldown, steady state characteristics and experience of supercritical helium operations during the TF coils test campaign have been discussed.

  9. 2014 Radiological Monitoring Results Associated with the Advanced Test Reactor Complex Cold Waste Pond

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

    Lewis, Mike

    2015-02-01

    This report summarizes radiological monitoring performed of the Idaho National Laboratory Site’s Advanced Test Reactor Complex Cold Waste wastewater prior to discharge into the Cold Waste Pond and of specific groundwater monitoring wells associated with the Industrial Wastewater Reuse Permit (#LA-000161-01, Modification B). All radiological monitoring is performed to fulfill Department of Energy requirements under the Atomic Energy Act.

  10. 21-cm lensing and the cold spot in the cosmic microwave background.

    PubMed

    Kovetz, Ely D; Kamionkowski, Marc

    2013-04-26

    An extremely large void and a cosmic texture are two possible explanations for the cold spot seen in the cosmic microwave background. We investigate how well these two hypotheses can be tested with weak lensing of 21-cm fluctuations from the epoch of reionization measured with the Square Kilometer Array. While the void explanation for the cold spot can be tested with Square Kilometer Array, given enough observation time, the texture scenario requires significantly prolonged observations, at the highest frequencies that correspond to the epoch of reionization, over the field of view containing the cold spot.

  11. Study of plate-fin heat exchanger and cold plate for the active thermal control system of Space Station

    NASA Technical Reports Server (NTRS)

    Chyu, MING-C.

    1992-01-01

    Plate-fin heat exchangers will be employed in the Active Thermal Control System of Space Station Freedom. During ground testing of prototypic heat exchangers, certain anomalous behaviors have been observed. Diagnosis has been conducted to determine the cause of the observed behaviors, including a scrutiny of temperature, pressure, and flow rate test data, and verification calculations based on such data and more data collected during the ambient and thermal/vacuum tests participated by the author. The test data of a plate-fin cold plate have been also analyzed. Recommendation was made with regard to further tests providing more useful information of the cold plate performance.

  12. Advanced Vehicle Testing Activity Cold Weather On-road Testing of the Chevrolet Volt

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

    Smart, John

    This report details cold weather on-road testing of a Chevrolet Volt. It quantifies changes in efficiency and electric range as ambient temperature changes. It will be published to INL's AVTA website as an INL technical report and will be accessible to the general public.

  13. Cold Shock as a Screen for Genes Involved in Cold Acclimatization in Neurospora crassa

    PubMed Central

    Watters, Michael K.; Manzanilla, Victor; Howell, Holly; Mehreteab, Alexander; Rose, Erik; Walters, Nicole; Seitz, Nicholas; Nava, Jacob; Kekelik, Sienna; Knuth, Laura; Scivinsky, Brianna

    2018-01-01

    When subjected to rapid drops of temperature (cold shock), Neurospora responds with a temporary shift in its morphology. This report is the first to examine this response genetically. We report here the results of a screen of selected mutants from the Neurospora knockout library for alterations in their morphological response to cold shock. Three groups of knockouts were selected to be subject to this screen: genes previously suspected to be involved in hyphal development as well as knockouts resulting in morphological changes; transcription factors; and genes homologous to E. coli genes known to alter their expression in response to cold shock. A total of 344 knockout strains were subjected to cold shock. Of those, 118 strains were identified with altered responses. We report here the cold shock morphologies and GO categorizations of strains subjected to this screen. Of strains with knockouts in genes associated with hyphal growth or morphology, 33 of 131 tested (25%) showed an altered response to cold shock. Of strains with knockouts in transcription factor genes, 30 of 145 (20%) showed an altered response to cold shock. Of strains with knockouts in genes homologous to E. coli genes which display altered levels of transcription in response to cold shock, a total of 55 of 68 tested (81%) showed an altered cold shock response. This suggests that the response to cold shock in these two organisms is largely shared in common. PMID:29563189

  14. Test of cold asphalt storability based on alternative approaches

    NASA Astrophysics Data System (ADS)

    Abaffyová, Zora; Komačka, Jozef

    2017-09-01

    Cold asphalt products for potholes repairs should be workable (soft enough) for long time to ensure their applicability. Storability is assessed indirectly using various tests of workability. Therefore, simple test methods (self-compaction and disintegration test) was developed and verified to investigate changes of storability of this group of cold asphalts. Selfcompaction of the tested mixture in the upturned Abram’s cone for the cement concrete slump test and in the mould for the California Bearing Ratio test was assessed in first stage. After that the video record of disintegration test was taken. During this test, the mould was lifted up and the mixture fell off the mould (Abram’s cone) or disintegrate (CBR mould). The drop of surface after 10 min self-compaction and netto time related to falling out or disintegration of the mixture were used to evaluate the mixture from storability point of view. It was found out the self-compaction test has not a potential to reveal and prove changes of mixture properties. Based on the disintegration test results it can be stated this test at 5 °C using the upturned Abram’s cone could be a suitable approach to determine qualitative changes of a cold mixture from storability point of view.

  15. IgG-based elimination diet in migraine plus irritable bowel syndrome.

    PubMed

    Aydinlar, Elif Ilgaz; Dikmen, Pinar Yalinay; Tiftikci, Arzu; Saruc, Murat; Aksu, Muge; Gunsoy, Hulya G; Tozun, Nurdan

    2013-03-01

    To evaluate therapeutic potential of the immunoglobulin G (IgG)-based elimination diet among migraine patients with irritable bowel syndrome (IBS). Food elimination has been suggested as an effective and inexpensive therapeutic strategy in patients with migraine and concomitant IBS in the past studies. A total of 21 patients (mean [standard deviation] age: 38.0 [11.2] years; 85.7% females) diagnosed with migraine and IBS were included in this double-blind, randomized, controlled, cross-over clinical trial composed of baseline (usual diet), first diet (elimination or provocation diets), and second diet (interchange of elimination or provocations diets) phases and 4 visits. IgG antibody tests against 270 food allergens revealed mean (standard deviation) reaction count to be 23.1 (14.1). Compared with baseline levels, elimination diet per se was associated with significant reductions in attack count (4.8 [2.1] vs 2.7 [2.0]; P < .001), maximum attack duration (2.6 [0.6] vs. 1.4 [1.1] days; P < .001), mean attack duration (1.8 [0.5] vs. 1.1 [0.8] days; P < .01), maximum attack severity (visual analog scale 8.5 [1.4] vs. visual analog scale 6.6 [3.3]; P < .001), and number of attacks with acute medication (4.0 [1.5] vs. 1.9 [1.8]; P < .001). There was a significant reduction in pain-bloating severity (1.8 [1.3] vs. 3.2 [0.8]; P < .05), pain-bloating within the last 10 days (3.2 [2.8] vs. 5.5 [3.1]; P < .05), and improvement obtained in quality of life (3.6 [1.4] vs. 2.9 [1.0]; P < .05) by the elimination diet as compared with provocation diet. Our findings indicate that food elimination based on IgG antibodies in migraine patients who suffer from concomitant IBS may effectively reduce symptoms from both disorders with possible positive impact on the quality of life of the patients as well as potential savings to the health-care system. © 2012 American Headache Society.

  16. Intranasal administration of oxytocin increases human aggressive behavior.

    PubMed

    Ne'eman, R; Perach-Barzilay, N; Fischer-Shofty, M; Atias, A; Shamay-Tsoory, S G

    2016-04-01

    Considering its role in prosocial behaviors, oxytocin (OT) has been suggested to diminish levels of aggression. Nevertheless, recent findings indicate that oxytocin may have a broader influence on increasing the salience of social stimuli and may therefore, under certain circumstances, increase antisocial behaviors such as aggression. This controversy led to the following speculations: If indeed oxytocin promotes primarily prosocial behavior, administration of OT is expected to diminish levels of aggression. However, if oxytocin mainly acts to increase the salience of social stimuli, it is expected to elevate levels of aggression following provocation. In order to test this assumption we used the Social Orientation Paradigm (SOP), a monetary game played against a fictitious partner that allows measuring three types of responses in the context of provocation: an aggressive response - reducing a point from the fictitious partner, an individualistic response - adding a point to oneself, and a collaborative response - adding half a point to the partner and half a point to oneself. In the current double-blind, placebo-controlled, within-subject study design, 45 participants completed the SOP task following the administration of oxytocin or placebo. The results indicated that among subjects naïve to the procedure oxytocin increased aggressive responses in comparison with placebo. These results support the saliency hypothesis of oxytocin and suggest that oxytocin plays a complex role in the modulation of human behavior. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Enzyme potentiated desensitisation in treatment of seasonal allergic rhinitis: double blind randomised controlled study

    PubMed Central

    Radcliffe, Michael J; Lewith, George T; Turner, Richard G; Prescott, Philip; Church, Martin K; Holgate, Stephen T

    2003-01-01

    Objective To assess the efficacy of enzyme potentiated desensitisation in the treatment of severe summer hay fever poorly controlled by pharmacotherapy. Design Double blind randomised placebo controlled parallel group study. Setting Hospital in Hampshire. Participants 183 participants aged between 18 and 64 with a history of severe summer hay fever for at least two years; all were skin prick test positive to timothy grass pollen. 90 randomised to active treatment; 93 randomised to placebo. Interventions Active treatment: two injections of enzyme potentiated desensitisation, given between eight and 11 weeks apart, each comprising 200 Fishman units of β glucuronidase, 50 pg 1,3-cyclohexanediol, 50 ng protamine sulphate, and a mixed inhaled allergen extract (pollen mixes for trees, grasses, and weeds; allergenic fungal spores; cat and dog danders; dust and storage mites) in a total volume of 0.05 ml of buffered saline. Placebo: two injections of 0.05 ml buffered saline solution. Main outcome measures Proportion of problem-free days; global rhinoconjunctivitis quality of life scores assessed weekly during pollen season. Results The active treatment group and the placebo group did not differ in the proportion of problem-free days, quality of life scores, symptom severity scores, change in quantitative skin prick provocation threshold, or change in conjunctival provocation threshold. No clinically significant adverse reactions occurred. Conclusions Enzyme potentiated desensitisation showed no treatment effect in this study. PMID:12896934

  18. Short-term secretory regulation of ghrelin during growth hormone provocative tests in prepubertal children with various growth hormone secretory capacities.

    PubMed

    Matsuoka, Hisafumi; Hosoda, Hiroshi; Sugawara, Hisae; Iwama, Saika; Kim, Hye Sook; Kangawa, Kenji; Sugihara, Shigetaka

    2005-01-01

    Ghrelin is a novel gastric peptide which stimulates GH secretion and has been demonstrated to have orexigenic and adipogenic properties. Insulin is a physiological and dynamic modulator of plasma ghrelin, and insulinemia possibly mediates the effect of the nutritional state on the plasma concentrations of ghrelin in adults. No data on the regulation of GH secretion by ghrelin have so far been reported, nor has the possible influence of hypoglycemia on the plasma ghrelin levels in children been reported. Provocative studies were performed using a variety of stimuli, including insulin-induced hypoglycemia, and glucagon, arginine and L-dopa loading. We studied a group of 27 children with short stature being investigated for GH deficiency (10 F, 17 M; age 4-14 years; height SDS -0.92 to -3.27); the subjects were instructed to fast overnight, and the following morning, the relationships among the plasma ghrelin, GH and glucose levels were investigated by determining the plasma ghrelin profiles during those provocative tests. Using a new method for determining the two types of ghrelin, samples were obtained for determination of the plasma ghrelin, serum glucose and serum GH levels after the administration of the aforementioned stimulating agents. All the four stimuli caused a significant decrease in the circulating C- and N-ghrelin levels with a nadir at +30 min, with the exception of the N-ghrelin level following the L-dopa loading. During the same period, the plasma GH level increased following insulin, arginine and L-dopa loading, and the plasma glucose level increased significantly following glucagon loading. In the arginine and L-dopa load connected, a significant correlation was observed between the 30-min change in the serum GH level and the 30-min change in the plasma C-ghrelin level. In the multiple regression analysis to explain the 30-min change in the plasma level of C-ghrelin, the baseline plasma level of C-ghrelin (basal), height and % overweight were the only three significant parameters, accounting for 85.2% of the variance. This study demonstrated that the inverse relation between the circulating GH and ghrelin levels may indicate the existence of a feedback loop, and also lends support to the assumption of a GH-independent relationship between plasma ghrelin and glucose levels. These observations constitute further evidence to suggest that peripheral ghrelin is a direct growth-promoting hormone. Copyright 2005 S. Karger AG, Basel

  19. Cold Weather Admixture Systems Demonstration at Fort Wainwright, Alaska

    DTIC Science & Technology

    2010-08-01

    3, and 5, the remaining two test sec- tions (Test Sections 2 and 4) were readied for concrete . The interior formwork was removed, and the rebar was...Washington, DC 20314-1000 ERDC/CRREL TR-10-6 ii Abstract: Cold Weather Admixture Systems (CWAS) is a new approach to cold weather concreting that...incorporates suites of commercially avail- able chemical admixtures in concrete mixes. When used in combination, these admixtures depress the freezing

  20. Cold-End Subsystem Testing for the Fission Power System Technology Demonstration Unit

    NASA Technical Reports Server (NTRS)

    Briggs, Mazwell; Gibson, Marc; Ellis, David; Sanzi, James

    2013-01-01

    The Fission Power System (FPS) Technology Demonstration Unit (TDU) consists of a pumped sodiumpotassium (NaK) loop that provides heat to a Stirling Power Conversion Unit (PCU), which converts some of that heat into electricity and rejects the waste heat to a pumped water loop. Each of the TDU subsystems is being tested independently prior to full system testing at the NASA Glenn Research Center. The pumped NaK loop is being tested at NASA Marshall Space Flight Center; the Stirling PCU and electrical controller are being tested by Sunpower Inc.; and the pumped water loop is being tested at Glenn. This paper describes cold-end subsystem setup and testing at Glenn. The TDU cold end has been assembled in Vacuum Facility 6 (VF 6) at Glenn, the same chamber that will be used for TDU testing. Cold-end testing in VF 6 will demonstrate functionality; validated coldend fill, drain, and emergency backup systems; and generated pump performance and system pressure drop data used to validate models. In addition, a low-cost proof-of concept radiator has been built and tested at Glenn, validating the design and demonstrating the feasibility of using low-cost metal radiators as an alternative to highcost composite radiators in an end-to-end TDU test.

  1. Opioid Hypersensitivity: Predictors of Allergy and Role of Drug Provocation Testing.

    PubMed

    Li, Philip H; Ue, Kok Loong; Wagner, Annette; Rutkowski, Ryszard; Rutkowski, Krzysztof

    True IgE-mediated hypersensitivity to opioids is rare and many reactions are due to direct mast cell degranulation. Opioid drug provocation testing (DPT) is the gold standard for diagnosis but is underutilized. The objective of this study was to evaluate the clinical characteristics and predictors of opioid hypersensitivity, as well as outcomes of opioid DPT. Patients referred for opioid DPT over the past 9 years were studied. Patient characteristics, indications for opioid use, symptoms of index reaction, and outcomes of DPT were analyzed. Association analysis was performed to study variables associated with a diagnosis of opioid hypersensitivity. Of the total of 98 patients referred with suspected opioid hypersensitivity, 15 (15%) were diagnosed with opioid allergy. Angioedema (odds ratio [OR]: 5.66; 95% confidence interval [CI]: 1.49-21.47; P = .011) and hypotension (OR: 5.00; 95% CI: 1.15-21.70; P = .032) were significantly more frequent in opioid allergic patients than those with a negative DPT. Patients who received opioids during anesthesia were significantly more likely to be opioid allergic (OR: 6.74; 95% CI: 2.05-22.13; P = .001). In contrast, a negative association was identified with patients who received opioids for analgesia (OR: 0.27; 95% CI: 0.08-0.86; P = .008). Only 15% of our cohort were diagnosed with opioid allergy, emphasizing the importance of DPT in preventing erroneous overdiagnosis. Patients with a history of angioedema or hypotension as their index reaction were significantly more likely to be opioid allergic. DPT are safe when performed by experienced clinicians after risk stratification and using individualized protocols. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  2. Allergy immunotherapy with a hypoallergenic recombinant birch pollen allergen rBet v 1-FV in a randomized controlled trial.

    PubMed

    Klimek, Ludger; Bachert, Claus; Lukat, Karl-Friedrich; Pfaar, Oliver; Meyer, Hanns; Narkus, Annemie

    2015-01-01

    Pollen extracts and chemically modified allergoids are used successfully in allergen immunotherapy (AIT). Recombinant extracts offer potential advantages with respect to pharmaceutical quality, standardization and dosing. A hypoallergenic recombinant folding variant of the major birch pollen allergen (rBet v 1-FV) was compared with an established native birch preparation. A pre-seasonal, randomized, actively controlled phase II study was performed in birch pollen allergic rhino-conjunctivitis with or without asthma, GINA I/ II. 51 patients (24 rBet v 1-FV, 27 native extract) started therapy with subcutaneous allergen immunotherapy (SCIT). Primary end-point was a combined symptom medication score (SMS), changes in nasal provocation test, visual rating score and specific antibody responses secondary end-points. After one pre-seasonal treatment course the combined SMS was 5.86 (median; IQR: 14.02) for the rBet v 1-FV group versus 12.40 (median; IQR: 9.32) for the comparator during the three weeks pollen season (p = 0.330). After treatment in the second year, scores were 3.00 (median; IQR: 6.50) and 2.93 (4.86) respectively. Allergen tolerance in a nasal provocation test improved to a comparable extent in both groups. Significant increases in birch pollen-specific IgG1 and IgG4 were observed in both treatment groups following the first treatment phase and remained significantly raised until the end of the study. In this first in man, proof of concept phase II trial no statistical difference between rBet v 1-FV and an established natural pollen extract could be observed. rBet v 1-FV could be administered in higher doses than the native protein with no increase in adverse effects. The study was registered in clinicalTrials.gov (NCT00266526).

  3. Influence of violent video gaming on determinants of the acquired capability for suicide.

    PubMed

    Teismann, Tobias; Förtsch, Eva-Maria A D; Baumgart, Patrick; Het, Serkan; Michalak, Johannes

    2014-01-30

    The interpersonal theory of suicidal behavior proposes that fearlessness of death and physical pain insensitivity is a necessary requisite for self-inflicted lethal self-harm. Repeated experiences with painful and provocative events are supposed to cause an incremental increase in acquired capability. The present study examined whether playing a first-person shooter-game in contrast to a first-person racing game increases pain tolerance, a dimension of the acquired capability construct, and risk-taking behavior, a risk factor for developing acquired capability. N=81 male participants were randomly assigned to either play an action-shooter or a racing game before engaging in a game on risk-taking behavior and performing a cold pressor task (CPT). Participants exhibited higher pain tolerance after playing an action shooter game than after playing a racing game. Furthermore, playing an action shooter was generally associated with heightened risk-taking behavior. Group-differences were not attributable to the effects of the different types of games on self-reported mood and arousal. Overall these results indicate that action-shooter gaming alters pain tolerance and risk-taking behavior. Therefore, it may well be that long-term consumption of violent video games increases a person's capability to enact lethal self-harm. © 2013 Published by Elsevier Ireland Ltd.

  4. Lessons from history: morbidity of cold injury in the Royal Marines during the Falklands Conflict of 1982

    PubMed Central

    2013-01-01

    Background Environmental conditions in the Falklands Conflict of 1982 favoured the genesis of cold injuries. Immediately, post-war, cold injury morbidity and its contributory factors were assessed, in the personnel of UK 3 Commando Brigade (3 Cdo Bde). Methods A questionnaire survey of the 3,006 members of 3 Cdo Bde who landed on the islands was conducted within 6–10 weeks of the end of hostilities. Questions included those relating to features of cold injury, body morphology, age, symptoms experienced, past medical history and other possible contributory causes. Additionally, the unit medical team conducted a cursory examination. Data were sent to the Royal Navy Institute of Naval Medicine (INM), where the degree of likely cold injury was broadly classified (‘asymptomatic’ ‘mild’, ‘moderate’ or ‘severe’). A sample (total 109) was then selected at random from each category and subsequently examined and tested at the INM (nerve conduction, photoplethysmography and thermography testing). Forty-seven non-cold exposed sailors acted as a control group. These contemporaneous records have now been identified and interrogated. Results Some 2,354 (78%) completed questionnaires were returned, revealing that 1,505 (64%) had experienced symptoms of non-freezing cold injury. The morbidity in the infantry units was significantly greater than that in the support troops (1,051 (76%) vs 454 (46%), p < 0.05). No evidence was found to support an influence of a number of factors, commonly believed to have an aetiological role in the production of cold injury. Whilst there was no significant relationship between past history and cold injury morbidity in the brigade as a whole, or within the infantry units alone, an association was identified in the collective infantry units (73%) and the support/headquarter units (59%) (p < 0.05). In comparison with uninjured sailors who acted as controls (n = 47), nerve conduction was impaired in 35% of those screened some months after returning to the UK, while the photoplethysmography and thermographic responses to a cold sensitivity test showed that most (including those classed by questionnaire as asymptomatic) had residual ‘cold sensitivity’. Conclusions Although the passage of time has made retrospective interrogation of historical documents hard, the available data do appear to offer valuable historical and clinical insights. Cold injury affected the majority of those fighting in the cold temperate climate of the Falklands. The overwhelming environmental conditions meant that, for most, a past history of cold injury did not appear to represent a risk factor for subsequent injury, as is the case for less severe conditions. Importantly, even asymptomatic individuals when tested often showed physiological evidence of cold injury—perhaps predisposing them to subsequent elevation in risk. PMID:24070118

  5. Optimization of the intravenous glucose tolerance test in T2DM patients using optimal experimental design.

    PubMed

    Silber, Hanna E; Nyberg, Joakim; Hooker, Andrew C; Karlsson, Mats O

    2009-06-01

    Intravenous glucose tolerance test (IVGTT) provocations are informative, but complex and laborious, for studying the glucose-insulin system. The objective of this study was to evaluate, through optimal design methodology, the possibilities of more informative and/or less laborious study design of the insulin modified IVGTT in type 2 diabetic patients. A previously developed model for glucose and insulin regulation was implemented in the optimal design software PopED 2.0. The following aspects of the study design of the insulin modified IVGTT were evaluated; (1) glucose dose, (2) insulin infusion, (3) combination of (1) and (2), (4) sampling times, (5) exclusion of labeled glucose. Constraints were incorporated to avoid prolonged hyper- and/or hypoglycemia and a reduced design was used to decrease run times. Design efficiency was calculated as a measure of the improvement with an optimal design compared to the basic design. The results showed that the design of the insulin modified IVGTT could be substantially improved by the use of an optimized design compared to the standard design and that it was possible to use a reduced number of samples. Optimization of sample times gave the largest improvement followed by insulin dose. The results further showed that it was possible to reduce the total sample time with only a minor loss in efficiency. Simulations confirmed the predictions from PopED. The predicted uncertainty of parameter estimates (CV) was low in all tested cases, despite the reduction in the number of samples/subject. The best design had a predicted average CV of parameter estimates of 19.5%. We conclude that improvement can be made to the design of the insulin modified IVGTT and that the most important design factor was the placement of sample times followed by the use of an optimal insulin dose. This paper illustrates how complex provocation experiments can be improved by sequential modeling and optimal design.

  6. Delving into cornerstones of hypersensitivity to antineoplastic and biological agents: value of diagnostic tools prior to desensitization.

    PubMed

    Alvarez-Cuesta, E; Madrigal-Burgaleta, R; Angel-Pereira, D; Ureña-Tavera, A; Zamora-Verduga, M; Lopez-Gonzalez, P; Berges-Gimeno, M P

    2015-07-01

    Evidence regarding drug provocation test (DPT) with antineoplastic and biological agents is scarce. Our aim was to assess the usefulness of including DPT as a paramount gold standard diagnostic tool (prior to desensitization). Prospective, observational, longitudinal study with patients who, during a 3-year period, were referred to the Desensitization Program at Ramon y Cajal University Hospital. Patients underwent a structured diagnostic protocol by means of anamnesis, skin tests (ST), risk assessment, and DPT. Oxaliplatin-specific IgE was determined in oxaliplatin-reactive patients (who underwent DPT regardless of oxaliplatin-specific IgE results). Univariate analysis and multivariate analysis were used to identify predictors of the final diagnosis among several variables. A total of 186 patients were assessed. A total of 104 (56%) patients underwent DPT. Sixty-four percent of all DPTs were negative (i.e., hypersensitivity was excluded). Sensitivity for oxaliplatin-specific IgE (0.35 UI/l cutoff point) was 34%, specificity 90.3%, negative predictive value 45.9%, positive predictive value 85%, negative likelihood ratio 0.7, and positive likelihood ratio 3.5. These are the first reported data based on more than 100 DPTs with antineoplastic and biological agents (paclitaxel, oxaliplatin, rituximab, infliximab, irinotecan, and other drugs). Implementation of DPT in diagnostic protocols helps exclude hypersensitivity (in 36% of all referred patients), and avoids unnecessary desensitizations in nonhypersensitive patients (30-56% of patients, depending on culprit-drug). Drug provocation test is vital to validate diagnostic tools; consequently, quality data are shown on oxaliplatin-specific IgE and oxaliplatin-ST in the largest series of oxaliplatin-reactive patients reported to date (74 oxaliplatin-reactive patients). Identifying phenotypes and predictors of a diagnosis of hypersensitivity may be helpful for tailored plans. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Controlling motion sickness and spatial disorientation and enhancing vestibular rehabilitation with a user-worn see-through display.

    PubMed

    Krueger, Wesley W O

    2011-01-01

    An eyewear mounted visual display ("User-worn see-through display") projecting an artificial horizon aligned with the user's head and body position in space can prevent or lessen motion sickness in susceptible individuals when in a motion provocative environment as well as aid patients undergoing vestibular rehabilitation. In this project, a wearable display device, including software technology and hardware, was developed and a phase I feasibility study and phase II clinical trial for safety and efficacy were performed. Both phase I and phase II were prospective studies funded by the NIH. The phase II study used repeated measures for motion intolerant subjects and a randomized control group (display device/no display device) pre-posttest design for patients in vestibular rehabilitation. Following technology and display device development, 75 patients were evaluated by test and rating scales in the phase II study; 25 subjects with motion intolerance used the technology in the display device in provocative environments and completed subjective rating scales, whereas 50 patients were evaluated before and after vestibular rehabilitation (25 using the display device and 25 in a control group) using established test measures. All patients with motion intolerance rated the technology as helpful for nine symptoms assessed, and 96% rated the display device as simple and easy to use. Duration of symptoms significantly decreased with use of the technology displayed. In patients undergoing vestibular rehabilitation, there were no significant differences in amount of change from pre- to posttherapy on objective balance tests between display device users and controls. However, those using the technology required significantly fewer rehabilitation sessions to achieve those outcomes than the control group. A user-worn see-through display, utilizing a visual fixation target coupled with a stable artificial horizon and aligned with user movement, has demonstrated substantial benefit for individuals susceptible to motion intolerance and spatial disorientation and those undergoing vestibular rehabilitation. The technology developed has applications in any environment where motion sensitivity affects human performance.

  8. Replication of heart rate variability provocation study with 2.4-GHz cordless phone confirms original findings.

    PubMed

    Havas, Magda; Marrongelle, Jeffrey

    2013-06-01

    This is a replication of a study that we previously conducted in Colorado with 25 subjects designed to test the effect of electromagnetic radiation generated by the base station of a cordless phone on heart rate variability (HRV). In this study, we analyzed the response of 69 subjects between the ages of 26 and 80 in both Canada and the USA. Subjects were exposed to radiation for 3-min intervals generated by a 2.4-GHz cordless phone base station (3-8 μW/cm²). A few participants had a severe reaction to the radiation with an increase in heart rate and altered HRV indicative of an alarm response to stress. Based on the HRV analyses of the 69 subjects, 7% were classified as being "moderately to very" sensitive, 29% were "little to moderately" sensitive, 30% were "not to little" sensitive and 6% were "unknown". These results are not psychosomatic and are not due to electromagnetic interference. Twenty-five percent of the subjects' self-proclaimed sensitivity corresponded to that based on the HRV analysis, while 32% overestimated their sensitivity and 42% did not know whether or not they were electrically sensitive. Of the 39 participants who claimed to experience some electrical hypersensitivity, 36% claimed they also reacted to a cordless phone and experienced heart symptoms and, of these, 64% were classified as having some degree of electrohypersensitivity (EHS) based on their HRV response. Novel findings include documentation of a delayed response to radiation. Orthostatic HRV testing combined with provocation testing may provide a diagnostic tool for some sufferers of EHS when they are exposed to electromagnetic emitting devices. The protocol used underestimates reaction to electromagnetic radiation for those who have a delayed autonomic nervous system reaction and it may under diagnose those who have adrenal exhaustion as their ability to mount a response to a stressor is diminished.

  9. Three-Dimensional Simulation of Traveling-Wave Tube Cold-Test Characteristics Using CST MICROWAVE STUDIO

    NASA Technical Reports Server (NTRS)

    Chevalier, Christine T.; Herrmann, Kimberly A.; Kory, Carol L.; Wilson, Jeffrey D.; Cross, Andrew W.; Santana , Samuel

    2003-01-01

    The electromagnetic field simulation software package CST MICROWAVE STUDIO (MWS) was used to compute the cold-test parameters - frequency-phase dispersion, on-axis impedance, and attenuation - for a traveling-wave tube (TWT) slow-wave circuit. The results were compared to experimental data, as well as to results from MAFIA, another three-dimensional simulation code from CST currently used at the NASA Glenn Research Center (GRC). The strong agreement between cold-test parameters simulated with MWS and those measured experimentally demonstrates the potential of this code to reduce the time and cost of TWT development.

  10. 40 CFR 1060.102 - What permeation emission control requirements apply for fuel lines?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... handheld Small SI engines installed in cold-weather equipment must meet the standards for EPA Cold-Weather... when measured according to the test procedure described in § 1060.515. (3) EPA Cold-Weather Fuel Lines... described in § 1060.515: Table 1 to § 1060.102—Permeation Standards for EPA Cold-Weather Fuel Lines Model...

  11. Corneal epithelial barrier function after oxybuprocaine provocation in diabetics.

    PubMed

    Stolwijk, T R; van Best, J A; Boor, J P; Lemkes, H H; Oosterhuis, J A

    1990-03-01

    Corneal epithelial permeability for fluorescein was determined after provocation by a local anesthetic in 18 non-insulin-dependent diabetes mellitus (NIDDM) patients, 23 insulin-dependent diabetes mellitus (IDDM) patients, and 22 healthy controls to evaluate the corneal epithelial barrier function in diabetes. All volunteers had Oxybuprocaine instilled into one eye and saline into the other eye. The epithelial permeability values were determined by fluorophotometry, and the ratio between both eyes was calculated for each individual. The mean permeability values of the saline-instilled eyes in the diabetic patients did not differ significantly from those in the healthy controls (P greater than 0.2). The individual ratios between Oxybuprocaine- and saline-instilled eyes in the NIDDM and IDDM patients differed significantly from those in the healthy controls (mean ratios: 2.6, 1.9, and 1.0, respectively; P less than 0.002). The permeability ratios and the percentage glycosylated hemoglobin (HbAlc) were linearly correlated in the NIDDM patients but not in the IDDM patients (r = 0.73, P less than 0.001, and r = 0.09, P greater than 0.68, respectively). The results showed that the corneal epithelial barrier function in the diabetic patients was not impaired compared with that in the healthy controls. After provocation by a local anesthetic, the barrier function was impaired in the diabetic patients only.

  12. Children's responses to hypothetical provocation by peers: coordination of assertive and aggressive strategies.

    PubMed

    Dirks, Melanie A; Suor, Jennifer H; Rusch, Dana; Frazier, Stacy L

    2014-10-01

    Children often respond to aggression by peers with assertive bids or aggressive retaliation. Little is known, however, about whether and how children coordinate these strategies across different types of provocation. The present study examined endorsement of aggressive and assertive responses to hypothetical physical, relational, and verbal provocation in a sample of lower-income children (N = 402, M age = 10.21, SD = 1.46). Latent-profile analysis revealed 3-class models for both aggression and assertion, each reflecting low, moderate, and high levels of endorsement. There was no association between children's reported use of aggression and assertion. For example, children who endorsed high levels of aggression were equally likely to be classified as low, moderate, or high on assertive responding. For both assertion and aggression, parental ratings of children's externalizing behavior and social skills differed across the low and high groups. No such differences were found between the low and moderate groups, despite the latter groups endorsing markedly higher levels of assertive and aggressive responses. This pattern of findings may be due, in part, to the situation specificity of children's responding. Our findings hint at the complexity of children's behavioral repertoires and contribute to a growing literature that suggests the need for intervention models that consider both social skills and social situations.

  13. The effect of cold priming on the fitness of Arabidopsis thaliana accessions under natural and controlled conditions.

    PubMed

    Cvetkovic, Jelena; Müller, Klaus; Baier, Margarete

    2017-03-09

    Priming improves an organism's performance upon a future stress. To test whether cold priming supports protection in spring and how it is affected by cold acclimation, we compared seven Arabidopsis accessions with different cold acclimation potentials in the field and in the greenhouse for growth, photosynthetic performance and reproductive fitness in March and May after a 14 day long cold-pretreatment at 4 °C. In the plants transferred to the field in May, the effect of the cold pretreatment on the seed yield correlated with the cold acclimation potential of the accessions. In the March transferred plants, the reproductive fitness was most supported by the cold pretreatment in the accessions with the weakest cold acclimation potential. The fitness effect was linked to long-term effects of the cold pretreatment on photosystem II activity stabilization and leaf blade expansion. The study demonstrated that cold priming stronger impacts on plant fitness than cold acclimation in spring in accessions with intermediate and low cold acclimation potential.

  14. Solid phase testing in the HLA laboratory: implications for organ allocation.

    PubMed

    Eckels, D D

    2008-08-01

    This piece was originally requested as a white paper from the Scientific and Clinical Affairs Committee of the American Society for Histocompatibility and Immunogenetics (ASHI), of which the author was then Chairman. Upon review by the ASHI Board of Directors and the Editors of their journal, it was considered too controversial for publication. It is intended to be provocative and controversial; it is not intended as a review of the literature. Though written with a decided 'American point of view', it is of importance that the issues facing US transplantation and laboratory testing efforts are shared to varying degrees by the international community, and who, unlike some of their American cousins, may be able to tolerate a spirited discussion. Sadly, we sometimes forget that dissent from dogma can be fun!

  15. 40 CFR 600.113-08 - Fuel economy calculations for FTP, HFET, US06, SC03 and cold temperature FTP tests.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... EMISSIONS OF MOTOR VEHICLES Fuel Economy and Carbon-Related Exhaust Emission Test Procedures § 600.113-08 Fuel economy calculations for FTP, HFET, US06, SC03 and cold temperature FTP tests. The Administrator... specific gravity, carbon weight fraction and net heating value of the test fuel must be determined. The FTP...

  16. Significance of perianular enhancement associated with anular tears on magnetic resonance imagings in diagnosis of radiculopathy.

    PubMed

    Byun, Woo Mok; Ahn, Sang Ho; Ahn, Myun-Whan

    2008-10-15

    Retrospective analysis of magnetic resonance imaging (MRI) and clinical findings about chemical radiculitis-associated anular tear in patients with radiculopathy. To investigate MRI findings of the chemical radiculitis caused by anular tears and to determine whether chemical radiculitis detected by MRI is the cause of radiculopathy. Many studies document that irritation of adjacent nerve roots by a chemical mediator of inflammation from the nucleus pulposus may result in radiculopathy. Computed tomography (CT) discography may be the best examination for diagnosing discogenic chemical radiculitis but is too invasive. A reliable imaging method for replacing invasive provocative CT discography and diagnosing chemical radiculitis is required. The study population consisted of 12 patients with pain referred to leg(s) with or without low back pain who underwent lumbar spine MRI. All cases of our study demonstrated perianular enhancement caused by chemical radiculitis associated with anular tears. Patterns and locations of perianular enhancement adjacent to anular tears on MRI were assessed. MRI findings were compared with clinical symptoms and/or provocative transforaminal epidural injection (n = 6). For documentation of the relationship between perianular enhancement and radiculopathy, provocative CT discography was performed in 2 cases. Perianular enhancement associated with anular tears revealed thick linear patterns (2.5-7 mm thickness) along margins of anular tears on contrast enhanced axial T1-weighted images with fat suppression. Locations of perianular enhancement adjacent to anular tears were at foraminal (n = 6) and extraforaminal portions (n = 6). CT discography showed a leak of contrast from anular tear to the perianular regions. Pain reproduction at contrast leak level during discography showed concordant pain. There was an apparent correlation between perianular enhancement on MRI and clinical symptoms or provocative epidural nerve root injection in all cases. The perianular enhancement adjacent to anular tears on MRI may be relevant in the diagnosis of symptomatic chemical radiculitis.

  17. Value of 3D MR lumbosacral radiculography in the diagnosis of symptomatic chemical radiculitis.

    PubMed

    Byun, W M; Ahn, S H; Ahn, M-W

    2012-03-01

    Radiologic methods for the diagnosis of chemical radiculitis associated with anular tears in the lumbar spine have been rare. Provocative diskography is one of the methods for diagnosing diskogenic chemical radiculitis but is invasive. A reliable imaging method for replacing provocative diskography and diagnosing chemical radiculitis is required. Our aim was to investigate the value of 3D MR radiculography depicted by rendering imaging in the diagnosis of symptomatic chemical radiculopathy associated with anular tears. The study population consisted of 17 patients (age range, 32-88 years) with unilateral radiculopathy. Symptomatic chemical radiculopathy was confirmed with provocative CT diskography and/or provocative selective nerve root block for agreement of sides and levels. Through adhering to the principles of selective excitation (Proset imaging), we acquired 3D coronal FFE sequences with selective water excitation. Morphologic changes in the ipsilateral symptomatic nerve root caused by chemical radiculopathy were compared with those in the contralateral nerve root on 3D MR lumbosacral radiculography. Pain reproduction at the contrast-leak level during diskography (n = 4) and selective nerve root injection (n = 13) showed concordant pain in all patients. All patients with symptomatic chemical radiculopathy showed nerve root swelling in both ipsilateral levels and sides on 3D MR radiculography. The most common nerve root affected by the chemical radiculopathy was the L5 nerve root (n = 13), while the most common segment exhibiting nerve root swelling was the exit nerve root (n = 16). All patients with radicular leg pain caused by chemical radiculopathy showed nerve root swelling on 3D MR radiculography. We believe that in cases without mechanical nerve root compression caused by disk herniation or stenosis in the lumbar spine, nerve root swelling on 3D MR radiculography in patients with radiculopathy associated with an anular tear may be relevant in the diagnosis of symptomatic chemical radiculopathy.

  18. Re-defining the Unique Roles for Eosinophils in Allergic Respiratory Inflammation

    PubMed Central

    Jacobsen, Elizabeth A.; Lee, Nancy A.; Lee, James J.

    2014-01-01

    Summary The role of eosinophils in the progression and resolution of allergic respiratory inflammation is poorly defined despite the commonality of their presence and in some cases their use as a biomarker for disease severity and/or symptom control. However, this ambiguity belies the wealth of insights that have recently been gained through the use of eosinophil-deficient/attenuated strains of mice that have demonstrated novel immunoregulatory and remodeling/repair functions for these cells in the lung following allergen provocation. Specifically, studies of eosinophil-deficient mice suggest that eosinophils contribute to events occurring in the lungs following allergen provocation at several key moments: (i) The initiating phase of events leading to Th2-polarized pulmonary inflammation, (ii) The suppression Th1/Th17 pathways in lung draining lymph nodes, (iii) The recruitment of effector Th2 T cells to the lung, and finally (iv) Mechanisms of inflammatory resolution that re-establish pulmonary homeostasis. These suggested functions have recently been confirmed and expanded upon using allergen provocation of an inducible eosinophil-deficient strain of mice (iPHIL) that demonstrated an eosinophil-dependent mechanism(s) leading to Th2 dominated immune responses in the presence of eosinophils in contrast to neutrophilic as well as mixed Th1/Th17/Th2 variant phenotypes in the absence of eosinophils. These findings highlighted that eosinophils are not exclusively downstream mediators controlled by T cells, dendritic cells (DC), and/or innate lymphocytic cells (ILC2). Instead, eosinophils appear to be more aptly described as significant contributors in complex interrelated pathways that lead to pulmonary inflammation and subsequently promote resolution and the re-establishment of homeostatic baseline. In this review we summarize and put into the context the evolving hypotheses that are now expanding our understanding of the roles eosinophils likely have in the lung following allergen provocation. PMID:24961290

  19. 40 CFR 86.1336-84 - Engine starting, restarting, and shutdown.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    .... (4) If a failure to start occurs during the hot start portion of the test and is caused by engine... stalling. (1) If the engine stalls during the initial idle period of either the cold or hot start test, the engine shall be restarted immediately using the appropriate cold or hot starting procedure and the test...

  20. 40 CFR 86.1336-84 - Engine starting, restarting, and shutdown.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    .... (4) If a failure to start occurs during the hot start portion of the test and is caused by engine... stalling. (1) If the engine stalls during the initial idle period of either the cold or hot start test, the engine shall be restarted immediately using the appropriate cold or hot starting procedure and the test...

  1. 40 CFR 86.1336-84 - Engine starting, restarting, and shutdown.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    .... (4) If a failure to start occurs during the hot start portion of the test and is caused by engine... stalling. (1) If the engine stalls during the initial idle period of either the cold or hot start test, the engine shall be restarted immediately using the appropriate cold or hot starting procedure and the test...

  2. Influence of coating defects on the corrosion behavior of cold sprayed refractory metals

    NASA Astrophysics Data System (ADS)

    Kumar, S.; Rao, A. Arjuna

    2017-02-01

    The defects in the cold sprayed coatings are critical in the case of corrosion performances of the coatings in aggressive conditions. To understand the influence of coating defects on corrosion, immersion tests have been carried out in HF solution for the cold sprayed and heat treated Titanium, Tantalum and Niobium coatings. Long duration immersion tests reveal inhomogeneous weight losses of the samples prepared at different heat treatment conditions. The weight loss for different coatings has been well corroborated with the coating defects and microstructures. Chemical and micro structural analysis elucidates the reason behind the inhomogeneous performance of different type of cold sprayed coatings in corrosion medium. In the case of cold sprayed titanium, formation of stable oxide along the inter-splat boundary hinders the aggressive attack of the corrosion medium which is not so in other cases.

  3. Test Operations Procedure (TOP) 1-1-003 Cold Regions Personnel Effects

    DTIC Science & Technology

    2008-09-15

    4 3.3 Freezing Injuries : Frostnip and Frostbite...4 3.4 Non-freezing injuries ........................................................................... 5 3.5 Snow...3. Information concerning the symptoms, methods of prevention, and treatment of various types of cold injuries is also provided. 2.2 Cold Weather

  4. The roles of ingroup identification and outgroup entitativity in intergroup retribution.

    PubMed

    Stenstrom, Douglas M; Lickel, Brian; Denson, Thomas F; Miller, Norman

    2008-11-01

    A new aspect of intergroup conflict was investigated- vicarious retribution-in which neither the agent of retribution nor the target of retribution are directly involved in the initial intergroup provocation. The underlying processes involved in vicarious intergroup retribution were tested correlationally (Study 1) and experimentally (Study 2). Both ingroup identification and outgroup entitativity predict the degree of vicarious retribution. In both studies, there was evidence of motivated cognition, specifically that highly identified individuals perceived the outgroup as higher in entitativity than individuals low in identification. Structural equation modeling demonstrated that part of the effect of identification on retribution against the outgroup was mediated through perceptions of entitativity.

  5. [Pulmonary reaction after furazidin (Furagin). Case report].

    PubMed

    Zielonka, T M; Demkow, U; Kuś, J

    1997-05-01

    For the first time in Poland we present the case of pulmonary reaction to furazidin which is by chemical structure closely related to nitrofurantoin. 63 years old woman presented generalized symptoms of acute hypersensitivity reaction induced by furazidin as well as features of chronic pulmonary fibrosis. After few months of treatment with this drug patients complained of weight loss, dyspnea on effort, non-productive cough, chills and fever. Radiological and functional evaluation of respiratory system confirmed features of lung fibrosis. Drug provocation test was positive. In vitro furazidin in low concentrations stimulated proliferation of patient's lymphocytes. After cessation of treatment we have observed rapid improvement of clinical, radiological, biochemical and functional parameters.

  6. Esophageal manometry in gastroesophageal reflux disease.

    PubMed

    Mello, Michael; Gyawali, C Prakash

    2014-03-01

    High-resolution manometry (HRM) allows nuanced evaluation of esophageal motor function, and more accurate evaluation of lower esophageal sphincter (LES) function, in comparison with conventional manometry. Pathophysiologic correlates of gastroesophageal reflux disease (GERD) and esophageal peristaltic performance are well addressed by this technique. HRM may alter the surgical decision by assessment of esophageal peristaltic function and exclusion of esophageal outflow obstruction before antireflux surgery. Provocative testing during HRM may assess esophageal smooth muscle peristaltic reserve and help predict the likelihood of transit symptoms following antireflux surgery. HRM represents a continuously evolving new technology that compliments the evaluation and management of GERD. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. COLD TEMPERATURE MOTOR VEHICLE EMISSIONS TESTING IN ALASKA

    EPA Science Inventory

    A motor vehicle emissions testing study was conducted in Anchorage and Fairbanks during the winter of 1998-99 to collect actual measurements of initial idle emission rates. The study was performed for a sample of 111 automobiles and light-duty trucks under cold wintertime ambient...

  8. Performance evaluation approach for the supercritical helium cold circulators of ITER

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

    Vaghela, H.; Sarkar, B.; Bhattacharya, R.

    2014-01-29

    The ITER project design foresees Supercritical Helium (SHe) forced flow cooling for the main cryogenic components, namely, the superconducting (SC) magnets and cryopumps (CP). Therefore, cold circulators have been selected to provide the required SHe mass flow rate to cope with specific operating conditions and technical requirements. Considering the availability impacts of such machines, it has been decided to perform evaluation tests of the cold circulators at operating conditions prior to the series production in order to minimize the project technical risks. A proposal has been conceptualized, evaluated and simulated to perform representative tests of the full scale SHe coldmore » circulators. The objectives of the performance tests include the validation of normal operating condition, transient and off-design operating modes as well as the efficiency measurement. A suitable process and instrumentation diagram of the test valve box (TVB) has been developed to implement the tests at the required thermodynamic conditions. The conceptual engineering design of the TVB has been developed along with the required thermal analysis for the normal operating conditions to support the performance evaluation of the SHe cold circulator.« less

  9. Experimental Study of Axially Tension Cold Formed Steel Channel Members

    NASA Astrophysics Data System (ADS)

    Apriani, Widya; Lubis, Fadrizal; Angraini, Muthia

    2017-12-01

    Experimental testing is commonly used as one of the steps to determine the cause of the collapse of a building structure. The collapse of structures can be due to low quality materials. Although material samples have passed laboratory tests and the existing technical specifications have been met but there may be undetected defects and known material after failure. In this paper will be presented Experimental Testing of Axially Tension Cold Formed Steel Channel Members to determine the cause of the collapse of a building roof truss x in Pekanbaru. Test of tensile strength material cold formed channel sections was performed to obtain the main characteristics of Cold Formed steel material, namely ultimate tensile strength loads that can be held by members and the yield stress possessed by channel sections used in construction. Analysis of axially tension cold formed steel channel section presents in this paper was conducted through experimental study based on specificationsAnnualBook of ASTM Standards: Metal Test methods and Analitical Procedures, Section 3 (1991). The result of capacity loads experimental test was compared with design based on SNI 03-7971-2013standard of Indonesia for the design of cold formed steel structural members. The results of the yield stress of the material will be seen against the minimum allowable allowable stress range. After the test, the percentace of ultimate axial tension capacity theory has a result that is 16.46% larger than the ultimate axial tension capacity experimental. When compared with the load that must be borne 5.673 kN/m it can be concluded that 2 specimens do not meet. Yield stress of member has fulfilled requirement that wass bigger than 550 MPa. Based on the curve obtained ultimate axial tension capacity theory, results greater than experimental. The greatest voltage value (fu) is achieved under the same conditions as its yield stress. For this specimen with a melting voltage value fy = 571.5068 MPa has fulfilled the minimum melting point value of 550 MPa required for standard mild steel materials in accordance with the code SNI 03-7971-2013 about Cold formed steel.

  10. Experimental Study of Axially Tension Cold Formed Steel Channel Members

    NASA Astrophysics Data System (ADS)

    Apriani, Widya; Lubis, Fadrizal; Angraini, Muthia

    2017-12-01

    Experimental testing is commonly used as one of the steps to determine the cause of the collapse of a building structure. The collapse of structures can be due to low quality materials. Although material samples have passed laboratory tests and the existing technical specifications have been met but there may be undetected defects and known material after failure. In this paper will be presented Experimental Testing of Axially Tension Cold Formed Steel Channel Members to determine the cause of the collapse of a building roof truss x in Pekanbaru. Test of tensile strength material cold formed channel sections was performed to obtain the main characteristics of Cold Formed steel material, namely ultimate tensile strength loads that can be held by members and the yield stress possessed by channel sections used in construction. Analysis of axially tension cold formed steel channel section presents in this paper was conducted through experimental study based on specificationsAnnualBook of ASTM Standards: Metal Test methods and Analitical Procedures, Section 3 (1991). The result of capacity loads experimental test was compared with design based on SNI 03-7971- 2013standard of Indonesia for the design of cold formed steel structural members. The results of the yield stress of the material will be seen against the minimum allowable allowable stress range. After the test, the percentace of ultimate axial tension capacity theory has a result that is 16.46% larger than the ultimate axial tension capacity experimental. When compared with the load that must be borne 5.673 kN/m it can be concluded that 2 specimens do not meet. Yield stress of member has fulfilled requirement that wass bigger than 550 MPa. Based on the curve obtained ultimate axial tension capacity theory, results greater than experimental. The greatest voltage value (fu) is achieved under the same conditions as its yield stress. For this specimen with a melting voltage value fy = 571.5068 MPa has fulfilled the minimum melting point value of 550 MPa required for standard mild steel materials in accordance with the code SNI 03- 7971-2013 about Cold formed steel.

  11. Exposure to heat and freezing in the vaccine cold chain in Thailand.

    PubMed

    Techathawat, Sirirat; Varinsathien, Porpit; Rasdjarmrearnsook, Aimorn; Tharmaphornpilas, Piyanit

    2007-01-26

    This study investigated exposure to heat and freezing of vaccines used in Thailand's National Immunization Program. Cold chain temperatures on 48 randomly selected shipment routes nationwide were monitored. Measles and hepatitis B vaccines were despatched with recording devices and subsequently tested. The study found that extremes of cold appear to be the more significant problem. Heat exposure was relatively brief and not at very high temperatures, so vaccine deterioration was unlikely, as was confirmed by measles vaccine testing. Exposure to temperatures below -0.5 degrees C was widespread, which would be expected to damage hepatitis B vaccine, but shake tests did not detect damage.

  12. Shoulder pain in primary care: diagnostic accuracy of clinical examination tests for non-traumatic acromioclavicular joint pain

    PubMed Central

    2013-01-01

    Background Despite numerous methodological flaws in previous study designs and the lack of validation in primary care populations, clinical tests for identifying acromioclavicular joint (ACJ) pain are widely utilised without concern for such issues. The aim of this study was to estimate the diagnostic accuracy of traditional ACJ tests and to compare their accuracy with other clinical examination features for identifying a predominant ACJ pain source in a primary care cohort. Methods Consecutive patients with shoulder pain were recruited prospectively from primary health care clinics. Following a standardised clinical examination and diagnostic injection into the subacromial bursa, all participants received a fluoroscopically guided diagnostic block of 1% lidocaine hydrochloride (XylocaineTM) into the ACJ. Diagnostic accuracy statistics including sensitivity, specificity, predictive values, positive and negative likelihood ratios (LR+ and LR-) were calculated for traditional ACJ tests (Active Compression/O’Brien’s test, cross-body adduction, localised ACJ tenderness and Hawkins-Kennedy test), and for individual and combinations of clinical examination variables that were associated with a positive anaesthetic response (PAR) (P≤0.05) defined as 80% or more reduction in post-injection pain intensity during provocative clinical tests. Results Twenty two of 153 participants (14%) reported an 80% PAR. None of the traditional ACJ tests were associated with an 80% PAR (P<0.05) and combinations of traditional tests were not able to discriminate between a PAR and a negative anaesthetic response (AUC 0.507; 95% CI: 0.366, 0.647; P>0.05). Five clinical examination variables (repetitive mechanism of pain onset, no referred pain below the elbow, thickened or swollen ACJ, no symptom provocation during passive glenohumeral abduction and external rotation) were associated with an 80% PAR (P<0.05) and demonstrated an ability to accurately discriminate between an PAR and NAR (AUC 0.791; 95% CI 0.702, 0.880; P<0.001). Less than two positive clinical features resulted in 96% sensitivity (95% CI 0.78, 0.99) and a LR- 0.09 (95% CI 0.02, 0.41) and four positive clinical features resulted in 95% specificity (95% CI 0.90, 0.98) and a LR+ of 4.98 (95% CI 1.69, 13.84). Conclusions In this cohort of primary care patients with predominantly subacute or chronic ACJ pain of non-traumatic onset, traditional ACJ tests were of limited diagnostic value. Combinations of other history and physical examination findings were able to more accurately identify injection-confirmed ACJ pain in this cohort. PMID:23634871

  13. Clinical Cold Welding of the Modular Total Hip Arthroplasty Prosthesis.

    PubMed

    Whittaker, Robert K; Zaghloul, Ahmed M; Hothi, Harry S; Siddiqui, Imran A; Blunn, Gordon W; Skinner, John A; Hart, Alister J

    2017-02-01

    A head that is "clinically cold welded" to a stem is one of the commonest reasons for unplanned removal of the stem. It is not clear which hip designs are at greatest risk of clinical cold welding. This was a case-control study of consecutively received hip implant retrievals; we chose the design of hip that had the greatest number of truly cold-welded heads (n = 11). For our controls, we chose retrieved hips of the same design but without cold welding of the head (n = 35). We compared the clinical variables between these 2 groups using nonparametric Mann-Whitney tests to investigate the significance of differences between the cold-welded and non-cold-welded groups. The design that most commonly caused cold welding was a combination of a Ti stem and Ti taper: 11 out of 48 (23%) were truly cold welded. Comparison of the clinical data showed that no individual factor could be used to predict this preoperatively with none of the 4 predictors tested showing any significance: (1) time to revision (P = .687), (2) head size (P = .067), (3) patient age at primary (P = .380), and (4) gender (P = .054). We have shown that clinical cold welding is most prevalent in Ti-Ti combinations of the stem and taper; approximately 25% of cases received at our center were cold welded. Analysis of clinical variables showed that it is not possible to predict which will be cold welded preoperatively. Surgeons should be aware of this potential complication when revising a Ti-Ti stem/head junction. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Controlling Motion Sickness and Spatial Disorientation and Enhancing Vestibular Rehabilitation with a User-Worn See-Through Display

    PubMed Central

    Krueger, Wesley W.O.

    2010-01-01

    Objectives/Hypotheses An eyewear mounted visual display (“User-worn see-through display”) projecting an artificial horizon aligned with the user's head and body position in space can prevent or lessen motion sickness in susceptible individuals when in a motion provocative environment as well as aid patients undergoing vestibular rehabilitation. In this project, a wearable display device, including software technology and hardware, was developed and a phase I feasibility study and phase II clinical trial for safety and efficacy were performed. Study Design Both phase I and phase II were prospective studies funded by the NIH. The phase II study used repeated measures for motion intolerant subjects and a randomized control group (display device/no display device) pre-post test design for patients in vestibular rehabilitation. Methods Following technology and display device development, 75 patients were evaluated by test and rating scales in the phase II study; 25 subjects with motion intolerance used the technology in the display device in provocative environments and completed subjective rating scales while 50 patients were evaluated before and after vestibular rehabilitation (25 using the display device and 25 in a control group) using established test measures. Results All patients with motion intolerance rated the technology as helpful for nine symptoms assessed, and 96% rated the display device as simple and easy to use. Duration of symptoms significantly decreased with use of the technology displayed. In patients undergoing vestibular rehabilitation, there were no significant differences in amount of change from pre- to post-therapy on objective balance tests between display device users and controls. However, those using the technology required significantly fewer rehabilitation sessions to achieve those outcomes than the control group. Conclusions A user-worn see-through display, utilizing a visual fixation target coupled with a stable artificial horizon and aligned with user movement, has demonstrated substantial benefit for individuals susceptible to motion intolerance and spatial disorientation and those undergoing vestibular rehabilitation. The technology developed has applications in any environment where motion sensitivity affects human performance. PMID:21181963

  15. Reactor Simulator Testing

    NASA Technical Reports Server (NTRS)

    Schoenfeld, Michael P.; Webster, Kenny L.; Pearson, Boise J.

    2013-01-01

    As part of the Nuclear Systems Office Fission Surface Power Technology Demonstration Unit (TDU) project, a reactor simulator test loop (RxSim) was design & built to perform integrated testing of the TDU components. In particular, the objectives of RxSim testing was to verify the operation of the core simulator, the instrumentation and control system, and the ground support gas and vacuum test equipment. In addition, it was decided to include a thermal test of a cold trap purification design and a pump performance test at pump voltages up to 150 V since the targeted mass flow rate of 1.75 kg/s was not obtained in the RxSim at the originally constrained voltage of 120 V. This paper summarizes RxSim testing. The gas and vacuum ground support test equipment performed effectively in NaK fill, loop pressurization, and NaK drain operations. The instrumentation and control system effectively controlled loop temperature and flow rates or pump voltage to targeted settings. The cold trap design was able to obtain the targeted cold temperature of 480 K. An outlet temperature of 636 K was obtained which was lower than the predicted 750 K but 156 K higher than the cold temperature indicating the design provided some heat regeneration. The annular linear induction pump (ALIP) tested was able to produce a maximum flow rate of 1.53 kg/s at 800 K when operated at 150 V and 53 Hz.

  16. Reactor Simulator Integration and Testing

    NASA Technical Reports Server (NTRS)

    Schoenfield, M. P.; Webster, K. L.; Pearson, J. B.

    2013-01-01

    As part of the Nuclear Systems Office Fission Surface Power Technology Demonstration Unit (TDU) project, a reactor simulator (RxSim) test loop was designed and built to perform integrated testing of the TDU components. In particular, the objectives of RxSim testing were to verify the operation of the core simulator, the instrumentation and control system, and the ground support gas and vacuum test equipment. In addition, it was decided to include a thermal test of a cold trap purification design and a pump performance test at pump voltages up to 150 V because the targeted mass flow rate of 1.75 kg/s was not obtained in the RxSim at the originally constrained voltage of 120 V. This Technical Memorandum summarizes RxSim testing. The gas and vacuum ground support test equipment performed effectively in NaK fill, loop pressurization, and NaK drain operations. The instrumentation and control system effectively controlled loop temperature and flow rates or pump voltage to targeted settings. The cold trap design was able to obtain the targeted cold temperature of 480 K. An outlet temperature of 636 K was obtained, which was lower than the predicted 750 K but 156 K higher than the cold temperature, indicating the design provided some heat regeneration. The annular linear induction pump tested was able to produce a maximum flow rate of 1.53 kg/s at 800 K when operated at 150 V and 53 Hz.

  17. CRACK GROWTH RESPONSE OF ALLOY 690 IN SIMULATED PWR PRIMARY WATER

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

    Toloczko, Mychailo B.; Bruemmer, Stephen M.

    2009-12-01

    The stress corrosion crack growth response of three extruded alloy 690 CRDM tube heats was investigated in several thermomechanical conditions. Extremely low propagation rates (< 1 x 10{sup -9} mm/s) were observed under constant stress intensity factor (K) loading at 325-350 C in the as-received, thermally treated (TT) materials despite using a variety of transitioning techniques. Post-test observation of the crack-growth surfaces revealed only isolated intergranular (IG) cracking. One-dimensional cold rolling to 17% reduction and testing in the S-L orientation did not promote enhanced stress corrosion rates. However, somewhat higher propagation rates were observed in a 30% cold-rolled alloy 690TTmore » specimen tested in the T-L orientation. Cracking of the cold-rolled material was promoted on grain boundaries oriented parallel to the rolling plane with the % IG increasing with the amount of cold rolling.« less

  18. The Effects of Cold Whirlpool on Power, Speed, Agility, and Range of Motion

    PubMed Central

    Patterson, Stephen M.; Udermann, Brian E.; Doberstein, Scott T.; Reineke, David M.

    2008-01-01

    The purpose was to determine if cold whirlpool treatment decreases functional performance equally regardless of gender. A secondary aim was to determine if there is a gradual increase in functional performance across time. Twenty-one college-aged subjects volunteered to participate in this study and were required to perform four measures of functional performance including: counter movement vertical jump, T-test, 36.58-meter dash (40-yard), and active range of motion of the ankle. Participants were treated with a 20 minute, 10 degree Celsius cold whirlpool following the pre-test of a given functional performance measure. Participants demonstrated significant decreases in counter movement vertical jump, T-test, and 40-yard dash performance immediately following treatment. Vertical jump performance remained impaired for at least 32 minutes. While both the T-test and 40-yard dash were affected for 7 and 22 minutes post- treatment, respectively. Participants also demonstrated significant decreases in peak power and average power immediately after and for 32 minutes post-treatment. Dorsiflexion was significantly decreased 7 and 12 minutes following treatment. There were no differences for plantar flexion, inversion, or eversion. These data suggest functional performance was affected immediately following and for up to 32 minutes after cold whirlpool treatment. It was also evident that there is a gradual performance increase for each measure of functional performance across time. Therefore, the consequences should be carefully considered before returning athletes to activity following cold whirlpool treatment. Key pointsCryotherapy is a common and highly effective modality in treating acute and chronic athletic injuries.The results indicated that cold whirlpool does have an immediate and subsequent effect on functional performance.Understanding how cold whirlpool adversely affects functional performance allows clinicians to continue using this modality before vigorous athletic activity. PMID:24149907

  19. Environment-Assisted Cracking in Custom 465 Stainless Steel

    NASA Astrophysics Data System (ADS)

    Lee, E. U.; Goswami, R.; Jones, M.; Vasudevan, A. K.

    2011-02-01

    The influence of cold work and aging on the environment-assisted cracking (EAC) behavior and mechanical properties of Custom 465 stainless steel (SS) was studied. Four sets of specimens were made and tested. All specimens were initially solution annealed, rapidly cooled, and refrigerated (SAR condition). The first specimen set was steel in the SAR condition. The second specimen set was aged to the H1000 condition. The third specimen set was 60 pct cold worked, and the fourth specimen set was 60 pct cold worked and aged at temperatures ranging from 755 K to 825 K (482 °C to 552 °C) for 4 hours in air. The specimens were subsequently subjected to EAC and mechanical testing. The EAC testing was conducted, using the rising step load (RSL) technique, in aqueous solutions of NaCl of pH 7.3 with concentrations ranging from 0.0035 to 3.5 pct at room temperature. The microstructure, dislocation substructure, and crack paths, resulting from the cold work, aging, or subsequent EAC testing, were examined by optical microscopy, transmission electron microscopy (TEM), and scanning electron microscopy (SEM). The aging of the cold-worked specimens induced carbide precipitation within the martensite lath, but not at the lath or packet boundaries. In the aged specimens, as aging temperature rose, the threshold stress intensity for EAC (KIEAC), elongation, and fracture toughness increased, but the strength and hardness decreased. The KIEAC also decreased with increasing yield strength and NaCl concentration. In the SAR and H1000 specimens, the EAC propagated along the prior austenite grain boundary, while in the cold-worked and cold-worked and aged specimens, the EAC propagated along the martensite lath, and its packet and prior austenite grain boundaries. The controlling mechanism for the observed EAC was identified to be hydrogen embrittlement.

  20. A Comparison of Three-Dimensional Simulations of Traveling-Wave Tube Cold-Test Characteristics Using CST MICROWAVE STUDIO and MAFIA

    NASA Technical Reports Server (NTRS)

    Chevalier, C. T.; Herrmann, K. A.; Kory, C. L.; Wilson, J. D.; Cross, A. W.; Williams, W. D. (Technical Monitor)

    2001-01-01

    Previously, it was shown that MAFIA (solutions of Maxwell's equations by the Finite Integration Algorithm), a three-dimensional simulation code, can be used to produce accurate cold-test characteristics including frequency-phase dispersion, interaction impedance, and attenuation for traveling-wave tube (TWT) slow-wave structures. In an effort to improve user-friendliness and simulation time, a model was developed to compute the cold-test parameters using the electromagnetic field simulation software package CST MICROWAVE STUDIO (MWS). Cold-test parameters were calculated for several slow-wave circuits including a ferruled coupled-cavity, a folded waveguide, and a novel finned-ladder circuit using both MWS and MAFIA. Comparisons indicate that MWS provides more accurate cold-test data with significantly reduced simulation times. Both MAFIA and MWS are based on the finite integration (FI) method; however, MWS has several advantages over MAFIA. First, it has a Windows based interface for PC operation, making it very user-friendly, whereas MAFIA is UNIX based. MWS uses a new Perfect Boundary Approximation (PBA), which increases the accuracy of the simulations by avoiding stair step approximations associated with MAFIA's representation of structures. Finally, MWS includes a Visual Basic for Applications (VBA) compatible macro language that enables the simulation process to be automated and allows for the optimization of user-defined goal functions, such as interaction impedance.

  1. Cold Test Operation of the German VEK Vitrification Plant

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

    Fleisch, J.; Schwaab, E.; Weishaupt, M.

    2008-07-01

    In 2007 the German High-Level Liquid Waste (HLLW) Vitrification plant VEK (Verglasungseinrichtung Karlsruhe) has passed a three months integral cold test operation as final step before entering the hot phase. The overall performance of the vitrification process equipment with a liquid-fed ceramic glass melter as main component proved to be completely in line with the requirements of the regulatory body. The retention efficiency of main radioactive-bearing elements across melter and wet off-gas treatment system exceeded the design values distinctly. The strategy to produce a specified waste glass could be successfully demonstrated. The results of the cold test operation allow enteringmore » the next step of hot commissioning, i.e. processing of approximately 2 m{sup 3} of diluted HLLW. In summary: An important step of the VEK vitrification plant towards hot operation has been the performance of the cold test operation from April to July 2007. This first integral operation was carried out under boundary conditions and rules established for radioactive operation. Operation and process control were carried out following the procedure as documented in the licensed operational manuals. The function of the process technology and the safe operation could be demonstrated. No severe problems were encountered. Based on the positive results of the cold test, application of the license for hot operation has been initiated and is expected in the near future. (authors)« less

  2. Correlation of Wissler Human Thermal Model Blood Flow and Shiver Algorithms

    NASA Technical Reports Server (NTRS)

    Bue, Grant; Makinen, Janice; Cognata, Thomas

    2010-01-01

    The Wissler Human Thermal Model (WHTM) is a thermal math model of the human body that has been widely used to predict the human thermoregulatory response to a variety of cold and hot environments. The model has been shown to predict core temperature and skin temperatures higher and lower, respectively, than in tests of subjects in crew escape suit working in a controlled hot environments. Conversely the model predicts core temperature and skin temperatures lower and higher, respectively, than in tests of lightly clad subjects immersed in cold water conditions. The blood flow algorithms of the model has been investigated to allow for more and less flow, respectively, for the cold and hot case. These changes in the model have yielded better correlation of skin and core temperatures in the cold and hot cases. The algorithm for onset of shiver did not need to be modified to achieve good agreement in cold immersion simulations

  3. Efficacy of a heat exchanger mask in cold exercise-induced asthma.

    PubMed

    Beuther, David A; Martin, Richard J

    2006-05-01

    To determine the efficacy of a novel mask device in limiting cold air exercise-induced decline in lung function in subjects with a history of exercise-induced asthma (EIA). In spite of appropriate medical therapy, many asthma patients are limited in cold weather activities. In study 1, 13 asthmatic subjects performed two randomized, single-blind treadmill exercise tests while breathing cold air (- 25 to - 15 degrees C) through a placebo or active heat exchanger mask. In study 2, five subjects with EIA performed three treadmill exercise tests while breathing cold air: one test using the heat exchanger mask, one test without the mask but with albuterol pretreatment, and one test with neither the mask nor albuterol pretreatment (unprotected exercise). For all studies, spirometry was performed before and at 5, 15, and 30 min after exercise challenge. For both studies, a total of 15 subjects with a history of asthma symptoms during cold air exercise were recruited. In study 1, the mean decrease (+/- SE) in FEV1 was 19 +/- 4.9% with placebo, and 4.3 +/- 1.6% with the active device (p = 0.0002). The mean decrease in maximum mid-expiratory flow (FEF(25-75)) was 31 +/- 5.7% with placebo and 4.7 +/- 1.7% with the active device (p = 0.0002). In study 2, the mean decrease in FEV1 was 6.3 +/- 3.9%, 11 +/- 3.7%, and 28 +/- 10% for the heat exchanger mask, albuterol pretreatment, and unprotected exercises, respectively (p = 0.4375 for mask vs albuterol, p = 0.0625 for mask vs unprotected exercise). The mean decrease in FEF(25-75) was 10 +/- 4.8%, 23 +/- 6.0%, and 36 +/- 11%, respectively (p = 0.0625 for mask vs albuterol, p = 0.0625 for mask vs unprotected exercise). This heat exchanger mask blocks cold exercise-induced decline in lung function at least as effectively as albuterol pretreatment.

  4. Behavioral and anatomical characterization of the bilateral sciatic nerve chronic constriction (bCCI) injury: correlation of anatomic changes and responses to cold stimuli

    PubMed Central

    2010-01-01

    Background Unilateral constrictive sciatic nerve injury (uCCI) is a common neuropathic pain model. However, the bilateral constrictive injury (bCCI) model is less well studied, and shows unique characteristics. In the present study, we sought to correlate effects of bCCI on nocifensive responses to cold and mechanical stimuli with selected dorsal horn anatomic markers. bCCI or sham ligation of both rat sciatic nerves were followed up to 90 days of behavioural testing. Additional rats sacrificed at 15, 30 and 90 days were used for anatomic analyses. Behavioural tests included hindpaw withdrawal responses to topical acetone, cold plate testing, an operant thermal preference task and hindpaw withdrawal thresholds to mechanical probing. Results All nocifensive responses to cold increased and remained enhanced for >45 days. Mechanical withdrawal thresholds decreased for 25 days only. Densitometric analyses of immunoperoxidase staining in the superficial dorsal horn at L4-5 revealed decreased cholecystokinin (CCK) staining at all times after bCCI, decreased mu opiate receptor (MOR) staining, maximal at 15 days, increased neuropeptide Y (NPY) staining only at days 15 and 30, and increased neurokinin-1 receptor (NK-1R) staining at all time points, maximal at 15 days. Correlation analyses at 45 days post-bCCI, were significant for individual rat nocifensive responses in each cold test and CCK and NK-1R, but not for MOR or NPY. Conclusions These results confirm the usefulness of cold testing in bCCI rats, a new approach using CCI to model neuropathic pain, and suggest a potential value of studying the roles of dorsal horn CCK and substance P in chronic neuropathic pain. Compared to human subjects with neuropathic pain, responses to cold stimuli in rats with bCCI may be a useful model of neuropathic pain. PMID:20105332

  5. Behavioral and anatomical characterization of the bilateral sciatic nerve chronic constriction (bCCI) injury: correlation of anatomic changes and responses to cold stimuli.

    PubMed

    Datta, Sukdeb; Chatterjee, Koel; Kline, Robert H; Wiley, Ronald G

    2010-01-27

    Unilateral constrictive sciatic nerve injury (uCCI) is a common neuropathic pain model. However, the bilateral constrictive injury (bCCI) model is less well studied, and shows unique characteristics. In the present study, we sought to correlate effects of bCCI on nocifensive responses to cold and mechanical stimuli with selected dorsal horn anatomic markers. bCCI or sham ligation of both rat sciatic nerves were followed up to 90 days of behavioural testing. Additional rats sacrificed at 15, 30 and 90 days were used for anatomic analyses. Behavioural tests included hindpaw withdrawal responses to topical acetone, cold plate testing, an operant thermal preference task and hindpaw withdrawal thresholds to mechanical probing. All nocifensive responses to cold increased and remained enhanced for >45 days. Mechanical withdrawal thresholds decreased for 25 days only. Densitometric analyses of immunoperoxidase staining in the superficial dorsal horn at L4-5 revealed decreased cholecystokinin (CCK) staining at all times after bCCI, decreased mu opiate receptor (MOR) staining, maximal at 15 days, increased neuropeptide Y (NPY) staining only at days 15 and 30, and increased neurokinin-1 receptor (NK-1R) staining at all time points, maximal at 15 days. Correlation analyses at 45 days post-bCCI, were significant for individual rat nocifensive responses in each cold test and CCK and NK-1R, but not for MOR or NPY. These results confirm the usefulness of cold testing in bCCI rats, a new approach using CCI to model neuropathic pain, and suggest a potential value of studying the roles of dorsal horn CCK and substance P in chronic neuropathic pain. Compared to human subjects with neuropathic pain, responses to cold stimuli in rats with bCCI may be a useful model of neuropathic pain.

  6. Comparative analysis of the cold acclimation and freezing tolerance capacities of seven diploid Brachypodium distachyon accessions

    PubMed Central

    Colton-Gagnon, Katia; Ali-Benali, Mohamed Ali; Mayer, Boris F.; Dionne, Rachel; Bertrand, Annick; Do Carmo, Sonia; Charron, Jean-Benoit

    2014-01-01

    Background and Aims Cold is a major constraint for cereal cultivation under temperate climates. Winter-hardy plants interpret seasonal changes and can acquire the ability to resist sub-zero temperatures. This cold acclimation process is associated with physiological, biochemical and molecular alterations in cereals. Brachypodium distachyon is considered a powerful model system to study the response of temperate cereals to adverse environmental conditions. To date, little is known about the cold acclimation and freezing tolerance capacities of Brachypodium. The main objective of this study was to evaluate the cold hardiness of seven diploid Brachypodium accessions. Methods An integrated approach, involving monitoring of phenological indicators along with expression profiling of the major vernalization regulator VRN1 orthologue, was followed. In parallel, soluble sugars and proline contents were determined along with expression profiles of two COR genes in plants exposed to low temperatures. Finally, whole-plant freezing tests were performed to evaluate the freezing tolerance capacity of Brachypodium. Key Results Cold treatment accelerated the transition from the vegetative to the reproductive phase in all diploid Brachypodium accessions tested. In addition, low temperature exposure triggered the gradual accumulation of BradiVRN1 transcripts in all accessions tested. These accessions exhibited a clear cold acclimation response by progressively accumulating proline, sugars and COR gene transcripts. However, whole-plant freezing tests revealed that these seven diploid accessions only have a limited capacity to develop freezing tolerance when compared with winter varieties of temperate cereals such as wheat and barley. Furthermore, little difference in terms of survival was observed among the accessions tested despite their previous classification as either spring or winter genotypes. Conclusions This study is the first to characterize the freezing tolerance capacities of B. distachyon and provides strong evidence that some diploid accessions such as Bd21 have a facultative growth habit. PMID:24323247

  7. Toxicity of Cold Lake Blend and Western Canadian Select dilbits to standard aquatic test species

    EPA Science Inventory

    Dilbits are blends of bitumen and natural gas condensates or crude oils with only limited toxicity data. Two dilbits, Cold Lake Blend and Western Canadian Select, were tested as either unweathered or weathered oils for acute and chronic toxicity to standard freshwater and estuari...

  8. Cold Spray Technology for Repair of Magnesium Rotorcraft Components (Briefing Charts)

    DTIC Science & Technology

    2007-01-01

    control valve Nozzle Braided flex hose Helium Tank Powder Feeder Spray Nozzle ARL Portable System Parameters for Applying CP-Al to ZE41A - Mg...and Advantages of Cold Spray •Present Test Results to Date •Coating Integrity and Microstructural Analysis •Adhesion, Hardness and Corrosion Tests

  9. Cold in-place recycling using solventless emulsion - phase IV (emulsion qualification and long-term field performance).

    DOT National Transportation Integrated Search

    2016-05-01

    This report looks into how a successful Cold In-Place solventless emulsion behaves and how the emulsion : break test developed in Phase III of this project demonstrates that behavior. Modifications to the test have been : made to improve the consiste...

  10. Primary acquired cold urticaria.

    PubMed

    Lee, Chyh-Woei; Sheffer, Albert L

    2003-01-01

    Primary acquired cold urticaria (ACU) is the most common type of cold urticaria characterized by rapid onset of pruritic hives, swelling, and possible severe systemic reactions including hypotension and shock after cold exposure. Primary ACU is diagnosed by history of such symptoms, a positive immediate cold-contact stimulation test, and negative laboratory evaluation for underlying systemic disorders. Clinicians should be aware that patients with ACU may be susceptible to life-threatening systemic reactions especially during aquatic activities and that proper patient education is extremely important. This article reviews the clinical presentation, pathogenesis, diagnosis, and management of primary ACU.

  11. Early sign of microangiopathy in systemic sclerosis: The significance of cold stress test in dynamic laser Doppler flowmetry.

    PubMed

    Yu, Sebastian; Hu, Stephen Chu-Sung; Yu, Hsin-Su; Chin, Yi-Ying; Cheng, Yang-Chun; Lee, Chih-Hung

    2018-06-05

    Skin physiology measurement is receiving more attention for detecting vasculopathy in systemic sclerosis (SSc). Laser Doppler flowmetry (LDF) is a widely used physiological measurement to assess cutaneous microcirculation. However, findings of LDF may be normal during early stage of microangiopathy in SSc. We hypothesized that cold stress test combined with LDF could detect early-stage microangiopathy in patients with SSc. A 67-year-old male came with multiple ulcerations on his fingers for one year. After excluding diseases such as diabetes mellitus-related peripheral arterial occlusive disease and smoking-related Buerger's disease, the diagnosis of SSc was made according to the 2013 ACR/EULAR criteria. We performed LDF and angiography for a patient with SSc and compared the results. Although occlusions of right ulnar and digital arteries were obvious in angiography, the baseline skin temperature and perfusion unit on right fingers remained within normal limits. While the microcirculatory abnormalities measured by LDF alone are subtle, LDF combined with cold stress test detected a significant slow recovery of skin blood flow 40 minutes after cold immersion. In conclusion, there may be discordance between macrovasculopathy and baseline microcirculatory blood flow in SSc. In such a case, cold immersion test is essential to measure the dynamic change and slow recovery of blood flow.

  12. Hypersensitivity reaction to mizolastine: study of cross reactions.

    PubMed

    Gonzalo-Garijo, M A; Jiménez-Ferrera, G; Bobadilla-González, P; Cordobés-Durán, C

    2006-01-01

    A 26-year-old male suffering from acute rhinitis took the first dose of Zolistan (mizolastine, 10 mg), orally, and 15 minutes later he developed intense generalized pruritus, cutaneous rash, oropharyngeal pruritus, edema on his face, difficulty in swallowing, and mild dyspnea. He was treated with methylprednisolone and epinephrine and improved within 30 minutes. The patient had not taken mizolastine before and he has avoided it since the reaction. Cutaneous tests with Zolistan and its excipients proved negative. Simple-blind oral challenge tests with the excipients and then with Zolistan were positive only with Zolistan. In order to confirm the absence of cross-reactivity between mizolastine and other benzimidazoles, we tested omeprazole, domperidone and mebendazole, all of which yielded negative results. To our knowledge, this is the second case of immediate hypersensitivity to mizolastine documented to date. In our case, the clinical history, physical examination and provocation tests allow us to establish the diagnosis of hypersensitivity to mizolastine and exclude the cross reactivity with other benzimidazole derivatives.

  13. Performance, Physiological, and Acceptance Tests of a 1500 KCAL emergency/Assault Food Packet Diet in a Cold Weather Environment

    DTIC Science & Technology

    1980-11-01

    acket (E/AP) and to assess performance and physiological effects of t he ration at two different ca loric levels. During a f ive-day exercise in a...PACKET FIELD FEEDING RAT IONS DIET(S) PHYSIOLOG ICAL EMERGENCY RATIONS COMPRESSED FOODS TESTS FREEZE DRIED FOODS COLD WEATH ER PERFORMANCE...cold-weather climate, one group of Marines was issued the standard C ration (3550 kca l) while half of a second group were issued one E/AP per day

  14. Impact of cold temperature on Euro 6 passenger car emissions.

    PubMed

    Suarez-Bertoa, Ricardo; Astorga, Covadonga

    2018-03-01

    Hydrocarbons, CO, NOx, NH 3 , N 2 O, CO 2 and particulate matter emissions affect air quality, global warming and human health. Transport sector is an important source of these pollutants and high pollution episodes are often experienced during the cold season. However, EU vehicle emissions regulation at cold ambient temperature only addresses hydrocarbons and CO vehicular emissions. For that reason, we have studied the impact that cold ambient temperatures have on Euro 6 diesel and spark ignition (including: gasoline, ethanol flex-fuel and hybrid vehicles) vehicle emissions using the World-harmonized Light-duty Test Cycle (WLTC) at -7 °C and 23 °C. Results indicate that when facing the WLTC at 23 °C the tested vehicles present emissions below the values set for type approval of Euro 6 vehicles (still using NEDC), with the exception of NOx emissions from diesel vehicles that were 2.3-6 times higher than Euro 6 standards. However, emissions disproportionally increased when vehicles were tested at cold ambient temperature (-7 °C). High solid particle number (SPN) emissions (>1 × 10 11 # km -1 ) were measured from gasoline direct injection (GDI) vehicles and gasoline port fuel injection vehicles. However, only diesel and GDI SPN emissions are currently regulated. Results show the need for a new, technology independent, procedure that enables the authorities to assess pollutant emissions from vehicles at cold ambient temperatures. Harmful pollutant emissions from spark ignition and diesel vehicles are strongly and negatively affected by cold ambient temperatures. Only hydrocarbon, CO emissions are currently regulated at cold temperature. Therefore, it is of great importance to revise current EU winter vehicle emissions regulation. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. Aggression in Women: Behavior, Brain and Hormones

    PubMed Central

    Denson, Thomas F.; O’Dean, Siobhan M.; Blake, Khandis R.; Beames, Joanne R.

    2018-01-01

    We review the literature on aggression in women with an emphasis on laboratory experimentation and hormonal and brain mechanisms. Women tend to engage in more indirect forms of aggression (e.g., spreading rumors) than other types of aggression. In laboratory studies, women are less aggressive than men, but provocation attenuates this difference. In the real world, women are just as likely to aggress against their romantic partner as men are, but men cause more serious physical and psychological harm. A very small minority of women are also sexually violent. Women are susceptible to alcohol-related aggression, but this type of aggression may be limited to women high in trait aggression. Fear of being harmed is a robust inhibitor of direct aggression in women. There are too few studies and most are underpowered to detect unique neural mechanisms associated with aggression in women. Testosterone shows the same small, positive relationship with aggression in women as in men. The role of cortisol is unclear, although some evidence suggests that women who are high in testosterone and low in cortisol show heightened aggression. Under some circumstances, oxytocin may increase aggression by enhancing reactivity to provocation and simultaneously lowering perceptions of danger that normally inhibit many women from retaliating. There is some evidence that high levels of estradiol and progesterone are associated with low levels of aggression. We highlight that more gender-specific theory-driven hypothesis testing is needed with larger samples of women and aggression paradigms relevant to women. PMID:29770113

  16. Vasospasm of atherosclerotic coronary arteries precipitates acute ischemic myocardial damage in myocardial infarction-prone strain of the Watanabe heritable hyperlipidemic rabbits.

    PubMed

    Shiomi, Masashi; Ishida, Tatsuro; Kobayashi, Tsutomu; Nitta, Norihisa; Sonoda, Akinaga; Yamada, Satoshi; Koike, Tomonari; Kuniyoshi, Nobue; Murata, Kiyoshi; Hirata, Ken-ichi; Ito, Takashi; Libby, Peter

    2013-11-01

    This study tested the hypothesis that vasospasm can trigger coronary plaque injury and acute ischemic myocardial damage. Myocardial infarction-prone strain of the Watanabe heritable hyperlipidemic rabbits received an intravenous bolus of ergonovine maleate (0.45 µmol/kg) during intravenous infusion of norepinephrine (12 nmol/kg per minute) to provoke coronary spasm in vivo. After this treatment, coronary angiography demonstrated vasospasm, and the ECG showed ischemic abnormalities (ST depression/elevation and T-wave inversion) in 77% of animals (23/30). These changes normalized after nitroglycerin injection. In rabbits that demonstrated these ECG findings for >20 minutes, echocardiograms showed left ventricular wall motion abnormality. Serum levels of heart-type fatty acid-binding protein, cardiac troponin-I, and myoglobin increased markedly 4 hours after spasm provocation. In coronary lesions of myocardial infarction-prone strain of the Watanabe heritable hyperlipidemic rabbits with provoked coronary spasm, we observed intimal injury in 60.9% in the form of endothelial cell protrusions (39.1%), denudation (30.4%), and macrophage extravasation (56.5%). Plaque disruption with luminal thrombus, however, was only seen in 2 of 23 animals (8.7%), and mural microthrombus was rarely observed (4.3%). These observations show that provocation of vasospasm in myocardial infarction-prone strain of the Watanabe heritable hyperlipidemic rabbits associates with subsequent ischemic myocardial damage. Although treatment with spasmogens altered aspects of plaque morphology, for example, endothelial protrusion and macrophage emigration, thrombosis was rare in these animals with chronic atherosclerotic disease.

  17. Social anxiety disorder in Saudi adolescent boys: Prevalence, subtypes, and parenting style as a risk factor.

    PubMed

    Ghazwani, Jaafar Y; Khalil, Shamsun N; Ahmed, Razia A

    2016-01-01

    Available information on social anxiety disorder (SAD) in adolescents in Saudi Arabia is limited. The objective of the study was to estimate the prevalence, severity, and subtypes of SAD, and parenting style risk factors associated with SAD in the adolescent. This cross-sectional study was conducted in two secondary schools for boys in Abha, Saudi Arabia during the Academic year 2013. To collect the data, a questionnaire eliciting information on background characteristics and parenting style as well as the Liebowitz Social Anxiety Scale Test (LSAS), for the evaluation of SAD, were used. A total of 454 students participated in the study. The age of the participants ranged between 15 and 20 years with a mean of 17.4 years. The prevalence of SAD was 11.7%. Around 36% and 11.4% of the students respectively had severe and more severe forms of SAD. Parenting style such as parental anger, criticism particularly in front of others, exaggerated protection, maltreatment and family provocation emerged as a significant risk factor for SAD. The independent predictors of SAD were a parental provocation and physical or emotional maltreatment by the parent (odds ratio [OR] = 3.97, 95% confidence interval [CI]: 1.90-8.31 and OR = 2.67, 95% CI: 3.17-5.19, respectively). The prevalence of SAD in secondary school students at Abha is high. Parenting style risk factors for SAD are modifiable. In this context, a national program to improve mental health in this age group is crucial.

  18. Aggression in Women: Behavior, Brain and Hormones.

    PubMed

    Denson, Thomas F; O'Dean, Siobhan M; Blake, Khandis R; Beames, Joanne R

    2018-01-01

    We review the literature on aggression in women with an emphasis on laboratory experimentation and hormonal and brain mechanisms. Women tend to engage in more indirect forms of aggression (e.g., spreading rumors) than other types of aggression. In laboratory studies, women are less aggressive than men, but provocation attenuates this difference. In the real world, women are just as likely to aggress against their romantic partner as men are, but men cause more serious physical and psychological harm. A very small minority of women are also sexually violent. Women are susceptible to alcohol-related aggression, but this type of aggression may be limited to women high in trait aggression. Fear of being harmed is a robust inhibitor of direct aggression in women. There are too few studies and most are underpowered to detect unique neural mechanisms associated with aggression in women. Testosterone shows the same small, positive relationship with aggression in women as in men. The role of cortisol is unclear, although some evidence suggests that women who are high in testosterone and low in cortisol show heightened aggression. Under some circumstances, oxytocin may increase aggression by enhancing reactivity to provocation and simultaneously lowering perceptions of danger that normally inhibit many women from retaliating. There is some evidence that high levels of estradiol and progesterone are associated with low levels of aggression. We highlight that more gender-specific theory-driven hypothesis testing is needed with larger samples of women and aggression paradigms relevant to women.

  19. Anatomical and functional overlap within the insula and anterior cingulate cortex during interoception and phobic symptom provocation.

    PubMed

    Caseras, Xavier; Murphy, Kevin; Mataix-Cols, David; López-Solà, Marina; Soriano-Mas, Carles; Ortriz, Hector; Pujol, Jesus; Torrubia, Rafael

    2013-05-01

    The anterior insula and the dorsal anterior cingulate cortex (ACC) are regarded as key brain structures associated with the integration of perceived phobic characteristics of external stimuli and the perception of ones own body responses that leads to emotional feelings. To test to what extent the activity in these two brain structures anatomically and functionally overlap during phobic reactions and interoception, we submitted the same group of phobic participants (n = 29; either spider or blood-injection-injury (BII) phobics) and controls (n = 17) to both type of experimental paradigms. Results showed that there was a clear anatomical overlap in the Blood Oxygen Level-Dependent (BOLD) responses within the anterior insula and ACC elicited during phobic symptom provocation and during interoceptive awareness. The activity within these two brain structures also showed to be correlated in the spider phobia group, but not in the BII phobic participants. Our results seem to support the idea that the activity within these two brain areas would be associated with the integration of perceived stimuli characteristics and bodily responses that lead to what we label as "fear." However, that seems not to be the case in BII phobia, where more research is needed in order to clarify to what extent that could be associated with the idiosyncratic physiological response that these patients present in front of phobic stimuli (i.e., drop in heart rate and blood pressure). Copyright © 2011 Wiley Periodicals, Inc.

  20. Characterizing convective cold pools: Characterizing Convective Cold Pools

    DOE PAGES

    Drager, Aryeh J.; van den Heever, Susan C.

    2017-05-09

    Cold pools produced by convective storms play an important role in Earth's climate system. However, a common framework does not exist for objectively identifying convective cold pools in observations and models. The present study investigates convective cold pools within a simulation of tropical continental convection that uses a cloud-resolving model with a coupled land-surface model. Multiple variables are assessed for their potential in identifying convective cold pool boundaries, and a novel technique is developed and tested for identifying and tracking cold pools in numerical model simulations. This algorithm is based on surface rainfall rates and radial gradients in the densitymore » potential temperature field. The algorithm successfully identifies near-surface cold pool boundaries and is able to distinguish between connected cold pools. Once cold pools have been identified and tracked, composites of cold pool evolution are then constructed, and average cold pool properties are investigated. Wet patches are found to develop within the centers of cold pools where the ground has been soaked with rainwater. These wet patches help to maintain cool surface temperatures and reduce cold pool dissipation, which has implications for the development of subsequent convection.« less

  1. Characterizing convective cold pools: Characterizing Convective Cold Pools

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

    Drager, Aryeh J.; van den Heever, Susan C.

    Cold pools produced by convective storms play an important role in Earth's climate system. However, a common framework does not exist for objectively identifying convective cold pools in observations and models. The present study investigates convective cold pools within a simulation of tropical continental convection that uses a cloud-resolving model with a coupled land-surface model. Multiple variables are assessed for their potential in identifying convective cold pool boundaries, and a novel technique is developed and tested for identifying and tracking cold pools in numerical model simulations. This algorithm is based on surface rainfall rates and radial gradients in the densitymore » potential temperature field. The algorithm successfully identifies near-surface cold pool boundaries and is able to distinguish between connected cold pools. Once cold pools have been identified and tracked, composites of cold pool evolution are then constructed, and average cold pool properties are investigated. Wet patches are found to develop within the centers of cold pools where the ground has been soaked with rainwater. These wet patches help to maintain cool surface temperatures and reduce cold pool dissipation, which has implications for the development of subsequent convection.« less

  2. Nitrogen Dioxide Exposure and Airway Responsiveness in ...

    EPA Pesticide Factsheets

    Controlled human exposure studies evaluating the effect of inhaled NO2 on the inherent responsiveness of the airways to challenge by bronchoconstricting agents have had mixed results. In general, existing meta-analyses show statistically significant effects of NO2 on the airway responsiveness of individuals with asthma. However, no meta-analysis has provided a comprehensive assessment of clinical relevance of changes in airway responsiveness, the potential for methodological biases in the original papers, and the distribution of responses. This paper provides analyses showing that a statistically significant fraction, 70% of individuals with asthma exposed to NO2 at rest, experience increases in airway responsiveness following 30-minute exposures to NO2 in the range of 200 to 300 ppb and following 60-minute exposures to 100 ppb. The distribution of changes in airway responsiveness is log-normally distributed with a median change of 0.75 (provocative dose following NO2 divided by provocative dose following filtered air exposure) and geometric standard deviation of 1.88. About a quarter of the exposed individuals experience a clinically relevant reduction in their provocative dose due to NO2 relative to air exposure. The fraction experiencing an increase in responsiveness was statistically significant and robust to exclusion of individual studies. Results showed minimal change in airway responsiveness for individuals exposed to NO2 during exercise. A variety of fa

  3. Evaluation of vaccine cold chain in urban health centers of municipal corporation of surat city, Western India.

    PubMed

    Naik, Ashish K; Rupani, Mihir P; Bansal, R K

    2013-12-01

    The success of immunization depends highly on the level of cold chain maintenance. The aim of the study was to assess the condition of cold chain equipment, practices adopted for cold chain maintenance and knowledge of the vaccinators. It was a cross-sectional study conducted in 20 UHCs of Surat Municipal Corporation (SMC). Cold chain equipment were observed with regards to their condition, along with the practices adopted by vaccinators for cold chain maintenance. A pre-designed and pre-tested questionnaire was used to interview the vaccinators regarding their knowledge and awareness regarding cold chain practices, management and handling. Data were entered and analyzed using Epi Info v 3.5.1. Simple proportions were calculated. Absence of separate stabilizer for deep freezers and ILRs (85%), ill-maintained temperature-record register, lack of criss-cross pattern of ice packs in deep freezer (65%), presence of things other than ice packs in deep freezer (10%) and things other than vaccines in ILR (10%) indicate poor cold chain maintenance. In addition to this, expired vaccines in ILR (5%), vaccines in the "unusable" stages of VVM (15%), lack of emergency contact number nearby in case of cold chain failure (85%), lack of inverter (85%), lack of generator (85%) and failure to note time of reconstitution on the vaccine vial at the time of vaccination (25%) indicate poor cold chain practices. Lack of knowledge of defrosting of ILR and deep freezer (45%), lack of knowledge about Shake test (40%), lack of knowledge of temperature range to be maintained in deep freezer (70%) and in ILR (15%) indicate poor knowledge of vaccinators. Cold chain maintenance and practices need improvement. Knowledge of vaccinators was overall unsatisfactory.

  4. Polymorphic ventricular tachycardia due to variant angina diagnosed on Holter monitoring and confirmed with cold pressor test.

    PubMed

    Öztürk, Semi; Aktemur, Tuğba; Kalyoncuoğlu, Muhsin; Durmuş, Gündüz; Can, Mehmet

    2017-04-01

    A 52-year-old man complaining of persistent recurring chest pain at night underwent coronary angiogram at another institution. Normal coronaries were observed and he was discharged with muscle spasmolytic prescription. Since symptoms had continued, 24-hour Holter monitoring was ordered at our facility and results revealed huge ST elevation and polymorphic ventricular tachycardia. Cold pressor test performed in catheterization laboratory also resulted in ventricular tachycardia. Nifedipine was prescribed and follow-up Holter monitoring revealed no further vasospastic episodes. Utility of 24-hour Holter rhythm monitoring and cold pressor test in patients with recurrent chest pain at night is demonstrated in this report.

  5. Design verification and cold-flow modeling test report

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

    Not Available

    1993-07-01

    This report presents a compilation of the following three test reports prepared by TRW for Alaska Industrial Development and Export Authority (AIDEA) as part of the Healy Clean Coal Project, Phase 1 Design of the TRW Combustor and Auxiliary Systems, which is co-sponsored by the Department of Energy under the Clean Coal Technology 3 Program: (1) Design Verification Test Report, dated April 1993, (2) Combustor Cold Flow Model Report, dated August 28, 1992, (3) Coal Feed System Cold Flow Model Report, October 28, 1992. In this compilation, these three reports are included in one volume consisting of three parts, andmore » TRW proprietary information has been excluded.« less

  6. Nationalism, Nuclear Policy and Children in Cold War America.

    ERIC Educational Resources Information Center

    Stephens, Sharon

    1997-01-01

    Theorizes the place of children in America's "Cold War Consensus" of the 1950s-60s. Counterposes dominant Cold War images of abstract, generic children (inevitably white middle class) to actual children most vulnerable to risks associated with nuclear weapons production and testing. Concludes that in various ways, these children were all…

  7. Unexplained lower abdominal pain associated with sacroiliac joint dysfunction: report of 2 cases.

    PubMed

    Morimoto, Daijiro; Isu, Toyohiko; Kim, Kyongsong; Matsumoto, Ryoji; Isobe, Masanori

    2011-01-01

    A 25-year-old woman and a 31-year-old man presented with chronic lower back pain and unexplained lower abdominal pain. Both patients had groin tenderness at the medial border of the anterior superior iliac spine. The results of radiographical and physical examinations suggested sacroiliac joint dysfunction. Sacroiliac joint injection relieved their symptoms, including groin tenderness. In our experience, groin tenderness is highly specific for sacroiliac joint dysfunction. We speculate that spasm of the iliac muscle can cause groin pain and tenderness. Groin pain and a history of unexplained abdominal pain, with lower back pain, are symptoms that suggest sacroiliac joint dysfunction. Additionally, compression of the iliac muscle is a simple and useful maneuver; therefore, it can be used as a screening test for sacroiliac joint dysfunction, alongside other provocation tests.

  8. [Modern Diagnosis and Therapy of the rhinitis allergica].

    PubMed

    Hauswald, B; Yarin, Y M

    2015-05-01

    The prevalence of allergic diseases is increasing worldwide. The highest increase rate is observed in rhinitis allergica. Apart from the anamnesis, the diagnosis relies mainly on skin tests, laboratory analyses and if necessary provocation tests. Symptomatic and causal therapy with abstention and specific immunotherapy are available as therapeutic means. Specific immunotherapy should be aspired as the method of choice. It is comprised of subcutane and sublingular immunity therapy. Usually native allergens and allergoids are used as therapeutics. Recombinant allergens are currently under development. Modern therapy procedures involving these drugs consist of year-round or pre- and co-seasonal treatment which spans at least 3-4 years. In cases of polyvalent allergy, different types of drugs and therapy procedures can be combined. The future of rhinitis allergica treatment lies in further development of specific immunotherapy. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Cold Helium Pressurization for Liquid Oxygen / Liquid Methane Propulsion Systems: Fully-Integrated Initial Hot-Fire Test Results

    NASA Technical Reports Server (NTRS)

    Morehead, R. L.; Atwell, M. J.; Melcher, J. C.; Hurlbert, E. A.

    2016-01-01

    A prototype cold helium active pressurization system was incorporated into an existing liquid oxygen (LOX) / liquid methane (LCH4) prototype planetary lander and hot-fire tested to collect vehicle-level performance data. Results from this hot-fire test series were used to validate integrated models of the vehicle helium and propulsion systems and demonstrate system effectiveness for a throttling lander. Pressurization systems vary greatly in complexity and efficiency between vehicles, so a pressurization performance metric was also developed as a means to compare different active pressurization schemes. This implementation of an active repress system is an initial sizing draft. Refined implementations will be tested in the future, improving the general knowledge base for a cryogenic lander-based cold helium system.

  10. Thermal math model analysis of FRSI test article subjected to cold soak and entry environments. [Flexible Reuseable Surface Insulation in Space Shuttle Orbiter

    NASA Technical Reports Server (NTRS)

    Gallegos, J. J.

    1978-01-01

    A multi-objective test program was conducted at the NASA/JSC Radiant Heat Test Facility in which an aluminum skin/stringer test panel insulated with FRSI (Flexible Reusable Surface Insulation) was subjected to 24 simulated Space Shuttle Orbiter ascent/entry heating cycles with a cold soak in between in the 10th and 20th cycles. A two-dimensional thermal math model was developed and utilized to predict the thermal performance of the FRSI. Results are presented which indicate that the modeling techniques and property values have been proven adequate in predicting peak structure temperatures and entry thermal responses from both an ambient and cold soak condition of an FRSI covered aluminum structure.

  11. Symmetrical drug-related intertriginous and flexural exanthema.

    PubMed

    Tan, Sze-Chin; Tan, Justina W-L

    2011-08-01

    Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE), previously termed drug-related baboon syndrome, is a benign and self-limiting type IV hypersensitivity reaction characterized by symmetrical erythema involving the gluteal and intertriginous areas in the absence of systemic involvement. It may also occur in the absence of previous drug exposure. Antibiotics, in particular beta-lactams, comprise the majority of causes of SDRIFE. Other drugs which have been implicated include antihypertensives, radiocontrast media, chemotherapeutic agents, and biologics. Histology of lesional skin is variable with predominance of superficial perivascular inflammatory cell infiltrates. Outcomes of allergy tests are variable with positive delayed intradermal tests reported for penicillin V, allopurinol; positive patch tests for erythromycin, mitomycin, nystatin, pseudoephdrine; positive lymphocyte transformation tests for erythromycin; and positive drug provocation tests for clindamycin, cimetidine, corticosteroids, terbinafine, and valacyclovir. Diagnosis of SDRIFE is dependent upon recognition of the clinical morphology and distribution of the rash, and its temporal relationship to the use of the suspected drug. Outcomes of in-vivo and in-vitro tests have been inconsistent, and thus may not be useful in the identification of the putative drug.

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

    Denslow, Kayte M.; Bontha, Jagannadha R.; Adkins, Harold E.

    This document presents the visual and ultrasonic PulseEcho critical velocity test results obtained from the System Performance test campaign that was completed in September 2012 with the Remote Sampler Demonstration (RSD)/Waste Feed Flow Loop cold-test platform located at the Monarch test facility in Pasco, Washington. This report is intended to complement and accompany the report that will be developed by WRPS on the design of the System Performance simulant matrix, the analysis of the slurry test sample concentration and particle size distribution (PSD) data, and the design and construction of the RSD/Waste Feed Flow Loop cold-test platform.

  13. 2015 Groundwater Radiological Monitoring Results Associated with the Advanced Test Reactor Complex Cold Waste Ponds

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

    Lewis, Michael George

    This report summarizes radiological monitoring results from groundwater wells associated with the Idaho National Laboratory Site’s Advanced Test Reactor Complex Cold Waste Ponds Reuse Permit (I-161-02). All radiological monitoring is performed to fulfill Department of Energy requirements under the Atomic Energy Act.

  14. Fluid Structure Interaction in a Cold Flow Test and Transient CFD Analysis of Out-of-Round Nozzles

    NASA Technical Reports Server (NTRS)

    Ruf, Joseph; Brown, Andrew; McDaniels, David; Wang, Ten-See

    2010-01-01

    This viewgraph presentation describes two nozzle fluid flow interactions. They include: 1) Cold flow nozzle tests with fluid-structure interaction at nozzle separated flow; and 2) CFD analysis for nozzle flow and side loads of nozzle extensions with various out-of-round cases.

  15. Reactor Simulator Testing

    NASA Technical Reports Server (NTRS)

    Schoenfeld, Michael P.; Webster, Kenny L.; Pearson, Boise Jon

    2013-01-01

    As part of the Nuclear Systems Office Fission Surface Power Technology Demonstration Unit (TDU) project, a reactor simulator test loop (RxSim) was design & built to perform integrated testing of the TDU components. In particular, the objectives of RxSim testing was to verify the operation of the core simulator, the instrumentation and control system, and the ground support gas and vacuum test equipment. In addition, it was decided to include a thermal test of a cold trap purification design and a pump performance test at pump voltages up to 150 V since the targeted mass flow rate of 1.75 kg/s was not obtained in the RxSim at the originally constrained voltage of 120 V. This paper summarizes RxSim testing. The gas and vacuum ground support test equipment performed effectively in NaK fill, loop pressurization, and NaK drain operations. The instrumentation and control system effectively controlled loop temperature and flow rates or pump voltage to targeted settings. The cold trap design was able to obtain the targeted cold temperature of 480 K. An outlet temperature of 636 K was obtained which was lower than the predicted 750 K but 156 K higher than the cold temperature indicating the design provided some heat regeneration. The annular linear induction pump (ALIP) tested was able to produce a maximum flow rate of 1.53 kg/s at 800 K when operated at 150 V and 53 Hz. Keywords: fission, space power, nuclear, liquid metal, NaK.

  16. Maternal risk factors in fetal alcohol syndrome: provocative and permissive influences.

    PubMed

    Abel, E L; Hannigan, J H

    1995-01-01

    We present an hypothesis integrating epidemiological, clinical case, and basic biomedical research to explain why only relatively few women who drink alcohol during pregnancy give birth to children with alcohol-related birth defects (ARBDs), in particular, Fetal Alcohol Syndrome (FAS). We argue that specific sociobehavioral risk factors, e.g., low socioeconomic status, are permissive for FAS in that they provide the context for increased vulnerability. We illustrate how these permissive factors are related to biological factors, e.g., decreased antioxidant status, which in conjunction with alcohol, provoke FAS/ARBDs in vulnerable fetuses. We propose an integrative heuristic model hypothesizing that these permissive and provocative factors increase the likelihood of FAS/ARBDs because they potentiate two related mechanisms of alcohol-induced teratogenesis, specifically, maternal/fetal hypoxia and free radical formation.

  17. Impact of suggestion on the human experimental model of cold hyperalgesia after topical application of high-concentration menthol [40%].

    PubMed

    Helfert, S; Reimer, M; Barnscheid, L; Hüllemann, P; Rengelshausen, J; Keller, T; Baron, R; Binder, A

    2018-05-14

    Human experimental pain models in healthy subjects offer unique possibilities to study mechanisms of pain within a defined setting of expected pain symptoms, signs and mechanisms. Previous trials in healthy subjects demonstrated that topical application of 40% menthol is suitable to induce cold hyperalgesia. The objective of this study was to evaluate the impact of suggestion on this experimental human pain model. The study was performed within a single-centre, randomized, placebo-controlled, double-blind, two-period crossover trial in a cohort of 16 healthy subjects. Subjects were tested twice after topical menthol application (40% dissolved in ethanol) and twice after ethanol (as placebo) application. In the style of a balanced placebo trial design, the subjects received during half of the testing the correct information about the applied substance (topical menthol or ethanol) and during half of the testing the incorrect information, leading to four tested conditions (treatment conditions: menthol-told-menthol and menthol-told-ethanol; placebo conditions: ethanol-told-menthol and ethanol-told-ethanol). Cold but not mechanical hyperalgesia was reliably induced by the model. The cold pain threshold decreased in both treatment conditions regardless whether true or false information was given. Minor suggestion effects were found in subjects with prior ethanol application. The menthol model is a reliable, nonsuggestible model to induce cold hyperalgesia. Mechanical hyperalgesia is not as reliable to induce. Cold hyperalgesia may be investigated under unbiased and suggestion-free conditions using the menthol model of pain. © 2018 European Pain Federation - EFIC®.

  18. Phenol degradation and heavy metal tolerance of Antarctic yeasts.

    PubMed

    Fernández, Pablo Marcelo; Martorell, María Martha; Blaser, Mariana G; Ruberto, Lucas Adolfo Mauro; de Figueroa, Lucía Inés Castellanos; Mac Cormack, Walter Patricio

    2017-05-01

    In cold environments, biodegradation of organic pollutants and heavy metal bio-conversion requires the activity of cold-adapted or cold-tolerant microorganisms. In this work, the ability to utilize phenol, methanol and n-hexadecane as C source, the tolerance to different heavy metals and growth from 5 to 30 °C were evaluated in cold-adapted yeasts isolated from Antarctica. Fifty-nine percent of the yeasts were classified as psychrotolerant as they could grow in all the range of temperature tested, while the other 41% were classified as psychrophilic as they only grew below 25 °C. In the assimilation tests, 32, 78, and 13% of the yeasts could utilize phenol, n-hexadecane, and methanol as C source, respectively, but only 6% could assimilate the three C sources evaluated. In relation to heavy metals ions, 55, 68, and 80% were tolerant to 1 mM of Cr(VI), Cd(II), and Cu(II), respectively. Approximately a half of the isolates tolerated all of them. Most of the selected yeasts belong to genera previously reported as common for Antarctic soils, but several other genera were also isolated, which contribute to the knowledge of this cold environment mycodiversity. The tolerance to heavy metals of the phenol-degrading cold-adapted yeasts illustrated that the strains could be valuable as inoculant for cold wastewater treatment in extremely cold environments.

  19. Viscoelastic behaviour of cold recycled asphalt mixes

    NASA Astrophysics Data System (ADS)

    Cizkova, Zuzana; Suda, Jan

    2017-09-01

    Behaviour of cold recycled mixes depends strongly on both the bituminous binder content (bituminous emulsion or foamed bitumen) and the hydraulic binder content (usually cement). In the case of cold recycled mixes rich in bitumen and with low hydraulic binder content, behaviour is close to the viscoelastic behaviour of traditional hot mix asphalt. With decreasing bituminous binder content together with increasing hydraulic binder content, mixes are characteristic with brittle behaviour, typical for concrete pavements or hydraulically bound layers. The behaviour of cold recycled mixes with low content of both types of binders is similar to behaviour of unbound materials. This paper is dedicated to analysing of the viscoelastic behaviour of the cold recycled mixes. Therefore, the tested mixes contained higher amount of the bituminous binder (both foamed bitumen and bituminous emulsion). The best way to characterize any viscoelastic material in a wide range of temperatures and frequencies is through the master curves. This paper includes interesting findings concerning the dependency of both parts of the complex modulus (elastic and viscous) on the testing frequency (which simulates the speed of heavy traffic passing) and on the testing temperature (which simulates the changing climate conditions a real pavement is subjected to).

  20. Commissioning and operational results of helium refrigeration system at JLab for the 12GeV upgrade

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

    Knudsen, Peter N.; Ganni, Venkatarao; Dixon, Kelly D.

    The new 4.5 K refrigerator system at the Jefferson Lab (JLab) Central Helium Liquefier (CHL-2) for the 12 GeV upgrade was commissioned in late spring of 2013, following the commissioning of the new compressor system, and has been supporting 12 GeV LINAC commissioning since that time. Six design modes were tested during commissioning, consisting of a maximum capacity, nominal capacity, maximum liquefaction, maximum refrigeration, maximum fill and a stand-by/reduced load condition. The maximum capacity was designed to support a 238 g/s, 30 K and 1.16 bar cold compressor return flow, a 15 g/s, 4.5 K liquefaction load and a 12.6more » kW, 35-55 K shield load. The other modes were selected to ensure proper component sizing and selection to allow the cold box to operate over a wide range of conditions and capacities. The cold box system is comprised of two physically independent cold boxes with interconnecting transfer-lines. The outside (upper) 300-60 K vertical cold box has no turbines and incorporates a liquid nitrogen pre-cooler and 80-K beds. The inside (lower) 60-4.5 K horizontal cold box houses seven turbines that are configured in four expansion stages including one Joule-Thompson expander and a 20-K bed. The helium compression system has five compressors to support three pressure levels in the cold box. This paper will summarize the analysis of the test data obtained over the wide range of operating conditions and capacities which were tested.« less

  1. Methods of Testing Thermal Insulation and Associated Test Apparatus

    NASA Technical Reports Server (NTRS)

    Fesmire, James E. (Inventor); Augustynowicz, Stanislaw D. (Inventor)

    2004-01-01

    The system and method for testing thermal insulation uses a cryostatic insulation tester having a vacuum chamber and a cold mass including a test chamber and upper and lower guard chambers adjacent thereto. The thermal insulation is positioned within the vacuum chamber and adjacent the cold mass. Cryogenic liquid is supplied to the test chamber, upper guard and lower guard to create a first gas layer in an upper portion of the lower guard chamber and a second gas layer in an upper portion of the test chamber. Temperature are sensed within the vacuum chamber to test the thermal insulation.

  2. Behavior in the Lesch--Nyhan Syndrome

    ERIC Educational Resources Information Center

    Nyhan, William L.

    1976-01-01

    The Lesch-Nyhan syndrome (which only affects males) is a heritable disorder of the metabolism of uric acid in which behavioral manifestations are prominent and among the most provocative. (Author/SBH)

  3. 40 CFR 86.201-11 - General applicability.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...-Duty Passenger Vehicles; Cold Temperature Test Procedures § 86.201-11 General applicability. (a) This subpart describes procedures for determining the cold temperature carbon monoxide (CO) emissions from 1994...

  4. 40 CFR 86.201-94 - General applicability.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...-Duty Passenger Vehicles; Cold Temperature Test Procedures § 86.201-94 General applicability. (a) This subpart describes procedures for determining the cold temperature carbon monoxide (CO) emission from 1994...

  5. 40 CFR 86.201-94 - General applicability.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...-Duty Passenger Vehicles; Cold Temperature Test Procedures § 86.201-94 General applicability. (a) This subpart describes procedures for determining the cold temperature carbon monoxide (CO) emission from 1994...

  6. 40 CFR 86.201-94 - General applicability.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...-Duty Passenger Vehicles; Cold Temperature Test Procedures § 86.201-94 General applicability. (a) This subpart describes procedures for determining the cold temperature carbon monoxide (CO) emission from 1994...

  7. 40 CFR 86.201-11 - General applicability.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...-Duty Passenger Vehicles; Cold Temperature Test Procedures § 86.201-11 General applicability. (a) This subpart describes procedures for determining the cold temperature carbon monoxide (CO) emissions from 1994...

  8. 40 CFR 86.201-11 - General applicability.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...-Duty Passenger Vehicles; Cold Temperature Test Procedures § 86.201-11 General applicability. (a) This subpart describes procedures for determining the cold temperature carbon monoxide (CO) emissions from 1994...

  9. Urinary excretion of adrenal steroids, catecholamines and electrolytes in man, before and after acclimatization to cold in Antarctica

    PubMed Central

    Budd, G. M.; Warhaft, N.

    1970-01-01

    1. Urine samples were collected from four men before and during test cold exposures in Melbourne, Australia, and Mawson, Antarctica. Changes in the response of body temperature to the test exposures showed that the men had acclimatized to cold at Mawson. 2. Excretion rates of 17-hydroxycorticosteroids and 17-ketosteroids were significantly greater at Mawson than in Melbourne, in both the pre-exposure and exposure periods. 3. Excretion rates of noradrenaline, adrenaline, sodium, potassium and creatinine did not differ significantly between Mawson and Melbourne, nor did urine flow rates. 4. During the cold exposure significant increases occurred, to the same extent at Mawson as in Melbourne, in urine flow rate and in all measured urinary constituents except creatinine. PMID:5501486

  10. INDUCTION HEATING PROCESS FOR MELTING TITANIUM (COLD-WALL CRUCIBLES, SEGMENTED AND NON-SEGMENTED).

    DTIC Science & Technology

    system during melting tests. Three types of cold-wall crucibles were investigated. The first was a four-segment copper crucible , the second a non...segmented silicon bronze crucible, and the third a two-segment copper crucible coated with BeO. Attempts to melt titanium in an induction field in a cold

  11. Identification of Sweet Sorghum accessions with seedling cold tolerance using both lab cold germination test and field early Spring planting evaluation

    USDA-ARS?s Scientific Manuscript database

    Cultivars with quick seedling emergence and stand establishment at early spring cold conditions may be planted early in the same region with an extended period of plant growth and can potentially increase either grain yield, stem sugar yield, or biomass production of sorghum. Planting cultivars with...

  12. Sequential administration of arginine and arginine plus GHRH to test somatotroph function in short children.

    PubMed

    Bellone, J; Aimaretti, G; Bellone, S; Baffoni, C; Corneli, G; Origlia, C; Cappa, M; Ghigo, E

    2000-02-01

    The hormonal diagnosis of GH deficiency in childhood is conventionally based on the GH response to at least two provocative stimuli. Among these, arginine (ARG) has long been considered a classical, centrally mediated stimulus of GH secretion. ARG is also able to potentiate the GH response to GHRH, likely inhibiting hypothalamic somatostatin; this combined test is one of the most potent to explore the maximal secretory capacity of somatotroph cells. Based on these premises, we verified whether the sequential administration of ARG and ARG+GHRH could be feasible as single step provocative test to evaluate the GH releasable pool in short children. To this goal, 48 normal short children (35 M and 13 F, 12.0+/-0.4 yr, PS 1: 255 II-IV: 23) underwent a test with ARG (0.5 g/kg i.v. from 0 to +30 min) followed by a coadministration of ARG (from +120 to 150 min) plus GHRH (1 microg/kg i.v. at +120 min). ARG alone elicited a clear GH response (mean peak vs baseline: 12.1+/-1.7 vs 2.0+/-0.4 microg/l, p<0.001, Cmax range 12-51.0 microg/l). Following this GH rise, the hormonal levels at +120 min approached to baseline levels (4.2+/-0.8 microg/l) but then showed marked response to the coadministration of ARG+GHRH. The GH peak following ARG+GHRH (mean peak: 47.8+/-3.3 microg/l, p<0.001; Cmax 22.4-150.0 microg/l) was clearly higher (p<0.001) than that recorded after ARG alone. The GH responses to both ARG and ARG+GHRH were independent of gender, puberty, height velocity, body mass index (BMI) and IGF-I levels. Nine normal short children (16%) had GH peaks lower than 7 microg/l after ARG alone, while none showed GH peak below 20 microg/l after ARG+GHRH. Thus, ARG alone is a good stimulus of GH secretion but false positive responses frequently occur in normal short children. ARG+GHRH is a more potent stimulus giving no false positive responses even after previous challenge with ARG alone. Testing with sequential administration of ARG and ARG+GHRH may allow the single step evaluation of the somatotroph response to central and pituitary stimuli in short children.

  13. Early detection of subclinical visual damage after blast-mediated TBI enables prevention of chronic visual deficit by treatment with P7C3-S243.

    PubMed

    Dutca, Laura M; Stasheff, Steven F; Hedberg-Buenz, Adam; Rudd, Danielle S; Batra, Nikhil; Blodi, Frederick R; Yorek, Matthew S; Yin, Terry; Shankar, Malini; Herlein, Judith A; Naidoo, Jacinth; Morlock, Lorraine; Williams, Noelle; Kardon, Randy H; Anderson, Michael G; Pieper, Andrew A; Harper, Matthew M

    2014-12-02

    Traumatic brain injury (TBI) frequently leads to chronic visual dysfunction. The purpose of this study was to investigate the effect of TBI on retinal ganglion cells (RGCs), and to test whether treatment with the novel neuroprotective compound P7C3-S243 could prevent in vivo functional deficits in the visual system. Blast-mediated TBI was modeled using an enclosed over-pressure blast chamber. The RGC physiology was evaluated using a multielectrode array and pattern electroretinogram (PERG). Histological analysis of RGC dendritic field and cell number were evaluated at the end of the study. Visual outcome measures also were evaluated based on treatment of mice with P7C3-S243 or vehicle control. We show that deficits in neutral position PERG after blast-mediated TBI occur in a temporally bimodal fashion, with temporary recovery 4 weeks after injury followed by chronically persistent dysfunction 12 weeks later. This later time point is associated with development of dendritic abnormalities and irreversible death of RGCs. We also demonstrate that ongoing pathologic processes during the temporary recovery latent period (including abnormalities of RGC physiology) lead to future dysfunction of the visual system. We report that modification of PERG to provocative postural tilt testing elicits changes in PERG measurements that correlate with a key in vitro measures of damage: the spontaneous and light-evoked activity of RGCs. Treatment with P7C3-S243 immediately after injury and throughout the temporary recovery latent period protects mice from developing chronic visual system dysfunction. Provocative PERG testing serves as a noninvasive test in the living organism to identify early damage to the visual system, which may reflect corresponding damage in the brain that is not otherwise detectable by noninvasive means. This provides the basis for developing an earlier diagnostic test to identify patients at risk for developing chronic CNS and visual system damage after TBI at an earlier stage when treatments may be more effective in preventing these sequelae. In addition, treatment with the neuroprotective agent P7C3-S243 after TBI protects from visual system dysfunction after TBI. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  14. Early Detection of Subclinical Visual Damage After Blast-Mediated TBI Enables Prevention of Chronic Visual Deficit by Treatment With P7C3-S243

    PubMed Central

    Dutca, Laura M.; Stasheff, Steven F.; Hedberg-Buenz, Adam; Rudd, Danielle S.; Batra, Nikhil; Blodi, Frederick R.; Yorek, Matthew S.; Yin, Terry; Shankar, Malini; Herlein, Judith A.; Naidoo, Jacinth; Morlock, Lorraine; Williams, Noelle; Kardon, Randy H.; Anderson, Michael G.; Pieper, Andrew A.; Harper, Matthew M.

    2014-01-01

    Purpose. Traumatic brain injury (TBI) frequently leads to chronic visual dysfunction. The purpose of this study was to investigate the effect of TBI on retinal ganglion cells (RGCs), and to test whether treatment with the novel neuroprotective compound P7C3-S243 could prevent in vivo functional deficits in the visual system. Methods. Blast-mediated TBI was modeled using an enclosed over-pressure blast chamber. The RGC physiology was evaluated using a multielectrode array and pattern electroretinogram (PERG). Histological analysis of RGC dendritic field and cell number were evaluated at the end of the study. Visual outcome measures also were evaluated based on treatment of mice with P7C3-S243 or vehicle control. Results. We show that deficits in neutral position PERG after blast-mediated TBI occur in a temporally bimodal fashion, with temporary recovery 4 weeks after injury followed by chronically persistent dysfunction 12 weeks later. This later time point is associated with development of dendritic abnormalities and irreversible death of RGCs. We also demonstrate that ongoing pathologic processes during the temporary recovery latent period (including abnormalities of RGC physiology) lead to future dysfunction of the visual system. We report that modification of PERG to provocative postural tilt testing elicits changes in PERG measurements that correlate with a key in vitro measures of damage: the spontaneous and light-evoked activity of RGCs. Treatment with P7C3-S243 immediately after injury and throughout the temporary recovery latent period protects mice from developing chronic visual system dysfunction. Conclusions. Provocative PERG testing serves as a noninvasive test in the living organism to identify early damage to the visual system, which may reflect corresponding damage in the brain that is not otherwise detectable by noninvasive means. This provides the basis for developing an earlier diagnostic test to identify patients at risk for developing chronic CNS and visual system damage after TBI at an earlier stage when treatments may be more effective in preventing these sequelae. In addition, treatment with the neuroprotective agent P7C3-S243 after TBI protects from visual system dysfunction after TBI. PMID:25468886

  15. Analysis of cold worked holes for structural life extension

    NASA Technical Reports Server (NTRS)

    Wieland, David H.; Cutshall, Jon T.; Burnside, O. Hal; Cardinal, Joseph W.

    1994-01-01

    Cold working holes for improved fatigue life of fastener holes are widely used on aircraft. This paper presents methods used by the authors to determine the percent of cold working to be applied and to analyze fatigue crack growth of cold worked fastener holes. An elastic, perfectly-plastic analysis of a thick-walled tube is used to determine the stress field during the cold working process and the residual stress field after the process is completed. The results of the elastic/plastic analysis are used to determine the amount of cold working to apply to a hole. The residual stress field is then used to perform damage tolerance analysis of a crack growing out of a cold worked fastener hole. This analysis method is easily implemented in existing crack growth computer codes so that the cold worked holes can be used to extend the structural life of aircraft. Analytical results are compared to test data where appropriate.

  16. Validation of standard ASTM F2732 and comparison with ISO 11079 with respect to comfort temperature ratings for cold protective clothing.

    PubMed

    Gao, Chuansi; Lin, Li-Yen; Halder, Amitava; Kuklane, Kalev; Holmér, Ingvar

    2015-01-01

    American standard ASTM F2732 estimates the lowest environmental temperature for thermal comfort for cold weather protective clothing. International standard ISO 11079 serves the same purpose but expresses cold stress in terms of required clothing insulation for a given cold climate. The objective of this study was to validate and compare the temperature ratings using human subject tests at two levels of metabolic rates (2 and 4 MET corresponding to 116.4 and 232.8 W/m(2)). Nine young and healthy male subjects participated in the cold exposure at 3.4 and -30.6 °C. The results showed that both standards predict similar temperature ratings for an intrinsic clothing insulation of 1.89 clo and for 2 MET activity. The predicted temperature rating for 2 MET activity is consistent with test subjects' thermophysiological responses, perceived thermal sensation and thermal comfort. For 4 MET activity, however, the whole body responses were on the cold side, particularly the responses of the extremities. ASTM F2732 is also limited due to its omission and simplification of three climatic variables (air velocity, radiant temperature and relative humidity) and exposure time in the cold which are of practical importance. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  17. Room temperature creep behavior of Ti–Nb–Ta–Zr–O alloy

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

    Zhang, Wei-dong

    The room temperature creep behavior and deformation mechanisms of a Ti–Nb–Ta–Zr–O alloy, which is also called “gum metal”, were investigated with the nanoindentation creep and conventional creep tests. The microstructure was observed with electron backscattered diffraction analysis (EBSD) and transmission electron microscopy (TEM). The results show that the creep stress exponent of the alloy is sensitive to cold deformation history of the alloy. The alloy which was cold swaged by 85% shows high creep resistance and the stress exponent is approximately equal to 1. Microstructural observation shows that creep process of the alloy without cold deformation is controlled by dislocationmore » mechanism. The stress-induced α' martensitic phase transformation also occurs. The EBSD results show that the grain orientation changes after the creep tests, and thus, the creep of the cold-worked alloy is dominated by the shear deformation of giant faults without direct assistance from dislocations. - Highlights: •Nanoindentation was used to investigate room temperature creep behavior of gum metal. •The creep stress exponent of gum metal is sensitive to the cold deformation history. •The creep stress exponent of cold worked gum metal is approximately equal to 1. •The creep of the cold-worked gum metal is governed by the shear deformation of giant faults.« less

  18. The Chinese restaurant syndrome: an anecdote revisited.

    PubMed

    Kenney, R A

    1986-04-01

    The Chinese Restaurant Syndrome arose from an anecdote of discomfort experienced after eating Chinese cuisine. Monosodium glutamate has been implicated as the causative agent. Work over the past 17 years has consistently failed to reveal any objective sign accompanying the transient sensations that some individuals experience after the experimental ingestion of monosodium glutamate and it is questionable whether the term 'Chinese Restaurant Syndrome' has any validity. When some common food materials are used in the same experimental setting, similar symptoms can be produced in a limited number of people. Double-blind testing of individuals who identify themselves as suffering the 'syndrome' has failed to confirm the role of monosodium glutamate as the provocative agent.

  19. Allergy to dexchlorpheniramine. Study of a case.

    PubMed

    Cáceres Calle, O; Fernández-Benítez, M

    2004-01-01

    Dexchlorpheniramine (DH) is a classical or first generation antihistamine belonging to the ethanolamine group. Adverse effects related to these antihistamines are frequent, but the hypersensitivity reactions described in the literature since 1940 are exceptional. We report the case of a 32-year-old woman who experienced two episodes of akathisia secondary to intravenous (i.v.) dexchlorpheniramine administration for a possible hypersensitivity reaction to local anesthetics. Allergological study consisted of the following tests: skin prick tests with routine allergens, with a negative result; skin prick and intradermal tests with local anesthetics and DH, with a positive result to DH in the intradermal skin test (+ +); serum specific IgE, which was within normal levels; histamine release test with DH with a negative result, and the basophil activation test (BAT) with local anesthetics and DH, which was positive for DH and weakly positive to Lidocaine. BAT is proving to be a highly useful tool in the field of drug allergy, with a higher sensitivity and specificity than other in vitro tests. Because it avoids the need for provocation tests, this is especially important in drug-induced allergic reactions in which in vivo tests are repeatedly negative despite a clear clinical history.

  20. Cold startup and low temperature performance of the Brayton cycle electrical subsystem

    NASA Technical Reports Server (NTRS)

    Vrancik, J. E.; Bainbridge, R. C.

    1971-01-01

    Cold performance tests and startup tests were conducted on the Brayton-cycle inverter, motor-driven pump, dc supply, speed control with parasitic load resistor and the Brayton control system. These tests were performed with the components in a vacuum and mounted on coldplates. A temperature range of ?25 to -50 C was used for the tests. No failures occurred, and component performance gave no indication that there would be any problem with the safe operation of the Brayton power generating system.

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