Trends in autumn rain of West China from 1961 to 2014

NASA Astrophysics Data System (ADS)

Zhang, Chi; Wang, Zunya; Zhou, Botao; Li, Yonghua; Tang, Hongyu; Xiang, Bo

2018-02-01

Autumn rain of West China is a typical climate phenomenon, which is characterized by continuous rainy days and large rainfall amounts and exerts profound impacts on the economic society. Based on daily precipitation data from 524 observation stations for the period of 1961-2014, this article comprehensively examined secular changes in autumn rain of West China, including its amount, frequency, intensity, and associated extremes. The results generally show a significant reduction of rainfall amount and rainy days and a significant enhancement of mean rainfall intensity for the average of West China during autumn (September-October) since 1961. Meanwhile, decreasing trends are consistently observed in the maximum daily rainfall, the longest consecutive rainy days, the greatest consecutive rainfall amount, and the frequencies of the extreme daily rainfall, consecutive rainfall, and consecutive rainfall process. Further analysis indicates that the decreases of autumn rainfall and related extremes in West China are associated with the decreases in both water vapor content and atmospheric unstable stratification during the past decades. On the regional scale, some differences exist in the changes of autumn rainfall between the eastern and western parts of West China. Besides, it is found that the autumn rainy season tends to start later and terminate earlier particularly in eastern West China.

40 CFR 422.55 - Standards of performance for new sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

... any 1 day Average of daily values for 30 consecutive days shall not exceed— Total phosphorus (as P... consecutive days shall not exceed— Total phosphorus (as P) 105 35 Fluoride (as F) 75 25 pH (1) (1) 1 Within...

40 CFR 422.55 - Standards of performance for new sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... any 1 day Average of daily values for 30 consecutive days shall not exceed— Total phosphorus (as P... consecutive days shall not exceed— Total phosphorus (as P) 105 35 Fluoride (as F) 75 25 pH (1) (1) 1 Within...

The Effects of Exhaustive Exercise on Thermoregulatory Fatigue During Cold Exposure

DTIC Science & Technology

2002-04-01

exercise routine for days 1-7 consisted of the following activities each day: running & sprinting (hiking substituted on D3 & D7), weightlifting ...ergometry, and an anaerobic power test. Subjects ran 4.8 km at their personal best and sprinted 800 m three consecutive times. Weightlifting consisted of one... injury on Day 5 and did not participate in the Day 7 cold exposure. The main reasons for not completing all 6 hours during CW included hip flexor

Shift Work, Chronotype, and Melatonin Patterns among Female Hospital Employees on Day and Night Shifts.

PubMed

Leung, Michael; Tranmer, Joan; Hung, Eleanor; Korsiak, Jill; Day, Andrew G; Aronson, Kristan J

2016-05-01

Shift work-related carcinogenesis is hypothesized to be mediated by melatonin; however, few studies have considered the potential effect modification of this underlying pathway by chronotype or specific aspects of shift work such as the number of consecutive nights in a rotation. In this study, we examined melatonin patterns in relation to shift status, stratified by chronotype and number of consecutive night shifts, and cumulative lifetime exposure to shift work. Melatonin patterns of 261 female personnel (147 fixed-day and 114 on rotations, including nights) at Kingston General Hospital were analyzed using cosinor analysis. Urine samples were collected from all voids over a 48-hour specimen collection period for measurement of 6-sulfatoxymelatonin concentrations using the Buhlmann ELISA Kit. Chronotypes were assessed using mid-sleep time (MSF) derived from the Munich Chronotype Questionnaire (MCTQ). Sociodemographic, health, and occupational information were collected by questionnaire. Rotational shift nurses working nights had a lower mesor and an earlier time of peak melatonin production compared to day-only workers. More pronounced differences in mesor and acrophase were seen among later chronotypes, and shift workers working ≥3 consecutive nights. Among nurses, cumulative shift work was associated with a reduction in mesor. These results suggest that evening-types and/or shift workers working ≥3 consecutive nights are more susceptible to adverse light-at-night effects, whereas long-term shift work may also chronically reduce melatonin levels. Cumulative and current exposure to shift work, including nights, affects level and timing of melatonin production, which may be related to carcinogenesis and cancer risk. Cancer Epidemiol Biomarkers Prev; 25(5); 830-8. ©2016 AACR. ©2016 American Association for Cancer Research.

36 CFR 254.22 - Designation and public notice.

Code of Federal Regulations, 2011 CFR

2011-07-01

... inserted once a week for 4 consecutive weeks in a local newspaper: (1) The notice shall include descriptive...; and (2) A period of 45 days, from first date of publication, must be provided for accepting public...

Intra-individual variation in urinary iodine concentration: effect of statistical correction on population distribution using seasonal three-consecutive-day spot urine in children

PubMed Central

Ji, Xiaohong; Liu, Peng; Sun, Zhenqi; Su, Xiaohui; Wang, Wei; Gao, Yanhui; Sun, Dianjun

2016-01-01

Objective To determine the effect of statistical correction for intra-individual variation on estimated urinary iodine concentration (UIC) by sampling on 3 consecutive days in four seasons in children. Setting School-aged children from urban and rural primary schools in Harbin, Heilongjiang, China. Participants 748 and 640 children aged 8–11 years were recruited from urban and rural schools, respectively, in Harbin. Primary and secondary outcome measures The spot urine samples were collected once a day for 3 consecutive days in each season over 1 year. The UIC of the first day was corrected by two statistical correction methods: the average correction method (average of days 1, 2; average of days 1, 2 and 3) and the variance correction method (UIC of day 1 corrected by two replicates and by three replicates). The variance correction method determined the SD between subjects (Sb) and within subjects (Sw), and calculated the correction coefficient (Fi), Fi=Sb/(Sb+Sw/di), where di was the number of observations. The UIC of day 1 was then corrected using the following equation: Results The variance correction methods showed the overall Fi was 0.742 for 2 days’ correction and 0.829 for 3 days’ correction; the values for the seasons spring, summer, autumn and winter were 0.730, 0.684, 0.706 and 0.703 for 2 days’ correction and 0.809, 0.742, 0.796 and 0.804 for 3 days’ correction, respectively. After removal of the individual effect, the correlation coefficient between consecutive days was 0.224, and between non-consecutive days 0.050. Conclusions The variance correction method is effective for correcting intra-individual variation in estimated UIC following sampling on 3 consecutive days in four seasons in children. The method varies little between ages, sexes and urban or rural setting, but does vary between seasons. PMID:26920442

26 CFR 31.3402(e)-1 - Included and excluded wages.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 15 2010-04-01 2010-04-01 false Included and excluded wages. 31.3402(e)-1... SOURCE Collection of Income Tax at Source § 31.3402(e)-1 Included and excluded wages. (a) If a portion of... not more than 31 consecutive days constitutes wages, and the remainder does not constitute wages, all...

Three consecutive days of interval runs to exhaustion affects lymphocyte subset apoptosis and migration.

PubMed

Navalta, James W; Tibana, Ramires Alsamir; Fedor, Elizabeth A; Vieira, Amilton; Prestes, Jonato

2014-01-01

This investigation assessed the lymphocyte subset response to three days of intermittent run exercise to exhaustion. Twelve healthy college-aged males (n = 8) and females (n = 4) (age = 26 ± 4 years; height = 170.2 ± 10 cm; body mass = 75 ± 18 kg) completed an exertion test (maximal running speed and VO2max) and later performed three consecutive days of an intermittent run protocol to exhaustion (30 sec at maximal running speed and 30 sec at half of the maximal running speed). Blood was collected before exercise (PRE) and immediately following the treadmill bout (POST) each day. When the absolute change from baseline was evaluated (i. e., Δ baseline), a significant change in CD4+ and CD8+ for CX3CR1 cells was observed by completion of the third day. Significant changes in both apoptosis and migration were observed following two consecutive days in CD19+ lymphocytes, and the influence of apoptosis persisted following the third day. Given these lymphocyte responses, it is recommended that a rest day be incorporated following two consecutive days of a high-intensity intermittent run program to minimize immune cell modulations and reduce potential susceptibility.

49 CFR 395.5 - Maximum driving time for passenger-carrying vehicles.

Code of Federal Regulations, 2010 CFR

2010-10-01

... hours in any 7 consecutive days if the employing motor carrier does not operate commercial motor vehicles every day of the week; or (2) Having been on duty 70 hours in any period of 8 consecutive days if the employing motor carrier operates commercial motor vehicles every day of the week. [70 FR 50073...

40 CFR 422.43 - Effluent limitations and guidelines representing the degree of effluent reduction attainable by...

Code of Federal Regulations, 2011 CFR

2011-07-01

... values for 30 consecutive days shall not exceed— Total phosphorus (as P) 105 35 Fluoride (as F) 75 25 (d... Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Total phosphorus...

40 CFR 422.43 - Effluent limitations and guidelines representing the degree of effluent reduction attainable by...

Code of Federal Regulations, 2010 CFR

2010-07-01

... values for 30 consecutive days shall not exceed— Total phosphorus (as P) 105 35 Fluoride (as F) 75 25 (d... Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Total phosphorus...

49 CFR 395.3 - Maximum driving time for property-carrying vehicles.

Code of Federal Regulations, 2010 CFR

2010-10-01

... on duty 60 hours in any period of 7 consecutive days if the employing motor carrier does not operate commercial motor vehicles every day of the week; or (2) Having been on duty 70 hours in any period of 8 consecutive days if the employing motor carrier operates commercial motor vehicles every day of the week. (c...

The 2100MHz radiofrequency radiation of a 3G-mobile phone and the DNA oxidative damage in brain.

PubMed

Sahin, Duygu; Ozgur, Elcin; Guler, Goknur; Tomruk, Arın; Unlu, Ilhan; Sepici-Dinçel, Aylin; Seyhan, Nesrin

2016-09-01

We aimed to evaluate the effect of 2100MHz radiofrequency radiation emitted by a generator, simulating a 3G-mobile phone on the brain of rats during 10 and 40 days of exposure. The female rats were randomly divided into four groups. Group I; exposed to 3G modulated 2100MHz RFR signal for 6h/day, 5 consecutive days/wk for 2 weeks, group II; control 10 days, were kept in an inactive exposure set-up for 6h/day, 5 consecutive days/wk for 2 weeks, group III; exposed to 3G modulated 2100MHz RFR signal for 6h/day, 5 consecutive days/wk for 8 weeks and group IV; control 40 days, were kept in an inactive exposure set-up for 6h/day, 5 consecutive days/wk for 8 weeks. After the genomic DNA content of brain was extracted, oxidative DNA damage (8-hydroxy-2'deoxyguanosine, pg/mL) and malondialdehyde (MDA, nmoL/g tissue) levels were determined. Our main finding was the increased oxidative DNA damage to brain after 10 days of exposure with the decreased oxidative DNA damage following 40 days of exposure compared to their control groups. Besides decreased lipid peroxidation end product, MDA, was observed after 40 days of exposure. The measured decreased quantities of damage during the 40 days of exposure could be the means of adapted and increased DNA repair mechanisms. Copyright © 2016 Elsevier B.V. All rights reserved.

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.

Genotoxicity Evaluation of Irrigative Wastewater from Shijiazhuang City in China

PubMed Central

Yang, Lixue; Zhang, Xiaolin; Wang, Liqin; Yu, Fengxue; Liu, Yi; Chen, Qing; Liu, Dianwu

2015-01-01

In the present study, the wastewater sample collected from the Dongming discharging river in Shijiazhuang city was analysed using both chemical analysis and biological assays including the Salmonella mutagenicity test, micronucleus test and single-cell gel electrophoresis. Chemical analysis of the sample was performed using gas chromatography mass spectrometry and inductively coupled plasma mass spectrometry. The Salmonella mutagenicity test was performed on Salmonella typhimurium TA97, TA98, TA100 and TA102 strains with and without S9 mixture. The mice received the wastewater in natura through drinking water at concentrations of 25%, 50%, and 100%. One group of mice was exposed for 2 consecutive days, and the other group of mice was exposed for 15 consecutive days. To establish the levels of primary DNA damage, single-cell gel electrophoresis was performed on treated mouse liver cell. The concentrations of chromium and lead in the sample exceeded the national standard (GB20922-2007) by 0.78 and 0.43-fold, respectively. More than 30 organic compounds were detected, and some of the detected compounds were mutagens, carcinogens and environmental endocrine disrupters. A positive response for Salmonella typhimurium TA98 strain was observed. Mouse exposure via drinking water containing 50% and 100% of wastewater for 15 consecutive days caused a significant increase of MN frequencies in a dose-response manner. Mouse exposure via drinking water containing 50% and 100% of wastewater for 15 consecutive days caused a significant increase of the Olive tail moments in a dose-response manner. All the results indicated that the sample from the Dongming discharging river in Shijiazhuang city exhibited genotoxicity and might pose harmful effects on the local residents. PMID:26658348

Time-dependent migration of citations through PubMed and OvidSP subsets: a study on a series of simultaneous PubMed and OvidSP searches.

PubMed

Boeker, Martin; Vach, Werner; Motschall, Edith

2013-01-01

To quantitatively describe (1) differences between search results derived at consecutive time points with the PubMed and OvidSP literature search interfaces over a five day interval, and (2) the migration of citations through different subsets to estimate the timeliness of OvidSP. PubMed-Identifiers (PMIDs) of the following subsets were retrieved from PubMed and OvidSP simultaneously (within 8 h) at 11 days in March and April 2010 including 5 consecutive days: as supplied by publisher, in process, PubMed not MEDLINE, and OLDMEDLINE. Search results were compared for difference and intersection sets. The migration of citations on individual level was determined by comparison of corresponding sets over several days. The "in process" set was stable with about 446,000 - 452,000 citations; a small fraction of up to 3 % of the total subsets were in PubMed only and OvidSP only subsets. About 96 % of the ca. 10,500 citations in the OvidSP only subset migrated within 2 days out of the "in process" subset. The database of OvidSP is updated within a period of two days.

Alemtuzumab Use in Clinical Practice: Recommendations from European Multiple Sclerosis Experts.

PubMed

Berger, Thomas; Elovaara, Irina; Fredrikson, Sten; McGuigan, Chris; Moiola, Lucia; Myhr, Kjell-Morten; Oreja-Guevara, Celia; Stoliarov, Igor; Zettl, Uwe K

2017-01-01

Alemtuzumab (Lemtrada™) is a humanized monoclonal antibody approved in more than 50 countries. Within the European Union, alemtuzumab is indicated for the treatment of adult patients with relapsing-remitting multiple sclerosis (RRMS) with active disease defined by clinical or imaging features; in the USA, the indication states that alemtuzumab should generally be reserved for the treatment of patients with relapsing forms of multiple sclerosis who have had an inadequate response to two or more disease-modifying therapies (DMTs). In clinical trials, alemtuzumab demonstrated efficacy in treatment-naïve patients with active RRMS and those relapsing on prior DMTs, with a consistent and manageable safety and tolerability profile. The European Union indication provides physicians with significant flexibility regarding treatment decisions, affording the opportunity for individualized treatment. Thus, alemtuzumab may be an appropriate treatment choice across a broad range of patients with RRMS, including, for example, treatment-naïve patients with active disease, patients with highly active disease, or for patients relapsing on prior DMTs. There are several practicalities to consider when using alemtuzumab, including the unique dosing regimen, administered via intravenous infusion on 5 consecutive days at baseline and on 3 consecutive days 12 months later, and as-needed retreatment (3 consecutive days at least 12 months after the last course) in cases of disease recurrence. Additionally, routine monthly monitoring is required for up to 48 months after the last infusion to promptly identify potentially serious autoimmune adverse events. Given these considerations, it is beneficial to gain insight into how alemtuzumab is being used in the real-world clinical setting. Here, we report recommendations from European multiple sclerosis experts regarding best practices for alemtuzumab treatment, including management of adverse events and compliance with ongoing safety monitoring requirements.

43 CFR 3862.4-1 - Newspaper publication.

Code of Federal Regulations, 2011 CFR

2011-10-01

... consecutive issues; if semiweekly or triweekly, in the issue of the same day of each week for nine consecutive weeks. In all cases the first day of issues shall be excluded in estimating the period of 60 days. [35... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Newspaper publication. 3862.4-1 Section...

40 CFR 418.35 - Standards of performance for new sources.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) EFFLUENT GUIDELINES AND STANDARDS FERTILIZER MANUFACTURING POINT SOURCE CATEGORY Urea Subcategory § 418.35... values for 30 consecutive days shall not exceed— Ammonia (as N) 0.53 0.27 Organic nitrogen (as N) .45 .24... any 1 day Average of daily values for 30 consecutive days shall not exceed— Ammonia (as N) 0.53 0.27...

40 CFR 418.35 - Standards of performance for new sources.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) EFFLUENT GUIDELINES AND STANDARDS FERTILIZER MANUFACTURING POINT SOURCE CATEGORY Urea Subcategory § 418.35... values for 30 consecutive days shall not exceed— Ammonia (as N) 0.53 0.27 Organic nitrogen (as N) .45 .24... any 1 day Average of daily values for 30 consecutive days shall not exceed— Ammonia (as N) 0.53 0.27...

40 CFR 418.35 - Standards of performance for new sources.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) EFFLUENT GUIDELINES AND STANDARDS FERTILIZER MANUFACTURING POINT SOURCE CATEGORY Urea Subcategory § 418.35... values for 30 consecutive days shall not exceed— Ammonia (as N) 0.53 0.27 Organic nitrogen (as N) .45 .24... any 1 day Average of daily values for 30 consecutive days shall not exceed— Ammonia (as N) 0.53 0.27...

40 CFR 418.35 - Standards of performance for new sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) EFFLUENT GUIDELINES AND STANDARDS FERTILIZER MANUFACTURING POINT SOURCE CATEGORY Urea Subcategory § 418.35... values for 30 consecutive days shall not exceed— Ammonia (as N) 0.53 0.27 Organic nitrogen (as N) .45 .24... any 1 day Average of daily values for 30 consecutive days shall not exceed— Ammonia (as N) 0.53 0.27...

Iron Supplementation during Three Consecutive Days of Endurance Training Augmented Hepcidin Levels.

PubMed

Ishibashi, Aya; Maeda, Naho; Kamei, Akiko; Goto, Kazushige

2017-07-30

Iron supplementation contributes an effort to improving iron status among athletes, but it does not always prevent iron deficiency. In the present study, we explored the effect of three consecutive days of endurance training (twice daily) on the hepcidin-25 (hepcidin) level. The effect of iron supplementation during this period was also determined. Fourteen male endurance athletes were enrolled and randomly assigned to either an iron-treated condition (Fe condition, n = 7) or a placebo condition (Control condition; CON, n = 7). They engaged in two 75-min sessions of treadmill running at 75% of maximal oxygen uptake on three consecutive days (days 1-3). The Fe condition took 12 mg of iron twice daily (24 mg/day), and the CON condition did not. On day 1, both conditions exhibited significant increases in serum hepcidin and plasma interleukin-6 levels after exercise ( p < 0.05). In the CON condition, the hepcidin level did not change significantly throughout the training period. However, in the Fe condition, the serum hepcidin level on day 4 was significantly higher than that of the CON condition ( p < 0.05). In conclusion, the hepcidin level was significantly elevated following three consecutive days of endurance training when moderate doses of iron were taken.

Iron Supplementation during Three Consecutive Days of Endurance Training Augmented Hepcidin Levels

PubMed Central

Ishibashi, Aya; Maeda, Naho; Kamei, Akiko; Goto, Kazushige

2017-01-01

Iron supplementation contributes an effort to improving iron status among athletes, but it does not always prevent iron deficiency. In the present study, we explored the effect of three consecutive days of endurance training (twice daily) on the hepcidin-25 (hepcidin) level. The effect of iron supplementation during this period was also determined. Fourteen male endurance athletes were enrolled and randomly assigned to either an iron-treated condition (Fe condition, n = 7) or a placebo condition (Control condition; CON, n = 7). They engaged in two 75-min sessions of treadmill running at 75% of maximal oxygen uptake on three consecutive days (days 1–3). The Fe condition took 12 mg of iron twice daily (24 mg/day), and the CON condition did not. On day 1, both conditions exhibited significant increases in serum hepcidin and plasma interleukin-6 levels after exercise (p < 0.05). In the CON condition, the hepcidin level did not change significantly throughout the training period. However, in the Fe condition, the serum hepcidin level on day 4 was significantly higher than that of the CON condition (p < 0.05). In conclusion, the hepcidin level was significantly elevated following three consecutive days of endurance training when moderate doses of iron were taken. PMID:28758951

40 CFR 418.15 - Standards of performance for new sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Average of daily values for 30 consecutive days shall not exceed— Total phosphorus (as P) 105 35 Fluoride... consecutive days shall not exceed— Total phosphorus (as P) 105 35 Fluoride 75 25 [39 FR 12836, Apr. 8, 1974...

40 CFR 418.15 - Standards of performance for new sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Average of daily values for 30 consecutive days shall not exceed— Total phosphorus (as P) 105 35 Fluoride... consecutive days shall not exceed— Total phosphorus (as P) 105 35 Fluoride 75 25 [39 FR 12836, Apr. 8, 1974...

49 CFR 396.3 - Inspection, repair, and maintenance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... systematically inspected, repaired, and maintained, all motor vehicles and intermodal equipment subject to its... affect safety of operation, including but not limited to, frame and frame assemblies, suspension systems... cause to be maintained, records for each motor vehicle they control for 30 consecutive days. Intermodal...

40 CFR 418.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERTILIZER MANUFACTURING POINT SOURCE CATEGORY Urea... daily values for 30 consecutive days shall not exceed— Ammonia (as N) 0.95 0.48 Organic nitrogen (as N...) Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Ammonia (as N) 1...

40 CFR 418.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERTILIZER MANUFACTURING POINT SOURCE CATEGORY Urea... daily values for 30 consecutive days shall not exceed— Ammonia (as N) 0.95 0.48 Organic nitrogen (as N...) Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Ammonia (as N) 1...

40 CFR 418.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERTILIZER MANUFACTURING POINT SOURCE CATEGORY Urea... daily values for 30 consecutive days shall not exceed— Ammonia (as N) 0.95 0.48 Organic nitrogen (as N...) Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Ammonia (as N) 1...

40 CFR 418.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERTILIZER MANUFACTURING POINT SOURCE CATEGORY Urea... daily values for 30 consecutive days shall not exceed— Ammonia (as N) 0.95 0.48 Organic nitrogen (as N...) Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Ammonia (as N) 1...

Phase 2 Study of AZD2014, a Dual mTORC1/mTORC1 Inhibitor,for NF2 Patients with Progressive or Symptomatic Meningiomas

DTIC Science & Technology

2017-06-01

will be administered on a repeating basis at a dose of 125 mg twice daily for two consecutive days out of every seven days (1 cycle = 28 days ...a repeating basis at a dose of 125 mg twice daily for two consecutive days out of every seven days (1 cycle = 28 days ). Treatment will continue until...immunohistochemical analysis of blood and tumor specimens. Funding support N/A Name Justin Jordan, MD, MPH Project Role Co-Investigator Nearest

Topical kanamycin: an effective therapeutic option in aerobic vaginitis.

PubMed

Tempera, G; Abbadessa, G; Bonfiglio, G; Cammarata, E; Cianci, A; Corsello, S; Raimondi, A; Ettore, G; Nicolosi, D; Furneri, P M

2006-08-01

Eighty-one patients with clinical diagnosis of aerobic vaginitis (AV) were included in the study. The patients were randomized for treatment, 45 with kanamycin (100 mg vaginal ovules for 6 days, consecutively) and 36 with meclocycline (35 mg vaginal ovules for 6 days, consecutively). The patients were examined before starting the study, 1-2 days after treatment and 30 days after the end of the study. At the first follow-up the patients showed different levels of symptom reduction. Reduction in the presence of leukocytes, vaginal mucosa burning and itching were statistically significant in the group treated with kanamycin with respect to the group treated with meclocycline. Moreover, there was also reduced isolation of Enterobacteriaeae (97%) in the group treated with kanamycin versus those treated with meclocycline (76%). At the second follow-up, vaginal homeostasis (normalization of pH and presence of lactobacilli) was more evident in the kanamycin-treated group. In conclusion, our data suggest that the topical use of kanamycin could be considered a specific antibiotic for the therapy of this new pathology.

What is the preferred number of consecutive night shifts? results from a crossover intervention study among police officers in Denmark.

PubMed

Nabe-Nielsen, Kirsten; Jensen, Marie Aarrebo; Hansen, Åse Marie; Kristiansen, Jesper; Garde, Anne Helene

2016-10-01

Among police officers in Denmark, we studied (i) how many consecutive night shifts participants preferred at baseline; (ii) preferences regarding three intervention conditions (two, four, and seven consecutive night shifts followed by the same number of days off/day shifts: '2 + 2', '4 + 4', '7 + 7') at follow-up; (iii) characteristics of participants preferring each of these intervention conditions. Questionnaire data from a crossover intervention study were used (baseline: n = 73; follow-up: n = 68). At baseline, 49% preferred four consecutive night shifts. At follow-up, 57% preferred '4 + 4', 26% preferred '2 + 2' and 26% preferred '7 + 7'. Participants, who preferred longer spells of night work experienced that night work was less demanding, found it easier to sleep at different times of the day, and were more frequently evening types compared with participants who preferred shorter spells of night work. The participants' preferences are likely to be influenced by their previous shift work experience. Practitioner Summary: We investigated police officers' preferences regarding the number of consecutive night shifts. The majority preferred four consecutive night shifts. Those who preferred the longer spells of night work found night work less demanding, found it easier to sleep at different times of the day, and were more frequently evening types.

Estimating milk yield and value losses from increased somatic cell count on US dairy farms.

PubMed

Hadrich, J C; Wolf, C A; Lombard, J; Dolak, T M

2018-04-01

Milk loss due to increased somatic cell counts (SCC) results in economic losses for dairy producers. This research uses 10 mo of consecutive dairy herd improvement data from 2013 and 2014 to estimate milk yield loss using SCC as a proxy for clinical and subclinical mastitis. A fixed effects regression was used to examine factors that affected milk yield while controlling for herd-level management. Breed, milking frequency, days in milk, seasonality, SCC, cumulative months with SCC greater than 100,000 cells/mL, lactation, and herd size were variables included in the regression analysis. The cumulative months with SCC above a threshold was included as a proxy for chronic mastitis. Milk yield loss increased as the number of test days with SCC ≥100,000 cells/mL increased. Results from the regression were used to estimate a monetary value of milk loss related to SCC as a function of cow and operation related explanatory variables for a representative dairy cow. The largest losses occurred from increased cumulative test days with a SCC ≥100,000 cells/mL, with daily losses of $1.20/cow per day in the first month to $2.06/cow per day in mo 10. Results demonstrate the importance of including the duration of months above a threshold SCC when estimating milk yield losses. Cows with chronic mastitis, measured by increased consecutive test days with SCC ≥100,000 cells/mL, resulted in higher milk losses than cows with a new infection. This provides farm managers with a method to evaluate the trade-off between treatment and culling decisions as it relates to mastitis control and early detection. Copyright © 2018 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Work Enabling Opioid Management.

PubMed

Lavin, Robert A; Kalia, Nimisha; Yuspeh, Larry; Barry, Jill A; Bernacki, Edward J; Tao, Xuguang Grant

2017-08-01

This study describes the relationship between opioid prescribing and ability to work. The opioid prescription patterns of 4994 claimants were studied. Three groups were constructed: 1) at least 3 consecutive months prescribed (chronic opioid therapy; COT); 2) less than 3 consecutive months prescribed (acute opioid therapy; AOT); and 3) no opioids prescribed. Variables included sex, age, daily morphine equivalent dose (MED), days opioids were prescribed, temporary total days (TTDs), and medical/indemnity/total costs. The COT versus AOT claimants had higher opioid costs ($8618 vs $94), longer TTD (636.2 vs 182.3), and average MED (66.8 vs 34.9). Only 2% of the COT cohort were not released to work. Fifty-seven percent of patients in the COT category (64 of 112) were released to work while still receiving opioids. COT does not preclude ability to work when prescribing within established guidelines.

75 FR 33664 - Hours of Service of Drivers: RockTenn, Application for Exemption

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-14

... to 16 hours per day and be allowed to return to work with less than the mandatory 10 consecutive... required 10 hours off duty prior to returning to work and only allows them to work a maximum of 14 consecutive hours on any given day. They have three 8-hour shifts up to 7 days a week, and there are two...

49 CFR 395.15 - Automatic on-board recording devices.

Code of Federal Regulations, 2010 CFR

2010-10-01

... information concerning on-board system sensor failures and identification of edited data. Such support systems... driving today; (iv) Total hours on duty for the 7 consecutive day period, including today; (v) Total hours...-driver operation; (7) The on-board recording device/system identifies sensor failures and edited data...

5 CFR 211.102 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 180 consecutive days, other than for training, any part of which occurred during the period beginning... ending January 2, 1992; or (6) For more than 180 consecutive days, other than for training, any part of... reduction in force (see 5 U.S.C. 3502). Preference does not apply, however, to inservice placement actions...

5 CFR 211.102 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 180 consecutive days, other than for training, any part of which occurred during the period beginning... ending January 2, 1992; or (6) For more than 180 consecutive days, other than for training, any part of... reduction in force (see 5 U.S.C. 3502). Preference does not apply, however, to inservice placement actions...

5 CFR 211.102 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 180 consecutive days, other than for training, any part of which occurred during the period beginning... ending January 2, 1992; or (6) For more than 180 consecutive days, other than for training, any part of... reduction in force (see 5 U.S.C. 3502). Preference does not apply, however, to inservice placement actions...

5 CFR 211.102 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 180 consecutive days, other than for training, any part of which occurred during the period beginning... ending January 2, 1992; or (6) For more than 180 consecutive days, other than for training, any part of... reduction in force (see 5 U.S.C. 3502). Preference does not apply, however, to inservice placement actions...

5 CFR 211.102 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 180 consecutive days, other than for training, any part of which occurred during the period beginning... ending January 2, 1992; or (6) For more than 180 consecutive days, other than for training, any part of... reduction in force (see 5 U.S.C. 3502). Preference does not apply, however, to inservice placement actions...

Individual Behavior of Workers of the Formosan Subterranean Termite (Isoptera: Rhinotermitidae) on Consecutive Days of Tunnel Construction

PubMed Central

Cornelius, Mary L.

2012-01-01

This study examines the individual behavior of workers of the Formosan subterranean termite, Coptotermes formosanus Shirkai, on two consecutive days of tunnel construction. In each trial, a group of 30 termite workers was observed continuously during the first 60 min of construction of a new tunnel on two consecutive days. On each day, an average of 68% of individuals did not participate in tunnel construction, 19% spent <25 min tunneling, and 13% spent ≥25 min tunneling. There were specific individuals that did most of the work in the construction of new tunnels on both days. An individual that spent at least 25 min tunneling on Day 1 was significantly more likely to spend at least 25 min tunneling on Day 2 than individuals that spent <25 min tunneling on Day 1. When individuals were ranked based on the time spent tunneling on Day 1 and Day 2, there were individuals ranked as one of the top four excavators on both days in three of the four groups. These results indicate that there is evidence of task allocation by termite workers during the construction of a new tunnel. PMID:26466529

Effect of curcumin in mice model of vincristine-induced neuropathy.

PubMed

Babu, Anand; Prasanth, K G; Balaji, Bhaskar

2015-06-01

Curcumin exhibits a wide spectrum of biological activities which include neuroprotective, antinociceptive, anti-inflammatory, and antioxidant activity. The present study evaluates the effect of curcumin in vincristine-induced neuropathy in a mice model. Vincristine sulfate (0.1 mg/kg, i.p. for 10 consecutive days) was administered to mice to induce neuropathy. Pain behavior was assessed at different days, i.e., 0, 7, 10, and 14 d. Sciatic nerve total calcium, superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), reduced glutathione (GSH), nitric oxide (NO), and lipid peroxidation (LPO) were also estimated after the 14th day of study. Pregabalin (10 mg/kg, p.o.) and curcumin (15, 30, and 60 mg/kg, p.o.) were administered for 14 consecutive days. Curcumin at 60 mg/kg significantly attenuated the vincristine-induced neuropathic pain manifestations in terms of thermal hyperalgesia (p < 0.001) and allodynia (p < 0.001); mechanical hyperalgesia (p < 0.001); functional loss (p < 0.001); and in the delayed phase of formalin test (p < 0.001). Curcumin at 30 and 60 mg/kg exhibited significant changes (p < 0.001) in antioxidant levels and in total calcium levels in vincristine-injected mice. Curcumin at 30 and 60 mg/kg dose levels significantly attenuated vincristine-induced neuropathy which may be due to its multiple actions including antinociceptive, calcium inhibitory, and antioxidant effect.

Effect of Intermittent Energy Restriction on Flow Mediated Dilatation, a Measure of Endothelial Function: A Short Report.

PubMed

Headland, Michelle L; Clifton, Peter M; Keogh, Jennifer B

2018-06-04

Intermittent energy restriction is a popular alternative to daily energy restriction for weight loss; however, it is unknown if endothelial function, a risk factor for cardiovascular disease, is altered by periods of severe energy restriction. The objective of the study was to determine the impact of two consecutive very low energy intake days, which is the core component of the 5:2 intermittent energy restriction diet strategy, on endothelial function compared to consecutive ad libitum eating days. The secondary objective was to explore the effects of these dietary conditions on fasting glucose concentrations. This was a 4-week randomized, single-blinded, crossover study of 35 participants. Participants consumed a very low energy diet (500 calories for women, 600 calories for men) on two consecutive days per week and 5 days of habitual eating. In weeks 3 and 4 of the trial, participants had measurements of flow mediated dilatation (FMD) and blood samples taken following either 2 habitual eating days or 2 energy restricted days in a randomized order. FMD values were not different after the two eating states (8.6% vs. 8.3%, p = 0.7). All other outcome variables were unchanged. Endothelial function, as measured by flow mediated dilatation, was not altered by two consecutive very low energy intake days. Further investigations assessing the impact in specific population groups as well as different testing conditions would be beneficial.

[Lack of protection against gentamicin ototoxicity by auditory conditioning with noise].

PubMed

Strose, Alex; Hyppolito, Miguel Ângelo; Colombari, Gleice Cristina; Rossato, Maria; Oliveira, Jose Antônio Aparecido de

2014-01-01

Auditory conditioning consists of the pre-exposure to low levels of a potential harmful agent to protect against a subsequent harmful exposure. To confirm if conditioning with an agent different from that used to cause the trauma can also be effective. This was an experimental study with 17 guinea pigs, divided into three groups: an ototoxic control group (Cont) that received intramuscular administration of gentamicin 160 mg/kg/day for ten consecutive days, but no sound exposure; a sound control group (Sound) that was exposed to 85 dB broadband noise centered at 4 kHz, 30 min each day for ten consecutive days, but received no ototoxic medications; and an experimental group (Expt) that received sound exposure identical to the Sound group and after each noise presentation, received gentamicin similarly to Cont group. The animals were evaluated by distortion product otoacoustic emissions (DPOAEs), brainstem auditory evoked potentials (BAEPs), and scanning electron microscopy. The animals that were conditioned with noise did not show any protective effect compared with the ones that received only the ototoxic gentamicin administration. This lack of protection was observed functionally and morphologically. Conditioning with 85 dB broadband noises, 30 min a day for ten consecutive days does not protect against an ototoxic gentamicin administration of 160 mg/kg/day for ten consecutive days in the guinea pig. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Implementation of an institutional program to improve clinical and financial outcomes of mechanically ventilated patients: one-year outcomes and lessons learned.

PubMed

Burns, Suzanne M; Earven, Sidenia; Fisher, Charles; Lewis, Rose; Merrell, Paul; Schubart, Jane R; Truwit, Jonathon D; Bleck, Thomas P

2003-12-01

To determine the effect of an institutional approach to the care of patients requiring mechanical ventilation for longer than three consecutive days in five adult intensive care units (ICU) on clinical and financial outcomes. A multidisciplinary team was selected from five adult ICUs to design the approach. Planning occurred from August 1999 to September 2000. The process was called outcomes management (OM) and included an evidence-based clinical pathway, protocols for weaning and sedation use, and the selection of four advanced practice nurses (called outcomes managers) to manage and monitor the program. The project was completed in a 550-bed mid-Atlantic academic medical center. The ICUs included the following: coronary care, medical ICU, neuroscience ICU, surgical trauma ICU, and thoracic cardiovascular ICU. The sample included 595 pre-OM patients and 510 post-OM patients mechanically ventilated for greater than three consecutive days. Full implementation of the OM approach occurred in March 2001. Retrospective baseline (18 months pre-OM) and prospective (12 months OM) clinical and financial data were compared. Statistically significant differences in clinical outcomes were demonstrated in the managed patients compared with those managed before the institutional approach. Outcomes include ventilator duration (median days declined from ten to nine; p =.0001), ICU length of stay (median days declined from 15 to 12; p =.0008), hospital length of stay (median days declined from 22 to 20; p =.0001), and mortality rate (declined from 38% to 31%, p =.02). More than 3,000,000 US dollars cost savings were realized in the OM group. This institutional approach to the care of patients ventilated >3 days improved all clinical and financial outcomes of interest. To date, few similar initiatives have demonstrated similar results. The approach and lessons learned in this process improvement project may be helpful to other institutions attempting to improve outcomes in this vulnerable population.

Sleep Detriments Associated With Quick Returns in Rotating Shift Work: A Diary Study.

PubMed

Vedaa, Øystein; Mørland, Erik; Larsen, Marit; Harris, Anette; Erevik, Eilin; Sivertsen, Børge; Bjorvatn, Bjørn; Waage, Siri; Pallesen, Ståle

2017-06-01

We aimed to compared sleep characteristics associated with quick returns (QRs, <11 hours between shift intervals) with those associated with other common shift transitions. Sixty-seven nurses completed a 2-week work and sleep diary (94.0% female, mean age 47.7 years). A multilevel fixed effects model was used to examine the sleep in QRs compared with two consecutive night shifts, two consecutive evening shifts, and two consecutive day shifts, respectively. None of the other shift transitions studied encumbered as many detriments as QRs, which included short sleep duration (5.6 hours), slightly prolonged sleep onset latency, more abrupt ending of main sleep period, increased sleepiness, and higher level of perceived stress on the following shift. The study emphasizes the need for sufficient time for rest and recuperation between shifts.

Improvement of thrombocytopenia following bone marrow transplantation by pegylated recombinant human megakaryocyte growth and development factor in mice.

PubMed

Kabaya, K; Shibuya, K; Torii, Y; Nitta, Y; Ida, M; Akahori, H; Kato, T; Kusaka, M; Miyazaki, H

1996-12-01

We examined whether pegylated recombinant human megakaryocyte growth and development factor (PEG-rHuMGDF) is capable of improving thrombocytopenia and promoting thrombopoietic reconstitution following lethal irradiation and bone marrow transplantation (BMT) in mice. Immediately after receiving 10 Gy whole body irradiation (day 0), male C3H/HeN mice were inoculated with 10(6) bone marrow cells obtained from syngeneic mice. Circulating platelet counts decreased to below 4% of the normal counts with a nadir on day 10, and then returned to the normal level on day 28 in the control mice undergoing BMT. Subcutaneous consecutive treatment with PEG-rHuMGDF at doses from 10 to 300 micrograms/kg/day from day 1 for 13 days significantly improved the platelet nadir and promoted platelet recovery. The white blood cell counts and hemoglobin concentration following BMT were not influenced by the PEG-rHuMGDF. PEG-rHuMGDF-injection starting from day 5 did not improve the platelet nadir following BMT. Furthermore, administration with PEG-rHuMGDF on alternate days at 55.7 micrograms/kg/day for 7 days or at an interval of 3 days at 78 micrograms/kg/day for 4 days (twice a week for 2 weeks) had a significant efficacy, but these administration regimens had less efficacy than consecutive administration at 30 micrograms/kg/day for 13 days. The numbers of megakaryocytes and megakaryocyte progenitor cells decreased to 5 and 0.2% of normal level, respectively, in the control mice. Consecutive administration of PEG-rHuMGDF enhanced the recovery of the mean number of these cells compared to those in vehicle-treated mice, although such effects were not statistically significant except for the number of megakaryocyte progenitors on day 12. These results suggest that consecutive treatment with PEG-rHuMGDF beginning from the day after BMT may be effective in improving thrombocytopenia following BMT.

20 CFR 30.500 - What special statutory definitions apply to survivors under EEOICPA?

Code of Federal Regulations, 2010 CFR

2010-04-01

... individual for the 365 consecutive days immediately prior to the death of that individual. (2) Child or children includes a recognized natural child of a deceased covered Part B employee or deceased covered Part E employee, a stepchild who lived with that individual in a regular parent-child relationship, and...

Sleep patterns among shift-working flight controllers of the International Space Station: an observational study on the JAXA Flight Control Team.

PubMed

Mizuno, Koh; Matsumoto, Akiko; Aiba, Tatsuya; Abe, Takashi; Ohshima, Hiroshi; Takahashi, Masaya; Inoue, Yuichi

2016-09-01

Flight controllers of the International Space Station (ISS) are engaged in shift work to provide 24-h coverage to support ISS systems. The purpose of this study was to investigate the prevalence and associated factors of shift work sleep disorder (SWSD) among Japanese ISS flight controllers. A questionnaire study was conducted using the Standard Shiftwork Index to evaluate sleep-related problems and possible associated variables. Among 52 respondents out of 73 flight controllers, 30 subjects were identified as night shift workers who worked 3 or more night shifts per month. Those night shift workers who answered "almost always" to questions about experiencing insomnia or excessive sleepiness in any case of work shifts and days off were classified as having SWSD. Additionally, 7 night shift workers participated in supplemental wrist actigraphy data collection for 7 to 8 days including 3 to 4 days of consecutive night shifts. Fourteen of 30 night shift workers were classified as having SWSD. Significant group differences were observed where the SWSD group felt that night shift work was harder and reported more frequent insomniac symptoms after a night shift. However, no other variables demonstrated remarkable differences between groups. Actigraphy results characterized 5 subjects reporting better perceived adaptation as having regular daytime sleep, for 6 to 9 h in total, between consecutive night shifts. On the other hand, 2 subjects reporting perceived maladaptation revealed different sleep patterns, with longer daytime sleep and large day-to-day variation in daytime sleep between consecutive night shifts, respectively. As the tasks for flight control require high levels of alertness and cognitive function, several characteristics, namely shift-working schedule (2 to 4 consecutive night shifts), very short break time (5 to 10 min/h) during work shifts, and cooperative work with onboard astronauts during the evening/night shift, accounted for increasing workloads especially in the case of night shifts, resulting in higher or equal prevalence of SWSD to that among other shift-working populations. Further studies are required to collect more actigraphy data and examine the possibility of interventions to improve SWSD.

A decade of Australian methotrexate dosing errors.

PubMed

Cairns, Rose; Brown, Jared A; Lynch, Ann-Maree; Robinson, Jeff; Wylie, Carol; Buckley, Nicholas A

2016-06-06

Accidental daily dosing of methotrexate can result in life-threatening toxicity. We investigated methotrexate dosing errors reported to the National Coronial Information System (NCIS), the Therapeutic Goods Administration Database of Adverse Event Notifications (TGA DAEN) and Australian Poisons Information Centres (PICs). A retrospective review of coronial cases in the NCIS (2000-2014), and of reports to the TGA DAEN (2004-2014) and Australian PICs (2004-2015). Cases were included if dosing errors were accidental, with evidence of daily dosing on at least 3 consecutive days. Events per year, dose, consecutive days of methotrexate administration, reasons for the error, clinical features. Twenty-two deaths linked with methotrexate were identified in the NCIS, including seven cases in which erroneous daily dosing was documented. Methotrexate medication error was listed in ten cases in the DAEN, including two deaths. Australian PIC databases contained 92 cases, with a worrying increase seen during 2014-2015. Reasons for the errors included patient misunderstanding and incorrect packaging of dosette packs by pharmacists. The recorded clinical effects of daily dosage were consistent with those previously reported for methotrexate toxicity. Dosing errors with methotrexate can be lethal and continue to occur despite a number of safety initiatives in the past decade. Further strategies to reduce these preventable harms need to be implemented and evaluated. Recent suggestions include further changes in packet size, mandatory weekly dosing labelling on packaging, improving education, and including alerts in prescribing and dispensing software.

Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women: two open-label, randomised controlled trials.

PubMed

Stoffel, Nicole U; Cercamondi, Colin I; Brittenham, Gary; Zeder, Christophe; Geurts-Moespot, Anneke J; Swinkels, Dorine W; Moretti, Diego; Zimmermann, Michael B

2017-11-01

Current guidelines to treat iron deficiency recommend daily provision of ferrous iron divided through the day to increase absorption. However, daily dosing and split dosing might increase serum hepcidin and decrease iron absorption from subsequent doses. Our study aim was to compare iron absorption from oral iron supplements given on consecutive versus alternate days and given as single morning doses versus twice-daily split dosing. We did two prospective, open-label, randomised controlled trials assessing iron absorption using ( 54 Fe)-labelled, ( 57 Fe)-labelled, or ( 58 Fe)-labelled ferrous sulfate in iron-depleted (serum ferritin ≤25 μg/L) women aged 18-40 years recruited from ETH Zurich and the University of Zurich, Switzerland. In study 1, women were randomly assigned (1:1) to two groups. One group was given 60 mg iron at 0800 h (±1 h) on consecutive days for 14 days, and the other group was given the same doses on alternate days for 28 days. In study 2, women were assigned to two groups, stratified by serum ferritin so that two groups with similar iron statuses could be formed. One group was given 120 mg iron at 0800 h (±1 h) and the other was given the dose split into two divided doses of 60 mg at 0800 h (±1 h) and 1700 h (±1 h) for three consecutive days. 14 days after the final dose, the groups were each crossed over to the other regimen. Within-individual comparisons were done. The co-primary outcomes in both studies were iron bioavailability (total and fractional iron absorption), assessed by measuring the isotopic label abundance in erythrocytes 14 days after administration, and serum hepcidin. Group allocations in both studies were not masked and primary and safety analyses were done on an intention-to-treat basis. The studies were registered at ClinicalTrials.gov, numbers NCT02175888 (study 1) and NCT02177851 (study 2) and are complete. For study 1, 40 women were enrolled on Oct 15-29, 2015. 21 women were assigned to the consecutive-day group and 19 to the alternate-day group. At the end of treatment (14 days for the consecutive-day group and 28 days for the alternate-day group), geometric mean (-SD, +SD) cumulative fractional iron absorptions were 16·3% (9·3, 28·8) in the consecutive-day group versus 21·8% (13·7, 34·6) in the alternate-day group (p=0·0013), and cumulative total iron absorption was 131·0 mg (71·4, 240·5) versus 175·3 mg (110·3, 278·5; p=0·0010). During the first 14 days of supplementation in both groups, serum hepcidin was higher in the consecutive-day group than the alternate-day group (p=0·0031). In study 2, 20 women were enrolled between Aug 13 and 18, 2015. Ten women were assigned to receive once-daily dosing and ten were assigned to receive twice-daily divided dosing. No significant differences were seen in fractional (day 1-3 geometric mean: 11·8% [7·1, 19·4] once daily vs 13·1% [8·2, 20·7] twice daily; p=0·33) or total iron absorption (day 1-3: 44·3 mg [29·4, 66·7] once daily vs 49·4 [35·2, 69·4] twice daily; p=0·33) between the two dosing regimens. Twice-daily divided doses resulted in a higher serum hepcidin concentration than once-daily dosing (p=0·013). No grade 3 or 4 adverse events were reported in either study. In iron-depleted women, providing iron supplements daily as divided doses increases serum hepcidin and reduces iron absorption. Providing iron supplements on alternate days and in single doses optimises iron absorption and might be a preferable dosing regimen. These findings should be confirmed in iron-deficient anaemic patients. Swiss National Science Foundation, Bern, Switzerland. Copyright © 2017 Elsevier Ltd. All rights reserved.

Potential impact of 1.5 °C and 2 °C global warming on consecutive dry and wet days over West Africa

NASA Astrophysics Data System (ADS)

Ama Browne Klutse, Nana; Ajayi, Vincent O.; Olabode Gbobaniyi, Emiola; Egbebiyi, Temitope S.; Kouadio, Kouakou; Nkrumah, Francis; Akumenyi Quagraine, Kwesi; Olusegun, Christiana; Diasso, Ulrich; Abiodun, Babatunde J.; Lawal, Kamoru; Nikulin, Grigory; Lennard, Christopher; Dosio, Alessandro

2018-05-01

We examine the impact of +1.5 °C and +2 °C global warming levels above pre-industrial levels on consecutive dry days (CDD) and consecutive wet days (CWD), two key indicators for extreme precipitation and seasonal drought. This is done using climate projections from a multi-model ensemble of 25 regional climate model (RCM) simulations. The RCMs take boundary conditions from ten global climate models (GCMs) under the RCP8.5 scenario. We define CDD as the maximum number of consecutive days with rainfall amount less than 1 mm and CWD as the maximum number of consecutive days with rainfall amount more than 1 mm. The differences in model representations of the change in CDD and CWD, at 1.5 °C and 2 °C global warming, and based on the control period 1971‑2000 are reported. The models agree on a noticeable response to both 1.5 °C and 2 °C warming for each index. Enhanced warming results in a reduction in mean rainfall across the region. More than 80% of ensemble members agree that CDD will increase over the Guinea Coast, in tandem with a projected decrease in CWD at both 1.5 °C and 2 °C global warming levels. These projected changes may influence already fragile ecosystems and agriculture in the region, both of which are strongly affected by mean rainfall and the length of wet and dry periods.

Endoscopic sleeve gastroplasty: the learning curve.

PubMed

Hill, Christine; El Zein, Mohamad; Agnihotri, Abhishek; Dunlap, Margo; Chang, Angela; Agrawal, Alison; Barola, Sindhu; Ngamruengphong, Saowanee; Chen, Yen-I; Kalloo, Anthony N; Khashab, Mouen A; Kumbhari, Vivek

2017-09-01

 Endoscopic sleeve gastroplasty (ESG) is gaining traction as a minimally invasive bariatric treatment. Concern that the learning curve may be slow, even among those proficient in endoscopic suturing, is a barrier to widespread implementation of the procedure. Therefore, we aimed to define the learning curve for ESG in a single endoscopist experienced in endoscopic suturing who participated in a 1-day ESG training program.  Consecutive patients who underwent ESG between February 2016 and November 2016 were included. The performing endoscopist, who is proficient in endoscopic suturing for non-ESG procedures, participated in a 1-day ESG training session before offering ESG to patients. The outcome measurements were length of procedure (LOP) and number of plications per procedure. Nonlinear regression was used to determine the learning plateau and calculate the learning rate.  Twenty-one consecutive patients (8 males), with mean age 47.7 ± 11.2 years and mean body mass index 41.8 ± 8.5 kg/m 2 underwent ESG. LOP decreased significantly across consecutive procedures, with a learning plateau at 101.5 minutes and a learning rate of 7 cases ( P  = 0.04). The number of plications per procedure also decreased significantly across consecutive procedures, with a plateau at 8 sutures and a learning rate of 9 cases ( P  < 0.001). Further, the average time per plication decreased significantly with consecutive procedures, reaching a plateau at 9 procedures ( P  < 0.001).  Endoscopists experienced in endoscopic suturing are expected to achieve a reduction in LOP and number of plications per procedure in successive cases, with progress plateauing at 7 and 9 cases, respectively.

Contamination of Ambient Air with Acinetobacter baumannii on Consecutive Inpatient Days.

PubMed

Shimose, Luis A; Doi, Yohei; Bonomo, Robert A; De Pascale, Dennise; Viau, Roberto A; Cleary, Timothy; Namias, Nicholas; Kett, Daniel H; Munoz-Price, L Silvia

2015-07-01

Acinetobacter-positive patients had their ambient air tested for up to 10 consecutive days. The air was Acinetobacter positive for an average of 21% of the days; the rate of contamination was higher among patients colonized in the rectum than in the airways (relative risk [RR], 2.35; P = 0.006). Of the 6 air/clinical isolate pairs available, 4 pairs were closely related according to rep-PCR results. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

40 CFR 418.33 - Effluent limitations and guidelines representing the degree of effluent reduction attainable by...

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERTILIZER MANUFACTURING POINT SOURCE CATEGORY Urea Subcategory... consecutive days shall not exceed— Ammonia (as N) 0.53 0.27 Organic nitrogen (as N) 0.45 0.24 Note: Metric... of daily values for 30 consecutive days shall not exceed— Ammonia (as N) 0.53 0.27 Organic nitrogen...

40 CFR 418.33 - Effluent limitations and guidelines representing the degree of effluent reduction attainable by...

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERTILIZER MANUFACTURING POINT SOURCE CATEGORY Urea Subcategory... consecutive days shall not exceed— Ammonia (as N) 0.53 0.27 Organic nitrogen (as N) 0.45 0.24 Note: Metric... of daily values for 30 consecutive days shall not exceed— Ammonia (as N) 0.53 0.27 Organic nitrogen...

40 CFR 418.33 - Effluent limitations and guidelines representing the degree of effluent reduction attainable by...

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERTILIZER MANUFACTURING POINT SOURCE CATEGORY Urea Subcategory... consecutive days shall not exceed— Ammonia (as N) 0.53 0.27 Organic nitrogen (as N) 0.45 0.24 Note: Metric... of daily values for 30 consecutive days shall not exceed— Ammonia (as N) 0.53 0.27 Organic nitrogen...

40 CFR 418.33 - Effluent limitations and guidelines representing the degree of effluent reduction attainable by...

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERTILIZER MANUFACTURING POINT SOURCE CATEGORY Urea Subcategory... consecutive days shall not exceed— Ammonia (as N) 0.53 0.27 Organic nitrogen (as N) 0.45 0.24 Note: Metric... of daily values for 30 consecutive days shall not exceed— Ammonia (as N) 0.53 0.27 Organic nitrogen...

40 CFR 418.33 - Effluent limitations and guidelines representing the degree of effluent reduction attainable by...

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERTILIZER MANUFACTURING POINT SOURCE CATEGORY Urea Subcategory... consecutive days shall not exceed— Ammonia (as N) 0.53 0.27 Organic nitrogen (as N) 0.45 0.24 Note: Metric... of daily values for 30 consecutive days shall not exceed— Ammonia (as N) 0.53 0.27 Organic nitrogen...

The effects of compression garments on intermittent exercise performance and recovery on consecutive days.

PubMed

Duffield, Rob; Edge, Johann; Merrells, Robert; Hawke, Emma; Barnes, Matt; Simcock, David; Gill, Nicholas

2008-12-01

The aim of this study was to determine whether compression garments improve intermittent-sprint performance and aid performance or self-reported recovery from high-intensity efforts on consecutive days. Following familiarization, 14 male rugby players performed two randomized testing conditions (with or without garments) involving consecutive days of a simulated team sport exercise protocol, separated by 24 h of recovery within each condition and 2 weeks between conditions. Each day involved an 80-min high-intensity exercise circuit, with exercise performance determined by repeated 20-m sprints and peak power on a cart dynamometer (single-man scrum machine). Measures of nude mass, heart rate, skin and tympanic temperature, and blood lactate (La-) were recorded throughout each day; also, creatine kinase (CK) and muscle soreness were recorded each day and 48 h following exercise. No differences (P=.20 to 0.40) were present between conditions on either day of the exercise protocol for repeated 20-m sprint efforts or peak power on a cart dynamometer. Heart rate, tympanic temperature, and body mass did not significantly differ between conditions; however, skin temperature was higher under the compression garments. Although no differences (P=.50) in La- or CK were present, participants felt reduced levels of perceived muscle soreness in the ensuing 48 h postexercise when wearing the garments (2.5+/-1.7 vs 3.5+/-2.1 for garment and control; P=.01). The use of compression garments did not improve or hamper simulated team-sport activity on consecutive days. Despite benefits of reduced self-reported muscle soreness when wearing garments during and following exercise each day, no improvements in performance or recovery were apparent.

29 CFR 2520.101-3 - Notice of blackout periods under individual account plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... paragraph 4. of the model notice in paragraph (e)(2) of this section will satisfy this requirement); (v) In.... of the model notice in paragraph (e)(2) of this section will satisfy this requirement), and (B) An... three consecutive business days. (ii) Exclusions. The term “blackout period” does not include a...

Initial experience with robotic pancreatic surgery in Singapore: single institution experience with 30 consecutive cases.

PubMed

Goh, Brian K P; Low, Tze-Yi; Lee, Ser-Yee; Chan, Chung-Yip; Chung, Alexander Y F; Ooi, London L P J

2018-05-24

Presently, the worldwide experience with robotic pancreatic surgery (RPS) is increasing although widespread adoption remains limited. In this study, we report our initial experience with RPS. This is a retrospective review of a single institution prospective database of 72 consecutive robotic hepatopancreatobiliary surgeries performed between 2013 and 2017. Of these, 30 patients who underwent RPS were included in this study of which 25 were performed by a single surgeon. The most common procedure was robotic distal pancreatectomy (RDP) which was performed in 20 patients. This included eight subtotal pancreatectomies, two extended pancreatecto-splenectomies (en bloc gastric resection) and 10 spleen-saving-RDP. Splenic preservation was successful in 10/11 attempted spleen-saving-RDP. Eight patients underwent pancreaticoduodenectomies (five hybrid with open reconstruction), one patient underwent a modified Puestow procedure and one enucleation of uncinate tumour. Four patients had extended resections including two RDP with gastric resection and two pancreaticoduodenectomies with vascular resection. There was one (3.3%) open conversion and seven (23.3%) major (>Grade II) morbidities. Overall, there were four (13.3%) clinically significant (Grade B) pancreatic fistulas of which three required percutaneous drainage. These occurred after three RDP and one robotic enucleation. There was one reoperation for port-site hernia and no 30-day/in-hospital mortalities. The median post-operative stay was 6.5 (range: 3-36) days and there were six (20%) 30-day readmissions. Our initial experience showed that RPS can be adopted safely with a low open conversion rate for a wide variety of procedures including pancreaticoduodenectomy. © 2018 Royal Australasian College of Surgeons.

Branched-Chain Amino Acids and Arginine Improve Performance in Two Consecutive Days of Simulated Handball Games in Male and Female Athletes: A Randomized Trial

PubMed Central

Chang, Chen-Kang; Chang Chien, Kun-Ming; Chang, Jung-Hsien; Huang, Mei-Hsuan; Liang, Ya-Chuan; Liu, Tsung-Han

2015-01-01

The central nervous system plays a crucial role in the development of physical fatigue. The purpose of this study is to investigate the effect of combined supplementation of branched-chain amino acids (BCAA) and arginine on intermittent sprint performance in simulated handball games on 2 consecutive days. Methods: Fifteen male and seven female handball players consumed 0.17 g/kg BCAA and 0.04 g/kg arginine together (AA trial), or placebo (PB trial) before exercise. Each trial contained two 60-min simulated handball games on consecutive days. The game was consisted of 30 identical 2-min blocks and a 20 m all-out sprint was performed at the end of each block. The performance, measured by percentage changes of sprint time between day 1 and 2, was significantly better in the AA trial (first half: AA trial: -1.34±0.60%, PB trial: -0.21±0.69%; second half: AA trial: -1.68±0.58%, PB trial: 0.49±0.42%). The average ratings of perceive exertion throughout the 2-day trial was significantly lower in the AA trial (14.2±0.3) than the PB trial (15.1±0.4). Concurrently, post-exercise tryptophan/BCAA ratio on both days in the AA trial was significantly lower than the baseline. This study showed that BCAA and arginine supplementation could improve performance in intermittent sprints on the second consecutive day of simulated handball games in well-trained athletes by potentially alleviating central fatigue. PMID:25803783

Loan and nonloan flows in the Australian interbank network

NASA Astrophysics Data System (ADS)

Sokolov, Andrey; Webster, Rachel; Melatos, Andrew; Kieu, Tien

2012-05-01

High-value transactions between banks in Australia are settled in the Reserve Bank Information and Transfer System (RITS) administered by the Reserve Bank of Australia. RITS operates on a real-time gross settlement (RTGS) basis and settles payments and transfers sourced from the SWIFT payment delivery system, the Austraclear securities settlement system, and the interbank transactions entered directly into RITS. In this paper, we analyse a dataset received from the Reserve Bank of Australia that includes all interbank transactions settled in RITS on an RTGS basis during five consecutive weekdays from 19 February 2007 inclusive, a week of relatively quiescent market conditions. The source, destination, and value of each transaction are known, which allows us to separate overnight loans from other transactions (nonloans) and reconstruct monetary flows between banks for every day in our sample. We conduct a novel analysis of the flow stability and examine the connection between loan and nonloan flows. Our aim is to understand the underlying causal mechanism connecting loan and nonloan flows. We find that the imbalances in the banks' exchange settlement funds resulting from the daily flows of nonloan transactions are almost exactly counterbalanced by the flows of overnight loans. The correlation coefficient between loan and nonloan imbalances is about -0.9 on most days. Some flows that persist over two consecutive days can be highly variable, but overall the flows are moderately stable in value. The nonloan network is characterised by a large fraction of persistent flows, whereas only half of the flows persist over any two consecutive days in the loan network. Moreover, we observe an unusual degree of coherence between persistent loan flow values on Tuesday and Wednesday. We probe static topological properties of the Australian interbank network and find them consistent with those observed in other countries.

Anthelmintic efficacy of ivermectin and abamectin, administered orally for seven consecutive days (100 µg/kg/day), against nematodes in naturally infected pigs.

PubMed

Lopes, Welber Daniel Zanetti; Teixeira, Weslen Fabricio Pires; Felippelli, Gustavo; Cruz, Breno Cayeiro; Buzulini, Carolina; Maciel, Willian Giquelin; Fávero, Flávia Carolina; Gomes, Lucas Vinicius Costa; Prando, Luciana; Bichuette, Murilo A; Dos Santos, Thais Rabelo; da Costa, Alvimar José

2014-12-01

The present study aimed to evaluate ivermectin and abamectin, both administered orally in naturally infected domestic swine, as well as analysing if the EPG (eggs per gram of faeces) values were equivalent with the ivermectin and abamectin efficacy obtained by parasitological necropsies. The animals were randomly selected based on the average of three consecutive EPG counts of Strongylida, Ascaris suum and Trichuris for experiment I, and of Strongylida and Trichuris for experiment II. After the random draw, eight animals were treated, orally, during seven consecutive days with 100 µg/kg/day ivermectin (Ivermectina® premix, Ouro Fino Agronegócios), eight other animals were treated, orally, during seven consecutive days with 100 µg/kg/day abamectin (Virbamax® premix - Virbac do Brasil Indústria e Comércio Ltda.), and eight pigs were kept as controls. EPG counts were performed for each individual animal at 14th day post-treatment (DPT). All animals (control and treatment) were necropsied at the 14th DPT. The results from both experiments demonstrate that both ivermectin and abamectin, administered orally for a continuous period of seven days, at a daily dosage of 100 µg/kg, were highly effective (>95%) against Hyostrongylus rubidus, Strongyloides ransomi, Ascaris suum and Metastrongylus salmi. Against Oesophagostomum dentatum, abamectin presented over 95% efficacy against both evaluated strains, while ivermectin reached other strain as resistant. Regarding T. suis, both ivermectin and abamectin were effective (efficacies >90%) against one of the tested strains, while the other one was classified as resistant. Furthermore, the EPG values were equivalent with the ivermectin and abamectin efficacy obtained by parasitological necropsies. Copyright © 2014 Elsevier Ltd. All rights reserved.

SAFETY AND TOXICITY OF AN ACCELERATED COARSELY FRACTIONATED RADIATION PROTOCOL FOR TREATMENT OF APPENDICULAR OSTEOSARCOMA IN 14 DOGS: 10 GY × 2 FRACTIONS.

PubMed

Pagano, Candace; Boudreaux, Bonnie; Shiomitsu, Keijiro

2016-09-01

Coarsely fractionated radiation is commonly used as a method for pain control in dogs with appendicular osteosarcoma, however there is little published information on optimal protocols. The aim of this retrospective, descriptive study was to report safety and toxicity findings in a sample of dogs with appendicular osteosarcoma that had been treated with a radiation scheme of 10 Gy delivered over two consecutive days for a total of 20 Gy. Dogs were included in the study if they had osteosarcoma that was treated with the aforementioned protocol. Dogs were excluded if treated with the same protocol for any other bone tumor besides osteosarcoma or inadequate follow-up. Thirteen of the 14 patients received adjuvant therapy with pamidronate and a nonsteroidal anti-inflammatory. Nine dogs received adjuvant chemotherapy with carboplatin after radiation was complete. Within a median of 14 days, 92.8% of dogs subjectively had improved pain control. Median duration of response (DOR) was 80 days (range 20-365). The majority of patients developed VRTOG grade one toxicity, primarily alopecia. Five dogs (35.7%) developed pathologic fracture postradiation treatment. Timing of fracture was variable ranging from 24 to 250 days. This radiation protocol was well tolerated, with minimal toxicity, subjectively improved survival time, and had the benefit of being completed in two consecutive days. © 2016 American College of Veterinary Radiology.

Survey of Access to GastroEnterology in Canada: The SAGE wait times program

PubMed Central

Leddin, Desmond; Bridges, Ronald J; Morgan, David G; Fallone, Carlo; Render, Craig; Plourde, Victor; Gray, Jim; Switzer, Connie; McHattie, Jim; Singh, Harminder; Walli, Eric; Murray, Iain; Nestel, Anthony; Sinclair, Paul; Chen, Ying; Irvine, E Jan

2010-01-01

BACKGROUND: Assessment of current wait times for specialist health services in Canada is a key method that can assist government and health care providers to plan wisely for future health needs. These data are not readily available. A method to capture wait time data at the time of consultation or procedure has been developed, which should be applicable to other specialist groups and also allows for assessment of wait time trends over intervals of years. METHODS: In November 2008, gastroenterologists across Canada were asked to complete a questionnaire (online or by fax) that included personal demographics and data from one week on at least five consecutive new consultations and five consecutive procedure patients who had not previously undergone a procedure for the same indication. Wait times were collected for 18 primary indications and results were then compared with similar survey data collected in 2005. RESULTS: The longest wait times observed were for screening colonoscopy (201 days) and surveillance of previous colon cancer or polyps (272 days). The shortest wait times were for cancer-likely based on imaging or physical examination (82 days), severe or rapidly progressing dysphagia or odynophagia (83 days), documented iron-deficiency anemia (90 days) and dyspepsia with alarm symptoms (99 days). Compared with 2005 data, total wait times in 2008 were lengthened overall (127 days versus 155 days; P<0.05) and for most of the seven individual indications that permitted data comparison. CONCLUSION: Median wait times for gastroenterology services continue to exceed consensus conference recommended targets and have significantly worsened since 2005. PMID:20186352

Fluctuations in heart rate variability of health care workers during four consecutive extended work shifts and recovery during rest and sleep.

PubMed

Goffeng, Elisabeth M; Nordby, Karl-Christian; Tarvainen, Mika P; Järvelin-Pasanen, Susanna; Wagstaff, Anthony; Goffeng, Lars Ole; Bugge, Merete; Skare, Øivind; Sigstad Lie, Jenny-Anne

2018-04-07

The aim of this study was to investigate fluctuations in heart rate variability (HRV), which reflect autonomic nervous system (ANS) function and potential psychological and physical strain, among 24 health care workers during work and sleep during four consecutive extended work shifts. Data included 24/36/12 h of HRV measurements, two logbooks, and a questionnaire. A cross-shift/cross-week design was applied. HRV was measured during work, leisure time, and sleep. The HRV data included time-domain [mean RR, SD of normal to normal R-R intervals (SDNN), and root mean square of the successive differences (RMSSD)] and frequency-domain [low frequency (LF)/high frequency (HF) ratio] parameters. HRV parameters revealed significant differences among work, leisure time, and sleep. Mean RR, RMSSD, and SDNN values were lower and the LF/HF ratio was higher on the first versus last day of the work period; however, the differences were most prominent in the morning hours. The results indicate higher levels of cardiovascular stress on the first versus fourth day of the working period, and measurements at night indicate a satisfactory recovery from the extended shifts.

40 CFR 420.83 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Average of daily values for 30 consecutive days Kg/kkg (pounds per 1,000 lb) of product Chromium 0.00292 0... per 1,000 lb) of product Chromium 0.00175 0.000701 Nickel 0.00158 0.000526 (3) Batch, pipe and tube... values for 30 consecutive days Kg/kkg (pounds per 1,000 lb) of product Chromium 0.00709 0.00284 Nickel 0...

Intra-Seasonal Variability of Climate and Peasant Perception of Climate Change in Massili Basin in Burkina Faso.

NASA Astrophysics Data System (ADS)

Kabore Bontogho, P. E.

2014-12-01

Knowledge of climate variability is relevant and challenging for farmers, decision makers and population in general. Ninety percent of Burkina Faso active population is engaged in agriculture and livestock, which accounts for 39% of gross domestic product. Located between the coordinates 1o15'-1o55' West and 12o17'- 12o50'North, Massili basin includes Ouagadougou the capital and has four dams, of which the most important dam, Loumbila is used for the capital water supply and irrigation. A change of climate may affect the water resources most likely limit the access to safe water. In order to characterize Massili basin climate variability, daily temperature and precipitation over 1960 to 2012 was analyzed using long-term records from the Ouagadougou synoptic station. By applying R-climdex and instat tools, indices were calculated by a consistent approach recommended by the World Meteorological Organization Expert Team on Climate Change Detection and Indices. The precipitation parameters computed were: the maximum 5-day precipitationamount; the number of days with precipitation amount ≥50 mm ; the maximum precipitation amount in consecutive wet days with RR≥ 1mm; the consecutives dry days;the extremely wet days ; the extreme precipitation in one day, the total precipitation in wet days; the temperature indices computed were : the maximum of the maximum daily temperature, the minimum of daily maximum temperature,the minimum of daily minimum temperature,the cold spell duration indices and the warm spell duration indicator. Results show a slight increase of the maximum 5-day precipitation, maximum precipitation amount in consecutive wet days with RR≥1mm, the onset delayed and the cessation is earlier meaning that the rainfall period is shortening. The total precipitationwas decreased in the basin but there is a slight increase in the occurrence of extremely wet days. CSDI is decreasing while warm spell duration indices are increasing. In parallel of the data analysis, a survey of 200 peasant spread within 20 villages was done to assess their perception on climate change. Farmers perception corroborate with the above results as their majority describes climate change as decrease of rainfall (79%) and increase of temperature (99%). In addition, all farmers agreed that more floods are occurring.

Effect of overtime work on cognitive function in automotive workers.

PubMed

Proctor, S P; White, R F; Robins, T G; Echeverria, D; Rocskay, A Z

1996-04-01

The present investigation examined whether increased overtime work predicts impairment in cognitive performance in the domains of attention, executive function, and mood. The behavioral and cognitive functions of 248 automotive workers were measured by a neurobehavioral test performance. Overtime, defined as number of hours worked greater than 8 h a day or greater than 5 d a week, was calculated from company payroll records for the week before the test day. The number of consecutive days worked before the test day was also determined. Cross-sectional data analysis by multiple linear regression, after adjustment for the effects of age, education, gender, alcohol intake, repeated grade in school, acute petroleum naphtha exposure, shift worked, job type, number of consecutive days worked before the test day, and number of hours worked on the test day before the testing, demonstrated that increased overtime was significantly associated with impaired performance on several tests of attention and executive function. Increased feelings of depression, fatigue, and confusion were also associated with increased overtime work. In addition significant interaction effects were observed for job type but not for naphtha exposure. The findings support the hypothesis that overtime work results in impaired cognitive performance in the areas of attention and executive function and that both overtime hours and the number of consecutive days worked prior to a test day affect mood.

Comparison of Three Risk Scores to Predict Outcomes of Severe Lower Gastrointestinal Bleeding

PubMed Central

Camus, Marine; Jensen, Dennis M.; Ohning, Gordon V.; Kovacs, Thomas O.; Jutabha, Rome; Ghassemi, Kevin A.; Machicado, Gustavo A.; Dulai, Gareth S.; Jensen, Mary Ellen; Gornbein, Jeffrey A.

2014-01-01

Background & aims Improved medical decisions by using a score at the initial patient triage level may lead to improvements in patient management, outcomes, and resource utilization. There is no validated score for management of lower gastrointestinal bleeding (LGIB) unlike for upper GIB. The aim of our study was to compare the accuracies of 3 different prognostic scores (CURE Hemostasis prognosis score, Charlston index and ASA score) for the prediction of 30 day rebleeding, surgery and death in severe LGIB. Methods Data on consecutive patients hospitalized with severe GI bleeding from January 2006 to October 2011 in our two-tertiary academic referral centers were prospectively collected. Sensitivities, specificities, accuracies and area under the receiver operating characteristic (AUROC) were computed for three scores for predictions of rebleeding, surgery and mortality at 30 days. Results 235 consecutive patients with LGIB were included between 2006 and 2011. 23% of patients rebled, 6% had surgery, and 7.7% of patients died. The accuracies of each score never reached 70% for predicting rebleeding or surgery in either. The ASA score had a highest accuracy for predicting mortality within 30 days (83.5%) whereas the CURE Hemostasis prognosis score and the Charlson index both had accuracies less than 75% for the prediction of death within 30 days. Conclusions ASA score could be useful to predict death within 30 days. However a new score is still warranted to predict all 30 days outcomes (rebleeding, surgery and death) in LGIB. PMID:25599218

Test of Cure for Anogenital Gonorrhoea Using Modern RNA-Based and DNA-Based Nucleic Acid Amplification Tests: A Prospective Cohort Study.

PubMed

Wind, Carolien M; Schim van der Loeff, Maarten F; Unemo, Magnus; Schuurman, Rob; van Dam, Alje P; de Vries, Henry J C

2016-06-01

The use of nucleic acid amplification tests (NAATs) to diagnose Neisseria gonorrhoeae infections complicates the performance of a test of cure (TOC) to monitor treatment failure, if this is indicated. As evidence for the timing of TOC using modern NAATs is limited, we performed a prospective cohort study to assess time to clearance when using modern RNA- and DNA-based NAATs. We included patients with anogenital gonorrhoea visiting the Sexually Transmitted Infection Clinic Amsterdam from March through October 2014. After treatment with ceftriaxone mono- or dual therapy (with azithromycin or doxycycline), anal, vaginal, or urine samples were self-collected during 28 consecutive days, and analyzed using an RNA-based NAAT (Aptima Combo 2) and a DNA-based NAAT (Cobas 4800). Clearance was defined as 3 consecutive negative results, and blips as isolated positive results following clearance. We included 77 patients; 5 self-cleared gonorrhoea before treatment and 10 were lost to follow-up. Clearance rate of the remaining 62 patients was 100%. Median time to clearance was 2 days, with a range of 1-7 days for RNA-based NAAT and 1-15 days for DNA-based NAAT. The risk of finding a blip after clearance was 0.8% and 1.5%, respectively. One patient had a reinfection. If indicated, we recommend that TOC be performed for anogenital gonorrhoea at least 7 or 14 days after administering therapy, when using modern RNA- or DNA-based NAATs, respectively. When interpreting TOC results for possible treatment failure, both the occurrence of blips and a possible reinfection need to be taken into account. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Gastro-protective effect of methanol extract of Vernonia amygdalina (del.) leaf on aspirin-induced gastric ulcer in Wistar rats.

PubMed

Adefisayo, Modinat A; Akomolafe, Rufus O; Akinsomisoye, Stephen O; Alabi, Quadri K; Ogundipe, Olaofe L; Omole, Joseph G; Olamilosoye, Kehinde P

2017-01-01

This study investigated the protective effects of methanol extract of Vernonia amygdalina leaf (MEVA) on aspirin induced gastric ulcer in rats. Thirty Wistar rats, 150-200 g were divided into six groups as follows: Group 1 (control) rats received 2 mL/kg of propylene glycol for 28 consecutive days. Group 2 (Ulcer Control) received 150 mg/kg/day of aspirin suspended in 3 mL of 1% carboxymethylcellulose in water orally for 3 consecutive days during which the rats were fasted for the induction of ulcer. Group 3 received cimetidine at 100 mg/kg/day orally for 28 consecutive days and thereafter treated as group 2. Groups 4, 5 and 6 received MEVA orally at 200, 300 and 400 mg/kg/day respectively for 28 consecutive days and thereafter were treated with aspirin as group 2. All the animals were sacrifice at the end of the study to determine the gastric pH, gastric acidity, gastric ulcer score, haematological indices, superoxide dismutase (SOD) activity, reduced glutathione (GSH) and Lipid peroxidation (LPO) levels. The result showed that aspirin significantly (p < 0.05) increased gastric ulcer score and index, decreased gastric pH, gastric acidity, SOD activity, GSH level as well as increased LPO level. It induced significant necrosis of the stomach tissue. Administration of MEVA significantly (p < 0.05) increased gastric pH, but decreased gastric acid secretion and reversed alteration of haematological parameters. It also significantly (p < 0.05) increased SOD activity, GSH level and decreased LPO level. The results suggest that Vernonia amygdalina possesses gastro-protective properties against aspirin-induced gastric ulcer.

Variability of tropical days over Greece within the second half of the twentieth century

NASA Astrophysics Data System (ADS)

Nastos, P. T.; Matzarakis, A. P.

2008-06-01

Tropical days (TD) are defined as the days with a maximum air temperature greater than 30.0 °C. It is clear that the study of TD includes also the absolute maximum temperatures, which are of great interest for the description of a region’s climate. These days are considered as very hot, and they particularly are of great importance not only for bioclimatology and applied sciences, but also for the individuals who are sensitive in the heat-stress. The regime of the TD in Greece is the focus of this study. The aim is to demonstrate their changes from decade to decade, for the time period 1960-2000. For this study, the Annual Number of Tropical Days (ANTD) recorded by each of the 26 meteorological stations of National Meteorological Service, which are uniformly distributed in the Hellenic peninsula, was calculated and analysed. In terms of quantifying the conditions in a humanbiometeorological manner, the thermal index Physiological Equivalent Temperature (PET) and the consecutive days for Athens have been included in this study. The trends of the TD for each station were analysed through the Mann-Kendall technique, while the spatial distribution per decade reveals the regions with change (increase or decrease) in the ANTD during the examined period. Two characteristic periods of change for the ANTD appear in the majority of the meteorological stations in Greece. The first period (1955-1976) is determined by a negative trend, which is statistically significant (c.l. 95%), for adequate stations. In the period between 1976 and 2000, the increase in the ANTD and the maximum temperature exceed the corresponding maximum that appeared in the beginning of the 1950s for several of the examined meteorological stations. The human-biometeorological analysis shows that the consecutive days of PET > 35 °C have had a positive trend in the last two decades of the last century.

40 CFR 424.63 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... consecutive days shall not exceed— Metric units (kg/kkg of product) Manganese 0.678 0.339 Ammonia-N 6.778 3.389 English units (lb/1,000 lb of product) Manganese 0.678 0.339 Ammonia-N 6.778 3.389 (b) The... consecutive days shall not exceed— Metric units (kg/kkg of product) Manganese 0.176 0.088 Ammonia-N 1.762 .881...

40 CFR 424.63 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... consecutive days shall not exceed— Metric units (kg/kkg of product) Manganese 0.678 0.339 Ammonia-N 6.778 3.389 English units (lb/1,000 lb of product) Manganese 0.678 0.339 Ammonia-N 6.778 3.389 (b) The... consecutive days shall not exceed— Metric units (kg/kkg of product) Manganese 0.176 0.088 Ammonia-N 1.762 .881...

40 CFR 424.63 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... consecutive days shall not exceed— Metric units (kg/kkg of product) Manganese 0.678 0.339 Ammonia-N 6.778 3.389 English units (lb/1,000 lb of product) Manganese 0.678 0.339 Ammonia-N 6.778 3.389 (b) The... consecutive days shall not exceed— Metric units (kg/kkg of product) Manganese 0.176 0.088 Ammonia-N 1.762 .881...

40 CFR 424.63 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... consecutive days shall not exceed— Metric units (kg/kkg of product) Manganese 0.678 0.339 Ammonia-N 6.778 3.389 English units (lb/1,000 lb of product) Manganese 0.678 0.339 Ammonia-N 6.778 3.389 (b) The... consecutive days shall not exceed— Metric units (kg/kkg of product) Manganese 0.176 0.088 Ammonia-N 1.762 .881...

40 CFR 424.63 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... consecutive days shall not exceed— Metric units (kg/kkg of product) Manganese 0.678 0.339 Ammonia-N 6.778 3.389 English units (lb/1,000 lb of product) Manganese 0.678 0.339 Ammonia-N 6.778 3.389 (b) The... consecutive days shall not exceed— Metric units (kg/kkg of product) Manganese 0.176 0.088 Ammonia-N 1.762 .881...

40 CFR 428.105 - Standards of performance for new sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... consecutive days shall not exceed— Metric units (kg/kkg of raw material) Oil and grease 2.0 0.73 BOD5 3.72 2.20 TSS 6.96 2.90 pH (1) (1) English units (lb/1,000 lb of raw material) Oil and grease 2.0 0.73 BOD5... daily values for 30 consecutive days shall not exceed— Metric units (kg/kkg of raw material) Chromium 0...

40 CFR 428.105 - Standards of performance for new sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

... consecutive days shall not exceed— Metric units (kg/kkg of raw material) Oil and grease 2.0 0.73 BOD5 3.72 2.20 TSS 6.96 2.90 pH (1) (1) English units (lb/1,000 lb of raw material) Oil and grease 2.0 0.73 BOD5... daily values for 30 consecutive days shall not exceed— Metric units (kg/kkg of raw material) Chromium 0...

Neuropeptide Y - an early biomarker for cerebral vasospasm after aneurysmal subarachnoid hemorrhage.

PubMed

Schebesch, Karl-Michael; Brawanski, Alexander; Bele, Sylvia; Schödel, Petra; Herbst, Andreas; Bründl, Elisabeth; Kagerbauer, Simone Maria; Martin, Jan; Lohmeier, Anette; Stoerr, Eva-Maria; Proescholdt, Martin

2013-12-01

In the human brain, the potent vasoconstrictive neuropeptide Y (NPY) is abundantly expressed. Neuropeptide Y, which is stored in perivascular nerve fibers of the cerebral arteries, regulates the cerebral vascular diameter as well as cerebral blood flow. However, the role of NPY in the pathogenesis of cerebral vasospasm (CV) related to subarachnoid hemorrhage (SAH) is unclear. We prospectively analyzed and compared the release of endogenous NPY in the cerebrospinal fluid (CSF) of 66 patients with SAH to NPY release in a control group. Additionally, we correlated the levels of NPY with CV and consecutive ischemic stroke. Sixty-six consecutive patients (40 women, 26 men; mean age 53·1 years) with aneurysmal SAH were included. In the SAH group, CSF was drawn daily from day 1 to day 10 after the onset of SAH. The CSF of 29 patients undergoing spinal anesthesia for orthopedic surgery served as control samples. The NPY levels were determined in duplicate CSF samples by means of a competitive enzyme immunoassay (EIA). The levels of NPY in CSF were correlated with the development of CV over the 10-day period after the onset of SAH and to the occurrence of consecutive ischemic stroke. To evaluate CSF NPY levels as a predictive biomarker for vasospasm, we calculated the sensitivity and specificity as well as the positive and negative predictive values. The NPY levels were significantly higher in the SAH group than in the control group (p < 0·001). The treatment modality (clip versus coil) did not influence the level of NPY in CSF (p > 0·05). Patients with CV showed significantly higher NPY levels than patients without CV during the entire observation period. The NPY levels of the non-CV group dissipated over time, whereas the CV group showed continuously increasing values. The NPY levels from day 4 to 10 were significantly higher in patients with CV-related stroke than in non-stroke patients. Using 0·3 ng/ml as a cut-off value, NPY levels on day 3 predicted the occurrence of CV with a sensitivity and specificity of 82% and 72%, respectively. High NPY levels, starting on day 4, significantly correlated with poor Glasgow Outcome Score grading at the follow-up (p < 0·05). Our data indicate that NPY is involved in the pathogenesis of SAH-related CV and ischemia. Neuropeptide Y represents an early and reliable biomarker for the prediction of CV and consecutive stroke due to aneurysmal SAH.

40 CFR 428.73 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... consecutive days shall not exceed— Metric units (kg/kkg of raw material) Oil and grease 0.26 0.093 TSS 0.50 0.25 pH (1) (1) English units (lb/1,000 lb of raw material) Oil and grease 0.26 0.093 TSS 0.50 0.25 pH... Average of daily values for 30 consecutive days shall not exceed— Metric units (kg/kkg of raw material...

40 CFR 428.53 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... consecutive days shall not exceed— Metric units (kg/kkg of raw material) Oil and grease 0.70 0.25 TSS 1.28 0.64 pH (1) (1) English units (lb/1,000 lb of raw material) Oil and grease 0.70 0.25 TSS 1.28 0.64 pH... Average of daily values for 30 consecutive days shall not exceed— Metric units (kg/kkg of raw material...

40 CFR 428.63 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... consecutive days shall not exceed— Metric units (kg/kkg of raw material) Oil and grease 0.42 0.15 TSS 0.80 0.40 pH (1) (1) English units (lb/1,000 lb of raw material) Oil and grease 0.42 0.15 TSS 0.80 0.40 pH... Average of daily values for 30 consecutive days shall not exceed— Metric units (kg/kkg of raw material...

40 CFR 428.53 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... consecutive days shall not exceed— Metric units (kg/kkg of raw material) Oil and grease 0.70 0.25 TSS 1.28 0.64 pH (1) (1) English units (lb/1,000 lb of raw material) Oil and grease 0.70 0.25 TSS 1.28 0.64 pH... Average of daily values for 30 consecutive days shall not exceed— Metric units (kg/kkg of raw material...

40 CFR 428.73 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... consecutive days shall not exceed— Metric units (kg/kkg of raw material) Oil and grease 0.26 0.093 TSS 0.50 0.25 pH (1) (1) English units (lb/1,000 lb of raw material) Oil and grease 0.26 0.093 TSS 0.50 0.25 pH... Average of daily values for 30 consecutive days shall not exceed— Metric units (kg/kkg of raw material...

40 CFR 428.63 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... consecutive days shall not exceed— Metric units (kg/kkg of raw material) Oil and grease 0.42 0.15 TSS 0.80 0.40 pH (1) (1) English units (lb/1,000 lb of raw material) Oil and grease 0.42 0.15 TSS 0.80 0.40 pH... Average of daily values for 30 consecutive days shall not exceed— Metric units (kg/kkg of raw material...

Effect of pitching consecutive days in youth softball tournaments on objective shoulder strength and subjective shoulder symptoms

PubMed Central

Skillington, S. Andrew; Brophy, Robert H.; Wright, Rick W.; Smith, Matthew V.

2017-01-01

Background The windmill pitching motion has been associated with risk for shoulder injury. Since there are no pitching limits on youth fast-pitch softball pitchers, these athletes often pitch multiple games across consecutive days. Strength changes, fatigue levels, and shoulder pain that develop among female fast-pitch pitchers over the course of consecutive days of pitching have not been investigated. Hypothesis Over the course of 2 and 3-day fast-pitch softball tournaments, pitchers will develop progressive objective weakness and increased subjective shoulder fatigue and pain without complete recovery between days. Study Design Cross-Sectional Study. Methods Female fast-pitch softball pitchers between the ages of 14 and 18 who were pitching in 2 and 3-day tournaments were recruited for study participation. At the beginning and end of each day of tournament play, pitchers were asked to quantify shoulder fatigue and shoulder pain levels of their dominant throwing arm using a 10-point visual analog scale (VAS). Shoulder abduction, flexion, external rotation, internal rotation, elbow flexion, and elbow extension strength measurements were gathered using a hand-held dynamometer. Results Over the course of an average single day of tournament participation, pitchers developed significant increases in VAS shoulder fatigue (2.0, 95% CI: 1.3 to 3.0), and pain (1.3, 95% CI: 0.5 to 2.3) and significant strength loss in all tested motions. Pitchers also developed significant increases in VAS shoulder fatigue (3.5, 95% CI: 1.5 to 5.5), VAS shoulder pain (2.5, 95% CI: 1.0 to 4.5) and strength loss in all tested motions over the entire tournament. Shoulder pain, fatigue, and strength do not fully recover between days. The accumulation of subjective shoulder pain and fatigue over the course of tournament play were closely correlated. Conclusion Among youth female fast-pitch softball pitchers, there is a progressive increase in shoulder fatigue, pain, and weakness over the course of 2 and 3-day tournaments without full recovery between consecutive days pitching. PMID:28298058

Effect of Pitching Consecutive Days in Youth Fast-Pitch Softball Tournaments on Objective Shoulder Strength and Subjective Shoulder Symptoms.

PubMed

Skillington, S Andrew; Brophy, Robert H; Wright, Rick W; Smith, Matthew V

2017-05-01

The windmill pitching motion has been associated with risk for shoulder injury. Because there are no pitching limits on youth fast-pitch softball pitchers, these athletes often pitch multiple games across consecutive days. Strength changes, fatigue levels, and shoulder pain that develop among female fast-pitch pitchers over the course of consecutive days of pitching have not been investigated. Over the course of 2- and 3-day fast-pitch softball tournaments, pitchers will develop progressive objective weakness and increased subjective shoulder fatigue and pain without complete recovery between days. Cross-sectional study; Level of evidence, 3. Fourteen female fast-pitch softball pitchers between the ages of 14 and 18 years were evaluated for strength and fatigue changes across 2- and 3-day tournaments. At the beginning and end of each day of tournament play, pitchers were asked to quantify shoulder fatigue and shoulder pain levels of their dominant throwing arm using a 10-point visual analog scale (VAS). Shoulder abduction, flexion, external rotation, internal rotation, elbow flexion, and elbow extension strength measurements were gathered using a handheld dynamometer. Over the course of an average single day of tournament participation, pitchers developed significant increases in VAS scores for shoulder fatigue (median, 2.0; 95% CI, 1.3-3.0) and pain (median, 1.3; 95% CI, 0.5-2.3) and significant strength loss in all tested motions. Pitchers also developed significant increases in VAS shoulder fatigue (median, 3.5; 95% CI, 1.5-5.5), VAS shoulder pain (median, 2.5; 95% CI, 1.0-4.5), and strength loss in all tested motions over the entire tournament. Shoulder pain, fatigue, and strength do not fully recover between days. The accumulation of subjective shoulder pain and fatigue over the course of tournament play were closely correlated. Among youth female fast-pitch softball pitchers, there is a progressive increase in shoulder fatigue, pain, and weakness over the course of 2- and 3-day tournaments without full recovery between consecutive days of pitching.

Protective effect of gallic acid against cisplatin-induced ototoxicity in rats.

PubMed

Kilic, Korhan; Sakat, Muhammed Sedat; Akdemir, Fazile Nur Ekinci; Yildirim, Serkan; Saglam, Yavuz Selim; Askin, Seda

2018-04-07

Cisplatin is an antineoplastic agent widely used in the treatment of a variety of cancers. Ototoxicity is one of the main side-effects restricting the use of cisplatin. The purpose of this study was to investigate the protective efficacy of gallic acid, in biochemical, functional and histopathological terms, against ototoxicity induced by cisplatin. Twenty-eight female Sprague Dawley rats were included. Rats were randomly assigned into four groups of seven animals each. Cisplatin group received a single intraperitoneal dose of 15mg/kg cisplatin. Gallic acid group received intraperitoneal gallic acid at 100mg/kg for five consecutive days. Cisplatin+Gallic acid group received intraperitoneal gallic acid at 100mg/kg for five consecutive days and a single intraperitoneal dose of 15mg/kg cisplatin at 3rd day. A control group received 1mL intraperitoneal saline solution for five consecutive days. Prior to drug administration, all rats were exposed to the distortion product otoacoustic emissions test. The test was repeated on the 6th day of the study. All rats were then sacrificed; the cochleas were removed and set aside for biochemical and histopathological analyses. In Cisplatin group, Day 6 signal noise ratio values were significantly lower than those of the other groups. Also, malondialdehyde levels in cochlear tissues were significantly higher, superoxide dismutase and glutathione peroxidase activities were significantly lower compared to the control group. Histopathologic evaluation revealed erosion in the stria vascularis, degeneration and edema in the connective tissue layer in endothelial cells, impairment of outer hair cells and a decrease in the number of these calls. In the Cisplatin+Gallic acid group, this biochemical, histopathological and functional changes were reversed. In the light of our findings, we think that gallic acid may have played a protective role against cisplatin-induced ototoxicity in rats, as indicated by the distortion product otoacoustic emissions test results, biochemical findings and immunohistochemical analyses. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Obtaining Reliable Estimates of Ambulatory Physical Activity in People with Parkinson's Disease.

PubMed

Paul, Serene S; Ellis, Terry D; Dibble, Leland E; Earhart, Gammon M; Ford, Matthew P; Foreman, K Bo; Cavanaugh, James T

2016-05-05

We determined the number of days required, and whether to include weekdays and/or weekends, to obtain reliable measures of ambulatory physical activity in people with Parkinson's disease (PD). Ninety-two persons with PD wore a step activity monitor for seven days. The number of days required to obtain a reliable estimate of daily activity was determined from the mean intraclass correlation (ICC2,1) for all possible combinations of 1-6 consecutive days of monitoring. Two days of monitoring were sufficient to obtain reliable daily activity estimates (ICC2,1 > 0.9). Amount (p = 0.03) but not intensity (p = 0.13) of ambulatory activity was greater on weekdays than weekends. Activity prescription based on amount rather than intensity may be more appropriate for people with PD.

Predictors of bleeding and user satisfaction during consecutive use of the levonorgestrel-releasing intrauterine system.

PubMed

Heikinheimo, O; Inki, P; Kunz, M; Gemzell-Danielsson, K

2010-06-01

Consecutive use of the levonorgestrel-releasing intrauterine system (LNG-IUS) is increasing. However, little is known about factors that predict the bleeding during consecutive use. The objective of this study was to analyse the possible factors which may predict the bleeding pattern during the first year of use of a second LNG-IUS. Fertile-aged women (n = 204) who had used their first LNG-IUS for over 4 years and who opted for a second LNG-IUS were recruited. Bleeding data were reported using 90-day reference periods (RPs) starting from the last 90 days of the first LNG-IUS use (baseline), until the end of the first year of the second LNG-IUS (RPs 1-4). Demographic factors such as age, parity, body mass index, indication of LNG-IUS use or smoking could not be identified as predictors for bleeding and spotting (B/S). Mean (+/-SD) number of B/S days was 8.9 (+/-9.1) at baseline. This increased slightly during RP1 and fell to 6.4 (+/-8.1) during RP4. Compared with the mean, women with uterine fibroids or a bleeding pattern of >9 days of spotting or any bleeding at RP1 had more B/S days during RP1-4. Although the number of B/S days decreased progressively from RP1 to RP4 in the group with a bleeding pattern of >9 days of spotting or any bleeding at baseline, such a phenomenon was not observed for women with fibroids. The difference for the change in B/S days between women with and without fibroids was statistically significant at RP3 and RP4. A high degree (91.7%) of satisfaction with the bleeding pattern was observed, with amenorrhoeic women being most satisfied. Uterine B/S is reduced during consecutive use of the LNG-IUS. Women with uterine fibroids or any bleeding at baseline continued to have more B/S than other women.

Efficacy of triplet regimen antiemetic therapy for chemotherapy-induced nausea and vomiting (CINV) in bone and soft tissue sarcoma patients receiving highly emetogenic chemotherapy, and an efficacy comparison of single-shot palonosetron and consecutive-day granisetron for CINV in a randomized, single-blinded crossover study

PubMed Central

Kimura, Hiroaki; Yamamoto, Norio; Shirai, Toshiharu; Nishida, Hideji; Hayashi, Katsuhiro; Tanzawa, Yoshikazu; Takeuchi, Akihiko; Igarashi, Kentaro; Inatani, Hiroyuki; Shimozaki, Shingo; Kato, Takashi; Aoki, Yu; Higuchi, Takashi; Tsuchiya, Hiroyuki

2015-01-01

The first aim of this study was to evaluate combination antiemetic therapy consisting of 5-HT3 receptor antagonists, neurokinin-1 receptor antagonists (NK-1RAs), and dexamethasone for multiple high emetogenic risk (HER) anticancer agents in bone and soft tissue sarcoma. The second aim was to compare the effectiveness of single-shot palonosetron and consecutive-day granisetron in a randomized, single-blinded crossover study. A single randomization method was used to assign eligible patients to the palonosetron or granisetron arm. Patients in the palonosetron arm received a palonosetron regimen during the first and third chemotherapy courses and a granisetron regimen during the second and fourth courses. All patients received NK-1RA and dexamethasone. Patients receiving the palonosetron regimen were administered 0.75 mg palonosetron on day 1, and patients receiving the granisetron regimen were administered 3 mg granisetron twice daily on days 1 through 5. All 24 patients in this study received at least 4 chemotherapy courses. A total of 96 courses of antiemetic therapy were evaluated. Overall, the complete response CR rate (no emetic episodes and no rescue medication use) was 34%, while the total control rate (a CR plus no nausea) was 7%. No significant differences were observed between single-shot palonosetron and consecutive-day granisetron. Antiemetic therapy with a 3-drug combination was not sufficient to control chemotherapy-induced nausea and vomiting (CINV) during chemotherapy with multiple HER agents for bone and soft tissue sarcoma. This study also demonstrated that consecutive-day granisetron was not inferior to single-shot palonosetron for treating CINV. PMID:25533447

Extreme Precipitation in Poland in the Years 1951-2010

NASA Astrophysics Data System (ADS)

Malinowska, Miroslawa

2017-12-01

The characteristics of extreme precipitation, including the dominant trends, were analysed for eight stations located in different parts of Poland for the period 1951-2010. Five indices enabling the assessment of the intensity and frequency of both extremely dry and wet conditions were applied. The indices included the number of days with precipitation ≥10mm·d-1 (R10), maximum number of consecutive dry days (CDD), maximum 5-day precipitation total (R5d), simple daily intensity index (SDII), and the fraction of annual total precipitation due to events exceeding the 95th percentile calculated for the period 1961-1990. Annual trends were calculated using standard linear regression method, while the fit of the model was assessed with the F-test at the 95% confidence level. The analysed changes in extreme precipitation showed mixed patterns. A significant positive trend in the number of days with precipitation ≥10mm·d-1 (R10) was observed in central Poland, while a significant negative one, in south-eastern Poland. Based on the analysis of maximum 5-day precipitation totals (R5d), statistically significant positive trends in north-western, western and eastern parts of the country were detected, while the negative trends were found in the central and northeastern parts. Daily precipitation, expressed as single daily intensity index (SDII), increased over time in northern and central Poland. In southern Poland, the variation of SDII index showed non-significant negative tendencies. Finally, the fraction of annual total precipitation due to the events exceeding the 1961-1990 95th percentile increased at one station only, namely, in Warsaw. The indicator which refers to dry conditions, i.e. maximum number of consecutive dry days (CDD) displayed negative trends throughout the surveyed area, with the exception of Szczecin that is a representative of north-western Poland.

Comparison of Three Risk Scores to Predict Outcomes of Severe Lower Gastrointestinal Bleeding.

PubMed

Camus, Marine; Jensen, Dennis M; Ohning, Gordon V; Kovacs, Thomas O; Jutabha, Rome; Ghassemi, Kevin A; Machicado, Gustavo A; Dulai, Gareth S; Jensen, Mary E; Gornbein, Jeffrey A

2016-01-01

Improved medical decisions by using a score at the initial patient triage level may lead to improvements in patient management, outcomes, and resource utilization. There is no validated score for management of lower gastrointestinal bleeding (LGIB) unlike for upper gastrointestinal bleeding. The aim of our study was to compare the accuracies of 3 different prognostic scores [Center for Ulcer Research and Education Hemostasis prognosis score, Charlson index, and American Society of Anesthesiologists (ASA) score] for the prediction of 30-day rebleeding, surgery, and death in severe LGIB. Data on consecutive patients hospitalized with severe gastrointestinal bleeding from January 2006 to October 2011 in our 2 tertiary academic referral centers were prospectively collected. Sensitivities, specificities, accuracies, and area under the receiver operator characteristic curve were computed for 3 scores for predictions of rebleeding, surgery, and mortality at 30 days. Two hundred thirty-five consecutive patients with LGIB were included between 2006 and 2011. Twenty-three percent of patients rebled, 6% had surgery, and 7.7% of patients died. The accuracies of each score never reached 70% for predicting rebleeding or surgery in either. The ASA score had a highest accuracy for predicting mortality within 30 days (83.5%), whereas the Center for Ulcer Research and Education Hemostasis prognosis score and the Charlson index both had accuracies <75% for the prediction of death within 30 days. ASA score could be useful to predict death within 30 days. However, a new score is still warranted to predict all 30 days outcomes (rebleeding, surgery, and death) in LGIB.

40 CFR 436.42 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

...— TSS 45 mg/l 25 mg/l. pH (1) (1) 1 Within the range 6.0 to 9.0. (2) Except as provided in paragraphs (a... daily values for 30 consecutive days shall not exceed— TSS 0.046 0.023 Total fluoride .006 .003 pH (1... consecutive days shall not exceed— TSS 45 mg/l 25 mg/l. pH (1) (1) 1 Within the range 6.0 to 9.0. (b) Any...

Characterizing prolonged heat effects on mortality in a sub-tropical high-density city, Hong Kong

NASA Astrophysics Data System (ADS)

Ho, Hung Chak; Lau, Kevin Ka-Lun; Ren, Chao; Ng, Edward

2017-11-01

Extreme hot weather events are likely to increase under future climate change, and it is exacerbated in urban areas due to the complex urban settings. It causes excess mortality due to prolonged exposure to such extreme heat. However, there is lack of universal definition of prolonged heat or heat wave, which leads to inadequacies of associated risk preparedness. Previous studies focused on estimating temperature-mortality relationship based on temperature thresholds for assessing heat-related health risks but only several studies investigated the association between types of prolonged heat and excess mortality. However, most studies focused on one or a few isolated heat waves, which cannot demonstrate typical scenarios that population has experienced. In addition, there are limited studies on the difference between daytime and nighttime temperature, resulting in insufficiency to conclude the effect of prolonged heat. In sub-tropical high-density cities where prolonged heat is common in summer, it is important to obtain a comprehensive understanding of prolonged heat for a complete assessment of heat-related health risks. In this study, six types of prolonged heat were examined by using a time-stratified analysis. We found that more consecutive hot nights contribute to higher mortality risk while the number of consecutive hot days does not have significant association with excess mortality. For a day after five consecutive hot nights, there were 7.99% [7.64%, 8.35%], 7.74% [6.93%, 8.55%], and 8.14% [7.38%, 8.88%] increases in all-cause, cardiovascular, and respiratory mortality, respectively. Non-consecutive hot days or nights are also found to contribute to short-term mortality risk. For a 7-day-period with at least five non-consecutive hot days and nights, there was 15.61% [14.52%, 16.70%] increase in all-cause mortality at lag 0-1, but only -2.00% [-2.83%, -1.17%] at lag 2-3. Differences in the temperature-mortality relationship caused by hot days and hot nights imply the need to categorize prolonged heat for public health surveillance. Findings also contribute to potential improvement to existing heat-health warning system.

Characterizing prolonged heat effects on mortality in a sub-tropical high-density city, Hong Kong.

PubMed

Ho, Hung Chak; Lau, Kevin Ka-Lun; Ren, Chao; Ng, Edward

2017-11-01

Extreme hot weather events are likely to increase under future climate change, and it is exacerbated in urban areas due to the complex urban settings. It causes excess mortality due to prolonged exposure to such extreme heat. However, there is lack of universal definition of prolonged heat or heat wave, which leads to inadequacies of associated risk preparedness. Previous studies focused on estimating temperature-mortality relationship based on temperature thresholds for assessing heat-related health risks but only several studies investigated the association between types of prolonged heat and excess mortality. However, most studies focused on one or a few isolated heat waves, which cannot demonstrate typical scenarios that population has experienced. In addition, there are limited studies on the difference between daytime and nighttime temperature, resulting in insufficiency to conclude the effect of prolonged heat. In sub-tropical high-density cities where prolonged heat is common in summer, it is important to obtain a comprehensive understanding of prolonged heat for a complete assessment of heat-related health risks. In this study, six types of prolonged heat were examined by using a time-stratified analysis. We found that more consecutive hot nights contribute to higher mortality risk while the number of consecutive hot days does not have significant association with excess mortality. For a day after five consecutive hot nights, there were 7.99% [7.64%, 8.35%], 7.74% [6.93%, 8.55%], and 8.14% [7.38%, 8.88%] increases in all-cause, cardiovascular, and respiratory mortality, respectively. Non-consecutive hot days or nights are also found to contribute to short-term mortality risk. For a 7-day-period with at least five non-consecutive hot days and nights, there was 15.61% [14.52%, 16.70%] increase in all-cause mortality at lag 0-1, but only -2.00% [-2.83%, -1.17%] at lag 2-3. Differences in the temperature-mortality relationship caused by hot days and hot nights imply the need to categorize prolonged heat for public health surveillance. Findings also contribute to potential improvement to existing heat-health warning system.

Incomplete adherence among treatment-experienced adults on antiretroviral therapy in Tanzania, Uganda and Zambia

PubMed Central

Denison, Julie A.; Koole, Olivier; Tsui, Sharon; Menten, Joris; Torpey, Kwasi; van Praag, Eric; Mukadi, Ya Diul; Colebunders, Robert; Auld, Andrew F.; Agolory, Simon; Kaplan, Jonathan E.; Mulenga, Modest; Kwesigabo, Gideon P.; Wabwire-Mangen, Fred; Bangsberg, David R.

2016-01-01

Objectives To characterize antiretroviral therapy (ART) adherence across different programmes and examine the relationship between individual and programme characteristics and incomplete adherence among ART clients in sub-Saharan Africa. Design A cross-sectional study. Methods Systematically selected ART clients (≥18 years; on ART ≥6 months) attending 18 facilities in three countries (250 clients/facility) were interviewed. Client self-reports (3-day, 30-day, Case Index ≥48 consecutive hours of missed ART), healthcare provider estimates and the pharmacy medication possession ratio (MPR) were used to estimate ART adherence. Participants from two facilities per country underwent HIV RNA testing. Optimal adherence measures were selected on the basis of degree of association with concurrent HIV RNA dichotomized at less than or greater/equal to 1000 copies/ml. Multivariate regression analysis, adjusted for site-level clustering, assessed associations between incomplete adherence and individual and programme factors. Results A total of 4489 participants were included, of whom 1498 underwent HIV RNA testing. Nonadherence ranged from 3.2% missing at least 48 consecutive hours to 40.1% having an MPR of less than 90%. The percentage with HIV RNA at least 1000 copies/ml ranged from 7.2 to 17.2% across study sites (mean = 9.9%). Having at least 48 consecutive hours of missed ART was the adherence measure most strongly related to virologic failure. Factors significantly related to incomplete adherence included visiting a traditional healer, screening positive for alcohol abuse, experiencing more HIV symptoms, having an ART regimen without nevirapine and greater levels of internalized stigma. Conclusion Results support more in-depth investigations of the role of traditional healers, and the development of interventions to address alcohol abuse and internalized stigma among treatment-experienced adult ART patients. PMID:25686684

Observed changes in extreme precipitation in Poland: 1991-2015 versus 1961-1990

NASA Astrophysics Data System (ADS)

Pińskwar, Iwona; Choryński, Adam; Graczyk, Dariusz; Kundzewicz, Zbigniew W.

2018-01-01

Several episodes of extreme precipitation excess and extreme precipitation deficit, with considerable economic and social impacts, have occurred in Europe and in Poland in the last decades. However, the changes of related indices exhibit complex variability. This paper analyses changes in indices related to observed abundance and deficit of precipitated water in Poland. Among studied indices are maximum seasonal 24-h precipitation for the winter half-year (Oct.-March) and the summer half-year (Apr.-Sept.), maximum 5-day precipitation, maximum monthly precipitation and number of days with intense or very intense precipitation (respectively, in excess of 10 mm or 20 mm per day). Also, the warm-seasonal maximum number of consecutive dry days (longest period with daily precipitation below 1 mm) was examined. Analysis of precipitation extremes showed that daily maximum precipitation for the summer half-year increased for many stations, and increases during the summer half-year are more numerous than those in the winter half-year. Also, analysis of 5-day and monthly precipitation sums show increases for many stations. Number of days with intense precipitation increases especially in the north-western part of Poland. The number of consecutive dry days is getting higher for many stations in the summer half-year. Comparison of these two periods: colder 1961-1990 and warmer 1991-2015, revealed that during last 25 years most of statistical indices, such as 25th and 75th percentiles, median, mean and maximum are higher. However, many changes discussed in this paper are weak and statistically insignificant. The findings reported in this paper challenge results based on earlier data that do not include 2007-2015.

Mycoplasma gallisepticum in pheasants and the efficacy of tylvalosin to treat the disease.

PubMed

Forrester, C Anne; Bradbury, Janet M; Dare, Cynthia M; Domangue, Rickie J; Windsor, Helena; Tasker, John B; Mockett, A P Adrian

2011-12-01

Infectious sinusitis, a common condition seen in adult pheasants, is primarily caused by Mycoplasma gallisepticum. The aims of the present study were to investigate the pathogenicity of M. gallisepticum in 14-day-old pheasants and evaluate the macrolide antibiotic tylvalosin (TVN) as a treatment for infectious sinusitis. The minimum inhibitory concentration of TVN for five isolates of M. gallisepticum taken from pheasants confirmed their susceptibility to TVN (range: 0.002 to 0.008 µg/ml). One of the isolates (G87/02) was inoculated intranasally into 72 pheasants (two groups of 36) at 14 days of age. Eight days later, when 18/72 (25%) of the pheasants showed clinical signs, one group was treated with 25 mg TVN/kg bodyweight daily in drinking water for three consecutive days. An uninfected, unmedicated control group (n=12) was also included. In contrast to the uninfected control group, a range of clinical signs typical of infectious sinusitis with varying severity was observed in challenged birds and M. gallisepticum was re-isolated from the infraorbital sinus and the eye/conjunctiva at necropsy, 22 days post challenge. In comparison with untreated birds, medication with TVN significantly reduced clinical signs and the re-isolation/detection of M. gallisepticum (P≤0.0021). The daily liveweight gain of treated birds was significantly increased in comparison with untreated birds (P=0.0002), and similar to daily liveweight gains observed in the uninfected control group. In conclusion, TVN at 25 mg/kg bodyweight daily for three consecutive days in drinking water was efficacious in the treatment of M. gallisepticum infection induced by challenging 14-day-old pheasants.

The reliability of the quantitative timed up and go test (QTUG) measured over five consecutive days under single and dual-task conditions in community dwelling older adults.

PubMed

Smith, Erin; Walsh, Lorcan; Doyle, Julie; Greene, Barry; Blake, Catherine

2016-01-01

The timed up and go (TUG) test is a commonly used assessment in older people with variations including the addition of a motor or cognitive dual-task, however in high functioning older adults it is more difficult to assess change. The quantified TUG (QTUG) uses inertial sensors to detect test and gait parameters during the test. If it is to be used in the longitudinal assessment of older adults, it is important that we know which parameters are reliable and under which conditions. This study aims to examine the relative reliability of the QTUG over five consecutive days under single, motor and cognitive dual-task conditions. Twelve community dwelling older adults (10 females, mean age 74.17 (3.88)) performed the QTUG under three conditions for five consecutive days. The relative reliability of each of the gait parameters was assessed using intra-class correlation coefficient (ICC 3,1) and standard error of measurement (SEM). Five of the measures demonstrated excellent reliability (ICC>0.70) under all three conditions (time to complete test, walk time, number of gait cycles, number of steps and return from turn time). Measures of variability and turn derived parameters demonstrated weak reliability under all three conditions (ICC=0.05-0.49). For the most reliable parameters under single-task conditions, the addition of a cognitive task resulted in a reduction in reliability suggesting caution when interpreting results under these conditions. Certain sensor derived parameters during the QTUG test may provide an additional resource in the longitudinal assessment of older people and earlier identification of falls risk. Copyright © 2015 Elsevier B.V. All rights reserved.

Differences on the effect of heat waves on mortality by sociodemographic and urban landscape characteristics.

PubMed

Xu, Yihan; Dadvand, Payam; Barrera-Gómez, Jose; Sartini, Claudio; Marí-Dell'Olmo, Marc; Borrell, Carme; Medina-Ramón, Mercè; Sunyer, Jordi; Basagaña, Xavier

2013-06-01

Mortality increases during heat waves have been reported worldwide. The magnitude of these increases can vary within regions according to sociodemographic and urban landscape characteristics. The objectives of this study were to explore this variation and its determinants, and to identify the most heat-vulnerable areas by mapping heat vulnerability. We conducted a time-stratified case-crossover analysis using daily mortality in the Barcelona metropolitan area during the warm seasons of 1999-2006. Temperature data on the date of death were assigned to each individual, which were assigned to their census tract of residence. Eight census tract-level variables on socioeconomic or built environment characteristics were obtained from the census. Residence surrounding greenness was obtained from satellite data. The relative risk (RR) of mortality after three consecutive hot days (defined as those exceeding the 95th percentile of maximum temperature) was calculated via conditional logistic regression. Effect modification was examined by including interaction terms. Analyses were based on 52 806 deaths. The effect of three consecutive hot days was a 30% increase in all-cause mortality (RR=1.30, 95% CI 1.24 to 1.38). Heterogeneity of this effect was observed across census tracts. The effect of heat on mortality was higher in the census tracts with a large percentage of old buildings (RR=1.21, 95% CI 1.00 to 1.46), manual workers (RR=1.25, 95% CI 0.96 to 1.64) and residents perceiving little surrounding greenness (RR=1.29, 95% CI 1.01 to 1.65). After three consecutive hot days, mortality doubled in the most heat-vulnerable census tracts. Sociodemographic and urban landscape characteristics are associated to mortality risk during heat waves and are useful to build heat vulnerability maps.

Serial measurement of type-specific human papillomavirus load enables classification of cervical intraepithelial neoplasia lesions according to occurring human papillomavirus-induced pathway.

PubMed

Verhelst, Stefanie; Poppe, Willy A J; Bogers, Johannes J; Depuydt, Christophe E

2017-03-01

This retrospective study examined whether human papillomavirus (HPV) type-specific viral load changes measured in two or three serial cervical smears are predictive for the natural evolution of HPV infections and correlate with histological grades of cervical intraepithelial neoplasia (CIN), allowing triage of HPV-positive women. A cervical histology database was used to select consecutive women with biopsy-proven CIN in 2012 who had at least two liquid-based cytology samples before the diagnosis of CIN. Before performing cytology, 18 different quantitative PCRs allowed HPV type-specific viral load measurement. Changes in HPV-specific load between measurements were assessed by linear regression, with calculation of coefficient of determination (R) and slope. All infections could be classified into one of five categories: (i) clonal progressing process (R≥0.85; positive slope), (ii) simultaneously occurring clonal progressive and transient infection, (iii) clonal regressing process (R≥0.85; negative slope), (iv) serial transient infection with latency [R<0.85; slopes (two points) between 0.0010 and -0.0010 HPV copies/cell/day], and (v) transient productive infection (R<0.85; slope: ±0.0099 HPV copies/cell/day). Three hundred and seven women with CIN were included; 124 had single-type infections and 183 had multiple HPV types. Only with three consecutive measurements could a clonal process be identified in all CIN3 cases. We could clearly demonstrate clonal regressing lesions with a persistent linear decrease in viral load (R≥0.85; -0.003 HPV copies/cell/day) in all CIN categories. Type-specific viral load increase/decrease in three consecutive measurements enabled classification of CIN lesions in clonal HPV-driven transformation (progression/regression) and nonclonal virion-productive (serial transient/transient) processes.

Overweight and Obese Humans Overeat Away from Home

PubMed Central

de Castro, John M.; King, George A.; Duarte-Gardea, Maria; Gonzalez-Ayala, Salvador; Kooshian, Charles H.

2012-01-01

The built environment has been implicated in the development of the epidemic of obesity. We investigated the differences in the meal patterns of normal weight vs. overweight/obese individuals occurring at home vs. other locations. The location of meals and their size in free-living participants were continuously recorded for 7 consecutive days. Study 1: 81 males and 84 females recorded their intake in 7-d diet diaries and wore a belt that contained a GPS Logger to record their location continuously for 7 consecutive days. Study 2: 388 males and 621 females recorded their intake in diet diaries for 7 consecutive days. In both studies, compared to eating at home, overweight/obese participants ate larger meals away from home in both restaurants and other locations than normal weight participants. Overweight/obese individuals appear to be more responsive to environmental cues for eating away from home. This suggests that the influence of the built environment on the intake of overweight/obese individuals may contribute to the obesity epidemic. PMID:22565154

The effect of acetaminophen (four grams a day for three consecutive days) on hepatic tests in alcoholic patients – a multicenter randomized study

PubMed Central

Kuffner, EK; Green, JL; Bogdan, GM; Knox, PC; Palmer, RB; Heard, K; Slattery, JT; Dart, RC

2007-01-01

Background Hepatic failure has been associated with reported therapeutic use of acetaminophen by alcoholic patients. The highest risk period for alcoholic patients is immediately after discontinuation of alcohol intake. This period exhibits the largest increase in CYP2E1 induction and lowest glutathione levels. Our hypothesis was that common liver tests would be unaffected by administration of the maximum recommended daily dosage of acetaminophen for 3 consecutive days to newly-abstinent alcoholic subjects. Methods Adult alcoholic subjects entering two alcohol detoxification centers were enrolled in a prospective double-blind, randomized, placebo-controlled trial. Subjects were randomized to acetaminophen, 4 g/day, or placebo for 3 consecutive days. The study had 95% probability of detecting a 15 IU/L difference in serum ALT. Results A total of 443 subjects were enrolled: 308 (258 completed) received acetaminophen and 135 subjects (114 completed) received placebo. Study groups did not differ in demographics, alcohol consumption, nutritional status or baseline laboratory assessments. The peak mean ALT activity was 57 ± 45 IU/L and 55 ± 48 IU/L in the acetaminophen and placebo groups, respectively. Subgroup analyses for subjects presenting with an elevated ALT, subjects fulfilling a diagnosis of alcoholic hepatitis and subjects attaining a peak ALT greater than 200 IU/L showed no statistical difference between the acetaminophen and control groups. The one participant developing an increased international normalized ratio was in the placebo group. Conclusion Alcoholic patients treated with the maximum recommended daily dose of acetaminophen for 3 consecutive days did not develop increases in serum transaminase or other measures of liver injury. Treatment of pain or fever for 3 days with acetaminophen appears safe in newly-abstinent alcoholic patients, such as those presenting for acute medical care. PMID:17537264

The association between consecutive days' heat wave and cardiovascular disease mortality in Beijing, China.

PubMed

Yin, Qian; Wang, Jinfeng

2017-02-23

Although many studies have examined the effects of heat waves on the excess mortality risk (ER) posed by cardiovascular disease (CVD), scant attention has been paid to the effects of various combinations of differing heat wave temperatures and durations. We investigated such effects in Beijing, a city of over 20 million residents. A generalized additive model (GAM) was used to analyze the ER of consecutive days' exposure to extreme high temperatures. A key finding was that when extremely high temperatures occur continuously, at varying temperature thresholds and durations, the adverse effects on CVD mortality vary significantly. The longer the heat wave lasts, the greater the mortality risk is. When the daily maximum temperature exceeded 35 °C from the fourth day onward, the ER attributed to consecutive days' high temperature exposure saw an increase to about 10% (p < 0.05), and at the fifth day, the ER even reached 51%. For the thresholds of 32 °C, 33 °C, and 34 °C, from the fifth day onward, the ER also rose sharply (16, 29, and 31%, respectively; p < 0.05). In addition, extreme high temperatures appeared to contribute to a higher proportion of CVD deaths among elderly persons, females and outdoor workers. When the daily maximum temperature was higher than 33 °C from the tenth consecutive day onward, the ER of CVD death among these groups was 94, 104 and 149%, respectively (p < 0.05), which is considerably higher than the ER for the overall population (87%; p < 0.05). The results of this study may assist governments in setting standards for heat waves, creating more accurate heat alerts, and taking measures to prevent or reduce temperature-related deaths, especially against the backdrop of global warming.

Do PICU patients meet technical criteria for performing indirect calorimetry?

PubMed

Beggs, Megan R; Garcia Guerra, Gonzalo; Larsen, Bodil M K

2016-10-01

Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown. In the current study, we aimed to quantify the daily proportion of consecutive PICU patients who met technical criteria to perform indirect calorimetry and describe the technical contraindications when criteria were not met. Prospective, observational, single-centre study conducted in a cardiac and general PICU. All consecutive patients admitted for at least 96 h were included in the study. Variables collected for each patient included age at admission, admission diagnosis, and if technical criteria for indirect calorimetry were met. Technical criteria variables were collected within the same 2 h each morning and include: provision of supplemental oxygen, ventilator settings, endotracheal tube (ETT) leak, diagnosis of chest tube air leak, provision of external gas support (i.e. nitric oxide), and provision of extracorporeal membrane oxygenation (ECMO). 288 patients were included for a total of 3590 patient days between June 2014 and February 2015. The main reasons for admission were: surgery (cardiac and non-cardiac), respiratory distress, trauma, oncology and medicine/other. The median (interquartile range) patient age was 0.7 (0.3-4.6) years. The median length of PICU stay was 7 (5-14) days. Only 34% (95% CI, 32.4-35.5%) of patient days met technical criteria for IC. For patients less than 6 months of age, technical criteria were met on significantly fewer patient days (29%, p < 0.01). Moreover, 27% of patients did not meet technical criteria for IC on any day during their PICU stay. Most frequent reasons for why IC could not be performed included supplemental oxygen, ECMO, and ETT leak. In the current study, technical criteria to perform IC in the PICU were not met for 27% of patients and were not met on 66% of patient days. Moreover, criteria were met on only 29% of days for infants 6 months and younger where children 24 months of age and older still only met criteria on 40% of patient days. This data represents a major gap in the feasibility of current recommendations for assessing energy requirements of this population. Future studies are needed to improve methods of predicting and measuring energy requirements in critically ill children who do not meet current criteria for indirect calorimetry. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

History of irrigation and characteristics of streamflow in Nebraska, part of the North and South Platte River basins

USGS Publications Warehouse

Shaffer, F. Butler

1976-01-01

Statistics on streamflow for selected periods of time are presented for 28 gaging sites in the Nebraska part of the North and South Platte River basins. Monthly mean discharges, monthly means in percent of annual runoff, standard deviations, coefficients of variation, and monthly extremes are given. Also tabulated are probabilities of high discharges for 1 day and for 3, 7, 15, 30, and 60 consecutive days and of low discharges for 1 day and for 3, 7, 14, 30, and 60 consecutive days. All statistics are based on records that are representative of 1973 conditions of streamflow. Brief historical data are given for 27 of the principal irrigation canals diverting from the North and South Platte Rivers. (Woodard-USGS)

Pilot fatigue : intercontinental jet flight. 1. Oklahoma City Tokyo.

DOT National Transportation Integrated Search

1965-03-01

Following 3 consecutive days of biomedical assessment in Oklahoma City, six healthy subjects were transported to Tokyo, where assessments were made on alternate days throughout a period of 10 days, and were then transported back to Oklahoma City, whe...

Time off is crucial.

PubMed

Arif, Zeba

2016-10-05

Most nurses are contracted to work 37.5 hours over five days, followed by two days off. But many areas of the health service are so short staffed that split days off, where nurses do not get two consecutive days off, are becoming more common as managers struggle to provide cover for shifts.

Intermittent-sprint performance and muscle glycogen after 30 h of sleep deprivation.

PubMed

Skein, Melissa; Duffield, Rob; Edge, Johann; Short, Michael J; Mündel, Toby

2011-07-01

The aim of this study was to determine the effects of 30 h of sleep deprivation on consecutive-day intermittent-sprint performance and muscle glycogen content. Ten male, team-sport athletes performed a single-day "baseline" session and two consecutive-day experimental trials separated either by a normal night's sleep (CONT1 and CONT2) or no sleep (SDEP1 and SDEP2). Each session included a 30-min graded exercise run and 50-min intermittent-sprint exercise protocol, including a 15-m maximal sprint every minute and self-paced exercise bouts of varying intensities. Muscle biopsies were extracted before and after exercise during the baseline session and before exercise on day 2 during experimental trials. Voluntary force and activation of the right quadriceps, nude mass, HR, core temperature, capillary blood lactate and glucose, RPE, and a modified POMS were recorded before, after, and during the exercise protocols. Mean sprint times were slower on SDEP2 (2.78±0.17 s) compared with SDEP1 (2.70±0.16 s) and CONT2 (2.74±0.15 s, P<0.05). Distance covered during self-paced exercise was reduced during SDEP2 during the initial 10 min compared with SDEP1 and during the final 10 min compared with CONT2 (P<0.05). Muscle glycogen concentration was lower before exercise on SDEP2 (209±60 mmol·kg dry weight) compared with CONT2 (274±54 mmol·kg dry weight, P=0.05). Voluntary force and activation were reduced on day 2 of both conditions; however, both were lower in SDEP2 compared with CONT2 (P<0.05). Sleep loss did not affect RPE but negatively affected POMS ratings (P<0.05). Sleep loss and associated reductions in muscle glycogen and perceptual stress reduced sprint performance and slowed pacing strategies during intermittent-sprint exercise for male team-sport athletes.

'Test n Treat (TnT)': a cluster-randomised feasibility trial of frequent, rapid-testing and same-day, on-site treatment to reduce rates of chlamydia in high-risk further education college students: statistical analysis plan.

PubMed

Phillips, Rachel; Oakeshott, Pippa; Kerry-Barnard, Sarah; Reid, Fiona

2018-06-05

There are high rates of sexually transmitted infections (STIs) in ethnically diverse, sexually active students aged 16-24 years attending London further education (FE) colleges. However, uptake of chlamydia screening remains low. The TnT study aims to assess the feasibility of conducting a future trial in FE colleges to investigate if frequent, rapid, on-site testing and treatment (TnT) reduces chlamydia rates. This article presents the statistical analysis plan for the main study publication as approved and signed off by the Trial Management Group prior to the first data extraction for the final report. TnT is a cluster-randomised feasibility trial conducted over 7 months with parallel qualitative and economic assessments. Colleges will be randomly allocated into the intervention (TnT) or the control group (no TnT). Six FE colleges in London will be included. At each college for 2 days, 80 consecutive sexually active students aged 16-24 years (total 480 students across all six colleges) will be recruited from public areas and asked to provide baseline samples. One and 4 months after recruitment intervention colleges will be visited on two consecutive days by the TnT team where participating students will be texted and invited to come for same-day, on-site, rapid chlamydia testing and, if positive, treatment. Participants in the control colleges will receive 'thank you' texts 1 and 4 months after recruitment. Seven months after recruitment, participants from both groups will be invited to complete questionnaires and provide samples for TnT. All samples will be tested, and same-day treatment offered to participants with positive results. Key feasibility outcomes include: recruitment rates, testing and treatment uptake rates (at 1 and 4 months) and follow-up rates (at 7 months). ISRCTN 58038795 . Registered on 31 August 2016.

Ocular flora and their antibiotic susceptibility in patients having cataract surgery in Italy.

PubMed

Papa, Vincenzo; Blanco, Anna Rita; Santocono, Marcello

2016-09-01

To characterize the ocular flora in a consecutive group of patients having cataract surgery and to determine the antibiotic susceptibility profile of isolates to several ophthalmic antibiotics. Hospital Di Stefano, Catania, Italy. Observational case series. Conjunctival and eyelid cultures from patients were obtained 14 days before surgery and, if positive, repeated the day of the surgery. Antimicrobial susceptibility for aminoglycosides (netilmicin and tobramycin), fluoroquinolones (ofloxacin, levofloxacin, and moxifloxacin), chloramphenicol, and azithromycin was tested using the Kirby-Bauer disk diffusion method. Susceptibility was also tested for oxacillin, cefuroxime, and vancomycin. All positive patients received a 2-day preoperative course of 3 mg/mL netilmicin ophthalmic solution 4 times a day. The recovery rate of microorganisms after antibiotic treatment compared with baseline was calculated. One hundred twenty consecutive patients were included in the study. Cultures were positive in 72.5% of patients; 131 isolates, mainly gram-positive, were identified. Staphylococcus epidermidis (58.0%) and Staphylococcus aureus (15.3%) were the most frequently isolated microorganisms. Methicillin-resistant staphylococci accounted for 3.8% of S epidermidis and 20.0% of S aureus. A high in vitro susceptibility (>90%) for all isolates, including multiresistant coagulase-negative Staphylococcus, was obtained for netilmicin, vancomycin, and cefuroxime. The recovery rate of isolates before surgery was reduced by 93.9% (P < .001). Conjunctival and lid margin isolates were sensitive to netilmicin, vancomycin, and cefuroxime. Microorganisms were less susceptible to other ophthalmic antibiotics, with the exception of moxifloxacin. A 2-day preoperative course with topical netilmicin reduced most bacteria identified on the conjunctiva and eyelids. Dr. Papa and Ms. Blanco are employees of Società Industria Farmaceutica Italiana SpA. Dr. Santocono has no financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Redistribution, Hyperproliferation, Activation of Natural Killer Cells and CD8 T Cells, and Cytokine Production During First-in-Human Clinical Trial of Recombinant Human Interleukin-15 in Patients With Cancer

PubMed Central

Conlon, Kevin C.; Lugli, Enrico; Welles, Hugh C.; Rosenberg, Steven A.; Fojo, Antonio Tito; Morris, John C.; Fleisher, Thomas A.; Dubois, Sigrid P.; Perera, Liyanage P.; Stewart, Donn M.; Goldman, Carolyn K.; Bryant, Bonita R.; Decker, Jean M.; Chen, Jing; Worthy, Tat'Yana A.; Figg, William D.; Peer, Cody J.; Sneller, Michael C.; Lane, H. Clifford; Yovandich, Jason L.; Creekmore, Stephen P.; Roederer, Mario; Waldmann, Thomas A.

2015-01-01

Purpose Interleukin-15 (IL-15) has significant potential in cancer immunotherapy as an activator of antitumor CD8 T and natural killer (NK) cells. The primary objectives of this trial were to determine safety, adverse event profile, dose-limiting toxicity, and maximum-tolerated dose of recombinant human IL-15 (rhIL-15) administered as a daily intravenous bolus infusion for 12 consecutive days in patients with metastatic malignancy. Patients and Methods We performed a first in-human trial of Escherichia coli–produced rhIL-15. Bolus infusions of 3.0, 1.0, and 0.3 μg/kg per day of IL-15 were administered for 12 consecutive days to patients with metastatic malignant melanoma or metastatic renal cell cancer. Results Flow cytometry of peripheral blood lymphocytes revealed dramatic efflux of NK and memory CD8 T cells from the circulating blood within minutes of IL-15 administration, followed by influx and hyperproliferation yielding 10-fold expansions of NK cells that ultimately returned to baseline. Up to 50-fold increases of serum levels of multiple inflammatory cytokines were observed. Dose-limiting toxicities observed in patients receiving 3.0 and 1.0 μg/kg per day were grade 3 hypotension, thrombocytopenia, and elevations of ALT and AST, resulting in 0.3 μg/kg per day being determined the maximum-tolerated dose. Indications of activity included clearance of lung lesions in two patients. Conclusion IL-15 could be safely administered to patients with metastatic malignancy. IL-15 administration markedly altered homeostasis of lymphocyte subsets in blood, with NK cells and γδ cells most dramatically affected, followed by CD8 memory T cells. To reduce toxicity and increase efficacy, alternative dosing strategies have been initiated, including continuous intravenous infusions and subcutaneous IL-15 administration. PMID:25403209

Ameliorative effect of Vernonia cinerea in vincristine-induced painful neuropathy in rats.

PubMed

Thiagarajan, Venkata Rathina Kumar; Shanmugam, Palanichamy; Krishnan, Uma Maheswari; Muthuraman, Arunachalam

2014-10-01

The present study was designed to investigate the antinociceptive potential of Vernonia cinerea (VC) on vincristine-induced painful neuropathy in rats. A chemotherapeutic agent, vincristine (50 μg/kg intraperitoneally for 10 consecutive days), was administered for the induction of neuropathic pain in rats. The painful behavioral changes were assessed using hot plate, acetone drop, paw pressure, Von Frey hair and tail immersion tests to assess the degree of hyperalgesic and allodynic pain sensation in paw and tail. Tissue biomarker changes including thiobarbituric acid reactive substances (TBARSs), reduced glutathione (GSH) and total calcium levels were estimated in sciatic nerve tissue samples to assess the degree of oxidative stress. Histopathological changes were also observed in transverse sections of rat sciatic nerve tissue. Ethanolic extract of VC leaves and pregabalin were administered for 14 consecutive days from day 0 (day of surgery). Pregabalin served as a positive control in the present study. Vincristine administration resulted in a significant reduction in painful behavioral changes along with a rise in the levels of TBARS, total calcium and decrease in GSH levels when compared with the normal control group. Furthermore, significant histopathological changes were also observed. Pretreatment with VC significantly attenuated vincristine-induced development of painful behavioral, biochemical and histological changes in a dose-dependent manner, which is similar to that of pregabalin-pretreated group. The attenuating effect of VC in vincristine-induced nociceptive painful sensation may be due to its potential of antioxidative, neuroprotective and calcium channel inhibitory action. © The Author(s) 2012.

Conservative management of empyema-complicated post-lobectomy bronchopleural fistulas: experience of consecutive 13 cases in 9 years

PubMed Central

Mao, Rui; Ying, Peng-Qing; Xie, Dong; Dai, Chen-Yang; Zha, Jun-Yan; Chen, Tao; Jiang, Ge-Ning; Fei, Ke

2016-01-01

Background Bronchopleural fistula (BPF) is an infrequent but life-threatening complication after lung surgery. Tentative closure of the fistula and irrigation have been the conventional treatments, but are also surgically challenging and associated with a considerable failure rate. This study reports on a conservative practice of this difficult issue, in aim to examine its outcomes. Method All enrolled cases were handled consecutively from September 2006 to June 2015. The empyema was first properly drained till disseminated pneumonia controlled. After conducting lavage, tube drainage was gradually transited to postural drainage. During the follow-up, information on tube removal, fistula healing, and survival were recorded. Results Thirteen cases were enrolled, including 9 rights and 4 lefts. The primary diseases were lung cancer [10], lung abscess [1], organizing pneumonia [1], and aspergillosis [1]. Early fistula (≤30 days postoperatively) occurred in 8 cases and late fistula (>30 days postoperatively) in 5 cases. Two patients underwent debridement to ascertain complete drainage. Chest tubes retained from 7 to 114 days (mean 40.54±30.49 days) before removal. At follow-up, we observed gradually narrowing-down of all residual cavities, and symptoms of fistula and empyema eventually disappeared in all patients. No complication or death occurred during the follow-up. Conclusions Conservative management by a combination of tube and postural drainage provides an effective and safe treatment for empyema-complicated post-lobectomy BPFs. PMID:27499946

Biodegradable Synthetic Polyurethane Foam Nasal Packing After Septoplasty.

PubMed

Shakeel, Muhammad; Karlsson, Therese R; Khan, Imran; Hariharadas, Bobbi; Mansoor, Rashid; Maini, Sangeeta K

2015-06-01

To determine the usefulness of biodegradable Synthetic Polyurethane Foam (SPF) nasal packing as an adjunct to day-case septoplasty. Comparative, observational case series. Aberdeen Royal Infirmary, University of Aberdeen, Scotland, UK, in the year 2011. One-hundred consecutive patients who underwent septoplasty and received SPF packing in 2010 were prospectively audited while one-hundred consecutive patients undergoing septoplasty in the year 2000 were studied retrospectively. Data collected include demographics, type of operation and duration of hospital stay. Excel and SPSS were used for data collection and analysis. In the year 2000, the average age of the patients was 40.6 years. There were 37 females and 63 males. One patient returned home the same day, 22 stayed one night, 69 spent two nights and 8 stayed more than two nights in hospital for their operation. The average length of stay was 1.84 nights. In 2010, the average age of patients was 37.86 years, with 31 patients being female and 69 male. All patients in this cohort received SPF packing postoperatively. Seventy-three patients went home the same day, 24 patients stayed one night and 3 patients spent two nights in hospital for their operation. Average length of hospital stay was 0.3 nights. Results were statistically significant (p < 0.001). SPF was a useful nasal packing option after septoplasty and inferior turbinate surgery, which enabled the surgeons to carry out this surgery safely as a day-case procedure.

Associations between mortality and prolonged exposure to elevated particulate matter concentrations in East Asia.

PubMed

Kim, Satbyul Estella; Bell, Michelle L; Hashizume, Masahiro; Honda, Yasushi; Kan, Haidong; Kim, Ho

2018-01-01

Previous epidemiological studies regarding mortality and particulate matter with an aerodynamic diameter of <10μm (PM 10 ) have considered only absolute concentrations of PM 10 as a risk factor. However, none have evaluated the durational effect of multi-day periods with high PM 10 concentrations. To evaluate the durational effect (i.e., number of days) of high PM 10 concentrations on mortality, we collected data regarding 3,662,749 deaths from 28 cities in Japan, South Korea, and China (1993-2009). Exposure was defined as consecutive days with daily PM 10 concentrations ≥75μg/m 3 . A Poisson model was used with duration as the variable of interest, while controlling for daily PM 10 concentrations, meteorological variables, seasonal trends, and day of the week. The increase in mortality risk for each additional consecutive day with PM 10 concentrations ≥75μg/m 3 was 0.68% in Japan (95% confidence interval [CI]: 0.35-1.01%), 0.48% in South Korea (95% CI: 0.30-0.66%), and 0.24% in China (95% CI: 0.14-0.33%). The annual average maximum number of consecutive days with high PM 10 in Japan (2.40days), South Korea (6.96days), and China (42.26days) was associated with non-accidental death increases of 1.64% (95% CI: 1.31-1.98%), 3.37% (95% CI: 3.19-3.56%), and 10.43% (95% CI: 10.33-10.54%), respectively. These findings may facilitate the planning of public health interventions to minimize the health burden of air pollution. Copyright © 2017 Elsevier Ltd. All rights reserved.

Anterior cervical discectomy and fusion in the outpatient ambulatory surgery setting compared with the inpatient hospital setting: analysis of 1000 consecutive cases.

PubMed

Adamson, Tim; Godil, Saniya S; Mehrlich, Melissa; Mendenhall, Stephen; Asher, Anthony L; McGirt, Matthew J

2016-06-01

OBJECTIVE In an era of escalating health care costs and pressure to improve efficiency and cost of care, ambulatory surgery centers (ASCs) have emerged as lower-cost options for many surgical therapies. Anterior cervical discectomy and fusion (ACDF) is one of the most prevalent spine surgeries performed, and the frequency of its performance is rapidly increasing as the aging population grows. Although ASCs offer significant cost advantages over hospital-based surgical centers, concern over the safety of outpatient ACDF has slowed its adoption. The authors intended to 1) determine the safety of the first 1000 consecutive ACDF surgeries performed in their outpatient ASC, and 2) compare the safety of these outpatient ACDFs with that of consecutive ACDFs performed during the same time period in the hospital setting. METHODS A total of 1000 consecutive patients who underwent ACDF in an ACS (outpatient ACDF) and 484 consecutive patients who underwent ACDF at Vanderbilt University Hospital (inpatient ACDF) from 2006 to 2013 were included in this retrospective study of patients' medical records. Data were collected on patient demographics, comorbidities, operative details, and perioperative and 90-day morbidity. Perioperative morbidity and hospital readmission were compared between the outpatient and inpatient ACDF groups. RESULTS Of the first 1000 outpatient ACDF cases performed in the authors' ASC, 629 (62.9%) were 1-level and 365 (36.5%) were 2-level ACDFs. Mean patient age was 49.5 ± 8.6, and 484 (48.4%) were males. All patients were observed postoperatively at the ASC postanesthesia care unit (PACU) for 4 hours before being discharged home. Eight patients (0.8%) were transferred from the surgery center to the hospital postoperatively (for pain control [n = 3], chest pain and electrocardiogram changes [n = 2], intraoperative CSF leak [n = 1], postoperative hematoma [n = 1], and profound postoperative weakness and surgical reexploration [n = 1]). No perioperative deaths occurred. The 30-day hospital readmission rate was 2.2%. All 90-day surgical morbidity was similar between outpatient and inpatient cohorts for both 1-level and 2-level ACDFs. CONCLUSIONS An analysis of 1000 consecutive patients who underwent ACDF in an outpatient setting demonstrates that surgical complications occur at a low rate (1%) and can be appropriately diagnosed and managed in a 4-hour ASC PACU window. Comparison with an inpatient ACDF surgery cohort demonstrated similar results, highlighting that ACDF can be safely performed in the outpatient ambulatory surgery setting without compromising surgical safety. In an effort to decrease costs of care, surgeons can safely perform 1- and 2-level ACDFs in an ASC environment.

Efficacy of triplet regimen antiemetic therapy for chemotherapy-induced nausea and vomiting (CINV) in bone and soft tissue sarcoma patients receiving highly emetogenic chemotherapy, and an efficacy comparison of single-shot palonosetron and consecutive-day granisetron for CINV in a randomized, single-blinded crossover study.

PubMed

Kimura, Hiroaki; Yamamoto, Norio; Shirai, Toshiharu; Nishida, Hideji; Hayashi, Katsuhiro; Tanzawa, Yoshikazu; Takeuchi, Akihiko; Igarashi, Kentaro; Inatani, Hiroyuki; Shimozaki, Shingo; Kato, Takashi; Aoki, Yu; Higuchi, Takashi; Tsuchiya, Hiroyuki

2015-03-01

The first aim of this study was to evaluate combination antiemetic therapy consisting of 5-HT3 receptor antagonists, neurokinin-1 receptor antagonists (NK-1RAs), and dexamethasone for multiple high emetogenic risk (HER) anticancer agents in bone and soft tissue sarcoma. The second aim was to compare the effectiveness of single-shot palonosetron and consecutive-day granisetron in a randomized, single-blinded crossover study. A single randomization method was used to assign eligible patients to the palonosetron or granisetron arm. Patients in the palonosetron arm received a palonosetron regimen during the first and third chemotherapy courses and a granisetron regimen during the second and fourth courses. All patients received NK-1RA and dexamethasone. Patients receiving the palonosetron regimen were administered 0.75 mg palonosetron on day 1, and patients receiving the granisetron regimen were administered 3 mg granisetron twice daily on days 1 through 5. All 24 patients in this study received at least 4 chemotherapy courses. A total of 96 courses of antiemetic therapy were evaluated. Overall, the complete response CR rate (no emetic episodes and no rescue medication use) was 34%, while the total control rate (a CR plus no nausea) was 7%. No significant differences were observed between single-shot palonosetron and consecutive-day granisetron. Antiemetic therapy with a 3-drug combination was not sufficient to control chemotherapy-induced nausea and vomiting (CINV) during chemotherapy with multiple HER agents for bone and soft tissue sarcoma. This study also demonstrated that consecutive-day granisetron was not inferior to single-shot palonosetron for treating CINV. © 2014 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Endurance exercise-induced changes in BNP concentrations in cardiovascular patients versus healthy controls.

PubMed

Aengevaeren, Vincent L; Hopman, Maria T E; Thijssen, Dick H J; van Kimmenade, Roland R; de Boer, Menko-Jan; Eijsvogels, Thijs M H

2017-01-15

Healthy athletes demonstrated increased B-type natriuretic peptide (BNP) concentrations following exercise, but it is unknown whether these responses are exaggerated in individuals with cardiovascular risk factors (CVRF) or disease (CVD). We compared exercise-induced increases in BNP between healthy controls (CON) and individuals with CVRF or CVD. Furthermore, we aimed to identify predictors for BNP responses. Serum BNP concentrations were measured in 191 participants (60±12yrs) of the Nijmegen Marches before (baseline) and immediately after 4 consecutive days of walking exercise (30-50km/day). CVRF (n=54) was defined as hypertension, hypercholesterolemia, obesity or smoking and CVD (n=55) was defined as a history of myocardial infarction, heart failure, atrial fibrillation or angina pectoris. Individuals walked 487±79min/day at 65±10% of their maximum heart rate. Baseline BNP concentrations were higher for CVD (median: 28.1pg/ml; interquartile range: 13-50, p<0.001) compared to CVRF (3.9pg/ml; 0-14) and CON (5.5pg/ml; 0-14). Post-exercise BNP concentrations were elevated in CVD (35.7pg/ml, 17-67, p=0.01), but not in CVRF participants (p=0.11) or CON (p=0.07). No cumulative effect in BNP concentrations was observed across the consecutive walking days (p>0.05). Predictors for post-exercise BNP (R 2 =0.77) were baseline BNP, beta-blocker use and age. Prolonged moderate-intensity walking exercise increases BNP concentrations in CVD participants, but not in CVRF and CON. BNP increases were small, and did not accumulate across consecutive days of exercise. These findings suggest that prolonged walking exercise for multiple consecutive days is feasible with minimal effect on myocardial stretch, even for participants with CVD. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

The Acute Effect of Concurrent Training on Running Performance over 6 Days

ERIC Educational Resources Information Center

Doma, Kenji; Deakin, Glen

2015-01-01

Purpose: This study examined the effects of strength training on alternating days and endurance training on consecutive days on running performance for 6 days. Methods: Sixteen male and 8 female moderately trained individuals were evenly assigned into concurrent-training (CCT) and strength-training (ST) groups. The CCT group undertook strength…

TOXICITY STUDIES OF EPICHLOROHYDRIN IN SPRAGUE-DAWLEY RATS

EPA Science Inventory

Adult male and female Sprague-Dawley rats received epichlorohydrin via gavage in distilled water for 10 consecutive days at dose levels of 3, 7, 19, and 46 mg/kg-day, and for 90 days at dose levels of 1, 5, and 25 mg/kg-day. Epichlorohydrin did not adversely effect mortality, but...

Excretion pattern of enrofloxacin after oral treatment of chicken broilers.

PubMed

Slana, M; Pahor, V; Cvitkovič Maričič, L; Sollner-Dolenc, M

2014-12-01

The metabolism and excretion of enrofloxacin were studied when applied as oral solution to chicken broilers for five consecutive days. Sixty 9-day-old broilers were isolated within an intensively rearing poultry farm during enrofloxacin therapy (15.5 mg/kg per day). The excreta of the isolated broilers were collected daily, 9 days after therapy termination, for 13 consecutive days, and analyzed for the presence of enrofloxacin and its metabolites [ciprofloxacin, desethylene-enrofloxacin (DES-EF) and desethylene-ciprofloxacin (DES-CF)]. Enrofloxacin was excreted predominantly in the form of the parent compound between days 1 and 13. Ciprofloxacin was detected in the excreta between days 1 and 6, whereas minor amounts of DES-EF and DES-CF were excreted only between days 1-7 and 1-6, respectively. In conclusion, the analysis of the excreta showed that approximately 74% of orally applied enrofloxacin was excreted as the parent compound, approximately 25% as the main metabolite ciprofloxacin, and approximately 1% as the minor metabolites desethylene-enrofloxacin and desethylene-ciprofloxacin. © 2014 John Wiley & Sons Ltd.

Predictive factors of mortality within 30 days in patients with nonvariceal upper gastrointestinal bleeding.

PubMed

Lee, Yoo Jin; Min, Bo Ram; Kim, Eun Soo; Park, Kyung Sik; Cho, Kwang Bum; Jang, Byoung Kuk; Chung, Woo Jin; Hwang, Jae Seok; Jeon, Seong Woo

2016-01-01

Nonvariceal upper gastrointestinal bleeding (NVUGIB) is a common medical emergency that can be life threatening. This study evaluated predictive factors of 30-day mortality in patients with this condition. A prospective observational study was conducted at a single hospital between April 2010 and November 2012, and 336 patients with symptoms and signs of gastrointestinal bleeding were consecutively enrolled. Clinical characteristics and endoscopic findings were reviewed to identify potential factors associated with 30-day mortality. Overall, 184 patients were included in the study (men, 79.3%; mean age, 59.81 years), and 16 patients died within 30 days (8.7%). Multivariate analyses revealed that comorbidity of diabetes mellitus (DM) or metastatic malignancy, age ≥ 65 years, and hypotension (systolic pressure < 90 mmHg) during hospitalization were significant predictive factors of 30-day mortality. Comorbidity of DM or metastatic malignancy, age ≥ 65 years, and hemodynamic instability during hospitalization were predictors of 30-day mortality in patients with NVUGIB. These results will help guide the management of patients with this condition.

The association between daily steps and health, and the mediating role of body composition: a pedometer-based, cross-sectional study in an employed South African population.

PubMed

Pillay, Julian D; van der Ploeg, Hidde P; Kolbe-Alexander, Tracy L; Proper, Karin I; van Stralen, Maartje; Tomaz, Simone A; van Mechelen, Willem; Lambert, Estelle V

2015-02-22

Walking is recognized as an easily accessible mode of physical activity and is therefore supported as a strategy to promote health and well-being. To complement walking, pedometers have been identified as a useful tool for monitoring ambulatory physical activity, typically measuring total steps/day. There is, however, little information concerning dose-response for health outcomes in relation to intensity or duration of sustained steps. We aimed to examine this relationship, along with factors that mediate it, among employed adults. A convenience sample, recruited from work-site health risk screening (N = 312, 37 ± 9 yrs), wore a pedometer for at least three consecutive days. Steps were classified as "aerobic" (≥100 steps/minute and ≥10 consecutive minutes) or "non-aerobic" (<100 steps/minute and/or <10 consecutive minutes). The data were sub-grouped according to intensity-based categories i.e. "no aerobic activity", "low aerobic activity" (1-20 minutes/day of aerobic activity) and "high aerobic activity" (≥21 minutes/day of aerobic activity), with the latter used as a proxy for current PA guidelines (150-minutes of moderate-intensity PA per week). Health outcomes included blood pressure, body mass index, percentage body fat, waist circumference, blood cholesterol and blood glucose. Analysis of covariance, adjusting for age, gender and total steps/day were used to compare groups according to volume and intensity-based steps categories. A further analysis compared the mediation effect of body fat estimates (percentage body fat, body mass index and waist circumference) on the association between steps and health outcomes, independently. Average steps/day were 6,574 ± 3,541; total steps/day were inversely associated with most health outcomes in the expected direction (p < 0.05). The "no aerobic activity" group was significantly different from the "low aerobic activity" and "high aerobic activity" in percentage body fat and diastolic blood pressure only (P < 0.05). Percentage body fat emerged as the strongest mediator of the relationship between steps and outcomes, while body mass index showed the least mediation effect. The study provides a presentation of cross-sectional pedometer data that relate to a combination of intensity and volume-based steps/day and its relationship to current guidelines. The integration of volume, intensity and duration of ambulatory physical activity in pedometer-based messages is of emerging relevance.

[Therapeutic regimens for treating bacterial vaginosis in pregnant women].

PubMed

Borisov, I; Dimitrova, V; Mazneĭkova, V; Shopova, E

1999-01-01

The study comprises 128 pregnant women examined at different gestational weeks. The diagnosis of bacterial vaginosis was made using: a) the complex clinical criteria--vaginal discharge, vaginal pH, amine test and "clue cells" b) Nugent scoring system c) Spiegel criteria. Two therapeutic regimens were compared--intravaginal 2% clindamycin creme (Dalacin V) 5 g three consecutive days and intravaginal metronidazole (Flagyl) 500 mg once daily for 5 consecutive days. Control examination was carried out 5-7 days after completion of therapy using the same protocol. 28 women from the first group and 31 women from the second group had the control examination. Bacterial vaginosis was eradicated in 93% of women using intravaginal clindamycin and in 87% of women using intravaginal metronidazole. Both regimes were more effective compared to treatment with oral ampicillin for 7 days, where the cure rate was 62%.

Carnosine reverses the aging-induced down regulation of brain regional serotonergic system.

PubMed

Banerjee, Soumyabrata; Ghosh, Tushar K; Poddar, Mrinal K

2015-12-01

The purpose of the present investigation was to study the role of carnosine, an endogenous dipeptide biomolecule, on brain regional (cerebral cortex, hippocampus, hypothalamus and pons-medulla) serotonergic system during aging. Results showed an aging-induced brain region specific significant (a) increase in Trp (except cerebral cortex) and their 5-HIAA steady state level with an increase in their 5-HIAA accumulation and declination, (b) decrease in their both 5-HT steady state level and 5-HT accumulation (except cerebral cortex). A significant decrease in brain regional 5-HT/Trp ratio (except cerebral cortex) and increase in 5-HIAA/5-HT ratio were also observed during aging. Carnosine at lower dosages (0.5-1.0μg/Kg/day, i.t. for 21 consecutive days) didn't produce any significant response in any of the brain regions, but higher dosages (2.0-2.5μg/Kg/day, i.t. for 21 consecutive days) showed a significant response on those aging-induced brain regional serotonergic parameters. The treatment with carnosine (2.0μg/Kg/day, i.t. for 21 consecutive days), attenuated these brain regional aging-induced serotonergic parameters and restored towards their basal levels that observed in 4 months young control rats. These results suggest that carnosine attenuates and restores the aging-induced brain regional down regulation of serotonergic system towards that observed in young rats' brain regions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Should All Patients Be Included in Alternative Payment Models for Primary Total Hip Arthroplasty and Total Knee Arthroplasty?

PubMed

Rozell, Joshua C; Courtney, Paul M; Dattilo, Jonathan R; Wu, Chia H; Lee, Gwo-Chin

2016-09-01

Alternative payment models in total joint replacement incentivize cost effective health care delivery and reward reductions in length of stay (LOS), complications, and readmissions. If not adjusted for patient comorbidities, they may encourage restrictive access to health care. We prospectively evaluated 802 consecutive primary total hip arthroplasty and total knee arthroplasty patients evaluating comorbidities associated with increased LOS and readmissions. During this 9-month period, 115 patients (14.3%) required hospitalization >3 days and 16 (1.99%) were readmitted within 90 days. Univariate analysis demonstrated that preoperative narcotic use, heart failure, stroke, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), and liver disease were more likely to require hospitalization >3 days. In multivariate analysis, CKD and COPD were independent risk factors for LOS >3 days. A Charlson comorbidity index >5 points was associated with increased LOS and readmissions. Patients with CKD, COPD, and Charlson comorbidity index >5 points should not be included in alternative payment model for THA and TKA. Copyright © 2016 Elsevier Inc. All rights reserved.

40 CFR 469.26 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2011 CFR

2011-07-01

... Pollutant or pollutant property Maximum for any 1 day Average of daily values for 30 consecutive days.... 3 The arsenic (T) limitation only applies to manufacturers of gallium or indium arsenide crystals...

Inter-day Reliability of the IDEEA Activity Monitor for Measuring Movement and Non-Movement Behaviors in Older Adults.

PubMed

de la Cámara, Miguel Ángel; Higueras-Fresnillo, Sara; Martinez-Gomez, David; Veiga, Oscar L

2018-05-29

The inter-day reliability of the Intelligent Device for Energy Expenditure and Activity (IDEEA) has not been studied to date. The study purpose was to examine the inter-day variability and reliability on two consecutive days collected with the IDEEA, as well as to predict the number of days needed to provide a reliable estimate of several movement (walking and climbing stairs) and non-movement behaviors (lying, reclining, sitting) and standing in older adults. The sample included 126 older adults (74 women) who wore the IDEEA for 48-h. Results showed low variability between the two days and its reliability was from moderate (ICC=0.34) to high (ICC=0.80) in most of movement and non-movement behaviors analyzed. The Bland-Altman plots showed a high-moderate agreement between days and the Spearman-Brown formula estimated ranged from 1.2 and 9.1 days of monitoring with the IDEEA are needed to achieve ICCs≥0.70 in older adults for sitting and climbing stairs, respectively.

Effects of water-management alternatives on streamflow in the Ipswich River basin, Massachusetts

USGS Publications Warehouse

Zarriello, Philip J.

2001-01-01

Management alternatives that could help mitigate the effects of water withdrawals on streamflow in the Ipswich River Basin were evaluated by simulation with a calibrated Hydrologic Simulation Program--Fortran (HSPF) model. The effects of management alternatives on streamflow were simulated for a 35-year period (196195). Most alternatives examined increased low flows compared to the base simulation of average 1989-93 withdrawals. Only the simulation of no septic-effluent inflow, and the simulation of a 20-percent increase in withdrawals, further lowered flows or caused the river to stop flowing for longer periods of time than the simulation of average 198993 withdrawals. Simulations of reduced seasonal withdrawals by 20 percent, and by 50 percent, resulted in a modest increase in low flow in a critical habitat reach (model reach 8 near the Reading town well field); log-Pearson Type III analysis of simulated daily-mean flow indicated that under these reduced withdrawals, model reach 8 would stop flowing for a period of seven consecutive days about every other year, whereas under average 198993 withdrawals this reach would stop flowing for a seven consecutive day period almost every year. Simulations of no seasonal withdrawals, and simulations that stopped streamflow depletion when flow in model reach 19 was below 22 cubic feet per second, indicated flow would be maintained in model reach 8 at all times. Simulations indicated wastewater-return flows would augment low flow in proportion to the rate of return flow. Simulations of a 1.5 million gallons per day return flow rate indicated model reach 8 would stop flowing for a period of seven consecutive days about once every 5 years; simulated return flow rates of 1.1 million gallons per day indicated that model reach 8 would stop flowing for a period of seven consecutive days about every other year. Simulation of reduced seasonal withdrawals, combined with no septic effluent return flow, indicated only a slight increase in low flow compared to low flows simulated under average 198993 withdrawals. Simulation of reduced seasonal withdrawal, combined with 2.6 million gallons per day wastewater-return flows, provided more flow in model reach 8 than that simulated under no withdrawals.

Rotating night shifts too quickly may cause anxiety and decreased attentional performance, and impact prolactin levels during the subsequent day: a case control study.

PubMed

Chang, Yu-San; Chen, Hsiang-Lan; Wu, Yu-Hsuan; Hsu, Chung-Yao; Liu, Ching-Kuan; Hsu, Chin

2014-08-05

We investigated circadian changes and effects on mood, sleep-related hormones and cognitive performance when nurses worked consecutive night shifts in a rapidly rotating shift system. Daytime cognitive function, sleep propensity and sleep-related hormones (growth hormone, cortisol, prolactin, thyrotropin) were compared after participants worked two and four consecutive night shifts. Twenty-three off-duty nurses, 20 nurses working two consecutive night shifts and 16 nurses working four consecutive night shifts were enrolled. All participants completed the Maintenance of Wakefulness Test, State-Trait Anxiety Inventory, Stanford Sleepiness Scale, visual attention tasks (VAT), Wisconsin Card Sorting Test, and modified Multiple Sleep Latency Test. Hormone levels were also measured four times throughout the day, at 2-h intervals. During the day, the participants in the night shift groups were less able to maintain wakefulness, had poor performance on VAT, and higher thyrotropin levels than did those in the off-duty group. Participants who worked two night shifts were better able to maintain wakefulness, had higher anxiety scale scores, poorer initial performance and lack of learning effect on VAT, and higher prolactin levels compared with those who worked four night shifts. There were no differences in cortisol levels between the two- and four- shift groups. Rotating night shifts too quickly may cause anxiety and decreased attentional performance, and may impact daytime prolactin levels after night shifts. It is possible that the two-shift group had a higher cortisol level than did the four-shift group, which would be consistent with the group's higher state anxiety scores. The negative findings may be due to the small sample size. Further studies on the effects of consecutive night shifts on mood and cortisol levels during the daytime after sleep restriction would be valuable.

Fluid intake, hydration, work physiology of wildfire fighters working in the heat over consecutive days.

PubMed

Raines, Jenni; Snow, Rodney; Nichols, David; Aisbett, Brad

2015-06-01

(i) To evaluate firefighters' pre- and post-shift hydration status across two shifts of wildfire suppression work in hot weather conditions. (ii) To document firefighters' fluid intake during and between two shifts of wildfire suppression work. (iii) To compare firefighters' heart rate, activity, rating of perceived exertion (RPE), and core temperature across the two consecutive shifts of wildfire suppression work. Across two consecutive days, 12 salaried firefighters' hydration status was measured immediately pre- and post-shift. Hydration status was also measured 2h post-shift. RPE was also measured immediately post-shift on each day. Work activity, heart rate, and core temperature were logged continuously during each shift. Ten firefighters also manually recorded their food and fluid intake before, during, and after both fireground shifts. Firefighters were not euhydrated at all measurement points on Day one (292±1 mOsm l(-1)) and euhydrated across these same time points on Day two (289±0.5 mOsm l(-1)). Fluid consumption following firefighters' shift on Day one (1792±1134ml) trended (P = 0.08) higher than Day two (1108±1142ml). Daily total fluid intake was not different (P = 0.27), averaging 6443±1941ml across both days. Core temperature and the time spent ≥ 70%HRmax were both elevated on Day one (when firefighters were not euhydrated). Firefighters' work activity profile was not different between both days of work. There was no difference in firefighters' pre- to post-shift hydration within each shift, suggesting ad libitum drinking was at least sufficient to maintain pre-shift hydration status, even in hot conditions. Firefighters' relative hypohydration on Day one (despite a slightly lower ambient temperature) may have been associated with elevations in core temperature, more time in the higher heart rate zones, and 'post-shift' RPE. © The Author 2015. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Liver Resections Combined with Closure of Loop Ileostomies: A Retrospective Analysis

PubMed Central

Lordan, Jeffrey T.; Riga, Angela T.; Karanjia, Nariman D.

2008-01-01

Background. The management of patients with colorectal liver metastases and loop ileostomies remains controversial. This study was performed to assess the outcome of combined liver resection and loop ileostomy closure. Methods. Analysis of prospectively collected perioperative data, including morbidity and mortality, of 283 consecutive hepatectomies for colorectal liver metastases was undertaken. Consecutive liver resections were performed from 1996 to 2006 in one centre by a single surgeon (NDK). Fourteen of these patients had combined liver resection and ileostomy closure. Case-matched analysis was undertaken. Results. Six (2.2%) patients died in the hepatectomy only group and none died in the combined group. There was no difference in operative blood loss between the two groups (0.09). Perioperative morbidity was 36% in the combined group and 23% in the hepatectomy alone group (P = 0.33). Mean hospital stay was 14 days in the combined group and 11 days in the hepatectomy only group (P = 0.046). Case-matched analysis showed a significant increase in hospital stay (P = 0.03) and complications (P = 0.049) in the combined group. Conclusion. In patients with CRLM, combined liver resection and closure of ileostomy may be associated with a higher operative morbidity and a prolonged hospital stay. PMID:19096524

40 CFR 133.101 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... arithmetic mean of pollutant parameter values for samples collected in a period of 7 consecutive days. (b) 30-day average. The arithmetic mean of pollutant parameter values of samples collected in a period of 30... percentile value for the 30-day average effluent quality achieved by a treatment works in a period of at...

77 FR 31684 - Hours of Service of Drivers: RockTenn, Exemption Application

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-29

... 14th hour of coming on duty. This exemption will allow these individuals to occasionally work up to 16 consecutive hours and be allowed to return to work with less than the mandatory 10 consecutive hours off duty... public road--Compress Street--an average of forty times per day to travel between its manufacturing...

40 CFR 469.28 - Pretreatment standards for new sources (PSNS).

Code of Federal Regulations, 2011 CFR

2011-07-01

... property Maximum for any 1 day Average of daily values for 30 consecutive days Milligrams per liter (mg/l...) limitation only applies to manufacturers of gallium or indium arsenide crystals. (b) A new source submitting...

40 CFR 417.161 - Specialized definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... determined by incubation at 20 degrees C for a period of 7 days using an acclimated seed. Agitation employing... consecutive day period that are of such degree and type as to require thorough purging and washing of the fill...

40 CFR 417.161 - Specialized definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... determined by incubation at 20 degrees C for a period of 7 days using an acclimated seed. Agitation employing... consecutive day period that are of such degree and type as to require thorough purging and washing of the fill...

40 CFR 417.161 - Specialized definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... determined by incubation at 20 degrees C for a period of 7 days using an acclimated seed. Agitation employing... consecutive day period that are of such degree and type as to require thorough purging and washing of the fill...

40 CFR 417.161 - Specialized definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... determined by incubation at 20 degrees C for a period of 7 days using an acclimated seed. Agitation employing... consecutive day period that are of such degree and type as to require thorough purging and washing of the fill...

40 CFR 417.161 - Specialized definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... determined by incubation at 20 degrees C for a period of 7 days using an acclimated seed. Agitation employing... consecutive day period that are of such degree and type as to require thorough purging and washing of the fill...

Volume of hydration in terminal cancer patients.

PubMed

Bruera, E; Belzile, M; Watanabe, S; Fainsinger, R L

1996-03-01

In this retrospective study we reviewed the volume and modality of hydration of consecutive series of terminal cancer patients in two different settings. In a palliative care unit 203/290 admitted patients received subcutaneous hydration for 12 +/- 8 days at a daily volume of 1015 +/- 135 ml/day. At the cancer center, 30 consecutive similar patients received intravenous hydration for 11.5 +/- 5 days (P > 0.2) but at a daily volume of 2080 +/- 720 ml/day (P < 0.001). None of the palliative care unit patients required discontinuation of hydration because of complications. Hypodermoclysis was administered mainly as a continuous infusion, an overnight infusion, or in one to three 1-h boluses in 62 (31%), 98 (48%) and 43 (21%) patients, respectively. Our findings suggest that, in some settings, patients may be receiving excessive volumes of hydration by less comfortable routes such as the intravenous route. Increased education and research in this area are badly needed.

How Many Days Are Enough? A Study of 365 Days of Pedometer Monitoring

ERIC Educational Resources Information Center

Kang, Minsoo; Bassett, David R.; Barreira, Tiago V.; Tudor-Locke, Catrine; Ainsworth, Barbara; Reis, Jared P.; Strath, Scott; Swartz, Ann

2009-01-01

This study was designed to determine the number of days of pedometer monitoring necessary to achieve reliable and valid estimates of a 1-year average of step counts in adults based on either consecutive days (CD) or random days (RD) of data collection. Twenty-three participants (16 women; M age = 38 years, SD = 9.9) wore a Yamax SW 200 pedometer…

Sleep deficit and stress hormones in helicopter pilots on 7-day duty for emergency medical services.

PubMed

Samel, Alexander; Vejvoda, Martin; Maass, Hartmut

2004-11-01

Helicopter-based emergency medical services in Germany operate from sunrise to sunset, requiring up to 15.5 h of continuous duty during the summer months for pilots, who work for seven consecutive days. Because of concerns regarding the safety of this procedure with respect to pilot fatigue and stress, the German Ministry of Transport asked our laboratory to investigate the risks involved. There were 13 pilots (mean age 38 yr) who were studied in the summer months for 2 d before, 7 d during, and 2 d after their duty cycle. Measured variables included sleep duration and quality, subjective fatigue, and heart rate, as well as 24-h excretion levels of stress hormones. During actual helicopter operations, maximum heart rates did not exceed 120 bpm. Over the 7-d duty period, mean sleep duration decreased from 7.8 h to 6 h or less, resulting in a cumulative sleep loss of about 15 h. Mean levels of excreted adrenalin, noradrenalin, and cortisol increased significantly by 50 to 80%; cortisol and noradrenalin excretion also remained elevated for the two post-duty days. Although the actual flights did not cause critical physiological responses, the acute and accumulated sleep deficit led to incomplete recuperation between duty hours and induced elevated stress indicators. It was, therefore, recommended that the duty cycle be amended as follows: 1.) enforce a 10-h rest period and at least an 8-h sleep opportunity per day; 2.) modify the duty period to allow no more than 3 consecutive rest periods of reduced sleep opportunities (8.5 h); and 3.) follow duty with several days that offer unrestricted sleep opportunities.

Open versus robotic-assisted transabdominal preperitoneal (R-TAPP) inguinal hernia repair: a multicenter matched analysis of clinical outcomes.

PubMed

Gamagami, R; Dickens, E; Gonzalez, A; D'Amico, L; Richardson, C; Rabaza, J; Kolachalam, R

2018-04-26

To compare the perioperative outcomes of initial, consecutive robotic-assisted transabdominal preperitoneal (R-TAPP) inguinal hernia repair (IHR) cases with consecutive open cases completed by the same surgeons. Multicenter, retrospective, comparative study of perioperative results from open and robotic IHR using standard univariate and multivariate regression analyses for propensity score matched (1:1) cohorts. Seven general surgeons at six institutions contributed 602 consecutive open IHR and 652 consecutive R-TAPP IHR cases. Baseline patient characteristics in the unmatched groups were similar with the exception of previous abdominal surgery and all baseline characteristics were comparable in the matched cohorts. In matched analyses, postoperative complications prior to discharge were comparable. However, from post discharge through 30 days, fewer patients experienced complications in the R-TAPP group than in the open group [4.3% vs 7.7% (p = 0.047)]. The R-TAPP group had no reoperations post discharge through 30 days of follow-up compared with five patients (1.1%) in the open group (p = 0.062), respectively. Multivariate logistic regression analysis which demonstrated patient age > 65 years and the open approach were risk factors for complications within 30 days post discharge in the matched group [age > 65 years: odds ratio (OR) = 3.33 (95% CI 1.89, 5.87; p < 0.0001); open approach: OR = 1.89 (95% CI 1.05, 3.38; p = 0.031)]. In this matched analysis, R-TAPP provides similar postoperative complications prior to discharge and a lower rate of postoperative complications through 30 days compared to open repair. R-TAPP is a promising and reproducible approach, and may facilitate adoption of minimally invasive repairs of inguinal hernias.

Methods of extending crop signatures from one area to another

NASA Technical Reports Server (NTRS)

Minter, T. C. (Principal Investigator)

1979-01-01

Efforts to develop a technology for signature extension during LACIE phases 1 and 2 are described. A number of haze and Sun angle correction procedures were developed and tested. These included the ROOSTER and OSCAR cluster-matching algorithms and their modifications, the MLEST and UHMLE maximum likelihood estimation procedures, and the ATCOR procedure. All these algorithms were tested on simulated data and consecutive-day LANDSAT imagery. The ATCOR, OSCAR, and MLEST algorithms were also tested for their capability to geographically extend signatures using LANDSAT imagery.

A randomized trial on the acute and steady-state effects of a new antidepressant, vortioxetine (Lu AA21004), on actual driving and cognition.

PubMed

Theunissen, E L; Street, D; Højer, A-M; Vermeeren, A; van Oers, A; Ramaekers, J G

2013-06-01

The aim of this study was to assess the effects of a novel antidepressant, vortioxetine 10 mg, on driving, cognitive, and psychomotor performance in 24 healthy subjects in a double-blind, placebo-controlled, three-way crossover design. Mirtazapine 30 mg was included as an active comparator. Drugs were administered in the evening of 15 consecutive days. Performance was measured in the morning of days 2 and 16, using standardized tests measuring on-the-road driving, memory, tracking, divided attention, and vigilance. The statistical analysis on the primary measure of driving, i.e., SD of lateral position showed noninferiority of vortioxetine on days 2 and 16, and inferiority for mirtazapine on day 2. Vortioxetine did not cause cognitive or psychomotor impairment. Mirtazapine, however, impaired cognitive and psychomotor performance on day 2. Most of these effects disappeared after multiple doses of mirtazapine. To conclude, vortioxetine did not impair driving, cognitive, or psychomotor performance after single or multiple doses.

Ovicidal efficacy of fenbendazole after treatment of horses naturally infected with cyathostomins.

PubMed

Daniels, S P; Proudman, C J

2016-08-30

The ovicidal activity of benzimidazole (BZ) anthelmintics is unique and not seen in other drug classes. Such ovicidal efficacy is not widely reported for equine cyathostomins, nor has this activity been tested in the face of BZ resistance. Although the product label states that fenbendazole is for use against BZ-susceptible cyathostomins, susceptibility testing is rarely performed. In this field-based study, the ovicidal efficacy of fenbendazole in horses (n=39) harbouring BZ-resistant cyathostomins was compared when dosed at 7.5mg/kg body weight (BW) orally, as a single dose per os (n=21) or daily for five consecutive days in feed (n=18). Suppression of egg hatch rate was observed in the single and five- day treatment groups; a significant difference between pre- and post-treatment egg hatch rates (P<0.05) was observed for three days after treatment with a single dose of fenbendazole (on premises with BZ-resistant cyathostomins), and for three days after treatment for five consecutive days with fenbendazole (on premises with BZ-resistant cyathostomins). Post treatment numbers of eggs and larvae remained significantly lower (P<0.05) than pre-treatment levels to the end of the trial. We conclude that in the face of BZ-resistant cyathostomins the ovicidal effect of fenbendazole persist for three days after both a single oral dose of 7.5mg/kg per os and after treatment orally for five consecutive daily doses at 7.5mg/kg in feed. Copyright © 2016 Elsevier B.V. All rights reserved.

Altered metabolism of orally administered loxoprofen in human subjects after an oral administration of loxoprofen for three consecutive days followed by a seven-day washout.

PubMed

Kim, In-Wha; Chung, Suk-Jae; Shim, Chang-Koo

2002-04-01

The effect of pretreatment (i.e., oral administration of loxoprofen for 3 consecutive days followed by a 7-day washout) on the pharmacokinetics and metabolism of the drug was studied in humans. In a control study, a Loxonin tablet (60 mg as loxoprofen anhydrous) was administered orally to 6 healthy male Korean subjects. In a pretreatment study, a Loxonin tablet was administered orally to the subjects once daily for 3 consecutive days. On the 10(th) day, a Loxonin tablet was administered orally to the subjects, and the concentrations of loxoprofen and the trans- and cis-alcohol metabolites in the plasma and urine were measured as a function of time. Using this pretreatment, the area under the curve (AUC) of the trans-alcohol metabolite of loxoprofen in the plasma, but not those of loxoprofen and the cis-alcohol metabolite, was increased (1.5-fold, p < 0.05), leading to increased contribution of the trans-alcohol metabolite to the total urinary recovery of loxoprofen (1.3-fold, p < 0.05). The urinary recovery of total metabolites, which was largely (> 90%) comprised of conjugate metabolites, was also increased as a result of the pretreatment (1.5-fold, p < 0.05). These results indicate that stereoselective reduction to trans-alcohol metabolites as well as the phase II metabolism of loxoprofen may be increased by such a pretreatment in human subjects. Copyright 2002 Wiley-Liss, Inc. and the American Pharmaceutical Association J Pharm Sci 91:973-979, 2002

8-isoprostane as Oxidative Stress Marker in Coal Mine Workers.

PubMed

Zimet, Zlatko; Bilban, Marjan; Marc Malovrh, Mateja; Korošec, Peter; Poljšak, Borut; Osredkar, Joško; Šilar, Mira

2016-08-01

This study was to investigate whether working in conditions of elevated concentrations of mine gases (CO2, CO, CH4, DMS) and dust may result in oxidative stress. Coal miners (n=94) from the Velenje Coal mine who were arranged into control group and three groups according to a number of consecutive working days. 8-isoprostane as a biological marker of oxidative stress was measured in exhaled breath condensate (EBC). Miners who worked for three consecutive days had higher 8-isoprostane values in EBC compared to the control group. Gas/dust concentrations and exposure time of a single/two day shift seem too low to trigger immediate oxidative stress. Copyright © 2016 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

Cytologic, hormonal, and ultrasonographic correlates of the menstrual cycle of the New World monkey Cebus apella.

PubMed

Ortiz, R E; Ortiz, A C; Gajardo, G; Zepeda, A J; Parraguez, V H; Ortiz, M E; Croxatto, H B

2005-07-01

Few reports on the reproductive physiology of Cebus apella have been published. In this study we characterized menstrual cycle events by means of vaginal cytology, ultrasonography (US), and hormonal measurements in serum during three consecutive cycles in 10 females, and assessed the probability that ovulation would occur in the same ovary in consecutive cycles in 18 females. The lengths and phases of the cycles were determined according to vaginal cytology. Taking the first day of endometrial bleeding as the first day of the cycle, the mean cycle length +/- SEM was 19.5+/-0.4 days, with follicular and luteal phases lasting 8.2+/-0.2 and 11.3+/-0.4 days, respectively. The follicular phase included menstruation and the periovulatory period, which was characterized by the presence of a large number of superficial eosinophilic cells in the vaginal smear. The myometrium, endometrium, and ovaries were clearly distinguished on US examination. During each menstrual cycle a single follicle was recruited at random from either ovary. The follicle grew from 3 mm to a maximum diameter of 8-9 mm over the course of 8 days, in association with increasing estradiol (E(2)) serum levels (from 489+/-41 to 1600+/-92 pmol/L). At ovulation, the mean diameter of the dominant follicle usually decreased by >20%, 1 day after the maximum E(2) level was reached. Ovulation was associated with an abrupt fall in E(2), a decreased number of eosinophilic cells, the presence of leukocytes and intermediate cells in the vaginal smear, and a progressive increase in progesterone (P) levels that reached a maximum of 892+/-65 nmol/L on days 3-6 of the luteal phase. The menstrual cycle of Cebus apella differs in several temporal and quantitative aspects from that in humans and Old World primates, but it exhibits the same correlations between ovarian endocrine and morphologic parameters. (c) 2005 Wiley-Liss, Inc.

Neural control of cursor trajectory and click by a human with tetraplegia 1000 days after implant of an intracortical microelectrode array

NASA Astrophysics Data System (ADS)

Simeral, J. D.; Kim, S.-P.; Black, M. J.; Donoghue, J. P.; Hochberg, L. R.

2011-04-01

The ongoing pilot clinical trial of the BrainGate neural interface system aims in part to assess the feasibility of using neural activity obtained from a small-scale, chronically implanted, intracortical microelectrode array to provide control signals for a neural prosthesis system. Critical questions include how long implanted microelectrodes will record useful neural signals, how reliably those signals can be acquired and decoded, and how effectively they can be used to control various assistive technologies such as computers and robotic assistive devices, or to enable functional electrical stimulation of paralyzed muscles. Here we examined these questions by assessing neural cursor control and BrainGate system characteristics on five consecutive days 1000 days after implant of a 4 × 4 mm array of 100 microelectrodes in the motor cortex of a human with longstanding tetraplegia subsequent to a brainstem stroke. On each of five prospectively-selected days we performed time-amplitude sorting of neuronal spiking activity, trained a population-based Kalman velocity decoding filter combined with a linear discriminant click state classifier, and then assessed closed-loop point-and-click cursor control. The participant performed both an eight-target center-out task and a random target Fitts metric task which was adapted from a human-computer interaction ISO standard used to quantify performance of computer input devices. The neural interface system was further characterized by daily measurement of electrode impedances, unit waveforms and local field potentials. Across the five days, spiking signals were obtained from 41 of 96 electrodes and were successfully decoded to provide neural cursor point-and-click control with a mean task performance of 91.3% ± 0.1% (mean ± s.d.) correct target acquisition. Results across five consecutive days demonstrate that a neural interface system based on an intracortical microelectrode array can provide repeatable, accurate point-and-click control of a computer interface to an individual with tetraplegia 1000 days after implantation of this sensor.

Neural control of cursor trajectory and click by a human with tetraplegia 1000 days after implant of an intracortical microelectrode array

PubMed Central

Simeral, J D; Kim, S-P; Black, M J; Donoghue, J P; Hochberg, L R

2013-01-01

The ongoing pilot clinical trial of the BrainGate neural interface system aims in part to assess the feasibility of using neural activity obtained from a small-scale, chronically implanted, intracortical microelectrode array to provide control signals for a neural prosthesis system. Critical questions include how long implanted microelectrodes will record useful neural signals, how reliably those signals can be acquired and decoded, and how effectively they can be used to control various assistive technologies such as computers and robotic assistive devices, or to enable functional electrical stimulation of paralyzed muscles. Here we examined these questions by assessing neural cursor control and BrainGate system characteristics on five consecutive days 1000 days after implant of a 4 × 4 mm array of 100 microelectrodes in the motor cortex of a human with longstanding tetraplegia subsequent to a brainstem stroke. On each of five prospectively-selected days we performed time-amplitude sorting of neuronal spiking activity, trained a population-based Kalman velocity decoding filter combined with a linear discriminant click state classifier, and then assessed closed-loop point-and-click cursor control. The participant performed both an eight-target center-out task and a random target Fitts metric task which was adapted from a human-computer interaction ISO standard used to quantify performance of computer input devices. The neural interface system was further characterized by daily measurement of electrode impedances, unit waveforms and local field potentials. Across the five days, spiking signals were obtained from 41 of 96 electrodes and were successfully decoded to provide neural cursor point-and-click control with a mean task performance of 91.3% ± 0.1% (mean ± s.d.) correct target acquisition. Results across five consecutive days demonstrate that a neural interface system based on an intracortical microelectrode array can provide repeatable, accurate point-and-click control of a computer interface to an individual with tetraplegia 1000 days after implantation of this sensor. PMID:21436513

Brief Report: Severe Inflammation Following Vaccination Against Streptococcus pneumoniae in Patients With Cryopyrin-Associated Periodic Syndromes.

PubMed

Walker, Ulrich A; Hoffman, Hal M; Williams, Rene; Kuemmerle-Deschner, Jasmin; Hawkins, Philip N

2016-02-01

Pneumococcal vaccination is recommended for patients receiving immunosuppressive drugs. We describe unusually severe adverse reactions to pneumococcal vaccination in each of 7 consecutive patients with cryopyrin-associated periodic syndromes (CAPS). Seven consecutive patients with CAPS were vaccinated with pneumococcal polysaccharide or conjugate vaccines. Clinical information was collected retrospectively. Within a few hours after the vaccination, all 7 patients developed severe local reactions at the injection site. Two patients had to be hospitalized for systemic reactions including fever. All symptoms resolved in a period of 3-17 days. Our findings indicate that pneumococcal vaccines can trigger a severe local and systemic inflammatory reaction in patients with CAPS and possibly patients with other autoinflammatory diseases. Careful consideration is warranted when implementing current European League Against Rheumatism immunization guidelines in this patient population. © 2015, American College of Rheumatology.

Infusion phlebitis in post-operative patients: when and why.

PubMed

Monreal, M; Oller, B; Rodriguez, N; Vega, J; Torres, T; Valero, P; Mach, G; Ruiz, A E; Roca, J

1999-01-01

The most common complication of intravenous therapy is infusion phlebitis. This study was done to prospectively assess its frequency in a series of consecutive patients who will undergo surgery, and to identify which variables may predict an increased risk for phlebitis. 400 consecutive patients who will undergo surgery in a general surgery department were included. Only the first catheter, inserted the day before surgery, was taken into account. Eighteen variables (from the infusion, the catheter and from the patient) were prospectively evaluated for their contribution to the occurrence of phlebitis. 60/400 patients (15%) developed phlebitis, and most of them needed insertion of a further catheter. The univariate analysis showed that patients who developed phlebitis were older, and their pre-operative levels of both blood haemoglobin and neutrophil cound were significantly higher than those in patients who did not develop phlebitis. However, the multivariate analysis only confirmed the association with blood haemoglobin levels: the risk of phlebitis sharply increased in the patients with the highest haemoglobin levels. As to the influence of time on phlebitis development, there was a significant decrease in the day-specific risk, from the 5th day on. In our series, blood haemoglobin levels were found to be the only variable associated to a higher risk of phlebitis. Besides, in contrast with the recommendations by the Centers for Disease Control, no significant increase in the day-specific risk of phlebitis was found. Thus, a guideline to select the type of catheter to be inserted in an individual patient is suggested. Copyright 2000 S. Karger AG, Basel

Topically applied 1% voriconazole induces dysplastic changes on the ocular surface: animal study.

PubMed

Arikan, Gul; Karatas, Ezgi; Lebe, Banu; Ayhan, Ziya; Utine, Canan Asli; Kutsoylu, Oya Eren; Gunenc, Uzeyir; Yilmaz, Osman

2018-04-26

To identify the risk of inducing ocular surface dysplasia following topical administration of 1% voriconazole eye drop. Fourteen noninflamed healthy eyes of 14 white adult New Zealand rabbits were included in the study. The rabbits were randomly divided into two groups comprised of 7 rabbits each. Group 1 received topical 1% voriconazole and Group 2 received topical saline as the control group. In all animals, right eye was selected for the study. In Group 1 (Voriconazole Group), single drop of voriconazole was instilled every 10 min consecutively for 17 times a day for 60 days. In Group 2 (Control Group), single drop of saline was instilled every 10 min consecutively for 17 times a day for 60 days. At two months, animals were sacrificed and study eyes were enucleated with the eyelids. The specimens were stained with hematoxylin-eosin and histopathologic changes in cornea, bulbar and palpebral conjunctiva were evaluated under light microscope. There were no macroscopically visible lesions on the ocular surface of any rabbits. Histopathological evaluation showed mild to moderate dysplasia localized mainly in the limbus and extending to the adjacent cornea and bulbar conjunctiva in all rabbits in Voriconazole Group. Severe dysplasia or carcinoma in situ was not observed. In the Control Group, dysplasia was not observed, at all. This animal study provides a possible relationship between topically administered 1% voriconazole and ocular surface dysplasia. We recommend ophthalmologists to be aware of the risk of ocular surface dysplasia in patients received voriconazole eye drop.

40 CFR 426.133 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... than 50 gallons per day of process waste water, and employs hydrofluoric acid finishing techniques... any 1 day Average of daily values for 30 consecutive days shall not exceed— Lead 0.2 0.1 Fluoride 26.0..., discharges greater than 50 gallons per day of process waste water, and employs hydrofluoric acid finishing...

40 CFR 426.133 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... than 50 gallons per day of process waste water, and employs hydrofluoric acid finishing techniques... any 1 day Average of daily values for 30 consecutive days shall not exceed— Lead 0.2 0.1 Fluoride 26.0..., discharges greater than 50 gallons per day of process waste water, and employs hydrofluoric acid finishing...

40 CFR 426.133 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... than 50 gallons per day of process waste water, and employs hydrofluoric acid finishing techniques... any 1 day Average of daily values for 30 consecutive days shall not exceed— Lead 0.2 0.1 Fluoride 26.0..., discharges greater than 50 gallons per day of process waste water, and employs hydrofluoric acid finishing...

[The influence of vibration training in combination with general magnetotherapy on dynamics of performance efficiency in athletes].

PubMed

Mikheev, A A; Volchkova, O A; Voronitskiĭ, N E

2010-01-01

The objective of this study was to evaluate effects of a combined treatment including vibrostimulation and magnetotherapy on the working capacity of athletes. Participants of the study were 8 male judo wrestlers. It was shown that implementation of a specialized training program comprising seances of vibration loading and general magnetotherapy 40 and 60 min in duration respectively during 3 consecutive days produced marked beneficial effect on the hormonal status of the athletes. Specifically, the three-day long treatment resulted in a significant increase of blood cortisol and testosterone levels considered to be an objective sign of improved performance parameters in athletes engaged in strength and speed sports. The optimal length of vibration training during 3 days of specialized training is estimated at 20 to 40 minutes supplemented by general magnetotherapy for 60 minutes.

Safety and tolerance of ester-C compared with regular ascorbic acid.

PubMed

Gruenwald, Joerg; Graubaum, Hans-Joachim; Busch, Regina; Bentley, Christine

2006-01-01

The goal of this randomized, double-blind crossover clinical trial in 50 healthy volunteers sensitive to acidic foods was to evaluate whether Ester-C calcium ascorbate causes fewer epigastric adverse effects than are produced by regular ascorbic acid (AA). Volunteers were randomly separated into 2 groups of 25. The study comprised an observation period of 9 days (phase 1 medication for 3 consecutive days, washout phase for 3 consecutive days, phase 2 medication for 3 consecutive days). Participants took 1000 mg vitamin C as Ester-C during phase 1 of the study followed by 1000 mg of vitamin C as AA during phase 2, or vice versa. During the course of the study, 3 examinations for the evaluation of epigastric adverse effects were performed (on days 0, 3, and 9). Participants used a diary to record epigastric adverse effects on a daily basis. In total, 28 (56%) of 50 participants reported 88 epigastric adverse effects of mild to moderate intensity. Of these 88 adverse effects, 33 (37.5%) occurred after intake of Ester-C and 55 (62.5%) were noted after intake of AA. The tolerability of Ester-C was rated "very good" by 72% of participants, whereas AA was rated "very good" by only 54%. This difference is statistically significant (P<.05). Investigators concluded that Ester-C compared with AA caused significantly fewer epigastric adverse effects in participants sensitive to acidic foods and that Ester-C is much better tolerated.

Influence of process parameters on the extraction of soluble substances from OFMSW and methane production.

PubMed

Campuzano, Rosalinda; González-Martínez, Simón

2017-04-01

Microorganisms involved in anaerobic digestion require dissolved substrates to transport them through the cell wall to different processing units and finally to be disposed as waste, such as methane and carbon dioxide. In order to increase methane production, this work proposes to separate the soluble substances from OFMSW and analyse methane production from extracts and OFMSW. Using water as solvent, four extraction parameters were proposed: (1) Number of consecutive extractions, (2) Duration of mixing for every consecutive extraction, (3) OFMSW to water mass ratios 1:1, 1:2, and 1:3 and, (4) The influence of temperature on the extraction process. Results indicated that is possible to separate 40% of VS from OFMSW with only three consecutive extraction with mixing of 30min in every extraction using ambient temperature water. For every OFMSW to water combination, the first three consecutive extracts were analysed for biochemical methane potential test during 21days at 35°C; OFMSW was also tested as reference. Methane production from all substrates is highest during the first day and then it slowly decreases to increase again during a second stage. This was identified as diauxic behaviour. Specific methane production at day 21 increased with increasing water content of the extracts where OFMSW methane production was the lowest of all with 535NL/kgVS. These results indicate that it is feasible to rapidly produce methane from extracted substances. Copyright © 2017 Elsevier Ltd. All rights reserved.

Survival of cool and warm freshwater fish following chloramine-T exposure

USGS Publications Warehouse

Gaikowski, M.P.; Larson, W.J.; Gingerich, W.H.

2008-01-01

Chloramine-T is presently available in the USA to control mortalities associated with bacterial gill disease or external columnaris only through an Investigational New Animal Drug Permit authorized by the US Food and Drug Administration (FDA). Its US approval hinges on FDA's acceptance of several key data, including those describing animal safety. Chloramine-T is presently applied in US aquaculture, by permit only, once daily on consecutive or alternate days for 1??h at 10 to 20??mg/L to control mortalities associated with bacterial gill disease or external columnaris. Our objective was to determine the safety of chloramine-T bath exposures at multiples of the proposed maximum treatment concentration (i.e., 0, 20, 60, 100, and 200??mg/L) administered on four consecutive days at 20????C to lake sturgeon Acipenser fulvescens, northern pike Esox lucius, and walleye Sander vitreum, or at 27????C to channel catfish Ictalurus punctatus, and largemouth bass Micropterus salmoides. All fish were tested as five to eight week old fry except for walleye and channel catfish which were tested as both fry and fingerling (fingerlings were at least four weeks older than the fry tested). Walleye and channel catfish were selected to evaluate the effects of life stage (fry vs. fingerling), temperature (walleye - 15, 20, or 25????C; channel catfish - 22, 27, or 32????C), exposure duration (60 vs. 180??min), and water chemistry (walleye only - reconstituted soft water vs. well water). Except for channel catfish fry, survival was significantly reduced only when fish were treated at 100 or 200??mg/L. Channel catfish fry survival was significantly reduced when exposed at 60??mg/L for 180??min at 27????C. Based on our mortality data, chloramine-T administered once daily for 60??min on four consecutive days at concentrations of up to 20??mg/L is not likely to adversely affect survival of cool or warmwater fish cultured in freshwater. Crown Copyright ?? 2007.

Comparison of a wipe method with and without a rinse to recover wall losses in closed face 37-mm cassettes used for sampling lead dust particulates

PubMed Central

Ceballos, Diana; King, Bradley; Beaucham, Catherine; Brueck, Scott E.

2015-01-01

Closed-face 37-millimeter (mm) polystyrene cassettes are often used for exposure monitoring of metal particulates. Several methods have been proposed to account for the wall loss in air sampling cassettes, including rinsing, wiping, within-cassette dissolution, and an internal capsule fused to the filter that could be digested with the filter. Until internal capsules replace filters, other methods for assessing wall losses may be considered. To determine if rinsing and wiping or wiping alone is adequate to determine wall losses on cassettes, we collected 54 full-shift area air samples at a battery recycling facility. We collected six replicate samples at three locations within the facility for 3 consecutive days. The wall losses of three replicate cassettes from each day-location were analyzed following a rinse and two consecutive wipes. The wall losses of the other three replicates from each day-location were analyzed following two consecutive wipes only. Mixed-cellulose ester membrane filter, rinse, and wipes were analyzed separately following NIOSH Method 7303. We found an average of 29% (range: 8%–54%) recovered lead from the cassette walls for all samples. We also found that rinsing prior to wiping the interior cassette walls did not substantially improve recovery of wall losses compared to wiping alone. A rinse plus one wipe recovered on average 23% (range: 13%–33%) of the lead, while one wipe alone recovered on average 21% (range: 16%–22%). Similarly we determined that a second wipe did not provide substantial additional recovery of lead (average: 4%, range: 0.4%–19%) compared to the first wipe disregarding the rinse (average: 18%, range: 4%–39%). We concluded that when an internal capsule is not used, wall losses of lead dust in air sampling cassettes can be adequately recovered by wiping the internal wall surfaces of the cassette with a single wipe. PMID:26125330

Effects of mixed-method cooling on recovery of medium-fast bowling performance in hot conditions on consecutive days.

PubMed

Minett, Geoffrey M; Duffield, Rob; Kellett, Aaron; Portus, Marc

2012-01-01

This investigation examined physiological and performance effects of cooling on recovery of medium-fast bowlers in the heat. Eight, medium-fast bowlers completed two randomised trials, involving two sessions completed on consecutive days (Session 1: 10-overs and Session 2: 4-overs) in 31 ± 3°C and 55 ± 17% relative humidity. Recovery interventions were administered for 20 min (mixed-method cooling vs. control) after Session 1. Measures included bowling performance (ball speed, accuracy, run-up speeds), physical demands (global positioning system, counter-movement jump), physiological (heart rate, core temperature, skin temperature, sweat loss), biochemical (creatine kinase, C-reactive protein) and perceptual variables (perceived exertion, thermal sensation, muscle soreness). Mean ball speed was higher after cooling in Session 2 (118.9 ± 8.1 vs. 115.5 ± 8.6 km · h⁻¹; P = 0.001; d = 0.67), reducing declines in ball speed between sessions (0.24 vs. -3.18 km · h⁻¹; P = 0.03; d = 1.80). Large effects indicated higher accuracy in Session 2 after cooling (46.0 ± 11.2 vs. 39.4 ± 8.6 arbitrary units [AU]; P = 0.13; d = 0.93) without affecting total run-up speed (19.0 ± 3.1 vs. 19.0 ± 2.5 km · h⁻¹; P = 0.97; d = 0.01). Cooling reduced core temperature, skin temperature and thermal sensation throughout the intervention (P = 0.001-0.05; d = 1.31-5.78) and attenuated creatine kinase (P = 0.04; d = 0.56) and muscle soreness at 24-h (P = 0.03; d = 2.05). Accordingly, mixed-method cooling can reduce thermal strain after a 10-over spell and improve markers of muscular damage and discomfort alongside maintained medium-fast bowling performance on consecutive days in hot conditions.

40 CFR 426.135 - Standards of performance for new sources.

Code of Federal Regulations, 2013 CFR

2013-07-01

... greater than 50 gallons per day of process waste water, and employs hydrofluoric acid finishing techniques... any 1 day Average of daily values for 30 consecutive days shall not exceed— Lead 0.2 0.1 Fluoride 26.0... waste water, and employs hydrofluoric acid finishing techniques shall meet the following limitations...

40 CFR 426.135 - Standards of performance for new sources.

Code of Federal Regulations, 2012 CFR

2012-07-01

... greater than 50 gallons per day of process waste water, and employs hydrofluoric acid finishing techniques... any 1 day Average of daily values for 30 consecutive days shall not exceed— Lead 0.2 0.1 Fluoride 26.0... waste water, and employs hydrofluoric acid finishing techniques shall meet the following limitations...

40 CFR 426.135 - Standards of performance for new sources.

Code of Federal Regulations, 2014 CFR

2014-07-01

... greater than 50 gallons per day of process waste water, and employs hydrofluoric acid finishing techniques... any 1 day Average of daily values for 30 consecutive days shall not exceed— Lead 0.2 0.1 Fluoride 26.0... waste water, and employs hydrofluoric acid finishing techniques shall meet the following limitations...

Benefits of Alcohol on Arsenic Toxicity in Rats

PubMed Central

Dutta, Shubha Ranjan; Passi, Deepak; Bharti, Jaya

2017-01-01

Introduction It has been demonstrated earlier that exposure to ethanol and/or arsenic compounds (such as sodium arsenite) produces toxic effects as shown by both in vitro and in vivo experiments. Chronic exposure of humans to arsenic through drinking water, pesticides or consumption of alcoholic beverages has produced major health problem and concern in recent years. Water being one of the main ingredients for alcohol formation (beer fermentation process) can lead to contamination with arsenic. Thus, people consuming such alcohol are getting continuously exposed to arsenic compounds as well along with alcohol. Aim The present study was undertaken to investigate the effect of alcohol co-administration on arsenic induced changes in carbohydrate metabolic status in adult male albino rats. Materials and Methods Adult male albino rats of Wistar strain (weighing~100g) were divided into three groups (n=8 rats/group) including Control or vehicle treated (C), Arsenic treated (As) and Arsenic treated alcohol co-exposed (As+Alc). Treatment with Sodium-arsenite included intra-peritoneal injection consecutively for 14 days at a dose of 5.55 mg/kg (equivalent to 35% of LD50) per day. Absolute alcohol (15% v/v) was fed at a dose of 0.5 ml/100 g body weight per day for five consecutive days from start of the treatment schedule. Distilled water (D/W) was used as vehicle. Blood Glucose (BG) level, levels of glycogen, Pyruvic Acid (PA), Free Amino Acid Nitrogen (FAAN), total protein, Glutamate Oxalate transaminase (GOT) and Glutamate Pyruvate Transaminase (GPT) activity, and glucose-6-phosphatase (G6Pase) activity were measured in tissues including liver, kidney and muscle. Results Treatment with arsenic decreased the levels of BG, liver glycogen and PA, tissue protein and G6Pase activity, GOT activity in liver and muscle, and increased free amino acid content in kidney and muscle, GPT activity in liver and kidney. Alcohol administration to rats co-exposed to arsenic treatment reversed these changes. Conclusion Thus, it is suggested that combined administration of alcohol with arsenic can result in the suppression of the down-regulating action of arsenic on glucose homeostasis as evidenced by its hypoglycaemic effect and increased gluconeogenesis and transamination in liver. PMID:28273963

Benefits of Alcohol on Arsenic Toxicity in Rats.

PubMed

Singh, Purnima; Dutta, Shubha Ranjan; Passi, Deepak; Bharti, Jaya

2017-01-01

It has been demonstrated earlier that exposure to ethanol and/or arsenic compounds (such as sodium arsenite) produces toxic effects as shown by both in vitro and in vivo experiments. Chronic exposure of humans to arsenic through drinking water, pesticides or consumption of alcoholic beverages has produced major health problem and concern in recent years. Water being one of the main ingredients for alcohol formation (beer fermentation process) can lead to contamination with arsenic. Thus, people consuming such alcohol are getting continuously exposed to arsenic compounds as well along with alcohol. The present study was undertaken to investigate the effect of alcohol co-administration on arsenic induced changes in carbohydrate metabolic status in adult male albino rats. Adult male albino rats of Wistar strain (weighing~100g) were divided into three groups (n=8 rats/group) including Control or vehicle treated (C), Arsenic treated (As) and Arsenic treated alcohol co-exposed (As+Alc). Treatment with Sodium-arsenite included intra-peritoneal injection consecutively for 14 days at a dose of 5.55 mg/kg (equivalent to 35% of LD50) per day. Absolute alcohol (15% v/v) was fed at a dose of 0.5 ml/100 g body weight per day for five consecutive days from start of the treatment schedule. Distilled water (D/W) was used as vehicle. Blood Glucose (BG) level, levels of glycogen, Pyruvic Acid (PA), Free Amino Acid Nitrogen (FAAN), total protein, Glutamate Oxalate transaminase (GOT) and Glutamate Pyruvate Transaminase (GPT) activity, and glucose-6-phosphatase (G6Pase) activity were measured in tissues including liver, kidney and muscle. Treatment with arsenic decreased the levels of BG, liver glycogen and PA, tissue protein and G6Pase activity, GOT activity in liver and muscle, and increased free amino acid content in kidney and muscle, GPT activity in liver and kidney. Alcohol administration to rats co-exposed to arsenic treatment reversed these changes. Thus, it is suggested that combined administration of alcohol with arsenic can result in the suppression of the down-regulating action of arsenic on glucose homeostasis as evidenced by its hypoglycaemic effect and increased gluconeogenesis and transamination in liver.

[Results of requesting a second consecutive sperm ejaculate on the day of oocyte pick-up in assisted reproductive technology].

PubMed

Zhai, Dan-mei; Li, Mu-jun; Jiang, Li; Qin, Ai-ping; Li, Liu-ming; Hang, Fu

2011-05-01

To evaluate the results of requesting a second consecutive sperm ejaculate in order to reduce ICSI cycles by PESA or TESE on the day of oocyte pick-up in assisted reproductive technology (ART). We collected 68 semen samples as a second consecutive ejaculate from 34 men, compared the semen volume and sperm concentration, motility and total count between the first and the second ejaculation, and analyzed the laboratory results and clinical outcomes of fertilization with the mixed sperm. The 34 males ejaculated twice within 4 hours by masturbation, with an interval of 26-183 (94.9 +/- 39.8) minutes between the first and second ejaculation. The volume of the first ejaculate was (2.0 +/- 1.4) ml, significantly higher than that of the second ([1.5 +/- 0.9] ml) (P = 0.007), although the numbers of motile sperm and grade a + b sperm of the first ([40.8 +/- 25.3]% and [30.9 +/- 22.4]%) were significantly lower than those of the second ([52.2 +/- 21.1]% and [39.9 +/- 17.5]%) (P < 0.05). There were no statistically significant differences in the sperm concentration or total sperm count between the two ejaculates (P > 0.05). The ICSI, IVF + ICSI, and IVF cycles were 3, 3 and 28 respectively among the 34 couples undergoing ART. The number of retrieved oocytes, normal fertilization rate, high quality embryo rate and frozen cycles/fresh transfer cycles ratio were 15.5 +/- 8.7, 57.0% (247/433), 58.7% (145/247) and 20/24 for the IVF cycle, 21.7 +/- 8.3, 61.5% (40/65), 67.5% (27/40) and 3/2 for the ICSI cycle, and 10.0 +/- 2.6, 72.4% (21/29), 66.7% (14/21) and 3/3 for the IVF + ICSI cycle. Fourteen live births were achieved out of the 18 pregnancies, including 6 healthy boys and 9 healthy girls. A clinical pregnancy rate of >30% can be achieved by requesting a second consecutive sperm ejaculate on the day of oocyte pick-up in order to collect more sperm and/or increase the total number of motile sperm for ART. And this method can avoid other invasive sperm processing techniques and the need of unnecessary micromanipulative fertilization.

Menstruation and the Menopause Transition

PubMed Central

Harlow, Siobán D.; Paramsothy, Pangaja

2011-01-01

SYNOPSIS This paper characterizes changes in menstrual bleeding during perimenopause, including bleeding changes that represent markers of the menopausal transition. Recent results from the Study of Women’s Health Across the Nation (SWAN), a multiethnic cohort study of midlife women, as well as data from other cohort studies of women in the midlife are reviewed. Emerging data describing subpopulation differences in the transition experience is highlighted . Early transition, defined as a persistent difference in consecutive menstrual cycle length of seven or more days, begins on average 6-8 years before the FMP. Late transition, defined by an episode of 60 or more days of amenorrhea, begins on average two years before the FMP. When treating women in the midlife, clinicians should pay careful attention to medical factors, including both conditions and treatments, that may increase menstrual blood loss or alter menstrual cycle characteristics sufficiently to obscure the onset of the menopausal transition or the FMP. PMID:21961722

Physical activity levels at work and outside of work among Commercial Construction Workers

PubMed Central

Arias, Oscar E.; Caban-Martinez, Alberto J.; Umukoro, Peter E.; Okechukwu, Cassandra A.; Dennerlein, Jack T.

2015-01-01

Objective Characterize the number of minutes of moderate and vigorous physical activity at work and outside of work during seven consecutive days, in a sample of 55 commercial construction workers. Methods Workers wore accelerometers during work and outside work hours for seven consecutive days, and completed brief survey at the seventh day of data collection. Results From the directly measured physical activity, the average number per participant of moderate minutes of occupational physical activity and physical activity outside of work obtained in short bouts were 243 minutes (65%) and 130 minutes (35%), respectively. Directly measured minutes of vigorous occupational physical activity were significant and positively correlated with self-reported fatigue. Conclusions Among commercial construction workers, physical activity from work contributes significantly, approximately 2/3, towards a workers total amount of weekly minutes of moderate physical activity. PMID:25563543

Effect of Reduced Meal Frequency during Ramadan Fasting on Retinal and Choroidal Thickness.

PubMed

Ersan, Ismail; Tufan, Hasan Ali; Arikan, Sedat; Kara, Selcuk; Gencer, Baran; Hondur, Ahmet Murat

2017-01-01

To evaluate the effects of Ramadan fasting on central foveal thickness (CFT) and subfoveal choroidal thickness (SFCT) in healthy individuals using enhanced depth imaging optical coherence tomography (EDI-OCT). The EDI-OCT scans of 42 healthy individuals obtained after about 12 hours of fasting on at least the twenty-first consecutive day of fasting were compared to scans of the same patients taken one month after the last day they had fasted. CFT values were similar for both time periods (p > 0.05). The SFCT was significantly higher after consecutive fasting days towards the end of Ramadan, compared to the SFCT after one month of no fasting (one month after Ramadan ended) (p < 0.001). Ramadan fasting may lead to a significant increase in subfoveal choroidal thickness without affecting the central foveal thickness.

IMMUNOTOXICOLOGIC ASSESSMENT OF SUBACUTE EXPOSURE OF RATS TO CARBON TETRACHLORIDE WITH COMPARISON TO HEPATOXICITY AND NEPHROTOXICITY

EPA Science Inventory

The immunotoxicity, hepatoxicity and nephrotoxicity of subacute exposure to carbon tetrachloride (CCl4) was evaluated In young adult (8-9 week old) male Fischer 344 rats, dosed by gavage with CCl4 for ten consecutive days at 0, 5, 10, 20 or 40 mg/kg/day. wo days following the las...

29 CFR 780.316 - Thirteen week provision.

Code of Federal Regulations, 2010 CFR

2010-07-01

... consisting of seven consecutive 24-hour periods during which the employee worked at least 1 “man-day.” Section 3(u) of the Act defines a man-day as “any day during which an employee performs any agricultural... 13(a)(6)(C) (as well as section 3(e)(2)) comports with the traditional definition of week used in...

Optimal bladder diary duration for patients with suprapontine neurogenic lower urinary tract dysfunction.

PubMed

Konstantinidis, Charalampos; Kratiras, Zisis; Samarinas, Michael; Skriapas, Konstantinos

2016-01-01

To identify the minimum bladder diary's length required to furnish reliable documentation of LUTS in a specific cohort of patients suffering from neurogenic urinary dysfunction secondary to suprapontine pathology. From January 2008 to January 2014, patients suffering from suprapontine pathology and LUTS were requested to prospectively complete a bladder diary form for 7 consecutive days. Micturitions per day, excreta per micturition, urgency and incontinence episodes and voided volume per day were evaluated from the completed diaries. We compared the averaged records of consecutive days (2-6 days) to the total 7 days records for each patient's diary, seeking the minimum diary's length that could provide records comparable to the 7 days average, the reference point in terms of reliability. From 285 subjects, 94 male and 69 female patients enrolled in the study. The records of day 1 were significantly different from the average of the 7 days records in every parameter, showing relatively small correlation and providing insuficiente documentation. Correlations gradually increased along the increase in diary's duration. According to our results a 3-day duration bladder diary is efficient and can provide results comparable to a 7 day length for four of our evaluated parameters. Regarding incontinence episodes, 3 days seems inadequate to furnish comparable results, showing a borderline difference. A 3-day diary can be used, as its reliability is efficient regarding number of micturition per day, excreta per micturition, episodes of urgency and voided volume per day. Copyright© by the International Brazilian Journal of Urology.

Analysis of 2-Week Data from Two Randomized, Controlled Trials Conducted in Subjects with Frequent Heartburn Treated with Esomeprazole 20 mg.

PubMed

Katz, Philip O; Le Moigne, Anne; Pollack, Charles

2017-05-01

These secondary analyses used data from 2 similarly designed studies in subjects experiencing frequent heartburn to evaluate the efficacy of esomeprazole 20 mg once daily for 2 weeks, which reflects the approved over-the-counter dosage and duration. Subjects without endoscopically identified erosive esophagitis who were experiencing heartburn for ≥6 months and ≥4 of 7 days prior to baseline (study 1, N = 368; study 2, N = 349) were randomly assigned to receive double-blind treatment with esomeprazole 40 or 20 mg (administered as esomeprazole magnesium trihydrate 44.5 and 22.3 mg, respectively) or placebo once daily for 4 weeks. Subjects recorded the severity of heartburn in a daily diary, and investigators assessed subjects at each study visit. Two-week assessments were the primary end points of interest in these analyses and included the percentage of subjects with complete heartburn resolution (no episodes during 7 consecutive days), time to sustained complete heartburn resolution (the first of 7 consecutive episode-free days), and heartburn relief (no episodes other than ≤1 mild episode during 7 consecutive days). At week 2, the percentages of subjects who experienced complete heartburn resolution were significantly greater with esomeprazole 40 mg (study 1, 26.1%; study 2, 35.3%) and 20 mg (study 1, 25.2%; study 2, 35.7%) compared with placebo (study 1, 9.0%; study 2, 3.4%) (all, P ≤ 0.001). Beginning on day 1, the percentages of subjects who experienced sustained heartburn resolution was significantly greater in the groups treated with esomeprazole 40 mg (study 1, 19%; study 2, 19%; P < 0.0001) and 20 mg (study 1, 10%; study 2, 15%; P < 0.05) compared with the group that received placebo (study 1, 2%; study 2, 1%). Additionally, at week 2, the percentages of subjects experiencing heartburn relief were significantly greater with esomeprazole 40 mg (study 1, 35.3%; study 2, 40.5%) and 20 mg (study 1, 34.5%; study 2, 46.4%) compared with placebo (study 1, 16.5%; study 2, 8.6%) (all, P ≤ 0.001). The results of this study demonstrate that once-daily treatment with esomeprazole 20 mg for 2 weeks effectively resolved subjects׳ heartburn compared with placebo, beginning on day 1. Studies precede FDA Act 801 clinical trial registration and results submission requirements. Copyright © 2017 Elsevier HS Journals, Inc. All rights reserved.

Laparoscopic sleeve gastrectomy as a viable option for an ambulatory surgical procedure: our 52-month experience.

PubMed

Lalezari, Sepehr; Musielak, Matthew C; Broun, Lisa A; Curry, Trace W

2018-06-01

We present our experience with same-day discharge (without an overnight stay) after laparoscopic sleeve gastrectomy (SG) in 821 consecutive patients from 2011 to 2015. This is the largest series published to date of patients undergoing ambulatory surgery for such a procedure. To review our outcomes from ambulatory SG over 52 months to determine if SG can be safely performed in the ambulatory setting. Ambulatory surgery center. Retrospective review of all consecutive patients undergoing ambulatory SG from January 2011 to April 2015. All patients were discharged home the same day after surgery without an overnight stay at the hospital. Incidence of complications and admission to the hospital after discharge was reviewed up to 30 days from surgery. From January 2011 to April 2015, 821 consecutive patients underwent SG. Nineteen 30-day complications occurred in the series, 17 of them requiring admission to the hospital. Of the 19 cases, gastric leaks accounted for 7, intr-aabdominal abscess for 4, and dehydration/nausea/vomiting for 4; 4 were due to other causes. Complication and readmission rates at 30 days were 2.3% and 2.1%, respectively. Follow-up at 30 days was 98.4%. With stringent patient selection and utilization of enhanced recovery pathways, our study indicates that SG may be suitable for the outpatient setting. Experience and comfort with bariatric surgery is essential on the part of the operating surgeon to ensure good outcomes. Our low overall readmission and complication rate portends to the feasibility of laparoscopic SG as a safe outpatient procedure. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Diurnal variations in axial length, choroidal thickness, intraocular pressure, and ocular biometrics.

PubMed

Chakraborty, Ranjay; Read, Scott A; Collins, Michael J

2011-07-11

To investigate the pattern of diurnal variations in axial length (AL), choroidal thickness, intraocular pressure (IOP), and ocular biometrics over 2 consecutive days. Measurements of ocular biometrics and IOP were collected for 30 young adult subjects (15 myopes, 15 emmetropes) at 10 different times over 2 consecutive days. Five sets of measurements were collected each day at approximately 3-hour intervals, with the first measurement taken at ~9 AM and final measurement at ~9 PM. AL underwent significant diurnal variation (P < 0.0001) that was consistently observed across the 2 measurement days. The longest AL was typically observed at the second measurement session (mean time, 12:26) and the shortest AL at the final session of each day (mean time, 21:06). The mean diurnal change in AL was 0.032 ± 0.018 mm. Choroidal thickness underwent significant diurnal variation (mean change, 0.029 ± 0.016 mm; P < 0.001) and varied approximately in antiphase to the AL changes. Significant diurnal variations were also found in vitreous chamber depth (VCD; mean change, 0.06 ± 0.029 mm; P < 0.0001) and IOP (mean change, 3.54 ± 0.84 mm Hg; P < 0.0001). A positive association was found between the variations of AL and IOP (r(2) = 0.17, P < 0.0001) and AL and VCD (r(2) = 0.31, P < 0.0001) and a negative association between AL and choroidal thickness (r(2) = 0.13, P < 0.0001). There were no significant differences in the magnitude and timing of diurnal variations associated with refractive error. Significant diurnal variations in AL, choroidal thickness, and IOP were consistently observed over 2 consecutive days of testing.

Opportunistic Visitors: Long-Term Behavioural Response of Bull Sharks to Food Provisioning in Fiji

PubMed Central

Brunnschweiler, Juerg M.; Barnett, Adam

2013-01-01

Shark-based tourism that uses bait to reliably attract certain species to specific sites so that divers can view them is a growing industry globally, but remains a controversial issue. We evaluate multi-year (2004–2011) underwater visual (n = 48 individuals) and acoustic tracking data (n = 82 transmitters; array of up to 16 receivers) of bull sharks Carcharhinus leucas from a long-term shark feeding site at the Shark Reef Marine Reserve and reefs along the Beqa Channel on the southern coast of Viti Levu, Fiji. Individual C. leucas showed varying degrees of site fidelity. Determined from acoustic tagging, the majority of C. leucas had site fidelity indexes >0.5 for the marine reserve (including the feeding site) and neighbouring reefs. However, during the time of the day (09:00–12:00) when feeding takes place, sharks mainly had site fidelity indexes <0.5 for the feeding site, regardless of feeding or non-feeding days. Site fidelity indexes determined by direct diver observation of sharks at the feeding site were lower compared to such values determined by acoustic tagging. The overall pattern for C. leucas is that, if present in the area, they are attracted to the feeding site regardless of whether feeding or non-feeding days, but they remain for longer periods of time (consecutive hours) on feeding days. The overall diel patterns in movement are for C. leucas to use the area around the feeding site in the morning before spreading out over Shark Reef throughout the day and dispersing over the entire array at night. Both focal observation and acoustic monitoring show that C. leucas intermittently leave the area for a few consecutive days throughout the year, and for longer time periods (weeks to months) at the end of the calendar year before returning to the feeding site. PMID:23516496

Opportunistic visitors: long-term behavioural response of bull sharks to food provisioning in Fiji.

PubMed

Brunnschweiler, Juerg M; Barnett, Adam

2013-01-01

Shark-based tourism that uses bait to reliably attract certain species to specific sites so that divers can view them is a growing industry globally, but remains a controversial issue. We evaluate multi-year (2004-2011) underwater visual (n = 48 individuals) and acoustic tracking data (n = 82 transmitters; array of up to 16 receivers) of bull sharks Carcharhinus leucas from a long-term shark feeding site at the Shark Reef Marine Reserve and reefs along the Beqa Channel on the southern coast of Viti Levu, Fiji. Individual C. leucas showed varying degrees of site fidelity. Determined from acoustic tagging, the majority of C. leucas had site fidelity indexes >0.5 for the marine reserve (including the feeding site) and neighbouring reefs. However, during the time of the day (09:00-12:00) when feeding takes place, sharks mainly had site fidelity indexes <0.5 for the feeding site, regardless of feeding or non-feeding days. Site fidelity indexes determined by direct diver observation of sharks at the feeding site were lower compared to such values determined by acoustic tagging. The overall pattern for C. leucas is that, if present in the area, they are attracted to the feeding site regardless of whether feeding or non-feeding days, but they remain for longer periods of time (consecutive hours) on feeding days. The overall diel patterns in movement are for C. leucas to use the area around the feeding site in the morning before spreading out over Shark Reef throughout the day and dispersing over the entire array at night. Both focal observation and acoustic monitoring show that C. leucas intermittently leave the area for a few consecutive days throughout the year, and for longer time periods (weeks to months) at the end of the calendar year before returning to the feeding site.

Impacts of the seasonal distribution of rainfall on vegetation productivity across the Sahel

NASA Astrophysics Data System (ADS)

Zhang, Wenmin; Brandt, Martin; Tong, Xiaoye; Tian, Qingjiu; Fensholt, Rasmus

2018-01-01

Climate change in drylands has caused alterations in the seasonal distribution of rainfall including increased heavy-rainfall events, longer dry spells, and a shifted timing of the wet season. Yet the aboveground net primary productivity (ANPP) in drylands is usually explained by annual-rainfall sums, disregarding the influence of the seasonal distribution of rainfall. This study tested the importance of rainfall metrics in the wet season (onset and cessation of the wet season, number of rainy days, rainfall intensity, number of consecutive dry days, and heavy-rainfall events) for growing season ANPP. We focused on the Sahel and northern Sudanian region (100-800 mm yr-1) and applied daily satellite-based rainfall estimates (CHIRPS v2.0) and growing-season-integrated normalized difference vegetation index (NDVI; MODIS) as a proxy for ANPP over the study period: 2001-2015. Growing season ANPP in the arid zone (100-300 mm yr-1) was found to be rather insensitive to variations in the seasonal-rainfall metrics, whereas vegetation in the semi-arid zone (300-700 mm yr-1) was significantly impacted by most metrics, especially by the number of rainy days and timing (onset and cessation) of the wet season. We analysed critical breakpoints for all metrics to test if vegetation response to changes in a given rainfall metric surpasses a threshold beyond which vegetation functioning is significantly altered. It was shown that growing season ANPP was particularly negatively impacted after > 14 consecutive dry days and that a rainfall intensity of ˜ 13 mm day-1 was detected for optimum growing season ANPP. We conclude that the number of rainy days and the timing of the wet season are seasonal-rainfall metrics that are decisive for favourable vegetation growth in the semi-arid Sahel and need to be considered when modelling primary productivity from rainfall in the drylands of the Sahel and elsewhere.

A combined field and laboratory design for assessing the impact of night shift work on police officer operational performance.

PubMed

Waggoner, Lauren B; Grant, Devon A; Van Dongen, Hans P A; Belenky, Gregory; Vila, Bryan

2012-11-01

This study assessed the utility of a combined field and laboratory research design for measuring the impact of consecutive night shift work on the sleepiness, vigilance, and driving performance of police patrol officers. For police patrol officers working their normal night shift duty cycles, simulated driving performance and psychomotor vigilance were measured in a laboratory on two separate occasions: in the morning after the last of five consecutive 10.7-h night shifts, and at the same time in the morning after three consecutive days off duty. Order of participation in conditions was randomized among subjects. Subjects experienced manipulation of sleep schedules due to working night shifts in a real operational environment, but performance testing was conducted under controlled laboratory conditions. N = 29 active-duty police patrol officers (27 male, 2 female; age 37.1 ± 6.3 years) working night shift schedules participated in this study. Simulated driving performance, psychomotor vigilance, and subjective sleepiness were significantly degraded following 5 consecutive night shifts as compared to 3 consecutive days off duty, indicating that active-duty police officers are susceptible to performance degradation as a consequence of working nights. This combined field and laboratory research design succeeded in bridging the gap between the realism of the operational environment and the control of laboratory performance testing, demonstrating that this is a useful approach for addressing the relationship between shift work induced fatigue and critical operational task performance.

Effect of working consecutive night shifts on sleep time, prior wakefulness, perceived levels of fatigue and performance on a psychometric test in emergency registrars.

PubMed

Haire, Julia Christine Lydia; Ferguson, Sally Anne; Tilleard, James D; Negus, Paul; Dorrian, Jillian; Thomas, Matthew Jw

2012-06-01

To evaluate the effect of working consecutive night shifts on sleep time, prior wakefulness, perceived levels of fatigue and psychomotor performance in a group of Australian emergency registrars. A prospective observational study with a repeated within-subjects component was conducted. Sleep time was determined using sleep diaries and activity monitors. Subjective fatigue levels and reciprocal reaction times were evaluated before and after day and night shifts. A total of 11 registrars participated in the study with 120 shifts analysed. Sleep time was found to be similar during consecutive night and day shifts. The mean number of hours spent awake before the end of a night shift was 14.33. Subjective fatigue scores were worst at the end of a night shift. There was no difference in reciprocal reaction time between the end of night shift and the start of day shift. Registrars sleep a similar amount of time surrounding night and day shifts. Despite reporting the highest levels of fatigue at the end of a night shift, there is no significant difference in reaction times at the end of night shift compared with the beginning of day shift. This correlates with the finding that at the end of night shift the registrars have been awake for less than 16 h, which is the point at which psychomotor performance is expected to decline. © 2012 The Authors. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

40 CFR 418.12 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... exceed— Total phosphorus (as P) 105 35 Fluoride 75 25 TSS 150 50 The total suspended solid limitation set...) Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Total phosphorus...

40 CFR 418.12 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... exceed— Total phosphorus (as P) 105 35 Fluoride 75 25 TSS 150 50 The total suspended solid limitation set...) Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Total phosphorus...

Probability analysis for consecutive-day maximum rainfall for Tiruchirapalli City (south India, Asia)

NASA Astrophysics Data System (ADS)

Sabarish, R. Mani; Narasimhan, R.; Chandhru, A. R.; Suribabu, C. R.; Sudharsan, J.; Nithiyanantham, S.

2017-05-01

In the design of irrigation and other hydraulic structures, evaluating the magnitude of extreme rainfall for a specific probability of occurrence is of much importance. The capacity of such structures is usually designed to cater to the probability of occurrence of extreme rainfall during its lifetime. In this study, an extreme value analysis of rainfall for Tiruchirapalli City in Tamil Nadu was carried out using 100 years of rainfall data. Statistical methods were used in the analysis. The best-fit probability distribution was evaluated for 1, 2, 3, 4 and 5 days of continuous maximum rainfall. The goodness of fit was evaluated using Chi-square test. The results of the goodness-of-fit tests indicate that log-Pearson type III method is the overall best-fit probability distribution for 1-day maximum rainfall and consecutive 2-, 3-, 4-, 5- and 6-day maximum rainfall series of Tiruchirapalli. To be reliable, the forecasted maximum rainfalls for the selected return periods are evaluated in comparison with the results of the plotting position.

ENDOGENOUS FORMATION OF N-NITROSOMORPHOLINE IN MICE FROM 15NO2 BY INHALATION AND MORPHOLINE BY GAVAGE

EPA Science Inventory

Male CD-1 mice were exposed to a nominal concentration of 20 ppm of 15N-nitrogen dioxide (15NO2) for 6 hr/day for 4 days and for 2 hr on the fifth day, and to 1g morpholine/kg body weight by gavage daily for 5 consecutive days. -nitrosomorpholine (NMOR) was found in whole mice, s...

Granulocyte-Colony Stimulating Factor (G-CSF) Administration for Chemotherapy-Induced Neutropenia.

PubMed

Yalçin, Ş; Güler, N; Kansu, E; Ertenli, I; Güllü, I; Barişta, I; Çelik, I; Kars, A; Tekuzman, G; Baltali, E; Firat, D

1996-01-01

This study was aimed to evaluate the efficacy of G-CSF (Granulocyte colony stimulating factor) administration to 37 patients with neutropenia following intensive combination chemotherapy. The patients were divided into two subgroups including solid tumors given ifosfamide and etoposide combination chemotherapy (IMET subgroup) and acute myeloid leukemia (AML) patients treated with mitoxantrone and cytarabine. Control group consisted of 31 acute myeloid leukemia patients. G-CSF was started on the first day of absolute neutropenia until the absolute neutrophil count was above 1000/mm(3) for two consecutive days. G-CSF was found to be effective for early recovery of neutrophil count. Expected response was achieved within 14 days in 91.5% of the courses with a median of fifth day of G-CSF treatment. In conclusion, this study showed the efficacy of G-CSF in early recovery of neutrophil count without any reduction in the incidence of febrile episodes and documented rates of bacterial and fungal infections in patients with acute myeloid leukemia.

A simple experimental method to study depigmenting agents.

PubMed

Abella, M L; de Rigal, J; Neveux, S

2007-08-01

The first objective of the study was to verify that a controlled UV exposure of four areas of the forearms together with randomized product application enabled to compare treatment efficacy and then to compare the depigmenting efficacy of different products with a simple experimental method. Sixteen volunteers received 0.7 minimal erythermal dose for four consecutive days. Products tested were ellagic acid (0.5%), vitamin C (5%) and C8-LHA (2%). Product application started 72 h post last exposure, was repeated for 42 days, the control zone being exposed, non-treated. Colour measurements included Chromameter, Chromasphere, Spectro-colorimeter and visual assessment. Comparison of colour values at day 1 and at day 7 showed that all zones were comparably tanned, allowing a rigorous comparison of the treatments. We report a new simple experimental model, which enables the rapid comparison of different depigmenting products. The efficacy and good tolerance of C8-LHA make it an excellent candidate for the treatment of hyperpigmentory disorders.

Pregabalin in the treatment of inferior alveolar nerve paraesthesia following overfilling of endodontic sealer

PubMed Central

Alonso-Ezpeleta, Oscar; Martín, Pablo J.; López-López, José; Castellanos-Cosano, Lizett; Martín-González, Jenifer; Segura-Egea, Juan J.

2014-01-01

A case of orofacial pain and inferior alveolar nerve (IAN) paraesthesia after extrusion of endodontic sealer within the mandibular canal treated with prednisone and pregabalin is described. A 36-year-old woman underwent root canal treatment of the mandibular second right premolar tooth. Post-operative panoramic radiograph revealed the presence of radiopaque canal sealer in the mandibular canal. Damage to IAN consecutive to extrusion of endodontic sealer was diagnosed. Non-surgical management was decided, including: 1 mg/kg/day prednisone 2 times/day, once-daily regimen, and 150 mg/day pregabalin, two doses per day, monitoring the progress with periodic follow-up visits. Six weeks after the incident the signs and symptoms were gone. The complete resolution of paraesthesia and the control of pain achieved suggest that a non-surgical approach, combining prednisone and the GABA analogue pregabalin, is a good option in the management of the IAN damage subsequent to endodontic sealer extrusion. Key words:Endodontics, inferior alveolar nerve, neuropathic pain, orofacial pain, paraesthesia, pregabalin. PMID:24790724

Effect of day of the week of primary total hip arthroplasty on length of stay at a university-based teaching medical center.

PubMed

Rathi, Pranav; Coleman, Sheldon; Durbin-Johnson, Blythe; Giordani, Mauro; Pereira, Gavin; Di Cesare, Paul E

2014-12-01

Length of hospital stay (LHS) after primary total hip arthroplasty (THA) constitutes a critical outcome measure, as prolonged LHS implies increased resource expenditure. Investigations have highlighted factors that affect LHS after THA. These factors include advanced age, medical comorbidities, obesity, intraoperative time, anesthesia technique, surgical site infection, and incision length. We retrospectively analyzed the effect of day of the week of primary THA on LHS. We reviewed the surgery and patient factors of 273 consecutive patients who underwent THA at our institution, a tertiary-care teaching hospital. There was a 15% increase in LHS for patients who underwent THA on Thursday versus Monday when controlling for other covariates that can affect LHS. Other statistically significant variables associated with increased LHS included American Society of Anesthesiologists grade, transfusion requirements, and postoperative complications. The day of the week of THA may be an independent variable affecting LHS. Institutions with reduced weekend resources may want to perform THA earlier in the week to try to reduce LHS.

Effect of Day of the Week of Primary Total Hip Arthroplasty on Length of Stay at a University-Based Teaching Medical Center

PubMed Central

Rathi, Pranav; Coleman, Sheldon; Durbin-Johnson, Blythe; Giordani, Mauro; Pereira, Gavin; Di Cesare, Paul E.

2016-01-01

Length of hospital stay (LHS) after primary total hip arthroplasty (THA) constitutes a critical outcome measure, as prolonged LHS implies increased resource expenditure. Investigations have highlighted factors that affect LHS after THA. These factors include advanced age, medical comorbidities, obesity, intraoperative time, anesthesia technique, surgical site infection, and incision length. We retrospectively analyzed the effect of day of the week of primary THA on LHS. We reviewed the surgery and patient factors of 273 consecutive patients who underwent THA at our institution, a tertiary-care teaching hospital. There was a 15% increase in LHS for patients who underwent THA on Thursday versus Monday when controlling for other covariates that can affect LHS. Other statistically significant variables associated with increased LHS included American Society of Anesthesiologists grade, transfusion requirements, and post-operative complications. The day of the week of THA may be an independent variable affecting LHS. Institutions with reduced weekend resources may want to perform THA earlier in the week to try to reduce LHS. PMID:25490016

Evaluation of effect of minocycline on rewarding potential and alcohol relapse in place preference model in mice.

PubMed

Gajbhiye, Snehalata V; Tripathi, Raakhi K; Salve, Bharat; Petare, Anup; Potey, Anirudha V

2017-05-10

Medical management for alcohol abuse has limitations. Alcohol consumption activates N-methyl-d-aspartate receptors and release of nitric oxide which can be inhibited by minocycline as it readily crosses blood brain barrier and may have effect on alcohol consumption. Thus, study objective is to evaluate the effect of minocycline on rewarding property, extinction and the reinstatement phenomenon induced by alcohol in a model of conditioned place preference (CPP) in mice. To evaluate rewarding effects of alcohol, CPP procedure consisted of 4 parts, including adaptation (day 1), pre-conditioning test (day 2), conditionings with alcohol (days 3, 5, 7 and 9) or saline (days 4, 6, 8 and 10) and postconditioning test (day 11) conducted on 11 consecutive days. The groups included were saline treated group (alcohol control), naltrexone - 1mg/kg (positive control), and minocycline in the doses of 10, 30 and 50mg/kg. To evaluate the effect of minocycline on alcohol relapse, CPP procedure consisted 6 parts, the first 4 were the same as enumerated above followed by extinction (days 12-16) and reinstatement phase (day 17). The time spent in alcohol paired compartment by different groups, revealed that minocycline and naltrexone significantly attenuated alcohol-induced place preference compared to alcohol control (p<0.05). Pretreatment with minocycline and naltrexone blocked reinstatement of extinguished CPP. Minocycline may have a role in attenuating the rewarding property of alcohol and prevent alcohol relapse. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluation of propolis, honey, and royal jelly in amelioration of peripheral blood leukocytes and lung inflammation in mouse conalbumin-induced asthma model

PubMed Central

El-Aidy, Waleed K.; Ebeid, Ahmad A.; Sallam, Abd El-Raouf M.; Muhammad, Ibrahim E.; Abbas, Ayman T.; Kamal, M.A.; Sohrab, Sayed Sartaj

2014-01-01

Bee products have been used since ancient times to treat many diseases, including respiratory ailments. The present study aimed to examine the modulatory effect of honey, royal jelly, and propolis extract on peripheral blood leukocytes and lung inflammation in a mouse conalbumin-induced asthma model. The mice in group I were not sensitised or treated; they were kept as controls. The mice in group II were sensitised and challenged with conalbumin. Twenty-four hours after the first challenge with antigen, the mice in group III received 0.5 mg/kg of dexamethasone intraperitoneally per day for 18 consecutive days and kept as positive controls. The mice in groups IV, V, and VI received 650, 1000, and 30 mg/kg of honey, royal jelly, and propolis (aqueous and ethanolic extract), respectively, once per day for 18 consecutive days. Blood was collected from all of the mice for white blood cell differentiation, and the lungs were removed for histopathological studies. The groups treated with propolis extract exhibited considerable ameliorative effects against asthma, which might be explained by the flavonoids and phenolics found in propolis, which might have antioxidative effects. Otherwise, the sensitised and honey- or royal jelly-treated groups exhibited an increased incidence of asthma cascade events due to increased inflammatory cells. These results might be due to the immunostimulatory and vasodilatory effects of royal jelly and honey, which are antagonistic to bronchial asthma cases. Histopathological examination revealed that the sensitised treated propolis extract groups had significant decreases in inflammatory scores compared with other treatments and the sensitised untreated group. These results confirmed the previous data of peripheral blood cells. PMID:26587007

Evaluation of propolis, honey, and royal jelly in amelioration of peripheral blood leukocytes and lung inflammation in mouse conalbumin-induced asthma model.

PubMed

El-Aidy, Waleed K; Ebeid, Ahmad A; Sallam, Abd El-Raouf M; Muhammad, Ibrahim E; Abbas, Ayman T; Kamal, M A; Sohrab, Sayed Sartaj

2015-11-01

Bee products have been used since ancient times to treat many diseases, including respiratory ailments. The present study aimed to examine the modulatory effect of honey, royal jelly, and propolis extract on peripheral blood leukocytes and lung inflammation in a mouse conalbumin-induced asthma model. The mice in group I were not sensitised or treated; they were kept as controls. The mice in group II were sensitised and challenged with conalbumin. Twenty-four hours after the first challenge with antigen, the mice in group III received 0.5 mg/kg of dexamethasone intraperitoneally per day for 18 consecutive days and kept as positive controls. The mice in groups IV, V, and VI received 650, 1000, and 30 mg/kg of honey, royal jelly, and propolis (aqueous and ethanolic extract), respectively, once per day for 18 consecutive days. Blood was collected from all of the mice for white blood cell differentiation, and the lungs were removed for histopathological studies. The groups treated with propolis extract exhibited considerable ameliorative effects against asthma, which might be explained by the flavonoids and phenolics found in propolis, which might have antioxidative effects. Otherwise, the sensitised and honey- or royal jelly-treated groups exhibited an increased incidence of asthma cascade events due to increased inflammatory cells. These results might be due to the immunostimulatory and vasodilatory effects of royal jelly and honey, which are antagonistic to bronchial asthma cases. Histopathological examination revealed that the sensitised treated propolis extract groups had significant decreases in inflammatory scores compared with other treatments and the sensitised untreated group. These results confirmed the previous data of peripheral blood cells.

Complications following prostate needle biopsy requiring hospital admission or emergency department visits - experience from 1000 consecutive cases.

PubMed

Pinkhasov, G Igor; Lin, Yu-Kuan; Palmerola, Ricardo; Smith, Paul; Mahon, Frank; Kaag, Matthew G; Dagen, J Edward; Harpster, Lewis E; Reese, Carl T; Raman, Jay D

2012-08-01

• To review a contemporary cohort of patients undergoing a transrectal ultrasound-guided prostate needle biopsy (TRUS PNBx) at a single centre to determine the incidence of major complications necessitating hospital admission or emergency department (ED) visits. • The charts of 1000 consecutive patients undergoing TRUS PNBx were reviewed. • All patients received peri-procedural antibiotic prophylaxis with either ciprofloxacin or co-trimoxazole. • Hospital admission and ED visits within 30 days of the procedure were identified for indication, management and outcome. • Patient comorbidities and biopsy characteristics were reviewed for association with complications. • Of the 1000 patients, 25 (2.5%) had post-biopsy complications requiring hospital admission or an ED visit. • Indications included twelve patients (1.2%) with urosepsis, eight (0.8%) with acute urinary retention requiring urethral catheterization, four (0.4%) with gross haematuria requiring bladder irrigation for <24 h, and one (0.1%) with a transient ischaemia attack 1 day after biopsy. • Patients with urosepsis had an average hospitalization of 5 days, and 75% carried quinolone-resistant Escherichia coli organisms. • All patients with urinary retention had catheters removed within 10 days. No patients with haematuria required a blood transfusion. • No demographic or biopsy variables were particularly associated with development of a post-procedure complication. • In this large contemporary series of TRUS PNBx, we observed a 2.5% rate of major complications requiring hospital admission or an ED visit. • No clinical or biopsy variables were directly associated with development of complications. • These data may be valuable when counselling patients before biopsy. © 2012 THE AUTHORS. BJU INTERNATIONAL © 2012 BJU INTERNATIONAL.

The optimal duration of frequency-volume charts related to compliance and reliability.

PubMed

van Haarst, Ernst P; Bosch, J L H Ruud

2014-03-01

To assess Frequency-volume charts (FVCs) for the yield of additional recorded days and the ideal duration of recording related to compliance and reliability. Of 500 consecutive urologic outpatients willing to complete a 7-day FVC, 378 FVCs were evaluable. During seven consecutive days every voiding time and volume were recorded. Missed entries were indicated with a coded letter, thereby assessing the true frequency and compliance. Reliability is the agreement of the day-to-day FVC parameters with the 7-day FVC pattern. Single-day reliability was assessed and used in the Spearman-Brown formula. FVCs of 228 male and 150 females were evaluated. Mean age was 55.2 years (standard deviation [SD]: 16.2 years), and mean 24-hr urine production was 1,856 ml (SD: 828 ml). The percentage of patients with complete FVCs decreased from 78% on day 2 to 58% on day 7, and dropped below 70% after 4 days. Single-day reliability was r = 0.63 for nocturnal urine production, r = 0.72 for 24-hr urine production, and r = 0.80 for mean voided volume. At 5 days, reliability of 90% was achieved for all parameters. With each additional day, FVCs showed a decrease in compliance and an increase in reliability. At day 3, reliability of 80% was achieved for all FVC parameters, but compliance dropped to 73%. Beyond 5 days, the yield of additional recorded days was limited. We advocate an FVC duration of 3 days, but the duration may be shortened or extended depending on the goal of the FVC. © 2013 Wiley Periodicals, Inc.

Implementation of a guideline for physical therapy in the postoperative period of upper abdominal surgery reduces the incidence of atelectasis and length of hospital stay.

PubMed

Souza Possa, S; Braga Amador, C; Meira Costa, A; Takahama Sakamoto, E; Seiko Kondo, C; Maida Vasconcellos, A L; Moran de Brito, C M; Pereira Yamaguti, W

2014-01-01

The aim of this study was to evaluate the effectiveness of implementing a physical therapy guideline for patients undergoing upper abdominal surgery (UAS) in reducing the incidence of atelectasis and length of hospital stay in the postoperative period. A "before and after" study design with historical control was used. The "before" period included consecutive patients who underwent UAS before guideline implementation (intervention). The "after" period included consecutive patients after guideline implementation. Patients in the pre-intervention period were submitted to a program of physical therapy in which the treatment planning was based on the individual experience of each professional. On the other hand, patients who were included in the post-intervention period underwent a standardized program of physical therapy with a focus on the use of additional strategies (EPAP, incentive spirometry and early mobilization). There was a significant increase in the use of incentive spirometry and positive expiratory airway pressure after guideline implementation. Moreover, it was observed that early ambulation occurred in all patients in the post-intervention period. No patient who adhered totally to the guideline in the post-intervention period developed atelectasis. Individuals in the post-intervention period presented a shorter length of hospital stay (9.2±4.1 days) compared to patients in the pre-intervention period (12.1±8.3 days) (p<0.05). The implementation of a physical therapy guideline for patients undergoing UAS resulted in reduced incidence of atelectasis and reduction in length of hospital stay in the postoperative period. Copyright © 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

The consecutive dry days to trigger rainfall over West Africa

NASA Astrophysics Data System (ADS)

Lee, J. H.

2018-01-01

In order to resolve contradictions in addressing a soil moisture-precipitation feedback mechanism over West Africa and to clarify the impact of antecedent soil moisture on subsequent rainfall evolution, we first validated various data sets (SMOS satellite soil moisture observations, NOAH land surface model, TRMM rainfall, CMORPH rainfall and HadGEM climate models) with the Analyses Multidisciplinaires de la Mousson Africaine (AMMA) field campaign data. Based on this analysis, it was suggested that biases of data sets might cause contradictions in studying mechanisms. Thus, by taking into account uncertainties in data, it was found that the approach of consecutive dry days (i.e. a relative comparison of time-series) showed consistency across various data sets, while the direct comparison approach for soil moisture state and rainfall did not. Thus, it was discussed that it may be difficult to directly relate rain with soil moisture as the absolute value, however, it may be reasonable to compare a temporal progress of the variables. Based upon the results consistently showing a positive relationship between the consecutive dry days and rainfall, this study supports a negative feedback often neglected by climate model structure. This approach is less sensitive to interpretation errors arising from systematic errors in data sets, as this measures a temporal gradient of soil moisture state.

Efficacy of metaphylactic florfenicol therapy during natural outbreaks of bovine respiratory disease.

PubMed

Catry, B; Duchateau, L; Van de Ven, J; Laevens, H; Opsomer, G; Haesebrouck, F; De Kruif, A

2008-10-01

The efficacy of an injectable formulation of florfenicol (300 mg/mL) as metaphylactic control of naturally occurring bovine respiratory disease (BRD) was evaluated in two double-blind randomly controlled field studies on two Dutch veal calf herds (A and B). Cattle aged not older than 3 months and in the direct presence of calves with clinical respiratory disease were randomly allocated to treatment with 40 mg/kg florfenicol subcutaneously (s.c.) a positive control treatment (12.5 mg/kg tilmicosin p.o. twice daily for five consecutive days in herd A, and 12.5 mg/kg doxycycline p.o. twice daily for five consecutive days in herd B), or a negative control (one placebo saline s.c. administration on D0). The predominant respiratory pathogens present in pretreatment respiratory samples from affected animals were Mycoplasma bovis and Pasteurella multocida in outbreaks A and B, respectively. Metaphylactic administration of florfenicol resulted in a statistically significant weight gain, decreased rectal temperature for five consecutive days after treatment and decreased metaphylactic failure percentages compared with both positive and negative control groups. In summary, these studies demonstrated that a single s.c. injection of florfenicol is effective and practical for control of the bacterial component of BRD in veal calves.

Distraction, not hunger, is associated with lower mood and lower perceived work performance on fast compared to non-fast days during intermittent fasting.

PubMed

Appleton, Katherine M; Baker, Stephanie

2015-06-01

Using a repeated measures design, 16 females recorded hunger, distraction, mood and perceived work performance on two consecutive fast days, on two earlier and on two subsequent consecutive non-fast days, during intermittent fasting. Using regression analyses, low positive mood was associated with higher distraction (β = -0.38, p < 0.01), and lower perceived work performance was associated with higher distraction (β = -0.50, p < 0.01) and lower positive mood (β = 0.59, p = 0.01). No associations were found with hunger (largest β = -0.11, p = 0.15). Associations between mood, perceived work performance and distraction but not hunger mirror those found in traditional dieting and suggest no benefit for attention from intermittent fasting-type regimes. © The Author(s) 2015.

Predictive variables for postoperative pain after 520 consecutive dental extraction surgeries.

PubMed

Bortoluzzi, Marcelo Carlos; Manfro, Aline Rosler Grings; Nodari, Rudy Jose; Presta, Andreia Antoniuk

2012-01-01

The aim of this study was to evaluate postoperative pain in patients who had a single tooth or multiple erupted teeth extracted. This research evaluated 520 consecutive dental extraction surgeries in which 680 teeth were removed. Data collection was obtained through a questionnaire of patients and of the undergraduate students who performed all procedures. Pain was evaluated through qualitative self-reported scores at seven days postsurgery. An increased pain level was statistically associated with ostectomy, postoperative complications, and tobacco consumption. Pain that persisted for more than two days was statistically associated with the amount of anesthetic solution used, with a notable increase in surgical time and development of postoperative complications. Periods of pain lasting more than two days could be expected for traumatic surgeries lasting more than 30 minutes. Both severe and prolonged pain were signs of development of postoperative complications, such as alveolar osteitis and alveolar infection.

[Intensive hemoperfusion and long-term hemofiltration for treatment of paraquat poisoning: a case report].

PubMed

Peng, Zhi-Yun; Chang, Ping; Wang, Hua; Cen, Zhong-Ran; Zhou, Jian; Liu, Zhan-Guo

2015-10-01

A 20-year-old male patient was admitted in our department 14 h after paraquat poisoning at the dose of about 50 mL. The patient underwent intensive hemoperfusion for 2 h (3 times a day) for 9 consecutive days and received continuous renal replacement therapy (CRRT) in the mode of continuous veno-venous hemofiltration (CVVH) for 10 consecutive days in addition to routine medications. The biochemical indexes were monitored during the therapy. After the treatment, paraquat concentrations in the blood and urine were decreased, and the patient's urine volume (UV) increased, serum creatinine (Cr) level decreased, and the oxygenation index became normal. Dynamic CT scan showed no obvious pulmonary fibrosis. The patient was followed up for 6 months after discharge and no complaint of discomforts was reported. This case suggests that early intensive hemoperfusion and long-term CVVH may help improve the prognosis after paraquat poisoning.

Changes in extreme temperature and precipitation events in the Loess Plateau (China) during 1960-2013 under global warming

NASA Astrophysics Data System (ADS)

Sun, Wenyi; Mu, Xingmin; Song, Xiaoyan; Wu, Dan; Cheng, Aifang; Qiu, Bing

2016-02-01

In recent decades, extreme climatic events have been a major issue worldwide. Regional assessments on various climates and geographic regions are needed for understanding uncertainties in extreme events' responses to global warming. The objective of this study was to assess the annual and decadal trends in 12 extreme temperature and 10 extreme precipitation indices in terms of intensity, frequency, and duration over the Loess Plateau during 1960-2013. The results indicated that the regionally averaged trends in temperature extremes were consistent with global warming. The occurrence of warm extremes, including summer days (SU), tropical nights (TR), warm days (TX90), and nights (TN90) and a warm spell duration indicator (WSDI), increased by 2.76 (P < 0.01), 1.24 (P < 0.01), 2.60 (P = 0.0003), 3.41 (P < 0.01), and 0.68 (P = 0.0041) days/decade during the period of 1960-2013, particularly, sharp increases in these indices occurred in 1985-2000. Over the same period, the occurrence of cold extremes, including frost days (FD), ice days (ID), cold days (TX10) and nights (TN10), and a cold spell duration indicator (CSDI) exhibited decreases of - 3.22 (P < 0.01), - 2.21 (P = 0.0028), - 2.71 (P = 0.0028), - 4.31 (P < 0.01), and - 0.69 (P = 0.0951) days/decade, respectively. Moreover, extreme warm events in most regions tended to increase while cold indices tended to decrease in the Loess Plateau, but the trend magnitudes of cold extremes were greater than those of warm extremes. The growing season (GSL) in the Loess Plateau was lengthened at a rate of 3.16 days/decade (P < 0.01). Diurnal temperature range (DTR) declined at a rate of - 0.06 °C /decade (P = 0.0931). Regarding the precipitation indices, the annual total precipitation (PRCPTOT) showed no obvious trends (P = 0.7828). The regionally averaged daily rainfall intensity (SDII) exhibited significant decreases (- 0.14 mm/day/decade, P = 0.0158), whereas consecutive dry days (CDD) significantly increased (1.96 days/decade, P = 0.0001) during 1960-2013. Most of stations with significant changes in SDII and CDD occurred in central and southeastern Loess Plateau. However, the changes in days of erosive rainfall, heavy rain, rainstorm, maximum 5-day precipitation, and very-wet-day and extremely wet-day precipitation were not significant. Large-scale atmospheric circulation indices, such as the Western Pacific Subtropical High Intensity Index (WPSHII) and Arctic Oscillation (AO), strongly influences warm/cold extremes and contributes significantly to climate changes in the Loess Plateau. The enhanced geopotential height over the Eurasian continent and increase in water vapor divergence in the rainy season have contributed to the changes of the rapid warming and consecutive drying in the Loess Plateau.

Impacts of air pollution wave on years of life lost: A crucial way to communicate the health risks of air pollution to the public.

PubMed

Huang, Jing; Pan, Xiaochuan; Guo, Xinbiao; Li, Guoxing

2018-04-01

Limited studies have explored the impacts of exposure to sustained high levels of air pollution (air pollution wave) on mortality. Given that the frequency, intensity and duration of air pollution wave has been increasing in highly polluted regions recently, understanding the impacts of air pollution wave is crucial. In this study, air pollution wave was defined as 2 or more consecutive days with air pollution index (API) > 100. The impacts of air pollution wave on years of life lost (YLL) due to non-accidental, cardiovascular and respiratory deaths were evaluated by considering both consecutive days with high levels of air pollution and daily air pollution levels in Tianjin, China, from 2006 to 2011. The results showed the durational effect of consecutive days with high levels of air pollution was substantial in addition to the effect of daily air pollution. For instance, the durational effect was related to an increase in YLL of 116.6 (95% CI: 4.8, 228.5) years from non-accidental deaths when the air pollution wave was sustained for 4 days, while the corresponding daily air pollution's effect was 121.2 (95% CI: 55.2, 187.1) years. A better interpretation of the health risks of air pollution wave is crucial for air pollution control policy making and public health interventions. Copyright © 2018 Elsevier Ltd. All rights reserved.

Energy Drinks and Alcohol: Links to Alcohol Behaviors and Consequences Across 56 Days

PubMed Central

Patrick, Megan E.; Maggs, Jennifer L.

2013-01-01

Purpose To examine short-term consequences associated with consuming alcohol and energy drinks compared with consuming alcohol without energy drinks. Methods A longitudinal measurement-burst design (14-day bursts of daily surveys in four consecutive college semesters) captured both within-person variation across occasions and between-person differences across individuals. The analytic sample of late adolescent alcohol users included 4,203 days with alcohol use across up to four semesters per person from 508 college students. Results Adding energy drink use to a given day with alcohol use was associated with an increase in number of alcoholic drinks, a trend toward more hours spent drinking, elevated estimated blood alcohol content (eBAC), a greater likelihood of subjective intoxication, and more negative consequences of drinking that day. After controlling for eBAC, energy drink use no longer predicted subjective intoxication but was still associated with a greater number of negative consequences. Conclusions The consumption of energy drinks may lead to increases in alcohol consumption and, after controlling for eBAC, negative consequences. Use of energy drinks plus alcohol represents an emerging threat to public health. PMID:24309196

Survey of carbamate and organophosphorous pesticide export from a south Florida (U.S.A.) agricultural watershed: implications of sampling frequency on ecological risk estimation.

PubMed

Wilsont, P Chris; Foos, Jane Ferguson

2006-11-01

The objectives of the present study were to characterize the presence of selected carbamate and organophosphorous pesticides in Ten Mile Creek (Fort Pierce, FL, U.S.A.) and to evaluate the implications of sampling frequency on ecological risk estimates. Ten Mile Creek originates in a predominately agricultural watershed that is drained by an extensive network of cross-linked canals. Water samples were collected daily or every other day and were analyzed for azinphos-methyl, chlorpyrifos, diazinon, dimethoate, ethion, fenamiphos, malathion, methidathion, carbaryl, carbofuran, 3-hydroxycarbofuran, methiocarb, methomyl, oxamyl, and propoxur. A total of 457 samples were analyzed for the carbamate suite, and a total of 332 samples were analyzed for the organophosphorous suite. Carbaryl was detected in eight samples; half of these detections occurred on four consecutive days (October 26-29, 2001) at concentrations ranging from 0.33 to 0.95 microg/L. Methomyl was detected in samples collected on five consecutive days (March 30-April 3, 2002) at concentrations ranging from 1.0 to 2.2 microg/L. Oxamyl was detected in four samples, three of which occurred on three consecutive days (February 17-19, 2002) at concentrations ranging from 6.2 to 6.8 microg/L. The carbamates propoxur, 3-hydroxycarbofuran, carbofuran, and methiocarb were not detected. Diazinon and ethion were the only organophosphorous pesticides detected. Diazinon was detected at 0.9 and 0.7 microg/L on January 5, 2002, and on January 6, 2002, respectively. Ethion was detected in 18 consecutive samples (August 3-20, 2001). The mean, maximum, minimum, and median detected concentrations were 0.38, 0.61, 0.30, and 0.33 microg/L, respectively. Results indicate that frequent sampling is necessary to characterize the presence of these pesticides in this intensively drained watershed. This conclusion also may apply to similar canalized watersheds.

Police Work Absence: An Analysis of Stress and Resiliency

PubMed Central

Fekedulegn, Desta; Hartley, Tara A.; Andrew, Michael E.; Charles, Luenda; Tinney-Zara, Cathy A.; Burchfiel, Cecil M.

2015-01-01

Police work is a high stress occupation and stress has been implicated in work absence. The present study examined (1) associations between specific types of police stress and work absences, (2) distinctions between “voluntary” (1-day) and “involuntary” (> 3-days) absences; and (3) the modifying effect of resiliency. Officers (n=337) from the Buffalo Cardio-Metabolic Occupational Police Stress study were included in the present study. The sample was 72% male, 77% Caucasian, 73% married, and 75% patrol officers. Mean age was 41 years (SD=6.4). Measures included: the Spielberger Police Stress Survey, 1-year payroll absence data, and the Dispositional Resilience Scale. The negative binomial regression was used to estimate rate ratios (RR) of 1-day and >3-days work absences for increasing stress scores. Models were adjusted for age, race/ethnicity, rank, smoking status, alcohol intake, and sleep duration. For one-unit increase in stress scores, the covariate adjusted RRs for one-day work absences were: total stress score (RR=1.19, 95% CI: 1.04–1.36); administrative stress (RR=1.52, 95% CI: 1.05–2.18); physical/psychological stress (RR=1.54, 95% CI: 1.14–2.07); and lack of support (RR=1.75, 95% CI: 1.01–3.05). Results suggest that officers were more likely to take voluntary 1-day absences due to specific types of stress at work. When the entire sample was considered, there was no significant association between police specific stress and episodes of work absence lasting at least three consecutive days. Hardy individuals, including those with high scores on the challenge sub-score, may use 1-day absences as a positive coping strategy. PMID:26709384

The 1996 NASA Aerospace Battery Workshop

NASA Technical Reports Server (NTRS)

Brewer, Jeffrey C. (Compiler)

1997-01-01

The 1996 Workshop was held on three consecutive days and was divided into five sessions. The first day consisted of a General Primary Battery Session and a Nickel-Hydrogen Battery On-Orbit Reconditioning Experience Focused Session. The second day consisted of a Nickel-Hydrogen Session and a Nickel-Cadmium Session. The third and final day was devoted to an Other Secondary Technologies Session which covered sodium-sulfur, nickel-zinc, nickel-metal hydride, and lithium ion technologies.

40 CFR 415.66 - Pretreatment standards for new sources (PSNS).

Code of Federal Regulations, 2011 CFR

2011-07-01

... the mercury cell process, which introduces pollutants into a publicly owned treatment works, must...): Subpart F—Chlor-Alkali-Mercury Cells Pollutant or pollutant property PSNS effluent limitations Maximum for any 1 day Average of daily values for 30 consecutive days Milligrams per liter Mercury (T) 0.11 0.048...

40 CFR 418.13 - Effluent limitations and guidelines representing the degree of effluent reduction attained by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Total phosphorus... exceed— Total phosphorus (as P) 105 35 Fluoride 75 25 [39 FR 12836, Apr. 8, 1974, as amended at 41 FR...

40 CFR 418.13 - Effluent limitations and guidelines representing the degree of effluent reduction attained by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Total phosphorus... exceed— Total phosphorus (as P) 105 35 Fluoride 75 25 [39 FR 12836, Apr. 8, 1974, as amended at 41 FR...

47 CFR 73.691 - Visual modulation monitoring.

Code of Federal Regulations, 2010 CFR

2010-10-01

... must have measuring equipment for determining that the transmitted visual signal conforms to the... a period of not more than 30 days without specific authority from the FCC: provided that, the date... operation at variance will exceed 10 consecutive days, a notification must be sent to the FCC in Washington...

PROBABILITIES OF TEMPERATURE EXTREMES IN THE U.S.

EPA Science Inventory

The model Temperature Extremes Version 1.0 provides the capability to estimate the probability, for 332 locations in the 50 U.S. states, that an extreme temperature will occur for one or more consecutive days and/or for any number of days in a given month or season, based on stat...

21 CFR 526.313 - Ceftiofur.

Code of Federal Regulations, 2010 CFR

2010-04-01

... by or on the order of a licensed veterinarian. (e) Conditions of use in cattle—(1) Lactating cows—(i... Escherichia coli. (iii) Limitations. Milk taken from cows during treatment (a maximum of eight daily infusions... for up to 8 consecutive days, a 2-day pre-slaughter withdrawal period is required. (2) Dry cows—(i...

[Equating scores using bridging stations on the clinical performance examination].

PubMed

Yoo, Dong-Mi; Han, Jae-Jin

2013-06-01

This study examined the use of the Tucker linear equating method in producing an individual student's score in 3 groups with bridging stations over 3 consecutive days of the clinical performance examination (CPX) and compared the differences in scoring patterns by bridging number. Data were drawn from 88 examinees from 3 different CPX groups-DAY1, DAY2, and DAY3-each of which comprised of 6 stations. Each group had 3 common stations, and each group had 2 or 3 stations that differed from other groups. DAY1 and DAY3 were equated to DAY2. Equated mean scores and standard deviations were compared with the originals. DAY1 and DAY3 were equated again, and the differences in scores (equated score-raw score) were compared between the 3 sets of equated scores. By equating to DAY2, DAY1 decreased in mean score from 58.188 to 56.549 and in standard deviation from 4.991 to 5.046, and DAY3 fell in mean score from 58.351 to 58.057 and in standard deviation from 5.546 to 5.856, which demonstrates that the scores of examinees in DAY1 and DAY2 were accentuated after use of the equation. The patterns in score differences between the equated sets to DAY1, DAY2, and DAY3 yielded information on the soundness of the equating results from individual and overall comparisons. To generate equated scores between 3 groups on 3 consecutive days of the CPX, we applied the Tucker linear equating method. We also present a method of equating reciprocal days to the anchoring day as much as bridging stations.

Screen and effect analysis of immunostimulants for sea cucumber, Apostichopus japonicus

NASA Astrophysics Data System (ADS)

Li, Jiye; Sun, Xiuqin; Zheng, Fengrong; Hao, Linhua

2009-02-01

Immunostimulants may improve disease resistance of aquaculture animals by promoting the nonspecific immunity response of the organisms. Five types of saccharides, including chitosan, yeast polysaccharide, burdock oligosaccharide, seaweed polysaccharide and lentinus edodes polysaccharide, were screened for potential use as immunostimulants by using spectrophotometry. The saccharides were injected into Apostichopus japonicus, a sea cucumber, and the lysozyme and superoxide dismutase (SOD) activities of the coelomic fluid and epidermal slime were monitored in six consecutive days. The results show that the lysozyme activity of the animal’s coelomic fluid was significantly stimulated on day 2, day 4 and day 6 after the injection of the saccharides ( P<0.05). The effects of chitosan and yeast polysaccharide were the most notable. The lysozyme activity of the epidermal slime was significantly increased by chitosana, yeast polysaccharide, seaweed polysaccharide, and burdock oligosaccharide on day 1 and day 2 after the injection ( P<0.05). The SOD activity of the coelomic fluid was significantly promoted by the saccharides on day 2 and day 4 post-injection ( P<0.05), while the SOD activity of the epidermal slime increased on day 2. These findings indicate that chitosan and yeast polysaccharide are the most effective immunostimulants and potential healthy anti-disease feedstuff for A. japonicus.

21 CFR 558.261 - Florfenicol.

Code of Federal Regulations, 2013 CFR

2013-04-01

... disease (SRD) associated with Actinobacillus pleuropneumoniae, Pasteurella multocida, Streptococcus suis... streptococcal septicemia associated with Streptococcus iniae Feed as a sole ration for 10 consecutive days to...

An evaluation of performance by older persons on a simulated telecommuting task.

PubMed

Sharit, Joseph; Czaja, Sara J; Hernandez, Mario; Yang, Yulong; Perdomo, Dolores; Lewis, John E; Lee, Chin Chin; Nair, Sankaran

2004-11-01

Telecommuting work represents a strategy for managing the growing number of older people in the workforce. This study involved a simulated customer service telecommuting task that used e-mail to answer customer queries about media-related products and company policies. Participants included 27 "younger" older adults (50-65 years) and 25 "older" older adults (66-80 years). The participants performed the task for two 2-hr sessions a day over 4 consecutive days. Although both age groups showed significant improvement across sessions on many of the performance criteria, in general the improvements were more marked for the older age-group participants. However, the participants from both age groups had difficulty meeting some of the task performance requirements. These results are discussed in terms of training strategies for older workers.

Triangular osteosynthesis of vertically unstable sacrum fractures: a new concept allowing early weight-bearing.

PubMed

Schildhauer, T A; Josten, Ch; Muhr, G

2006-01-01

Presentation of a new triangular osteosynthesis technique that permits early weight-bearing in vertically unstable sacral fractures. : Retrospective evaluation of a consecutive series. Level I trauma center. Thirty-four patients, twenty-eight of whom were poly-traumatized, all with vertically unstable sacral fractures. This group included eight women and twenty-six men, with a mean age of thirty-five years. Average time between trauma and definite operation was thirteen days (range 0 to 28 days). All patients underwent triangular osteosynthesis using a combination of a vertical vertebro-pelvic distraction osteosynthesis (pedicle screw system) and a transverse fixation of the sacrum fracture with either iliosacral screws or trans-sacral plating. Immediate postoperative weight-bearing was permitted postoperatively. Nineteen patients were treated with early progressive weight-bearing and advanced to full weight-bearing, on average, after twenty-three days (range 8 to 70 days). Three of the thirty-four patients (9 percent) experienced loosening of hardware, including two patients (6 percent) who required secondary intervention because of loss of the original reduction. Further complications included one pulmonary embolism (3 percent), one iatrogenic nerve lesion (3 percent), one wound necrosis (3 percent), and two local infections (6 percent). Triangular osteosynthesis is a demanding procedure that can be performed on vertically unstable sacral fractures to allow early progressive weight-bearing with an acceptable complication rate.

The effects of a heat acclimation protocol in persons with spinal cord injury.

PubMed

Trbovich, Michelle B; Kiratli, Jenny B; Price, Mike J

2016-12-01

Persons without spinal cord injury (SCI) physiologically acclimate between seven to fourteen consecutive days of exercise in the heat. Decreased resting and exercise core temperature, decreased heart rate, increased plasma volume and increased thermal comfort during exercise are changes consistent with heat acclimation. Autonomic dysfunction after SCI impairs heat dissipation through sweating and vasodilation. The purpose of this study is to determine if seven consecutive days of exercise in the heat would result in physiologic changes consistent with heat acclimation in persons with SCI. Ten persons with SCI divided into two groups: tetraplegia (n=5) and paraplegia (n=5) exercised in 35°C using an arm ergometer at 50% W peak for 30min followed by 15min rest. This protocol was repeated over seven consecutive days. Heart rate (HR), skin temperature, aural temperature (T aur ), rate of perceived exertion (RPE), rate of perceived thermal strain (RPTS), and plasma volume (PV) were measured throughout the protocol. There were no significant differences in resting T aur exercise T aur , mean skin temperature, HR, PV, RPE or RPTS over the 7 days for either the tetraplegic or paraplegic group. Participants with SCI did not demonstrate the ability to dissipate heat more efficiently over 7 days of exercise at 35°C. The lack of heat acclimation seen in persons with SCI has implications for the athlete and non-athlete alike. For the SCI athlete, inability to acclimate will impair performance and endurance especially in warm environments, compared to the person without SCI. For the SCI non-athlete, there is a greater risk of heat-related illness in warm environments that can negatively affect participation in outdoor activities and thus quality of life. Published by Elsevier Ltd.

Effects of pegylated recombinant human megakaryocyte growth and development factor on thrombocytopenia induced by a new myelosuppressive chemotherapy regimen in mice.

PubMed

Akahori, H; Shibuya, K; Ozai, M; Ida, M; Kabaya, K; Kato, T; Miyazaki, H

1996-11-01

Thrombopoietin, the endogenous c-Mpl ligand, is a novel lineage-specific hematopoietic factor that plays a pivotal role in the regulation of megakaryocytopoiesis and thrombopoiesis. In this study, we examined the effects of pegylated recombinant human megakaryocyte growth and development factor (PEG-rHuMGDF), a truncated molecule of recombinant human c-Mpl ligand derivatized with polyethylene glycol, on myelosuppressive chemotherapy-induced thrombocytopenia in mice. We developed a new murine model of thrombocytopenia induced by i.v. injections of mitomycin C (MMC) for two consecutive days. In control mice, platelet counts began to decrease on day 6, reached a nadir of less than 5% of basal level on day 14, and could not recover to basal level by day 26. Administration of PEG-rHuMGDF greatly enhanced recovery of the number of megakaryocyte progenitor cells and the megakaryocytes in bone marrow, and markedly reduced the severity of thrombocytopenia; it also accelerated platelet recovery in a dose-dependent manner in myelosuppressed mice. Mice receiving consecutive administration of higher doses of PEG-rHuMGDF showed no thrombocytopenia but rather had platelet counts being increased over basal level. Although absolute neutrophil counts and red cell counts also were decreased following MMC treatment, administration of PEG-rHuMGDF also improved neutropenia and anemia. Administration of PEG-rHuMGDF on alternate days or once a week after chemotherapy was almost as effective as consecutive administration in improving thrombocytopenia. Combined administration of PEG-rHuMGDF and rHuG-CSF had an additive effect on improvement of thrombocytopenia and neutropenia. These results suggest that PEG-rHuMGDF is a therapeutically effective agent in the treatment of thrombocytopenia associated with chemotherapy.

The Lawrence D. Dorr Surgical Techniques & Technologies Award: "Running Two Rooms" Does Not Compromise Outcomes or Patient Safety in Joint Arthroplasty.

PubMed

Hamilton, William G; Ho, Henry; Parks, Nancy L; Strait, Alexander V; Hopper, Robert H; McDonald, James F; Goyal, Nitin; Fricka, Kevin B; Engh, C Anderson

2018-07-01

Scrutiny from the federal government and the media regarding the safety of 1 surgeon doing cases in 2 operating rooms (ORs) on the same day, prompted us to examine our own institutional data. Over the past 11 years, surgeons at our facility have operated consecutively in 1 OR on a given day or used 2 alternating ORs. This study compares these cases with a focus on revisions and complications in both groups. Six surgeons performed a total of 16,916 primary hip and knee arthroplasties from 2006-2016. 7002 cases (41%) were consecutive cases (CCs) and 9914 cases (59%) were overlapping cases (OCs). Intraoperative complications, component revisions, and postoperative complications within 90 days of surgery were compared between the CC and OC groups. There was no difference in intraoperative complication rates between the two groups (CC 1.6% vs. OC 1.7%, relative risk 1.082, 95% confidence interval 0.852 to 1.375, P = .52). There was no difference in 90-day component revision rates among the CC and OC groups (0.66% vs. 0.85% respectively, relative risk = 1.290, 95% confidence interval 0.901 to 1.845, P = .19). There was also no difference in 90-day complication rates among the CC and OC groups (1.33% vs. 1.45% respectively, relative risk = 1.094, 95% confidence interval 0.844 to 1.417, P = .54). This large study of a single institution with multiple surgeons over an 11-year period shows no compromise in patient safety or outcomes when comparing cases done in either consecutive or overlapping rooms. Copyright © 2018 Elsevier Inc. All rights reserved.

21 CFR 522.2260 - Sulfamethazine.

Code of Federal Regulations, 2012 CFR

2012-04-01

... of 5 consecutive days. (2) Indications for use. For cattle for treatment of bacterial pneumonia and bovine respiratory disease complex (shipping fever complex) (Pasteurella spp.), colibacillosis (bacterial...

21 CFR 522.2260 - Sulfamethazine.

Code of Federal Regulations, 2013 CFR

2013-04-01

... of 5 consecutive days. (2) Indications for use. For cattle for treatment of bacterial pneumonia and bovine respiratory disease complex (shipping fever complex) (Pasteurella spp.), colibacillosis (bacterial...

7 CFR 1230.621 - Voting period.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE PORK PROMOTION, RESEARCH, AND... term Voting period means the 3-consecutive business day period for in-person voting. Referendum ...

Feasibility of dietary assessment methods, other tools and procedures for a pan-European food consumption survey among infants, toddlers and children.

PubMed

Ocké, Marga; Brants, Henny; Dofkova, Marcela; Freisling, Heinz; van Rossum, Caroline; Ruprich, Jiri; Slimani, Nadia; Temme, Elisabeth; Trolle, Ellen; Vandevijvere, Stefanie; Huybrechts, Inge; de Boer, Evelien

2015-08-01

To test the feasibility of tools and procedures for a pan-European food consumption survey among children 0-10 years and to recommend one of two tested dietary assessment methods. Two pilot studies including 378 children were conducted in Belgium and the Czech Republic in the Pilot studies for Assessment of Nutrient intake and food Consumption among Kids in Europe. One protocol included a 3-day food diary which was checked with a parent, and data were entered afterwards using EPIC-Soft. The alternative protocol consisted of two non-consecutive 1-day food diaries followed by EPIC-Soft completion interviews. Both protocols included general and food propensity questionnaires and anthropometric measurements. The protocols were compared using evaluation questionnaires among the participating parents and study personnel. The parents found the questionnaires and instructions for filling in the food diaries understandable. Food description and food quantification was evaluated as problematic by 29 and 15% of the participants for the 3-day diaries versus 15 and 12% for the 1-day diaries. The protocol with 1-day food diaries was evaluated as less burdensome by the parents and logistically more challenging by the interviewers. Both dietary assessment methods with related tools and administration protocols were evaluated as feasible. The administration protocol with two 1-day food diaries with completion interviews offers more advantages for the future pan-European survey in children 0-10 years. The positive evaluation of feasibility of tools and materials is an important step towards harmonised food consumption data at European level among the younger age groups.

Aortic arch atherosclerosis in patients with severe aortic stenosis can be argued by greater day-by-day blood pressure variability.

PubMed

Iwata, Shinichi; Sugioka, Kenichi; Fujita, Suwako; Ito, Asahiro; Matsumura, Yoshiki; Hanatani, Akihisa; Takagi, Masahiko; Di Tullio, Marco R; Homma, Shunichi; Yoshiyama, Minoru

2015-07-01

Although it is well known that the prevalence of aortic arch plaques, one of the risk factors for ischemic stroke, is high in patients with severe aortic stenosis, the underlying mechanisms are not well understood. Increased day-by-day blood pressure (BP) variability is also known to be associated with stroke; however, little is known on the association between day-by-bay BP variability and aortic arch atherosclerosis in patients with aortic stenosis. Our objective was to clarify the association between day-by-day BP variables (average values and variability) and aortic arch atherosclerosis in patients with severe aortic stenosis. The study population consisted of 104 consecutive patients (mean age 75 ± 8 years) with severe aortic stenosis who were scheduled for aortic valve replacement. BP was measured in the morning in at least 4 consecutive days (mean 6.8 days) prior to the day of surgery. Large (≥4 mm), ulcerated, or mobile plaques were defined as complex plaques using transesophageal echocardiography. Cigarette smoking and all systolic BP variables were associated with the presence of complex plaques (p < 0.05), whereas diastolic BP variables were not. Multiple regression analysis indicated that day-by-day mean systolic BP and day-by-day systolic BP variability remained independently associated with the presence of complex plaques (p < 0.05) after adjustment for age, male sex, cigarette smoking, hypertension, hypercholesterolemia, and diabetes mellitus. These findings suggest that higher day-by-day mean systolic BP and day-by-day systolic BP variability are associated with complex plaques in the aortic arch and consequently stroke risk in patients with aortic stenosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Progressive decrease of melatonin production over consecutive days of simulated night work.

PubMed

Dumont, Marie; Paquet, Jean

2014-12-01

Decreased melatonin production, due to nighttime exposure to light, has been proposed as one of the physiological mechanisms increasing cancer risk in night workers. However, few studies measured melatonin production in night workers, and most of these studies did not measure melatonin over 24 h. One study compared total melatonin production between day and night shifts in rotating night workers and did not find significant differences. However, without baseline measures, it was not possible to exclude that melatonin production was reduced during both day and night work. Here, we used data collected in a simulation study of night work to determine the effect of night work on both nighttime and 24-h melatonin production, during three consecutive days of simulated night work. Thirty-eight healthy subjects (15 men, 23 women; 26.6 ± 4.2 years) participated in a 6-d laboratory study. Circadian phase assessments were made with salivary dim light melatonin onset (DLMO) on the first and last days. Simulated day work (09:00-17:00 h) occurred on the second day, followed by three consecutive days of simulated night work (00:00-08:00 h). Light intensity at eye level was set at 50 lux during both simulated day and night work. The subjects were divided into three matched groups exposed to specific daytime light profiles that produced various degrees of circadian phase delays and phase advances. Melatonin production was estimated with the excretion of urinary 6-sulfatoxymelatonin (aMT6s). For the entire protocol, urine was collected every 2 h, except for the sleep episodes when the interval was 8 h. The aMT6s concentration in each sample was multiplied by the urine volume and then added to obtain total aMT6s excretion during nighttime (00:00-08:00 h) and during each 24-h day (00:00-00:00 h). The results showed that melatonin production progressively decreased over consecutive days of simulated night work, both during nighttime and over the 24 h. This decrease was larger in women using oral contraceptives. There was no difference between the three groups, and the magnitude of the decrease in melatonin production for nighttime and for the 24 h was not associated with the magnitude of the absolute circadian phase shift. As light intensity was relatively low and because the decrease in melatonin production was progressive, direct suppression by nighttime light exposure was probably not a significant factor. However, according to previous experimental observations, the decrease in melatonin production most likely reflects the circadian disruption associated with the process of re-entrainment. It remains to be determined whether reduced melatonin production can be harmful by itself, but long-term and repeated circadian disruption most probably is.

Inhaled concentrated ambient particles are associated with hematologic and bronchoalveolar lavage changes in canines.

PubMed Central

Clarke, R W; Coull, B; Reinisch, U; Catalano, P; Killingsworth, C R; Koutrakis, P; Kavouras, I; Murthy, G G; Lawrence, J; Lovett, E; Wolfson, J M; Verrier, R L; Godleski, J J

2000-01-01

Pulmonary inflammatory and hematologic responses of canines were studied after exposure to concentrated ambient particles (CAPs) using the Harvard ambient particle concentrator (HAPC). For pulmonary inflammatory studies, normal dogs were exposed in pairs to either CAPs or filtered air (paired studies) for 6 hr/day on 3 consecutive days. For hematologic studies, dogs were exposed for 6 hr/day for 3 consecutive days with one receiving CAPs while the other was simultaneously exposed to filtered air; crossover of exposure took place the following week (crossover studies). Physicochemical characterization of CAPs exposure samples included measurements of particle mass, size distribution, and composition. No statistical differences in biologic responses were found when all CAPs and all sham exposures were compared. However, the variability in biologic response was considerably higher with CAPs exposure. Subsequent exploratory graphical analyses and mixed linear regression analyses suggested associations between CAPs constituents and biologic responses. Factor analysis was applied to the compositional data from paired and crossover experiments to determine elements consistently associated with each other in CAPs samples. In paired experiments, four factors were identified; in crossover studies, a total of six factors were observed. Bronchoalveolar lavage (BAL) and hematologic data were regressed on the factor scores. Increased BAL neutrophil percentage, total peripheral white blood cell (WBC) counts, circulating neutrophils, and circulating lymphocytes were associated with increases in the aluminum/silicon factor. Increased circulating neutrophils and increased BAL macrophages were associated with the vanadium/nickel factor. Increased BAL neutrophils were associated with the bromine/lead factor when only the compositional data from the third day of CAPs exposure were used. Significant decreases in red blood cell counts and hemoglobin levels were correlated with the sulfur factor. BAL or hematologic parameters were not associated with increases in total CAPs mass concentration. These data suggest that CAPs inhalation is associated with subtle alterations in pulmonary and systemic cell profiles, and specific components of CAPs may be responsible for these biologic responses. PMID:11133399

21 CFR 558.261 - Florfenicol.

Code of Federal Regulations, 2014 CFR

2014-04-01

... disease (SRD) associated with Actinobacillus pleuropneumoniae, Pasteurella multocida, Streptococcus suis... septicemia associated with Streptococcus iniae Feed as a sole ration for 10 consecutive days to deliver 15 mg...

Evaluation of dynamic balance among community-dwelling older adult fallers: a generalizability study of the limits of stability test.

PubMed

Clark, S; Rose, D J

2001-04-01

To establish reliability estimates of the 75% Limits of Stability Test (75% LOS test) when administered to community-dwelling older adults with a history of falls. Generalizability theory was used to estimate both the relative contribution of identified error sources to the total measurement error and generalizability coefficients. A random effects repeated-measures analysis of variance (ANOVA) was used to assess consistency of LOS test movement variables across both days and targets. A motor control research laboratory in a university setting. Fifty community-dwelling older adults with 2 or more falls in the previous year. Spatial and temporal measures of dynamic balance derived from the 75% LOS test included average movement velocity, maximum center of gravity (COG) excursion, end-point COG excursion, and directional control. Estimated generalizability coefficients for 2 testing days ranged from.58 to.87. Total variance in LOS test measures attributable to inconsistencies in day-to-day test performance (Day and Subject x Day facets) ranged from 2.5% to 8.4%. The ANOVA results indicated that no significant differences were observed in the LOS test variables across the 2 testing days. The 75% LOS test administered to older adult fallers on 2 consecutive days provides consistent and reliable measures of dynamic balance.

The role of the central histaminergic receptors in the exercise-induced improvements of the spatial learning and memory in rats.

PubMed

Taati, Majid; Moghaddasi, Mehrnoush; Esmaeili, Masoumeh; Pourkhodadad, Soheila; Nayebzadeh, Hassan

2014-10-31

While it is well known that exercise can improve cognitive performance, the underlying mechanisms are not fully understood. There is now evidence that histamine can modulate learning and memory in different types of behavioral tasks. The present study was designed to examine the possible role of central histamine H1 and H2 receptors in forced treadmill running-induced enhancement of learning and memory in rats. For this purpose the animals received intracerebroventricularly chlorpheniramine (H1 receptor blocker) and cimetidine (H2 receptor blocker) before each day of fifteen consecutive days of exercise. Then their learning and memory were tested on the water maze task using a four-trial-per-day for 4 consecutive days. A probe trial was performed after the last training day. Our data showed that cimetidine reversed the exercise-induced improvement in learning and memory in rats; however, this was not the case regarding chlorpheniramine. Our findings indicate that central histamine H2 receptors play an important role in mediating the beneficial effects of forced exercise on learning and memory. Copyright © 2014 Elsevier B.V. All rights reserved.

40 CFR 417.151 - Specialized definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... demand as determined by incubation at 20 degrees C for a period of 7 days using an acclimated seed... scrubbing, and without more than 6 turnarounds in a 30 consecutive day period, thus permitting essentially... period that are of such degree and type (e.g., high phosphate to no phosphate) as to require cleaning of...

Student Achievement in the Four-Day School Week.

ERIC Educational Resources Information Center

Daly, Joseph L.; Richburg, Robert W.

To gather longitudinal student achievement data from schools utilizing the four-day week, Iowa Tests of Basic Skills (ITBS) grade equivalent scores were obtained in 1984 from five rural Colorado school districts for four consecutive years--two years prior to and two years following the districts' change to the shortened week. A first analysis…

Reducing Maternal Psychological Distress after the NICU Experience through Journal Writing.

ERIC Educational Resources Information Center

Barry, Leasha M.; Singer, George H. S.

2001-01-01

A study examined the effect of a brief journal writing exercise on the depressive and posttraumatic stress symptoms of 38 mothers of Neonatal Intensive Care Unit graduates. Results found that the journal writing for 30 minutes a day for 4 consecutive days reduced physiological distress for the mothers. (Contains references.) (CR)

40 CFR 417.151 - Specialized definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... demand as determined by incubation at 20 degrees C for a period of 7 days using an acclimated seed... scrubbing, and without more than 6 turnarounds in a 30 consecutive day period, thus permitting essentially... period that are of such degree and type (e.g., high phosphate to no phosphate) as to require cleaning of...

40 CFR 417.151 - Specialized definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... demand as determined by incubation at 20 degrees C for a period of 7 days using an acclimated seed... scrubbing, and without more than 6 turnarounds in a 30 consecutive day period, thus permitting essentially... period that are of such degree and type (e.g., high phosphate to no phosphate) as to require cleaning of...

40 CFR 417.151 - Specialized definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... demand as determined by incubation at 20 degrees C for a period of 7 days using an acclimated seed... scrubbing, and without more than 6 turnarounds in a 30 consecutive day period, thus permitting essentially... period that are of such degree and type (e.g., high phosphate to no phosphate) as to require cleaning of...

40 CFR 417.151 - Specialized definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... demand as determined by incubation at 20 degrees C for a period of 7 days using an acclimated seed... scrubbing, and without more than 6 turnarounds in a 30 consecutive day period, thus permitting essentially... period that are of such degree and type (e.g., high phosphate to no phosphate) as to require cleaning of...

POD experiments using real and simulated time-sharing observations for GEO satellites in C-band transfer ranging system

NASA Astrophysics Data System (ADS)

Fen, Cao; XuHai, Yang; ZhiGang, Li; ChuGang, Feng

2016-08-01

The normal consecutive observing model in Chinese Area Positioning System (CAPS) can only supply observations of one GEO satellite in 1 day from one station. However, this can't satisfy the project need for observing many GEO satellites in 1 day. In order to obtain observations of several GEO satellites in 1 day like GPS/GLONASS/Galileo/BeiDou, the time-sharing observing model for GEO satellites in CAPS needs research. The principle of time-sharing observing model is illuminated with subsequent Precise Orbit Determination (POD) experiments using simulated time-sharing observations in 2005 and the real time-sharing observations in 2015. From time-sharing simulation experiments before 2014, the time-sharing observing 6 GEO satellites every 2 h has nearly the same orbit precision with the consecutive observing model. From POD experiments using the real time-sharing observations, POD precision for ZX12# and Yatai7# are about 3.234 m and 2.570 m, respectively, which indicates the time-sharing observing model is appropriate for CBTR system and can realize observing many GEO satellites in 1 day.

Effect of apitherapy in piglets with preweaning diarrhea.

PubMed

Choi, Seok Hwa; Cho, Seong Koo; Kang, Seong Soo; Bae, Chun Sik; Bai, Young Hoon; Lee, Seung Hoo; Pak, Sok Cheon

2003-01-01

This study was designed to examine the therapeutic effect of honeybee (Apis mellifera L.) venom in piglets with bacterial diarrhea Comparison between bee venom- and drug-treated groups was our main concern in the present study. Preweaning piglets were assigned to treated and non-treated control groups. In the treated group, 47 piglets were acupunctured with the worker honeybee once a day for three consecutive days. Two acupoints, GV-1 (Jiao-chao) and ST-25 (Hai-men), were selected for apitherapy. In the control group, 44 piglets were intramuscularly injected with a standard dose of a known antibacterial drug, colistin sulfate (300,000 IU/kg of body weight), and an antidiarrheal drug (berberine, 2 ml/kg) once a day for three consecutive days. At post-treatment, 90.9% of the control piglets and 93.6% of piglets in the treated group recovered from bacterial diarrhea. Bee acupuncture therapy did not show any side effects such as allergy, intoxication, hemorrhage or infection. It is concluded that bee venom therapy was effective in controlling bacterial diarrhea in preweaning piglets.

Fluticasone furoate/vilanterol once daily improves night-time awakenings in asthma patients with night symptoms; post-hoc analyses of three randomized controlled trials.

PubMed

Kerwin, Edward; Barnes, Neil; Gibbs, Michael; Leather, David; Forth, Richard; Jacques, Loretta; Yates, Louisa J

2017-08-07

Symptoms, including night-time awakenings, affect the quality of life of people with asthma. Fluticasone furoate/vilanterol (FF/VI) reduces exacerbations, improves lung function, and rescue-free and symptom-free 24-hour periods in patients with asthma. These post-hoc analyses compared daytime and night-time symptoms in patients with asthma who received FF/VI, versus FF, fluticasone propionate (FP) or placebo. Daytime and night-time symptoms were collected via electronic daily diary cards in three Phase III randomized studies of once-daily FF/VI in patients with uncontrolled asthma on inhaled corticosteroids (ICS) ±long-acting beta 2 -agonists (LABA) (n = 609/1039/586). Endpoints included: change from baseline in symptom-free days and nights (analyzed by Analysis of Covariance, covariates: baseline, region, sex, age, treatment), time for patients to achieve 7 consecutive symptom-free nights (analyzed by Cox proportional hazards model, covariates as above), and proportion of patients experiencing 100% symptom-free nights per week (analyzed by logistic regression, covariates: percentage of symptom-free nights, sex, age, treatment). Improvements in symptom-free days and nights were generally observed for all treatments. More patients who received FF/VI experienced 100% symptom-free nights in the last week of the treatment period than patients who received ICS alone or placebo. FF/VI also reduced time to 7 consecutive symptom-free nights. Patients with at least one night of symptoms at baseline experienced an additional 2.7 and 2.0 symptom-free nights per week with FF/VI 100/25 µg, versus 1.9 and 1.7 with FF alone; similar findings were seen with FF/VI 200/25 µg. Benefits in terms of symptom-free days and nights were observed for patients receiving FF/VI versus comparators in these post-hoc analyses.

Prenatal Exposure of Guinea Pigs to the Organophosphorus Pesticide Chlorpyrifos Disrupts the Structural and Functional Integrity of the Brain

PubMed Central

Mullins, Roger J.; Xu, Su; Pereira, Edna F.R.; Pescrille, Joseph D.; Todd, Spencer W.; Mamczarz, Jacek; Albuquerque, Edson X.; Gullapalli, Rao P.

2015-01-01

This study was designed to test the hypothesis that prenatal exposure of guinea pigs to the organophosphorus (OP) pesticide chlorpyrifos (CPF) disrupts the structural and functional integrity of the brain. Pregnant guinea pigs were injected with chlorpyrifos (20 mg/kg, s.c.) or vehicle (peanut oil) once per day for ten consecutive days, starting approximately on the 50th day of gestation. Cognitive behavior of female offspring was examined starting at 40–45 post-natal days (PND) using the Morris Water Maze (MWM), and brain structural integrity was analyzed at PND 70 using magnetic resonance imaging (MRI) methods, including T2-weighted anatomical scans and Diffusion Kurtosis Imaging (DKI). The offspring of exposed mothers had significantly decreased body weight and brain volume, particularly in the frontal regions of the brain including the striatum. Furthermore, the offspring demonstrated significant spatial learning deficits in MWM recall compared to the vehicle group. Diffusion measures revealed reduced white matter integrity within the striatum and amygdala that correlated with spatial learning performance. These findings reveal the lasting effect of pre-natal exposure to CPF as well as the danger of mother to child transmission of CPF in the environment. PMID:25704171

Thirteen Hundred and Thirty Days. A Pilot Study of Teacher Time in Key Stage 1. Final Report.

ERIC Educational Resources Information Center

Campbell, R. J.; Neill, S. St. J.

Ninety-five teachers in Key Stage 1 in England and Wales completed a questionnaire and records of time spent on work over a period of 14 consecutive days, resulting in detailed records of 1,330 days of teachers' time. The data are analyzed in terms of overall time spent on work; time distribution; and time spent specifically on teaching,…

The Effect of Cold Showering on Health and Work: A Randomized Controlled Trial

PubMed Central

Sierevelt, Inger N.; van der Heijden, Bas C. J. M.; Dijkgraaf, Marcel G.; Frings-Dresen, Monique H. W.

2016-01-01

Purpose The aim of this study was to determine the cumulative effect of a routine (hot-to-) cold shower on sickness, quality of life and work productivity. Methods Between January and March 2015, 3018 participants between 18 and 65 years without severe comorbidity and no routine experience of cold showering were randomized (1:1:1:1) to a (hot-to-) cold shower for 30, 60, 90 seconds or a control group during 30 consecutive days followed by 60 days of showering cold at their own discretion for the intervention groups. The primary outcome was illness days and related sickness absence from work. Secondary outcomes were quality of life, work productivity, anxiety, thermal sensation and adverse reactions. Results 79% of participants in the interventions groups completed the 30 consecutive days protocol. A negative binomial regression model showed a 29% reduction in sickness absence for (hot-to-) cold shower regimen compared to the control group (incident rate ratio: 0.71, P = 0.003). For illness days there was no significant group effect. No related serious advents events were reported. Conclusion A routine (hot-to-) cold shower resulted in a statistical reduction of self-reported sickness absence but not illness days in adults without severe comorbidity. Trial Registration Netherlands National Trial Register NTR5183 PMID:27631616

Daily variations in weather and the relationship with physical activity and sedentary time in European 10- to 12-year-olds: The ENERGY-Project.

PubMed

Yildirim, Mine; Schoeni, Anna; Singh, Amika S; Altenburg, Teatske M; Brug, Johannes; De Bourdeaudhuij, Ilse; Kovacs, Eva; Bringolf-Isler, Bettina; Manios, Yannis; Chinapaw M, J M

2014-02-01

The aim of the study was to examine the association of daily variations in rainfall and temperature with sedentary time (ST) and physical activity (PA) in European children. Children were included from 5 countries (Belgium, Greece, Hungary, the Netherlands, Switzerland) as part of the ENERGY-project. We used cross-sectional data from 722 children aged 10-12 years (47% boys). ST and PA were measured by accelerometers for 6 consecutive days, including weekend days. Weather data were collected from online national weather reports. Multilevel regression models were used for data analyses. Maximum temperature was positively associated with light PA (β = 3.1 min/day; 95% CI = 2.4-3.8), moderate-to-vigorous PA (β = 0.6 min/day; 95% CI = 0.4-0.8), and average PA [β = 4.1 counts per minute (cpm); 95% CI = 1.6-6.5, quadratic relationship]. Rainfall was inversely and quadratically associated with light PA (β = -1.3 min/day; 95% CI = -1.9 to -0.6), moderate-to-vigorous PA (β = -0.6 min/day; 95% CI = -0.8 to -0.3), and average PA (β = -1.6 cpm; 95% CI = -2.2 to -0.9). Maximum temperature was not significantly associated with ST (β = -0.2 min/day; 95% CI = -1.0 to 0.6), while rainfall was positively associated with ST (β = 0.9 min/day; 95% CI = 0.6-1.3). The current study shows that temperature and rainfall are significantly associated with PA and ST in 10- to 12-year-old European children.

Evaluation of a community-based inner-city disease management program for postmyocardial infarction patients: a randomized controlled trial

PubMed Central

Young, Wendy; Rewa, George; Goodman, Shaun G.; Jaglal, Susan Brenda; Cash, Linda; Lefkowitz, Charles; Coyte, Peter C.

2003-01-01

Background Disease management programs (DMPs) that use multidisciplinary teams and specialized clinics reduce hospital admissions and improve quality of life and functional status. Evaluations of cardiac DMPs delivered by home health nurses are required. Methods Between August 1999 and August 2000 we identified consecutive patients admitted to hospital with elevated cardiac enzymes. Patients who agreed were randomly assigned to participate in a DMP or to receive usual care. The DMP included 6 home visits by a cardiac-trained nurse, a standardized nurses' checklist, referral criteria for specialty care, communication with the family physician and patient education. We measured readmission days per 1000 follow-up days for angina, congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD); all-cause readmission days; and provincial claims for emergency department visits, physician visits, diagnostic or therapeutic services and laboratory services. Results We screened 715 consecutive patients admitted with elevated cardiac markers between August 1999 and August 2000. Of those screened 71 DMP and 75 usual care patients met the diagnostic criteria for myocardial infarction, were eligible for visits from a home health nurse and consented to participate in the study. Readmission days for angina, CHF and COPD per 1000 follow-up days were significantly higher for usual care patients than for DMP patients (incidence density ratio [IDR] = 1.59, 95% confidence interval [CI] 1.27–2.00, p < 0.001). All-cause readmission days per 1000 follow-up days were significantly higher for usual care patients than for DMP patients (IDR = 1.53, 95% CI 1.37–1.71, p < 0.001). The difference in emergency department encounters per 1000 follow-up days was significant (IDR = 2.08, 95% CI 1.56–2.77, p < 0.001). During the first 25 days after discharge, there were significantly fewer provincial claims submitted for DMP patients than for usual care patients for emergency department visits (p = 0.007), diagnostic or therapeutic services (p = 0.012) and laboratory services (p = 0.007). Interpretation The results provide evidence that an appropriately developed and implemented community-based inner-city DMP delivered by home health nurses has a positive impact on patient outcomes. PMID:14581307

Planar embryos have poor prognosis in terms of blastocyst formation and implantation.

PubMed

Ebner, T; Maurer, M; Shebl, O; Moser, M; Mayer, R B; Duba, H C; Tews, G

2012-09-01

Normally, day-2 embryos show a crosswise arrangement of four cells with three blastomeres lying side by side. Cleavage anomalies include embryos that are characterized by a particular planar constellation of four blastomeres with presumed incomplete cleavage. Since little is known on the developmental fate of such conceptuses, within a 10-month period all consecutive patients were screened for day-2 planar embryos. A total of 64/2070 embryos with suboptimal blastomere configuration were detected (3.1%). In conventional IVF, planar embryos were significantly less frequent (0.7%) as compared with intracytoplasmic sperm injection (2.8%; P<0.05) and cases of testicular sperm extraction (5.4%; P<0.01). Interestingly, embryos with a cleavage anomaly showed better morphology both on day 2 (P<0.005) and day 3 (P<0.001). In contrast, blastocyst formation (P<0.001) and blastocyst quality (P=NS) was higher in tetrahedral embryos. There was a significant increase in implantation rate if tetrahedral embryos could be transferred compared with when planar embryos had to be transferred (P<0.01). It may be postulated that, in planar embryos, the mitotic spindle might have been affected, e.g. sperm centrosome composition or function, which in turn might have led to the observed cleavage anomaly. Normally, day-2 embryos show a crosswise arrangement of four cells with three blastomeres lying side by side. Cleavage anomalies include more planar embryos that are characterized by a particular flat constellation of four blastomeres with presumed premature cleavage (like a tetrafoliate clover). Since little is known on the developmental fate of such embryos within a 10-month study period, all consecutive patients were screened for the presence of day-2 planar embryos (study group). A total of 64 (out of 2070) embryos with abnormal blastomere configuration were detected (3.1%). Interestingly, in conventional IVF (0.7%), the presence of planar embryos was significantly less frequent as compared with intracytoplasmic sperm injection (2.8%; P<0.05) and cases of testicular biopsy (5.4%; P<0.01). Embryos from the study group showed better morphology both on day 2 (P<0.005) and day 3 (P<0.001). In contrast, blastocyst formation (survival to day 5 of preimplantation development) was higher in the normally cleaved control group (P<0.001) and so was blastocyst quality; however, the latter parameter did not reach level of significance. This was also reflected in a significantly higher implantation rate in the control group (P<0.01). Based on present data, it may be postulated that, in planar embryos, the mitotic spindle (which involves the sperm centrosome) might have been affected, which in turn might have led to an incomplete cleavage. Copyright © 2012 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Expressing breast milk at home for 24-h periods provides viable samples for macronutrient analysis.

PubMed

Anderssen, Sven-Harald; Løvlund, Emma E; Nygaard, Egil A; Selberg, Terje R; Størdal, Ketil

2015-01-01

This study aimed to evaluate the reproducibility of macronutrient measurements of domestic pooled human milk from mothers with preterm infants and to see how the results affected human milk fortifications. We asked 28 new mothers to express their breast milk for 24 h on two consecutive days and repeat the process at weekly intervals. The samples were analysed using mid-infrared technology to calculate the differences between the milk collected on two consecutive days for reproducibility and the total protein supply with standard fortification. There was a significant linear correlation between the two consecutive days with regard to protein (r = 0.94, p < 0.001), lipids (r = 0.86, p < 0.001), lactose (r = 0.91, p < 0.001) and 24-h volume (r = 0.96, p < 0.001). The percentage of the samples that would provide a protein supply of 3.5-4.5 g/kg/d with a fortification of 0.6 and 1.2 g protein/100 mL at a volume of 170 mL/kg were 28% and 41%, respectively. The domestic pooling of 24-h expressed human milk for macronutrient analysis was a simple and reliable way of obtaining representative data. Standard fortification implies there is a risk of under- and over-nutrition, and individual fortification may improve the nutrition of preterm infants. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

21 CFR 529.2464 - Ticarcillin.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) Specifications. Each vial contains ticarcillin disodium powder equivalent to 6 grams of ticarcillin for... 6 grams daily by intrauterine infusion for 3 consecutive days during estrus. (2) Indications for use...

21 CFR 558.450 - Oxytetracycline.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Lobsters: For control of gaffkemia caused by Aerococcus viridans. Administer as sole ration for 5 consecutive days; withdraw medicated feed 30 d before harvesting lobsters. 066104 (6) Oxytetracycline may be...

21 CFR 558.450 - Oxytetracycline.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Lobsters: For control of gaffkemia caused by Aerococcus viridans. Administer as sole ration for 5 consecutive days; withdraw medicated feed 30 d before harvesting lobsters. 066104 (6) Oxytetracycline may be...

Effect of natural sunlight on adrenaline and noradrenaline excretion in man.

PubMed

Tatár, P; Tureceková, A

1987-08-01

Sympathoadrenal activity was evaluated in 6 healthy subjects by excretory rate of adrenaline and noradrenaline in 6 hour samples of urine throughout three consecutive days. Subjects were exposed to natural sunlight for 4 hours on the second day of experiment, the first and third days served for control measurements. Sunbath caused erythema in all subjects and it had no impact adrenaline on excretion. However, significantly higher no radrenalineexcretion was present during 6 hours after exposition to sunshine when compared to control days.

Tailored prolapse surgery for the treatment of haemorrhoids and obstructed defecation syndrome with a new dedicated device: TST STARR Plus.

PubMed

Naldini, Gabriele; Martellucci, Jacopo; Rea, Roberto; Lucchini, Stefano; Schiano di Visconte, Michele; Caviglia, Angelo; Menconi, Claudia; Ren, Donglin; He, Ping; Mascagni, Domenico

2014-05-01

The aim of the study was to assess the safety, efficacy and feasibility of stapled transanal procedures performed by a new dedicated device, TST STARR Plus, for tailored transanal stapled surgery. All the consecutive patients admitted to eight referral centres affected by prolapses with III-IV degrees haemorrhoids or obstructed defecation syndrome (ODS) with rectocele and/or rectal intussusception that underwent stapled transanal resection with TST STARR plus were included in the present study. Haemostatic stitches for bleeding of the suture line, specimen volume, operative time, hospital stay and perioperative complications were recorded. From 1 November 2012 to 31 March 2013, 160 consecutive patients (96 females) were enrolled in the study. In 94 patients, the prolapse was over the half of the circular anal dilator (CAD). The mean duration of the procedure was 25 min. The mean resected volume of the specimen was 13.3 cm(3), the mean hospital stay was 2.2 days. In 88 patients (55%), additional stitches on the suture line were needed (mean 2.1). Suture line dehiscence was reported in four cases, with intraoperative reinforcement. Bleeding was reported in seven patients (5%). Urgency after 30 days was reported in one patient. No major complication occurred. The new device seems to be safe and effective for a tailored approach to anorectal prolapse due to haemorrhoids or obstructed defecation.

Impact of Striped-Squirrel Nectar-Robbing Behaviour on Gender Fitness in Alpinia roxburghii Sweet (Zingiberaceae).

PubMed

Deng, Xiaobao; Mohandass, Dharmalingam; Katabuchi, Masatoshi; Hughes, Alice C; Roubik, David W

2015-01-01

Nectar-robbing has the potential to strongly affect male and female reproductive fitness of plants. One example of nectar theft is that shown by striped-squirrels (Tamiops swinhoei) on a number of ginger species, including Alpinia roxburghii and A. kwangsiensis (Zingiberaceae). In this study, we used a fluorescent dye as a pollen analogue, and measured fruit and seed output, to test the effect of squirrel nectar-robbing on A. roxburghii reproductive fitness. Pollen transfer between robbed and unrobbed flowers was assessed by comparing 60 randomly established plots containing robbed and unrobbed flowers. The frequency of squirrel robbing visits and broken styles were recorded from a number of flowers for five consecutive days. Two bee species (Bombus eximius and Apis cerana), were the primary pollinators, and their visitation frequency was recorded for six consecutive days. The results showed that fluorescent powder from unrobbed flowers was dispersed further, and to a greater number of flowers than that placed on robbed flowers. Additionally, robbing flowers caused significant damage to reproductive organs, resulting in lower fruit and seed sets in robbed than in unrobbed flowers and influencing both male and female fitness. The frequency of the primary pollinator visits (B. eximius) was significantly higher for unrobbed plants than for robbed plants. The present study clearly shows the negative impact of squirrel robbing on A. roxburghii male reproductive fitness and neutral impact on female reproductive fitness.

Clinical outcomes of intravenous immunoglobulin therapy in refractory uveitis.

PubMed

Garcia-Geremias, M; Carreño, E; Epps, S J; Lee, R W J; Dick, A D

2015-04-01

Intravenous immunoglobulin (IVIg) therapy has multiple mechanisms of immunomodulatory action. We wished therefore to assess its efficacy in a spectrum of patients with refractory uveitis. Retrospective review of clinical charts was conducted to document response to IVIg treatment in consecutive patients with treatment-refractory uveitis. Main outcome measures were control of intraocular inflammation, visual acuity, progression of the disease, and complications. Four (two male) patients, with a mean age at the beginning of the treatment of 47 years (range: 39-64), were included in the study. Indication for treatment was patients with active non-infectious uveitis refractory to steroids and immunomodulatory therapy. All patients received a course of 0.5 g/kg per day of IVIg for three consecutive days, repeating this course at a mean of 11 week (range: 2-39 weeks) intervals when indicated clinically. The median duration of the IVIg therapy was 7 months (range: 3-14 months). In three patients treatment resulted in stabilisation and prevention of progression of the disease, and additionally in two patients it facilitated a decrease in prednisolone dose. Treatment failed to induce long-term remission in one patient with recurrence of macular oedema. IVIg was well tolerated with neither immediate nor longer-term adverse events observed. In three out of four cases IVIg was an effective adjunctive therapy and well tolerated for the management of treatment-refractory uveitis.

Implementation of the Exeter enhanced recovery programme for patients undergoing radical cystectomy.

PubMed

Dutton, Thomas J; Daugherty, Mark O; Mason, Robert G; McGrath, John S

2014-05-01

To describe our experience with the implementation and refinement of an enhanced recovery programme (ERP) for radical cystectomy (RC) and urinary diversion. To assess the impact on length of stay (LOS), complication and readmission rates. In all, 165 consecutive patients undergoing open RC (ORC) and urinary diversion between January 2008 and April 2013 were entered into an ERP. A retrospective case note review was undertaken. Outcomes recorded included LOS, time to mobilisation, complication rates within the first 30 days (Clavien-Dindo classification) and readmissions. All patients were successfully entered into the ERP. As enhanced recovery principles became embedded in the unit, LOS reduced from a mean of 14 days over the initial year of the ERP to a mean of 9.2 days. The complication rate was 6.6% for Clavien ≥3, and 43.5% for Clavien ≤2. The 30-day mortality rate was 1.2%. The 30-day readmission rate was 13.9%. In the most contemporary subset of 52 patients: the median time after ORC to sit out of bed, mobilise and open bowels was day 1, 2 and 6, respectively. The ERP described for patients undergoing ORC appears to be safe. Benefits include early feeding, mobilisation and hospital discharge. The ERP will continue to develop with the incorporation of advancing evidence and technology, in particular the introduction of robot-assisted RC. © 2013 The Authors. BJU International © 2013 BJU International.

Concomitant external pneumatic compression treatment with consecutive days of high intensity interval training reduces markers of proteolysis.

PubMed

Haun, Cody T; Roberts, Michael D; Romero, Matthew A; Osburn, Shelby C; Healy, James C; Moore, Angelique N; Mobley, Christopher B; Roberson, Paul A; Kephart, Wesley C; Mumford, Petey W; Goodlett, Michael D; Pascoe, David D; Martin, Jeffrey S

2017-12-01

To compare the effects of external pneumatic compression (EPC) and sham when used concurrently with high intensity interval training (HIIT) on performance-related outcomes and recovery-related molecular measures. Eighteen recreationally endurance-trained male participants (age: 21.6 ± 2.4 years, BMI: 25.7 ± 0.5 kg/m 2 , VO 2peak : 51.3 ± 0.9 mL/kg/min) were randomized to balanced sham and EPC treatment groups. Three consecutive days of HIIT followed by EPC/sham treatment (Days 2-4) and 3 consecutive days of recovery (Days 5-7) with EPC/sham only on Days 5-6 were employed. Venipuncture, flexibility and pressure-to-pain threshold (PPT) measurements were made throughout. Vastus lateralis muscle was biopsied at PRE (i.e., Day 1), 1-h post-EPC/sham treatment on Day 2 (POST1), and 24-h post-EPC/sham treatment on Day 7 (POST2). 6-km run time trial performance was tested at PRE and POST2. No group × time interaction was observed for flexibility, PPT, or serum measures of creatine kinase (CK), hsCRP, and 8-isoprostane. However, there was a main effect of time for serum CK (p = 0.005). Change from PRE in 6-km run times at POST2 were not significantly different between groups. Significant between-groups differences existed for change from PRE in atrogin-1 mRNA (p = 0.018) at the POST1 time point (EPC: - 19.7 ± 8.1%, sham: + 7.7 ± 5.9%) and atrogin-1 protein concentration (p = 0.013) at the POST2 time point (EPC: - 31.8 ± 7.5%, sham: + 96.0 ± 34.7%). In addition, change from PRE in poly-Ub proteins was significantly different between groups at both the POST1 (EPC: - 26.0 ± 10.3%, sham: + 34.8 ± 28.5%; p = 0.046) and POST2 (EPC: - 33.7 ± 17.2%, sham: + 21.4 ± 14.9%; p = 0.037) time points. EPC when used concurrently with HIIT and in subsequent recovery days reduces skeletal muscle markers of proteolysis.

Aging-dependent alterations in gene expression and a mitochondrial signature of responsiveness to human influenza vaccination.

PubMed

Thakar, Juilee; Mohanty, Subhasis; West, A Phillip; Joshi, Samit R; Ueda, Ikuyo; Wilson, Jean; Meng, Hailong; Blevins, Tamara P; Tsang, Sui; Trentalange, Mark; Siconolfi, Barbara; Park, Koonam; Gill, Thomas M; Belshe, Robert B; Kaech, Susan M; Shadel, Gerald S; Kleinstein, Steven H; Shaw, Albert C

2015-01-01

To elucidate gene expression pathways underlying age-associated impairment in influenza vaccine response, we screened young (age 21-30) and older (age≥65) adults receiving influenza vaccine in two consecutive seasons and identified those with strong or absent response to vaccine, including a subset of older adults meeting criteria for frailty. PBMCs obtained prior to vaccination (Day 0) and at day 2 or 4, day 7 and day 28 post-vaccine were subjected to gene expression microarray analysis. We defined a response signature and also detected induction of a type I interferon response at day 2 and a plasma cell signature at day 7 post-vaccine in young responders. The response signature was dysregulated in older adults, with the plasma cell signature induced at day 2, and was never induced in frail subjects (who were all non-responders). We also identified a mitochondrial signature in young vaccine responders containing genes mediating mitochondrial biogenesis and oxidative phosphorylation that was consistent in two different vaccine seasons and verified by analyses of mitochondrial content and protein expression. These results represent the first genome-wide transcriptional profiling analysis of age-associated dynamics following influenza vaccination, and implicate changes in mitochondrial biogenesis and function as a critical factor in human vaccine responsiveness.

l-Arginine administration attenuates airway inflammation by altering l-arginine metabolism in an NC/Nga mouse model of asthma.

PubMed

Zhang, Ran; Kubo, Masayuki; Murakami, Ikuo; Setiawan, Heri; Takemoto, Kei; Inoue, Kiyomi; Fujikura, Yoshihisa; Ogino, Keiki

2015-05-01

Changes in l-arginine metabolism, including increased arginase levels and decreased nitric oxide production, are involved in the pathophysiology of asthma. In this study, using an intranasal mite-induced NC/Nga mouse model of asthma, we examined whether administration of l-arginine ameliorated airway hyperresponsiveness and inflammation by altering l-arginine metabolism. Experimental asthma was induced in NC/Nga mice via intranasal administration of mite crude extract (50 µg/day) on 5 consecutive days (days 0-4, sensitization) and on day 11 (challenge). Oral administration of l-arginine (250 mg/kg) was performed twice daily on days 5-10 for prevention or on days 11-13 for therapy. On day 14, we evaluated the inflammatory airway response (airway hyperresponsiveness, the number of cells in the bronchoalveolar lavage fluid, and the changes in pathological inflammation of the lung), arginase expression and activity, l-arginine bioavailability, and the concentration of NOx, the end products of nitric oxide. Treatment with l-arginine ameliorated the mite-induced inflammatory airway response. Furthermore, l-arginine administration attenuated the increases in arginase expression and activity and elevated the NOx levels by enhancing l-arginine bioavailability. These findings indicate that l-arginine administration may contribute to the improvement of asthmatic symptoms by altering l-arginine metabolism.

Associations between number of consecutive night shifts and impairment of neurobehavioral performance during a subsequent simulated night shift.

PubMed

Magee, Michelle; Sletten, Tracey L; Ferguson, Sally A; Grunstein, Ronald R; Anderson, Clare; Kennaway, David J; Lockley, Steven W; Rajaratnam, Shantha Mw

2016-05-01

This study aimed to investigate sleep and circadian phase in the relationships between neurobehavioral performance and the number of consecutive shifts worked. Thirty-four shift workers [20 men, mean age 31.8 (SD 10.9) years] worked 2-7 consecutive night shifts immediately prior to a laboratory-based, simulated night shift. For 7 days prior, participants worked their usual shift sequence, and sleep was assessed with logs and actigraphy. Participants completed a 10-minute auditory psychomotor vigilance task (PVT) at the start (~21:00 hours) and end (~07:00 hours) of the simulated night shift. Mean reaction times (RT), number of lapses and RT distribution was compared between those who worked 2-3 consecutive night shifts versus those who worked 4-7 shifts. Following 4-7 shifts, night shift workers had significantly longer mean RT at the start and end of shift, compared to those who worked 2-3 shifts. The slowest and fastest 10% RT were significantly slower at the start, but not end, of shift among participants who worked 4-7 nights. Those working 4-7 nights also demonstrated a broader RT distribution at the start and end of shift and had significantly slower RT based on cumulative distribution analysis (5 (th), 25 (th), 50 (th), 75 (th)percentiles at the start of shift; 75th percentile at the end of shift). No group differences in sleep parameters were found for 7 days and 24 hours prior to the simulated night shift. A greater number of consecutive night shifts has a negative impact on neurobehavioral performance, likely due to cognitive slowing.

Clinical application of the Natural Y stent in the management of benign carinal stenosis.

PubMed

Nam, Hae-Seong; Um, Sang Won; Koh, Won-Jung; Suh, Gee Young; Chung, Man Pyo; Kwon, O Jung; Kim, Jhingook; Kim, Hojoong

2009-08-01

The Y-shaped structure of the carinal bifurcation causes difficulties in the treatment of carinal stenosis. We describe a new Y-shaped silicone stent, called the Natural Y stent. We investigated its clinical efficacy through a review of patients with benign carinal stenosis who undewent consecutive Natural Y stent placement. Between January 2004 and February 2008, 11 patients underwent ballooning, neodymium:yttrium-aluminum-garnet laser resection, or bougienation (by rigid bronchoscopy) to dilate the airway, followed by placement of the Natural Y stent. The underlying etiologies of carinal stenosis included posttuberculosis stricture in 7 patients (64%), postintubation stenosis in 2 (18%), and postoperative malacia in 2 (18%). All patients reported subjective symptomatic relief immediately after stent placement. No procedurally related deaths or immediate major complications occurred. Stent-related late complications included granulation tissue formation (64%) and mucostasis (18%, defined as > or = 50% narrowing). The median duration of overall stent placement was 439 days (range, 119 to 1729 days). The stents were successfully removed in 4 patients (36%) after a median of 409 days. The Natural Y stent provides an effective and feasible therapeutic modality in patients with benign carinal stenosis, with or without previous thoracic airway interventions.

Repeatability and sensitivity of high resolution blood volume mapping in mouse kidney disease.

PubMed

Wang, Feng; Jiang, Rosie T; Tantawy, Mohammed Noor; Borza, Dorin B; Takahashi, Keiko; Gore, John C; Harris, Raymond C; Takahashi, Takamune; Quarles, C Chad

2014-04-01

To evaluate the repeatability of MRI-derived relative blood volume (RBV) measurements in mouse kidneys across subjects and days and to evaluate sensitivity of this approach to renal pathology. A 7 Tesla MRI system and an intravascular iron-oxide contrast agent were used to acquire spin-echo-based renal RBV maps in 10 healthy mice on 2 consecutive days. Renal RBV maps were also acquired in the Alport and unilateral ureteral obstruction mouse models of renal disease. The average renal RBV measured on consecutive days was 19.97 ± 1.50 and 19.86 ± 1.62, yielding a concordance correlation coefficient of 0.94, indicating that this approach is highly repeatable. In the disease models, the RBV values were regionally dissimilar and substantially lower than those found in control mice. In vivo renal iron-oxide-based RBV mapping in mice complements the physiological information obtained from conventional assays of kidney function and could shed new insights into the pathological mechanisms of kidney disease. Copyright © 2013 Wiley Periodicals, Inc.

On the representativeness of behavior observation samples in classrooms.

PubMed

Tiger, Jeffrey H; Miller, Sarah J; Mevers, Joanna Lomas; Mintz, Joslyn Cynkus; Scheithauer, Mindy C; Alvarez, Jessica

2013-01-01

School consultants who rely on direct observation typically conduct observational samples (e.g., 1 30-min observation per day) with the hopes that the sample is representative of performance during the remainder of the day, but the representativeness of these samples is unclear. In the current study, we recorded the problem behavior of 3 referred students for 4 consecutive school days between 9:30 a.m. and 2:30 p.m. using duration recording in consecutive 10-min sessions. We then culled 10-min, 20-min, 30-min, and 60-min observations from the complete record and compared these observations to the true daily mean to assess their accuracy (i.e., how well individual observations represented the daily occurrence of target behaviors). The results indicated that when behavior occurred with low variability, the majority of brief observations were representative of the overall levels; however, when behavior occurred with greater variability, even 60-min observations did not accurately capture the true levels of behavior. © Society for the Experimental Analysis of Behavior.

[Effect of the chelator Zn-DTPA on the excretion of lead in lead intoxication mice detected with ICP-MS].

PubMed

Li, Chen; Lu, Kai-zhi; Zhou, Qi; Wang, Qiong; Zeng, Yu-liang; Yin, Hong-jun; He, Xuan-hui; Tian, Ying; Dong, Jun-Xing

2014-11-01

To study the lead excretion effect of the chelator Zn-DTPA on the lead intoxication mice, inductively coupled plasma mass spectrometry (ICP-MS) was applied to detect the lead content of biological samples. The acute lead intoxication mice model was established by injecting lead acetate intraperitoneally with the dose of 1 mg. Zn-DTPA was administered intraperitoneally to mice once daily for five consecutive days 4 h after intoxication. Control group, model group, combination of Zn-DTPA and Ca-DTPA group were evaluated at the same time. The urine was collected every day. The mice were sacrificed in batches in the 2rd, 4th, 6th day. Biological samples including urine, whole blood, femur and brain were prepared and nitrated. Lead concentration was detected by ICP-MS. The result showed that Zn-DTPA could increase lead content in urine markedly and reduce lead content in blood, femur and brain.

20 CFR 655.735 - What are the special provisions for short-term placement of H-1B nonimmigrants at place(s) of...

Code of Federal Regulations, 2010 CFR

2010-04-01

...) as that of the H-1B nonimmigrant(s). (3) For every day the H-1B nonimmigrant(s) is placed or assigned... term workday shall mean any day on which an H-1B nonimmigrant performs any work at any worksite(s... a nonimmigrant works three non-consecutive days at three different worksites (whether or not the...

33 CFR 117.35 - Temporary change to a drawbridge operating schedule.

Code of Federal Regulations, 2010 CFR

2010-07-01

... District Commander for approval of the change. (2) The request must describe the reason for the closure and... receipt of the request. If the request is denied, the reasons for the denial will be set out in the... broken into separate time periods on the same day or on consecutive days, the drawbridge must provide...

78 FR 54481 - Alaska Native Claims Selection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-04

... FIRS is available 24 hours a day, 7 days a week, to leave a message or question with the BLM. The BLM... a week for four consecutive weeks in the Fairbanks Daily News-Miner. DATES: Any party claiming a... requirements of 43 CFR part 4 within the following time limits: 1. Unknown parties, parties unable to be...

PRENATAL WINDOW OF SUSCEPTIBILITY TO PERFLUOROOCTANE SULFONATE-INDUCED NEONATAL MORTALITY IN THE SPRAGUE-DAWLEY RAT

EPA Science Inventory

Abstract
The critical period for increased neonatal mortality induced by PFOS exposure was evaluated in the rat . Timed-pregnant Sprague-Dawley rats were treated by oral gavage with 25 mg/kg/d PFOS/K+ on four consecutive days during gestation (gestation days (GD) 2-5, 6-9, 1...

40 CFR 406.45 - Standards of performance for new sources.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Bulgur Wheat Flour Milling Subcategory... limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of wheat) BOD5 0.015 0.005 TSS 0.0099 .0033 pH (1) (1) English units...

40 CFR 406.45 - Standards of performance for new sources.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Bulgur Wheat Flour Milling Subcategory... limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of wheat) BOD5 0.015 0.005 TSS 0.0099 .0033 pH (1) (1) English units...

40 CFR 406.65 - Standards of performance for new sources.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Parboiled Rice Processing Subcategory... limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of rice) BOD5 0.21 0.07 TSS 0.09 .03 pH (1) (1) English units (pounds per...

40 CFR 406.65 - Standards of performance for new sources.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Parboiled Rice Processing Subcategory... limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of rice) BOD5 0.21 0.07 TSS 0.09 .03 pH (1) (1) English units (pounds per...

40 CFR 406.45 - Standards of performance for new sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Bulgur Wheat Flour Milling Subcategory... limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of wheat) BOD5 0.015 0.005 TSS 0.0099 .0033 pH (1) (1) English units...

40 CFR 406.65 - Standards of performance for new sources.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Parboiled Rice Processing Subcategory... limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of rice) BOD5 0.21 0.07 TSS 0.09 .03 pH (1) (1) English units (pounds per...

40 CFR 406.45 - Standards of performance for new sources.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Bulgur Wheat Flour Milling Subcategory... limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of wheat) BOD5 0.015 0.005 TSS 0.0099 .0033 pH (1) (1) English units...

34 CFR 300.536 - Change of placement because of disciplinary removals.

Code of Federal Regulations, 2010 CFR

2010-07-01

... consecutive school days; or (2) The child has been subjected to a series of removals that constitute a pattern— (i) Because the series of removals total more than 10 school days in a school year; (ii) Because the... the series of removals; and (iii) Because of such additional factors as the length of each removal...

34 CFR 300.536 - Change of placement because of disciplinary removals.

Code of Federal Regulations, 2013 CFR

2013-07-01

... consecutive school days; or (2) The child has been subjected to a series of removals that constitute a pattern— (i) Because the series of removals total more than 10 school days in a school year; (ii) Because the... the series of removals; and (iii) Because of such additional factors as the length of each removal...

34 CFR 300.536 - Change of placement because of disciplinary removals.

Code of Federal Regulations, 2011 CFR

2011-07-01

... consecutive school days; or (2) The child has been subjected to a series of removals that constitute a pattern— (i) Because the series of removals total more than 10 school days in a school year; (ii) Because the... the series of removals; and (iii) Because of such additional factors as the length of each removal...

34 CFR 300.536 - Change of placement because of disciplinary removals.

Code of Federal Regulations, 2014 CFR

2014-07-01

... consecutive school days; or (2) The child has been subjected to a series of removals that constitute a pattern— (i) Because the series of removals total more than 10 school days in a school year; (ii) Because the... the series of removals; and (iii) Because of such additional factors as the length of each removal...

34 CFR 300.536 - Change of placement because of disciplinary removals.

Code of Federal Regulations, 2012 CFR

2012-07-01

... consecutive school days; or (2) The child has been subjected to a series of removals that constitute a pattern— (i) Because the series of removals total more than 10 school days in a school year; (ii) Because the... the series of removals; and (iii) Because of such additional factors as the length of each removal...

Vildagliptin ameliorates pulmonary fibrosis in lipopolysaccharide-induced lung injury by inhibiting endothelial-to-mesenchymal transition.

PubMed

Suzuki, Toshio; Tada, Yuji; Gladson, Santhi; Nishimura, Rintaro; Shimomura, Iwao; Karasawa, Satoshi; Tatsumi, Koichiro; West, James

2017-10-16

Pulmonary fibrosis is a late manifestation of acute respiratory distress syndrome (ARDS). Sepsis is a major cause of ARDS, and its pathogenesis includes endotoxin-induced vascular injury. Recently, endothelial-to-mesenchymal transition (EndMT) was shown to play an important role in pulmonary fibrosis. On the other hand, dipeptidyl peptidase (DPP)-4 was reported to improve vascular dysfunction in an experimental sepsis model, although whether DPP-4 affects EndMT and fibrosis initiation during lipopolysaccharide (LPS)-induced lung injury is unclear. The aim of this study was to investigate the anti-EndMT effects of the DPP-4 inhibitor vildagliptin in pulmonary fibrosis after systemic endotoxemic injury. A septic lung injury model was established by intraperitoneal injection of lipopolysaccharide (LPS) in eight-week-old male mice (5 mg/kg for five consecutive days). The mice were then treated with vehicle or vildagliptin (intraperitoneally, 10 mg/kg, once daily for 14 consecutive days from 1 day before the first administration of LPS.). Flow cytometry, immunohistochemical staining, and quantitative polymerase chain reaction (qPCR) analysis was used to assess cell dynamics and EndMT function in lung samples from the mice. Lung tissue samples from treated mice revealed obvious inflammatory reactions and typical interstitial fibrosis 2 days and 28 days after LPS challenge. Quantitative flow cytometric analysis showed that the number of pulmonary vascular endothelial cells (PVECs) expressing alpha-smooth muscle actin (α-SMA) or S100 calcium-binding protein A4 (S100A4) increased 28 days after LPS challenge. Similar increases in expression were also confirmed by qPCR of mRNA from isolated PVECs. EndMT cells had higher proliferative activity and migration activity than mesenchymal cells. All of these changes were alleviated by intraperitoneal injection of vildagliptin. Interestingly, vildagliptin and linagliptin significantly attenuated EndMT in the absence of immune cells or GLP-1. Inhibiting DPP-4 signaling by vildagliptin could ameliorate pulmonary fibrosis by downregulating EndMT in systemic LPS-induced lung injury.

Incidence of Propionibacterium acnes in initially culture-negative thioglycollate broths-a prospective cohort study at a Danish University Hospital.

PubMed

Kvich, L; Jensen, P Ø; Justesen, U S; Bjarnsholt, T

2016-11-01

The aim of this study was to prospectively investigate the incidence of Propionibacterium acnes in thioglycollate broths reported as culture-negative at the Department of Clinical Microbiology, Rigshospitalet, to evaluate whether 5 days of incubation was enough to find all relevant cases. Five hundred thioglycollate broths reported as culture-negative after 5 days were consecutively collected and incubated for at least a further 9 days (at least 14 days of incubation in total). Only tissue samples from sterile sites of the body (n = 298), bone tissue (n = 197) and foreign material (n = 5) were included in this study. Samples were divided into two groups: infected group and control group. This made it possible to compare findings between groups, thereby making it possible to estimate the level of true-positive findings and contamination. Samples from 296 participants were included in this study. After exclusion criteria were met, P. acnes was cultured from ten out of 151 patients (6.6%) in the infected group and from one out of 138 participants (0.7%) in the control group. This resulted in more findings of P. acnes in the infected group on day 14 than on day 5 (p 0.002). Furthermore, P. acnes was cultured more often from bone tissue and tissue surrounding foreign materials on day 14 than on day 5 (p 0.04). Clinical microbiology laboratories should consider incubating thioglycollate broths for at least 14 days to find all relevant cases of P. acnes, especially when it comes to bone tissue and tissue surrounding foreign materials. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Drug fever after cancer chemotherapy is most commonly observed on posttreatment days 3 and 4.

PubMed

Ogawara, Daiki; Fukuda, Minoru; Ueno, Shiro; Ohue, Yoshihiro; Takemoto, Shinnosuke; Mizoguchi, Kosuke; Nakatomi, Katsumi; Nakamura, Yoichi; Obase, Yasushi; Honda, Takuya; Tsukamoto, Kazuhiro; Ashizawa, Kazuto; Oka, Mikio; Kohno, Shigeru

2016-02-01

This study was undertaken to analyze the characteristics of fever after cancer chemotherapy in order to reduce unnecessary medical care. Retrospectively, 1016 consecutive cycles of cancer chemotherapy were analyzed. Fever was defined as a temperature of ≥ 37.5 °C lasting for 1 h. Age, sex, tumor histology, the treatment regimen, the timing of fever onset, the number of days for which the fever persisted, the cause of the fever, the presence or absence of radiotherapy, and the use of granulocyte colony-stimulating factor (G-CSF) were examined. The patients included 748 males and 268 females (median age = 68, range = 29-88), of whom 949, 52, and 15 were suffering from lung cancer, malignant pleural mesothelioma, and other diseases, respectively. Fever was observed in 367 cycles (36 %), including 280 cycles (37 %) involving males and 87 cycles (32 %) involving females. Fever occurred most commonly in the first cycles and was higher than later cycles (41 vs. 30 %, p < 0.001). Fever occurred most frequently on posttreatment days 4 (8 %), 3 (7 %), and 12 (7 %), and the distribution of fever episodes exhibited two peaks on posttreatment days 3 and 4 and 10-14. Fever on posttreatment days 3 and 4 was most commonly observed in patients treated with gemcitabine (20 %) or docetaxel (18 %). The causes of fever included infection (47 %; including febrile neutropenia [24 %]), adverse drug effects (24 %), unknown causes (19 %), and tumors (7 %). Radiotherapy led to a significant increase in the frequency of fever (46 vs. 34 %, p < 0.001). Thirty-three percent of patients received G-CSF, and the incidence ratios of fever in patients who received G-CSF were higher than those who did not receive G-CSF (44 vs. 31 %, p < 0.001). The febrile episodes that occurred on posttreatment days 3 and 4 were considered to represent adverse drug reactions after cancer chemotherapy. Physicians should be aware of this feature of chemotherapy-associated fever and avoid unnecessary examination and treatments including prescribing antibiotics.

Energy drinks and alcohol: links to alcohol behaviors and consequences across 56 days.

PubMed

Patrick, Megan E; Maggs, Jennifer L

2014-04-01

To examine short-term consequences associated with consuming alcohol and energy drinks compared with consuming alcohol without energy drinks. A longitudinal measurement-burst design (14-day bursts of daily surveys in four consecutive college semesters) captured both within-person variation across occasions and between-person differences across individuals. The analytic sample of late adolescent alcohol users included 4,203 days with alcohol use across up to four semesters per person from 508 college students. Adding energy drink use to a given day with alcohol use was associated with an increase in number of alcoholic drinks, a trend toward more hours spent drinking, elevated estimated blood alcohol content (eBAC), a greater likelihood of subjective intoxication, and more negative consequences of drinking that day. After controlling for eBAC, energy drink use no longer predicted subjective intoxication but was still associated with a greater number of negative consequences. The consumption of energy drinks may lead to increases in alcohol consumption and, after controlling for eBAC, negative consequences. Use of energy drinks plus alcohol represents an emerging threat to public health. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Effect of hydrotherapy on recovery from fatigue.

PubMed

Vaile, J; Halson, S; Gill, N; Dawson, B

2008-07-01

The present study investigated the effects of three hydrotherapy interventions on next day performance recovery following strenuous training. Twelve cyclists completed four experimental trials differing only in 14-min recovery intervention: cold water immersion (CWI), hot water immersion (HWI), contrast water therapy (CWT), or passive recovery (PAS). Each trial comprised five consecutive exercise days of 105-min duration, including 66 maximal effort sprints. Additionally, subjects performed a total of 9-min sustained effort (time trial - TT). After completing each exercise session, athletes performed one of four recovery interventions (randomly assigned to each trial). Performance (average power), core temperature, heart rate (HR), and rating of perceived exertion (RPE) were recorded throughout each session. Sprint (0.1 - 2.2 %) and TT (0.0 - 1.7 %) performance were enhanced across the five-day trial following CWI and CWT, when compared to HWI and PAS. Additionally, differences in rectal temperature were observed between interventions immediately and 15-min post-recovery; however, no significant differences were observed in HR or RPE regardless of day of trial/intervention. Overall, CWI and CWT appear to improve recovery from high-intensity cycling when compared to HWI and PAS, with athletes better able to maintain performance across a five-day period.

Detection of erythropoietin misuse by the Athlete Biological Passport combined with reticulocyte percentage.

PubMed

Bejder, Jacob; Aachmann-Andersen, Niels Jacob; Bonne, Thomas Christian; Olsen, Niels Vidiendal; Nordsborg, Nikolai Baastrup

2016-10-01

The sensitivity of the adaptive model of the Athlete Biological Passport (ABP) and reticulocyte percentage (ret%) in detection of recombinant human erythropoietin (rHuEPO) misuse was evaluated using both a long-term normal dose and a brief high dose treatment regime. Sixteen subjects received either 65 IU rHuEPO × kg -1 every second day for two weeks (normal-dose), 390 IU rHuEPO × kg -1 on three consecutive days (high-dose), or frequent placebo treatment for 13 days in a randomized, placebo-controlled, double-blind crossover design. Blood variables were measured 4, 11, and 25 days following treatment initiation. The ABP based on haemoglobin concentration ([Hb]) and OFF-hr score ([Hb] - 60 × √ret%) yielded atypical profiles following both normal-dose and high-dose treatment (0 %, 31 %, 13 % vs. 21 %, 33 %, 20 % at days 4, 11, and 25 after normal and high dose, respectively). Including ret% as a stand-alone marker for atypical blood profiles increased (P < 0.05) the sensitivity of the adaptive model at day 11 to 63 % and 67 % for normal-dose and high-dose rHuEPO administration, respectively. In conclusion, ~30 % of subjects injecting a normal-dose rHuEPO for two weeks or a high-dose rHuEPO for three days will present an atypical ABP profile. Including ret% as a stand-alone parameter improves the sensitivity two-fold. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Evaluation of a new continuous mononuclear cell collection procedure in a single transplant center cohort enriched for AL amyloidosis patients.

PubMed

Pudusseri, Anita; Smith, India; Sarnacki, Diane; Brauneis, Dina; Shelton, Anthony; Sanchorawala, Vaishali; Sloan, J Mark; Sarosiek, Shayna; Quillen, Karen

2018-04-26

The Spectra Optia continuous mononuclear cell (CMNC) program is newly available, and herein validated in a single-center cohort enriched with AL amyloidosis patients to collect a target CD34+ yield of 2.5 × 10 6 cells/kg within 2 days. Consecutive autologous transplant patients in 2016 are included. Patients undergo leukapheresis with Optia CMNC and Spectra v4.7 over a 2-day cycle. Data collection includes collection efficiency, adverse events and engraftment kinetics. 36 leukapheresis procedures on 18 patients are included. The diagnoses are AL amyloidosis (9), myeloma (7), lymphoma (2), and scleroderma (1). Median age is 60; 12 are men. Plerixafor was employed pre-emptively in 6 cycles. Median blood CD34+ on Day 1 of leukapheresis was 46 cells/uL. Median number of blood volumes processed on Day 1 was 3.1. All collection cycles were completed within 2 days; only one in a heavily pretreated lymphoma patient did not reach the target requiring a second mobilization attempt. Mean collection efficiencies were comparable between the two devices. There were 2 adverse events: tubing rupture on the Optia; and one case of hypotension. All 18 patients underwent high-dose chemotherapy: median cell dose infused was 7.7 × 10 6 CD34+ cells/kg. Median days to neutrophil and platelet engraftment were 10 and 13 respectively. The Optia CMNC collection protocol is safe and effective in a small single-center autologous stem cell transplant cohort enriched for high-risk patients with AL amyloidosis and cardiac involvement. Caution is needed for tubing setup because there is less cumulative experience with Optia. Copyright © 2018 Elsevier Ltd. All rights reserved.

Impact of robotics on the outcome of elderly patients with endometrial cancer.

PubMed

Lavoue, Vincent; Zeng, Xing; Lau, Susie; Press, Joshua Z; Abitbol, Jeremie; Gotlieb, Raphael; How, Jeffrey; Wang, Yifan; Gotlieb, Walter H

2014-06-01

To evaluate the impact of introducing a robotics program on clinical outcome of elderly patients with endometrial cancer. Evaluation and comparison of peri-operative morbidity and disease-free interval in 163 consecutive elderly patients (≥70years) with endometrial cancer undergoing staging procedure with traditional open surgery compared to robotic surgery. All consecutive patients ≥70years of age with endometrial cancer who underwent robotic surgery (n=113) were compared with all consecutive patients ≥70years of age (n=50) before the introduction of a robotic program in December 2007. Baseline patient characteristics were similar in both eras. Patients undergoing robotic surgery had longer mean operating times (244 compared with 217minutes, p=0.009) but fewer minor adverse events (17% compared with 60%, p<0.001). The robotics cohort had less estimated mean blood loss (75 vs 334mL, p<0.0001) and shorter mean hospital stay (3 vs 6days, p<0.0001). There was no difference in disease-free survival (p=0.61) during the mean follow-up time of 2years. Transitioning from open surgery to a robotics program for the treatment of endometrial cancer in the elderly has significant benefits, including lower minor complication rate, less operative blood loss and shorter hospitalization without compromising 2-year disease-free survival. Copyright © 2014 Elsevier Inc. All rights reserved.

Consecutive Isoproterenol and Adenosine Treatment Confers Marked Protection against Reperfusion Injury in Adult but Not in Immature Heart: A Role for Glycogen.

PubMed

Lewis, Martin; Szobi, Adrian; Balaska, Dirki; Khaliulin, Igor; Adameova, Adriana; Griffiths, Elinor; Orchard, Clive H; Suleiman, M-Saadeh

2018-02-07

Consecutive treatment of adult rat heart with isoproterenol and adenosine (Iso/Aden), known to consecutively activate PKA/PKC signaling, is cardioprotective against ischemia and reperfusion (I/R). Whether this is cardioprotective in an immature heart is unknown. Langendorff-perfused hearts from adult and immature (60 and 14 days old) male Wistar rats were exposed to 30 min ischemia and 120 min reperfusion, with or without prior perfusion with 5 nM Iso for 3 min followed by 30 μM Aden for 5 min. Changes in hemodynamics (developed pressure and coronary flow) and cardiac injury (Lactate Dehydrogenase (LDH) release and infarct size) were measured. Additional hearts were used to measure glycogen content. Iso induced a similar inotropic response in both age groups. Treatment with Iso/Aden resulted in a significant reduction in time to the onset of ischemic contracture in both age groups whilst time to peak contracture was significantly shorter only in immature hearts. Upon reperfusion, the intervention reduced cardiac injury and functional impairment in adults with no protection of immature heart. Immature hearts have significantly less glycogen content compared to adult. This work shows that Iso/Aden perfusion confers protection in an adult heart but not in an immature heart. It is likely that metabolic differences including glycogen content contribute to this difference.

Consecutive Isoproterenol and Adenosine Treatment Confers Marked Protection against Reperfusion Injury in Adult but Not in Immature Heart: A Role for Glycogen

PubMed Central

Szobi, Adrian; Balaska, Dirki; Khaliulin, Igor; Adameova, Adriana; Griffiths, Elinor; Orchard, Clive H.; Suleiman, M.-Saadeh

2018-01-01

Consecutive treatment of adult rat heart with isoproterenol and adenosine (Iso/Aden), known to consecutively activate PKA/PKC signaling, is cardioprotective against ischemia and reperfusion (I/R). Whether this is cardioprotective in an immature heart is unknown. Langendorff–perfused hearts from adult and immature (60 and 14 days old) male Wistar rats were exposed to 30 min ischemia and 120 min reperfusion, with or without prior perfusion with 5 nM Iso for 3 min followed by 30 μM Aden for 5 min. Changes in hemodynamics (developed pressure and coronary flow) and cardiac injury (Lactate Dehydrogenase (LDH) release and infarct size) were measured. Additional hearts were used to measure glycogen content. Iso induced a similar inotropic response in both age groups. Treatment with Iso/Aden resulted in a significant reduction in time to the onset of ischemic contracture in both age groups whilst time to peak contracture was significantly shorter only in immature hearts. Upon reperfusion, the intervention reduced cardiac injury and functional impairment in adults with no protection of immature heart. Immature hearts have significantly less glycogen content compared to adult. This work shows that Iso/Aden perfusion confers protection in an adult heart but not in an immature heart. It is likely that metabolic differences including glycogen content contribute to this difference. PMID:29414860

Advance care planning and end-of-life care in a network of rural Western Australian hospitals.

PubMed

Auret, Kirsten; Sinclair, Craig; Averill, Barbara; Evans, Sharon

2015-08-01

To provide a current perspective on end-of-life (EOL) care in regional Western Australia, with a particular focus on the final admission prior to death and the presence of documented advance care planning (ACP). Retrospective medical notes audit. One regional hospital (including colocated hospice) and four small rural hospitals in the Great Southern region of Western Australia. Ninety recently deceased patients, who died in hospitals in the region. Fifty consecutive patients from the regional hospital and 10 consecutive patients from each of the four rural hospitals were included in the audit. A retrospective medical notes audit was undertaken. A 94-item audit tool assessed patient demographics, primary diagnosis, family support, status on admission and presence of documented ACP. Detailed items described the clinical care delivered during the final admission, including communication with family, referral to palliative care, transfers, medical investigations, medical treatments and use of EOL care pathways. Fifty-two per cent were women; median age was 82 years old. Forty per cent died of malignancy. Median length of stay was 7 days. Thirty-nine per cent had formal or informal ACP documented. Rural hospitals performed comparably with the regional hospital on all measures. This study provides benchmarking information that can assist other rural hospitals and suggests ongoing work on optimal methods of measuring quality in EOL care. © 2015 National Rural Health Alliance Inc.

Evaluation of methodological aspects of digestibility measurements in ponies fed different haylage to concentrate ratios.

PubMed

Schaafstra, F J W C; van Doorn, D A; Schonewille, J T; van Riet, M M J; Visser, P; Blok, M C; Hendriks, W H

2017-11-01

Methodological aspects of digestibility measurements were studied in four Welsh pony geldings consuming haylage-based diets with increasing proportions of a pelleted concentrate according to a 4×4 Latin square design experiment. Ponies were fed four experimental, iso-energetic (net energy (NE) basis) diets (i.e. 22 MJ NE/day) with increasing proportions of a pelleted concentrate (C) in relation to haylage (H). The absolute amounts of diet dry matter fed per day were 4.48 kg of H (100H), 3.36 and 0.73 kg of H and C (75H25C), 2.24 and 1.45 kg of H and C (50H50C) and 1.12 and 2.17 kg of H and C (25H75C). Diets were supplemented with minerals, vitamins and TiO2 (3.7 g Ti/day). Voluntary voided faeces were quantitatively collected daily during 10 consecutive days and analysed for moisture, ash, ADL, acid-insoluble ash (AIA) and Ti. A minimum faeces collection period of 6 consecutive days, along with a 14-day period to adapt the animals to the diets and become accustomed to the collection procedure, is recommended to obtain accurate estimations on dry matter digestibility and organic matter digestibility (OMD) in equids fed haylage-based diets supplemented with concentrate. In addition, the recovery of AIA, ADL and Ti was determined and evaluated. Mean faecal recovery over 10 consecutive days across diets for AIA, ADL and Ti was 124.9% (SEM 2.9), 108.7% (SEM 2.0) and 97.5% (SEM 0.9), respectively. Cumulative faecal recovery of AIA significantly differed between treatments, indicating that AIA is inadequate to estimate the OMD in equines. In addition, evaluation of the CV of mean cumulative faecal recoveries obtained by AIA, ADL and Ti showed greater variations in faecal excretion of AIA (9.1) and ADL (7.4) than Ti (3.7). The accuracy of prediction of OMD was higher with the use of Ti than ADL. The use of Ti is preferred as a marker in digestibility trials in equines fed haylage-based diets supplemented with increasing amounts of pelleted concentrate.

Replacement of the aortic root with a composite valve-graft conduit: risk factor analysis in 246 consecutive patients.

PubMed

Woldendorp, Kei; Starra, Eric; Seco, Michael; Hendel, P Nicholas; Jeremy, Richmond W; Wilson, Michael K; Vallely, Michael P; Bannon, Paul G

2014-12-01

Composite valve-graft (CVG) replacement of the aortic root is a well-studied and recognised treatment for various aortic root conditions, including valvular disease with associated aortopathy. There have been few previous studies of the procedure in large numbers in an Australian setting. From January 2006 to June 2013, 246 successive patients underwent CVG root replacements at our institution. Mean age was 56.8 years, 85.4% were male, and 87 had evidence of bicuspid aortic valve. Indications for operation included ascending aortic aneurysm in 222 patients, annuloaortic ectasia in 67 patients, and aortic dissection in 38 patients. The overall unit 30-day mortality was 5.7%, including: elective 30-day mortality of 2.2%, and emergent 30-day mortality of 17.2%. Statistically significant multivariate predictors of 30-day mortality were: acute aortic dissection (OR=20.07), peripheral vascular disease (OR=11.17), new ventricular tachycardia (OR=30.17), re-operation for bleeding (OR=14.42), concomitant mitral stenosis (OR=68.30), and cerebrovascular accident (OR=144.85). Low postoperative mortality in our series matches closely with results from similar sized international studies, demonstrating that this procedure can be performed with low risk in centres with sufficient experience in the operative procedure. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Is there a learning curve for the TVT-O procedure? A prospective single-surgeon study of 372 consecutive cases.

PubMed

Serati, Maurizio; Bogani, Giorgio; Braga, Andrea; Sorice, Paola; Salvatore, Stefano; Uccella, Stefano; Ghezzi, Fabio

2015-03-01

To evaluate for the first time in the literature the learning curve of Inside-out transobturator tape (TVT-O™). A prospective observational study was conducted in a tertiary reference center. Consecutive women treated by TVT-O™ performed by one surgeon were included. Data regarding subjective, objective cure rates, and adverse events were collected. Trends, over the number of procedures, were estimated using assay analyses. Number of procedures and variables were interpolating in standard curves using linear lines. Three hundred and seventy two procedures were included. Postoperative pain levels decreased with the increase in the level of expertise (pain levels: 1-day: from 6.6 (±3.3) to 4.3 (±3.1); 95%CI: -0.01603 to 0.001235, p=0.04; 2-day: from 5.6 (±4.1) to 3.6 (±3.7); 95%CI: -0.02092 to -0.002497, p=0.01; 12-month: from 0.1 (±0.7) to 0 (±0); 95%CI: -0.001814 to 0.05019, p=0.07). Overall, objective cure rate was achieved in 93.5% of patients. Additionally, 88.2% and 88.7% patients reported "much better" feeling at PGI-I scale and 80% reduction in UDI score, respectively. We observed, that delta ICIQ-sf (from 12 (±8.7) to 14 (±6.0); p=0.04) and delta-UDI (from 91% to 97%; p=0.04) improved over the time. TVT-O procedure offers excellent outcomes with high objective and subjective cure rates and low complications rate, even at the beginning of the surgeon's learning curve. However, a high experience of the surgeon could significantly improve the subjective cure rate and could reduce postoperative the groin pain. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Evaluation of Posttransplantation Diabetes Mellitus After Liver Transplantation: Assessment of Insulin Administration as a Risk Factor.

PubMed

Linder, Kristin E; Baker, William L; Rochon, Caroline; May, Scott T; Sheiner, Patricia A; Martin, Spencer T

2016-05-01

Impaired glucose regulation posttransplantation can affect allograft survival and may lead to the development of posttransplant diabetes mellitus (PTDM). The primary purpose of this study is to assess the difference in insulin burden between liver transplant patients who develop PTDM and patients who do not. This was a single-center, retrospective study. Adult liver transplant recipients transplanted between January 1, 2005, and August 1, 2013, were included. PTDM was defined as: (1) use of an oral antihyperglycemic agent for ≥30 consecutive days after transplant, (2) use of insulin ≥30 consecutive days after transplant, or (3) hemoglobin A1C≥6.5 any time after transplant. Of the 114 patients included, 48 (42%) developed PTDM. The average 24-hour insulin requirement on the medical floors was 17.2 ± 14.5 units in the PTDM group and 11.3 ± 12.2 units in the PTDM-free group;P= 0.02. The average blood glucose level on the medical floor was 184.7 ± 31.5 mg/dL in the PTDM group and 169.3 ± 31.4 mg/dL in the PTDM-free group;P= 0.013. Multivariate analysis revealed that experiencing rejection was positively associated with the development of PTDM: adjusted odds ratio (AOR) = 3.237; 95% CI = 1.214-8.633. Basiliximab was negatively associated with the development of PTDM: AOR = 0.182; 95% CI = 0.040-0.836. Univariate analyses suggest that insulin burden is a positive risk factor for the development of PTDM; this association is lost in multivariate analyses. Rejection was a positive predictor, and use of basiliximab was a negative predictor for the development of PTDM. © The Author(s) 2016.

Latanoprost-Eluting Contact Lenses in Glaucomatous Monkeys.

PubMed

Ciolino, Joseph B; Ross, Amy E; Tulsan, Rehka; Watts, Amy C; Wang, Rong-Fang; Zurakowski, David; Serle, Janet B; Kohane, Daniel S

2016-10-01

To assess the ability of latanoprost-eluting contact lenses to lower the intraocular pressure (IOP) of glaucomatous eyes of cynomolgus monkeys. Preclinical efficacy study of 3 treatment arms in a crossover design. Female cynomolgus monkeys with glaucoma induced in 1 eye by repeated argon laser trabeculoplasty. Latanoprost-eluting low-dose contact lenses (CLLO) and high-dose contact lenses (CLHI) were produced by encapsulating a thin latanoprost-polymer film within the periphery of a methafilcon hydrogel, which was lathed into a contact lens. We assessed the IOP-lowering effect of CLLO, CLHI, or daily latanoprost ophthalmic solution in the same monkeys. Each monkey consecutively received 1 week of continuous-wear CLLO, 3 weeks without treatment, 5 days of latanoprost drops, 3 weeks without treatment, and 1 week of continuous-wear CLHI. On 2 consecutive days before initiation of each study arm, the IOP was measured hourly over 7 consecutive hours to establish the baseline IOP. Two-tailed Student t tests and repeated-measures analysis of variance were used for statistical analysis. Intraocular pressure. Latanoprost ophthalmic solution resulted in IOP reduction of 5.4±1.0 mmHg on day 3 and peak IOP reduction of 6.6±1.3 mmHg on day 5. The CLLO reduced IOP by 6.3±1.0, 6.7±0.3, and 6.7±0.3 mmHg on days 3, 5, and 8, respectively. The CLHI lowered IOP by 10.5±1.4, 11.1±4.0, and 10.0±2.5 mmHg on days 3, 5, and 8, respectively. For the CLLO and CLHI, the IOP was statistically significantly reduced compared with the untreated baseline at most time points measured. The CLHI demonstrated greater IOP reduction than latanoprost ophthalmic solution on day 3 (P = 0.001) and day 5 (P = 0.015), and at several time points on day 8 (P < 0.05). Sustained delivery of latanoprost by contact lenses is at least as effective as delivery with daily latanoprost ophthalmic solution. More research is needed to determine the optimal continuous-release dose that would be well tolerated and maximally effective. Contact lens drug delivery may become an option for the treatment of glaucoma and a platform for ocular drug delivery. Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

21 CFR 522.1315 - Maropitant.

Code of Federal Regulations, 2011 CFR

2011-04-01

... dogs—(1) Amount. Administer 1.0 mg per kilogram body weight by subcutaneous injection once daily for up to 5 consecutive days. (2) Indications for use. For the prevention and treatment of acute vomiting...

21 CFR 522.1315 - Maropitant.

Code of Federal Regulations, 2010 CFR

2010-04-01

... dogs—(1) Amount. Administer 1.0 mg per kilogram body weight by subcutaneous injection once daily for up to 5 consecutive days. (2) Indications for use. For the prevention and treatment of acute vomiting...

21 CFR 522.1315 - Maropitant.

Code of Federal Regulations, 2012 CFR

2012-04-01

... dogs—(1) Amount. Administer 1.0 mg per kilogram body weight by subcutaneous injection once daily for up to 5 consecutive days. (2) Indications for use. For the prevention and treatment of acute vomiting...

Does Postoperative Erythropoietin Reduce Transfusions and Hemodynamic Instability Following Liposuction, Either Alone or Associated with Abdominoplasty or Mammaplasty? A Comparative, Prospective Study of 50 Consecutive Patients.

PubMed

Rosique, Rodrigo G; Rosique, Marina J F; Rabelo, Mariana Quintino

2017-02-01

Erythropoietin (EPO) is a hematopoietic growth factor and an alternative to avoid blood transfusion in high-blood-loss surgeries. We evaluate EPO efficacy to reduce clinically relevant anemia and dehydration in patients undergoing liposuction. We prospectively evaluated 50 consecutive patients subjected to liposuction greater than 2.5 L and alternately assigned into two comparable groups (25 patients each), except for the postoperative administration of erythropoietin (4000 UI per day subcutaneously) during five consecutive days. Incidence data for blood transfusion or parenteral hydration were collected. Statistical analyses were performed with significance at p value <5%. There was no significant difference between groups related to any preoperative feature or the incidence of dehydration (p = 0.1099) or transfusion (p = 1.0). Postoperative erythropoietin administration was not effective in preventing blood transfusion for anemia or parenteral hydration for hemodynamic instability in patients undergoing major liposuction. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266.

Lack of energy compensation over 4 days when white button mushrooms are substituted for beef.

PubMed

Cheskin, Lawrence J; Davis, Lisa M; Lipsky, Leah M; Mitola, Andrea H; Lycan, Thomas; Mitchell, Vanessa; Mickle, Brooke; Adkins, Emily

2008-07-01

Increasing intake of low energy density (ED) foods in place of high ED foods has been proposed as a strategy for preventing or treating obesity. This study investigated how substituting mushrooms for beef in a test lunch affected energy intake, fat intake, palatability, appetite, satiation and satiety in normal weight, overweight and obese adults. Each subject consumed a total of eight test lunches in our lab over two consecutive weeks. The order of presentation of four consecutive meat lunches and four consecutive mushroom lunches was randomized. Energy content of meat and mushroom lunches varied (783 kcal versus 339 kcal), while volume was held constant. Energy intakes were significantly higher during meat lunches than mushroom lunches (730+/-7.9 kcal versus 310+/-5.8 kcal). Subjects exhibited only partial compensation (11.4+/-12.0%) for this difference over 4 days. Total daily energy intake and fat intake were significantly greater in the meat condition than in the mushroom condition, while ratings of palatability, appetite, satiation and satiety did not differ significantly. These results suggest that substituting low ED foods for high ED foods in otherwise similar recipes can be an effective method for reducing daily energy and fat intake.

The effects of consecutive night shifts and shift length on cognitive performance and sleepiness: a field study.

PubMed

Haidarimoghadam, Rashid; Kazemi, Reza; Motamedzadeh, Majid; Golmohamadi, Rostam; Soltanian, Alireza; Zoghipaydar, Mohamad Reza

2017-06-01

The aim of this study was to evaluate the effects of consecutive night shifts (CNS) and shift length on cognitive performance and sleepiness. This study evaluated the sleepiness and performance of 30 control room operators (CROs) working in 7 nights, 7 days, 7 days off (7N7D7O) and 30 CROs working in 4 nights, 7 days, 3 nights, 7 days off (4N7D3N7O) shift patterns in a petrochemical complex on the last night shift before swinging into the day shift. To assess cognitive performance, the n-back test, continuous performance test and simple reaction time test were employed. To assess sleepiness, the Karolinska sleepiness scale was used. Both schedules indicated that the correct responses and response times of working memory were reduced (p = 0.001), while intentional errors and sleepiness increased during the shift work (p = 0.001). CNS had a significant impact on reaction time and commission errors (p = 0.001). The main duty of CROs at a petrochemical plant is checking hazardous processes which require appropriate alertness and cognitive performance. As a result, planning for appropriate working hours and suitable number of CNS in a rotating shift system is a contribution to improving CRO performance and enhancing safety.

Efficacy and safety of a transdermal contraceptive system.

PubMed

Smallwood, G H; Meador, M L; Lenihan, J P; Shangold, G A; Fisher, A C; Creasy, G W

2001-11-01

To evaluate the efficacy, cycle control, compliance, and safety of a transdermal contraceptive system that delivers norelgestromin 150 microg and ethinyl estradiol 20 microg daily. In this open-label, 73-center study, 1672 healthy, ovulatory, sexually active women received ORTHO EVRA/EVRA for six (n = 1171) or 13 cycles (n = 501). The treatment regimen for each cycle was three consecutive 7-day patches (21 days) followed by 1 patch-free week. The overall and method-failure probabilities of pregnancy through 13 cycles were 0.7% and 0.4%, respectively. The incidence of breakthrough bleeding was low throughout the study. Perfect compliance (21 consecutive days of dosing, followed by a 7-day drug-free interval; no patch could be worn for more than 7 days) was achieved in 90% of subject cycles; only 1.9% of patches detached completely. Adverse events were typical of hormonal contraception, and most were mild-to-moderate in severity and not treatment limiting. The most common adverse events resulting in discontinuation were application site reactions (1.9%), nausea (1.8%), emotional lability (1.5%), headache (1.1%), and breast discomfort (1.0%). The transdermal contraceptive patch provides effective contraception and cycle control, and is well tolerated. The weekly change schedule for the contraceptive patch is associated with excellent compliance and wearability characteristics.

Inhalation developmental toxicology studies: Teratology study of n-hexane in rats: Final report

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

Mast, T.J.

The straight chain hydrocarbon, n-hexane, is a volatile, ubiquitous solvent used in industrial, academic, and smaller commercial environments. The significant opportunity for women of child-bearing age to be exposed to this chemical prompted the undertaking of a study to assess the developmental toxicity of n-hexane in an animal model. Timed-pregnant (30 animals per group) and virgin (10 animals per group) Sprague-Dawley rats were exposed to 0 (filtered air), 200, 1000, and 5000 ppM n-hexane (99.9% purity) vapor in inhalation chambers for 20 h/day for a period of 14 consecutive days. Sperm-positive females were exposed for 6 to 19 days ofmore » gestation (dg) and virgins were exposed concurrently for 14 consecutive days. The day of sperm detection was designated as 0 dg for mated females. Adult female body weights were monitored prior to, throughout the exposure period, and at sacrifice. Uterine, placental, and fetal body weights were obtained for gravid females at sacrifice. Implants were enumerated and their status recorded as live fetus, early or late resorption, or dead. Live fetuses were sexed and examined for gross, visceral, skeletal, and soft-tissue craniofacial defects. 16 refs., 3 figs., 7 tabs.« less

Clinical significance of isolated biliary candidiasis in patients with unresectable cholangiocarcinoma.

PubMed

Kim, In-Ho; Choi, Jae-Ki; Lee, Dong-Gun; Lee, In Seok; Hong, Tae Ho; You, Young Kyoung; Chun, Ho Jong; Lee, Myung Ah

2016-10-01

The frequency of isolated biliary candidiasis is increasing in cancer patients. The clinical significance of isolated biliary candidiasis remains unclear. We analyzed the risk factors of biliary candidiasis and outcomes of the patients with unresectable cholangiocarcinoma after percutaneous transhepatic biliary drainage (PTBD). Among 430 patients who underwent PTBD between January 2012 and March 2015, 121 patients had unresectable cholangiocarcinoma. Bile and blood samples were collected for consecutive fungal culture. The study cohort included 49 women and 72 men with a median age of 71 years. Multivariate analysis showed that cancer progression (P=0.013), concurrent presence of another microorganism (P=0.010), and previous long-term (>7 days) antibiotic use (P=0.011) were potential risk factors of biliary candidiasis. Chemotherapy was not associated with overall biliary candidiasis (P=0.196), but was significantly related to repeated biliary candidiasis (P=0.011). Patients with isolated biliary candidiasis showed remarkably reduced survival compared with those without [median overall survival (OS): 32 vs 62 days, P=0.011]. Subgroup analysis was also performed. Patients with repeated candidiasis had markedly decreased survival compared with those with transient candidiasis (median OS: 30 vs 49 days, P=0.046). Biliary candidiasis was identified as a poor prognostic factor by univariate and multivariate analyses (P=0.033). Four cases of repeated candidiasis (4/19, 21%) showed Candida species in consecutive blood culture until the end of the study, but others showed no candidemia. Isolated biliary candidiasis may be associated with poor prognosis in patients with unresectable cholangiocarcinoma. Especially, repeated biliary candidiasis may have the possibility of progression to candidemia. We suggest that biliary dilatation treatment or antifungal agents might be helpful for patients with biliary candidiasis.

Can Bundled Payments Be Successful in the Medicaid Population for Primary Joint Arthroplasty?

PubMed

Courtney, P Maxwell; Edmiston, Tori; Batko, Brian; Levine, Brett R

2017-11-01

Although some bundled payment models have had success in total joint arthroplasty, concerns exist about access to care for higher cost patients who use more resources. The purpose of this study is to determine whether Medicaid patients have increased hospital costs and more resource utilization in a 90-day episode of care than Medicare or privately insured patients. We retrospectively reviewed a consecutive series of 7268 primary hip and knee arthroplasty patients at a single institution. Using a propensity score-matching algorithm for demographic variables, we matched the 92 consecutive Medicaid patients with 184 privately insured and 184 Medicare patients. Hospital-specific costs, discharge disposition, complications, and 90-day readmissions were analyzed. Medicaid patients had higher mean inpatient hospital costs than both of the matched Medicare and privately insured groups ($15,396 vs $12,165 vs $13,864, P < .001) with longer length of stay (3.34 vs 2.49 vs 1.46 days, P < .001). Medicaid and Medicare patients were more likely to be discharged to a rehabilitation facility than privately insured patients (17% vs 21% vs 1%, P < .001). When controlling for demographic factors and comorbidities, Medicaid insurance was a significant independent risk factor for increased hospital costs (odds ratio 3.64, 95% confidence interval 1.80-7.38, P < .001). Because of increased hospital costs, current bundled payment models should not include Medicaid patients because of concerns about patient selection and access to care. Further study is needed to determine whether bundling Medicaid arthroplasty costs in a stand-alone program with a separate target price will result in improved outcomes and decreased costs. Copyright © 2017 Elsevier Inc. All rights reserved.

Adolescent chronic restraint stress (aCRS) elicits robust depressive-like behavior in freely cycling, adult female rats without increasing anxiety-like behaviors.

PubMed

Hibicke, Meghan; Graham, Martha A; Hayslett, Renée L

2017-04-01

Stress during times of rapid development is a risk factor for Major Depressive Disorder, a mood disorder that disproportionately affects women. We developed an adolescent chronic restraint stress (aCRS) protocol using female rats to address the impact of adolescent stress on female adult depressive-like behavior. Animals were divided into 4 treatment groups: not restrained:saline (NRSAL), not restrained:desipramine (NRDES), restrained:saline (RSAL), and restrained:desipramine (RDES). NRSAL and NRDES rats were housed in a separate colony room from RSAL and RDES rats. All animals were weighed and handled daily. Beginning postnatal day (PND) 34(±1), RSAL and RDES rats were restrained for 1 hour daily for 14 consecutive days. Beginning PND 55(±1), NRDES and RDES rats were given subcutaneous desipramine (5 mg/kg), which served as a positive control, daily for 14 consecutive days. During that same time period, NRSAL and RSAL rats were given subcutaneous saline daily. aCRS (RSAL and RDES) rats showed significantly attenuated weight gain compared with nonrestrained (NRSAL and NRDES) rats during the restraint period. Weight gain normalized after the final restraint session. Behavioral testing took place PND 68-69(±1), and included open field testing, the elevated plus maze, locomotor activity, and the forced swim test (FST). RSAL rats showed significantly more immobility in the FST versus all other groups, indicating depressive-like behavior. No differences between groups were observed in the other behavioral measures. These results indicate that aCRS elicits depressive-like behavioral characteristics in adult female rats without increasing anxiety-like behaviors. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Incidence and predictors of permanent pacemaker implantation following treatment with the repositionable Lotus™ transcatheter aortic valve.

PubMed

Zaman, Sarah; McCormick, Liam; Gooley, Robert; Rashid, Hashrul; Ramkumar, Satish; Jackson, Damon; Hui, Samuel; Meredith, Ian T

2017-07-01

To determine the incidence and predictors of permanent pacemaker (PPM) requirement following transcatheter aortic valve replacement (TAVR) with the mechanically expanded Lotus TM Valve System (Boston Scientific). Pacemaker implantation is the most common complication following TAVR. Predictors of pacing following TAVR with the Lotus valve have not been systematically assessed. Consecutive patients with severe aortic stenosis who underwent Lotus valve implantation were prospectively recruited at a single-centre. Patients with a pre-existing PPM were excluded. Baseline ECG, echocardiographic and multiple detector computed tomography as well as procedural telemetry and depth of implantation were independently analyzed in a blinded manner. The primary endpoint was 30-day incidence of pacemaker requirement (PPM implantation or death while pacing-dependent). Multivariate analysis was performed to identify independent predictors of the primary endpoint. A total of 104 consecutive patients underwent TAVR with the Lotus valve with 9/104 (9%) with a pre-existing PPM excluded. New or worsened procedural LBBB occurred in 78%. Thirty-day incidence of the primary pacing endpoint was 28%. The most common indication for PPM implantation was complete heart block (CHB) (69%). Independent predictors of the primary endpoint included pre-existing RBBB (hazard ratio [HR] 2.8, 95% CI 1.1-7.0; P = 0.032) and depth of implantation below the noncoronary cusp (NCC) (HR 2.4, 95% CI 1.0-5.7; P = 0.045). Almost a third of Lotus valve recipients require pacemaker implantation within 30 days. The presence of pre-existing RBBB and the depth of prosthesis implantation below the NCC were significant pacing predictors. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Transversus Abdominis Plane Blocks with Single-Dose Liposomal Bupivacaine in Conjunction with a Nonnarcotic Pain Regimen Help Reduce Length of Stay following Abdominally Based Microsurgical Breast Reconstruction.

PubMed

Jablonka, Eric M; Lamelas, Andreas M; Kim, Julie N; Molina, Bianca; Molina, Nathan; Okwali, Michelle; Samson, William; Sultan, Mark R; Dayan, Joseph H; Smith, Mark L

2017-08-01

Side effects associated with use of postoperative narcotics for pain control can delay recovery after abdominally based microsurgical breast reconstruction. The authors evaluated a nonnarcotic pain control regimen in conjunction with bilateral transversus abdominis plane blocks on facilitating early hospital discharge. A retrospective analysis was performed of consecutive patients who underwent breast reconstruction using abdominally based free flaps, with or without being included in a nonnarcotic protocol using intraoperative transversus abdominis plane blockade. During this period, the use of locoregional analgesia evolved from none (control), to continuous bupivacaine infusion transversus abdominis plane and catheters, to single-dose transversus abdominis plane blockade with liposomal bupivacaine solution. Demographic factors, length of stay, inpatient opioid consumption, and complications were reported for all three groups. One hundred twenty-eight consecutive patients (182 flaps) were identified. Forty patients (62 flaps) were in the infusion-liposomal bupivacaine group, 48 (66 flaps) were in the single-dose blockade-catheter group, and 40 (54 flaps) were in the control group. The infusion-liposomal bupivacaine patients had a significantly shorter hospital stay compared with the single-dose blockade-catheter group (2.65 ± 0.66 versus 3.52 ± 0.92 days; p < 0.0001) and the control group (2.65 ± 0.66 versus 4.05 ± 1.26 days; p < 0.0001). There was no significant difference in flap loss or major complications among groups. When used as part of a nonnarcotic postoperative pain regimen, transversus abdominis plane blocks performed with single injections of liposomal bupivacaine help facilitate early hospital discharge after abdominally based microsurgical breast reconstruction. A trend toward consistent discharge by postoperative day 2 was seen. This could result in significant cost savings for health care systems. Therapeutic, III.

Lymphocyte responses to influenza and tetanus toxoid in vitro following intensive exercise and carbohydrate ingestion on consecutive days.

PubMed

Bishop, Nicolette C; Walker, Gary J; Bowley, Lee A; Evans, Kate F; Molyneux, Karen; Wallace, Fiona A; Smith, Alice C

2005-10-01

The effect of carbohydrate (CHO) ingestion on antigen- (rather than mitogen-) stimulated T-cell responses to prolonged, intensive exercise may give a more realistic insight into the effect of CHO on T-cell functional capacity and subsequent infection risk. This study investigated the effect of CHO ingestion during prolonged, intensive exercise on influenza- and tetanus toxoid-stimulated T-cell cytokine mRNA expression and proliferation. Mitogen- [phytohemagglutinin (PHA)] stimulated proliferation was assessed for comparison. Responses were assessed following exercise on consecutive mornings to determine any carryover effect. Fifteen male games players performed two exercise trials in a double-blind, randomized, crossover design. Each trial comprised 90 min of intensive, intermittent running on consecutive mornings, with either CHO (6.4% wt/vol) or placebo (PLA) beverage ingestion before, during, and after each bout of exercise. Postexercise CD3(+) cell counts were higher in PLA than CHO on both days (P < 0.05). Antigen-stimulated T-cell cytokine mRNA expression was unaffected by exercise or CHO ingestion. Before exercise on day 2, T-cell proliferative responses to PHA, influenza, and tetanus toxoid were higher in CHO than PLA by 99, 80, and 58%, respectively (P < 0.01 for PHA, P < 0.05 for influenza and tetanus toxoid). At 1 h postexercise on day 2, PHA-induced proliferation was 70% higher in CHO than PLA (P < 0.05), yet there were no differences between trials for antigen-induced proliferative responses. Therefore, mitogen-induced T-cell proliferation following strenuous exercise and CHO does not necessarily reflect responses to specific antigens and, consequently, may not provide a good model for the situation in vivo.

Safety, efficacy and cost-effectiveness of consecutive bilateral cataract surgery on two successive days in tribes at base hospital through community outreach program: A prospective study of Aravali Mountain, North West India

PubMed Central

Mohan, Amit; Kaur, Navjot; Bhatanagar, Vishal C

2017-01-01

Purpose: The aim of the study was to evaluate the safety and efficacy of consecutive bilateral cataract surgery (CBCS) on two successive days in a single hospital visit. Methods: Prospective study was conducted on 565 patients of various tribes of hilly area of West Rajasthan who had come to our hospital through community outreach programmed (CORP) between January 2015 and March 2016. Patients with significant bilateral cataract without any other ocular morbidity were advised bilateral manual small incision cataract surgery on two consecutive days. Intraoperative and postoperative complications were evaluated, and follow-up was done at 1 week, 1 month, and 3 months. Results: Out of 565 patients, 519 underwent both eye surgeries. Second eye surgery was deferred for a later date in 46 cases. Because of intraoperative and postoperative complications in the first eye, 31 had delayed surgeries while 15 patients refused to undergo another eye surgery either because of postoperative day 1 poor vision in the operated eye due to retinal pathologies (n = 8) or unwillingness (n = 7). The second eye surgery was performed for 519 patients, out of whom six had intra or postoperative complications. At 1 month follow-up, four patients had unilateral cystoid macular edema and three had prolonged postoperative inflammation. At 3 months, all patients were satisfied and had no complications. None of the patients had sight-threatening complications such as endophthalmitis, corneal decompensation, or vitreoretinal complications. Conclusion: CBCS may be considered safe and cost-effective for patients living in remote locations, dependent on CORP. PMID:29208839

Daily Stressors and Adult Day Service Use by Family Caregivers: Effects on Depressive Symptoms, Positive Mood and DHEA-S

PubMed Central

Zarit, Steven H.; Whetzel, Courtney A.; Kim, Kyungmin; Femia, Elia E.; Almeida, David M.; Rovine, Michael J.; Klein, Laura Cousino

2014-01-01

Objectives This study examines effects of daily use of adult day services (ADS) programs by caregivers of individuals with dementia (IWD) on a salivary biomarker of stress reactivity, dehydroepiandrosterone-sulfate (DHEA-S), and whether these effects on DHEA-S are associated with daily variability in positive mood and depressive symptoms. Design We used a daily diary design of 8 consecutive days with alternation of intervention (ADS) and non-intervention days to evaluate within- and between-person effects of the intervention. Setting Caregivers were interviewed daily by telephone at home. Participants 151 family caregivers of IWD who were using ADS. Measurements Saliva samples were collected from caregivers 5 times a day for 8 consecutive days and were assayed for DHEA-S. Daily telephone interviews assessed daily stressors and mood. Results DHEA-S levels were significantly higher on days following ADS use. Daily DHEA-S levels covaried significantly with daily positive mood, but not depressive symptoms. Conclusions These results demonstrate an association of ADS use by family caregivers and higher DHEA-S levels on the next day. Prior research has found that higher DHEA-S levels are protective against the physiological damaging effects of stressor exposure and may reduce risks of illness. Regular use of ADS may help reduce depletion of DHEA-S and allow the body to mount a protective and restorative response to the physiological demands of caregiving. To our knowledge, this is the first study to examine DHEA-S levels across the day in connection with an intervention that affected daily exposure to stressors. PMID:24566240

Assessment of tolerance to the effects of methamphetamine on daytime and nighttime activity evaluated with actigraphy in rhesus monkeys.

PubMed

Berro, Laís F; Andersen, Monica L; Howell, Leonard L

2017-08-01

Methamphetamine is one of the most largely consumed illicit drugs, and its use is associated with abuse liability and several adverse health effects, such as sleep impairment. Importantly, sleep quality can influence addiction treatment outcomes. Evidence suggests that tolerance can develop to the sleep-disrupting effects of stimulant drugs. The aim of the present study was to investigate the development of tolerance to the actigraphy-based sleep-disrupting and stimulant effects of methamphetamine self-administration in rhesus monkeys. Methamphetamine (0.03 mg/kg/inf, i.v.) self-administration was carried out following three different protocols: 14 consecutive days of self-administration, 5 days/week for 3 weeks, with a 2-day interval between 5-day blocks of self-administration, and 3 days/week for 3 weeks, with a 4-day interval between 3-day blocks of self-administration. Daytime activity and activity-based sleep measures were evaluated with Actiwatch monitors a week before (baseline parameters) and throughout each protocol. Methamphetamine self-administration markedly disrupted sleep-like measures and increased daytime activity. Tolerance developed to those effects with repeated methamphetamine intake exceeding five consecutive days. Inclusion of washout periods (2 or 4 days) between blocks of methamphetamine self-administration attenuated the development of tolerance, with longer breaks from methamphetamine intake being more effective in maintaining the sleep-disrupting and stimulant effects of methamphetamine. Tolerance can develop to the stimulant and sleep-disrupting effects of methamphetamine self-administration. Interruption of drug intake extends the effects of methamphetamine on sleep-like measures and daytime activity.

Phase I Study of RO4929097, a Gamma Secretase Inhibitor of Notch Signaling, in Patients With Refractory Metastatic or Locally Advanced Solid Tumors

PubMed Central

Tolcher, Anthony W.; Messersmith, Wells A.; Mikulski, Stanislaw M.; Papadopoulos, Kyriakos P.; Kwak, Eunice L.; Gibbon, Darlene G.; Patnaik, Amita; Falchook, Gerald S.; Dasari, Arvind; Shapiro, Geoffrey I.; Boylan, John F.; Xu, Zhi-Xin; Wang, Ka; Koehler, Astrid; Song, James; Middleton, Steven A.; Deutsch, Jonathan; DeMario, Mark; Kurzrock, Razelle; Wheler, Jennifer J.

2012-01-01

Purpose To determine the maximum-tolerated dose (MTD) and assess safety, pharmacokinetics, pharmacodynamics, and evidence of antitumor activity of RO4929097, a gamma secretase inhibitor of Notch signaling in patients with advanced solid malignancies. Patients and Methods Patients received escalating doses of RO4929097 orally on two schedules: (A) 3 consecutive days per week for 2 weeks every 3 weeks; (B) 7 consecutive days every 3 weeks. To assess reversible CYP3A4 autoinduction, the expanded part of the study tested three dosing schedules: (B) as above; modified A, 3 consecutive d/wk for 3 weeks; and (C) continuous daily dosing. Positron emission tomography scans with [18F]fluorodeoxyglucose (FDG-PET) were used to assess tumor metabolic effects. Results Patients on schedule A (n = 58), B (n = 47), and C (n = 5; expanded cohort) received 302 cycles of RO4929097. Common grade 1 to 2 toxicities were fatigue, thrombocytopenia, fever, rash, chills, and anorexia. Transient grade 3 hypophosphatemia (dose-limiting toxicity, one patient) and grade 3 pruritus (two patients) were observed at 27 mg and 60 mg, respectively; transient grade 3 asthenia was observed on schedule A at 80 mg (one patient). Tumor responses included one partial response in a patient with colorectal adenocarcinoma with neuroendocrine features, one mixed response (stable disease) in a patient with sarcoma, and one nearly complete FDG-PET response in a patient with melanoma. Effect on CYP3A4 induction was observed. Conclusion RO4929097 was well tolerated at 270 mg on schedule A and at 135 mg on schedule B; the safety of schedule C has not been fully evaluated. Further studies are warranted on the basis of a favorable safety profile and preliminary evidence of clinical antitumor activity. PMID:22529266

The effect of the number of consecutive night shifts on diurnal rhythms in cortisol, melatonin and heart rate variability (HRV): a systematic review of field studies.

PubMed

Jensen, Marie Aarrebo; Garde, Anne Helene; Kristiansen, Jesper; Nabe-Nielsen, Kirsten; Hansen, Åse Marie

2016-05-01

The purpose of this review is to summarize the current knowledge from field studies on how many consecutive night shifts are required for adaptation of diurnal rhythms in cortisol, melatonin and heart rate variability (HRV) to night work. A systematic search of the databases PubMed and Web of Science resulted in 18 studies selected for review. Cortisol was measured in five studies, melatonin in 11 studies and HRV in four studies. Diurnal rhythms were assessed by use of several different measures based on three to eight samples per day for cortisol and melatonin and 24-h recordings for HRV. Most of the studies in the review were small studies with less than 30 participants, and most studies evaluated diurnal rhythms after only two consecutive night shifts whereas only six studies used seven or more consecutive night shifts. The majority of studies found that adaptation to night work had not occurred after two consecutive night shifts, whereas a small number found evidence for full adaptation after seven consecutive night shifts based on diurnal rhythms in cortisol and melatonin. There are methodological differences in the field studies analyzing diurnal rhythms and large diversity in the occupational fields studied. Nevertheless, we conclude that diurnal rhythms in cortisol, melatonin and HRV are not adapted to night work after 1-3 consecutive night shifts. Studies are needed to establish how many consecutive night shifts are needed for full adaptation of diurnal rhythms to night work.

Phase I dose-escalation study of vinflunine hard capsules administered twice a day for 2 consecutive days every week in patients with advanced/metastatic solid tumors.

PubMed

Calvo, E; Vermorken, J B; Hiret, S; Rodon, J; Cortes, J; Senellart, H; Van den Brande, J; Dyck, J; Pétain, A; Ferre, P; Bennouna, J

2012-06-01

Vinflunine is a new microtubule inhibitor of the vinca-alkaloid family. It is marketed in transitional cell carcinoma of urothelial tract as a 20 min infusion given every 3 weeks in Europe. In this phase I study, vinflunine was administered to patients with advanced malignancies as hard capsules given twice a day on days 1-2 every week, with 3 weeks cycles. Serial blood samples were collected during the first cycle for pharmacokinetic investigations. Thirty-six patients (pts) were treated at 6 dose levels 150 (3 pts), 190 (3 pts), 230 (8 pts), 300 mg/day (6 pts) and then 250 (3 pts) and 270 mg/day (13 pts). The Maximal Tolerated Dose (MTD) was reached at 300 mg/day where 2 patients out of 6 experienced a dose limiting toxicity (febrile neutropenia with diarrhea). The lower dose level of 270 mg/day was the recommended dose (RD), the toxicity profile being mainly anaemia, neutropenia, fatigue and constipation. The pharmacokinetic analysis demonstrated the adequacy of the flat-fixed dosing regimen, as no correlation between clearance of vinflunine and body surface area was evidenced. Blood concentrations and exposure increased with dose, and a pharmacokinetic accumulation was observed, which is consistent with the terminal half-life of the compounds. The inter-individual exposure variability at the RD was 35%. Repeated weekly administration of oral vinflunine is feasible and exhibits a moderate inter-individual PK variability. The MTD was achieved at 300 mg/day given for 2 consecutive days. According to the protocol rules, the RD was established at 270 mg/day.

Effect of time to infusion of autologous stem cells (24 vs. 48 h) after high-dose melphalan in patients with multiple myeloma.

PubMed

Talamo, Giampaolo; Rakszawski, Kevin L; Rybka, Witold B; Dolloff, Nathan G; Malysz, Jozef; Berno, Tamara; Zangari, Maurizio

2012-08-01

High-dose melphalan (HD-Mel) is considered the current standard of care among the preparative regimens used in autologous peripheral blood stem cell transplantation (SCT) for multiple myeloma (MM), but optimal time and schedule of administration is not defined. We retrospectively analyzed outcomes and toxicities of HD-Mel administered on day -2 vs. day -1 before autologous stem cells infusion. A total of 138 consecutive MM patients treated at Penn State Hershey Cancer Institute between 2007 and 2010 were included in this study. No difference in time to hematopoietic recovery, common SCT-related toxicities, and clinical outcomes was seen between patients who received HD-Mel on day -2 (group A, n = 47), and those who received it on day -1 (group B, n = 91). Prompt and full hematopoietic recovery occurred even when stem cells were infused between 8 and 24 h after completion of chemotherapy. In the absence of prospective and randomized data, we conclude that a single I.V. infusion of HD-Mel on day -1 is a safe and effective practice, and the so-called 'day of rest' before the transplant appears not to be necessary. © 2012 John Wiley & Sons A/S.

Granulocyte-macrophage colony-stimulating factor alone or with dacarbazine in metastatic melanoma: a randomized phase II trial.

PubMed

Ravaud, A; Delaunay, M; Chevreau, C; Coulon, V; Debled, M; Bret-Dibat, C; Courbon, F; Gualde, N; Nguyen Bui, B

2001-11-16

The potential antitumoral effect of granulocyte-macrophage colony-stimulating factor (GM-CSF) led us to evaluate GM-CSF alone or with dacarbazine (DTIC) in metastatic melanoma in first line randomized phase II. Treatment was arm A: GM-CSF: 5 microg kg(-1), bid, 14 consecutive days every 21 days and arm B: GM-CSF: 5 microg kg(-1), bid, day 2 to day 19 every 21 days and DTIC: 800 mg m(-2), day 1 of each cycle. 32 patients (pts) were included, 15 pts in arm A and 17 in arm B. All pts had visceral metastatic sites. 9 had only one metastatic site. The median number of cycles given was 2 in arm A and 3 in arm B. 100% and 89.4% of the planned dose of GM-CSF was given in arm A and arm B respectively. No objective response was obtained. 19 pts experienced at least WHO grade 3 toxicity. All pts had fever, 29 had a decrease in performance status and 23 had pain. Grade 3 toxicity were fever (38.7%), decrease in performance status (32.3%), pain (19.4%) and dyspnoea (12.5%). In this study, GM-CSF alone or in association with DTIC did not induce any antitumoral activity with subsequent toxicity.

Effectiveness of treatment based on PiCCO parameters in critically ill patients with septic shock and/or acute respiratory distress syndrome: a randomized controlled trial.

PubMed

Zhang, Zhongheng; Ni, Hongying; Qian, Zhixian

2015-03-01

To compare treatment based on either PiCCO-derived physiological values or central venous pressure (CVP) monitoring, we performed a prospective randomized controlled trial with group sequential analysis. Consecutive critically ill patients with septic shock and/or ARDS were included. The planned total sample size was 715. The primary outcome was 28-day mortality after randomization. Participants underwent stratified randomization according to the classification of ARDS and/or septic shock. Caregivers were not blinded to the intervention, but participants and outcome assessors were blinded to group assignment. The study was stopped early because of futility after enrollment of 350 patients including 168 in the PiCCO group and 182 in the control group. There was no loss to follow-up and data from all enrolled participants were analyzed. The result showed that treatment based on PiCCO-derived physiological values was not able to reduce the 28-day mortality risk (odds ratio 1.00, 95 % CI 0.66-1.52; p = 0.993). There was no difference between the two groups in secondary outcomes such as 14-day mortality (40.5 vs. 41.2 %; p = 0.889), ICU length of stay (median 9 vs. 7.5 days; p = 0.598), days free of vasopressors (median 14.5 vs. 19 days; p = 0.676), and days free of mechanical ventilation (median 3 vs. 6 days; p = 0.168). No severe adverse event was reported in both groups. On the basis of our study, PICCO-based fluid management does not improve outcome when compared to CVP-based fluid management.

40 CFR 418.52 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... from nitric acid production in which all the raw material ammonia is in the gaseous form: [Metric units... limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Ammonia... all the raw material ammonia is in the shipped liquid form: [Metric units, kg/kkg of product; English...

40 CFR 418.52 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... from nitric acid production in which all the raw material ammonia is in the gaseous form: [Metric units... limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Ammonia... all the raw material ammonia is in the shipped liquid form: [Metric units, kg/kkg of product; English...

40 CFR 418.52 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... from nitric acid production in which all the raw material ammonia is in the gaseous form: [Metric units... limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Ammonia... all the raw material ammonia is in the shipped liquid form: [Metric units, kg/kkg of product; English...

40 CFR 418.52 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... from nitric acid production in which all the raw material ammonia is in the gaseous form: [Metric units... limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Ammonia... all the raw material ammonia is in the shipped liquid form: [Metric units, kg/kkg of product; English...

40 CFR 418.52 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... from nitric acid production in which all the raw material ammonia is in the gaseous form: [Metric units... limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Ammonia... all the raw material ammonia is in the shipped liquid form: [Metric units, kg/kkg of product; English...

Informal/Formal Learning and Workload among Ontario Secondary School Teachers. NALL Working Paper.

ERIC Educational Resources Information Center

Smaller, Harry; Hart, Doug; Clark, Rosemary; Livingstone, David

Following up on an earlier national survey study of Canadian teachers' formal and informal learning, this study had 13 Ontario secondary teachers keep detailed logs of their day and evening activities, along with notations about what they may have learned as a result of engaging in each activity, for 7 consecutive days in late 1999, and again in…

43 CFR 3602.42 - How does BLM publicize competitive mineral materials sales?

Code of Federal Regulations, 2011 CFR

2011-10-01

... where the material is located, on the same day once a week for 2 consecutive weeks; and (2) Will post a... are offering; (4) The unit of measurement; (5) The appraised prices; (6) The time and place for... cost recovery fee paid to BLM by the applicant up to 21 days before the sale; (9) The site access that...

49 CFR 192.5 - Class locations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... assembly) that is occupied by 20 or more persons on at least 5 days a week for 10 weeks in any 12-month period. (The days and weeks need not be consecutive.) (4) A Class 4 location is any class location unit... 2, 3, and 4 may be adjusted as follows: (1) A Class 4 location ends 220 yards (200 meters) from the...

40 CFR 413.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

... days shall not exceed CN, T 1.9 1.0 Cu 4.5 2.7 Ni 4.1 2.6 Cr 7.0 4.0 Zn 4.2 2.6 Pb 0.6 0.4 Cd 1.2 0.7... of daily values for 4 consecutive monitoring days shall not exceed CN, T 74 39 Cu 176 105 Ni 160 100...

40 CFR 413.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... days shall not exceed CN, T 1.9 1.0 Cu 4.5 2.7 Ni 4.1 2.6 Cr 7.0 4.0 Zn 4.2 2.6 Pb 0.6 0.4 Cd 1.2 0.7... of daily values for 4 consecutive monitoring days shall not exceed CN, T 74 39 Cu 176 105 Ni 160 100...

78 FR 57674 - Order Limiting Operations at Newark Liberty International Airport

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-19

... season. This waiver applies only to EWR slots for the following days and local times: (1) March 30... runway 4L/22R. Runway 4L/22R will be open during that period with reduced runway length. Night and... five or more consecutive days. However, the FAA does not routinely grant general waivers to the usage...

Expressive Writing for Gay-Related Stress: Psychosocial Benefits and Mechanisms Underlying Improvement

ERIC Educational Resources Information Center

Pachankis, John E.; Goldfried, Marvin R.

2010-01-01

Objective: This study tested the effectiveness of an expressive writing intervention for gay men on outcomes related to psychosocial functioning. Method: Seventy-seven gay male college students (mean age = 20.19 years, SD = 1.99) were randomly assigned to write for 20 min a day for 3 consecutive days about either (a) the most stressful or…

Prenatal tolbutamide treatment alters plasma glucose and insulin concentrations and negatively affects the postnatal performance of chickens.

PubMed

Franssens, L; Lesuisse, J; Wang, Y; De Ketelaere, B; Willems, E; Koppenol, A; Guo, X; Buyse, J; Decuypere, E; Everaert, N

2015-07-01

To examine the relationship of insulin and glucose, broiler embryos were subjected to acute or prolonged hypoglycemia during the late embryonic phase by, respectively, injecting once (at embryonic day [ED] 16 or 17) or on 3 consecutive days (ED 16, 17, and 18) with tolbutamide (80 μg/g embryo weight), a substance that stimulates insulin secretion from the pancreas. After 1 tolbutamide injection, a prolonged (32 h) decrease of plasma glucose and a profound acute increase in plasma insulin were observed. The 3 consecutive tolbutamide injections induced hypoglycemia for 4 days (from ED 16 to ED 19). The postnatal performance after 3 consecutive tolbutamide injections in broiler embryos was also investigated. Body weight was lower in tolbutamide-treated chickens from hatch to 42 d compared with sham (P = 0.001) and control (P < 0.001) chickens. Feed intake was lower in the tolbutamide group from hatch to 42 d as compared with sham (P = 0.007) and control (P = 0.017) animals. In addition, at 42 d, plasma glucose concentrations, after an insulin injection challenge (50 μg/kg body weight), were higher in tolbutamide-treated chickens compared with the sham and the control group as were their basal glucose levels (P value of group effect <0.001). In conclusion, tolbutamide treatment during the late embryonic development in broilers resulted in prolonged hypoglycemia in this period and negatively influenced the posthatch performance. Copyright © 2015 Elsevier Inc. All rights reserved.

Analysis of Correlation between Ionospheric Spatial Gradients and Space Weather Intensity under Nominal Conditions for Ground-Based Augmentation Systems

NASA Astrophysics Data System (ADS)

Lee, J.

2013-12-01

Ground-Based Augmentation Systems (GBAS) support aircraft precision approach and landing by providing differential GPS corrections to aviation users. For GBAS applications, most of ionospheric errors are removed by applying the differential corrections. However, ionospheric correction errors may exist due to ionosphere spatial decorrelation between GBAS ground facility and users. Thus, the standard deviation of ionosphere spatial decorrelation (σvig) is estimated and included in the computation of error bounds on user position solution. The σvig of 4mm/km, derived for the Conterminous United States (CONUS), bounds one-sigma ionospheric spatial gradients under nominal conditions (including active, but not stormy condition) with an adequate safety margin [1]. The conservatism residing in the current σvig by fixing it to a constant value for all non-stormy conditions could be mitigated by subdividing ionospheric conditions into several classes and using different σvig for each class. This new concept, real-time σvig adaptation, will be possible if the level of ionospheric activity can be well classified based on space weather intensity. This paper studies correlation between the statistics of nominal ionospheric spatial gradients and space weather indices. The analysis was carried out using two sets of data collected from Continuous Operating Reference Station (CORS) Network; 9 consecutive (nominal and ionospherically active) days in 2004 and 19 consecutive (relatively 'quiet') days in 2010. Precise ionospheric delay estimates are obtained using the simplified truth processing method and vertical ionospheric gradients are computed using the well-known 'station pair method' [2]. The remaining biases which include carrier-phase leveling errors and Inter-frequency Bias (IFB) calibration errors are reduced by applying linear slip detection thresholds. The σvig was inflated to overbound the distribution of vertical ionospheric gradients with the required confidence level. Using the daily maximum values of σvig, day-to-day variations of spatial gradients are compared to those of two space weather indices; Disturbance, Storm Time (Dst) index and Interplanetary Magnetic Field Bz (IMF Bz). The day-to-day variations of both space weather indices showed a good agreement with those of daily maximum σvig. The results demonstrate that ionospheric gradient statistics are highly correlated with space weather indices on nominal and off-nominal days. Further investigation on this relationship would facilitate prediction of upcoming ionospheric behavior based on space weather information and adjusting σvig in real time. Consequently it will improve GBAS availability by adding external information to operation. [1] Lee, J., S. Pullen, S. Datta-Barua, and P. Enge (2007), Assessment of ionosphere spatial decorrelation for GPS-based aircraft landing systems, J. Aircraft, 44(5), 1662-1669, doi:10.2514/1.28199. [2] Jung, S., and J. Lee (2012), Long-term ionospheric anomaly monitoring for ground based augmentation systems, Radio Sci., 47, RS4006, doi:10.1029/2012RS005016.

Study protocol of physical activity and sedentary behaviour measurement among schoolchildren by accelerometry--cross-sectional survey as part of the ENERGY-project.

PubMed

Yıldırım, Mine; Verloigne, Maïté; de Bourdeaudhuij, Ilse; Androutsos, Odysseas; Manios, Yannis; Felso, Regina; Kovács, Éva; Doessegger, Alain; Bringolf-Isler, Bettina; te Velde, Saskia J; Brug, Johannes; Chinapaw, Mai J M

2011-03-25

Physical activity and sedentary behaviour among children should be measured accurately in order to investigate their relationship with health. Accelerometry provides objective and accurate measurement of body movement, which can be converted to meaningful behavioural outcomes. The aim of this study was to evaluate the best evidence for the decisions on data collection and data processing with accelerometers among children resulting in a standardized protocol for use in the participating countries. This cross-sectional accelerometer study was conducted as part of the European ENERGY-project that aimed to produce an obesity prevention intervention among schoolchildren. Five countries, namely Belgium, Greece, Hungary, Switzerland and the Netherlands participated in the accelerometer study. We used three different Actigraph models--Actitrainers (triaxial), GT3Xs and GT1Ms. Children wore the device for six consecutive days including two weekend days. We selected an epoch length of 15 seconds. Accelerometers were placed at children's waist at the right side of the body in an elastic belt. In total, 1082 children participated in the study (mean age = 11.7 ± 0.75 y, 51% girls). Non-wearing time was calculated as periods of more than 20 minutes of consecutive zero counts. The minimum daily wearing time was set to 10 hours for weekdays and 8 hours for weekend days. The inclusion criterion for further analysis was having at least three valid weekdays and one valid weekend day. We selected a cut-point (count per minute (cpm)) of <100 cpm for sedentary behaviour, <3000 cpm for light, <5200 cpm for moderate, and >5200 cpm for vigorous physical activity. We also created time filters for school-time during data cleaning in order to explore school-time physical activity and sedentary behaviour patterns in particular. This paper describes the decisions for data collection and processing. Use of standardized protocols would ease future use of accelerometry and the comparability of results between studies.

Role of resolution in regional climate change projections over China

NASA Astrophysics Data System (ADS)

Shi, Ying; Wang, Guiling; Gao, Xuejie

2017-11-01

This paper investigates the sensitivity of projected future climate changes over China to the horizontal resolution of a regional climate model RegCM4.4 (RegCM), using RCP8.5 as an example. Model validation shows that RegCM performs better in reproducing the spatial distribution and magnitude of present-day temperature, precipitation and climate extremes than the driving global climate model HadGEM2-ES (HadGEM, at 1.875° × 1.25° degree resolution), but little difference is found between the simulations at 50 and 25 km resolutions. Comparison with observational data at different resolutions confirmed the added value of the RCM and finer model resolutions in better capturing the probability distribution of precipitation. However, HadGEM and RegCM at both resolutions project a similar pattern of significant future warming during both winter and summer, and a similar pattern of winter precipitation changes including dominant increase in most areas of northern China and little change or decrease in the southern part. Projected precipitation changes in summer diverge among the three models, especially over eastern China, with a general increase in HadGEM, little change in RegCM at 50 km, and a mix of increase and decrease in RegCM at 25 km resolution. Changes of temperature-related extremes (annual total number of daily maximum temperature > 25 °C, the maximum value of daily maximum temperature, the minimum value of daily minimum temperature in the three simulations especially in the two RegCM simulations are very similar to each other; so are the precipitation-related extremes (maximum consecutive dry days, maximum consecutive 5-day precipitation and extremely wet days' total amount). Overall, results from this study indicate a very low sensitivity of projected changes in this region to model resolution. While fine resolution is critical for capturing the spatial variability of the control climate, it may not be as important for capturing the climate response to homogeneous forcing (in this case greenhouse gas concentration changes).

Elective colorectal surgery without bowel preparation: a historical control and case-matched study.

PubMed

Pitot, D; Bouazza, E; Chamlou, R; Van de Stadt, J

2009-01-01

Although full bowel preparation, including mechanical washout and non-absorbable antibiotherapy, has been considered for decades as a prerequisite to any elective colorectal surgery, recent literature has suggested that this habit was perhaps unjustified. The aim of this study was to assess the safety of ileocolic, colocolic and colorectal anastomosis in the absence of pre-operative mechanical bowel preparation. During a 1-year period, 59 consecutive patients underwent elective colorectal surgery with ileocolic, colocolic or colorectal anastomosis without any pre-operative preparation. This "non-prepared group" (NPG) was compared to a "control group" (CG) composed of the previous 127 consecutive cases of classically managed patients. To improve the statistical power we also compared the NPG to a "match-controlled group" (MCG) of 59 patients within the CG. Primary end-points were anastomotic leakage and abdominal infections. Secondary end-points were oral diet resume time and hospital stay. There were no differences between the 3 groups for age, gender, BMI, immunodepression status, anastomosis site and suture technique. There were no differences between NPG and CG or MCG for anastomotic leakage (3.5%, 4.7% and 6.8% respectively, NPG/CG p = 0.68 and NPG/MCG p = 0.4) or for infectious abdominal complications. Mean diet resume time was 1.4 (1-5) days in the NPG versus 3.4 (1-19) days in the CG and 3.1 (1-6) days in the MCG (p < 0.00001). Median length of postoperative hospital stay was 5 (2-81) days in the NPG versus 8 (4-100) and 8 (4-100) in the CG and the MCG respectively. In accordance with the recent literature, the present experience does not show any benefit of mechanical bowel preparation in elective colorectal resection. This suggests that bowel preparation could be omitted before this type of surgery.

Effects of long working hours and the night shift on severe sleepiness among workers with 12-hour shift systems for 5 to 7 consecutive days in the automobile factories of Korea.

PubMed

Son, Mia; Kong, Jeong-Ok; Koh, Sang-Baek; Kim, Jaeyoung; Härmä, Mikko

2008-12-01

We investigated the effects of 12-hour shift work for five to seven consecutive days and overtime on the prevalence of severe sleepiness in the automobile industry in Korea. [Correction added after online publication 28 Nov: Opening sentence of the summary has been rephrased for better clarity.] A total of 288 randomly selected male workers from two automobile factories were selected and investigated using questionnaires and sleep-wake diaries in South Korea. The prevalence of severe sleepiness at work [i.e. Karolinska Sleepiness Scale (KSS) score of 7 or higher] was modeled using marginal logistic regression and included theoretical risk factors related to working hours and potential confounding factors related to socio-economic status, work demands, and health behaviors. Factors related to working hours increased the risk for severe sleepiness at the end of the shift in the following order: the night shift [odds ratio (OR): 4.7; 95% confidence interval (CI): 3.6-6.0)], daily overtime (OR: 2.2; 95% CI: 1.7-2.9), weekly overtime (OR: 1.6; 95% CI: 1.0-2.6), and night overtime (OR: 1.6; 95% CI: 0.8-3.0). Long working hours and shift work had a significant interactive effect for severe sleepiness at work. Night shift workers who worked for 12 h or more a day were exposed to a risk of severe sleepiness that was 7.5 times greater than day shift workers who worked less than 11 h. Night shifts and long working hours were the main risk factors for severe sleepiness among automobile factory workers in Korea. Night shifts and long working hours have a high degree of interactive effects resulting in severe sleepiness at work, which highlight the need for immediate measures to address these characteristics among South Korean labor force patterns.

Accelerating locomotor savings in learning: compressing four training days to one.

PubMed

Day, Kevin A; Leech, Kristan A; Roemmich, Ryan T; Bastian, Amy J

2018-06-01

Acquiring new movements requires the capacity of the nervous system to remember previously experienced motor patterns. The phenomenon of faster relearning after initial learning is termed "savings." Here we studied how savings of a novel walking pattern develops over several days of practice and how this process can be accelerated. We introduced participants to a split-belt treadmill adaptation paradigm for 30 min for 5 consecutive days. By training day 5, participants were able to produce near-perfect performance when switching between split and tied-belt environments. We found that this was due to their ability to shift specific elements of their stepping pattern to account for the split treadmill speeds from day to day. We also applied a state-space model to further characterize multiday locomotor savings. We then explored methods of achieving comparable savings with less total training time. We studied people training only on day 1, with either one extended split-belt exposure or alternating four times between split-belt and tied-belt conditions rapidly in succession. Both of these single-day training groups were tested again on day 5. Experiencing four abbreviated exposures on day 1 improved the performance on day 5 compared with one extended exposure on day 1. Moreover, this abbreviated group performed similarly to the group that trained for 4 consecutive days before testing on day 5, despite only having one-quarter of the total training time. These results demonstrate that we can leverage training structure to achieve a high degree of performance while minimizing training sessions. NEW & NOTEWORTHY Learning a new movement requires repetition. Here, we demonstrate how to more efficiently train an adapted walking pattern. By compressing split-belt treadmill training delivered over 4 days to four abbreviated bouts of training delivered on the first day of training, we were able to induce equivalent savings over a 5-day span. These results suggest that we can manipulate the delivery of training to most efficiently drive multiday learning of a novel walking pattern.

Implementation of enhanced recovery programme after pancreatoduodenectomy: a single-centre UK pilot study.

PubMed

Abu Hilal, Mohammed; Di Fabio, Francesco; Badran, Abdallah; Alsaati, Hani; Clarke, Hannah; Fecher, Imogen; Armstrong, Thomas H; Johnson, Colin D; Pearce, Neil W

2013-01-01

Data on enhanced recovery programmes after pancreatoduodenectomy (ERP-PD) is limited. The aim of this pilot study was to evaluate the feasibility, safety and clinical outcomes of ERP-PD when implemented at a high-volume UK university referral centre. This was an observational single-surgeon case-control study (before-and-after pathway). A total of 20 consecutive patients were prospectively enrolled for the ERP-PD and compared with 24 consecutive patients previously treated during an equal time frame. Patients in the ERP-PD group had a significant shorter time to remove naso-gastric tube (median of 5 vs. 7 days, p = 0.0001), start liquid diet (median of 2 vs. 5 days, p < 0.0001), start solid food (median of 4 vs. 9 days, p < 0.0001), pass stools (median of 6 vs. 7 days, p = 0.002), and had shorter length of stay (median of 8.5 days vs. 13 days, p = 0.015) compared to the pre-pathway group. Postoperative complications were overall less frequent but not significantly different in the ERP-PD group (p = 0.077). No difference in mortality and readmission rates was found. Our findings support the feasibility and safety of ERP-PD. Improved patients' outcomes, significant bed day savings and increase National Health Service productivity are anticipated with implementation of ERP-PD on a larger scale. Copyright © 2012 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Associations among daily stressors and salivary cortisol: findings from the National Study of Daily Experiences.

PubMed

Stawski, Robert S; Cichy, Kelly E; Piazza, Jennifer R; Almeida, David M

2013-11-01

While much research has focused on linking stressful experiences to emotional and biological reactions in laboratory settings, there is an emerging interest in extending these examinations to field studies of daily life. The current study examined day-to-day associations among naturally occurring daily stressors and salivary cortisol in a national sample of adults from the second wave of the National Study of Daily Experiences (NSDE). A sample of 1694 adults (age=57, range=33-84; 44% male) completed telephone interviews detailing their stressors and emotions on eight consecutive evenings. Participants also provided saliva samples upon waking, 30min post-waking, before lunch and before bed, on four consecutive interview days resulting in 5995 days of interview/cortisol data. Analyses revealed three main findings. First, cortisol AUC was significantly higher on stressor days compared to stressor-free days, particularly for arguments and overloads at home, suggesting that daily stressors are associated with increased cortisol output, but that not all daily stressors have such an influence. Second, individuals reporting a greater frequency of stressor days also exhibited a steeper diurnal cortisol slope. Finally, daily stressor-cortisol associations were unaltered after adjustment for daily negative affect and physical symptoms. Our discussion focuses on the influence of naturally occurring daily stressors on daily cortisol and the role of daily diary approaches for studying healthy cortisol responses to psychosocial stressors outside of traditional laboratory settings. Copyright © 2013 Elsevier Ltd. All rights reserved.

Associations among Daily Stressors and Salivary Cortisol: Findings from the National Study of Daily Experiences

PubMed Central

Stawski, Robert S.; Cichy, Kelly E.; Piazza, Jennifer R.; Almeida, David M.

2013-01-01

While much research has focused on linking stressful experiences to emotional and biological reactions in laboratory settings, there is an emerging interest in extending these examinations to field studies of daily life. The current study examined day-to-day associations among naturally-occurring daily stressors and salivary cortisol in a national sample of adults from the second wave of the National Study of Daily Experiences (NSDE). A sample of 1,694 adults (Age=57, Range=33–84; 44% male) completed telephone interviews detailing their stressors and emotions on eight consecutive evenings. Participants also provided saliva samples upon waking, 30 minutes post-waking, before lunch and before bed, on four consecutive interview days resulting in 5,995 days of interview/cortisol data. Analyses revealed three main findings. First, cortisol AUC was significantly higher on stressor days compared to stressor-free days, particularly for arguments and overloads at home, suggesting that daily stressors are associated with increased cortisol output, but that not all daily stressors have such an influence. Second, individuals reporting a greater frequency of stressor days also exhibited a steeper diurnal cortisol slope. Finally, daily stressor-cortisol associations were unaltered after adjustment for daily negative affect and physical symptoms. Our discussion focuses on the influence of naturally-occurring daily stressors on daily cortisol and the role of daily diary approaches for studying healthy cortisol responses to psychosocial stressors outside of traditional laboratory settings. PMID:23856186

Diagnostic Accuracy and Cost-Effectiveness of Alternative Methods for Detection of Soil-Transmitted Helminths in a Post-Treatment Setting in Western Kenya

PubMed Central

Kepha, Stella; Kihara, Jimmy H.; Njenga, Sammy M.; Pullan, Rachel L.; Brooker, Simon J.

2014-01-01

Objectives This study evaluates the diagnostic accuracy and cost-effectiveness of the Kato-Katz and Mini-FLOTAC methods for detection of soil-transmitted helminths (STH) in a post-treatment setting in western Kenya. A cost analysis also explores the cost implications of collecting samples during school surveys when compared to household surveys. Methods Stool samples were collected from children (n = 652) attending 18 schools in Bungoma County and diagnosed by the Kato-Katz and Mini-FLOTAC coprological methods. Sensitivity and additional diagnostic performance measures were analyzed using Bayesian latent class modeling. Financial and economic costs were calculated for all survey and diagnostic activities, and cost per child tested, cost per case detected and cost per STH infection correctly classified were estimated. A sensitivity analysis was conducted to assess the impact of various survey parameters on cost estimates. Results Both diagnostic methods exhibited comparable sensitivity for detection of any STH species over single and consecutive day sampling: 52.0% for single day Kato-Katz; 49.1% for single-day Mini-FLOTAC; 76.9% for consecutive day Kato-Katz; and 74.1% for consecutive day Mini-FLOTAC. Diagnostic performance did not differ significantly between methods for the different STH species. Use of Kato-Katz with school-based sampling was the lowest cost scenario for cost per child tested ($10.14) and cost per case correctly classified ($12.84). Cost per case detected was lowest for Kato-Katz used in community-based sampling ($128.24). Sensitivity analysis revealed the cost of case detection for any STH decreased non-linearly as prevalence rates increased and was influenced by the number of samples collected. Conclusions The Kato-Katz method was comparable in diagnostic sensitivity to the Mini-FLOTAC method, but afforded greater cost-effectiveness. Future work is required to evaluate the cost-effectiveness of STH surveillance in different settings. PMID:24810593

Pattern and determinants of hospitalization during heat waves: an ecologic study

PubMed Central

Mastrangelo, Giuseppe; Fedeli, Ugo; Visentin, Cristiana; Milan, Giovanni; Fadda, Emanuela; Spolaore, Paolo

2007-01-01

Background Numerous studies have investigated mortality during a heatwave, while few have quantified heat associated morbidity. Our aim was to investigate the relationship between hospital admissions and intensity, duration and timing of heatwave across the summer months. Methods The study area (Veneto Region, Italy) holds 4577408 inhabitants (on January 1st, 2003), and is subdivided in seven provinces with 60 hospitals and about 20000 beds for acute care. Five consecutive heatwaves (three or more consecutive days with Humidex above 40°C) occurred during summer 2002 and 2003 in the region. From the regional computerized archive of hospital discharge records, we extracted the daily count of hospital admissions for people aged ≥75, from June 1 through August 31 in 2002 and 2003. Among people aged over 74 years, daily hospital admissions for disorders of fluid and electrolyte balance, acute renal failure, and heat stroke (grouped in a single nosologic entity, heat diseases, HD), respiratory diseases (RD), circulatory diseases (CD), and a reference category chosen a priori (fractures of the femur, FF) were independently analyzed by Generalized Estimating Equations. Results Heatwave duration, not intensity, increased the risk of hospital admissions for HD and RD by, respectively, 16% (p < .0001) and 5% (p < .0001) with each additional day of heatwave duration. At least four consecutive hot humid days were required to observe a major increase in hospital admissions, the excesses being more than twofold for HD (p < .0001) and about 50% for RD (p < .0001). Hospital admissions for HD peaked equally at the first heatwave (early June) and last heatwave (August) in 2004 as did RD. No correlation was found for FF or CD admissions. Conclusion The first four days of an heatwave had only minor effects, thus supporting heat health systems where alerts are based on duration of hot humid days. Although the finding is based on a single late summer heatwave, adaptations to extreme temperature in late summer seem to be unlikely. PMID:17688689

Diagnostic accuracy and cost-effectiveness of alternative methods for detection of soil-transmitted helminths in a post-treatment setting in western Kenya.

PubMed

Assefa, Liya M; Crellen, Thomas; Kepha, Stella; Kihara, Jimmy H; Njenga, Sammy M; Pullan, Rachel L; Brooker, Simon J

2014-05-01

This study evaluates the diagnostic accuracy and cost-effectiveness of the Kato-Katz and Mini-FLOTAC methods for detection of soil-transmitted helminths (STH) in a post-treatment setting in western Kenya. A cost analysis also explores the cost implications of collecting samples during school surveys when compared to household surveys. Stool samples were collected from children (n = 652) attending 18 schools in Bungoma County and diagnosed by the Kato-Katz and Mini-FLOTAC coprological methods. Sensitivity and additional diagnostic performance measures were analyzed using Bayesian latent class modeling. Financial and economic costs were calculated for all survey and diagnostic activities, and cost per child tested, cost per case detected and cost per STH infection correctly classified were estimated. A sensitivity analysis was conducted to assess the impact of various survey parameters on cost estimates. Both diagnostic methods exhibited comparable sensitivity for detection of any STH species over single and consecutive day sampling: 52.0% for single day Kato-Katz; 49.1% for single-day Mini-FLOTAC; 76.9% for consecutive day Kato-Katz; and 74.1% for consecutive day Mini-FLOTAC. Diagnostic performance did not differ significantly between methods for the different STH species. Use of Kato-Katz with school-based sampling was the lowest cost scenario for cost per child tested ($10.14) and cost per case correctly classified ($12.84). Cost per case detected was lowest for Kato-Katz used in community-based sampling ($128.24). Sensitivity analysis revealed the cost of case detection for any STH decreased non-linearly as prevalence rates increased and was influenced by the number of samples collected. The Kato-Katz method was comparable in diagnostic sensitivity to the Mini-FLOTAC method, but afforded greater cost-effectiveness. Future work is required to evaluate the cost-effectiveness of STH surveillance in different settings.

Influence of desflurane on postoperative oral intake compared with propofol.

PubMed

Yatabe, Tomoaki; Yamashita, Koichi; Yokoyama, Masataka

2014-01-01

Postoperative oral intake is an important predictor of early postoperative recovery, and anesthesia is known to influence this intake. We compared the influences of desflurane anesthesia and propofol anesthesia on early postoperative oral intake retrospectively. The subjects included a consecutive series of patients who received general anesthesia with propofol or desflurane between June and December 2013. The total amount of calories and proteins taken orally and the incidence of postoperative nausea and vomiting (PONV) on postoperative days (POD) 0, 1, and 2 were collected. A total of 147 patients were analyzed. The desflurane (Des) and the propofol (Pro) groups included 52 and 95 patients, respectively. The incidence of PONV on POD 0, 1, and 2 did not show significant intergroup differences. Total calorie intake on POD 1 and 2 was not significantly different between the 2 groups (1117 ± 508 vs. 1036 ± 549 kcal/day, p=0.39 and 1504 ± 368 vs. 1437 ± 433 kcal/day, p=0.35, respectively). Total amount of protein via oral intake on POD 1 and 2 were not significantly different between the two groups (45.9 ± 21.1 vs. 43.8 ± 22.8 g/day, p=0.60 and 61.3 ± 15.0 vs. 58.9 ± 18.0 g/day, p=0.42, respectively). These findings suggest that desflurane and propofol affect postoperative oral intake in a similar fashion. These results should be confirmed in a future prospective study.

An effective repetitive training schedule to achieve skill proficiency using a novel robotic virtual reality simulator.

PubMed

Kang, Sung Gu; Ryu, Byung Ju; Yang, Kyung Sook; Ko, Young Hwii; Cho, Seok; Kang, Seok Ho; Patel, Vipul R; Cheon, Jun

2015-01-01

A robotic virtual reality simulator (Mimic dV-Trainer) can be a useful training method for the da Vinci surgical system. Herein, we investigate several repetitive training schedules and determine which is the most effective. A total of 30 medical students were enrolled and were divided into 3 groups according to the training schedule. Group 1 performed the task 1 hour daily for 4 consecutive days, group II performed the task on once per week for 1 hour for 4 consecutive weeks, and group III performed the task for 4 consecutive hours in 1 day. The effects of training were investigated by analyzing the number of repetitions and the time required to complete the "Tube 2" simulation task when the learning curve plateau was reached. The point at which participants reached a stable score was evaluated using the cumulative sum control graph. The average time to complete the task at the learning curve plateau was 150.3 seconds in group I, 171.9 seconds in group II, and 188.5 seconds in group III. The number of task repetitions required to reach the learning curve plateau was 45 repetitions in group I, 36 repetitions in group II, and 39 repetitions in group III. Therefore, there was continuous improvement in the time required to perform the task after 40 repetitions in group I only. There was a significant correlation between improvement in each trial interval and attempt, and the correlation coefficient (0.924) in group I was higher than that in group II (0.899) and group III (0.838). Daily 1-hour practice sessions performed for 4 consecutive days resulted in the best final score, continuous score improvement, and effective training while minimizing fatigue. This repetition schedule can be used for effectively training novices in future. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Assessing the performance of satellite-based precipitation products over the Mediterranean region

NASA Astrophysics Data System (ADS)

Xaver, Angelika; Dorigo, Wouter; Brocca, Luca; Ciabatta, Luca

2017-04-01

Detailed knowledge about the spatial and temporal patterns and quantities of precipitation is of high importance. This applies especially in the Mediterranean region, where water demand for agricultural, industrial and touristic needs is growing and climate projections foresee a decrease of precipitation amounts and an increase in variability. In this region, ground-based rain gauges are available only limited in number, particularly in northern Africa and the Middle East and lack to capture the high spatio-temporal character of precipitation over large areas. This has motivated the development of a large number of remote sensing products for monitoring rainfall. Satellite-based precipitation products are based on various observation principles and retrieval approaches, i.e. from thermal infra-red and microwaves. Although, many individual validation studies on the performance of these precipitation datasets exist, they mostly examine only one or a few of these rainfall products at the same time and are not targeted at the Mediterranean basin as a whole. Here, we present an extensive comparative study of seven different satellite-based precipitation products, namely CMORPH 30-minutes, CMORPH 3-hourly, GPCP, PERSIANN, SM2Rain CCI, TRMM TMPA 3B42, and TRMM TMPA 3B42RT, focusing on the whole Mediterranean region and on individual Mediterranean catchments. The time frame of investigation is restricted by the common availability of all precipitation products and covers the period 2000-2013. We assess the skill of the satellite products against gridded gauge-based data provided by GPCC and E-OBS. Apart from common characteristics like biases and temporal correlations we evaluate several sophisticated dataset properties that are of particular interest for Mediterranean hydrology, including the capability of the remotely sensed products to capture extreme events and trends. A clear seasonal dependency of the correlation results can be observed for the whole Mediterranean basin as well as for the individual catchments. While high correlation values are achieved for basins north of the Mediterranean Sea, the African Nile catchment is showing the lowest correlation values. When examining the climate indices, e.g. number of (very) heavy precipitation days, the maximum precipitation amount of five consecutive wet days, maximum number of consecutive wet days, it becomes clear that the satellite-based precipitation products are having difficulties in capturing consecutive rainfall events. More promising results are obtained when calculating the total annual amount of precipitation or the number of heavy precipitation days.

Risk assessment of the cumulative acute exposure of Hungarian population to organophosphorus pesticide residues with regard to consumers of plant based foods.

PubMed

Zentai, Andrea; Szabó, István J; Kerekes, Kata; Ambrus, Árpád

2016-03-01

Based on the Hungarian pesticide residues monitoring data of the last five years and the consumption data collected within a 3-day dietary record survey in 2009 (more than 2 million pesticide residue results and almost 5000, 0-101-year-old consumers 3 non-consecutive-day personal fruit and vegetable consumption data), the cumulative acute exposure of organophosphorus pesticide residues was evaluated. The relative potency factor approach was applied, with acephate chosen as index compound. According to our conservative calculation method, applying the measured residues only, the 99.95% of the 99th percentiles of calculated daily intakes was at or below 87 μg/kgbwday, indicating that the cumulative acute exposure of the whole Hungarian population (including all age classes) to organophosphorus compounds was not a health concern. Copyright © 2016 Elsevier Ltd. All rights reserved.

Novel ELANE Gene Mutation in a Korean Girl with Severe Congenital Neutropenia

PubMed Central

Shim, Ye Jee; Kim, Hee-Jin; Suh, Jang Soo

2011-01-01

Severe congenital neutropenia is a heterozygous group of bone marrow failure syndromes that cause lifelong infections. Mutation of the ELANE gene encoding human neutrophil elastase is the most common genetic alteration. A Korean female pediatric patient was admitted because of recurrent cervical lymphadenitis without abscess formation. She had a past history of omphalitis and isolated neutropenia at birth. The peripheral blood showed a markedly decreased absolute neutrophil count, and the bone marrow findings revealed maturation arrest of myeloid precursors at the promyelocyte to myelocyte stage. Her direct DNA sequencing analysis demonstrated an ELANE gene mutation (c.607G > C; p.Gly203Arg), but her parents were negative for it. She showed only transient response after subcutaneous 15 µg/kg/day of granulocyte colony stimulating factor administration for six consecutive days. During the follow-up observation period, she suffered from subsequent seven febrile illnesses including urinary tract infection, septicemia, and cellulitis. PMID:22148006

U.S. Department of Energy Office of Health, Safety and Security Illness and Injury Surveillance Program Worker Health at a Glance, 2000-2009

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

Strader, Cliff; Richter, Bonnie

2013-01-23

The Worker Health at a Glance, 2000 – 2009 provides an overview of selected illness and injury patterns among the current DOE contractor workforce that have emerged over the 10-years covered by this report. This report is a roll-up of data from 16 individual DOE sites, assigned to one of three program offices (Office of Environmental Management, Office of Science and the National Nuclear Security Administration). In this report, an absences is defined as 40 or more consecutive work hours (5+ calendar days) off the job. Shorter absences were not included.

Ovulatory effects of three oral contraceptive regimens: a randomized, open-label, descriptive trial.

PubMed

Seidman, Larry; Kroll, Robin; Howard, Brandon; Ricciotti, Nancy; Hsieh, Jennifer; Weiss, Herman

2015-06-01

This study describes ovarian activity suppression of a 21/7-active low-dose combined oral contraceptive (COC) regimen that included only ethinyl estradiol (EE) during the traditional hormone-free interval (HFI) and two commercially available 28-day regimens, a 24/4 and a 21/7 regimen. The randomized, open-label, parallel-group descriptive study was conducted at two US sites. Healthy, reproductive-aged women (n=146) were randomized to one of three groups for three consecutive 28-day cycles, as follows: treatment 1 (n=39 completed): 21/7-active COC [21 days of 150 mcg desogestrel (DSG)/20 mcg EE, followed by 7 days of 10 mcg EE (DSG/EE+7 days EE)], treatment 2 (n=39 completed): 24 days of 3mg drospirenone (DRSP)/20 mcg EE, followed by 4 placebo (PBO)-pill days (DRSP/EE+4 days PBO) and treatment 3 (n=42 completed): 21 days of 100 mcg levonorgestrel (LNG)/20 mcg EE, followed by 7 PBO-pill days (LNG/EE+7 days PBO). The primary outcome was ovarian activity suppression assessed by transvaginal ultrasound and serum hormone concentrations and classified using the Hoogland and Skouby (H/S) method. Ovarian activity rate (H/S grade 4 or 5) was low for all three treatments: 0% [95% confidence interval (CI) 0-2.8] for DSG/EE+7 days EE, 1% (95% CI 0.2-5.2) for DRSP/EE+4days PBO and 1% (95% CI 0-3.9) for LNG/EE+7 days PBO. All three treatments showed similar suppression of serum progesterone, 17β-estradiol, follicle-stimulating hormone and luteinizing hormone levels. The 21/7-active low-dose COC regimen (DSG/EE+7 days EE) showed ovarian activity suppression that was similar to the 24/4 (DRSP/EE+4 days PBO) and 21/7 (LNG/EE+7days PBO) regimens. The 21/7-active low-dose COC regimen (DSG/EE+7 days EE) that included only EE during the traditional HFI showed suppression of ovarian follicular activity that was similar to the 24/4 (DRSP/EE+4days PBO) and the 21/7 (LNG/EE+7 days PBO) comparator regimens. Copyright © 2015 Elsevier Inc. All rights reserved.

Oral cryotherapy reduces mucositis and opioid use after myeloablative therapy--a randomized controlled trial.

PubMed

Svanberg, Anncarin; Birgegård, Gunnar; Ohrn, Kerstin

2007-10-01

Mucositis is a major complication in myeloablative therapy, which often necessitates advanced pharmacological pain treatment, including i.v. opioids. Attempts to prevent oral mucositis have included oral cryotherapy, which has been shown to reduce mucositis, but there is a lack of knowledge concerning the effect of oral cryotherapy on opioid use by reducing the mucositis for patients treated with myeloablative therapy before bone marrow transplantation (BMT). The aim of the present study was to evaluate if oral cryotherapy could delay or alleviate the development of mucositis and thereby reduce the number of days with i.v. opioids among patients who receive myeloablative therapy before BMT. Eighty patients 18 years and older, scheduled for BMT, were included consecutively and randomised to oral cryotherapy or standard oral care. A stratified randomisation was used with regard to type of transplantation. Intensity of pain, severity of mucositis and use of opioids were recorded using pain visual analogue scale (VAS) scores, mucositis index scores and medical and nursing charts. This study showed that patients receiving oral cryotherapy had less pronounced mucositis and significantly fewer days with i.v. opioids than the control group. In the autologous setting, cryotherapy patients also needed significantly lower total dose of opioids. Oral cryotherapy is an effective and well-tolerated therapy to alleviate mucositis and consequently reduce the number of days with i.v. opioids among patients treated with myeloablative therapy before BMT.

Etiology and microbial patterns of pulmonary infiltrates in patients with orthotopic liver transplantation.

PubMed

Torres, A; Ewig, S; Insausti, J; Guergué, J M; Xaubet, A; Mas, A; Salmeron, J M

2000-02-01

To evaluate the etiology and microbial patterns of pulmonary infiltrates in liver transplant patients using a bronchoscopic diagnostic approach and the impact of diagnostic results on antimicrobial treatment decisions. A prospective cohort study. A 1,000-bed tertiary-care university hospital. Fifty consecutive liver transplant patients with 60 episodes of pulmonary infiltrates (33 episodes during mechanical ventilation) were studied using flexible bronchoscopy with protected specimen brush (PSB) and BAL. A definite infectious etiology was confirmed in 29 episodes (48%). Eighteen episodes corresponded to probable pneumonia (30%), 10 episodes had noninfectious etiologies (17%), and 3 remained undetermined (5%). Opportunistic infections were the most frequent etiology (16/29, 55%, including 1 mixed etiology). Bacterial infections (mainly Gram-negative) accounted for 14 of 29 episodes (48%), including 1 of mixed etiology. The majority of bacterial pneumonia episodes (n = 10, 71%) occurred in period 1 (1 to 28 days posttransplant) during mechanical ventilation, whereas opportunistic episodes were predominant in periods 2 and 3 (29 to 180 days and > 180 days posttransplant, respectively; n = 14, 82%). Microbial treatment was changed according to diagnostic results in 21 episodes (35%). Microbial patterns in liver transplant patients with pulmonary infiltrates corresponded to nosocomial, mainly Gram-negative bacterial pneumonia in period 1, and to opportunistic infections in period 2 and, to a lesser extent, period 3. A comprehensive diagnostic evaluation including PSB and BAL fluid examination frequently guided specific antimicrobial therapy.

Protocol to describe the analysis of text-based communication in medical records for patients discharged from intensive care to hospital ward.

PubMed

Parsons Leigh, Jeanna; Brown, Kyla; Buchner, Denise; Stelfox, Henry T

2016-07-08

Effective communication during hospital transitions of patient care is fundamental to ensuring patient safety and continuity of quality care. This study will describe text-based communication included in patient medical records before, during and after patient transfer from the intensive care unit (ICU) to a hospital ward (n=10 days) by documenting (1) the structure and focus of physician progress notes within and between medical specialties, (2) the organisation of subjective and objective information, including the location and accessibility of patient data and whether/how this changes during the hospital stay and (3) missing, illegible and erroneous information. This study is part of a larger mixed methods prospective observational study of ICU to hospital ward transfer practices in 10 ICUs across Canada. Medical records will be collected and photocopied for each consenting patient for a period of up to 10 consecutive days, including the final 2 days in the ICU, the day of transfer and the first 7 days on the ward (n=10 days). Textual analysis of medical record data will be completed by 2 independent reviewers to describe communication between stakeholders involved in ICU transfer. Research ethics board approval has been obtained at all study sites, including the coordinating study centre (which covers 4 Calgary-based sites; UofC REB 13-0021) and 6 additional study sites (UofA Pro00050646; UBC PHC Hi4-01667; Sunnybrook 336-2014; QCH 20140345-01H; Sherbrooke 14-172; Laval 2015-2171). Findings from this study will inform the development of an evidence-based tool that will be used to systematically analyse the series of notes in a patient's medical record. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

GREEN BEAST™ OIL SPILL & ODOR REMEDIATOR

EPA Pesticide Factsheets

Technical product bulletin: this surface washing agent used in oil spill cleanups works best applied at high pressure, for treating hydrocarbons on beaches, rocks, and hard surfaces. Preferably applied over 3 consecutive days on heavy spills.

Effect of bursa Fabricius extracts on antibody production in bursectomized or bursal cell autografted chickens.

PubMed Central

Baba, T; Okuno, Y

1976-01-01

Restoration and enhancement of immune response against BSA antigen was achieved by 5-day consecutive doses of BF estract from 4-5-week-old chickens, in birds which had been surgically bursectomized or given BF-cell autografts at 17 days of age. A similar 5-day treatment with other tissue extract, i.e. liver, spleen, pancreas or intestine, or with LPS of E. coli, in contrast, failed to provide such restoration or enhancement. PMID:61937

Impact of Dual Use of Department of Veterans Affairs and Medicare Part D Drug Benefits on Potentially Unsafe Opioid Use.

PubMed

Gellad, Walid F; Thorpe, Joshua M; Zhao, Xinhua; Thorpe, Carolyn T; Sileanu, Florentina E; Cashy, John P; Hale, Jennifer A; Mor, Maria K; Radomski, Thomas R; Hausmann, Leslie R M; Donohue, Julie M; Gordon, Adam J; Suda, Katie J; Stroupe, Kevin T; Hanlon, Joseph T; Cunningham, Francesca E; Good, Chester B; Fine, Michael J

2018-02-01

To estimate the prevalence and consequences of receiving prescription opioids from both the Department of Veterans Affairs (VA) and Medicare Part D. Among US veterans enrolled in both VA and Part D filling 1 or more opioid prescriptions in 2012 (n = 539 473), we calculated 3 opioid safety measures using morphine milligram equivalents (MME): (1) proportion receiving greater than 100 MME for 1 or more days, (2) mean days receiving greater than 100 MME, and (3) proportion receiving greater than 120 MME for 90 consecutive days. We compared these measures by opioid source. Overall, 135 643 (25.1%) veterans received opioids from VA only, 332 630 (61.7%) from Part D only, and 71 200 (13.2%) from both. The dual-use group was more likely than the VA-only group to receive greater than 100 MME for 1 or more days (34.3% vs 10.9%; adjusted risk ratio [ARR] = 3.0; 95% confidence interval [CI] = 2.9, 3.1), have more days with greater than 100 MME (42.5 vs 16.9 days; adjusted difference = 16.4 days; 95% CI = 15.7, 17.2), and to receive greater than 120 MME for 90 consecutive days (7.8% vs 3.1%; ARR = 2.2; 95% CI = 2.1, 2.3). Among veterans dually enrolled in VA and Medicare Part D, dual use of opioids was associated with more than 2 to 3 times the risk of high-dose opioid exposure.

Impact of Striped-Squirrel Nectar-Robbing Behaviour on Gender Fitness in Alpinia roxburghii Sweet (Zingiberaceae)

PubMed Central

Deng, Xiaobao; Mohandass, Dharmalingam; Katabuchi, Masatoshi; Hughes, Alice C.; Roubik, David W.

2015-01-01

Nectar-robbing has the potential to strongly affect male and female reproductive fitness of plants. One example of nectar theft is that shown by striped-squirrels (Tamiops swinhoei) on a number of ginger species, including Alpinia roxburghii and A. kwangsiensis (Zingiberaceae). In this study, we used a fluorescent dye as a pollen analogue, and measured fruit and seed output, to test the effect of squirrel nectar-robbing on A. roxburghii reproductive fitness. Pollen transfer between robbed and unrobbed flowers was assessed by comparing 60 randomly established plots containing robbed and unrobbed flowers. The frequency of squirrel robbing visits and broken styles were recorded from a number of flowers for five consecutive days. Two bee species (Bombus eximius and Apis cerana), were the primary pollinators, and their visitation frequency was recorded for six consecutive days. The results showed that fluorescent powder from unrobbed flowers was dispersed further, and to a greater number of flowers than that placed on robbed flowers. Additionally, robbing flowers caused significant damage to reproductive organs, resulting in lower fruit and seed sets in robbed than in unrobbed flowers and influencing both male and female fitness. The frequency of the primary pollinator visits (B. eximius) was significantly higher for unrobbed plants than for robbed plants. The present study clearly shows the negative impact of squirrel robbing on A. roxburghii male reproductive fitness and neutral impact on female reproductive fitness. PMID:26689684

Role of Biofeedback in Optimizing Psychomotor Performance in Sports

PubMed Central

Paul, Maman; Garg, Kanupriya; Singh Sandhu, Jaspal

2012-01-01

Purpose Biofeedback is an emerging tool to acquire and facilitate physiological and psychological domains of the human body like response time and concentration. Thus, the present study aims at determining the reconstitution of psychomotor and performance skills in basketball players through biofeedback training. Methods Basketball players (N=30) with different levels of expertise (university, state and national) aged 18-28 years (both male and female) were randomly divided into 3 equal groups - Experimental group, Placebo group and Control group. The experimental group received Heart Rate Variability Biofeedback training for 10 consecutive days for 20 minutes that included breathing at individual's resonant frequency through a pacing stimulus; Placebo group was shown motivational video clips for 10 consecutive days for 10 minutes, whereas Control group was not given any intervention. At session 1, 10 and 1month follow up, heart rate variability, respiration rate, response time (reaction and movement time), concentration and shooting performance were assessed. Results Two way repeated measure ANOVA was used to simultaneously compare within and between group differences. Response time, concentration, heart rate variability, respiration rate and shooting differences were statistically significant in each group along with interaction of group and time (P<0.001). Also, all the measures showed statistically significant inter group difference (P<0.05). Conclusion The results of the study suggest that biofeedback training may help to train stressed athletes to acquire a control over their psychophysiological processes, thus helping an athlete to perform maximally. PMID:22461963

Newer anesthesia and rehabilitation protocols enable outpatient hip replacement in selected patients.

PubMed

Berger, Richard A; Sanders, Sheila A; Thill, Elizabeth S; Sporer, Scott M; Della Valle, Craig

2009-06-01

Advancements in the surgical approach, anesthetic technique, and the initiation of rapid rehabilitation protocols have decreased the duration of hospitalization and subsequent length of recovery following elective total hip arthroplasty. We assessed the feasibility and safety of outpatient total hip arthroplasty in 150 consecutive patients. A comprehensive perioperative anesthesia and rehabilitation protocol including preoperative teaching, regional anesthesia, and preemptive oral analgesia and antiemetic therapy was implemented around a minimally invasive surgical technique. A rapid rehabilitation pathway was started immediately after surgery and patients had the option of being discharged to home the day of surgery if standard discharge criteria were met. All 150 patients were discharged to home the day of surgery, at which time 131 patients were able to walk without assistive devices. Thirty-eight patients required some additional intervention outside the pathway to resolve nausea, hypotension, or sedation prior to discharge. There were no readmissions for pain, nausea, or hypotension yet there was one readmission for fracture and nine emergency room evaluations in the three month perioperative period. This anesthetic and rehabilitation protocol allowed outpatient total hip arthroplasty to be routinely performed in these consecutive patients undergoing primary total hip arthroplasty. With current reimbursement approaches the modest savings to the hospital in length of stay may be outweighed by the additional costs of personnel, thereby making this outpatient system more expensive to implement. Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

The effectiveness of a self-reporting bedside pain assessment tool for oncology inpatients.

PubMed

Kim, Eun Bi; Han, Hye-Suk; Chung, Jung Hwa; Park, Bo Ram; Lim, Sung-Nam; Yim, Kyoung Hoon; Shin, Young Duck; Lee, Ki Hyeong; Kim, Wun-Jae; Kim, Seung Taik

2012-11-01

Pain is common during cancer treatment, and patient self-reporting of pain is an essential first step for ideal cancer pain management. However, many studies on cancer pain management report that, because pain may be underestimated, it is often inadequately managed. The aim of this study was to evaluate the effectiveness of bedside self-assessment of pain intensity for inpatients using a self-reporting pain board. Fifty consecutive inpatients admitted to the Oncology Department of Chungbuk National University Hospital were included in this observational prospective study from February 2011 to December 2011. The medical staff performed pain assessments by asking patients questions and using verbal rated scales (VRS) over 3 consecutive days. Then, for 3 additional days, patients used a self-reporting pain board attached to the bed, which had movable indicators representing 0-10 on a numeric rating scale (NRS) and the frequency of breakthrough pain. Patient reliability over the medical staff's pain assessment increased from 74% to 96% after applying the self-reporting pain board (p=0.004). The gap (mean±standard deviation [SD]) between the NRS reported by patients and the NRS recorded on the medical records decreased from 3.16±2.08 to 1.00±1.02 (p<0.001), and the level of patient satisfaction with pain management increased from 54% to 82% (p=0.002). This study suggests that the self-reporting bedside pain assessment tool provides a reliable and effective means of assessing pain in oncology inpatients.

Long-term green tea extract supplementation does not affect fat absorption, resting energy expenditure, and body composition in adults.

PubMed

Janssens, Pilou L H R; Hursel, Rick; Westerterp-Plantenga, Margriet S

2015-05-01

Green tea (GT) extract may play a role in body weight regulation. Suggested mechanisms are decreased fat absorption and increased energy expenditure. We examined whether GT supplementation for 12 wk has beneficial effects on weight control via a reduction in dietary lipid absorption as well as an increase in resting energy expenditure (REE). Sixty Caucasian men and women [BMI (in kg/m²): 18-25 or >25; age: 18-50 y] were included in a randomized placebo-controlled study in which fecal energy content (FEC), fecal fat content (FFC), resting energy expenditure, respiratory quotient (RQ), body composition, and physical activity were measured twice (baseline vs. week 12). For 12 wk, subjects consumed either GT (>0.56 g/d epigallocatechin gallate + 0.28-0.45 g/d caffeine) or placebo capsules. Before the measurements, subjects recorded energy intake for 4 consecutive days and collected feces for 3 consecutive days. No significant differences between groups and no significant changes over time were observed for the measured variables. Overall means ± SDs were 7.2 ± 3.8 g/d, 6.1 ± 1.2 MJ/d, 67.3 ± 14.3 kg, and 29.8 ± 8.6% for FFC, REE, body weight, and body fat percentage, respectively. GT supplementation for 12 wk in 60 men and women did not have a significant effect on FEC, FFC, REE, RQ, and body composition. © 2015 American Society for Nutrition.

Percutaneous Management of Postoperative Duodenal Stump Leakage with Foley Catheter

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

Oh, Jung Suk, E-mail: oj-cumc@daum.net; Lee, Hae Giu, E-mail: hgleehfh@catholic.ac.kr; Chun, Ho Jong

2013-10-15

Purpose: This study was designed to evaluate retrospectively the safety and efficacy of the percutaneous management of duodenal stump leakage with a Foley catheter after subtotal gastrectomy. Methods: Ten consecutive patients (M:F = 9:1, median age: 64 years) were included in this retrospective study. The duodenal stump leakages were diagnosed in all the patients within a median of 10 days (range, 6-20). At first, the patients underwent percutaneous drainage on the day of or the day after confirmation of the presence of duodenal stump leakage, and then the Foley catheters were replaced at a median of 9 days (range, 6-38)more » after the percutaneous drainage. Results: Foley catheters were placed successfully in the duodenal lumen of all the patients under a fluoroscopic guide. No complication was observed during and after the procedures in all the patients. All of the patients started a regular diet 1 day after the Foley catheter placement. The patients were discharged at a median of 7 days (range, 5-14) after the Foley catheter placement. The catheters were removed in an outpatient clinic 10-58 days (median, 28) after the Foley catheter placement. Conclusions: Fluoroscopy-guided percutaneous Foley catheter placement may be a safe and effective treatment option for postoperative duodenal stump leakage and may allow for shorter hospital stays, earlier oral intake, and more effective control of leakage sites.« less

29 CFR 553.230 - Maximum hours standards for work periods of 7 to 28 days-section 7(k).

Code of Federal Regulations, 2010 CFR

2010-07-01

...-section 7(k). 553.230 Section 553.230 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR... Compensation Rules § 553.230 Maximum hours standards for work periods of 7 to 28 days—section 7(k). (a) For... 28 consecutive days, no overtime compensation is required under section 7(k) until the number of...

40 CFR 406.62 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Parboiled Rice... Effluent limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of rice) BOD5 0.42 0.14 TSS 0.24 .08 pH (1) (1) English units...

40 CFR 406.62 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Parboiled Rice... Effluent limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of rice) BOD5 0.42 0.14 TSS 0.24 .08 pH (1) (1) English units...

40 CFR 406.22 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Corn Dry Milling... Effluent limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of corn) BOD5 0.21 0.07 TSS 0.18 .06 pH (1) (1) English units...

40 CFR 406.15 - Standards of performance for new sources.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Corn Wet Milling Subcategory § 406.15... Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of corn) BOD5 1.08 0.36 TSS 1.35 .45 pH (1) (1) English units (pounds per 1,000 stdbu...

40 CFR 406.25 - Standards of performance for new sources.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Corn Dry Milling Subcategory § 406.25... Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of corn) BOD5 0.11 0.036 TSS 0.054 0.18 pH (1) (1) English units (pounds per 1,000...

40 CFR 406.25 - Standards of performance for new sources.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Corn Dry Milling Subcategory § 406.25... Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of corn) BOD5 0.11 0.036 TSS 0.054 0.18 pH (1) (1) English units (pounds per 1,000...

40 CFR 406.42 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Bulgur Wheat Flour... Effluent limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of wheat) BOD5 0.025 0.0083 TSS 0.025 .0083 pH (1) (1) English units...

40 CFR 406.25 - Standards of performance for new sources.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Corn Dry Milling Subcategory § 406.25... Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of corn) BOD5 0.11 0.036 TSS 0.054 0.18 pH (1) (1) English units (pounds per 1,000...

40 CFR 406.42 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Bulgur Wheat Flour... Effluent limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of wheat) BOD5 0.025 0.0083 TSS 0.025 .0083 pH (1) (1) English units...

40 CFR 406.15 - Standards of performance for new sources.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Corn Wet Milling Subcategory § 406.15... Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of corn) BOD5 1.08 0.36 TSS 1.35 .45 pH (1) (1) English units (pounds per 1,000 stdbu...

40 CFR 406.15 - Standards of performance for new sources.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Corn Wet Milling Subcategory § 406.15... Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of corn) BOD5 1.08 0.36 TSS 1.35 .45 pH (1) (1) English units (pounds per 1,000 stdbu...

40 CFR 406.42 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Bulgur Wheat Flour... Effluent limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of wheat) BOD5 0.025 0.0083 TSS 0.025 .0083 pH (1) (1) English units...

40 CFR 406.42 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Bulgur Wheat Flour... Effluent limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of wheat) BOD5 0.025 0.0083 TSS 0.025 .0083 pH (1) (1) English units...

40 CFR 406.62 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Parboiled Rice... Effluent limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of rice) BOD5 0.42 0.14 TSS 0.24 .08 pH (1) (1) English units...

40 CFR 406.22 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Corn Dry Milling... Effluent limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of corn) BOD5 0.21 0.07 TSS 0.18 .06 pH (1) (1) English units...

40 CFR 406.22 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Corn Dry Milling... Effluent limitations Maximum for any 1 day Average of daily values for 30 consecutive days shall not exceed— Metric units (kilograms per 1,000 kg of corn) BOD5 0.21 0.07 TSS 0.18 .06 pH (1) (1) English units...

Depletion of penicillin G residues in heavy sows after intramuscular injection. Part II: Application of kidney inhibition swab tests

USDA-ARS?s Scientific Manuscript database

Sows (n = 126; 228 ± 30.1 kg) were administered daily IM doses of penicillin G procaine (33 000 IU/kg bw; 5× the label dose) for 3 consecutive days using three different administration patterns. Within treatment, six sows each were slaughtered on withdrawal day 5, 10, 15, 20, 25, 32, and 39. Tissues...

The influence of genital tract status in postpartum period on the subsequent reproductive performance in high producing dairy cows.

PubMed

López-Helguera, I; López-Gatius, F; Garcia-Ispierto, I

2012-04-15

The aim of the present study was to characterize the early postpartum period in clinically healthy dairy cows by ultrasonography (US), endometrial cytology (EC), and white blood cell counts, and determine possible relationships between postpartum findings and subsequent reproductive performance. Fifty-three dairy cows were examined on Days 15 to 21 (Visit 1), 22 to 28 (Visit 2), and 29 to 35 (Visit 3) postpartum. The clinical examination included: examination of vaginal fluid, EC, transrectal palpation and ultrasonography of the genital tract (cervical diameter, endometrial thickness, presence of a corpus luteum [CL] or intrauterine fluid [IUF] and its echogenicity). Luteal activity (presence of a CL in a single visit), return to cyclicity (presence of a CL in 2 consecutive visits), and conception rate at 70 and 120 days postpartum were considered as the dependent variables in four consecutive binary logistic regression analyses. Factors affecting leukocyte counts were established by general linear model (GLM) repeated measures analysis of variance. Based on the odds ratio (OR), the likelihood of luteal activity was higher in multiparous than primiparous cows (OR = 3.75) and tended to diminish in cows showing increased endometrial thickness in Visit 1 (V1) (OR = 0.06). The likelihood of returning to cyclicity decreased for each centimeter increase in cervical diameter in V1 (OR = 0.14) and that of conception on Day 70 was lower in cows showing the presence of echogenic or anechogenic IUF in V1 (OR = 0.09 or OR = 0.13, respectively) compared with cows lacking IUF. Effects of parity and IUF were observed on neutrophil counts. Positive EC results were unrelated to the cumulative conception rate at 70 and 120 days in milk, whereas cows returning a positive EC result in V1 showed a greater likelihood of increased endometrial thickness. In conclusion, measuring cervical diameter, endometrial thickness, and detecting the echogenicity of IUF by ultrasonography from Days 15 to 21 postpartum in clinically normal cows is an appropriate tool to predict subsequent reproductive performance. Vaginal examination and transrectal palpation alone did not emerge as valuable predictors. Copyright © 2012 Elsevier Inc. All rights reserved.

24-hour care: Work and sleep conditions of migrant Filipino live-in caregivers in Los Angeles.

PubMed

Riley, Kevin; Nazareno, Jennifer; Malish, Sterling

2016-12-01

Live-in formal caregivers spend consecutive days in patients' homes, raising questions about their ability to secure adequate sleep while on duty. Few studies have examined sleeping conditions and outcomes for this growing workforce. We collected weeklong sleep logs and interview data from 32 Filipino caregivers in Los Angeles who provide live-in services at least 3 consecutive days per week. Respondents recorded a total average of 6.4 sleep hours during workdays divided over 2.4 sleep periods. Caregivers rated sleep quality as lower while at work; over 40% indicated excessive daytime sleepiness. Female caregivers reported worse sleep outcomes than their male counterparts. Some variations in sleep outcomes were found by employment arrangements. Live-in caregivers experience frequent sleep interruptions at all hours of the day and night to attend to patients' needs. The resulting impacts on sleep quality pose risks for both work-related injury and errors in patient care. Am. J. Ind. Med. 59:1120-1129, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Serum C-reactive protein in patients undergoing elective shoulder arthroplasty. Prospective study.

PubMed

Torrens, Carlos; Santana, Fernando; Marí, Raquel; Puig, Lluis; Alier, Albert

2017-09-01

The objective of the study was to determine the normalization curve of the serum C-reactive protein (CRP) in elective shoulder arthroplasty. A prospective study including 58 consecutive patients who had undergone elective shoulder arthroplasty. Forty-one patients had received a Reverse Shoulder Arthroplasty, 13 a Total Shoulder Arthroplasty and 4 a Hemiarthroplasty. Based on a pilot study, blood samples to determine CRP values were obtained at baseline (1 h before surgery), on the 1st, 2nd, 6th, 8th and 14th postoperative days. All the patients included presented no postoperative complications during inpatient stay or any re-admission during the three months after surgery. Mean CRP values showed a rapid increase on the 1st postoperative day (7-fold higher than the baseline in cuff tear arthropathy, 11-fold higher in primary osteoarthritis, 1-fold higher in acute fracture) and reached a peak on the 2nd postoperative day (14-fold higher than the baseline in cuff tear arthropathy, 24-fold higher in primary osteoarthritis and 2-fold higher in acute fracture). After the 2nd postoperative day CRP values began to slowly decrease reaching the normal range in the 14th postoperative day. Serum CRP levels after elective shoulder arthroplasty rapidly increase to reach a maximum peak after the 2nd surgery day and then slowly decrease to return to normality on the 14th day. Knowing the normalization curve of CRP can be a helpful tool to help in the diagnosis of acute infections in elective shoulder arthroplasty. Copyright © 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

A Prospective Randomized Trial of the Efficacy of Fibrin Glue, Triamcinolone Acetonide, and Quilting Sutures in Seroma Prevention after Latissimus Dorsi Breast Reconstruction.

PubMed

Hart, Alexandra M; Duggal, Clarie; Pinell-White, Ximena; Losken, Albert

2017-04-01

Donor-site seroma is the most common complication following latissimus dorsi flap breast reconstruction. Various agents and techniques have attempted to minimize seroma formation. The purpose of this study was to compare the efficacy of different products and quilting sutures at seroma prevention. This is a single-center, double-blinded, randomized, controlled trial of a consecutive series of breast cancer patients (n = 96) undergoing latissimus dorsi flap reconstruction performed by a single surgeon. Patients were randomized to receive (1) fibrin glue (Tisseel) (n = 23), (2) triamcinolone acetonide (n = 26), or (3) normal saline (control) (n = 27) sprayed into the donor site. The fourth arm included donor-site quilting sutures (n = 20). Outcomes included seroma, drain output, and days to last drain removal. Drain removal was standardized at less than 30 cc/day. All groups were matched evenly without differences in risk, procedures, or complications. The overall seroma rate was 31.3 percent (n = 30). The quilting group had significantly less drainage for weeks 1 (p = 0.006) and 2 (p = 0.050) postoperatively. Quilting statistically reduced the incidence of seromas to 5.0 percent (n = 1; p = 0.038) compared with other groups (control, 34.5 percent; fibrin, 27.6 percent; and triamcinolone, 37.6 percent). Drains were removed 10 days earlier with quilting (control, 35.5 days; fibrin, 39.5 days; triamcinolone, 37.4 days; and quilting, 25.8 days; p = 0.001). The incidence of all other complications was similar between groups. The use of quilting donor sites significantly decreases the incidence of donor-site seromas and leads to earlier drain removal following latissimus dorsi flap reconstruction and maintains a low complication profile. Therapeutic, II.

Australian association for exercise and sports science position statement on exercise and hypertension.

PubMed

Sharman, James E; Stowasser, Michael

2009-03-01

Hypertension (high blood pressure; BP) is a leading contributor to premature death and disability from cardiovascular disease. Lifestyle modification that includes regular physical activity is often recommended to patients with hypertension as one of the first line treatments for lowering BP, as well as improving overall risk for cardiovascular events. It is recognised that allied health care professionals play an important role in helping patients to achieve BP control by influencing and reinforcing appropriate lifestyle behavior. The minimum amount of exercise that is recommended in patients with hypertension comprises a mix of moderate to vigorous aerobic (endurance) activity (up to 5 days/week) in addition to resistance (strength) training (on 2 or more non-consecutive days/week). However, due to the dose-response relationship between physical activity and health, exercise levels performed beyond the minimum recommendations are expected to confer additional health benefits. Vigorous exercise training is generally safe and well tolerated by most people, including those with hypertension, although some special considerations are required and these are discussed in this review.

Body composition and metabolic changes during a 520-day mission simulation to Mars.

PubMed

Strollo, F; Macchi, C; Eberini, I; Masini, M A; Botta, M; Vassilieva, G; Nichiporuk, I; Monici, M; Santucci, D; Celotti, F; Magni, P; Ruscica, M

2018-03-12

The "Mars-500 project" allowed to evaluate the changes in psychological/physiological adaptation over a prolonged confinement, in order to gather information for future missions. Here, we evaluated the impact of confinement and isolation on body composition, glucose metabolism/insulin resistance and adipokine levels. The "Mars-500 project" consisted of 520 consecutive days of confinement from June 3, 2010 to Nov 4, 2011. The crew was composed of six male subjects (three Russians, two Europeans, and one Chinese) with a median age of 31 years (range 27-38 years). During the 520-day confinement, total body mass and BMI progressively decreased, reaching a significant difference at the end (417 days) of the observation period (- 9.2 and - 5.5%, respectively). Fat mass remained unchanged. A progressive and significant increase of fasting plasma glucose was observed between 249 and 417 days (+ 10/+ 17% vs baseline), with a further increase at the end of confinement (up to + 30%). Median plasma insulin showed a non-significant early increment (60 days; + 86%). Total adiponectin halved (- 47%) 60 days after hatch closure, remaining at this nadir (- 51%) level for a further 60 days. High molecular weight adiponectin remained significantly lower from 60 to 168 days. Based on these data, countermeasures may be envisioned to balance the potentially harmful effects of prolonged confinement, including a better exercise program, with accurate monitoring of (1) the individual activity and (2) the relationship between body composition and metabolic derangement.

Energy expenditures and food intakes of lactating women in Guatemala.

PubMed

Schutz, Y; Lechtig, A; Bradfield, R B

1980-04-01

Total energy expenditures and intakes were simultaneously assessed in 18 free-ranging lactating women (10 months postpartum) and compared to six similarly-sized, nonlactating, nonpregnant but multiparous women living in the same rural villages in the Guatemalan highlands. Energy intakes were estimated by the 24-hr recall method for each of 4 consecutive days. Energy expenditures were determined for 2 days by monitoring heart rate throughout the day and relating heart rate to oxygen consumption by individually-determined regression lines. The mean energy intake for the 4 consecutive days was estimated to be 1929 +/- 360 kcal/day (39.2 kcal/kg per day) for the lactating group; and 1876 +/- 404 kcal/day (38.3 kcal/kg per day) for the nonlactating group. The 2-day mean energy expenditures were estimated to be 2007 +/- 292 kcal/day for the lactating women (41.8 kcal/kg per day) and 1966 +/- 382 kcal/day for the lactating women (40.1 kcal/kg per day). The way of life of both groups was judged "moderately active" by 1973 FAO/WHO classifications. Most of the lactating women had been losing weight progressively during the past 6 months. Over the 10-week period prior to our measurnth) (P less than 0.01) than in the nonlactating group (-35 g/month) (ns). The high correlation (r = 0.87) between weight loss and the reduction in the sum of the three skinfolds suggested adipose tissue loss. There were no significant differences between the two groups in terms of daily energy intake, daily energy expenditure, the energy cost of specific activities throughout the day. The slope of the heart rate/oxygen consumption regressions suggest adequate cardiorespiratory fitness. This study suggests that the energy cost of lactation was met to a greater extent by fat loss than by either increased energy intake, reduced energy expenditure, or both.

Efficacy of Lisdexamfetamine in Adults With Moderate to Severe Binge-Eating Disorder: A Randomized Clinical Trial.

PubMed

Hudson, James I; McElroy, Susan L; Ferreira-Cornwell, M Celeste; Radewonuk, Jana; Gasior, Maria

2017-09-01

The ability of pharmacotherapies to prevent relapse and maintain efficacy with long-term treatment in psychiatric conditions is important. To assess lisdexamfetamine dimesylate maintenance of efficacy in adults with moderate to severe binge-eating disorder. A multinational, phase 3, double-blind, placebo-controlled, randomized withdrawal study including 418 participants was conducted at 49 clinical research study sites from January 27, 2014, to April 8, 2015. Eligible adults met DSM-IV-R binge-eating disorder criteria and had moderate to severe binge eating disorder (≥3 binge-eating days per week for 14 days before open-label baseline; Clinical Global Impressions-Severity [CGI-S] scores ≥4 [moderate severity] at screening and open-label baseline). Following a 12-week, open-label phase (dose optimization, 4 weeks [lisdexamfetamine dimesylate, 50 or 70 mg]; dose maintenance, 8 weeks), lisdexamfetamine responders (≤1 binge eating day per week for 4 consecutive weeks and CGI-S scores ≤2 at week 12) were randomized to placebo or continued lisdexamfetamine during a 26-week, double-blind, randomized withdrawal phase. Lisdexamfetamine administration. The primary outcome variable, time to relapse (≥2 binge-eating days per week for 2 consecutive weeks and ≥2-point CGI-S score increases from randomized withdrawal baseline), was analyzed using a log-rank test (primary analysis); the analysis was stratified for dichotomized 4-week cessation status. Safety assessments included treatment-emergent adverse events. Of the 418 participants enrolled in the open-label phase of the study, 411 (358 [87.1%] women; mean [SD] age, 38.3 [10.4] years) were included in the safety analysis set. Of 275 randomized lisdexamfetamine responders (placebo, n = 138; lisdexamfetamine, n = 137), the observed proportions of participants meeting relapse criteria were 3.7% (5 of 136) for lisdexamfetamine and 32.1% (42 of 131) for placebo. Lisdexamfetamine demonstrated superiority over placebo on the log-rank test (χ21, 40.37; P < .001) for time to relapse; the hazard ratio, based on a Cox proportional hazards model for lisdexamfetamine vs placebo, was 0.09 (95% CI, 0.04-0.23). The treatment-emergent adverse events observed were generally consistent with the known profile of lisdexamfetamine. Risk of binge-eating relapse over 6 months was lower in participants continuing lisdexamfetamine than in those randomized to placebo. The hazard for relapse was lower with lisdexamfetamine than placebo. clinicaltrials.gov Identifier: NCT02009163.

Efficacy of Lisdexamfetamine in Adults With Moderate to Severe Binge-Eating Disorder

PubMed Central

McElroy, Susan L.; Ferreira-Cornwell, M. Celeste; Radewonuk, Jana; Gasior, Maria

2017-01-01

Importance The ability of pharmacotherapies to prevent relapse and maintain efficacy with long-term treatment in psychiatric conditions is important. Objective To assess lisdexamfetamine dimesylate maintenance of efficacy in adults with moderate to severe binge-eating disorder. Design, Setting, and Participants A multinational, phase 3, double-blind, placebo-controlled, randomized withdrawal study including 418 participants was conducted at 49 clinical research study sites from January 27, 2014, to April 8, 2015. Eligible adults met DSM-IV-R binge-eating disorder criteria and had moderate to severe binge eating disorder (≥3 binge-eating days per week for 14 days before open-label baseline; Clinical Global Impressions−Severity [CGI-S] scores ≥4 [moderate severity] at screening and open-label baseline). Following a 12-week, open-label phase (dose optimization, 4 weeks [lisdexamfetamine dimesylate, 50 or 70 mg]; dose maintenance, 8 weeks), lisdexamfetamine responders (≤1 binge eating day per week for 4 consecutive weeks and CGI-S scores ≤2 at week 12) were randomized to placebo or continued lisdexamfetamine during a 26-week, double-blind, randomized withdrawal phase. Interventions Lisdexamfetamine administration. Main Outcomes and Measures The primary outcome variable, time to relapse (≥2 binge-eating days per week for 2 consecutive weeks and ≥2-point CGI-S score increases from randomized withdrawal baseline), was analyzed using a log-rank test (primary analysis); the analysis was stratified for dichotomized 4-week cessation status. Safety assessments included treatment-emergent adverse events. Results Of the 418 participants enrolled in the open-label phase of the study, 411 (358 [87.1%] women; mean [SD] age, 38.3 [10.4] years) were included in the safety analysis set. Of 275 randomized lisdexamfetamine responders (placebo, n = 138; lisdexamfetamine, n = 137), the observed proportions of participants meeting relapse criteria were 3.7% (5 of 136) for lisdexamfetamine and 32.1% (42 of 131) for placebo. Lisdexamfetamine demonstrated superiority over placebo on the log-rank test (χ21, 40.37; P < .001) for time to relapse; the hazard ratio, based on a Cox proportional hazards model for lisdexamfetamine vs placebo, was 0.09 (95% CI, 0.04-0.23). The treatment-emergent adverse events observed were generally consistent with the known profile of lisdexamfetamine. Conclusions and Relevance Risk of binge-eating relapse over 6 months was lower in participants continuing lisdexamfetamine than in those randomized to placebo. The hazard for relapse was lower with lisdexamfetamine than placebo. Trial Registration clinicaltrials.gov Identifier: NCT02009163 PMID:28700805

40 CFR 422.65 - Standards of performance for new sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) EFFLUENT GUIDELINES AND STANDARDS PHOSPHATE MANUFACTURING POINT SOURCE CATEGORY Sodium Phosphates... consecutive days shall not exceed— TSS 0.35 0.18 Total phosphorus (as P) .56 .28 Fluoride (as F) .21 .11 pH (1...

40 CFR 422.65 - Standards of performance for new sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) EFFLUENT GUIDELINES AND STANDARDS PHOSPHATE MANUFACTURING POINT SOURCE CATEGORY Sodium Phosphates... consecutive days shall not exceed— TSS 0.35 0.18 Total phosphorus (as P) .56 .28 Fluoride (as F) .21 .11 pH (1...

Effect of hydration treatments on laryngeal nodules and polyps and related voice measures.

PubMed

Verdolini-Marston, K; Sandage, M; Titze, I R

1994-03-01

In this study, a double-blind, placebo-controlled approach was used in assessing the effectiveness of hydration treatments in the clinical management of selected voice disorders. Six adult female patients with laryngeal nodules or polyps each received 5 consecutive days of hydration treatment and 5 consecutive days of placebo/control treatment. The combined results indicated improvements in voice and in laryngeal appearance following both placebo/control and hydration treatments as compared with baseline. However, the greatest improvements were obtained following the hydration treatment. Although caution about generalization of the effects to the typical clinical situation is emphasized, the study provides preliminary evidence of a therapeutic benefit from hydration treatments in patients with nodules or polyps. Based on previous theoretical work, hydration effects may be related to reductions in the viscosity of vocal fold tissue, although other explanations are also possible.

KSC-98pc260

NASA Image and Video Library

1998-01-31

KENNEDY SPACE CENTER, FLA. -- The orbiter Endeavour closes the day peacefully on KSC's Shuttle Landing Facility Runway 15, completing the nearly nine-day STS-89 mission. Main gear touchdown was at 5:35:09 p.m. EST on Jan. 31, 1998. The wheels stopped at 5:36:19 EST, completing a total mission time of eight days, 19 hours, 48 minutes and four seconds. The 89th Space Shuttle mission was the 42nd (and 13th consecutive) landing of the orbiter at KSC, and STS-89 was the eighth of nine planned dockings of the Space Shuttle with the Russian Space Station Mir. STS-89 Mission Specialist Andrew Thomas, Ph.D., succeeded NASA astronaut and Mir 24 crew member David Wolf, M.D., who was on the Russian space station since late September 1997. Dr. Wolf returned to Earth on Endeavour with the remainder of the STS-89 crew, including Commander Terrence Wilcutt; Pilot Joe Edwards Jr.; and Mission Specialists James Reilly, Ph.D.; Michael Anderson; Bonnie Dunbar, Ph.D.; and Salizhan Sharipov with the Russian Space Agency. Dr. Thomas is scheduled to remain on Mir until the STS-91 Shuttle mission returns in June 1998. In addition to the docking and crew exchange, STS-89 included the transfer of science, logistical equipment and supplies between the two orbiting spacecrafts

Antioxidant status in oral subchronic toxicity of fipronil and fluoride co-exposure in buffalo calves.

PubMed

Gill, Kamalpreet Kaur; Dumka, Vinod Kumar

2016-02-01

The effects of fipronil and fluoride co-exposure were investigated on antioxidant status of buffalo calves. A total of 24 healthy male buffalo calves divided into 4 groups were treated for 98 consecutive days. Group I, receiving no treatment, served as the control. Animals of groups II and III were orally administered with fipronil at the dosage of 0.5 mg/kg/day and sodium fluoride (NaF) at the dosage of 6.67 mg/kg/day, respectively, for 98 days. Group IV was coadministered with fipronil and NaF at the same dosages as groups II and III. Administration of fipronil alone produced significant elevation in lipid peroxidation (LPO) and decrease in the levels of nonenzymatic antioxidant glutathione (GSH). However, it did not produce any significant effect on the activities of enzymatic antioxidants including glutathione peroxidase (GPx), catalase (CAT), and superoxide dismutase (SOD). NaF exposure led to enhanced oxidative stress as shown by significant increase in the LPO and SOD activities while GPx and CAT activities and GSH levels were significantly decreased. Co-exposure to fipronil and NaF showed additive effects on LPO, GPx activity, and GSH levels. © The Author(s) 2013.

The influence of the full moon on the number of admissions related to gastrointestinal bleeding.

PubMed

Román, Eva María; Soriano, Germán; Fuentes, Mercedes; Gálvez, María Luz; Fernández, Clotilde

2004-12-01

The objective of this study was to analyse whether the number of admissions for gastrointestinal bleeding to our bleeding unit increases during the full moon. In a prospective study, we included 447 consecutive patients with gastrointestinal haemorrhage admitted to our bleeding unit during a period of two years. The number of admissions was allocated to the corresponding day of the lunar cycle, and full moon and non-full moon days were compared. A wide variation in the number of admissions throughout the lunar cycle was observed. There were 26 admissions on the 25 days of full moon and 421 admissions in the remaining 713 days of non-full moon. This difference was mainly related to a higher incidence of haemorrhage in men and variceal haemorrhage at full moon. The results of this study suggest an increase in the number of admissions related to gastrointestinal haemorrhage in our bleeding unit during the full moon, especially in men and in patients experiencing variceal haemorrhage. However, the wide variation in the number of admissions throughout the lunar cycle could limit interpretation of the results. Therefore, further studies are needed to clarify the possible influence of the moon on gastrointestinal haemorrhage.

Glycemic control during consecutive days with prolonged walking exercise in individuals with type 1 diabetes mellitus.

PubMed

van Dijk, Jan-Willem; Eijsvogels, Thijs M; Nyakayiru, Jean; Schreuder, Tim H A; Hopman, Maria T; Thijssen, Dick H; van Loon, Luc J C

2016-07-01

Despite its general benefits for health, exercise complicates the maintenance of stable blood glucose concentrations in individuals with type 1 diabetes. The aim of the current study was to examine changes in food intake, insulin administration, and 24-h glycemic control in response to consecutive days with prolonged walking exercise (∼8h daily) in individuals with type 1 diabetes. Ten individuals with type 1 diabetes participating in the worlds' largest walking event were recruited for this observational study. Simultaneous measurements of 24-h glycemic control (continuous glucose monitoring), insulin administration and food intake were performed during a non-walking day (control) and during three subsequent days with prolonged walking exercise (daily distance 40 or 50km). Despite an increase in daily energy (31±18%; p<0.01) and carbohydrate (82±71g; p<0.01) intake during walking days, subjects lowered their insulin administration by 26±16% relative to the control day (p<0.01). Average 24-h blood glucose concentrations, the prevalence of hyperglycemia (blood glucose >10 mmol/L) and hypoglycemia (blood glucose <3.9mmol/L) did not differ between the control day and walking days (p>0.05 for all variables). The prolonged walking exercise was associated with a modest increase in glycemic variability compared with the control day (p<0.05). Prolonged walking exercise allows for profound reductions in daily insulin administration in persons with type 1 diabetes, despite large increments in energy and carbohydrate intake. When taking such adjustments into account, prolonged moderate-intensity exercise does not necessarily impair 24-h glycemic control. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Daily stressors and adult day service use by family caregivers: effects on depressive symptoms, positive mood, and dehydroepiandrosterone-sulfate.

PubMed

Zarit, Steven H; Whetzel, Courtney A; Kim, Kyungmin; Femia, Elia E; Almeida, David M; Rovine, Michael J; Klein, Laura Cousino

2014-12-01

This study examines effects of daily use of adult day service (ADS) programs by caregivers of individuals with dementia (IWD) on a salivary biomarker of stress reactivity, dehydroepiandrosterone-sulfate (DHEA-S), and whether these effects on DHEA-S are associated with daily variability in positive mood and depressive symptoms. We used a daily diary design of 8 consecutive days with alternation of intervention (ADS) and nonintervention days to evaluate within- and between-person effects of the intervention. Family caregivers (N = 151) of IWD who were using ADS were interviewed daily by telephone at home. Saliva samples were collected from caregivers five times a day for 8 consecutive days and were assayed for DHEA-S. Daily telephone interviews assessed daily stressors and mood. DHEA-S levels were significantly higher on days after ADS use. Daily DHEA-S levels covaried significantly with daily positive mood but not with depressive symptoms. These results demonstrate an association of ADS use by family caregivers and higher DHEA-S levels on the next day. Prior research has found that higher DHEA-S levels are protective against the physiologic damaging effects of stressor exposure and may reduce risks of illness. Regular use of ADS may help reduce depletion of DHEA-S and allow the body to mount a protective and restorative response to the physiologic demands of caregiving. To our knowledge, this is the first study to examine DHEA-S levels across the day in connection with an intervention that affected daily exposure to stressors. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Oesophageal atresia: Are "long gap" patients at greater anesthetic risk?

PubMed

Powell, Laura; Frawley, Jacinta; Crameri, Joe; Teague, Warwick J; Frawley, Geoff P

2018-03-01

Long gap oesophageal atresia occurs in approximately 10% of all oesophageal atresia infants and surgical repair is often difficult with significant postoperative complications. Our aim was to describe the perioperative course, morbidity, and early results following repair of long gap oesophageal atresia and to identify factors which may be associated with complications. This is a single center retrospective cohort study of consecutive patients with oesophageal atresia undergoing surgical repair at The Royal Children's Hospital Melbourne from January 2006 to June 2017. Two hundred and thirty-nine consecutive oesophageal atresia infants included 44 long gap oesophageal atresia infants and 195 non-long gap infants. A high rate of prematurity (24.7%), major cardiac (17%), and other surgically relevant malformations (12.6%) was found in both groups. The median age at oesophageal anastomosis surgery was 65.5 days for the long gap group vs 1 day for the oesophageal atresia group (mean difference 56.8 days, 95% CI 48.1-65.5 days, P < .01). Surgery for long gap oesophageal atresia included immediate primary anastomosis (n = 10), delayed primary anastomosis (n = 11), oesophageal lengthening techniques (n = 12) and primary oesophageal replacement (n = 6). Long gap oesophageal atresia was not associated with an increased incidence of difficult intubation (OR 2.8, 95% CI 0.6-22.1, P = .17), intraoperative hypoxemia (OR 1.6, 95% CI 0.6-4.5, P = .32), or hypotension (OR 0.9, 95% CI 0.5-1.8, P = .81). The surgical duration (177.7 vs 202.1 minute, mean difference [95% CI], 28 [5.5-50.4 minutes], P = .04) and mean duration of postoperative mechanical ventilation (107 vs 199.8 hours, mean difference [95% CI], 91.8 [34.5-149.1 hours], P < .01) were shorter for the non-long gap group. Overall in-hospital mortality was 7.5% (15.9% long gap vs 5.6% non-long gap oesophageal atresia OR 1.1, 95% CI 0.4-3.4, P = .85). Long gap oesophageal atresia infants have a similar incidence of perioperative complications to other infants with oesophageal atresia. Current surgical approaches to long gap repair, however, are associated with longer anesthetic exposures and require multiple procedures in infancy to achieve oesophageal continuity. © 2018 John Wiley & Sons Ltd.

The efficacy of the Kampo medicine rikkunshito for chemotherapy-induced anorexia (RICH trial): study protocol for a randomized controlled trial.

PubMed

Inoue, Takuya; Takagi, Hironori; Owada, Yuki; Watanabe, Yuzuru; Yamaura, Takumi; Fukuhara, Mitsuro; Muto, Satoshi; Okabe, Naoyuki; Matsumura, Yuki; Hasegawa, Takeo; Osugi, Jun; Hoshino, Mika; Higuchi, Mitsunori; Shio, Yutaka; Yokouchi, Hiroshi; Kanazawa, Kenya; Ohbuchi, Katsuya; Fukushima, Takahisa; Munakata, Mitsuru; Suzuki, Hiroyuki

2017-10-18

Cisplatin is a key drug in lung cancer therapy. However, cisplatin is also well known to induce gastrointestinal disorders, such as chemotherapy-induced nausea and vomiting, anorexia, and weight loss. These symptoms sometimes affect patients' quality of life and make continuation of chemotherapy difficult. Anorexia is a cause of concern for patients with cancer because a persistent loss of appetite progresses to cancer cachexia. Although evidence-based management for chemotherapy has recently been established, there is room for improvement. This placebo-controlled, double-blind, randomized trial will aim to determine the efficacy of the traditional Japanese Kampo medicine rikkunshito (TJ-43) for preventing anorexia caused by cisplatin-including chemotherapy in patients with lung cancer. Patients with lung cancer who plan to receive cisplatin-including chemotherapy will be recruited. Patients who provide written consent will be randomly allocated to receive either TJ-43 (arm A) or placebo (arm B) for one course of chemotherapy (21 or 28 consecutive days). Investigators and patients will be masked to the treatment assignment throughout the trial. The primary endpoint will be evaluated as the change in dietary intake from day 0 (the day before the start of chemotherapy) to day 7 of cisplatin-including chemotherapy. The two arms of the trial will comprise 30 patients each. From November 2014, a total of 60 patients will be recruited, and recruitment for the study is planned to be complete by October 2017. This trial is designed to examine the efficacy of rikkunshito (TJ-43) for reducing anorexia and maintaining food intake caused by cisplatin-including chemotherapy in patients with lung cancer. Japan Pharmaceutical Information Center Clinical Trials Information (JAPIC CTI), trial registration: JAPIC CTI-142747 . Registered on 15 December 2014; the RICH trial.

Antibacterial Activity of Freshly Prepared Ozonated Water and Chlorhexidine on Mutans Streptococcus When Used as an Oral Rinse - A Randomised Clinical Study.

PubMed

Anumula, Lavanya; Kumar, Kv Suneel; Krishna, Chnv Murali; Lakshmi, K Sree

2017-07-01

Dental caries is one of the most common causes of morbidity of the tooth. Attempts have been made to reduce the pathogen population size i.e., Mutans Streptococci (MS) to demote the incidence of caries and increase the resistance of the tooth to cariogenic attack. To evaluate the antibacterial efficacy of freshly prepared ozonated water, in proposing it as an alternative mouth rinse on MS in comparison to Chlorhexidine (CHX). Subjects with high caries incidence and MS counts more than 105 Colony Forming Unit (CFU) were selected and divided by block randomization into two groups of 23 subjects each. The subjects were advised to use the respective mouth rinses under the operator surveillance, consecutively for 14 days. Stimulated salivary samples were collected from the subjects on the first day, 7 th and 14 th day to analyse the changes in MS counts during the course of use of oral rinses. The obtained data was tabulated and statistically analysed. Freshly prepared ozonated water showed a statistically significant reduction in MS counts after an interval of 7 days and 14 days when compared to CHX. Ozonated water when consecutively used as a mouth rinse resulted in a significant reduction of MS counts. Hence, it can be used as an alternative to chlorhexidine.

Expression of DNA repair genes in burned skin exposed to low-level red laser.

PubMed

Trajano, Eduardo Tavares Lima; Mencalha, Andre Luiz; Monte-Alto-Costa, Andréa; Pôrto, Luís Cristóvão; de Souza da Fonseca, Adenilson

2014-11-01

Although red laser lights lie in the region of non-ionizing radiations in the electromagnetic spectrum, there are doubts whether absorption of these radiations causes lesions in the DNA molecule. Our aim was to investigate the expression of the genes involved with base excision and nucleotide excision repair pathways in skin tissue submitted to burn injury and exposed to low-level red laser. Wistar rats were divided as follows: control group-rats burned and not irradiated, laser group-rats burned and irradiated 1 day after injury for five consecutive days, and later laser group-rats injured and treated 4 days after injury for five consecutive days. Irradiation was performed according to a clinical protocol (20 J/cm(2), 100 mW, continuous wave emission mode). The animals were sacrificed on day 10, and scarred tissue samples were withdrawn for total RNA extraction, complementary DNA (cDNA) synthesis, and evaluation of gene expression by quantitative polymerase chain reaction. Low-level red laser exposure (1) reduces the expression of APE1 messenger (mRNA), (2) increases the expression of OGG1 mRNA, (3) reduces the expression of XPC mRNA, and (4) increases the expression of XPA mRNA both in laser and later laser groups. Red laser exposure at therapeutic fluences alters the expression of genes related to base excision and nucleotide excision pathways of DNA repair during wound healing of burned skin.

Protective Effect of Proanthocyanidins from Sea Buckthorn (Hippophae Rhamnoides L.) Seed against Visible Light-Induced Retinal Degeneration in Vivo.

PubMed

Wang, Yong; Zhao, Liang; Huo, Yazhen; Zhou, Feng; Wu, Wei; Lu, Feng; Yang, Xue; Guo, Xiaoxuan; Chen, Peng; Deng, Qianchun; Ji, Baoping

2016-05-02

Dietary proanthocyanidins (PACs) as health-protective agents have become an important area of human nutrition research because of their potent bioactivities. We investigated the retinoprotective effects of PACs from sea buckthorn (Hippophae rhamnoides L.) seed against visible light-induced retinal degeneration in vivo. Pigmented rabbits were orally administered sea buckthorn seed PACs (50 and 100 mg/kg/day) for 14 consecutive days of pre-illumination and seven consecutive days of post-illumination. Retinal function was quantified via electroretinography 7 days after light exposure. Retinal damage was evaluated by measuring the thickness of the full-thickness retina and outer nuclear layer 7 days after light exposure. Sea buckthorn seed PACs significantly attenuated the destruction of electroretinograms and maintained the retinal structure. Increased retinal photooxidative damage was expressed by the depletion of glutathione peroxidase and catalase activities, the decrease of total antioxidant capacity level and the increase of malondialdehyde level. Light exposure induced a significant increase of inflammatory cytokines (IL-1β, TNF-α and IL-6) and angiogenesis (VEGF) levels in retina. Light exposure upregulated the expression of pro-apoptotic proteins Bax and caspase-3 and downregulated the expression of anti-apoptotic protein Bcl-2. However, sea buckthorn seed PACs ameliorated these changes induced by light exposure. Sea buckthorn seed PACs mediated the protective effect against light-induced retinal degeneration via antioxidant, anti-inflammatory and antiapoptotic mechanisms.

Protective Effect of Proanthocyanidins from Sea Buckthorn (Hippophae Rhamnoides L.) Seed against Visible Light-Induced Retinal Degeneration in Vivo

PubMed Central

Wang, Yong; Zhao, Liang; Huo, Yazhen; Zhou, Feng; Wu, Wei; Lu, Feng; Yang, Xue; Guo, Xiaoxuan; Chen, Peng; Deng, Qianchun; Ji, Baoping

2016-01-01

Dietary proanthocyanidins (PACs) as health-protective agents have become an important area of human nutrition research because of their potent bioactivities. We investigated the retinoprotective effects of PACs from sea buckthorn (Hippophae rhamnoides L.) seed against visible light-induced retinal degeneration in vivo. Pigmented rabbits were orally administered sea buckthorn seed PACs (50 and 100 mg/kg/day) for 14 consecutive days of pre-illumination and seven consecutive days of post-illumination. Retinal function was quantified via electroretinography 7 days after light exposure. Retinal damage was evaluated by measuring the thickness of the full-thickness retina and outer nuclear layer 7 days after light exposure. Sea buckthorn seed PACs significantly attenuated the destruction of electroretinograms and maintained the retinal structure. Increased retinal photooxidative damage was expressed by the depletion of glutathione peroxidase and catalase activities, the decrease of total antioxidant capacity level and the increase of malondialdehyde level. Light exposure induced a significant increase of inflammatory cytokines (IL-1β, TNF-α and IL-6) and angiogenesis (VEGF) levels in retina. Light exposure upregulated the expression of pro-apoptotic proteins Bax and caspase-3 and downregulated the expression of anti-apoptotic protein Bcl-2. However, sea buckthorn seed PACs ameliorated these changes induced by light exposure. Sea buckthorn seed PACs mediated the protective effect against light-induced retinal degeneration via antioxidant, anti-inflammatory and antiapoptotic mechanisms. PMID:27144578

Between-day reliability of a method for non-invasive estimation of muscle composition.

PubMed

Simunič, Boštjan

2012-08-01

Tensiomyography is a method for valid and non-invasive estimation of skeletal muscle fibre type composition. The validity of selected temporal tensiomyographic measures has been well established recently; there is, however, no evidence regarding the method's between-day reliability. Therefore it is the aim of this paper to establish the between-day repeatability of tensiomyographic measures in three skeletal muscles. For three consecutive days, 10 healthy male volunteers (mean±SD: age 24.6 ± 3.0 years; height 177.9 ± 3.9 cm; weight 72.4 ± 5.2 kg) were examined in a supine position. Four temporal measures (delay, contraction, sustain, and half-relaxation time) and maximal amplitude were extracted from the displacement-time tensiomyogram. A reliability analysis was performed with calculations of bias, random error, coefficient of variation (CV), standard error of measurement, and intra-class correlation coefficient (ICC) with a 95% confidence interval. An analysis of ICC demonstrated excellent agreement (ICC were over 0.94 in 14 out of 15 tested parameters). However, lower CV was observed in half-relaxation time, presumably because of the specifics of the parameter definition itself. These data indicate that for the three muscles tested, tensiomyographic measurements were reproducible across consecutive test days. Furthermore, we indicated the most possible origin of the lowest reliability detected in half-relaxation time. Copyright © 2012 Elsevier Ltd. All rights reserved.

Supplemental intermittent-day heat training and the lactate threshold.

PubMed

Gollan, Stuart; Chalmers, Samuel; Alderton, Stephen; Norton, Kevin

2017-04-01

Heat acclimation over consecutive days has been shown to improve aerobic-based performance. Recently, it has been suggested that heat training can improve performance in a temperate environment. However, due to the multifactorial training demands of athletes, consecutive-day heat training may not be suitable. The current study aimed to investigate the effect of brief (8×30min) intermittent (every 3-4 days) supplemental heat training on the second lactate threshold point (LT 2 ) in temperate and hot conditions. 21 participants undertook eight intermittent-day mixed-intensity treadmill exercise training sessions in hot (30°C; 50% relative humidity [RH]) or temperate (18°C; 30% RH) conditions. A pre- and post-incremental exercise test occurred in temperate (18°C; 30% RH) and hot conditions (30°C; 50% RH) to determine the change in LT 2 . The heat training protocol did not improve LT 2 in temperate (Effect Size [ES]±90 confidence interval=0.10±0.16) or hot (ES=0.26±0.26) conditions. The primary finding was that although the intervention group had a change greater than the SWC, no statistically significant improvements were observed following an intermittent eight day supplemental heat training protocol comparable to a control group training only in temperate conditions. This is likely due to the brief length of each heat training session and/or the long duration between each heat exposure. Copyright © 2017 Elsevier Ltd. All rights reserved.

Resident education in robotic-assisted vertical sleeve gastrectomy: outcomes and cost-analysis of 411 consecutive cases.

PubMed

Ecker, Brett L; Maduka, Richard; Ramdon, Andre; Dempsey, Daniel T; Dumon, Kristoffel R; Williams, Noel N

2016-02-01

Robotic technology is increasingly prevalent in bariatric surgery, yet there are national deficiencies in exposure of surgical residents to robotic techniques. The purpose of this study is to accurately characterize the perioperative outcomes of a resident teaching model using the robotic-assisted sleeve gastrectomy. University Hospital. We identified 411 consecutive patients who underwent robotic sleeve gastrectomy at our institution from a prospectively maintained administrative database. Perioperative morbidity, operative time, and supply cost of the procedure were analyzed. Mean operative time was 96.4±24.9 minutes; mean robot usage time was 63.9 minutes (range 30.0-122.0 min). Ninety-day morbidities included reoperation (0.72%), major bleeding complications (0.48%), staple line leak (0.24%), stricture (0.97%), need for blood transfusion (3.86%), surgical site infection (1.69%), deep vein thrombosis (0.48%), and pulmonary embolism (0.48%). Mortality was nil. The resident cohort achieved operative time plateaus after five consecutive cases. Subset analysis for fiscal year 2014 demonstrated significantly increased supply cost for robotic sleeve gastrectomy compared with its laparoscopic equivalent. Robotic-assisted sleeve gastrectomy can be instituted as a model for resident robotic education with rates of morbidity and operative times equivalent to historical laparoscopic controls. The robot's enhanced ergonomics and its opportunity for resident education must be weighed against its increased supply cost. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Chemotherapy of Second Stage Human African Trypanosomiasis: Comparison between the Parenteral Diamidine DB829 and Its Oral Prodrug DB868 in Vervet Monkeys

PubMed Central

Thuita, John K.; Wolf, Kristina K.; Murilla, Grace A.; Bridges, Arlene S.; Boykin, David W.; Mutuku, James N.; Liu, Qiang; Jones, Susan K.; Gem, Charles O.; Ching, Shelley; Tidwell, Richard R.; Wang, Michael Z.; Paine, Mary F.; Brun, Reto

2015-01-01

Human African trypanosomiasis (HAT, sleeping sickness) ranks among the most neglected tropical diseases based on limited availability of drugs that are safe and efficacious, particularly against the second stage (central nervous system [CNS]) of infection. In response to this largely unmet need for new treatments, the Consortium for Parasitic Drug Development developed novel parenteral diamidines and corresponding oral prodrugs that have shown cure of a murine model of second stage HAT. As a rationale for selection of one of these compounds for further development, the pharmacokinetics and efficacy of intramuscular (IM) active diamidine 2,5-bis(5-amidino-2-pyridyl)furan (DB829; CPD-0802) and oral prodrug2,5-bis[5-(N-methoxyamidino)-2-pyridyl]furan (DB868) were compared in the vervet monkey model of second stage HAT. Treatment was initiated 28 days post-infection of monkeys with T. b. rhodesiense KETRI 2537. Results showed that IM DB829 at 5 mg/kg/day for 5 consecutive days, 5 mg/kg/day every other day for 5 doses, or 2.5 mg/kg/day for 5 consecutive days cured all monkeys (5/5). Oral DB868 was less successful, with no cures (0/2) at 3 mg/kg/day for 10 days and cure rates of 1/4 at 10 mg/kg/day for 10 days and 20 mg/kg/day for 10 days; in total, only 2/10 monkeys were cured with DB868 dose regimens. The geometric mean plasma Cmax of IM DB829 at 5 mg/kg following the last of 5 doses was 25-fold greater than that after 10 daily oral doses of DB868 at 20 mg/kg. These data suggest that the active diamidine DB829, administered IM, should be considered for further development as a potential new treatment for second stage HAT. PMID:25654243

The effect of a short course of moderate pressure sunflower oil massage on the weight gain velocity and length of NICU stay in preterm infants.

PubMed

Taheri, Peymaneh Alizadeh; Goudarzi, Zahra; Shariat, Mamak; Nariman, Shahin; Matin, Elahe Nikzinat

2018-02-01

The aim of this study was to evaluate the efficacy of five-day course of sunflower oil massage with moderate pressure on the weight gain and length of NICU stay in preterm infants. Forty-four healthy preterm infants with a corrected gestational age of 30-36 weeks at the time of the study, were randomly assigned to the study group receiving body massage with sunflower oil and the control group receiving only routine NICU care. The massage was performed three times per day, each session including three consecutive five-minute stages, for five days. The primary outcome was to evaluate the efficacy of a short course of moderate pressure sunflower oil massage on the weight gain velocity. The secondary outcome was to compare the length of NICU stay between the two groups. During the study period, the increase in the average daily and fifth-day weight gain was significant in the intervention group. The length of NICU stay was shorter in the intervention group significantly. Our findings suggest that even a short course of body massage with sunflower oil for only five days increases preterm infants' weight gain and decreases their duration of NICU stay significantly. Copyright © 2017 Elsevier Inc. All rights reserved.

Limb lengthening over plate

PubMed Central

Kulkarni, Ruta; Singh, Nishant; Kulkarni, Govind S; Kulkarni, Milind; Kulkarni, Sunil; Kulkarni, Vidisha

2012-01-01

Background: The limb lengthening over plate eliminates the associated risk of infection with limb lengthening over intramedullary nail. We present our experience of limb lengthening in 15 patients with a plate fixed on the proximal segment, followed by corticotomy and application of external fixator. Materials and Methods: 15 patients (7 females, 8 males) were included in this consecutive series. The average age was 18.1 years (range 8–35 years). Fifteen tibiae and one femur were lengthened in 15 patients. Lengthening was achieved at 1 mm/day followed by distal segment fixation with three or four screws on reaching the target length. Results: The preoperative target length was successfully achieved in all patients at a mean of 4.1 cm (range 1.8–6.5 cm). The mean duration of external fixation was 75.3 days (range 33–116 days) with the mean external fixation index at 19.2 days/cm (range 10.0–38.3 days/cm). One patient suffered deep infection up to the plate, three patients had mild procurvatum deformities, and one patient developed mild tendo achilles contracture. Conclusion: Lengthening over a plate allows early removal of external fixator and eliminates the risk of creating deep intramedullary infection as with lengthening over nail. Lengthening over plate is also applicable to children with open physis. PMID:22719123

Progressive Dehydration in Junior Laser Class Sailors During World Championship.

PubMed

Arnaoutis, Giannis; Verginadis, Panagiotis; Seal, Adam D; Vogiatzis, Ioannis; Sidossis, Labros S; Kavouras, Stavros A

2018-01-01

The purpose of this article is to assess the hydration status of elite young sailing athletes during World Championship competition. Twelve young, elite, male, Laser Class sailors (age: 15.8 ± 1.1 y, height: 1.74 ± 0.1 m, weight: 65.1 ± 1.5 kg, body fat: 12.5 ± 3.1%, training experience: 7.0 ± 1.2 y) participated in this descriptive study. After three-day baseline bodyweight measurements, hydration status was assessed via pre- and post-race body weights, urine-specific gravity, and thirst ratings via a visual analog scale during four consecutive days of racing. Measurements and data collection took place at the same time each racing day, with mean environmental temperature, humidity, and wind speed at 23.0 ± 0.8°C, 64-70%, and 9 ± 1 knots, respectively. Average racing time was 130 ± 9 min. Body weight was significantly decreased following each race-day as compared to prerace values (Day 1: -1.1 ± 0.2, Day 2: -2.5 ± 0.1, Day 3: -2.8 ± 0.1, and Day 4: -3.0 ± 0.1% of body weight; p < 0.05). The participants exhibited dehydration of -2.9 ± 0.2 and -5.8 ± 0.2% of body weight before and after the fourth racing day as compared to the three-day baseline body weight. Urine-specific gravity (pre-post → Day 1: 1.014-1.017; Day 2: 1.019-1.024; Day 3: 1.021-1.026; Day 4: 1.022-1.027) and thirst (pre-post → Day 1: 2.0-5.2; Day 2: 3.2-5.5; Day 3: 3.7-5.7; Day 4: 3.8-6.8) were also progressively and significantly elevated throughout the four days of competition. The data revealed progressive dehydration throughout four consecutive days of racing as indicated by decreased body weight, elevated urine concentration, and high thirst.

Effect of Hypoglycemic Agents on Ischemic Preconditioning in Patients With Type 2 Diabetes and Symptomatic Coronary Artery Disease

PubMed Central

Rahmi, Rosa Maria; Uchida, Augusto Hiroshi; Rezende, Paulo Cury; Lima, Eduardo Gomes; Garzillo, Cibele Larrosa; Favarato, Desiderio; Strunz, Celia M.C.; Takiuti, Myrthes; Girardi, Priscyla; Hueb, Whady; Kalil Filho, Roberto; Ramires, José A.F.

2013-01-01

OBJECTIVE To assess the effect of two hypoglycemic drugs on ischemic preconditioning (IPC) patients with type 2 diabetes and coronary artery disease (CAD). RESEARCH DESIGN AND METHODS We performed a prospective study of 96 consecutive patients allocated into two groups: 42 to group repaglinide (R) and 54 to group vildagliptin (V). All patients underwent two consecutive exercise tests (ET1 and ET2) in phase 1 without drugs. In phase 2, 1 day after ET1 and -2, 2 mg repaglinide three times daily or 50 mg vildagliptin twice daily was given orally to patients in the respective group for 6 days. On the seventh day, 60 min after 6 mg repaglinide or 100 mg vildagliptin, all patients underwent two consecutive exercise tests (ET3 and ET4). RESULTS In phase 1, IPC was demonstrated by improvement in the time to 1.0 mm ST-segment depression and rate pressure product (RPP). All patients developed ischemia in ET3; however, 83.3% of patients in group R experienced ischemia earlier in ET4, without significant improvement in RPP, indicating the cessation of IPC (P < 0.0001). In group V, only 28% of patients demonstrated IPC cessation, with 72% still having the protective effect (P < 0.0069). CONCLUSIONS Repaglinide eliminated myocardial IPC, probably by its effect on the KATP channel. Vildagliptin did not damage this protective mechanism in a relevant way in patients with type 2 diabetes and CAD, suggesting a good alternative treatment in this population. PMID:23250803

The SOURCE Registry: what is the learning curve in trans-apical aortic valve implantation?

PubMed

Wendler, Olaf; Walther, Thomas; Schroefel, Holger; Lange, Rüdiger; Treede, Hendrik; Fusari, Melissa; Rubino, Paolo; Thomas, Martyn

2011-06-01

Trans-apical aortic valve implantation (TA-AVI) has been shown to be a reproducible technique. Early results from the SAPIEN Aortic Bioprosthesis European Outcome (SOURCE) Registry identified major access complications associated with high 30-day mortality. Using the SOURCE Registry, we analyze the learning curve for TA-AVI over the first 2 years after commercialization. The SOURCE Registry gathered data for 2 consecutive years at European centers following commercialization of the Edwards SAPIEN bioprosthesis, totaling 2339 patients (1038 in COHORT 1 and 1301 in COHORT 2). Only data from centers that provided all of their consecutively treated patients were included in this study. We compared the 30-day results of TA-AVI from COHORT 1 (C-1: January/2008-January/2009) with the 30-day results of COHORT 2 (C-2: February/2009-January/2010). This analysis is based on a total number of 575 TA-AVIs in C-1 and 819 TA-AVIs in C-2. Mean age (C-1: 80.7 years, C-2: 80.5 years) and logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) (C-1: 29.1%, C-2 27.3%) were not significantly different. Valve malposition (C-1: 1.6%, C-2: 1.2%), valve migration/embolization (C-1: 0.5%, C-2: 1.0%), and major access complications (C-1: 2.1%, C-2: 1.8%) were in total less frequent, but not statistically significant lower in C-2. However, the reduction of aortic regurgitation >2+ immediately following the procedure (C-1: 4.52%, C-2: 2.1%, p=0.011) and conversion rate to open surgery (C-1: 3.7%, C-2: 1.5%, p=0.0315) reached statistical significance. Postoperative complications included dialysis (C-1: 7.0%, C-2: 5.7%, p=ns), pacemaker implantation (C-2: 7.7%, C-2: 6.7%, p=ns), stroke (C-1: 2.4%, C-2: 2.6%, p=ns), and myocardial infarct (C-1: 0.7%, C-2: 0.4%, p=ns). The total 30-day mortality was 10.8% and not significantly different between the two groups (C-1: 10.8%, C-2: 10.7%, p=ns). Although the incidence of technical intra procedural complications has trended downward, reflecting the learning curve for TA-AVI, 30-day mortality was unchanged, likely due to patient co-morbidities not captured by preoperative risk variables. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Adherence to Diurnal Cortisol Sampling Among Mother-Child Dyads From Maltreating and Nonmaltreating Families.

PubMed

Valentino, Kristin; De Alba, Ashley; Hibel, Leah C; Fondren, Kaitlin; McDonnell, Christina G

2017-11-01

There has been increasing interest in evaluating whether interventions for child maltreatment can improve and/or prevent child physiological dysregulation via measurement of diurnal cortisol. The assessment of diurnal cortisol typically involves the home-based collection of saliva multiple times per day, bringing forth important methodological considerations regarding adherence to collection instructions. To date, there has been no data regarding adherence to home collection of diurnal cortisol among maltreating families. The current study provides data on adherence to in-home sampling of salivary cortisol among 166 maltreating and demographically similar nonmaltreating mother-child dyads using electronic monitoring devices (Medication Event Monitoring System caps). Mothers collected saliva samples on themselves and their children 3 times per day (waking, midday, and evening) for 2 consecutive days. Analyses reveal that although maltreating families were more likely to be nonadherent to the collection protocol on their initial attempt, with additional support and resampling, maltreating and nonmaltreating families were comparable on most measures of adherence. Suggestions for best practices, including the use of electronic monitoring devices, for diurnal cortisol collection with maltreating families are provided.

[Evaluation of the treatment effectiveness of domestic G-SCF preparations in experiments on irradiated dogs].

PubMed

Rozhdestvenskiĭ, L M; Shliakova, T G; Shchegoleva, R A; Lisina, N I; Zorin, V V

2013-01-01

We have evaluated the treatment effectiveness of Leucostim and Neupomax in dogs exposed to radiation at lethal doses of 3 and 3.5 Gy, correspondingly, by testing the dynamics of the blood cell number, first of all, leucocytes and neutrophiles, and the 45-day survival. Supportive therapy for all the dogs, including the control ones, consisted in antibiotic treatment during the acute period of 7-24 days. It was shown that both pre-parations administered consecutively for about 17-21 days after irradiation positively influenced the dynamics of all blood cells but predominantly impacted the neutrophile number dynamics. The latter ones manifested a higher nadir level and an earlier onset of restoration in the G-SCF treated dogs in comparison with the control ones. The tendency to a positive influence on the survival has been shown in Neupomax-treated dogs exposed to 3.5 Gy of radiation (plus about 40%). The results of the experiments were in good accordance with the data by foreign authors who used Neupogen. This allows a conclusion that home-produced G-SCF preparations can replace their foreign analogues.

Non-invasive ventilation for cancer patients with life-support techniques limitation.

PubMed

Meert, Anne-Pascale; Berghmans, Thierry; Hardy, Michel; Markiewicz, Eveline; Sculier, Jean-Paul

2006-02-01

The study was conducted to determine the usefulness and efficacy of non-invasive ventilation (NIV) in cancer patients with "life-support techniques limitation" admitted for an acute respiratory distress, in terms of intensive care unit (ICU) and hospital discharges. A total of 18 consecutive cancer patients (17 with solid tumours and one with haematological malignancy) with "life-support techniques limitation" in acute respiratory failure and who benefited from NIV were included. NIV was provided with a standard face mask by the BiPAP Vision ventilator (Respironics Inc.). Variables related to the demographic parameters, SAPS II score, cancer characteristics, intensive care data and hospital discharge were recorded. Complications leading to NIV were hypoxemic respiratory failure in 11 patients and hypercapnic respiratory failure in seven. Total median duration of NIV was 29 h. NIV was applied during a median of 2.5 days with a median of 16 h per day. Total median ICU stay was 7 days (range 1-21). Fourteen and ten patients were discharged from ICU and from hospital, respectively. NIV appears to be an effective ventilation support for cancer patients with "life-support techniques limitation".

Effect of sprint training: training once daily versus twice every second day.

PubMed

Ijichi, Toshiaki; Hasegawa, Yuta; Morishima, Takuma; Kurihara, Toshiyuki; Hamaoka, Takafumi; Goto, Kazushige

2015-01-01

This study compared training adaptations between once daily (SINGLE) and twice every second day (REPEATED) sprint training, with same number of training sessions. Twenty physically active males (20.9 ± 1.3 yr) were assigned randomly to the SINGLE (n = 10) or REPEATED (n = 10) group. The SINGLE group trained once per day (5 days per week) for 4 weeks (20 sessions in total). The REPEATED group conducted two consecutive training sessions on the same day, separated by a rest period of 1 h (2-3 days per week) for 4 weeks (20 sessions in total). Each training session consisted of three consecutive 30-s maximal pedalling sets with a 10-min rest between sets. Before and after the training period, the power output during two bouts of 30-s maximal pedalling, exercise duration during submaximal pedalling and resting muscle phosphocreatine (PCr) levels were evaluated. Both groups showed significant increases in peak and mean power output during the two 30-s bouts of maximal pedalling after the training period (P < 0.05). The groups showed similar increases in VO2max after the training period (P < 0.05). The REPEATED group showed a significant increase in the onset of blood lactate accumulation (OBLA) after the training period (P < 0.05), whereas no change was observed in the SINGLE group. The time to exhaustion at 90% of VO2max and muscle PCr concentration at baseline did not change significantly in either group. Sprint training twice every second day improved OBLA during endurance exercise more than the same training once daily.

Gestational age and birth weight centiles of singleton babies delivered normally following spontaneous labor, in Southern Sri Lanka

PubMed

Attanayake, K; Munasinghe, S; Goonewardene, M; Widanapathirana, P; Sandeepani, I; Sanjeewa, L

2018-03-31

To estimate the gestational age and birth weight centiles of babies delivered normally, without any obstetric intervention, in women with uncomplicated singleton pregnancies establishing spontaneous onset of labour. Consecutive women with uncomplicated singleton pregnancies, attending the Academic Obstetrics and Gynecology Unit of the Teaching Hospital Mahamodara Galle, Sri Lanka, with confirmed dates and establishing spontaneous onset of labor and delivering vaginally between gestational age of 34 - 41 weeks, without any obstetric intervention , during the period September 2013 to February 2014 were studied. The gestational age at spontaneous onset of labor and vaginal delivery and the birth weights of the babies were recorded. There were 3294 consecutive deliveries during this period, and of them 1602 (48.6%) met the inclusion criteria. Median gestational age at delivery was 275 days (range 238-291 days, IQR 269 to 280 days) and the median birth weight was 3000 g (range1700g - 4350g; IQR 2750-3250g). The 10th, 50th and 90th birth weight centiles of the babies delivered at a gestational age of 275 days were approximately 2570g, 3050g and 3550g respectively. The median gestational age among women with uncomplicated singleton pregnancies who established spontaneous onset of labor and delivered vaginally, without any obstetric intervention, was approximately five days shorter than the traditionally accepted 280 days. At a gestational age of 275 days, the mean birth weight was approximately 3038g and the 50th centile of the birth weight of the babies delivered was approximately 3050g.

Focal vibration of quadriceps muscle enhances leg power and decreases knee joint laxity in female volleyball players.

PubMed

Brunetti, O; Botti, F M; Roscini, M; Brunetti, A; Panichi, R; Filippi, G M; Biscarini, A; Pettorossi, V E

2012-12-01

This double-blind randomized controlled study aims at determining the effect of repeated muscle vibration (rMV) on explosive and reactive leg power and on knee laxity of female volleyball players. Eighteen voluntary volleyball athletes, belonging to the same senior regional level team (age=22.7 ± 3 years, height=180.3 ± 5 cm, mass= 64 ± 4 kg) were assigned to three groups (N.=6) for vibration on contracted quadriceps (VC), vibration on relaxed muscle (VR), and sham vibration (NV), respectively. Intervention consisted in 3 rMV sessions performed in 3 consecutive days. In each session, 100 Hz, 300-500 μm amplitude vibratory stimuli were bilaterally delivered to the quadriceps in three consecutive 10-minutes applications. Explosive and reactive leg power and knee joint laxity were evaluated 1 day before, and 1, 30, and 240 days after intervention. In VC group, explosive and reactive leg power increased respectively by ~16% and ~9% at 1 day, by ~19% and ~11% at 30 days and by ~26% and ~13% at 240 days, concomitantly knee laxity decreased by ~6%, ~15% and ~18% at the same times. These changes were significantly larger than in the other groups, in which leg power increment and knee joint laxity reduction remained close to ~3%, ~5% and ~10% at 1, 30 and 240 days, respectively. Combined bilateral voluntary contraction and rMV of the quadriceps muscles is a short-lasting, non-invasive technique that can significantly and persistently improve muscle performance and knee laxity in volleyball women players.

Impact of a critical pathway on postoperative length of stay and outcomes after infrainguinal bypass.

PubMed

Stanley, A C; Barry, M; Scott, T E; LaMorte, W W; Woodson, J; Menzoian, J O

1998-06-01

To determine the effect of a critical pathway on postoperative length of stay and outcomes after infrainguinal bypass. A critical pathway for care of patients after infrainguinal bypass was introduced in December 1995 to coordinate postoperative care at our institution. We compared care of 67 consecutively treated patients before institution of the pathway with care of 69 consecutively treated patients with the critical pathway in place. Data collection was done by means of chart review. Univariate analyses were used to identify differences between prepathway and postpathway patients and to identify factors influencing postoperative length of stay. Multivariate analysis was used to identify factors that influenced length of stay and to examine the effect of use of the pathway after adjusting for other factors. Patients on the pathway were similar to prepathway controls with respect to comorbid illnesses, vascular risk factors, indications for surgical treatment, type of conduit, and type of operation. Factors associated with longer postoperative stays included distal anastomoses to tibial rather than popliteal vessels (p = 0.02), preexisting cardiac disease (p = 0.005), postoperative complications (p = 0.0003), lower preoperative hematocrit (p = 0.01), and elevated preoperative creatinine level (p = 0.006). Overall, pathway patients had somewhat shorter postoperative lengths of stay (median value 7 days; range 2 to 29 days) than prepathway patients (median value 6 days; range 2 to 35; p = 0.01), and the two groups had similar frequencies of postoperative complications, readmission, and 6-month mortality. However, patients on the pathway were more likely to be discharged to an intermediate-care facility rather than directly home. After 12 patients with extraordinarily prolonged postoperative stays were excluded, multivariate analysis indicated that pathway patients had significantly shorter postoperative stays (p = 0.001). However, the difference was not significant if patients with extraordinarily long postoperative stays were included in the analysis (p = 0.28). Use of a critical pathway was associated with a modest decrease in postoperative length of stay for most patients. This was accomplished without an adverse effect on readmission, complication, or mortality rates. However, the decrease in stay may have been achieved primarily by discharging more patients to intermediate-care facilities. The pathway did not appear to have any effect when the subset of patients with extraordinarily long stays because of complex medical problems was included.

27 CFR 28.222 - Claim, Form 1582-B (5130.6).

Code of Federal Regulations, 2010 CFR

2010-04-01

..., DEPARTMENT OF THE TREASURY LIQUORS EXPORTATION OF ALCOHOL Exportation of Beer With Benefit of Drawback § 28... serial number beginning with “1” for the first day of January of each year and running consecutively...

Comparison of lateral flow assay, kidney inhibition swab, and liquid chromatography-tandem mass spectrometry for the detection of penicillin G residues in sow urine

USDA-ARS?s Scientific Manuscript database

Sows (n=126) were administered penicillin G procaine at 5x the label dose for 3 consecutive days. Eighteen sows were slaughtered on each withdrawal days, 5, 10, 15, 20, 25, 32, or 39 d after treatment. Urine samples were collected at slaughter and were frozen at -80 °C until screening as positive ...

Stress and PTSD Mechanisms as Targets for Pharmacotherapy of Alcohol Abuse, Addiction and Relapse

DTIC Science & Technology

2017-10-01

and due to the need for some methodology refinements. 15. SUBJECT TERMS PTSD, alcohol, ethanol, prazosin, noradrenergic, startle, anxiety, stress...behaviors in the differing experimental models used in these studies; we continue to evaluate whether prazosin treatment disproportionately decreases...intermittent alcohol access (IAA, 24 h/day free choice between 20% alcohol vs water on 3 non -consecutive days/week) to establish stable elevated

Safety of aquaflor (florfenicol, 50% type a medicated article), administered in feed to channel catfish, Ictalurus punctatus

USGS Publications Warehouse

Gaikowski, Mark P.; Wolf, Jeffery C.; Endris, Richard G.; Gingerich, William H.

2003-01-01

Aquaflor, a feed premix containing the broad spectrum antibacterial agent florfenicol (50% w/w), is being developed for use to control enteric septicemia (ESC) in channel catfish Ictalurus punctatus caused by the gram-negative enterobacterium Edwardsiella ictaluri. The recommended dose of Aquaflor to control ESC is 10 mg/kg body weight (BW)/day for 10 days. The study objective was to determine the safety of Aquaflor administered in feed to channel catfish at doses of 0 (control), 10, 30, and 50 mg/kg BW/day for 20 consecutive days. Parameters evaluated included daily mortality, behavioral (appetite, distribution, flight/fright response), and water chemistry observations, initial and terminal weight measurements, and gross and microscopic pathology. Medicated feed consumption was 67-86% of target with group mean doses of 8.5 mg/kg BW/day, 24.6 mg/kg BW/day, and 34.9 mg/kg BW/day. There were no mortalities or clinically observable changes noted at any of the dose levels tested. Aquaflor-related changes were limited to the food consumption and histopathology data. Although Aquaflor-related decreased feed consumption was noted in the 30 and 50 mg/kg BW/day groups, there were no differences in fish growth among the treatment groups. Aquaflor-related histopathology findings were limited to a histomorphologically evident dose-dependent decrease in hematopoietic/lymphopoietic tissue in the anterior kidneys, posterior kidneys, and spleens of channel catfish.

Safety of Aquaflor (Florfenicol, 50% Type A Medicated Article), Administered in Feed to Channel Catfish, Ictalurus punctatus

USGS Publications Warehouse

Gaikowski, M.P.; Wolf, J.C.; Endris, R.G.; Gingerich, W.H.

2003-01-01

Aquaflor, a feed premix containing the broad spectrum antibacterial agent florfenicol (50% w/w), is being developed for use to control enteric septicemia (ESC) in channel catfish Ictalurus punctatus caused by the gram-negative enterobacterium Edwardsiella ictaluri. The recommended dose of Aquaflor to control ESC is 10 mg/kg body weight (BW)/day for 10 days. The study objective was to determine the safety of Aquaflor administered in feed to channel catfish at doses of 0 (control), 10, 30, and 50 mg/kg BW/day for 20 consecutive days. Parameters evaluated included daily mortality, behavioral (appetite, distribution, flight/fright response), and water chemistry observations, initial and terminal weight measurements, and gross and microscopic pathology. Medicated feed consumption was 67-86% of target with group mean doses of 8.5 mg/kg BW/day, 24.6 mg/kg BW/day, and 34.9 mg/kg BW/day. There were no mortalities or clinically observable changes noted at any of the dose levels tested. Aquaflor-related changes were limited to the food consumption and histopathology data. Although Aquaflor-related decreased feed consumption was noted in the 30 and 50 mg/kg BW/day groups, there were no differences in fish growth among the treatment groups. Aquaflor-related histopathology findings were limited to a histomorphologically evident dose-dependent decrease in hematopoietic/lymphopoietic tissue in the anterior kidneys, posterior kidneys, and spleens of channel catfish.

Toltrazuril and sulphonamide treatment against naturally Isospora suis infected suckling piglets: is there an actual profit?

PubMed

Scala, Antonio; Demontis, Francesca; Varcasia, Antonio; Pipia, Anna Paola; Poglayen, Giovanni; Ferrari, Nicola; Genchi, Marco

2009-08-26

A study was carried out to assess the efficacy and the economic profit of prophylactic treatment against Isopsora suis with toltrazuril or with a sulfamethazine/trimethoprim combination in piglets from an intensive pig farm. Thirty-one litters were included in study. Eight litters were treated once with toltrazuril (20 mg/kg b.w.) at 3 days of age (Toltra group); 8 litters were treated with 2 ml/animal of a [corrected] sulphonamide combination (sodium sulfamethazine 250 [DOSAGE ERROR CORRECTED] mg and trimethoprim 50 [DOSAGE ERROR CORRECTED] mg/kg b.w.) for 3 consecutive days starting at 3 days of age (Sulfa group), and 15 litters were untreated (control group). Counts of oocyst per gram on pooled feces sampled from each litter were carried out on Days 7, 14, 21 and 28 and diarrhea was registered daily from pooled samples. Piglets were weighed on Days 1, 7 and 28 and mean weight gain (WG) and daily weight gain (DWG) were evaluated. The economic profit of treatment was evaluated comparing the WG of piglets of each treatment group from the day of birth to Day 28. On Days 14, 21 and 28, toltrazuril showed a better efficacy in controlling fecal oocyst output, diarrhea and weight gain compared with sulphamidic treatment (P<0.001). The budgeting analysis showed a return of economic benefit of euro 0.915 per toltrazuril-treated piglets and an additional cost of euro 1.155 per sulphonamide-treated piglets.

Mandibular third molar surgery in 396 patients at a Norwegian university clinic: Morbidity recorded after 1 week utilizing an e-infrastructure for clinical research.

PubMed

Øyri, Hauk; Bjørnland, Tore; Barkvoll, Pål; Jensen, Janicke Liaaen

2016-01-01

To evaluate morbidity 1 week after mandibular third molar (3M) surgery in the authors' department. A prospective 1-year clinical study of patients followed up for 1 week after 3M surgery was performed. Consecutive patients of 18 years or older having 3M surgery under local anaesthesia were included. Patients not able to attend a follow-up appointment after 1 week were excluded. Demographic data, indication for surgery and clinical findings were recorded. Outcome variables were days requiring analgesic, days absent from work/school and complications. All data recording was performed utilizing an e-infrastructure for clinical research (InReach, University Health Network, www.uhnsl.com). Three hundred and ninety-six patients were examined 1 week after surgery. Mean number of days requiring analgesics was 3.8 and mean number of days absent from work/school after surgery was 0.6. Minor complications were reported by 7% of patients. Female patients reported more days requiring analgesics compared to male patients. Smokers had a higher odds ratio for being absent ≥ 3 days. Prophylactic removal of 3Ms was associated with fewer days requiring analgesics and days absent from work/school as compared to teeth with local disease. Overall morbidity after 3M surgery was low. Compared to patients subjected to therapeutic removal of 3Ms, patients undergoing prophylactic removal seem to have less pain and a faster return to normal activities.

Reproductive Strategies of the Insidious Fish Ectoparasite, Neobenedenia sp. (Capsalidae: Monogenea)

PubMed Central

Dinh Hoai, Truong; Hutson, Kate S.

2014-01-01

Fish monogeneans are lethal parasites in aquaculture. We provide the first experimental evidence that a notorious fish monogenean, Neobenedenia sp., can produce viable eggs in isolation for three consecutive generations. We infected individual, isolated, farmed barramundi, Lates calcarifer (Bloch) with a single oncomiracidium (larva) of the hermaphroditic monogenean Neobenedenia sp. Isolated parasites reached sexual maturity at day 10 post-hatch (24°C, 35‰) and laid ∼3,300 embryonated eggs over 17 days. Egg production rapidly increased following sexually maturity on day 10 (58±15 eggs) and peaked on day 15 (496±68 eggs) before gradually decreasing. Neobenedenia sp. exhibited egg laying and egg hatching rhythms. Parasites laid eggs continuously, but egg production increased in periods of darkness (64.3%), while the majority of oncomiracidia (81%) emerged from eggs in the first three hours of light. Eggs laid by isolated ‘parent’ parasites hatched and individual emerging oncomiracidia were used to infect more individual, isolated fish, with three consecutive, isolated, parasite generations (F1, F2 and F3) raised in the laboratory. Infection success and egg hatching success did not differ between generations. Our data show that one parasite, in the absence of a mate, presents a severe threat to captive fish populations. PMID:25264931

Circadian, day-of-week, and seasonal variability in myocardial infarction: comparison between working and retired patients.

PubMed

Spielberg, C; Falkenhahn, D; Willich, S N; Wegscheider, K; Völler, H

1996-09-01

The circadian, day-of-week, and seasonal distributions of acute myocardial infarction and its association with the patients' working status were analyzed in a regionally defined population (n = 103, 322) monitored from 1980 to 1988. Included were 2906 consecutive patients (1746 [60.1%] men and 1160 [39.9%] women; mean age 67.8 years) with confirmed diagnosis (by standardized diagnostic criteria in hospitalized patients and autopsy results in out-of-hospital deaths). The time of myocardial infarction on the basis of onset of symptoms was known in 1901 cases. Myocardial infarction occurred more frequently (p < 0.05) during the morning from 7:00 to 10:00 AM, on Mondays, and during the winter from January to March compared with other times of day, days of the week, and seasons. Compared with retired patients, working patients (32%) had a second circadian peak, in the afternoon at 4:00 PM (p < 0.05), and a trend toward an additional seasonal peak in September (p value not significant), whereas the day-of-week pattern was similar in the two subgroups. The occurrence of myocardial infarction demonstrates marked circadian, day-of-week, and seasonal variations, with some differences between working and retired patients. Further investigation of possible triggering events may aid in identifying underlaying mechanisms and perhaps in improving prevention of the disease.

Granulocyte-macrophage colony-stimulating factor alone or with dacarbazine in metastatic melanoma: a randomized phase II trial

PubMed Central

Ravaud, A; Delaunay, M; Chevreau, C; Coulon, V; Debled, M; Bret-Dibat, C; Courbon, F; Gualde, N; Bui, B Nguyen

2001-01-01

The potential antitumoural effect of granulocyte-macrophage colony-stimulating factor (GM-CSF) led us to evaluate GM-CSF alone or with dacarbazine (DTIC) in metastatic melanoma in first line randomized phase II. Treatment was arm A: GM-CSF: 5 μg kg−1, bid, 14 consecutive days every 21 days and arm B: GM-CSF: 5 μg kg−1, bid, day 2 to day 19 every 21 days and DTIC: 800 mg m−2, day 1 of each cycle. 32 patients (pts) were included, 15 pts in arm A and 17 in arm B. All pts had visceral metastatic sites. 9 had only one metastatic site. The median number of cycles given was 2 in arm A and 3 in arm B. 100% and 89.4% of the planned dose of GM-CSF was given in arm A and arm B respectively. No objective response was obtained. 19 pts experienced at least WHO grade 3 toxicity. All pts had fever, 29 had a decrease in performance status and 23 had pain. Grade 3 toxicity were fever (38.7%), decrease in performance status (32.3%), pain (19.4%) and dyspnoea (12.5%). In this study, GM-CSF alone or in association with DTIC did not induce any antitumoural activity with subsequent toxicity. © 2001 Cancer Research Campaign   http://www.bjcancer.com PMID:11720430

Comparative Analgesic Efficacy of Pregabalin Administered According to Either a Prevention Protocol or an Intervention Protocol in Rats with Cisplatin-induced Peripheral Neuropathy.

PubMed

Han, F Y; Kuo, A; Nicholson, J R; Corradinni, L; Smith, M T

2018-05-21

Chemotherapy-induced peripheral neuropathy (CIPN) is a type of peripheral neuropathic pain that may be dose-limiting in patients administered potentially curative cancer chemotherapy dosing regimens. In cancer survivors, persistent CIPN adversely affects patient quality of life and so adjuvant drugs (anticonvulsants e.g. pregabalin or antidepressants e.g. amitriptyline) are recommended for the relief of CIPN. However, most studies in rodent models of CIPN involve administration of single bolus doses of adjuvant drugs to assess pain-relieving efficacy. Hence this study was designed to assess the efficacy of pregabalin administered to CIPN-rats according to either a prevention or an intervention protocol. Groups of male Sprague-Dawley rats received four single intraperitoneal bolus doses of cisplatin at 3 mg/kg at once-weekly intervals to induce CIPN. For the prevention protocol, oral pregabalin (or vehicle) was administered to CIPN-rats once-daily for 21 consecutive days from day 0 to day 20 inclusive. For the intervention protocol, oral pregabalin was administered once-daily for 21 consecutive days from day 28 to day 48 inclusive. Mechanical allodynia and mechanical hyperalgesia in the bilateral hindpaws were assessed just prior to each dose of cisplatin and at least once-weekly until study completion (day 27, prevention protocol; or day 48, intervention protocol). Mechanical allodynia and mechanical hyperalgesia were also determined at the time of peak effect at ~2 h post- pregabalin/vehicle administration once-weekly until study completion. For the prevention protocol in CIPN-rats, pregabalin alleviated mechanical hyperalgesia but not mechanical allodynia. For the intervention protocol, pregabalin alleviated both mechanical allodynia and mechanical hyperalgesia in the hindpaws. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Temporal profile of pain and other sensory manifestations in Guillain-Barre' syndrome during ten days of hospitalization.

PubMed

Karkare, K; Taly, Arun B; Sinha, Sanjib; Rao, S

2011-01-01

Focused studies on sensory manifestations, especially pain and paresthesia in Guillain-Barre' (GB) syndrome are few and far between. To study the sensory manifestations in GB syndrome during 10 days of hospitalization with clinico-electrophysiological correlation. The study included 60 non-consecutive patients with GB syndrome, fulfilling National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) criteria for GB syndrome. Data especially related to clinical and electrophysiological evidence of sensory involvement were analyzed. Pain was assessed using a) visual analogue paraesthesias (Vapar), b) visual analogue for pain (Vap) and c) verbal rating scale for pain (Verp). Sensory symptoms were widely prevalent: paraesthesia in 45 (75%) patients and pain in 30 (50%) patients. Impairment of different sensory modalities included: pain in 8 (13.3%), joint position sense in 14 (23.3%), and vibration in 11 (18.3%). Electrophysiological evidence of abnormal sensory nerve conduction was noted in 35 (58.3%) patients. Pain assessment using Vapar, Vap and Verp for from Day 1 to Day 10 of hospitalization revealed that from Day 7 onwards the degree and frequency of sensory symptoms and signs decreased. On comparing various clinico-electrophysiological parameters among patients of GB syndrome with and without pain and paresthesia. Presence of respiratory distress correlated with pain and paresthesia (P=0.02). Sensory manifestations in GB syndrome are often under-recognized and under-emphasized. This study analyzed the evolution and the profile of pain and paresthesia in GB syndrome during hospitalization. Knowledge, especially about evolution of pain and paresthesia during hospitalization might improve understanding and patient care.

Elective laparoscopic recto-sigmoid resection for diverticular disease is suitable as a training operation.

PubMed

Bosker, Robbert; Hoogenboom, Froukje; Groen, Henk; Hoff, Christiaan; Ploeg, Rutger; Pierie, Jean-Pierre

2010-04-01

Some authors state that elective laparoscopic recto-sigmoid resection is more difficult for diverticular disease as compared with malignancy. For this reason, starting laparoscopic surgeons might avoid diverticulitis, making the implementation phase unnecessary long. The aim of this study was to determine whether laparoscopic resection for diverticular disease should be included during the implementation phase. All consecutive patients who underwent an elective laparoscopic recto-sigmoid resection in our hospital for diverticulitis or cancer from 2003 to 2007 were analysed. A total of 256 consecutive patients were included in this prospective cohort study. One hundred and fifty-one patients were operated on for diverticulitis and 105 for cancer. There was no significant difference in operation time (168 vs. 172 min), blood loss (189 vs. 208 ml), conversion rates (9.9% vs. 11.4%), hospital stay (8 vs. 8 days), total number of peroperative (2.3% vs. 1.6%) or postoperative complications (21.9% vs. 26.9%). The occurrence of anastomotic leakages was associated with higher American Society of Anesthesiologists (ASA) classification, which differed between the groups (86.8% vs. 64.8% ASA I-II, p < 0.001). Since there are no differences in operation time, blood loss, conversion rate and total complications, there is no need to avoid laparoscopic recto-sigmoid resection for diverticular disease early in the learning curve.

Comparisons of l-cysteine and d-cysteine toxicity in 4-week repeated-dose toxicity studies of rats receiving daily oral administration.

PubMed

Shibui, Yusuke; Sakai, Ryosei; Manabe, Yasuhiro; Masuyama, Takeshi

2017-07-01

Two 4-week repeated-dose toxicity studies were conducted to evaluate the potential toxicity of l-cysteine and d-cysteine. In one study, three groups of 6 male rats were each administered l-cysteine once daily by gavage at doses of 500, 1,000, or 2,000 mg/kg/day for 28 consecutive days. The control group was administered a 0.5% methylcellulose vehicle solution. The other study followed a similar protocol except that the experimental groups received d-cysteine. Toxicological observations showed that the l-cysteine-treated groups exhibited renal injuries such as basophilic tubules with eosinophilic material in the lumen, and there were increased numbers of basophilic tubules in all treated groups. In 1,000 or 2,000 mg/kg/day-treated groups, salivation and necropsy findings indicative of focal erosion in the stomach mucosa were found. Increases in reticulocyte counts were observed in the 2,000 mg/kg/day-treated group. Toxicological findings obtained for the d-cysteine-treated groups included anemia and renal injuries such as basophilic tubules with eosinophilic material in the lumen, increased numbers of basophilic tubules, and crystal deposition in the medulla in the 2,000 mg/kg/day-treated group. Additional findings included sperm granuloma in the epididymis, necropsy findings suggestive of focal erosion in the stomach mucosa, and salivation in the 1,000 or 2,000 mg/kg/day-treated groups. One rat in the 2,000 mg/kg/day-treated group died due to renal failure. In conclusion, the no-observed-adverse-effect levels (NOAELs) were estimated to be less than 500 mg/kg/day for l-cysteine and 500 mg/kg/day for d-cysteine under our study conditions. The toxicological profiles were similar for l-cysteine and d-cysteine; however, there were slight differences in the dose responses. The mechanisms underlying these differences remain to be determined.

Real-Time Electronic Tracking of Diarrheal Episodes and Laxative Therapy Enables Verification of Clostridium difficile Clinical Testing Criteria and Reduction of Clostridium difficile Infection Rates.

PubMed

Truong, Cynthia Y; Gombar, Saurabh; Wilson, Richard; Sundararajan, Gopalakrishnan; Tekic, Natasa; Holubar, Marisa; Shepard, John; Madison, Alexandra; Tompkins, Lucy; Shah, Neil; Deresinski, Stan; Schroeder, Lee F; Banaei, Niaz

2017-05-01

Health care-onset health care facility-associated Clostridium difficile infection (HO-CDI) is overdiagnosed for several reasons, including the high prevalence of C. difficile colonization and the inability of hospitals to limit testing to patients with clinically significant diarrhea. We conducted a quasiexperimental study from 22 June 2015 to 30 June 2016 on consecutive inpatients with C. difficile test orders at an academic hospital. Real-time electronic patient data tracking was used by the laboratory to enforce testing criteria (defined as the presence of diarrhea [≥3 unformed stools in 24 h] and absence of laxative intake in the prior 48 h). Outcome measures included C. difficile test utilization, HO-CDI incidence, oral vancomycin utilization, and clinical complications. During the intervention, 7.1% (164) and 9.1% (211) of 2,321 C. difficile test orders were canceled due to absence of diarrhea and receipt of laxative therapy, respectively. C. difficile test utilization decreased upon implementation from an average of 208.8 tests to 143.0 tests per 10,000 patient-days ( P < 0.001). HO-CDI incidence rate decreased from an average of 13.0 cases to 9.7 cases per 10,000 patient-days ( P = 0.008). Oral vancomycin days of therapy decreased from an average of 13.8 days to 9.4 days per 1,000 patient-days ( P = 0.009). Clinical complication rates were not significantly different in patients with 375 canceled orders compared with 869 episodes with diarrhea but negative C. difficile results. Real-time electronic clinical data tracking is an effective tool for verification of C. difficile clinical testing criteria and safe reduction of inflated HO-CDI rates. Copyright © 2017 American Society for Microbiology.

Development and validation of immune dysfunction score to predict 28-day mortality of sepsis patients

PubMed Central

Fang, Wen-Feng; Douglas, Ivor S.; Chen, Yu-Mu; Lin, Chiung-Yu; Kao, Hsu-Ching; Fang, Ying-Tang; Huang, Chi-Han; Chang, Ya-Ting; Huang, Kuo-Tung; Wang, Yi-His; Wang, Chin-Chou

2017-01-01

Background Sepsis-induced immune dysfunction ranging from cytokines storm to immunoparalysis impacts outcomes. Monitoring immune dysfunction enables better risk stratification and mortality prediction and is mandatory before widely application of immunoadjuvant therapies. We aimed to develop and validate a scoring system according to patients’ immune dysfunction status for 28-day mortality prediction. Methods A prospective observational study from a cohort of adult sepsis patients admitted to ICU between August 2013 and June 2016 at Kaohsiung Chang Gung Memorial Hospital in Taiwan. We evaluated immune dysfunction status through measurement of baseline plasma Cytokine levels, Monocyte human leukocyte-DR expression by flow cytometry, and stimulated immune response using post LPS stimulated cytokine elevation ratio. An immune dysfunction score was created for 28-day mortality prediction and was validated. Results A total of 151 patients were enrolled. Data of the first consecutive 106 septic patients comprised the training cohort, and of other 45 patients comprised the validation cohort. Among the 106 patients, 21 died and 85 were still alive on day 28 after ICU admission. (mortality rate, 19.8%). Independent predictive factors revealed via multivariate logistic regression analysis included segmented neutrophil-to-monocyte ratio, granulocyte-colony stimulating factor, interleukin-10, and monocyte human leukocyte antigen-antigen D–related levels, all of which were selected to construct the score, which predicted 28-day mortality with area under the curve of 0.853 and 0.789 in the training and validation cohorts, respectively. Conclusions The immune dysfunction scoring system developed here included plasma granulocyte-colony stimulating factor level, interleukin-10 level, serum segmented neutrophil-to-monocyte ratio, and monocyte human leukocyte antigen-antigen D–related expression appears valid and reproducible for predicting 28-day mortality. PMID:29073262

40 CFR 469.27 - New source performance standards (NSPS).

Code of Federal Regulations, 2011 CFR

2011-07-01

... Limitations Pollutant or pollutant property Maximum for any 1 day Average of daily values for 30 consecutive... manufacturers of gallium or indium arsenide crystals. 4 Within the range of 6.0 to 9.0. [48 FR 15394, Apr. 8...

Jello shot consumption among older adolescents: a pilot study of a newly identified public health problem.

PubMed

Binakonsky, Jane; Giga, Noreen; Ross, Craig; Siegel, Michael

2011-01-01

We investigated the extent of jello shot consumption among underage youths. We conducted a pilot study among a nonrandom national sample of 108 drinkers, aged 16-20 years, recruited from the Knowledge Networks Internet panel in 2010 by using consecutive sampling. The prevalence of past 30-day jello shot consumption among the 108 drinkers, aged 16-20 years, in our sample was 21.4%, and among those who consumed jello shots, the percentage of alcohol consumption attributable to jello shots averaged 14.5%. We concluded that jello shot use is prevalent among youths, representing a substantial proportion of their alcohol intake. Surveillance of youth alcohol use should include jello shot consumption.

Temporal association between hospitalization and rate of falls after discharge.

PubMed

Mahoney, J E; Palta, M; Johnson, J; Jalaluddin, M; Gray, S; Park, S; Sager, M

2000-10-09

Evidence suggests that acute illness and hospitalization may increase the risk for falls. To evaluate the rate of falls, and associated risk factors, for 90 days following hospital discharge. We consecutively enrolled 311 patients, aged 65 years and older, discharged from the hospital after an acute medical illness and receiving home-nursing services. Patients were assessed within 5 days of discharge for prehospital and current functioning by self-report, and balance, vision, cognition, and delirium by objective measures. Patients were followed up weekly for 13 weeks for falls, injuries, and health care use. The rate of falls was significantly higher in the first 2 weeks after hospitalization (8.0 per 1000 person-days) compared with 3 months later (1.7 per 1000 person-days) (P =.002). Fall-related injuries accounted for 15% of all hospitalizations in the first month after discharge. Independent prehospital risk factors significantly associated with falls included dependency in activities of daily living, use of a standard walker, 2 or more falls, and more hospitalizations in the year prior. Posthospital risk factors included use of a tertiary amine tricyclic antidepressant, probable delirium, and poorer balance, while use of a cane was protective. The rate of falls is substantially increased in the first month after medical hospitalization, and is an important cause of injury and morbidity. Posthospital risk factors may be potentially modifiable. Efforts to assess and modify risk factors should be integral to the hospital and posthospital care of older adults (those aged >/=65 years).

OUTCOME OF IMPLEMENTATION OF A MULTIDISCIPLINARY TEAM APPROACH TO THE CARE OF PATIENTS AFTER TRANSSPHENOIDAL SURGERY.

PubMed

Carminucci, Arthur S; Ausiello, John C; Page-Wilson, Gabrielle; Lee, Michelle; Good, Laura; Bruce, Jeffrey N; Freda, Pamela U

2016-01-01

Transsphenoidal surgery (TS) for sellar lesions is an established and safe procedure, but complications can occur, particularly involving the neuroendocrine system. We hypothesized that postoperative care of TS patients would be optimized when performed by a coordinated team including a pituitary neurosurgeon, endocrinologists, and a specialty nurse. We implemented a formalized, multidisciplinary team approach and standardized postoperative protocols for the care of adult patients undergoing TS by a single surgeon (J.N.B.) at our institution beginning in July 2009. We retrospectively compared the outcomes of 214 consecutive TS-treated cases: 113 cases prior to and 101 following the initiation of the team approach and protocol implementation. Outcomes assessed included the incidence of neurosurgical and endocrine complications, length of stay (LOS), and rates of hospital readmission and unscheduled clinical visits. The median LOS decreased from 3 days preteam to 2 days postteam (P<.01). Discharge occurred on postoperative day 2 in 46% of the preteam group patients compared to 69% of the postteam group (P<.01). Rates of early postoperative diabetes insipidus (DI) and readmissions within 30 days for syndrome of inappropriate antidiuretic hormone (SIADH) or other complications did not differ between groups. Implementation of a multidisciplinary team approach was associated with a reduction of LOS. Despite earlier discharge, postoperative outcomes were not compromised. The endocrinologist is central to the success of this team approach, which could be successfully applied to care of patients undergoing TS, as well as other types of endocrine surgery at other centers.

Spectrum of ocular firework injuries in children: A 5-year retrospective study during a festive season in Southern India.

PubMed

John, Deepa; Philip, Swetha Sara; Mittal, Rashmi; John, Sheeja Susan; Paul, Padma

2015-11-01

Ocular trauma is a major cause of acquired monocular blindness in children. Firework injuries account for 20% of ocular trauma. The purpose of our study was to document the profile of ocular firework injuries in children during the festive season of Diwali and to determine the prevalence of unilateral blindness in them. A retrospective chart analysis of ocular firework injury in children during the festival of Diwali from 2009 to 2013, conducted in a tertiary care eye center in Tamil Nadu, Southern India. Children below 18 years of age with ocular firework injuries who presented to the emergency department for 3 consecutive days - the day of Diwali, 1 day before, and 1 day after Diwali - were included in this study. Eighty-four children presented with firework-related ocular injuries during the study period. Male to female ratio was 4:1 with mean age 9.48 ± 4 years. Forty-four percentage required hospitalization. The prevalence of unilateral blindness in children due to fireworks was found to be 8% (95% confidence interval - 2-13%). Vision 2020 gives high priority to avoidable blindness, especially in children. In our study, for every 12 children who presented with firecracker injury, one resulted in unilateral blindness. This is an avoidable cause of blindness. Awareness needs to be created, and changes in policy regarding sales and handling of firecrackers including mandatory use of protective eyewear should be considered.

Spectrum of ocular firework injuries in children: A 5-year retrospective study during a festive season in Southern India

PubMed Central

John, Deepa; Philip, Swetha Sara; Mittal, Rashmi; John, Sheeja Susan; Paul, Padma

2015-01-01

Purpose: Ocular trauma is a major cause of acquired monocular blindness in children. Firework injuries account for 20% of ocular trauma. The purpose of our study was to document the profile of ocular firework injuries in children during the festive season of Diwali and to determine the prevalence of unilateral blindness in them. Materials and Methods: A retrospective chart analysis of ocular firework injury in children during the festival of Diwali from 2009 to 2013, conducted in a tertiary care eye center in Tamil Nadu, Southern India. Children below 18 years of age with ocular firework injuries who presented to the emergency department for 3 consecutive days - the day of Diwali, 1 day before, and 1 day after Diwali - were included in this study. Results: Eighty-four children presented with firework-related ocular injuries during the study period. Male to female ratio was 4:1 with mean age 9.48 ± 4 years. Forty-four percentage required hospitalization. The prevalence of unilateral blindness in children due to fireworks was found to be 8% (95% confidence interval - 2–13%). Conclusion: Vision 2020 gives high priority to avoidable blindness, especially in children. In our study, for every 12 children who presented with firecracker injury, one resulted in unilateral blindness. This is an avoidable cause of blindness. Awareness needs to be created, and changes in policy regarding sales and handling of firecrackers including mandatory use of protective eyewear should be considered. PMID:26669336

Inducing Sex Reversal in Marsupial Mammals.

PubMed

Chew, Keng Y; Renfree, Marilyn B

2016-01-01

Marsupials are born with undifferentiated gonads, and their reproductive organs differentiate consecutively, not simultaneously as in eutherian mammals. Thus, in the main marsupial model, the tammar wallaby, Macropus eugenii, the testis forms cords 2 days after birth, the ovary develops cortex and medulla about 8 days after birth, the Wolffian duct enlarges from day 10, the prostate begins to form prostatic buds about 25 days after birth, and the phallus does not become sexually dimorphic until after 50 days postpartum (pp). The brain responses also become sexually dimorphic relatively late in development, after day 25 pp. This relatively elongated period of differentiation has allowed experimental manipulation at each stage of development to induce often dramatic sex reversal of both internal and external genitalia. © 2016 S. Karger AG, Basel.

Measuring domestic water use: a systematic review of methodologies that measure unmetered water use in low-income settings.

PubMed

Tamason, Charlotte C; Bessias, Sophia; Villada, Adriana; Tulsiani, Suhella M; Ensink, Jeroen H J; Gurley, Emily S; Mackie Jensen, Peter Kjaer

2016-11-01

To present a systematic review of methods for measuring domestic water use in settings where water meters cannot be used. We systematically searched EMBASE, PubMed, Water Intelligence Online, Water Engineering and Development Center, IEEExplore, Scielo, and Science Direct databases for articles that reported methodologies for measuring water use at the household level where water metering infrastructure was absent or incomplete. A narrative review explored similarities and differences between the included studies and provide recommendations for future research in water use. A total of 21 studies were included in the review. Methods ranged from single-day to 14-consecutive-day visits, and water use recall ranged from 12 h to 7 days. Data were collected using questionnaires, observations or both. Many studies only collected information on water that was carried into the household, and some failed to mention whether water was used outside the home. Water use in the selected studies was found to range from two to 113 l per capita per day. No standardised methods for measuring unmetered water use were found, which brings into question the validity and comparability of studies that have measured unmetered water use. In future studies, it will be essential to define all components that make up water use and determine how they will be measured. A pre-study that involves observations and direct measurements during water collection periods (these will have to be determined through questioning) should be used to determine optimal methods for obtaining water use information in a survey. Day-to-day and seasonal variation should be included. A study that investigates water use recall is warranted to further develop standardised methods to measure water use; in the meantime, water use recall should be limited to 24 h or fewer. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Interset stretching does not influence the kinematic profile of consecutive bench-press sets.

PubMed

García-López, David; Izquierdo, Mikel; Rodríguez, Sergio; González-Calvo, Gustavo; Sainz, Nuria; Abadía, Olaia; Herrero, Azael J

2010-05-01

This study was undertaken to examine the role of interset stretching on the time course of acceleration portion AP and mean velocity profile during the concentric phase of 2 bench-press sets with a submaximal load (60% of the 1 repetition maximum). Twenty-five college students carried out, in 3 different days, 2 consecutive bench-press sets leading to failure, performing between sets static stretching, ballistic stretching, or no stretching. Acceleration portion and lifting velocity patterns of the concentric phase were not altered during the second set, regardless of the stretching treatment performed. However, when velocity was expressed in absolute terms, static stretching reduced significantly (p <0.05) the average lifting velocity during the second set compared to the first one. Therefore, if maintenance of a high absolute velocity over consecutive sets is important for training-related adaptations, static stretching should be avoided or replaced by ballistic stretching.

[Clinical research about the consecutive pain and flubiprofen axetil analgesia following uvulopalatopharyngoplasty].

PubMed

Zhao, Y Q; Wang, H M; Ma, Y; Yang, H A; Jiang, X J

2017-04-05

Objective: To evaluate the postoperative pain degree on OSAHS patients following UPPP, analyze the pain characteristic during seven consecutive days, and discuss the mechanism. To observe the analgesia effect by using flubiprofen axetil. Finally making a comprehensive understanding about UPPP perioperative period and providing more choices about analgesia treatment. Method: Fifty-five patients who underwent UPPP in the First Hospital of China Medical University were divided into analgesia group（n=30）and control group（n=25）.Normal saline 50 ml+ flubiprofen axetil 100 mg was used bid for pain relief in analgesia group during seven days following operation, and normal saline 50ml was used in control group.A visual analog scale(VAS) was used for measuring mean pain intensity each day during the period from operative day to the post-operative 7th day，scores were recorded. Continuous changes about pharynx pain were observed and VAS pain scores were compared betweenanalgesia groupand control group. Result: VAS pain scores were the highest on the operative day and the post-operative 1st day, median (interquartile range) was 7（5.5-8.25），7（6-8）respectively,then decreased gradually. The most significantly decrease happened on the post-operative 2nd and 5th day( P <0.01). Pain scores in analgesia group were most significantly lower than control group from the operative day to the post-operative 4th day( P <0.01), were lower during the post-operative 5th and 6th day( P <0.05),no difference on the post-operative 7th day. Conclusion: The most painful period following UPPP is from the operative day to the post-operative 1st day, then pain decreases gradually. The pain reduces significantly on the post-operative 2nd and 5,6th day.Surgical trauma, in flammatory reaction and suture pulling may be the reason of pain. Flubiprofen axetil effectively reduces pain and the suggested analgesia period is from the operative day to the post-operative 4th-6th day. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

[Effects of aspirin on dendritic cells in the inflammatory microenvironment of rabbit buccal VX-2 squamous cell carcinoma].

PubMed

Chen, Zhihong; Huang, Guilin; Zhang, Nini; Yi, Jie; Yao, Li; Zhang, Lin

2016-04-01

To explore the effects of aspirin and inflammation on the maturation and function of dendritic cells (DC) on the supernatant of VX-2 squamous cell carcinoma. The rabbit buccal VX-2 squamous cell carcinoma models with inflammation were established by tumor particle implantation, mechanical trauma, and high sugar diet. The rabbits were divided into three groups. For the experimental group (rabbit buccal VX-2 squamous cell carcinoma with local inflammation), aspirin were given by gavage for three consecutive days. For the control group (rabbit buccal VX-2 squamous cell carcinoma with local inflammation), normal saline was given by gavage for three consecutive days. For the blank group (tumor without inflammation), normal saline was given by gavage for three consecutive days. Each tumor specimens were collected in three days and made into tissue homogenate. The supernatant was collected after centrifugation. Normal rabbit peripheral blood mononuclear cells were separated and co-cultured with different states of supernatant. The expression of DC surface markers CD83, CD86, and human leukocyte antigen-DR (HLA-DR) were detected by flow cytometry. The state of function of DC was tested by mixed lymphocyte reaction. The positive rate of CD83, CD86, and HLA-DR of the experimental and control groups were both lower than that of the blank group (P<0.05). In addition, the ability to stimulate T cell proliferation of the experimental and control groups were weaker than that of the blank group (P<0.05). No significant difference was observed between the experi- and HLADR of DC. The short-term administration of aspirin is not conducive to the phenoty and function of DC in a rabbit mental and control groups (P>0.05). Inflammation may inhibit the function and expression of CD83, CD86, buccal VX-2 squamous cell carcinoma inflammatory environment

Evaluation of profertility effect of probiotic Lactobacillus plantarum 2621 in a murine model.

PubMed

Bhandari, Praveen; Prabha, Vijay

2015-07-01

Urogenital infections of bacterial origin have a high incidence among the female population at reproductive age, affecting the fertility. Strains of Escherichia coli can colonize the vagina and replace natural microflora. Lactobacillus the predominant vaginal microorganism in healthy women, maintains the acidic vaginal pH which inhibits pathogenic microorganisms. Studies on Lactobacillus have shown that these can inhibit E. coli growth and vaginal colonization. An alternative therapeutic approach to antimicrobial therapy is to re-establish Lactobacillus in this microbiome through probiotic administration to resurge fertility. Therefore, the aim of the present study was to determine the capability of L. plantarum 2621 strain with probiotic properties, to prevent the vaginal colonization of E. coli causing agglutination of sperms and to evaluate its profertility effect in a murine model. Screened mice were divided into five groups i.e. control group, E. coli group, Lactobacillus group, prophylactic and therapeutic groups. The control group was infused with 20 µl PBS, E.coli group was administered with 10 [6] cfu/20 µl E. coli, and probiotic group was administered with Lactobacillus (10 [8] cfu/20 µl) for 10 consecutive days. In prophylactic group, the vagina was colonized with 10 consecutive doses of Lactobacillus (10 [8] cfu/20 µl). After 24 h, it was followed by 10 day intravaginal infection with E. coli (10 [6] cfu/20 µl) whereas for the therapeutic group vagina was colonized with (10 [6] cfu/20 µl) E. coli for 10 consecutive days, followed by 10 day intravaginal administration with Lactobacillus after 24 h. Upon mating and completion of gestation period, control, probiotic and the therapeutic groups had litters in contrast to the prophylactic group and the group administered with E. coli. Results indicated that Lactobacillus intermitted colonization of pathogenic strains that resulted in reinforcement of natural microflora and resurge fertility.

What is the best predictor of mortality in perforated peptic ulcer disease? A population-based, multivariable regression analysis including three clinical scoring systems.

PubMed

Thorsen, Kenneth; Søreide, Jon Arne; Søreide, Kjetil

2014-07-01

Mortality rates in perforated peptic ulcer (PPU) have remained unchanged. The aim of this study was to compare known clinical factors and three scoring systems (American Society of Anesthesiologists (ASA), Boey and peptic ulcer perforation (PULP)) in the ability to predict mortality in PPU. This is a consecutive, observational cohort study of patients surgically treated for perforated peptic ulcer over a decade (January 2001 through December 2010). Primary outcome was 30-day mortality. A total of 172 patients were included, of whom 28 (16 %) died within 30 days. Among the factors associated with mortality, the PULP score had an odds ratio (OR) of 18.6 and the ASA score had an OR of 11.6, both with an area under the curve (AUC) of 0.79. The Boey score had an OR of 5.0 and an AUC of 0.75. Hypoalbuminaemia alone (≤37 g/l) achieved an OR of 8.7 and an AUC of 0.78. In multivariable regression, mortality was best predicted by a combination of increasing age, presence of active cancer and delay from admission to surgery of >24 h, together with hypoalbuminaemia, hyperbilirubinaemia and increased creatinine values, for a model AUC of 0.89. Six clinical factors predicted 30-day mortality better than available risk scores. Hypoalbuminaemia was the strongest single predictor of mortality and may be included for improved risk estimation.

Reciprocal Relations Between Objectively Measured Sleep Patterns and Diurnal Cortisol Rhythms in Late Adolescents

PubMed Central

Zeiders, Katharine H.; Doane Sampey, Leah D.; Adam, Emma K.

2011-01-01

Purpose To examine how hours of sleep and wake times relate to between-person differences and day-to-day changes in diurnal cortisol rhythms in late adolescents Methods Older adolescents (N = 119) provided six cortisol samples (wakeup, +30min, + 2 hours, +8 hours, + 12 hours, and bedtime) on each of three consecutive days while wearing an actigraph. We examined how average (across 3 days) and day-to-day changes in hours of sleep and wake times related to diurnal cortisol patterns. Results On average, greater hours of sleep related steeper decline in cortisol across the days. Day-to-day analyses revealed that prior night’s hours of sleep predicted steeper diurnal slopes the next day, while greater waking cortisol levels and steeper slopes predicted greater hours of sleep and a later wake time the next day. Conclusions Our results suggest a bidirectional relationship between sleep and HPA axis activity. PMID:21575815

Detection of residues in urine and tissues of sheep treated with trace levels of dietary ractopamine HCl

USDA-ARS?s Scientific Manuscript database

Ractopamine HCl was fed to sheep at 0 (Z), 0.001 (L), 0.01 (M), or 0.1 (H) mg/kg of diet (n = 4 per level, 0.5 kg of feed/day) for seven consecutive days and urine was collected daily about ~16 h post exposure. On-site lateral flow assays were able to reliably (0% false negatives) detect 20 ng of r...

Length of stay and risk of very early readmission in acute heart failure.

PubMed

Miñana, Gema; Bosch, Maria José; Núñez, Eduardo; Mollar, Anna; Santas, Enrique; Valero, Ernesto; García-Blas, Sergio; Pellicer, Mauricio; Bodí, Vicent; Chorro, Francisco J; Sanchis, Juan; Núñez, Julio

2017-07-01

In patients admitted for acute heart failure (AHF), optimal length of stay (LOS) remains controversial. Longer hospitalizations are associated with worse prognosis, but little is known about short hospitalizations. The aim of this work was to evaluate the relationship between LOS and the risk of short-term readmission in patients discharged after a hospitalization for AHF. We included 2110 consecutive patients. The independent associations between LOS and unplanned 10, 15 and 30-day readmissions were evaluated by Cox regression analysis adjusted for competing events. LOS was categorized as LOS1: ≤4days, LOS2: 5-7days, LOS3: 8-10days, and LOS4: >10days. The mean age was 73±11years and 52.6% exhibited left ventricle ejection fraction≥50%. The median (IQR) LOS was 7 (5-11) days. At 10, 15 and 30-day follow-up, 130 (6.2%), 181 (8.6%), and 282 (13.4%) unplanned readmissions were registered. Rates of 10 and 15-day readmission among LOS categories showed a J-shaped pattern with lower rates for those in LOS2 and higher at the both extremes (p=0.001). At 30-day, only longer stays showed higher rates of readmission (p=0.002). In the multivariate analysis, the U-shaped curve remained significant for 10 and 15-day readmissions (p<0.05). Compared to LOS2, LOS1, LOS3 and LOS4 showed about two-fold increased risk. At 30-day only longer stays showed a borderline and modest increase of risk. Shorter and longer stays are associated with the risk of very early readmissions after an episode of AHF. These associations are marginal for 30-day readmissions. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Outcome after failure of allogeneic hematopoietic stem cell transplantation in children with acute leukemia: a study by the société Francophone de greffe de moelle et de thérapie cellulaire (SFGM-TC).

PubMed

Roux, C; Tifratene, K; Socié, G; Galambrun, C; Bertrand, Y; Rialland, F; Jubert, C; Pochon, C; Paillard, C; Sirvent, A; Nelken, B; Vannier, J P; Freycon, C; Beguin, Y; Raus, N; Yakoub-Agha, I; Mohty, M; Dalle, J-H; Michel, G; Pradier, C; Peffault de Latour, R; Rohrlich, P-S

2017-05-01

Allogeneic hematopoietic stem cell transplantation (SCT) contributes to improved outcome in childhood acute leukemia (AL). However, therapeutic options are poorly defined in the case of post-transplantation relapse. We aimed to compare treatment strategies in 334 consecutive children with acute leukemia relapse or progression after SCT in a recent 10-year period. Data could be analyzed in 288 patients (157 ALL, 123 AML and 8 biphenotypic AL) with a median age of 8.16 years at transplantation. The median delay from first SCT to relapse or progression was 182 days. The treatment consisted of chemotherapy alone (n=108), chemotherapy followed by second SCT (n=70), supportive/palliative care (n=67), combination of chemotherapy and donor lymphocyte infusion (DLI; n=30), or isolated reinfusion of donor lymphocytes (DLI; n=13). The median OS duration after relapse was 164 days and differed according to therapy: DLI after chemotherapy=385 days, second allograft=391 days, chemotherapy=174 days, DLI alone=140 days, palliative care=43 days. A second SCT or a combination of chemotherapy and DLI yielded similar outcome (hazard ratio (HR)=0.85, P=0.53) unlike chemotherapy alone (HR=1.43 P=0.04), palliative care (HR=4.24, P<0.0001) or isolated DLI (HR=1,94, P<0.04). Despite limitations in this retrospective setting, strategies including immunointervention appear superior to other approaches, mostly in AML.

Fecal Fat Analyses in Chronic Pancreatitis Importance of Fat Ingestion before Stool Collection

PubMed Central

Engjom, Trond; Jurmy, Palwasha; Tjora, Erling; Gilja, Odd Helge; Dimcevski, Georg

2017-01-01

Objective Quantitative determination of fecal fat still is the gold standard for measuring malabsorption. We evaluated the importance of standardized food intake before and under the collection of feces. Material and Methods In a project, evaluating patients with suspected chronic pancreatitis (CP) and healthy volunteers (HC), stools were collected for 72 hours coupled to registration of nutritional intake over five consecutive days. Patient groups were created by a modified Layer score, which includes imaging findings, clinical parameters and pancreas function testing. Results We found 12 patients with CP, 11 patients without CP and 13 healthy individuals in our database. Median fecal fat in CP patients was 12 g/day, in non-CP patients 5 g/day and in healthy controls 5 g/day. Median fat absorption coefficient was 81% in those with chronic pancreatitis, 92% in those without CP and 92% in healthy controls. Corresponding median fat intake was 65 g/day, 68 g/day and 81 g/day in the respective groups. Spearman Rank Order Correlation between fecal fat (g/d) and fat absorption coefficient in all study subjects (n = 36) was good (-0.88 (p<0.001)). When we stratified groups according to fat intake, correlation between fecal fat and fat absorption was also good (-0.86 to -0.95). Conclusion In the diagnoses of fat malabsorption, calculating the ratio of fat absorption did not give additional information compared to fecal fat. PMID:28095460

Association between exposure to rotating night shift versus day shift using levels of 6-sulfatoxymelatonin and cortisol and other sex hormones in women.

PubMed

Gómez-Acebo, Inés; Dierssen-Sotos, Trinidad; Papantoniou, Kyriaki; García-Unzueta, María Teresa; Santos-Benito, María Francisca; Llorca, Javier

2015-02-01

The present study aims to compare 6-sulfatoxymelatonin (aMT6s) secretion patterns and levels of cortisol and sex hormones (estradiol, progesterone, DHEA, DHEAS, and testosterone) among rotating night-shift workers and day-shift workers. We performed a cross-sectional study in Cantabria (northern Spain) including 136 women (73 day-shift workers and 63 rotating night-shift workers). Blood and urine samples were obtained after two consecutive working days. Differences in means were estimated using ANCOVA, stratified by menopausal status, ovulation phase, and adjusted for season, age, body mass index, consumption of cigarettes in the last 24 h. aMT6s circadian rhythm was analyzed using the cosinor analysis. The present study showed that rotating night-shift workers had lower excretion of aMT6s than day-shift workers (mesor = 50.26 ng aMT6s/mg creatinine in women with rotating night shift versus 88.79 ng aMT6s/mg creatinine in women with day shift), lower fluctuation (amplitude = 45.24 ng aMT6s/mg creatinine in rotating night-shift workers versus 79.71 ng aMT6s/mg creatinine in day-shift workers), and a later acrophase (aMT6s peak time: 08:31 in rotating night-shift workers versus 07:13 h in day-shift workers). Additionally, women with rotating night shift had higher estradiol and progesterone levels, compared to day workers, especially in the follicular phase on the menstrual cycle.

A Preliminary Randomized Controlled Trial of Contingency Management for Alcohol Use Reduction Using a Transdermal Alcohol Sensor

PubMed Central

Barnett, Nancy P.; Celio, Mark A.; Tidey, Jennifer W.; Murphy, James G.; Colby, Suzanne M.; Swift, Robert M.

2017-01-01

Aims We tested the efficacy of daily contingent reinforcement for reducing alcohol use compared with (yoked) noncontingent reinforcement (NR) using a transdermal alcohol sensor to detect alcohol use. Design Pilot randomized controlled design with one baseline week, three intervention weeks, and one-month follow up. Setting New England, USA. Participants Heavy drinking adults (46.7% female) not seeking treatment were randomized to 1) an escalating schedule of cash reinforcement (CR; n =15) for days on which alcohol was neither reported nor detected or 2) yoked NR (n =15). Intervention and comparator Reinforcement for CR participants started at $5 and increased $2 every subsequent day on which alcohol was not detected or reported, to a maximum of $17. Participants received no reinforcement for days on which alcohol use was detected or reported, and the reinforcer value was re-set to $5 the day after a drinking day. NR participants were yoked to the daily reinforcer value of an individual in the CR condition, in order of enrollment. Paired participants in CR and NR therefore received the same amount of money, but the amount for the NR participant was not behavior-related. Measurements The primary outcome was percent days without sensor-detected drinking. Secondary outcomes were number of consecutive days with no detected drinking, peak transdermal alcohol concentration (TAC), self-reported drinks per week, and drinking below NIH low-risk guidelines. Findings Controlling for baseline, CR had higher percent days with no drinking detected (54.3%) than NR (31.2%) during intervention weeks (p = .05, Cohen’s d = 0.74; 95% CI: 007–1.47). The longest period of consecutive days with no drinking detected was 8.0 for CR vs. 2.9 for NR (p = .03, d = 0.85; 95% CI: .08–1.61). Peak TAC during intervention showed a nonsignificant group difference (p = .20; d = .48; 95% CI: .00–1.18); a similar result was found for drinks per week (p = .12; d = .59; 95% CI: .00–1.30). Four times more participants in CR drank below NIH low-risk drinking guidelines during intervention than did participants in NR: 31.1% vs. 7.1% (p = .07; d = .71; 95% CI: −0.04–1.46). At 1-month follow up, the highest number of consecutive days without drinking (self-report) did not differ significantly between conditions (p = .26), but showed a medium effect size (d = .44; 95% CI: −.32–1.18). Conclusions Cash incentives linked to a transdermal alcohol sensor can reduce heavy alcohol consumption while the incentives are in operation. PMID:28107772

Modified Helicobacter test using a new test meal and a 13C-urea breath test in Helicobacter pylori positive and negative dyspepsia patients on proton pump inhibitors.

PubMed

Tepeš, Bojan; Malfertheiner, Peter; Labenz, Joachim; Aygen, Sitke

2017-08-28

To determine the sensitivity and specificity of the 13 C-urea breath test (UBT) in patients taking proton pump inhibitors (PPIs), using a new test meal Refex. One hundred and fourteen consecutive patients with dyspepsia, 53 Helicobacter pylori ( H. pylori ) positive, 49 H. pylori negative, were included in the study. The patients were then given esomeprazole 40 mg for 29 consecutive days, and the 13 C-UBT with the new test meal was performed the next morning. The sensitivity of the 13 C-UBT with a cut off 2.5‰ was 92.45% (95%CI: 81.79%-97.91%) by per-protocol (PP) analysis and 78.13% (95%CI: 66.03%-87.49%) by intention-to-treat (ITT) analysis. The specificity of the 13 C-UBT test was 96.00% in the ITT population (95%CI: 86.29%-99.51%) and 97.96% in the PP population (95%CI: 89.15%-99.95%). The new test meal based 13 C-UBT is highly accurate in patients on PPIs and can be used in those unable to stop their PPI treatment.

Post-Exercise Heart Rate Recovery Independently Predicts Clinical Outcome in Patients with Acute Decompensated Heart Failure.

PubMed

Youn, Jong-Chan; Lee, Hye Sun; Choi, Suk-Won; Han, Seong-Woo; Ryu, Kyu-Hyung; Shin, Eui-Cheol; Kang, Seok-Min

2016-01-01

Post-exercise heart rate recovery (HRR) is an index of parasympathetic function associated with clinical outcome in patients with chronic heart failure. However, its relationship with the pro-inflammatory response and prognostic value in consecutive patients with acute decompensated heart failure (ADHF) has not been investigated. We measured HRR and pro-inflammatory markers in 107 prospectively and consecutively enrolled, recovered ADHF patients (71 male, 59 ± 15 years, mean ejection fraction 28.9 ± 14.2%) during the pre-discharge period. The primary endpoint included cardiovascular (CV) events defined as CV mortality, cardiac transplantation, or rehospitalization due to HF aggravation. The CV events occurred in 30 (28.0%) patients (5 cardiovascular deaths and 7 cardiac transplantations) during the follow-up period (median 214 days, 11-812 days). When the patients with ADHF were grouped by HRR according to the Contal and O'Quigley's method, low HRR was shown to be associated with significantly higher levels of serum monokine-induced by gamma interferon (MIG) and poor clinical outcome. Multivariate Cox regression analysis revealed that low HRR was an independent predictor of CV events in both enter method and stepwise method. The addition of HRR to a model significantly increased predictability for CV events across the entire follow-up period. Impaired post-exercise HRR is associated with a pro-inflammatory response and independently predicts clinical outcome in patients with ADHF. These findings may explain the relationship between autonomic dysfunction and clinical outcome in terms of the inflammatory response in these patients.

The Effectiveness of a Self-Reporting Bedside Pain Assessment Tool for Oncology Inpatients

PubMed Central

Kim, Eun Bi; Chung, Jung Hwa; Park, Bo Ram; Lim, Sung-nam; Yim, Kyoung Hoon; Shin, Young Duck; Lee, Ki Hyeong; Kim, Wun-Jae; Kim, Seung Taik

2012-01-01

Abstract Background Pain is common during cancer treatment, and patient self-reporting of pain is an essential first step for ideal cancer pain management. However, many studies on cancer pain management report that, because pain may be underestimated, it is often inadequately managed. Objective The aim of this study was to evaluate the effectiveness of bedside self-assessment of pain intensity for inpatients using a self-reporting pain board. Methods Fifty consecutive inpatients admitted to the Oncology Department of Chungbuk National University Hospital were included in this observational prospective study from February 2011 to December 2011. The medical staff performed pain assessments by asking patients questions and using verbal rated scales (VRS) over 3 consecutive days. Then, for 3 additional days, patients used a self-reporting pain board attached to the bed, which had movable indicators representing 0–10 on a numeric rating scale (NRS) and the frequency of breakthrough pain. Results Patient reliability over the medical staff's pain assessment increased from 74% to 96% after applying the self-reporting pain board (p=0.004). The gap (mean±standard deviation [SD]) between the NRS reported by patients and the NRS recorded on the medical records decreased from 3.16±2.08 to 1.00±1.02 (p<0.001), and the level of patient satisfaction with pain management increased from 54% to 82% (p=0.002). Conclusion This study suggests that the self-reporting bedside pain assessment tool provides a reliable and effective means of assessing pain in oncology inpatients. PMID:22974435

Cyclopamine-induced synophthalmia in sheep: defining a critical window and toxicokinetic evaluation.

PubMed

Welch, K D; Panter, K E; Lee, S T; Gardner, D R; Stegelmeier, B L; Cook, D

2009-07-01

Cyclopamine, a steroidal alkaloid, from the plant Veratrum californicum is teratogenic, causing a range of different birth defects. The critical window for cyclopamine-induced synophthalmia formation has been reported to be gestational day (GD) 14. The objectives of this study were to better describe cyclopamine-induced craniofacial deformities, to better define the window of susceptibility to synophthalmia formation, and to characterize cyclopamine toxicokinetics in sheep. Ewes were dosed i.v. with purified cyclopamine for toxicokinetic analysis. Another four groups of ewes were dosed orally twice daily with 0.88 g/kg of V. californicum on GD 13, 14 or 15 or consecutively on GD days 13-15. Pregnancy and pre-partum fetal malformations were determined by ultrasound imaging on GD 60. At parturition lambs were assessed for gross malformations. The elimination half-life of cyclopamine in ewes was determined to be 1.1 +/- 0.1 h. The rapid clearance of cyclopamine indicates that ingestion of V. californicum must occur during a very narrow window for synophthalmia formation to occur. Ewes dosed with V. californicum on GD 13 or 14 had lambs with various craniofacial malformations including cyclopia, maxillary dysplasia and mandibular micrognathia. Ewes dosed on GD 15 delivered normal lambs. Ewes dosed consecutively on GD 13-15 were not pregnant at GD 60 and Veratrum-induced embryonic death was assumed to be the cause. Interestingly, lambs with cyclopia were smaller, under-developed and appeared premature even though their twin appeared fully developed. Initial evaluations suggest this was due to placental dysplasia. 2009 by John Wiley & Sons, Ltd.

Association of subdural hematoma with increased mortality in lobar intracerebral hemorrhage.

PubMed

Patel, Pratik V; FitzMaurice, Emilie; Nandigam, R N Kaveer; Auluck, Pavan; Viswanathan, Anand; Goldstein, Joshua N; Rosand, Jonathan; Greenberg, Steven M; Smith, Eric E

2009-01-01

To determine the prevalence of subdural hematoma (SDH) in patients presenting with primary nontraumatic lobar intracerebral hemorrhage (ICH) and characteristics associated with the presence of SDH. Retrospective analysis of data collected in a prospective cohort study. Hospital. Consecutive sample of 200 patients with primary lobar ICH and 75 patients with deep hemispheric ICH. Presence of SDH and mortality. Subdural hematoma was present in 40 of 200 patients (20%) with primary lobar ICH. By contrast, SDH was not present in any of 75 consecutive patients with deep hemispheric ICH (P < .001 for comparison with lobar ICH). Intracerebral hemorrhage volume higher than 60 cm3 was the only independent predictor of SDH (odds ratio [OR], 2.69; 95% confidence interval [CI], 1.14-6.34; P = .02). Subdural hematoma thickness more than 5 mm was an independent predictor of increased 30-day mortality (OR, 7.60; 95% CI, 1.86-30.99; P = .005) after controlling for other factors including ICH volume. Further analysis showed that the effect of SDH on mortality depended on ICH volume, with larger odds for mortality in those with low ICH volume (OR, 12.85; 95% CI, 2.42-68.23; P = .003 for those with ICH volume <30 cm3). Cerebral amyloid angiopathy was present in 8 of 9 patients with pathological specimens. Nontraumatic SDH frequently accompanies primary lobar ICH and is associated with higher 30-day mortality, particularly when the ICH volume is relatively low. Rupture of an amyloid-laden leptomeningeal vessel, with extravasation into the brain parenchyma and subdural space, may be the pathogenic mechanism.

Effect of weekly high-dose vitamin D3 supplementation on serum cholecalciferol concentrations in pregnant women.

PubMed

Dimitris, Michelle C; Perumal, Nandita; Craig-Barnes, Hayley A; Leadley, Michael; Mahmud, Abdullah A; Baqui, Abdullah H; Roth, Daniel E

2016-04-01

Vitamin D status is conventionally defined by the serum concentration of 25-hydroxyvitamin D. However, it has been proposed that the serum cholecalciferol concentration (D3) also determines functional vitamin D sufficiency. The objective of this study was to describe the effect of weekly high-dose vitamin D3 supplementation on inter-dose serum D3 in pregnant women. We conducted a sub-study of a completed randomized double-blind placebo-controlled trial of vitamin D3 (35,000 IU/week) supplementation in late pregnancy (AViDD trial) in Dhaka, Bangladesh. This study included pregnant women enrolled at 26-29 weeks gestation who fully adhered to the prenatal supplement intervention for ≥8 consecutive weeks and for whom serum samples were available for D3 analysis (n=65). Serum D3 was uniformly low at enrolment. Mean D3 increased and was maximal at 1 day after vitamin D dose administration (152.09nmol/L, SD 25.11nmol/L) and remained significantly higher in VitD vs. Pl at 7 days (29.59nmol/L vs. 1.92nmol/L, p=0.007). Daily average of the group mean D3 during the week following dosing was 66.97nmol/L in VitD versus 2.13nmol/L in Pl. In conclusion, serum D3 remained significantly elevated throughout the week following ≥8 consecutive weekly doses of 35,000 IU D3 in pregnant women. However, the clinically significant minimum threshold of serum D3 remains to be established. Copyright © 2016 Elsevier Ltd. All rights reserved.

40 CFR 422.45 - Standards of performance for new sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

... of daily values for 30 consecutive days shall not exceed— Total phosphorus (as P) 105 35 Fluoride (as... phosphorus (as P) 105 35 Fluoride (as F) 75 25 pH (1) (1) 1 Within the range 6.0 to 9.5. ...

40 CFR 422.45 - Standards of performance for new sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... of daily values for 30 consecutive days shall not exceed— Total phosphorus (as P) 105 35 Fluoride (as... phosphorus (as P) 105 35 Fluoride (as F) 75 25 pH (1) (1) 1 Within the range 6.0 to 9.5. ...

Discipline under IDEA.

ERIC Educational Resources Information Center

Horton, Janet L.

1999-01-01

Discretion and regulatory flexibility must be managed without violating the amended, reauthorized Individuals with Disabilities Education Act. Misbehaving disabled students may be removed from their educational placements for 10 consecutive days or less--the same punishment meted out to regular students. Longer-term placements need IEP team…

Simulated drought regimes reveal community resilience and hydrological thresholds for altered decomposition.

PubMed

Rodríguez Pérez, Héctor; Borrel, Guillaume; Leroy, Céline; Carrias, Jean-François; Corbara, Bruno; Srivastava, Diane S; Céréghino, Régis

2018-05-01

Future climate scenarios forecast a 10-50% decline in rainfall in Eastern Amazonia. Altered precipitation patterns may change important ecosystem functions like decomposition through either changes in physical and chemical processes or shifts in the activity and/or composition of species. We experimentally manipulated hydroperiods (length of wet:dry cycles) in a tank bromeliad ecosystem to examine impacts on leaf litter decomposition. Gross loss of litter mass over 112 days was greatest in continuously submersed litter, lowest in continuously dry litter, and intermediate over a range of hydroperiods ranging from eight cycles of 7 wet:7 dry days to one cycle of 56 wet:56 dry days. The resilience of litter mass loss to hydroperiod length is due to a shift from biologically assisted decomposition (mostly microbial) at short wet:dry hydroperiods to physicochemical release of dissolved organic matter at longer wet:dry hydroperiods. Biologically assisted decomposition was maximized at wet:dry hydroperiods falling within the range of ambient conditions (12-22 consecutive dry days) but then declined under prolonged wet:dry hydroperiods (28 and 56 dry days. Fungal:bacterial ratios showed a similar pattern as biologically assisted decomposition to hydroperiod length. Our results suggest that microbial communities confer functional resilience to altered hydroperiod in tank bromeliad ecosystems. We predict a substantial decrease in biological activity relevant to decomposition under climate scenarios that increase consecutive dry days by 1.6- to 3.2-fold in our study area, whereas decreased frequency of dry periods will tend to increase the physicochemical component of decomposition.

A 3-day high-fat/low-carbohydrate diet does not alter exercise-induced growth hormone response in healthy males.

PubMed

Sasaki, Hiroto; Ishibashi, Aya; Tsuchiya, Yoshihumi; Shimura, Nobuhiro; Kurihara, Toshiyuki; Ebi, Kumiko; Goto, Kazushige

2015-12-01

The purpose of the present study was to examine the effects of 3 days isoenergetic high-fat/low-carbohydrate diet (HF-LC) relative to low-fat/high-carbohydrate diet (LF-HC) on the exercise-induced growth hormone (GH) response in healthy male subjects. Ten healthy young males participated in this study. Each subject consumed the HF-LC (18±1% protein, 61±2% fat, 21±1% carbohydrate, 2720 kcal per day) for 3 consecutive days after consuming the LF-HC (18±1% protein, 20±1% fat, 62±1% carbohydrate, 2755 kcal per day) for 3 consecutive days. After each dietary intervention period, the hormonal and metabolic responses to an acute exercise (30 min of continuous pedaling at 60% of V˙O2max) were compared. The intramyocellular lipid (IMCL) contents in the vastus lateralis, soleus, and tibialis anterior were evaluated by proton magnetic resonance spectroscopy. Serum GH concentrations increased significantly during the exercise after both the HF-LC and LF-HC periods (P<0.05). However, the exercise-induced GH response was not significantly different between the two periods. Fat utilization and lipolytic responses during the exercise were enhanced significantly after the HF-LC period compared with the LF-HC period. IMCL content did not differ significantly in any portion of muscle after the dietary interventions. We could not show that short-term HF-LC consumption changed significantly exercise-induced GH response or IMCL content in healthy young males. Copyright © 2015 Elsevier Ltd. All rights reserved.