Dose postural control improve following application of transcutaneous electrical nerve stimulation in diabetic peripheral neuropathic patients? A randomized placebo control trial.

PubMed

Saadat, Z; Rojhani-Shirazi, Z; Abbasi, L

2017-12-01

peripheral neuropathy is the most common problem of diabetes. Neuropathy leads to lower extremity somatosensory deficits and postural instability in these patients. However, there are not sufficient evidences for improving postural control in these patients. To investigate the effects of transcutaneous electrical nerve stimulation (TENS) on postural control in patients with diabetic neuropathy. Twenty eighth patients with diabetic neuropathy (40-55 Y/O) participated in this RCT study. Fourteen patients in case group received TENS and sham TENS was used for control group. Force plate platform was used to extract sway velocity and COP displacement parameters for postural control evaluation. The mean sway velocity and center of pressure displacement along the mediolateral and anteroposterior axes were not significantly different between two groups after TENS application (p>0.05). Application of 5min high frequency TENS on the knee joint could not improve postural control in patients with diabetic neuropathy. Copyright © 2017. Published by Elsevier Ltd.

Fatal toxic epidermal necrolysis associated with minoxidil.

PubMed

Karaoui, Lamis R; Chahine-Chakhtoura, Corinne

2009-04-01

Minoxidil is a direct-acting peripheral vasodilator for the treatment of symptomatic hypertension, or refractory hypertension associated with target organ damage, that is not manageable with a diuretic and two other antihypertensive drugs. The most frequent adverse events associated with minoxidil include hypertrichosis and cardiovascular events related to its powerful antihypertensive effect, and less frequently, rashes, bullous eruptions, and Stevens-Johnson syndrome (SJS). Evidence suggests that SJS and toxic epidermal necrolysis (TEN) are variants of a single disease with common causes and mechanisms, but differing severities. Epidermal detachment is mild in SJS, moderate in overlap SJS-TEN, and severe (> 30% of body surface area) in TEN. We describe a case of minoxidil-associated SJS that evolved into fatal TEN. A 69-year-old African-American woman with a history of chronic kidney disease was admitted to the hospital for a cerebrovascular accident and uncontrolled hypertension. On hospital day 12, oral minoxidil was added to her drug regimen. On day 23, she developed a maculopapular rash on her face that gradually diffused to her chest and back. Vesicles and papular lesions extended to her extremities and mucosal membranes; results of a skin biopsy revealed SJS. A positive Nikolsky's sign (blisters spread on application of pressure) was detected. On days 27-31, diffuse bullae developed with rash exacerbation. Skin detachment exceeded 30% and was consistent with TEN. The patient died on day 39. An evaluation of the causality and time course suggested that minoxidil was the most likely culpable drug, with a Naranjo adverse drug reaction probability scale score indicating that the likelihood of the association was possible (score of 3). The mechanism of this reaction has not been well elucidated. It may be related to an impaired clearance of the minoxidil metabolite, or an immune stimulation resulting in apoptosis and epidermis destruction. To our knowledge, this is the first case report of fatal TEN associated with minoxidil. This case report emphasizes the importance of monitoring for serious dermatologic reactions in patients receiving minoxidil therapy.

Warfarin-induced toxic epidermal necrolysis in combination therapy of Henoch-Schönlein purpura nephritis: a case report.

PubMed

Kasahara, Katsuaki; Gotoh, Yoshimitsu; Kuroyanagi, Yoshiyuki; Nagano, China

2017-07-14

Toxic epidermal necrolysis (TEN) is a rare life-threatening condition almost exclusively attributed to drugs. The main etiologic factors for TEN are sulphonamides, anticonvulsants, and antibiotics; however, there are no published reports of warfarin causing TEN. We present the case of a 3-year-old patient who developed TEN while receiving treatment for Henoch-Schönlein purpura nephritis (HSPN). With multiple-drug therapy comprising prednisolone, mizoribine, dipyridamole, and warfarin, it is difficult to detect which drug is the causative agent. While in most cases, diagnosis of the causative drug is based on clinical history without a lymphocyte transformation test (LTT), we performed the test three times and identified the causative drug as warfarin at the late phase. We continued HSPN treatment without warfarin, and results showed good renal function without life-threatening complications. To our knowledge, this is the first report about TEN caused by warfarin. Repeated LTTs could be useful for identifying TEN-causative drugs even in the late phase.

Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis and Treatment With a Biologic: A Case Report

PubMed Central

Chong, Ian; Chao, Alice

2017-01-01

Introduction One of the most dangerous dermatologic emergencies is Stevens-Johnson Syndrome (SJS)/toxic epidermal necrolysis (TEN). Although a rare disease, it can often lead to significant mortality. Case Presentation In this case report, we present a 77-year-old man who developed a sloughing rash that was secondary to a nonsteroidal anti-inflammatory drug. In addition to the recommended supportive care, the patient was treated with etanercept, a new, less commonly used intervention. Discussion We provide a brief review of SJS/TEN. Nonsteroidal anti-inflammatory drugs are a rare cause of SJS/TEN, and additionally, the use of biologics is a novel treatment modality for SJS/TEN. PMID:28488978

[Prevention concerning the different alternative routes for transmission of Trypanosoma cruzi in Brazil].

PubMed

Dias, João Carlos Pinto; Amato Neto, Vicente

2011-01-01

Vectorial, transfusion and congenital are considered the main transmission mechanisms in human Chagas disease. Alternative mechanisms are accidental, oral and by organ transplantation. Other hypothetic mechanisms could be by other vectors, sexual, criminal and by means of marsupial anal secretions. The present accorded strategies for prevention are: CONGENITAL: early case detection and immediate treatment. If possible, start during the pre natal period, throughout mothers serology, performing parasitological tests in the new born from positive women. For positive cases, immediate treatment; for those negative babies, conventional serology at the 8th month, treating specifically those with positive results. ACCIDENTAL TRANSMISSION: Rigorous training and utilization of protection equipments. IF accident occurs, immediate disinfection, conventional serology and beginning of specific treatment by ten days. Revision of the serology after 30 days: if positive, extend the treatment until the total dose (60 days or more). ORGAN TRANSPLANTATION: previous serology for donor and receptor. When the former is infected and the last negative, cancel the surgery or install the specific treatment by ten days before the surgery for the donor, followed by the receptor during ten days after the transplantation. ORAL TRANSMISSION: Specific measures are not available, food hygiene is recommended, including the cooking of meats delivered from possible reservoirs. Nowadays, the detection and immediate treatment of the case is recommended, followed by active research of new cases around the detected one.

Extraskeletal Ewing's Sarcoma: insight into a ten years follow-up.

PubMed

Zitelli, A; Manfredelli, S; Brunotti, G; Marcantonio, M; Pontone, S; Angelici, A

2013-01-01

Extraskeletal Ewing's sarcoma is a rare malignant soft tissue tumor, classified within the Ewing's Sarcoma Family Tumors. While the classical Ewing's Sarcoma affects mainly the bone during youth, the Extraskeletal histotype differs for age incidence, primary location and prognosis. Peak incidence and typical location are during adolescence and in the extremities respectively. We report a 30 year old woman case with a positive outcome after ten years from first diagnosis of Extraskeletal Ewing's sarcoma. Treatment was achieved through surgical resection plus adjuvant chemoradiotherapy derived from EW93 and IRS III trials. Conclusion. Our report represents an unusual case due to age of presentation, neoplasm location and long survival reached. In last decades several trials results demonstrated that long survival could be achieved by combined surgery and adjuvant multi-drug treatment.

Treating esophagus-cardiac carcinoma by YAG laser gasifying with irradiating of hemoporphyrin derivative laser: additional analyses of 110 cases

NASA Astrophysics Data System (ADS)

Yang, Chongjiang; Zhou, Hong; Jiang, Cuilin; Xu, Shouquan

1993-03-01

One-hundred-ten cases with esophagus-cardiac carcinoma treated by YAG laser gasifying together with irradiation of hemoporphyrin derivatives is reported. Here complete remission is seen in 28% of the patients, the total effective rate was 87%. The treatment method is simple and convenient, therefore, it is useful for the treatment of esophaguscardiac, carcinoma in a different stage.

Gender Differences in Mathematics Achievement and Retention Scores: A Case of Problem-Based Learning Method

ERIC Educational Resources Information Center

Ajai, John T.; Imoko, Benjamin I.

2015-01-01

This study was undertaken to assess gender differences in mathematics achievement and retention by using Problem-Based Learning (PBL). The design of the study was pre-posttest quasi-experimental. Four hundred and twenty eight senior secondary one (SS I) students using multistage sampling from ten grant-aided and government schools were involved in…

[Comparing clinical effects of titanic elastic nail and locking compression pine fixation in treating subtrochanteric fractures in older children].

PubMed

Zhu, Kang-xiang; Yin, Shan-qing

2013-12-01

To explore optimal choice of surgical treatment for subtrochanteric fractures in older children. A retrospective study of 36 older children with subtrochanteric fractures was performed between January 2010 and January 2012. Among them, 18 patients (11 males and 7 females) aged from 7 to 13 years old with an average of 9.4 were treated with titanic elastic nail (TEN) fixation, 4 cases were Type II A, 3 cases were II B, 2 cases were II C, 4 cases were III A, 3 cases were III B according to Seinsheimer classification. Eighteen patients (10 males and 8 females) aged was from 8 to 13 years with an average of 9.6 were treated with locking compression pine (LCP) fixation, and 3 cases were Type II A, 4 cases were II B, 3 cases were II C, 4 cases were IIIA, 2 cases were III B. Fracture healing time, postoperative complications (including wound infection, failure and breakage of internal fixtion, deformities of angular on the sagittal view, deformities of coxa vara) and recovery of hip joint function were observed and recorded. All children were followed up from 15 to 36 months with an average of 21. Fracture were all healed, the time ranged from 7 to 16 weeks (mean 9.5). Three cases in TEN group occurred mild deformities of angular on the sagittal view, 3 cases occurred deformities of coxa vara and 2 cases occurred limb shortening; while 1 case occurred mild deformities of angular on the sagittal view, and no deformities of coxa vara and limb shortening occurred in LCP group. No early close of epiphyseal injury, avascular necrosis of femoral head occurred. Clinical efficacy were evaluated by Sanders standard, 14 cases got excellent results, 3 cases were moderate in LCP group, while 9 cases in excellent, 4 in moderate in TEN group. There were no significant differences between two group in recovery of hip joint function and complications. For the treatment of subtrochanteric fractures in older children,the efficacy of LCP fixation is better than that of TFN fixation, which has advantages of reliable fixation, and less complications.

Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Standard Reporting and Evaluation Guidelines: Results of a National Institutes of Health Working Group.

PubMed

Maverakis, Emanual; Wang, Elizabeth A; Shinkai, Kanade; Mahasirimongkol, Surakameth; Margolis, David J; Avigan, Mark; Chung, Wen-Hung; Goldman, Jennifer; La Grenade, Lois; Pirmohamed, Munir; Shear, Neil H; Tassaeeyakul, Wichittra; Hoetzenecker, Wolfram; Klaewsongkram, Jettanong; Rerkpattanapipat, Ticha; Manuyakorn, Wiparat; Yasuda, Sally Usdin; Sharon, Victoria R; Sukhov, Andrea; Micheletti, Robert; Struewing, Jeff; French, Lars E; Cheng, Michelle Y

2017-06-01

Toxic epidermal necrolysis (TEN) and Stevens-Johnson Syndrome (SJS) are rare, acute, life-threatening dermatologic disorders involving the skin and mucous membranes. Research into these conditions is hampered by a lack of standardization of case reporting and data collection. To establish a standardized case report form to facilitate comparisons and maintain data quality based on an international panel of SJS/TEN experts who performed a Delphi consensus-building exercise. The elements presented for committee scrutiny were adapted from previous case report forms and from PubMed literature searches of highly cited manuscripts pertaining to SJS/TEN. The expert opinions and experience of the members of the consensus group were included in the discussion. Overall, 21 out of 29 experts who were invited to participate in the online Delphi exercise agreed to participate. Surveys at each stage were administered via an online survery software tool. For the first 2 Delphi rounds, results were analyzed using the Interpercentile Range Adjusted for Symmetry method and statements that passed consensus formulated a new case report form. For the third Delphi round, the case report form was presented to the committee, who agreed that it was "appropriate and useful" for documenting cases of SJS/TEN, making it more reliable and valuable for future research endeavors. With the consensus of international experts, a case report form for SJS/TEN has been created to help standardize the collection of patient information in future studies and the documentation of individual cases.

The Case for an Australian Certificate of Education

ERIC Educational Resources Information Center

Masters, Geoff

2006-01-01

The Commonwealth Department of Education, Science and Training on May 2005 commissioned the Australian Council for Educational Research to investigate and report on models and implementation arrangements for an Australian Certificate of Education. There are ten different certificates currently available across the six states and two territories of…

Association of HLA-B*5801 allele and allopurinol-induced stevens johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis

PubMed Central

2011-01-01

Background Despite some studies suggesting a possible association between human leukocyte antigen, HLA-B*5801 and allopurinol induced Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), the evidence of association and its magnitude remain inconclusive. This study aims to systematically review and meta-analyze the association between HLA-B*5801 allele and allopurinol-induced SJS/TEN. Methods A comprehensive search was performed in databases including MEDLINE, Pre-MEDLINE, Cochrane Library, EMBASE, International Pharmaceutical Abstracts (IPA), CINAHL, PsychInfo, the WHO International, Clinical Trial Registry, and ClinicalTrial.gov from their inceptions to June 2011. Only studies investigating association between HLA-B*5801 with allopurinol-induced SJS/TEN were included. All studies were extracted by two independent authors. The primary analysis was the carrier frequency of HLA-B*5801 comparison between allopurinol-induced SJS/TEN cases and each comparative group. The pooled odds ratios were calculated using a random effect model. Results A total of 4 studies with 55 SJS/TEN cases and 678 matched-controls (allopurinol-tolerant control) was identified, while 5 studies with 69 SJS/TEN cases and 3378 population-controls (general population) were found. SJS/TEN cases were found to be significantly associated with HLA-B*5801 allele in both groups of studies with matched-control (OR 96.60, 95%CI 24.49-381.00, p < 0.001) and population-control (OR 79.28, 95%CI 41.51-151.35, p < 0.001). Subgroup analysis for Asian and Non-Asian population yielded similar findings. Conclusion We found a strong and significant association between HLA-B*5801 and allopurinol-induced SJS/TEN. Therefore, HLA-B*5801 allele screening may be considered in patients who will be treated with allopurinol. PMID:21906289

SU-D-BRB-01: A Predictive Planning Tool for Stereotactic Radiosurgery

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

Palefsky, S; Roper, J; Elder, E

Purpose: To demonstrate the feasibility of a predictive planning tool which provides SRS planning guidance based on simple patient anatomical properties: PTV size, PTV shape and distance from critical structures. Methods: Ten framed SRS cases treated at Winship Cancer Institute of Emory University were analyzed to extract data on PTV size, sphericity (shape), and distance from critical structures such as the brainstem and optic chiasm. The cases consisted of five pairs. Each pair consisted of two cases with a similar diagnosis (such as pituitary adenoma or arteriovenous malformation) that were treated with different techniques: DCA, or IMRS. A Naive Bayesmore » Classifier was trained on this data to establish the conditions under which each treatment modality was used. This model was validated by classifying ten other randomly-selected cases into DCA or IMRS classes, calculating the probability of each technique, and comparing results to the treated technique. Results: Of the ten cases used to validate the model, nine had their technique predicted correctly. The three cases treated with IMRS were all identified as such. Their probabilities of being treated with IMRS ranged between 59% and 100%. Six of the seven cases treated with DCA were correctly classified. These probabilities ranged between 51% and 95%. One case treated with DCA was incorrectly predicted to be an IMRS plan. The model’s confidence in this case was 91%. Conclusion: These findings indicate that a predictive planning tool based on simple patient anatomical properties can predict the SRS technique used for treatment. The algorithm operated with 90% accuracy. With further validation on larger patient populations, this tool may be used clinically to guide planners in choosing an appropriate treatment technique. The prediction algorithm could also be adapted to guide selection of treatment parameters such as treatment modality and number of fields for radiotherapy across anatomical sites.« less

Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis and Treatment With a Biologic: A Case Report.

PubMed

Chong, Ian; Chao, Alice

2017-01-01

One of the most dangerous dermatologic emergencies is Stevens-Johnson Syndrome (SJS)/toxic epidermal necrolysis (TEN). Although a rare disease, it can often lead to significant mortality. In this case report, we present a 77-year-old man who developed a sloughing rash that was secondary to a nonsteroidal anti-inflammatory drug. In addition to the recommended supportive care, the patient was treated with etanercept, a new, less commonly used intervention. We provide a brief review of SJS/TEN. Nonsteroidal anti-inflammatory drugs are a rare cause of SJS/TEN, and additionally, the use of biologics is a novel treatment modality for SJS/TEN.

Does transcutaneous electrical nerve stimulation reduce pain and improve quality of life in patients with idiopathic chronic orchialgia? A randomized controlled trial

PubMed Central

Tantawy, Sayed A; Kamel, Dalia M; Abdelbasset, Walid Kamal

2018-01-01

Background Chronic orchialgia is defined as testicular pain, which may be either unilateral or bilateral, lasting for more than 3 months. It disturbs a patient’s daily activities and quality of life (QoL), inciting the patient to search for treatments to alleviate the pain. It is estimated that 25% of chronic orchialgia cases are idiopathic. Purpose The purpose of this study was to investigate how effective transcutaneous electrical nerve stimulation (TENS) is in pain reduction and how it consequently affects the QoL in patients with idiopathic chronic orchialgia (ICO). Patients and methods Seventy-one patients were randomly assigned to group A (study group), which included 36 patients who received TENS and analgesia, and group B (control group), which included 35 patients who received analgesia only. The outcome measures were the participants’ demographic data and results of the visual analog scale (VAS) and QoL questionnaire. These outcomes were measured before and after 4 weeks of treatment and at 2-month follow-up. Results The results showed that compared to pretreatment, there was a significant reduction in pain postintervention and at 2-month follow-up in group A (P<0.0001 and <0.001, respectively; F=7.1) as well as a significant improvement in QoL at these time points (P<0.0001 and <0.0001, respectively). There were no significant differences in the VAS score and QoL in group B at different time points of evaluation. Conclusion The findings indicate that TENS is effective in reducing pain and improving patients’ QoL in cases of ICO. TENS is an easy-to-use, effective, noninvasive, and simple method for ICO-associated pain control and QoL improvement. PMID:29343983

Association between HLA-B*44:03-HLA-C*07:01 haplotype and cold medicine-related Stevens-Johnson syndrome with severe ocular complications in Thailand.

PubMed

Jongkhajornpong, Passara; Lekhanont, Kaevalin; Pisuchpen, Phattrawan; Chantaren, Patchima; Puangsricharern, Vilavun; Prabhasawat, Pinnita; Suphapeetiporn, Kanya; Kinoshita, Shigeru; Ueta, Mayumi

2018-04-29

Polymorphisms in human leucocyte antigen (HLA) class I genes have been found to be associated with cold medicine (CM)-related Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) with severe ocular complications (SOC). Because ethnic differences in genetic predisposition to SJS/TEN among different populations have been proposed, we focused on Thai patients and investigated the association between HLA class I genotypes and CM-SJS/TEN with SOC. This multicentre case-control study was conducted between September 2014 and August 2017. Seventy-one Thai patients with SJS/TEN with SOC and 159 healthy Thai controls were enrolled. HLA typing was performed. Genetic relationships were analysed using Fisher's exact test. Of 71 patients with SJS/TEN with SOC (28 male, 43 female), 49 (69%) had a history of taking cold medications prior to SJS/TEN onset. The mean age of onset was 26.7±17.1 years (range, 2-77 years). HLA-B*44:03 (OR, 7.2, p=5.5×10 -6 , pc=1.1×10 -4 ) and HLA-C*07:01 (OR, 6.1, p=7.1×10 -6 , pc=1.1×10 -4 ) showed significant positive associations with Thai patients with CM-SJS/TEN with SOC. Additionally, 17 of 49 patients with CM-SJS/TEN with SOC (34.7%) significantly harboured the HLA-B*44:03 and HLA-C*07:01 haplotype compared with only 11 of 159 healthy controls (6.9%) (OR=7.1, p=5.5×10 -6 ). HLA-B*44:03-HLA-C*07:01 haplotype is a potential risk factor for CM-SJS/TEN with SOC in the Thai population. This study supports that HLA-B*44:03 might be a common marker for CM-SJS/TEN with SOC in Eurasia populations, including European, Indian, Japanese and Thai. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Hispanic College Students' Learning Styles, Personality Types, and Gender Differences: A Collective Case Study of Ten Hispanic College Students Exposed to the Myers Briggs Type Indicator

ERIC Educational Resources Information Center

Harris, Rachelle D.

2014-01-01

The research body regarding learning styles has been abundant; however, research related to Separate and Connected learning styles has not been as copious. The purpose of this qualitative study was to explore the association between learning styles, personality types, and gender differences for Hispanic college students between the ages of 18-24…

Large scale exact quantum dynamics calculations: Ten thousand quantum states of acetonitrile

NASA Astrophysics Data System (ADS)

Halverson, Thomas; Poirier, Bill

2015-03-01

'Exact' quantum dynamics (EQD) calculations of the vibrational spectrum of acetonitrile (CH3CN) are performed, using two different methods: (1) phase-space-truncated momentum-symmetrized Gaussian basis and (2) correlated truncated harmonic oscillator basis. In both cases, a simple classical phase space picture is used to optimize the selection of individual basis functions-leading to drastic reductions in basis size, in comparison with existing methods. Massive parallelization is also employed. Together, these tools-implemented into a single, easy-to-use computer code-enable a calculation of tens of thousands of vibrational states of CH3CN to an accuracy of 0.001-10 cm-1.

[Nutritional therapy in acute pancreatitis: a practical guide for the initial enteral nutritional support.].

PubMed

Gutiérrez-Salmeán, G; Peláez-Luna, M

2010-01-01

Nutritional support is a cornerstone in acute pancreatitis (AP) treatment, which is a catabolic state that can result in patient's nutritional depletion. First step in the management of AP is to asses its severity. Despite mild AP cases usually do not require nutritional support severe cases benefit from its early initiation. Total enteral nutrition (TEN) decreases the frequency of complications and is the preferred nutrition modality in AP. Availability of nutrition specialists is often limited and usually the primary care physician decides when and how to start nutritional support in AP. To perform a systematic review about nutritional support in AP and create a TEN guide to aid the non nutrition specialist involved in the treatment of AP patients. The search for eligible studies was carried out using the Pub Med and the National Library of Medicine electronic data bases. Controlled clinical trials, treatment guidelines and systematic review articles were selected. It is recommended to initiate nutritional support in AP cases that will be without oral intake longer than a week and TEN is the election modality. We created a TEN guide explaining how to choose and initiate TEN in AP. Early TEN improves AP prognosis and is the nutritional modality of choice in every AP patients that will remain without oral intake longer than a week.

Seeing the Implications of Zero Again

ERIC Educational Resources Information Center

Ponce, Gregorio A.

2015-01-01

Composing and decomposing numbers with base-ten blocks depends on children being able to see ten both as ten units and as one group of ten units (a long), cognizant that its value is the same in either case. Being able to see, or deciding when to see, an object or collection of objects as a unit is a key skill that children must develop to solve…

Childhood herpes zoster: a clustering of ten cases.

PubMed

Prabhu, Smitha; Sripathi, H; Gupta, Sanjeev; Prabhu, Mukyaprana

2009-01-01

Herpes zoster occurs due to reactivation of the latent varicella zoster virus and is usually a disease of the elderly. Childhood herpes zoster is believed to be rare, though recent studies suggest increasing incidence in children. Here we report ten cases of childhood herpes zoster, seven of which occurred within a short span of six months, at a tertiary care level hospital in Pokhara, Nepal. Only three of the ten children reported previous history of varicella infection and none was immunized against varicella. Though childhood herpes zoster accounted for less than 1% of the total zoster cases in the past, recent reports show an increase in the number of cases in apparently healthy children. So far, no studies have been done linking childhood herpes zoster with HIV, though there are many studies linking it with other immunocompromised conditions.

Tumor necrosis factor alpha inhibitors in the treatment of toxic epidermal necrolysis.

PubMed

Woolridge, Katelyn F; Boler, Patrick L; Lee, Brian D

2018-01-01

Toxic epidermal necrolysis (TEN) is a rare, life-threatening adverse drug reaction for which there is no standardized or consistently effective treatment. Due to a greater understanding of disease pathogenesis and the identification of tumor necrosis factor (TNF) α as a mediator of keratinocyte death, TNF-α antagonists have been used in the treatment of TEN. Specifically, infliximab and etanercept have been shown to be effective at halting disease progression. The objective of this study is to review published case reports and case series using anti-TNF-α medications in the treatment of TEN. Results of many of the articles reviewed support the use of TNF-α inhibitors in TEN in both adult and pediatric populations; however, the risks caused by these potent immunosuppressants must be weighed, and if administered, patients must be closely monitored for infections. Additional studies are needed to further characterize the role of TNF-α inhibition in the treatment of TEN.

Retrospective Analysis of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in 88 Chinese Patients

PubMed Central

Wang, Li; Mei, Xue-Ling

2017-01-01

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening diseases with high mortality rates. This study was designed to analyze the pathogenic factors, clinical manifestations, complications, treatment, and prognosis of SJS/TEN and to explore the differences between surviving and deceased patients. Methods: SJS/TEN patients admitted to Beijing Friendship Hospital from January 2006 to December 2015 were included in the study. Patients’ data were retrospectively analyzed. Comparative studies were performed on the survival group and the deceased group, and Fisher's exact probability test was used for statistical analysis. Results: Among the 88 patients included, 40 (45.5%) were male with a mean age of 45 ± 18 years. Forty-eight (54.5%) had SJS, 34 (38.6%) had SJS/TEN, and 6 (6.8%) had TEN. Fifty-three (60.2%) cases were caused by medications, mainly antibiotics (n = 24) followed by traditional Chinese medicines (n = 7). Forty-two cases (47.7%) developed visceral damage. Eighty-two patients improved or recovered and were discharged from hospital, and six patients died. Comparative studies on the survival group and the deceased group showed that the presence of malignant tumor (χ2 = 27.969, P < 0.001), connective tissue diseases (χ2 = 9.187, P = 0.002), previous abnormal liver/kidney functions (χ2 = 6.006, P = 0.014), heart rate >100 times/min (χ2 = 6.347, P = 0.012), detached skin area >20% (χ2 = 5.594, P = 0.018), concurrent mucosal involvement at the mouth, eyes, and external genitals (χ2 = 4.945, P = 0.026), subsequent accompanying liver/kidney damage (χ2 = 11.839, P = 0.001, and χ2 = 36.302, P < 0.001, respectively), and SCORTEN score >2 (χ2 = 37.148, P < 0.001) increased the risk of death. Conclusions: SJS/TEN is mainly caused by medications, and nearly half of patients develop visceral damage. Multiple factors increase the mortality risk. PMID:28469101

Differentiated Quality Assurance for the African Virtual University's Teacher Education Qualification in Mathematics and Science

ERIC Educational Resources Information Center

Hattingh, A.

2008-01-01

For the African Virtual University and its consortium of African universities the implementation of quality promoting initiatives are not without challenges and scepticisms. To be discussed in this article is the case of a teacher education qualification in ten different African countries. Seven countries were sampled and visited in 2006 with the…

Bronchoalveolar lavage, serum angiotensin-converting enzyme, and /sup 67/Ga scanning in extrathoracic sarcoidosis

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

Wallaert, B.; Ramon, P.; Fournier, E.

1982-11-01

Results of bronchoalveolar lavage (BAL), 67Ga scanning, and serum angiotensin-converting enzyme (SACE) assay are compared in the assessment of pulmonary involvement in ten cases of extrathoracic sarcoidosis. Standard clinical, radiologic, and pulmonary function tests detected no pulmonary changes in these patients, but BAL demonstrated an increased alveolar lymphocytosis in eight of ten cases. SACE levels were increased in two cases, and the thoracic gallium uptake was normal in all cases. BAL appears to be the best technique for diagnosing latent pulmonary involvement in extrathoracic sarcoidosis.

Toxic epidermal necrolysis successfully treated with etanercept.

PubMed

Gubinelli, Emanuela; Canzona, Flora; Tonanzi, Tiziano; Raskovic, Desanka; Didona, Biagio

2009-03-01

Toxic epidermal necrolysis (TEN) is a rare and acute severe adverse reaction to drugs, characterised by massive apoptosis and widespread epidermal and mucosal detachment. Although no gold standard therapy exists, human i.v. immunoglobulins have recently been described as an effective treatment for this disease. We report a case of phenobarbital-induced TEN in a 59-year-old white woman where the epidermal detachment stopped 48 h after beginning the etanercept treatment with complete healing after 20 days. To the best of our knowledge, this is only the second reported case of TEN successfully treated with etanercept.

[Contact dermatitis from polyacrylate in TENS electrode].

PubMed

Weber-Muller, F; Reichert-Penetrat, S; Schmutz, J-L; Barbaud, A

2004-05-01

Transcutaneous electric nerve stimulation (TENS) is useful for many chronic pains. It induces few serious side effects, but skin reactions are not rare. We report on two cases of contact dermatitis due to TENS electrodes by sensitization to the acrylate in TENS conductive gel. A 50 year-old man suffered from post-traumatic lumbar pair. He developed eczematous lesions on the sites where the TENS electrodes were applied. Patch tests were positive with the TENS gel, with ethylene glycol dimethylacrylate (2 p. 100 petrolatum) and ethyl-acrylate (2 p. 100 petrolatum) on day 2 and 4 readings. A 54 Year-old man had a paralysis of the foot elevator following rupture of an aneurysm. After 2 months, he had an eczema on the sites where the TENS electrodes were applied. Patch tests were negative with the TENS electrodes but positive with 2-hydroxyethyl acrylate (0.1 p. 100 petrolatum), triethyleneglycol diacrylate (0.1 p. 100 petrolatum), 2-hydroxyethyl methacrylate (2 p. 100 petrolatum) and 2-hydroxypropyl methacrylate (2 p. 100 petrolatum) on day 2 and 4 readings. TENS transmits small electrical currents through the skin that induce the depolarization of the affected sensory nerve endings. They have few serious side effects but skin reactions such as irritation, burns or allergy to propylene glycol in the electrode gel, to the rubber of the electrodes (mercaptobenzothiazole) or to the metallic part of the electrodes, i.e. nickel, are not uncommon. To our knowledge, only one case of an allergy to the polyacrylates of TENS electrode gel has been previously reported in the literature. We emphasize that acrylate could be the main sensitizer in the more recently commercialized TENS electrodes and will propose alternative ways of treating patients sensitized to acrylate and who require treatment with TENS.

Community Politics and Educational Change. Ten School Systems Under Court Order.

ERIC Educational Resources Information Center

Willie, Charles V., Ed.; Greenblath, Susan L., Ed.

This book contains reports on ten school districts' responses to court ordered desegregation. The book begins with an historical background and a discussion of racial politics and community conflict. Following the introduction are the ten case studies, whose titles reveal the city and issues under examination: (1) "Boston, Massachusetts:…

8 CFR 1216.6 - Petition by entrepreneur to remove conditional basis of lawful permanent resident status.

Code of Federal Regulations, 2011 CFR

2011-01-01

... reasonable time ten full-time jobs for qualifying employees. In the case of a “troubled business” as defined... demonstrates to the director's satisfaction that failure to file a timely petition was for good cause and due... to create within a reasonable period of time ten full-time jobs to qualifying employees. In the case...

Management of Toxic Epidermal Necrolysis with Plasmapheresis and Cyclosporine A: Our 10 Years’ Experience

PubMed Central

Giudice, Giuseppe; Maggio, Giulio; Bufano, Loredana; Memeo, Giuseppe

2017-01-01

Background: The management of toxic epidermal necrolysis (TEN) is controversial and there is no uniform strategy. Objective: To share our 10 years’ experience in treating severe TEN with a novel protocol based on the association of cyclosporine A and plasmapheresis. Methods: In this case series, we retrospectively collected and assessed the 12 cases of severe TEN treated from 2005 to 2015 at the Burn Unit of the University of Bari Policlinico hospital. Results: Average body surface area was 77; average SCORETEN was 4.3. The 12 patients had been treated with culprit drug withdrawal, systemic corticosteroids, and/or cyclosporine A with no response. The protocol was successfully administered in all 12 cases. Average time to response from protocol start was 4.9 days. Average time to remission from protocol start was 22 days; average hospital stay at our unit was 24.8 days. Four patients developed severe complications; 1 patient died. No complications linked to the protocol therapeutic measures were observed. The relatively small number of cases given the rarity of the condition is a limitation of this report. Conclusion: Our protocol based on the association of cyclosporine A and plasmapheresis is safe and efficacious in treating severe TEN. PMID:28280663

The "Lost Boys" of Higher Education African American Males from Basic Skills through University Transfer

ERIC Educational Resources Information Center

Harvey, Marilyn Denise

2010-01-01

Ten African American men, who began their college career in Basic Skills courses at an urban community college in California and successfully transferred to a four-year college or university, share their life stories through that process in this case study. Their experiences differed from the literature in peer group interaction and definition, in…

[Treatment of Pilon fractures complicated with fractures of fibula with titanic elastic nailing].

PubMed

Liu, Yi-jun; Lin, Fu-qing; Guo, Yu-xiang

2010-02-01

To explore the effect of titanic elastic nailing (TEN) fixing for Pilon fractures complicated with fractures of fibula. From March 2007 to March 2009, 20 patients with Pilon fractures complicated with fractures of fibula were surgically treated with TEN. There were 14 males and 7 females with an average age of 42.6 years ranging from 35 to 70 years. Among them, 12 cases were on the left, 8 cases were on the right. All patients were followed-up for from 6 to 23 months (averaged 11.6 months). The symptoms of all patients had primarily relieved and the patients coulde ambulate at 2 to 3 months after treatment. According to Johner-Wruhs critera, the therapeutic results were excellent in 10 cases, good in 8 cases, fair in 2 cases. No case had skin infection and skin necrosis. Treatment of Pilon fractures complicated with fractures of fibula with TEN has the advantages such as less invasion, high rate of bone union and less soft tissue complication, it is a safe and effective procedure.

Less deep vein thrombosis due to transcutaneous fibular nerve stimulation in total knee arthroplasty: a randomized controlled trial.

PubMed

Izumi, Masashi; Ikeuchi, Masahiko; Aso, Koji; Sugimura, Natsuki; Kamimoto, Yuko; Mitani, Tetsuya; Ueta, Tadashi; Sato, Takayuki; Yokoyama, Masataka; Sugiura, Tetsuro; Tani, Toshikazu

2015-11-01

It has been known for years that deep vein thrombi (DVT) start to develop during total joint arthroplasty. Previously, we reported effective prevention of venous stasis by transcutaneous electrical nerve stimulation (TENS). It is hypothesized that TENS might be a thromboprophylactic tool for the limb undergoing surgery. The purpose of this study is to clarify the clinical efficacy and safety of TENS in patients during total knee arthroplasty (TKA). Ninety patients undergoing primary TKA were involved and randomly allocated to the TENS or control group. In the TENS group, electrical stimulation of the common fibular nerve, which produced a brisk dorsiflexion of the ankle, was performed for the operated leg during surgery. In the control group, no electrical stimulation was applied. Serum D-dimer and soluble fibrin monomer complex (SFMC) levels were measured before surgery, immediately after surgery, and post-operative day (POD) 1. Ultrasonography was performed on POD 1. Immediately after surgery, D-dimer and SFMC levels of each group were significantly lower in the TENS group compared with control (p < 0.05). The incidence of DVT was 11 % (five cases) in the TENS group while 31 % (14 cases) in control (p = 0.02). There were no adverse effects related to TENS. TENS during TKA showed significant effects on preventing DVT. Sustaining muscle pump activation during surgery prevented not only venous stasis, but also hypercoagulability of blood. Intraoperative TENS is a safe and novel strategy against early post-operative thromboembolism, which is difficult to be completed through existing prophylaxis after total joint arthroplasty. Randomized controlled trial, Level I.

Nonlinear dynamics in ecosystem response to climatic change: Case studies and policy implications

USGS Publications Warehouse

Burkett, Virginia R.; Wilcox, Douglas A.; Stottlemyer, Robert; Barrow, Wylie; Fagre, Dan; Baron, Jill S.; Price, Jeff; Nielsen, Jennifer L.; Allen, Craig D.; Peterson, David L.; Ruggerone, Greg; Doyle, Thomas

2005-01-01

Many biological, hydrological, and geological processes are interactively linked in ecosystems. These ecological phenomena normally vary within bounded ranges, but rapid, nonlinear changes to markedly different conditions can be triggered by even small differences if threshold values are exceeded. Intrinsic and extrinsic ecological thresholds can lead to effects that cascade among systems, precluding accurate modeling and prediction of system response to climate change. Ten case studies from North America illustrate how changes in climate can lead to rapid, threshold-type responses within ecological communities; the case studies also highlight the role of human activities that alter the rate or direction of system response to climate change. Understanding and anticipating nonlinear dynamics are important aspects of adaptation planning since responses of biological resources to changes in the physical climate system are not necessarily proportional and sometimes, as in the case of complex ecological systems, inherently nonlinear.

Oxcarbazepine induced toxic epidermal necrolysis - a rare case report.

PubMed

Guleria, Vivek S; Sharda, Chetan; Rana, Tanuja; Sood, A K

2015-01-01

Carbamazepine, is well known to cause Stevens-Johnson syndrome and toxic epidermal necrolysis(TEN). Oxcarbazepine, a 10-keto analog of carbamazepine, is an anticholinergic, anticonvulsant and mood stabilizing drug, used primarily in the treatment of epilepsy. Its efficacy is similar to carbamazepine but allergic reactions and enzyme induction is low. We describe a case of oxcarbazepine induced TEN, who presented with erythematous ulcerative maculopapular rash.

Toxic epidermal necrolysis.

PubMed

Castelain, Florence; Humbert, Philippe

2012-11-01

Toxic epidermal necrolysis (TEN) is a severe mucocutaneous drug-induced syndrome that causes massive keratinocyte apoptosis and therefore hydro-electrolytic disorders and systemic infection. TEN approximately affects one to two cases per million per year. Mortality rate may reach thirty percent of cases. Thus, TEN constitutes a therapeutic emergency at diagnosis. Typically, clinical examination shows a mucocutaneous detachment involving more than thirty percent of body area. Definitive diagnosis is made on cutaneous biopsy with histological exam that shows the blister of necrotic keratinocytes. Main differential diagnosis are acute staphylococcus epidermis, acute generalized exanthematous pustulosis, linear IgA bullous dermatosis, paraneoplastic pemphigus, bullous fixed pigmented erythema, acute lupus erythematosus. In the early days, SCORTEN gives a good estimation and is now widely used as prognostic score. Drugs are generally considered as the main etiology of TEN but in some cases bacterial or viral infections could be involved. Physiopathology remains unclear even if recent advances have reported the possible implication of immune pathways based on activation of T and NK cells. Treatment of TEN requires to be instituted as soon as the diagnosis is made and the patient is preferentially referred to a specialized unit. Supportive care consist of covering areas of cutaneous detachment. No other therapy has demonstrated its efficiency, but high-dose intravenous immunoglobulin might improve the prognosis.

Management of Stevens-Johnson Syndrome-Toxic Epidermal Necrolysis: Looking Beyond Guidelines!

PubMed Central

Kumar, Rajesh; Das, Anupam; Das, Sudip

2018-01-01

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse reactions, which are mainly caused by drugs; and these are usually associated with high degree of morbidity and mortality. Recently, two detailed guidelines were published on the management of SJS/TEN, Indian guidelines and UK guidelines. Still, there is no consensus on the management of SJS/TEN. In this article, our aim is to conceptualize the management aspect of SJS/TEN considering Indian setup. Early discontinuation of all medicines, supportive measures (hydration, electrolytes, and care of denuded skin), corticosteroids and cyclosporine has been found to be useful. Oral provocation test is reserved for patients, who undergo complete remission and this is to be done after hospitalization, under strict vigilance. As there is no consensus, the treatment should be individualized on case to case basis. PMID:29692452

An Investigation of the Effects of Different Pulse Patterns of Transcutaneous Electrical Nerve Stimulation (TENS) on Perceptual Embodiment of a Rubber Hand in Healthy Human Participants With Intact Limbs.

PubMed

Mulvey, Matthew R; Fawkner, Helen J; Johnson, Mark I

2015-12-01

The aim of this study was to investigate the strength of perceptual embodiment achieved during an adapted version of the rubber hand illusion (RHI) in response to a series of modified transcutaneous electrical nerve stimulation (TENS) pulse patterns with dynamic temporal and spatial characteristics which are more akin to the mechanical brush stroke in the original RHI. A repeated-measures counterbalanced experimental study was conducted where each participant was exposed to four TENS interventions: continuous pattern TENS; burst pattern TENS (fixed frequency of 2 bursts per second of 100 pulses per second); amplitude-modulated pattern TENS (intensity increasing from zero to a preset level, then back to zero again in a cyclical fashion); and sham (no current) TENS. Participants rated the intensity of the RHI using a three-item numerical rating scale (each item was ranked from 0 to 10). Friedman's analysis of ranks (one-factor repeated measure) was used to test the differences in perceptual embodiment between TENS innervations; alpha was set at p ≤ 0.05. There were statistically significant differences in the intensity of misattribution and perceptual embodiment between sham and active TENS interventions, but no significant differences between the three active TENS conditions (amplitude-modulated TENS, burst TENS, and continuous TENS). Amplitude-modulated and burst TENS produced significantly higher intensity scores for misattribution sensation and perceptual embodiment compared with sham (no current) TENS, whereas continuous TENS did not. The findings provide tentative, but not definitive, evidence that TENS parameters with dynamic spatial and temporal characteristics may produce more intense misattribution sensations and intense perceptual embodiment than parameters with static characteristics (e.g., continuous pulse patterns). © 2015 International Neuromodulation Society.

Systemic lupus erythematosus presenting as Stevens-Johnson syndrome/toxic epidermal necrolysis.

PubMed

Baker, Mary Grace; Cresce, Nicole D; Ameri, Mariam; Martin, Adam A; Patterson, James W; Kimpel, Donald L

2014-04-01

Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN)-like lesions in acute cutaneous lupus erythematosus [LE]) are an unusual manifestation of systemic LE. We describe a patient with widespread vesiculobullous lesions diagnosed as SJS/TEN-like acute cutaneous LE as the initial presentation of systemic LE. Stevens-Johnson syndrome/TEN-like LE may be differentiated from other vesiculobullous lesions by factors including a history of recent LE exacerbation, photodistribution of lesions, lack of a precipitating infection or medication exposure, minimal mucosal involvement, a prolonged course, response steroid treatment, and histologic and immunofluorescence findings. It is paramount to identify SJS/TEN-like LE as this condition requires early and aggressive intervention. The optimal treatment approach for SJS/TEN-like LE is unclear, and although some case reports have shown glucocorticoids to be useful, there are also reports of cases in which additional measures, such as intravenous immunoglobulin and plasmapheresis, were required to achieve a response. Our patient's condition was refractory to high-dose corticosteroids and intravenous immunoglobulin but was successfully treated using plasma exchange. As such, this treatment may hold potential for improving the care of other patients with refractory SJS/TEN-like LE.

Bone marrow trephine morphology and immunohistochemical findings in chronic myelomonocytic leukaemia.

PubMed

Ngo, Nye-Thane; Lampert, Irvin A; Naresh, Kikkeri N

2008-06-01

Chronic myelomonocytic leukaemia (CMML) is a clonal disorder with myelodysplastic/myeloproliferative features. Its diagnosis is based on the presence of peripheral blood monocytosis and bone marrow aspirate findings, according to World Health Organization criteria. However, bone marrow trephine biopsy (BMTB) features characteristic of CMML have not been adequately investigated. We studied BMTB in 20 cases of CMML-1 and three cases of CMML-2 and compared with ten cases of polycythaemia vera, ten cases of chronic myeloid leukaemia (chronic phase) and ten cases of florid myeloid hyperplasia (MH). Furthermore, we evaluated the use of CD34, CD117 and CD68 (PGM-1) antibodies in diagnosis and subtyping of CMML and in differentiating from other categories. Hypercellularity, high myeloid:erythroid ratio, increased proportion of 'myelo/monocytic' cells often seen as clusters and/or nodules, absence of eosinophilia, and presence of abnormal localisation of immature precursors (ALIP) and dysmegakaryopoiesis can aid in the diagnosis of CMML in BMTB. CD68 (PGM-1) positive cells amounted to 20.7 +/- 6.1% cells among CMML trephines. The proportion of CD34(+) cells among cases of CMML-1 was /=10% cells in two of three cases and 5% in the other case. Morphological and immunohistochemical features of BMTB samples are extremely helpful in the diagnosis of CMML.

Diffusion tensor imaging depicting damage to the arcuate fasciculus in patients with conduction aphasia: a study of the Wernicke-Geschwind model.

PubMed

Zhang, Yumei; Wang, Chunxue; Zhao, Xingquan; Chen, Hongyan; Han, Zaizhu; Wang, Yongjun

2010-09-01

In contrast with disorders of comprehension and spontaneous expression, conduction aphasia is characterized by poor repetition, which is a hallmark of the syndrome. There are many theories on the repetition impairment of conduction aphasia. The disconnection theory suggests that a damaged in the arcuate fasciculus, which connects Broca's and Wernicke's area, is the cause of conduction aphasia. In this study, we examined the disconnection theory. We enrolled ten individuals with conduction aphasia and ten volunteers, and analysed their arcuate fasciculus using diffusion tensor imaging (DTI) and obtained fractional anisotropy (FA) values. Then, the results of the left hemisphere were compared with those of the right hemisphere, and the results of the conduction aphasia cases were compared with those of the volunteers. There were significant differences in the FA values between the left and right hemispheres of volunteers and conduction cases. In volunteers, there was an increase in fiber in the left hemisphere compared with the right hemisphere, whereas there was an increase in fiber in the right hemisphere compared with the left hemisphere in conduction aphasia patients. The results of diffusion tensor tractography suggested that the configuration of the arcuate fasciculus was different between conduction aphasia patients and volunteers, suggesting that there was damage to the arcuate fasciculus of conduction aphasia cases. The damage seen in the arcuate fasciculus of conduction aphasia cases in this study supports the Wernicke-Geschwind disconnection theory. A disconnection between Broca's area and Wernicke's area is likely to be one mechanism of conduction aphasia repetition impairment.

Necrotizing Fasciitis - Report of ten cases and review of recent literature

PubMed Central

Al Shukry, S; Ommen, J

2013-01-01

Necrotizing fasciitis is an uncommon disease that results in gross morbidity and mortality if not diagnosed and treated in its early stages. At onset, however, it is difficult to differentiate from other superficial skin conditions such as cellulitis. Family physicians must have a high level of suspicion and low threshold for surgical referral when confronted with cases of pain, fever, and erythema. We present ten cases of necrotizing fasciitis managed in a provincial secondary hospital in Oman over 3 years ago. A review of recent literature is also presented. PMID:23904882

Oxcarbazepine induced toxic epidermal necrolysis - a rare case report

PubMed Central

Guleria, Vivek S.; Sharda, Chetan; Rana, Tanuja; Sood, A. K.

2015-01-01

Carbamazepine, is well known to cause Stevens–Johnson syndrome and toxic epidermal necrolysis(TEN). Oxcarbazepine, a 10-keto analog of carbamazepine, is an anticholinergic, anticonvulsant and mood stabilizing drug, used primarily in the treatment of epilepsy. Its efficacy is similar to carbamazepine but allergic reactions and enzyme induction is low. We describe a case of oxcarbazepine induced TEN, who presented with erythematous ulcerative maculopapular rash. PMID:26288485

The Critical Period for Second Language Pronunciation: Is There Such a Thing? Ten Case Studies of Late Starters who Attained a Native-like Hebrew Accent

ERIC Educational Resources Information Center

Abu-Rabia, Salim; Kehat, Simona

2004-01-01

This paper investigates the critical period hypothesis (CPH) for the acquisition of a second language sound system (phonology) in a naturalistic setting. Ten cases of successful late-starters with a native-like Hebrew pronunciation are presented in an effort to determine possible variables that may account for their exceptional accomplishment. The…

[Mechanisms and applications of transcutaneous electrical nerve stimulation in analgesia].

PubMed

Tang, Zheng-Yu; Wang, Hui-Quan; Xia, Xiao-Lei; Tang, Yi; Peng, Wei-Wei; Hu, Li

2017-06-25

Transcutaneous electrical nerve stimulation (TENS), as a non-pharmacological and non-invasive analgesic therapy with low-cost, has been widely used to relieve pain in various clinical applications, by delivering current pulses to the skin area to activate the peripheral nerve fibers. Nevertheless, analgesia induced by TENS varied in the clinical practice, which could be caused by the fact that TENS with different stimulus parameters has different biological mechanisms in relieving pain. Therefore, to advance our understanding of TENS in various basic and clinical studies, we discussed (1) neurophysiological and biochemical mechanisms of TENS-induced analgesia; (2) relevant factors that may influence analgesic effects of TENS from the perspectives of stimulus parameters, including stimulated position, pulse parameters (current intensity, frequency, and pulse width), stimulus duration and used times in each day; and (3) applications of TENS in relieving clinical pain, including post-operative pain, chronic low back pain and labor pain. Finally, we propose that TENS may involve multiple and complex psychological neurophysiological mechanisms, and suggest that different analgesic effects of TENS with different stimulus parameters should be taken into consideration in clinical applications. In addition, to optimize analgesic effect, we recommend that individual-based TENS stimulation parameters should be designed by considering individual differences among patients, e.g., adaptively adjusting the stimulation parameters based on the dynamic ratings of patients' pain.

Wrapping rules (in) string theory

NASA Astrophysics Data System (ADS)

Bergshoeff, Eric A.; Riccioni, Fabio

2018-01-01

In this paper we show that the number of all 1/2-BPS branes in string theory compactified on a torus can be derived by universal wrapping rules whose formulation we present. These rules even apply to branes in less than ten dimensions whose ten-dimensional origin is an exotic brane. In that case the wrapping rules contain an additional combinatorial factor that is related to the highest dimension in which the ten-dimensional exotic brane, after compactification, can be realized as a standard brane. We show that the wrapping rules also apply to cases with less supersymmetry. As a specific example, we discuss the compactification of IIA/IIB string theory on ( T 4/ ℤ 2) × T n .

Phenytoin-induced toxic epidermal necrolysis: Review and recommendations

PubMed Central

Al-Quteimat, Osama M.

2016-01-01

Toxic epidermal necrolysis (TEN) is a serious, life-threatening skin reaction characterized by severe exfoliation and destruction of the epidermis of the skin. In most TEN cases, drugs are believed to be the causative agent; antipsychotics, antiepileptics, and other medications such as sulfonamides are among the most common causes of drug-induced TEN. Phenytoin, a commonly prescribed medication for seizure, was found to cause TEN. Evidence-based treatment guidelines are lacking, so the best strategy is to identify and avoid potential risk factors and to provide intensive supportive care. The aim of this literature review is to focus on phenytoin-induced TEN, to explore the risk factors, and to highlight the possible treatment options once phenytoin-induced TEN is confirmed. PMID:27651708

Effects of supplemental measles immunization on cases of measles admitted at the Wesley Guild Hospital, Ilesa, Nigeria.

PubMed

Peter, Kuti Bankole; Ademola, Adegoke Samuel; Oyeku, Oyelami Akibu

2014-03-01

Measles is a highly contagious vaccine-preventable infection which continues to be a significant cause of childhood morbidity and mortality in developing countries particularly those with poor routine immunisation coverage. Supplemental immunisation activities (SIAs) were thus introduced to improve vaccine coverage. This study was carried out to assess the impact of the supplemental measles vaccinations on the cases of measles admitted at a tertiary health facility in South west Nigeria. Weretrospectivelylooked at therecords of cases of measles in children admitted to the Wesley Guild Hospital, Ilesa over a ten year period (2001 - 2010); five years before and five years after the nationwide commencement of supplemental measles immunisation activities (SIAs) in the region in 2006. Measles cases were defined using the WHO case definition. Over the ten year study period, a total of 12,139 children were admitted andmanaged; out of which 302 (2.5%) were cases of complicated measles. There was no difference in the mean (SD) of children admitted in the years before and after the introduction of the SIAs {6040 (122.7) vs.6099 (120.2); t-test 0.02, p =0.988.} There was however a remarkable reduction in the proportion of the cases of measles admitted after the introduction of SIAs compared to the period before SIAs (4.3% vs. 0.6% x2=169.580; p < 0.001). SIAs have remarkably reduced morbidity and mortality associated with measles in the region. We advocate for sustenance of these efforts as well as improvement in routine immunisation coverage to avoid a backlash which can lead to devastating measles outbreak.

[10 congenital trigger fingers. Apropos of a case report].

PubMed

Moutet, F; Lebrun, C; Sartorius, C

1987-01-01

Ten congenital triggers fingers have been treated on a 3 years old girl after correction of congenital bilateral club feet. Such a case, without any other congenital malformation seems to be unique in the French literature and only found twice in the English one. This child in spite of a normal growth and good psychomotor development, presents an unusual face, with a mouth a little bit too small, but her karyotype is normal. No trismus and no microstomia were found to enable this case to be classified in a specific syndrome. The right diagnosis may be a non evolutive arthrogryposis of the extremities. Dividing the ten proximal pulleys (A1) let 10 voluminous nodules pass through and allowed full range of motion in nine out of ten fingers. A remaining flexion deformity of the proximal interphalangeal joint needed an anterior arthrolysis, the final result was good.

Skin rash in the intensive care unit: Stevens-Johnson syndrome, toxic epidermal necrolysis, or a rare manifestation of a hidden cutaneous malignancy: A case report.

PubMed

Al-Saffar, Farah; Ibrahim, Saif; Patel, Pujan; Jacob, Rafik; Palacio, Carlos; Cury, James

2016-03-01

Skin rashes are infrequently encountered in the intensive care units, either as a result or as a cause of admission. The entities of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) form a spectrum of desquamating skin diseases that have multiple etiologies, the most common being drug-related reactions; very rarely, the cause may be cutaneous malignancies. We herein present a unique case of a 54-year-old male patient with psoriasis treated with methotrexate, who presented with a cellulitis-like clinical picture, then developed a severe progressive systemic inflammatory response syndrome, and progressed clinically to SJS, then TEN even after discontinuing the antibiotics and methotrexate. A skin biopsy demonstrated an aggressive and rapidly-progressing T-cell lymphoma. The present case highlights the necessity of skin biopsy when encountering SJS and TEN in the ICU in order to identify potentially treatable/controllable causes. Although it appeared reasonable to correlate TEN solely to medications, the skin biopsies clearly demonstrated an aggressive T-cell skin lymphoma. In a patient with a better general condition it may have been helpful to treat this malignancy. TEN is a life-threatening condition and skin biopsy is the cornerstone of diagnosis, despite the presence of multiple risk factors and the typical physical findings of a drug-induced reaction.

Ten cases with 46,XX testicular disorder of sex development: single center experience.

PubMed

Akinsal, Emre Can; Baydilli, Numan; Demirtas, Abdullah; Saatci, Cetin; Ekmekcioglu, Oguz

2017-01-01

To present clinical, chromosomal and hormonal features of ten cases with SRY-positive 46,XX testicular disorder of sex development who were admitted to our infertility clinic. Records of the cases who were admitted to our infertility clinic between 2004 and 2015 were investigated. Ten 46,XX testicular disorder of sex development cases were detected. Clinical, hormonal and chromosomal assessments were analized. Mean age at diagnosis was 30.4, mean body height was 166.9cm. Hormonal data indicated that the patients had a higher FSH, LH levels, lower TT level and normal E2, PRL levels. Karyotype analysis of all patients confirmed 46,XX karyotype, and FISH analysis showed that SRY gene was positive and translocated to Xp. The AZFa, AZFb and AZFc regions were absent in 8 cases. In one case AZFb and AZFc incomplete deletion and normal AZFa region was present. In the other one all AZF regions were present. Gonadal development disorders such as SRY-positive 46,XX testicular disorder of sex development can be diagnosed in infertility clinics during infertility workup. Although these cases had no chance of bearing a child, they should be protected from negative effects of testosterone deficiency by replacement therapies. Copyright® by the International Brazilian Journal of Urology.

Hypoalgesia in response to transcutaneous electrical nerve stimulation (TENS) depends on stimulation intensity.

PubMed

Moran, Fidelma; Leonard, Tracey; Hawthorne, Stephanie; Hughes, Ciara M; McCrum-Gardner, Evie; Johnson, Mark I; Rakel, Barbara A; Sluka, Kathleen A; Walsh, Deirdre M

2011-08-01

Transcutaneous electrical nerve stimulation (TENS) is an electrophysical modality used for pain management. This study investigated the dose response of different TENS intensities on experimentally induced pressure pain. One hundred and thirty TENS naïve healthy individuals (18-64 years old; 65 males, 65 females) were randomly allocated to 5 groups (n = 26 per group): Strong Non Painful TENS; Sensory Threshold TENS; Below Sensory Threshold TENS; No Current Placebo TENS; and Transient Placebo TENS. Active TENS (80 Hz) was applied to the forearm for 30 minutes. Transient Placebo TENS was applied for 42 seconds after which the current amplitude automatically reset to 0 mA. Pressure pain thresholds (PPT) were recorded from 2 points on the hand and forearm before and after TENS to measure hypoalgesia. There were significant differences between groups at both the hand and forearm (ANOVA; P = .005 and .002). At 30 minutes, there was a significant hypoalgesic effect in the Strong Non Painful TENS group compared to: Below Sensory Threshold TENS, No Current Placebo TENS and Transient Placebo TENS groups (P < .0001) at the forearm; Transient Placebo TENS and No Current Placebo TENS groups at the hand (P = .001). There was no significant difference between Strong Non Painful TENS and Sensory Threshold TENS groups. The area under the curve for the changes in PPT significantly correlated with the current amplitude (r(2) = .33, P = .003). These data therefore show that there is a dose-response effect of TENS with the largest effect occurring with the highest current amplitudes. This study shows a dose response for the intensity of TENS for pain relief with the strongest intensities showing the greatest effect; thus, we suggest that TENS intensity should be titrated to achieve the strongest possible intensity to achieve maximum pain relief. Copyright © 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.

Erythema multiforme, Stevens-Johnson syndrome and toxic epidermal necrolysis: a comparative review.

PubMed

Yager, Julie A

2014-10-01

Human erythema multiforme (EM) and Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) are separate conditions. There is no consensus on classification criteria for the eponymous diseases in animals. Animal EM is very different from 90% of human EM, which is herpes virus associated (HAEM). Animals lack acrally distributed, typical raised targets. Unlike canine parvovirus 'EM', HAEM is not an active infection. Animal EM is often attributed to drugs, but this is rarely proved. Conversely, human and animal SJS/TEN are almost identical, life-threatening disorders of epidermal necrosis and detachment, typically triggered by drugs (occasionally by infectious agents). Both EM and SJS/TEN are mediated by cytotoxic lymphocyte responses against altered keratinocytes (infectious agents or drugs). Apoptosis results from direct cytotoxicity or through soluble mediators, namely Fas ligand, granzymes, perforin and granulysin. Diagnosis in humans is clinicopathological, with emphasis on clinical lesions; histopathology confirms the pathological process as interface (cytotoxic) dermatitis. Human EM is self-limiting; only recurrent and rare persistent cases require antiviral/immunosuppressive therapies. Drug-induced EM responds to drug withdrawal. Idiopathic canine EM (>40%) is usually chronic, refractory to treatment and may represent heterogeneous conditions. Early identification and removal of the causative drug and high-quality supportive care are critical in SJS/TEN. Mortality rate is nevertheless high. (1) Histopathological lesions do not reliably differentiate EM, SJS and TEN. (2) A multicentre study to develop a consensus set of clinical criteria for EM and SJS/TEN in animals is overdue. (3) No adjunctive therapies, including intravenous immunoglobulin and ciclosporin, have met evidence-based standards. © 2014 ESVD and ACVD.

Natura abhorret a vacuo--use of fibrin glue as a filler and sealant in neurosurgical "dead spaces". Technical note.

PubMed

Cappabianca, Paolo; Esposito, Felice; Magro, Francesco; Cavallo, Luigi Maria; Solari, Domenico; Stella, Lucio; de Divitiis, Oreste

2010-05-01

The objective of this study is to report our experience and illustrate our technique in the use of fibrin glue in the treatment of post-operatory cerebrospinal fluid (CSF) leaks and collections following different neurosurgical procedures. In a 3-year period, 40 subjects underwent endoscopic endonasal approach for different sellar and skull base lesions (three tuberculum sellae meningiomas, six craniopharyngiomas, three Rathke's cleft cysts and 28 pituitary macroadenomas), in which an intraoperative CSF leakage was evident. In such subjects, the fibrin glue was used as a first step of the final phase of the procedure-i.e. the reconstruction of the skull base defect-followed by the other materials employed. Furthermore, ten other patients, who had undergone transsphenoidal (four cases), spinal (two cases), posterior fossa (three cases) and transcortical intraventricular tumour removal (one case) neurosurgical procedures and developed CSF leaks or collections, were conservatively treated by single or repeated in situ injections of "modified" fibrin glue under local anaesthesia according to different described techniques. In total, 50 patients constitute the clinical material of the present study. In the cases where the fibrin glue was used during the reconstruction phase of the procedure (40 cases), the glue was injected inside the tumour cavity to fill the dead space left by the removal of the lesion. In case of post-operative CSF leak or CSF fluid collection (ten cases), after discarding 50-80% of the thrombin solution to obtain prevalence of the product's adhesive properties, fibrin glue was injected directly in the path of the CSF leak or into the collection cavity after aspiration of the collection's content. This was performed with the provided application system or through lumbar or Tuohy needles. Applications were repeated every 48 h until the disappearance of the leak. In all the treated cases, the disappearance of CSF leaks or collections was obtained with a number of applications ranging from one to five. Successful results are stable with a follow-up ranging from 6 months to 3 years. In our experience, the injection of fibrin glue has proved to be effective in filling or sealing post-operative "dead spaces" and treating minor or initial CSF leaks resulting from procedures of transsphenoidal, cranial and spinal surgery, adding another possibility in the management of many of these dreadful complications.

Impact of glutathione transferases genes polymorphisms in nevirapine adverse reactions: a possible role for GSTM1 in SJS/TEN susceptibility.

PubMed

Ciccacci, Cinzia; Latini, Andrea; Politi, Cristina; Mancinelli, Sandro; Marazzi, Maria C; Novelli, Giuseppe; Palombi, Leonardo; Borgiani, Paola

2017-10-01

Nevirapine (NVP) is used in developing countries as first-line treatment of HIV infection. Unfortunately, its use is associated with common serious adverse drug reactions, such as liver toxicity and the most severe and rare Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). GSTT1 and GSTM1 genes code for enzymes involved in the metabolism of a wide range of drugs. We hypothesized that this gene variability could be implicated in NVP adverse reactions. We analyzed the GSTM1 and GSTT1 null genotypes by multiplex PCR in a population of 181 patients from Mozambique, treated with NVP. A case/control association study was performed. We also counted the number of risk alleles in SJS/TEN patients and in controls, including the GSTM1 null genotype and four previously identified risk alleles in CYP2B6, HCP5, and TRAF3IP2 genes. Among patients, 27 had developed SJS/TEN and 76 had developed hepatotoxicity during the treatment. The GSTM1 null genotype was more frequent in the cases with SJS/TEN than in the controls (OR = 2.94, P = 0.027). This association is also observed when other risk factors are taken into account, by a multivariate analysis (P = 0.024 and OR = 3.58). The risk allele counting analysis revealed a significantly higher risk for SJS/TEN in patients carrying three or four risk alleles. Moreover, all subjects with five or six risk alleles developed SJS/TEN, while subjects without any risk alleles were present only in the control group. We observed an association between GSTM1 and SJS/TEN susceptibility. Moreover, GSTM1 contributes to the definition of a genetic risk profile for SJS/TEN susceptibility.

[Vemurafenib-induced toxic epidermal necrolysis].

PubMed

Wantz, M; Spanoudi-Kitrimi, I; Lasek, A; Lebas, D; Quinchon, J-F; Modiano, P

2014-03-01

Herein we report the first case of toxic epidermal necrolysis (TEN) occurring with use of vemurafenib. A 75-year-old female patient was being treated with vemurafenib for stage IV melanoma with BRAF V600E mutation. She suddenly presented fever, diffuse pruriginous maculopapular erythema, palpebral edema, palmar bulla, conjunctivitis, cheilitis and mucosal ulceration. The condition progressed towards detachment affecting 50% of the skin area. Cutaneous biopsy revealed lichenoid dermatosis, chiefly vesicular with numerous eosinophils. Direct immunofluorescence (IFD) was negative. Vemurafenib was the only drug to which the reaction was ascribable and we concluded on vemurafenib-induced TEN. To our knowledge, this is the first reported case of vemurafenib-induced TEN, but this adverse effect, although already described in the BRIM-3 study, appears rare in clinical practice. Other severe skin reactions have been described in the literature. These include a case of Stevens-Johnson syndrome in a female patient treated with vemurafenib and previously receiving ipilimumab. A more common occurrence is cutaneous reactions involving efflorescence of benign hyperkeratotic lesions, occasionally accompanied by authentic epidermal carcinoma or keratoacanthoma, and requiring regular dermatological monitoring of patients treated with vemurafenib. If maculopapular exanthema occurs under vemurafenib, continuation of this treatment should be reassessed since the risk of progression to a more serious condition such as TEN, as seen in the present case, cannot be ruled out. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

GENDER DIFFERENCES IN INTIMATE PARTNER HOMICIDES AMONG ETHNIC SUBGROUPS OF ASIANS

PubMed Central

SABRI, BUSHRA; CAMPBELL, JACQUELYN C.; DABBY, FIROZA CHIC

2013-01-01

This study explored differences in intimate partner homicides (IPHs) among Asian Americans. Data from newspapers and femicide reports by different state coalitions on 125 intimate partner killings occurring between 2000 and 2005 was analyzed. Men were the perpetrators in nearly nine out of ten cases of Asian IPHs. Gender differences were found in ages of victims and perpetrators, types of relationship between partners, and methods of killing. Most homicides occurred among South-east Asians, and East Asians had the highest within group proportion of suicides. The findings call for culturally competent risk assessment and intervention strategies to prevent IPHs among at-risk Asian Americans. PMID:26391620

Titanium template for scaphoid reconstruction.

PubMed

Haefeli, M; Schaefer, D J; Schumacher, R; Müller-Gerbl, M; Honigmann, P

2015-06-01

Reconstruction of a non-united scaphoid with a humpback deformity involves resection of the non-union followed by bone grafting and fixation of the fragments. Intraoperative control of the reconstruction is difficult owing to the complex three-dimensional shape of the scaphoid and the other carpal bones overlying the scaphoid on lateral radiographs. We developed a titanium template that fits exactly to the surfaces of the proximal and distal scaphoid poles to define their position relative to each other after resection of the non-union. The templates were designed on three-dimensional computed tomography reconstructions and manufactured using selective laser melting technology. Ten conserved human wrists were used to simulate the reconstruction. The achieved precision measured as the deviation of the surface of the reconstructed scaphoid from its virtual counterpart was good in five cases (maximal difference 1.5 mm), moderate in one case (maximal difference 3 mm) and inadequate in four cases (difference more than 3 mm). The main problems were attributed to the template design and can be avoided by improved pre-operative planning, as shown in a clinical case. © The Author(s) 2014.

[Use of intravenous immunoglobulin for the treatment of toxic epidermal necrolysis and Stevens-Johnson/toxic epidermal necrolysis overlap syndrome. Review of 15 cases].

PubMed

Molgó, Montserrat; Carreño, Néstor; Hoyos-Bachiloglu, Rodrigo; Andresen, Max; González, Sergio

2009-03-01

Toxic epidemial necrolysis (TEN) is an acute adverse drug reaction, that has an unpredictableprogression and a 30% mortality. The incidence of TEN in the general population is approximately 0.4 to 1.2 cases/million/year. It is characterized pathologically by keratinocyte apoptosis which leads to epidemial detachment. Keratinocyte apoptosis is triggered by activation of the Fas-FasL, pathway and could be prevented by the use of intravenous immunoglobulin (IVIG). To report the experience with the use of IVIG in TEN. Retrospective study of 15 patients with a diagnosis of Stevens-Johnson/TEN overlap (SJS/TEN) or TEN, that received a total dose of 23 +/- 0.6 mg/kg ofIVIG over aperiod of 3 to 4 days. The infusión was initiated during thefirst 24 hours after diagnosis and was associated with standard care for burn victims. Steroids were avoided if the patient was not in chronic steroidal therapy. Allpatients responded to IVIG in a lapse of 46.4 +/- 14.2 hours from the beginning of infusión. Eighty percent of patients survived, but one developed acute renal failure due to IVIG, and another became blind due to corneal opacities, a complication of TEN. Those who survived were discharged after a lapse of 19-8 +/- 6.6 days from the beginning ofthe disease. Despite the lack of blind, multicentric and randomized triáis, we agree with some international studies that TVIG is beneficial as a treatment for SSJ/NETand TEN .

A comparative analysis of media reports of U.S. parricide cases with officially reported national crime data and the psychiatric and psychological literature.

PubMed

Heide, Kathleen M; Boots, Denise Paquette

2007-12-01

This article is a content analysis of 150 unique cases of children killing parents in the United States as reported in the electronic news media. The accuracy of online coverage of U.S. parricide incidents is assessed using two types of resources: officially reported national statistics on known parricidal incidents and the psychological and psychiatric literature on matricide and patricide. Comparisons of news accounts of media-reported U.S. parricide cases with Supplementary Homicide Report data indicate that electronic media coverage of parricide cases focused on the more sensational and unusual parricides. Analyses of these media accounts by offender age found 13 significant differences between juvenile and adult offenders. Ten of these 13 differences related to motive and Heide's parricide offender types (severely abused, severely mentally ill, and dangerously antisocial) and were consistent with the mental health-related literature in this area. The limitations and directions for future research are discussed at length.

Voluntary activation of the trapezius muscle in cases with neck/shoulder pain compared to healthy controls.

PubMed

Bech, Katrine Tholstrup; Larsen, Camilla Marie; Sjøgaard, Gisela; Holtermann, Andreas; Taylor, Janet L; Søgaard, Karen

2017-10-01

Subjects reporting neck/shoulder pain have been shown to generate less force during maximal voluntary isometric contractions (MVC) of the shoulder muscles compared to healthy controls. This has been suggested to be caused by a pain-related decrease in voluntary activation (VA) rather than lack of muscle mass. The aim of the present study was to investigate VA of the trapezius muscle during MVCs in subjects with and without neck/shoulder pain by use of the twitch interpolation technique. Ten cases suffering from pain and ten age and gender matched, healthy controls were included in the study. Upper trapezius muscle thickness was measured using ultrasonography and pain intensity was measured on a 100mm visual analog scale (VAS). VA was calculated from five maximal muscle activation attempts. Superimposed stimuli were delivered to the accessory nerve at peak force and during a 2% MVC following the maximal contraction. Presented as mean±SD for cases and controls, respectively: VAS; 16.0±14.4mm and 2.1±4.1mm (P=0.004), MVC; 545±161N and 664±195N (P=0.016), upper trapezius muscle thickness; 10.9±1.9mm and 10.4±1.5mm (P=0.20), VA; 93.6±14.2% and 96.3±6.0% (P=0.29). In spite of significantly eight-fold higher pain intensity and ∼20% lower MVC for cases compared to controls, no difference was found in VA. Possible explanations for the reduction in MVC could be differences in co-activation of antagonists and synergists as well as muscle quality. Copyright © 2017 Elsevier Ltd. All rights reserved.

Different mechanisms for the short-term effects of real versus sham transcutaneous electrical nerve stimulation (TENS) in patients with chronic pain: a pilot study.

PubMed

Oosterhof, Jan; Wilder-Smith, Oliver H; Oostendorp, Rob A; Crul, Ben J

2012-01-01

Transcutaneous electrical nerve stimulation (TENS) has existed since the early 1970s. However, randomized placebo controlled studies show inconclusive results in the treatment of chronic pain. These results could be explained by assuming that TENS elicits a placebo response. However, in animal research TENS has been found to decrease hyperalgesia, which contradicts this assumption. The aim of this study is to use quantitative sensory testing to explore changes in pain processing during sham versus real TENS in patients with chronic pain. Patients with chronic pain (N = 20) were randomly allocated to real TENS or sham TENS application. Electrical pain thresholds (EPTs) were determined inside and outside the segment stimulated, before and after the first 20 minutes of the intervention, and after a period of 10 days of daily real/sham TENS application. Pain relief did not differ significantly for real versus sham TENS. However, by comparing time courses of EPTs, it was found that EPT values outside the segment of stimulation increased for sham TENS, whereas for real TENS these values decreased. There were, however, no differences for EPT measurements inside the segment stimulated. These results illustrate the importance of including mechanism-reflecting parameters in addition to symptoms when conducting pain research.

3D printed renal cancer models derived from MRI data: application in pre-surgical planning.

PubMed

Wake, Nicole; Rude, Temitope; Kang, Stella K; Stifelman, Michael D; Borin, James F; Sodickson, Daniel K; Huang, William C; Chandarana, Hersh

2017-05-01

To determine whether patient-specific 3D printed renal tumor models change pre-operative planning decisions made by urological surgeons in preparation for complex renal mass surgical procedures. From our ongoing IRB approved study on renal neoplasms, ten renal mass cases were retrospectively selected based on Nephrometry Score greater than 5 (range 6-10). A 3D post-contrast fat-suppressed gradient-echo T1-weighted sequence was used to generate 3D printed models. The cases were evaluated by three experienced urologic oncology surgeons in a randomized fashion using (1) imaging data on PACS alone and (2) 3D printed model in addition to the imaging data. A questionnaire regarding surgical approach and planning was administered. The presumed pre-operative approaches with and without the model were compared. Any change between the presumed approaches and the actual surgical intervention was recorded. There was a change in planned approach with the 3D printed model for all ten cases with the largest impact seen regarding decisions on transperitoneal or retroperitoneal approach and clamping, with changes seen in 30%-50% of cases. Mean parenchymal volume loss for the operated kidney was 21.4%. Volume losses >20% were associated with increased ischemia times and surgeons tended to report a different approach with the use of the 3D model compared to that with imaging alone in these cases. The 3D printed models helped increase confidence regarding the chosen operative procedure in all cases. Pre-operative physical 3D models created from MRI data may influence surgical planning for complex kidney cancer.

A Feasibility Study on the Use of a Structured Light Depth-Camera for Three-Dimensional Body Measurements of Dairy Cows in Free-Stall Barns

PubMed Central

2018-01-01

Frequent checks on livestock’s body growth can help reducing problems related to cow infertility or other welfare implications, and recognizing health’s anomalies. In the last ten years, optical methods have been proposed to extract information on various parameters while avoiding direct contact with animals’ body, generally causes stress. This research aims to evaluate a new monitoring system, which is suitable to frequently check calves and cow’s growth through a three-dimensional analysis of their bodies’ portions. The innovative system is based on multiple acquisitions from a low cost Structured Light Depth-Camera (Microsoft Kinect™ v1). The metrological performance of the instrument is proved through an uncertainty analysis and a proper calibration procedure. The paper reports application of the depth camera for extraction of different body parameters. Expanded uncertainty ranging between 3 and 15 mm is reported in the case of ten repeated measurements. Coefficients of determination R² > 0.84 and deviations lower than 6% from manual measurements where in general detected in the case of head size, hips distance, withers to tail length, chest girth, hips, and withers height. Conversely, lower performances where recognized in the case of animal depth (R² = 0.74) and back slope (R² = 0.12). PMID:29495290

Does transcutaneous nerve stimulation have effect on sympathetic skin response?

PubMed

Okuyucu, E Esra; Turhanoğlu, Ayşe Dicle; Guntel, Murat; Yılmazer, Serkan; Savaş, Nazan; Mansuroğlu, Ayhan

2018-01-01

This study examined the effects of transcutaneous electrical nerve stimulation (TENS) on the sympathetic nerve system by sympathetic skin response test. Fifty-five healthy volunteers received either: (i) 30minutes TENS (25 participants) (ii) 30minutes sham TENS (30 participants) and SSR test was performed pre- and post-TENS. The mean values of latency and peak-to-peak amplitude of five consecutive SSRs were calculated. A significant amplitude difference was found between TENS and sham TENS group both in right and left hand (p=0.04, p=0.01, respectively). However there was no significant latancy difference between two groups (p>0.05 ). TENS has an inhibitory effect on elicited SNS responses when compared with sham TENS control group. Copyright © 2017 Elsevier Ltd. All rights reserved.

Big Data Quality Case Study Preliminary Findings, U.S. Army MEDCOM MODS

DTIC Science & Technology

2013-09-01

captured in electronic form is relatively small, on the order of hundreds of thousands of health profiles at say around 500K per profile, or in the...in electronic form, then different language identification, handwriting recognition, and Natural Language Processing (NLP) techniques could be used...and patterns” [15]. Volume - The free text fields vary in length from say ten characters to several hundred characters. Other materials can be much

Biochemical diversity of betaines in earthworms

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

Liebeke, Manuel; Bundy, Jacob G., E-mail: j.bundy@imperial.ac.uk

2013-01-25

Highlights: ► We develop a method for rapid untargetted analysis of betaines. ► We profile betaines in a comparative study of ten earthworm species. ► Earthworms contain a surprisingly high number of different betaine metabolites. ► Earthworms contain betaines normally seen only in plants or marine animals. -- Abstract: The ability to accumulate osmoprotectant compounds, such as betaines, is an important evolutionary feature in many organisms. This is particularly the case for organisms that live in variable environments, which may have fluctuations in moisture and salinity levels. There is, surprisingly, very little known about betaines in soil invertebrates in general,more » and there is almost no information about earthworms – a group that are important ‘ecosystem engineers’ and key indicators of soil health. Here, we describe a fast and reliable {sup 1}H–{sup 13}C heteronuclear single quantum coherence (HSQC) 2D NMR approach for the metabolic profiling of a series of betaines and related metabolites in tissue extracts, and list {sup 1}H and {sup 13}C chemical shifts for the trimethylammonium signal for 23 such compounds. The analysis of ten different species from three different families (Lumbricidae, Megascolecidae and Glossoscolecidae) showed an unexpected diversity of betaines present in earthworms. In total ten betaines were identified, including hydroxyproline-betaine, proline-betaine, taurine-betaine, GABA-betaine and histidine-betaine, and a further eleven as-yet unassigned putative betaine metabolites detected. The findings clearly indicate a hitherto-unappreciated important role for betaine metabolism in earthworms.« less

Working memory, reasoning, and expertise in medicine-insights into their relationship using functional neuroimaging.

PubMed

Hruska, Pam; Krigolson, Olav; Coderre, Sylvain; McLaughlin, Kevin; Cortese, Filomeno; Doig, Christopher; Beran, Tanya; Wright, Bruce; Hecker, Kent G

2016-12-01

Clinical reasoning is dependent upon working memory (WM). More precisely, during the clinical reasoning process stored information within long-term memory is brought into WM to facilitate the internal deliberation that affords a clinician the ability to reason through a case. In the present study, we examined the relationship between clinical reasoning and WM while participants read clinical cases with functional magnetic resonance imaging (fMRI). More specifically, we examined the impact of clinical case difficulty (easy, hard) and clinician level of expertise (2nd year medical students, senior gastroenterologists) on neural activity within regions of cortex associated with WM (i.e., the prefrontal cortex) during the reasoning process. fMRI was used to scan ten second-year medical students and ten practicing gastroenterologists while they reasoned through sixteen clinical cases [eight straight forward (easy) and eight complex (hard)] during a single 1-h scanning session. Within-group analyses contrasted the easy and hard cases which were then subsequently utilized for a between-group analysis to examine effects of expertise (novice > expert, expert > novice). Reading clinical cases evoked multiple neural activations in occipital, prefrontal, parietal, and temporal cortical regions in both groups. Importantly, increased activation in the prefrontal cortex in novices for both easy and hard clinical cases suggests novices utilize WM more so than experts during clinical reasoning. We found that clinician level of expertise elicited differential activation of regions of the human prefrontal cortex associated with WM during clinical reasoning. This suggests there is an important relationship between clinical reasoning and human WM. As such, we suggest future models of clinical reasoning take into account that the use of WM is not consistent throughout all clinical reasoning tasks, and that memory structure may be utilized differently based on level of expertise.

Prophylactic titanium elastic nailing (TEN) following femoral lengthening (Lengthening then rodding) with one or two nails reduces the risk for secondary interventions after regenerate fractures: a cohort study in monolateral vs. bilateral lengthening procedures

PubMed Central

2013-01-01

Background Femoral fracture rates of up to 30% have been reported following lengthening procedures using fixators. “Lengthening then rodding” uses one or two titanium elastic nails (TENs) for prophylactic intramedullary nailing to reduce this complication. The aim of the study was to decide if usage of only one TEN is safe or has it a higher risk of getting a fracture? And we asked if there is a difference between patients with monolateral or bilateral lengthening procedures according to their fracture rate? Methods One or two TENs were implanted in two groups of patients (monolateral and bilateral) after femoral lengthening procedures. The regenerate quality was classified using the Li system and fractures were categorized using the Simpson and Kenwright classification. The follow-up period was at least 1 year after removal of the frame. Results Sixty-seven patients with 101 femoral lengthening procedures were included in 2007–2011. Group A included 34 patients with bilateral lengthening due to congenital short stature. Group B consisted of 33 patients with congenital disorders with leg length discrepancies. Seven fractures in six patients were seen in group A and five fractures in group B. One patient had residual shortening of 1 cm, and 11 fractures healed without relevant deviation (< 5°) or shortening (< 5 mm). A soft-tissue infection in one patient led to early removal of one TEN. Conclusions Fractures occurred in both groups of patients in total in 12 of the 101 cases (12%). The rate of secondary interventions was markedly reduced. Usage of one or two TENs did not influence the fracture rate. PMID:24156728

Early surgical managment of penetrating ocular injuries involving the posterior segment.

PubMed

Michels, R G

1976-09-01

Pars plana vitrectomy technic can be used in the early management of certain penetrating ocular injuries involving the posterior segment, including selected intraocular foreign bodies. This study reports the results of ten consecutive cases of intraocular foreign bodies in the posterior segment treated by a combination of vitrectomy (including lensectomy when necessary) and foreign-body extraction with forceps. The foreign body was successfully removed in nine of ten eyes, and nine of ten eyes were salvaged. This favorable experience using early vitreous surgery suggests that the vitrectomy technic can be used in other penetrating injuries involving the posterior segment that are not associated with intraocular foreign bodies. Possible indications for early vitrectomy are presented, including cases with a poor prognosis when managed by conventional methods.

Different effects of transcutaneous electric nerve stimulation and electroacupuncture at ST36–ST37 on the cerebral cortex

PubMed Central

Kang, Yu-Tien; Liao, Yi-Sheng; Hsieh, Ching-Liang

2015-01-01

Background The effects of transcutaneous electric nerve stimulation (TENS) and electroacupuncture (EA) on the cerebral cortex are largely unclear. The purpose of the present study was to investigate the effect of TENS and EA on the cerebral cortex by examining their effect on the median nerve-somatosensory evoked potentials (MN-SEPs). Methods Twenty volunteers were studied. The cortical and cervical spinal potentials were recorded by median nerve stimulation at the left wrist. Sham TENS, 2 Hz TENS and 2 Hz EA were applied to both ST36 and ST37. MN-SEPs were recorded during sham TENS, 2 Hz TENS and 2 Hz EA, with at least 1 week interval for each subject. One-way analysis of variance was used to determine the differences in latency and amplitude of the MN-SEPs observed in the stimulation and post-stimulation periods compared with baseline. Scheffe's post hoc correction was employed to identify pairwise differences. Results No differences in mean latency were found between the stimulation procedures during the stimulation and post-stimulation periods. 2 Hz EA but not sham TENS or 2 Hz TENS caused higher mean amplitudes in N20 and N30 during the stimulation and post-stimulation periods. Conclusions EA, but not TENS, induces changes in certain components of the signal. PMID:25432425

A continuous family of realistic SUSY SU(5) GUTs

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

Bajc, Borut, E-mail: borut.bajc@ijs.si

2016-06-21

It is shown that the minimal renormalizable supersymmetric SU(5) is still realistic providing the supersymmetric scale is at least few tens of TeV or large R-parity violating terms are considered. In the first case the vacuum is metastable, and different consistency constraints can give a bounded allowed region in the tan β − m{sub susy} plane. In the second case the mass eigenstate electron (down quark) is a linear combination of the original electron (down quark) and Higgsino (heavy colour triplet), and the mass ratio of bino and wino is determined. Both limits lead to light gravitino dark matter.

Etanercept therapy for toxic epidermal necrolysis.

PubMed

Paradisi, Andrea; Abeni, Damiano; Bergamo, Fabio; Ricci, Francesco; Didona, Dario; Didona, Biagio

2014-08-01

Toxic epidermal necrolysis (TEN) is a severe and potentially lethal drug reaction for which no standard treatment is available. To describe a case series of patients with TEN treated with a single dose of etanercept. We observed 10 consecutive patients with TEN. For each patient, we recorded the presence of comorbidities and all the drugs recently started (ie, in the last month). In all cases, 50 mg of etanercept was administered in a single subcutaneous injection. The clinical severity of disease was computed using the SCORe of Toxic Epidermal Necrosis (SCORTEN) scale. Using the probabilities of death linked to each level of SCORTEN score, we calculated the expected probability of death in our patients. Healing was defined as complete reepithelialization, and a time to healing curve was then obtained using the Kaplan-Meier method. All patients promptly responded to treatment, reaching complete reepithelialization without complications or side effects. The median time to healing was 8.5 days. This is a small, uncontrolled case series. These preliminary results suggest the possibility that tumor necrosis factor-alfa may be an effective target for control of TEN, a dangerous skin condition for which no effective cure has yet been found. Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Reliability of conventional shade guides in teeth color determination.

PubMed

Todorović, Ana; Todorović, Aleksandar; Gostović, Aleksandra Spadijer; Lazić, Vojkan; Milicić, Biljana; Djurisić, Slobodan

2013-10-01

Color matching in prosthodontic therapy is a very important task because it influences the esthetic value of dental restorations. Visual shade matching represents the most frequently applied method in clinical practice. Instrumental measurements provide objective and quantified data in color assessment of natural teeth and restorations. In instrumental shade analysis, the goal is to achieve the smallest deltaE value possible, indicating the most accurate shade match. The aim of this study was to evaluate the reliability of commercially available ceramic shade guides. VITA Easyshade spectrophotometer (VITA, Germany) was used for instrumental color determination. Utilizing this device, color samples of ten VITA Classical and ten VITA 3D - Master shade guides were analyzed. Each color sample from all shade guides was measured three times and the basic parameters of color quality were examined: deltaL, deltaC, deltaH, deltaE, deltaElc. Based on these parameters spectrophotometer marks the shade matching as good, fair or adjust. After performing 1,248 measurements of ceramic color samples, frequency of evaluations adjust, fair and good were statistically significantly different between VITA Classical and VITA 3D Master shade guides (p = 0.002). There were 27.1% cases scored as adjust, 66.3% as fair and 6.7% as good. In VITA 3D - Master shade guides 30.9% cases were evaluated as adjust, 66.4% as fair and 2.7% cases as good. Color samples from different shade guides, produced by the same manufacturer, show variability in basic color parameters, which once again proves the lack of precision and nonuniformity of the conventional method.

Transcutaneous Electrical Nerve Stimulation (TENS) A Possible Aid for Pain Relief in Developing Countries?

PubMed Central

Tashani, O; Johnson, MI

2009-01-01

Transcutaneous electrical nerve stimulation (TENS) refers to the delivery of electrical currents through the skin to activate peripheral nerves. The technique is widely used in developed countries to relieve a wide range of acute and chronic pain conditions, including pain resulting from cancer and its treatment. There are many systematic reviews on TENS although evidence is often inconclusive because of shortcomings in randomised control trials methodology. In this overview the basic science behind TENS will be discussed, the evidence of its effectiveness in specific clinical conditions analysed and a case for its use in pain management in developing countries will be made. PMID:21483510

Nucleolus organizer regions in Physalaemus cuvievi (Anura, Leptodactylidae), with evidence of a unique case of Ag-NOR variability.

PubMed

Silva, A P; Haddad, C F; Kasahara, S

1999-01-01

We studied ten specimens of Physalaemus cuvieri collected at different localities in Brazil using conventional staining and banding techniques. All specimens had 2n = 22. There were karyotypic variants: distinct patterns in the number and chromosome localization of Ag-NORs as well as in the corresponding secondary constrictions. Preliminary C-banding patterns obtained for specimens from two localities are also suggestive of karyotypic differentiation in P. cuvieri.

RS3PE syndrome: an overview.

PubMed

Olivieri, I; Salvarani, C; Cantini, F

2000-01-01

More than ten years ago McCarty et al. described the RS3PE syndrome based on their study of 23 patients. Numerous additional cases have since been reported. In addition to the isolated or "pure" type which probably forms part of the clinical spectrum of polymyalgia rheumatica, inflammatory swelling with pitting edema of the dorsum of the hands and/or feet can be observed in different inflammatory rheumatic diseases as well as in haematological and solid malignancies.

Cost-effectiveness of post-landing latent tuberculosis infection control strategies in new migrants to Canada.

PubMed

Campbell, Jonathon R; Johnston, James C; Sadatsafavi, Mohsen; Cook, Victoria J; Elwood, R Kevin; Marra, Fawziah

2017-01-01

The majority of tuberculosis in migrants to Canada occurs due to reactivation of latent TB infection. Risk of tuberculosis in those with latent tuberculosis infection can be significantly reduced with treatment. Presently, only 2.4% of new migrants are flagged for post-landing surveillance, which may include latent tuberculosis infection screening; no other migrants receive routine latent tuberculosis infection screening. To aid in reducing the tuberculosis burden in new migrants to Canada, we determined the cost-effectiveness of using different latent tuberculosis infection interventions in migrants under post-arrival surveillance and in all new migrants. A discrete event simulation model was developed that focused on a Canadian permanent resident cohort after arrival in Canada, utilizing a ten-year time horizon, healthcare system perspective, and 1.5% discount rate. Latent tuberculosis infection interventions were evaluated in the population under surveillance (N = 6100) and the total cohort (N = 260,600). In all evaluations, six different screening and treatment combinations were compared to the base case of tuberculin skin test screening followed by isoniazid treatment only in the population under surveillance. Quality adjusted life years, incident tuberculosis cases, and costs were recorded for each intervention and incremental cost-effectiveness ratios were calculated in relation to the base case. In the population under surveillance (N = 6100), using an interferon-gamma release assay followed by rifampin was dominant compared to the base case, preventing 4.90 cases of tuberculosis, a 4.9% reduction, adding 4.0 quality adjusted life years, and saving $353,013 over the ensuing ten-years. Latent tuberculosis infection screening in the total population (N = 260,600) was not cost-effective when compared to the base case, however could potentially prevent 21.8% of incident tuberculosis cases. Screening new migrants under surveillance with an interferon-gamma release assay and treating with rifampin is cost saving, but will not significantly impact TB incidence. Universal latent tuberculosis infection screening and treatment is cost-prohibitive. Research into using risk factors to target screening post-landing may provide alternate solutions.

Effect of Spinal Manipulative Therapy on the Singing Voice.

PubMed

Fachinatto, Ana Paula A; Duprat, André de Campos; Silva, Marta Andrada E; Bracher, Eduardo Sawaya Botelho; Benedicto, Camila de Carvalho; Luz, Victor Botta Colangelo; Nogueira, Maruan Nogueira; Fonseca, Beatriz Suster Gomes

2015-09-01

This study investigated the effect of spinal manipulative therapy (SMT) on the singing voice of male individuals. Randomized, controlled, case-crossover trial. Twenty-nine subjects were selected among male members of the Heralds of the Gospel. This association was chosen because it is a group of persons with similar singing activities. Participants were randomly assigned to two groups: (A) chiropractic SMT procedure and (B) nontherapeutic transcutaneous electrical nerve stimulation (TENS) procedure. Recordings of the singing voice of each participant were taken immediately before and after the procedures. After a 14-day period, procedures were switched between groups: participants who underwent SMT on the first day were subjected to TENS and vice versa. Recordings were subjected to perceptual audio and acoustic evaluations. The same recording segment of each participant was selected. Perceptual audio evaluation was performed by a specialist panel (SP). Recordings of each participant were randomly presented thus making the SP blind to intervention type and recording session (before/after intervention). Recordings compiled in a randomized order were also subjected to acoustic evaluation. No differences in the quality of the singing on perceptual audio evaluation were observed between TENS and SMT. No differences in the quality of the singing voice of asymptomatic male singers were observed on perceptual audio evaluation or acoustic evaluation after a single spinal manipulative intervention of the thoracic and cervical spine. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Effect of modulated-frequency and modulated-intensity transcutaneous electrical nerve stimulation after abdominal surgery: a randomized controlled trial.

PubMed

Tokuda, Mitsunori; Tabira, Kazuyuki; Masuda, Takashi; Nishiwada, Takashi; Shomoto, Koji

2014-07-01

This study aimed to evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) for treatment of postoperative pain and pulmonary functions (vital capacity [VC]; cough peak flow, [CPF]) in patients who underwent abdominal surgery. Forty-eight patients were randomly allocated to receive TENS, placebo TENS, or no TENS (control) 1 hour a day for 3 days postoperatively. A 0-100 visual analog scale was used to assess pain at preintervention, mid-intervention, and postintervention on the third postoperative day. Pulmonary functions (VC, CPF) were evaluated by spirometer at preoperation (baseline) and at preintervention, mid-intervention, and postintervention on the third postoperative day. One-way analysis of variance was used to assess differences between groups at baseline. Mann-Whitney test was used to compare the control group with the placebo-TENS and TENS group, at each assessment timepoint. Two-way analysis of variance and Bonferroni post hoc test assessed the difference between the 2 (placebo-TENS×TENS) groups. A value of P<0.01 was considered statistically significant. The baselines were not significantly different between any groups. The TENS group had significant reductions in postoperative pain compared with the placebo group (P<0.01) and control group (P<0.01). There was also improvement in pulmonary functions (VC, CPF) at mid-TENS and post-TENS, but not in the placebo-TENS (P<0.01) or control groups (P<0.01). TENS is a valuable treatment to alleviate postoperative pain and improve pulmonary functions (ie, VC, CPF) in patients following abdominal surgery.

Different effects of transcutaneous electric nerve stimulation and electroacupuncture at ST36-ST37 on the cerebral cortex.

PubMed

Kang, Yu-Tien; Liao, Yi-Sheng; Hsieh, Ching-Liang

2015-02-01

The effects of transcutaneous electric nerve stimulation (TENS) and electroacupuncture (EA) on the cerebral cortex are largely unclear. The purpose of the present study was to investigate the effect of TENS and EA on the cerebral cortex by examining their effect on the median nerve-somatosensory evoked potentials (MN-SEPs). Twenty volunteers were studied. The cortical and cervical spinal potentials were recorded by median nerve stimulation at the left wrist. Sham TENS, 2 Hz TENS and 2 Hz EA were applied to both ST36 and ST37. MN-SEPs were recorded during sham TENS, 2 Hz TENS and 2 Hz EA, with at least 1 week interval for each subject. One-way analysis of variance was used to determine the differences in latency and amplitude of the MN-SEPs observed in the stimulation and post-stimulation periods compared with baseline. Scheffe's post hoc correction was employed to identify pairwise differences. No differences in mean latency were found between the stimulation procedures during the stimulation and post-stimulation periods. 2 Hz EA but not sham TENS or 2 Hz TENS caused higher mean amplitudes in N20 and N30 during the stimulation and post-stimulation periods. EA, but not TENS, induces changes in certain components of the signal. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

30 CFR 942.816 - Performance standards-Surface mining activities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... primary roads. In no case shall there by any pitch grade over fifteen (15) percent. (ii) Culvert spacing... ten (10) percent, and three hundred (300) feet on grades of ten (10) percent or greater. Culverts.... Culverts may be constructed at greater intervals than the maximum indicated in this part if approved by the...

30 CFR 942.816 - Performance standards-Surface mining activities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... primary roads. In no case shall there by any pitch grade over fifteen (15) percent. (ii) Culvert spacing... ten (10) percent, and three hundred (300) feet on grades of ten (10) percent or greater. Culverts.... Culverts may be constructed at greater intervals than the maximum indicated in this part if approved by the...

30 CFR 942.816 - Performance standards-Surface mining activities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... primary roads. In no case shall there by any pitch grade over fifteen (15) percent. (ii) Culvert spacing... ten (10) percent, and three hundred (300) feet on grades of ten (10) percent or greater. Culverts.... Culverts may be constructed at greater intervals than the maximum indicated in this part if approved by the...

Building to Scale: An Analysis of Web-Based Services in CIC (Big Ten) Libraries.

ERIC Educational Resources Information Center

Dewey, Barbara I.

Advancing library services in large universities requires creative approaches for "building to scale." This is the case for CIC, Committee on Institutional Cooperation (Big Ten), libraries whose home institutions serve thousands of students, faculty, staff, and others. Developing virtual Web-based services is an increasingly viable…

Low dose intravenous immunoglobulins and steroids in toxic epidermal necrolysis: a prospective comparative open-labelled study of 36 cases.

PubMed

Jagadeesan, Soumya; Sobhanakumari, K; Sadanandan, Sadeep Melethil; Ravindran, Sheeba; Divakaran, Manjula Velikkakathu; Skaria, Lissy; Kurien, George

2013-01-01

Toxic epidermal necrolysis (TEN) is a severe adverse drug reaction associated with high mortality. Though different modalities of treatment are advocated, there is no consensus regarding specific therapy. Corticosteroids have shown conflicting results and for high dose intravenous immunoglobulins (IVIG), cost is a limiting factor. To find out the effectiveness of combination therapy with low-dose IVIG and steroids versus steroids alone in our TEN patients. After obtaining Ethical Committee approval, 36 consecutive TEN patients (2008-2012) were alternately allocated to 2 groups - Group A was given combination of low-dose IVIG (0.2-0.5 g/kg) and rapidly tapering course of steroids (intravenous dexamethasone 0.1- 0.3 mg/kg/day tapered in 1-2 weeks) while Group B was given same dose of steroids alone. Outcome parameters assessed were time taken for arrest of disease progression, time taken for re-epithelization, duration of hospital stay and mortality rates. Both groups had 18 patients. Baseline characteristics like age, sex ratio, SCORTEN, body surface area involvement and treatment interval were comparable. Time for arrest of disease progression and for re-epithelization was significantly lowered in Group A (P = 0.0001, P = 0.0009 respectively). Though duration of hospital stay and deaths were less in Group A, difference was not statistically significant. SCORTEN based standardized mortality ratio (SMR) analysis revealed that combination therapy reduced the probability of dying by 82% (SMR = 0.18 ± 0.36) and steroids by 37% (SMR = 0.63 ± 0.71). Difference in SMR was statistically significant (P = 0.00001). No significant side effects due to either modality were found in any of the patients. Combination therapy with low-dose IVIG and steroids is more effective in terms of reduced mortality and faster disease resolution when compared to steroids alone in TEN.

Piperacillin-tazobactam-induced linear IgA bullous dermatosis presenting clinically as Stevens-Johnson syndrome/toxic epidermal necrolysis overlap.

PubMed

Adler, N R; McLean, C A; Aung, A K; Goh, M S Y

2017-04-01

Linear IgA bullous dermatosis (LABD) is a subepidermal autoimmune bullous disease characterized by linear IgA deposition at the basement membrane zone, which is visualized by direct immunofluorescence. Patients with LABD typically present with widespread vesicles and bullae; however, this is not necessarily the case, as the clinical presentation of this disease is heterogeneous. LABD clinically presenting as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) is an infrequent, yet well-described phenomenon. Most cases of LABD are idiopathic, but some cases are drug-induced. Multiple drugs have been implicated in the development of LABD. We report a case of piperacillin-tazobactam-induced LABD presenting clinically as SJS/TEN overlap. This is the first reported case of a strong causal association between piperacillin-tazobactam and the development of LABD. © 2017 British Association of Dermatologists.

Age adjustment in ecological studies: using a study on arsenic ingestion and bladder cancer as an example.

PubMed

Guo, How-Ran

2011-10-20

Despite its limitations, ecological study design is widely applied in epidemiology. In most cases, adjustment for age is necessary, but different methods may lead to different conclusions. To compare three methods of age adjustment, a study on the associations between arsenic in drinking water and incidence of bladder cancer in 243 townships in Taiwan was used as an example. A total of 3068 cases of bladder cancer, including 2276 men and 792 women, were identified during a ten-year study period in the study townships. Three methods were applied to analyze the same data set on the ten-year study period. The first (Direct Method) applied direct standardization to obtain standardized incidence rate and then used it as the dependent variable in the regression analysis. The second (Indirect Method) applied indirect standardization to obtain standardized incidence ratio and then used it as the dependent variable in the regression analysis instead. The third (Variable Method) used proportions of residents in different age groups as a part of the independent variables in the multiple regression models. All three methods showed a statistically significant positive association between arsenic exposure above 0.64 mg/L and incidence of bladder cancer in men and women, but different results were observed for the other exposure categories. In addition, the risk estimates obtained by different methods for the same exposure category were all different. Using an empirical example, the current study confirmed the argument made by other researchers previously that whereas the three different methods of age adjustment may lead to different conclusions, only the third approach can obtain unbiased estimates of the risks. The third method can also generate estimates of the risk associated with each age group, but the other two are unable to evaluate the effects of age directly.

Airlines Performance and Eflciency Evaluation using a MCDA Methodology. The Case for Low Cost Carriers vs Legacy Carriers

NASA Astrophysics Data System (ADS)

Miranda, Miguel; Baltazar, Maria E.; Silva, Jorge

2016-11-01

The air transport has suffered a remarkable transformation over the past decade. Thewaywe travel today is quite different from how we did ten years ago. Due to the rise of low cost carriers, the market of air transportation has been constantly changing and presently witnessing the transformation of legacy carriers in order to manage to continue operating. The main purpose of thiswork is to show the differences in efficiency for different performance areas on a case study comprised of six different airline carriers, legacy and low cost, using a Multi Criteria Decision Making (MCDA) tool - Measuring Attractiveness by a Category Based Evaluation Technique (MACBETH). With the results obtained in this study, it is expected to show the work that is being carried out to obtain a model that would measure the efficiency of one or various airline companies in a defined period of time, using a set of performance indicators, to which specialists in the area previously have given weights.

Role of argon laser as an adjunctive therapy for treatment of resistant infected corneal ulcers

PubMed Central

Khater, Mohammad M; Selima, Adel A; El-Shorbagy, Mohammad S

2014-01-01

Purpose To evaluate the role of argon laser as an adjunctive therapy in ten patients with resistant infected corneal ulcers with or without hypopyon. Methods The study included 20 patients, split into two groups of ten, with resistant infected corneal ulcers with or without hypopyon. One group was considered as the control group and treated with local and systemic specific antimicrobial drugs guided with culture and sensitivity tests. The other group started with the same specific therapy as the control group for 1 week with no obvious improvement and then was further treated with argon laser. The ten patients in the control group included five cases of fungal ulcers, three mixed (fungal and bacterial) ulcers, and two viral ulcers. The ten patients in the other group included three cases of fungal ulcers, three mixed (fungal and viral) ulcers, three viral ulcers, and one bacterial ulcer as proven with microbial culture and sensitivity tests. Eight cases of the control group and seven cases of the other group were associated with hypopyon. Before laser treatment, a drop of benoxinate hydrochloride 0.4% and a single drop of fluorescein sodium 0.25% were instilled. Argon laser irradiation of the affected cornea was performed using an argon 532 nm wavelength (Carl Zeiss LSL 532s AG; Carl Zeiss Meditec AG, Jena, Germany). A spot size of 500 μm, pulse duration of 0.2 seconds, and power of 900 mW were used. All cases were followed up for 3 months after healing was achieved. Results During the first 4 weeks after laser treatment, all patients showed complete healing of the epithelial defect and resolution of stromal infiltration with no adverse effects. In the control group, four cases needed an amniotic membrane graft due to thinning and the other six cases were healed in a duration that ranged from 3 to 7 weeks. Conclusion Argon laser phototherapy is useful as an adjunctive treatment for resistant infected corneal ulcers. More cases are needed to get more reliable results and to confirm our findings. PMID:24920878

Role of argon laser as an adjunctive therapy for treatment of resistant infected corneal ulcers.

PubMed

Khater, Mohammad M; Selima, Adel A; El-Shorbagy, Mohammad S

2014-01-01

To evaluate the role of argon laser as an adjunctive therapy in ten patients with resistant infected corneal ulcers with or without hypopyon. The study included 20 patients, split into two groups of ten, with resistant infected corneal ulcers with or without hypopyon. One group was considered as the control group and treated with local and systemic specific antimicrobial drugs guided with culture and sensitivity tests. The other group started with the same specific therapy as the control group for 1 week with no obvious improvement and then was further treated with argon laser. The ten patients in the control group included five cases of fungal ulcers, three mixed (fungal and bacterial) ulcers, and two viral ulcers. The ten patients in the other group included three cases of fungal ulcers, three mixed (fungal and viral) ulcers, three viral ulcers, and one bacterial ulcer as proven with microbial culture and sensitivity tests. Eight cases of the control group and seven cases of the other group were associated with hypopyon. Before laser treatment, a drop of benoxinate hydrochloride 0.4% and a single drop of fluorescein sodium 0.25% were instilled. Argon laser irradiation of the affected cornea was performed using an argon 532 nm wavelength (Carl Zeiss LSL 532s AG; Carl Zeiss Meditec AG, Jena, Germany). A spot size of 500 μm, pulse duration of 0.2 seconds, and power of 900 mW were used. All cases were followed up for 3 months after healing was achieved. During the first 4 weeks after laser treatment, all patients showed complete healing of the epithelial defect and resolution of stromal infiltration with no adverse effects. In the control group, four cases needed an amniotic membrane graft due to thinning and the other six cases were healed in a duration that ranged from 3 to 7 weeks. Argon laser phototherapy is useful as an adjunctive treatment for resistant infected corneal ulcers. More cases are needed to get more reliable results and to confirm our findings.

Design and bidding of UV disinfection equipment -- Case study

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

Akyurek, M.

1998-07-01

Ultraviolet (UV) disinfection systems are being widely considered for application to treated wastewaters, in lieu of conventional chlorination facilities. The number of UV systems operating in the US was approximately 50 in 1984. In 1990 there were over 500 systems, a ten-fold increase. The use of UV disinfection has increased since 1990, and will likely to increase in the future. It is anticipated that as many chlorine disinfection facilities reach their useful life, most of them will be replaced with UV disinfection systems. Several manufacturers offer different UV disinfection equipment. Each offers something different for the designer. There are alsomore » different approaches used in estimating the number of lamps needed for the disinfection system. The lack of standardization in determination of the number of lamps for a UV system poses problems for the designer. Such was the case during the design of the disinfection system for the Watertown, SD Wastewater Treatment Plant (WWRP). The purpose of this paper is to present a case study for the design and bidding of UV disinfection equipment.« less

Magnetic study of turbidites

NASA Astrophysics Data System (ADS)

Tanty, Cyrielle; Valet, Jean Pierre; Carlut, Julie

2015-04-01

Turbidites induce sedimentary reworking and re-deposition caused by tsunami, earthquake, volcanic processes, and other catastrophic events. They result from rapid depositional processes and are thus considered not being pertinent for comparison with pelagic sediments. Turbidites are evidently ruled out from paleomagnetic records dealing with time-series. Consequently, no attention has ever been paid to the magnetization of turbidites which is fully justified if the high level of turbulence governing the depositional processes influences the acquisition of magnetization. In certain conditions like channeled turbidity currents, levees of sediment are generated and then associated with relatively calm although very fast redeposition processes. Such conditions will thus govern the subsequent acquisition of magnetization through mechanical lock-in of the magnetic grains. This situation is actually quite similar to what happens during the experiences of artificial redeposition that are conducted in laboratory. Therefore, combining laboratory experiments and studies of natural turbidites could reveal important information on the processes involved in the acquisition of magnetization, especially if the comparison with the overlying hemipelagic sediments does not show any striking difference. We will present the results of magnetic measurements performed on four different and relatively recent turbidites. We selected different origins associated either with spillover of channeled turbidity currents or with co-seismic faulting. Each event is characterized by a different thickness (ten to few tens of cm), lithology and mean granulometry (few tens of μm to hundreds of μm). We have carried out measurements of magnetic susceptibility, magnetic remanence, anisotropy of magnetic susceptibility (AMS) and we also scrutinize the evolution of various rock magnetic parameters (ARM, IRM, S ratio, magnetic grain sizes, hysteresis parameters…). The magnetic characteristics of the turbiditic levels have been compared with those of the surrounding hemipelagic sediments. In all cases, the magnetization of remanence reflect the expected field direction at the site location without significant change in direction inside the turbiditic levels. This is an indication that magnetization acquisition likely obeys the same rules as for slowly deposited hemipelagic sediments. As expected there is a grain size grading with relatively coarse sediment at the bottom and fine-grained sediment at the top, similarly to what is observed with laboratory redeposited sediments and thus further justify the comparison. Surprisingly, in most cases the magnetic grain sizes follow a similar pattern, which would imply that magnetic grains were not clustered inside sedimentary particles, otherwise we would expect a different relationship.

Why issues emerge

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

Coates, J.F.; Jarrett, J.; Decker, C.

1989-10-01

For those analysts and managers responsible for anticipating issues that may become important to their organizations, the origin of such issues is an important question. This study looks at how, and why, an issue may emerge from a situation, or an event. The full development of an issue, and its resolution may take from five to 30 years or more. The earlier it can be anticipated, the more opportunity for its stakeholders to develop positions and options for addressing it. Three approaches to examining the origins of issues are employed; the invention of ten models as metaphors for the formationmore » and growth of issues; the test of these models against 12 well-known, and fully developed issues; and the analysis of three case studies of issue development. This analysis assesses the readiness at different times for cultural, institutional and situational factors to allow or promote a situation to transition into an issue. Six of the ten conceptual models prove to be more powerful metaphors of issue development than the others. Analysis of the case studies shows that a readiness assessment of an unfolding situation may yield clues to a new issue. A readiness checklist is provided. 6 figs., 4 tabs.« less

Analysis of Uniform Random Numbers Generated by Randu and Urn Ten Different Seeds.

DTIC Science & Technology

The statistical properties of the numbers generated by two uniform random number generators, RANDU and URN, each using ten different seeds are...The testing is performed on a sequence of 50,000 numbers generated by each uniform random number generator using each of the ten seeds . (Author)

Granulocyte colony-stimulating factor in toxic epidermal necrolysis (TEN) and Chelsea & Westminster TEN management protocol [corrected].

PubMed

de Sica-Chapman, A; Williams, G; Soni, N; Bunker, C B

2010-04-01

Toxic epidermal necrolysis (TEN) is a rare but life-threatening, allergic drug reaction. Skin blistering with epidermal and mucosal necrolysis with subsequent detachment from an inflamed underlying dermis is a hallmark of the condition. The pathogenesis of TEN is not well understood, accounting for controversies about its management and significant delay in initiating potentially beneficial therapy. There are no management protocols based on a robust evidence base. Prompt recognition of the diagnosis and consensus on early management initiatives are necessary in order to improve outcomes and survival in TEN. To date, TEN management has been directed at arresting the allergic reaction and treating the complications. We have identified a need for specific medical interventions to accelerate wound regeneration. This approach has not previously been adopted in the management of TEN. We observed that in two cases of severe TEN, dramatic re-epithelialization and recovery coincided with the introduction of granulocyte colony-stimulating factor (G-CSF) for neutropenia. We explain how addition of the G-CSF promotes recovery from TEN by enhanced bioregeneration of the damaged tissues through accelerated re-epithelialization. G-CSF has been used for severe neutropenia in TEN, but we recommend and explain why, as in our Chelsea and Westminster protocol, G-CSF should be considered in treating severe TEN irrespective of the severity of neutropenia.

Use of CD25 as an immunohistochemical marker for acquired ocular toxoplasmosis.

PubMed

Miyamoto, Cristina; Mattos Neto, Rubens Belfort; Cesare, Sebastian Di; Belfort Junior, Rubens; Burnier, Miguel N

2010-01-01

Toxoplasmosis is the most common cause of posterior infectious uveitis worldwide. It is often impossible to determine its congenital or acquired nature. Interleukin-2 (IL-2) in peripheral blood has been described as a possible marker for acquired toxoplasmosis. The purpose of this study is to evaluate the histopathological characteristics of ocular toxoplasmosis cases using CD25 as a marker for the expression of interleukin-2. Ten formalin-fixed, paraffin-embedded enucleated globes from ten immunocompetent patients with clinical diagnosis of toxoplasmosis were evaluated. Four patients had the acquired form of ocular toxoplasmosis (positive IgM) while six were IgM negative and IgG positive for toxoplasmosis. Histopathological slides were reviewed for the extension of the retinal necrosis, number of toxo cysts, the granulomatous inflammatory reaction, the presence of T and B cells within the choroid and the IL-2 expression. Immunohistochemistry using monoclonal antibodies was performed to observe the expression of CD4, CD8, CD20, CD25, and CD68. The histopathological evaluation disclosed no differences between acquired and the other ocular toxoplasmosis cases regarding the characteristics studied. However, CD25 showed a higher expression of IL-2 on the 4 acquired cases of ocular toxoplasmosis compared to the remainders. To the best of our knowledge, this is the first report showing that the use of CD25 as a marker for interleukin-2 could differentiate acquired ocular toxoplasmosis.

An overview of UK C130 observations from the FIRE marine stratocumulus IFO

NASA Technical Reports Server (NTRS)

Nicholls, S.; Leighton, J.; Barlow, R.

1990-01-01

An overview of the characteristics of the ten flights made by the C130 during the Intensive Field Observations (IFO) are presented. An indication of data quality is given. Comparisons of the carbon dioxide radiation thermometer and the Rosemount suggest there may be potentially serious wetting problems with the latter, especially close to cloud base. The main features of the cloud layers sampled by the C130 are summarized, including microphysical parameters. Many of the results shown are derived from a first order analysis of turbulence quantities. The gross vertical variation of heat, vapor, and liquid water fluxes from case to case, together with the observed vertical velocity variance, a good indicator of convective activity, are discussed. Preliminary results suggest that the different cases can be usefully categorized using these data. The relationship between these and the measured boundary conditions is mentioned. Similarities and differences between the various cases are highlighted, and interpreted in terms of the researchers' current understanding of stratocumulus. Attention is given to particular features of the various flights which may deserve more intensive study.

A good preoperative response to transcutaneous electrical nerve stimulation predicts a better therapeutic effect of implanted occipital nerve stimulation in pharmacologically intractable headaches.

PubMed

Nguyen, Jean-Paul; Nizard, Julien; Kuhn, Emmanuelle; Carduner, Florence; Penverne, Frédérique; Verleysen-Robin, Marie-Christine; Terreaux, Luc; de Gaalon, Solène; Raoul, Sylvie; Lefaucheur, Jean-Pascal

2016-02-01

Occipital nerve stimulation (ONS) is a surgical approach to treat patients with medically intractable chronic headache disorders. However, no preoperative test has been yet validated to allow candidates to be selected for implantation. In this study, the analgesic efficacy of transcutaneous electrical nerve stimulation (TENS) was tested for 1 to 3 months in 41 patients with pharmacologically intractable headache disorders of various origins, using a new technique of electrode placement over the occipital nerve. ONS electrodes were subsequently implanted in 33 patients (occipital neuralgia [n=15], cervicogenic headache [n=7], cluster headache [n=6], chronic migraine [n=5]) who had responded at least moderately to TENS. Assessment was performed up to five years after implantation (three years on average), based on the mean and maximum daily pain intensity scored on a 0-10 visual analogue scale and the number of headache days per month. Both TENS and chronic ONS therapy were found to be efficacious (57-76% improvement compared to baseline on the various clinical variables). The efficacy of ONS was better in cases of good or very good preoperative response to TENS than in cases of moderate response to TENS. Implanted ONS may be a valuable therapeutic option in the long term for patients with pharmacologically intractable chronic headache. Although we cannot conclude in patients with poor or no response to TENS, a good or very good response to TENS can support the indication of ONS therapy. This preoperative test could particularly be useful in patients with chronic migraine, in whom it may be difficult to indicate an invasive technique of cranial neurostimulation. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Expression of prostaglandin E receptor subtype EP4 in conjunctival epithelium of patients with ocular surface disorders: case-control study.

PubMed

Ueta, Mayumi; Sotozono, Chie; Yamada, Keiko; Yokoi, Norihiko; Inatomi, Tsutomu; Kinoshita, Shigeru

2012-01-01

To confirm the downregulation of PTGER4 mRNA in the conjunctiva of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) and ocular cicatricial pemphigoid (OCP) patients and to examine the expression of its EP4 protein in the conjunctival epithelium of patients with various ocular surface disorders. Case-control study. We performed quantitative reverse transcription-PCR (RT-PCR) analysis of PTGER4 mRNA in conjunctival tissue sections from patients with SJS/TEN and OCP to confirm the downregulation of PTGER4 mRNA expression. We also analysed EP4 immunohistologically in other ocular surface disorders. Conjunctival tissues were obtained from patients undergoing surgical reconstruction of the ocular surface due to chemical eye burns, subacute SJS/TEN or chronic SJS/TEN, chronic OCP, severe graft versus host disease (GVHD) and from patients with Mooren's ulcers treated by resection of the inflammatory conjunctiva. The expression of PTGER4 mRNA and EP4 protein assessed by quantitative RT-PCR assay and immunohistological methods. PTGER4 mRNA was significantly lower in conjunctival tissues from SJS and OCP patients than in the control conjunctivochalasis samples. EP4 protein was detected in conjunctival epithelium from patients with chemical eye burn and in control conjunctival epithelium from patients with conjunctivochalasis. Its expression varied in conjunctival epithelium from patients with Mooren's ulcer. We did not detect EP4 immunoreactivity in conjunctival epithelium from patients with subacute SJS/TEN, severe GVHD, chronic SJS/TEN or OCP. The strong downregulation of EP4 expression in conjunctival epithelium from patients with OCP or SJS/TEN may be attributable to ocular surface inflammation.

Expression of prostaglandin E receptor subtype EP4 in conjunctival epithelium of patients with ocular surface disorders: case-control study

PubMed Central

Ueta, Mayumi; Sotozono, Chie; Yamada, Keiko; Yokoi, Norihiko; Inatomi, Tsutomu; Kinoshita, Shigeru

2012-01-01

Objectives To confirm the downregulation of PTGER4 mRNA in the conjunctiva of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) and ocular cicatricial pemphigoid (OCP) patients and to examine the expression of its EP4 protein in the conjunctival epithelium of patients with various ocular surface disorders. Design Case-control study. Setting and participants We performed quantitative reverse transcription-PCR (RT-PCR) analysis of PTGER4 mRNA in conjunctival tissue sections from patients with SJS/TEN and OCP to confirm the downregulation of PTGER4 mRNA expression. We also analysed EP4 immunohistologically in other ocular surface disorders. Conjunctival tissues were obtained from patients undergoing surgical reconstruction of the ocular surface due to chemical eye burns, subacute SJS/TEN or chronic SJS/TEN, chronic OCP, severe graft versus host disease (GVHD) and from patients with Mooren's ulcers treated by resection of the inflammatory conjunctiva. Primary and secondary outcome measures The expression of PTGER4 mRNA and EP4 protein assessed by quantitative RT-PCR assay and immunohistological methods. Results PTGER4 mRNA was significantly lower in conjunctival tissues from SJS and OCP patients than in the control conjunctivochalasis samples. EP4 protein was detected in conjunctival epithelium from patients with chemical eye burn and in control conjunctival epithelium from patients with conjunctivochalasis. Its expression varied in conjunctival epithelium from patients with Mooren's ulcer. We did not detect EP4 immunoreactivity in conjunctival epithelium from patients with subacute SJS/TEN, severe GVHD, chronic SJS/TEN or OCP. Conclusions The strong downregulation of EP4 expression in conjunctival epithelium from patients with OCP or SJS/TEN may be attributable to ocular surface inflammation. PMID:23065448

Primary biliary cirrhosis: an epidemiological study.

PubMed Central

Triger, D R

1980-01-01

A three-year study (1977-9) of primary biliary cirrhosis in the city of Sheffield disclosed 34 cases, a point prevalence of 54 per million population. Closer inspection showed an apparent clustering of cases, and the prevalence in relation to one water reservoir appeared to be more than ten times that of the other reservoirs. Nevertheless, analyses of the water showed no significant relevant differences between the reservoir serving areas with a high prevalence of cirrhosis and other reservoirs. Despite the inconclusive results of the water analyses, these findings do suggest that an environmental agent may be a cause of primary biliary cirrhosis and that further epidemiological studies may help to elucidate the cause. PMID:7427444

Purpura fulminans mimicking toxic epidermal necrolysis - additional value of 16S rRNA sequencing and skin biopsy.

PubMed

Dautzenberg, K H W; Polderman, F N; van Suylen, R J; Moviat, M A M

2017-05-01

Both purpura fulminans and toxic epidermal necrolysis (TEN) are rare and life-threatening disorders with a high mortality. We present a case of suspected rapidly progressive, severe pneumococcal sepsis-induced purpura fulminans complicated by multiple organ failure, severe epidermolysis and cutaneous necrosis. We show the diagnostic challenge to differentiate between purpura fulminans and TEN, as the extensive epidermolysis in purpura fulminans may mimic TEN and we highlight the additional value of repeated skin biopsies and 16S rRNA gene sequencing.

Property.

ERIC Educational Resources Information Center

Goldblatt, Steven M.; Piele, Philip K.

This chapter reviews 1982 cases related to school property. Cases involving citizen efforts to overturn school board decisions to close schools dominate the property chapter, and courts continue to uphold school board authority to close schools, transfer students, and sell or lease the buildings. Ten cases involving detachment and attachment of…

Self organized striping in ultra thin polymer films near melt: An investigation using Monte Carlo simulation

NASA Astrophysics Data System (ADS)

Singh, Satya Pal

2018-05-01

This paper work presents the results of Monte Carlo simulation performed for ultra thin short chained polymer films near melt, under strong confinement. Thin polymer films get ruptured when annealed above their glass transition temperatures. The pattern formations are generally explained on the basis of spinodal mechanism, if the thickness of the film is of the order of few tens of nanometers i.e. <100 nm. In this case, the film seems to tear apart in strips. The free end segments of the chains are more dynamic and coalescence into one another. This process seems to dominate over the spinodal waves resulting into a different type of dynamics. Polymer chains with 30 monomers are taken. 160, 200 and 240 chains are taken for three different cases of the studies. The three cases correspond to three different thickness of the films with 8, 10 and 12 layers of chains along direction perpendicular to the confining substrates. The bottom surface has affinity to monomers, whereas the upper surface has hard wall interaction with the monomers. Different time micrographs of the films are plotted along with density distributions of the monomers to explore the process.

Ten Tonne Plan: Education for Sustainability from a Whole Systems Thinking Perspective

ERIC Educational Resources Information Center

Lewis, Elaine; Mansfield, Caroline; Baudains, Catherine

2014-01-01

The "Ten Tonne Plan" is a greenhouse gas emissions reduction initiative that aimed to reduce school emissions by 10 tonnes (metric tons) in one year. A case study was conducted on the impact of this initiative at a primary school in Western Australia. Research investigated student, staff, parent, and community partner perceptions…

The floating shoulder—-clinical and radiological results after intramedullary stabilization of the clavicle in cases with minor displacement of the scapular neck fracture.

PubMed

Izadpanah, Kaywan; Jaeger, Martin; Maier, Dirk; Kubosch, David; Hammer, Thorsten Oliver; Südkamp, Norbert P

2012-02-01

The aim of this study was to compare the clinical and radiologic results of titanium elastic nail (TEN) and plate osteosynthesis for treatment of clavicle fractures in patients with a floating shoulder injury. From 2000 to 2008, 16 patients with a floating shoulder injury (ipsilateral clavicle and minor displaced scapular neck fracture) were treated by isolated stabilization of the clavicle. The patients were treated with open reduction and plate osteosynthesis (group 1[G1]) or TEN osteosynthesis (group 2 [G2]). Both procedures were compared with regard to functional and radiologic outcome. Nine patients were treated with a plate osteosynthesis (G1) and seven with a TEN osteosynthesis (G2). The follow-up time was 35.7 months ± 16 months. There was no difference in functional outcome with regard to the intraindividual Constant score 83.9(G1) versus 86.7 (G2) or the American Shoulder and Elbow Surgeons score 79.1 (G1) versus 85.7 (G2). No significant postoperative dislocation of the glenopolar angle appeared. In the TEN-treated group, a clavicle shortening of 2.4 mm was observed. Subgroup analysis revealed significant greater shortening in type B and C compared with type A (OTA) clavicle fractures(4.7 mm vs. 0.8 mm). No clavicle shortening in the plate-treated group appeared. The treatment of floating shoulder injuries with TEN and plate osteosynthesis of the clavicle and nonoperative treatment of a minimally displaced glenoid neck fracture provide equal functional results. However, in type B and C (but not in type A) fractures of the clavicle, a shortening of 5 mm can be expected after titanium elastic nailing. Copyright ©2012 by Lippincott Williams & Wilkins

Retrospective study of canine cutaneous tumors in Korea

PubMed Central

Pakhrin, Bidur; Kang, Min-Soo; Bae, Il-Hong; Park, Mi-Sun; Jee, Hyang; You, Mi-Hyeon; Kim, Jae-Hoon; Yoon, Byung-Il; Choi, Yang-Kyu

2007-01-01

Over the 42 month period from January 2003 to June 2006, a total of 2,952 canine biopsy specimens were received from the Veterinary Medical Teaching Hospital of Seoul National University and from veterinary practitioners across the nation. Out of these, 748 (25.34%) cases were diagnosed as canine cutaneous tumors in the Department of Veterinary Pathology, College of Veterinary Medicine, Seoul National University, Korea. Thirty-eight different types of cutaneous tumors were identified and categorized into epithelial and melanocytic tumors (56.95%), mesenchymal tumors (38.90%), and hematopoietic tumors (4.14%) located in the skin. Among these, 69.25% were benign and 30.74% were malignant. The top ten most frequently diagnosed cutaneous tumors were epidermal and follicular cysts (12.70%), lipoma (11.36%), mast cell tumors (8.82%), cutaneous histiocytoma (7.49%), basal cell tumors (6.82%), sebaceous gland adenoma (6.68%), sebaceous gland hyperplasia (5.08%), hepatoid gland adenoma (3.61%), apocrine adenocarcinoma (3.07%), and fibroma (2.81%), in order of prevalence. They comprised 68.45% of all cutaneous tumors. These top ten cutaneous tumors were distributed on the trunk (30.08%), head and neck (20.9%), extremities (19.14%), anal and perianal area (8.59%), and tail (3.91%). The age of the dogs with the ten most frequent tumors had a mean age of 8.3 years, with a range of 2 months to 19 years. When all types of tumors were considered together in the entire population, there was no difference in incidence according to sex. PMID:17679768

Yolk embolism associated with trauma in vitellogenic sea turtles in Florida (USA): a review of 11 cases.

PubMed

Stacy, Brian A; Foley, Allen; Garner, Michael M; Mettee, Nancy

2013-12-01

Case information and postmortem examination findings are presented for 11 adult female sea turtles in reproductive form that died in Florida, USA. All had abundant, large vitellogenic follicles, and most were either gravid or had recently nested. Species included six loggerheads (Caretta caretta) and five green turtles (Chelonia mydas). Identified proximate causes of death included falls or entrapment by obstructions on nesting beaches, burial under collapsed dunes, and other traumatic injuries of different causes. Evidence of yolk embolization was found in 10 cases and suspected in an 11th turtle. Ten turtles also had various amounts of free intracoelomic yolk. Although the effects of yolk embolization are uncertain at this time, precedence of pathologic importance in other species suggests that embolism may complicate traumatic injuries, including seemingly minor events.

Frequent homozygosity in both mature and immature ovarian teratomas: a shared genetic basis of tumorigenesis.

PubMed

Snir, Olivia L; DeJoseph, Maura; Wong, Serena; Buza, Natalia; Hui, Pei

2017-10-01

Although homozygosity is well documented in mature teratomas, the genetic zygosity of ovarian immature teratomas and mixed germ cell tumors is less well studied. Ten cases of mature cystic teratomas, eleven cases of grade 2 or 3 immature teratomas, and seven cases of mixed germ cell tumors with an immature teratoma component were investigated by short tandem repeat genotyping to interrogate their genetic zygosity. DNA genotyping was informative in eight mature teratomas, seven immature teratomas and six cases of mixed germ cell tumors. Out of the eight mature teratomas, five cases showed partial or complete homozygosity (63%) with two cases demonstrating complete homozygosity (25%). Of the immature teratomas, six cases showed partial or complete homozygosity (86%) with two cases demonstrating complete homozygosity (29%). For the mixed germ cell tumors, two cases showed partial homozygosity (33%) and none displayed complete homozygosity. Long-term clinical follow-up was available for five immature teratomas (mean follow-up 110 months) and five mixed germ cell tumors (mean follow-up 66 months). None of the five patients with pure immature teratoma had a recurrence; in contrast, four out of five mixed ovarian germ cell tumors recurred between 4 months to 8 years (P=0.048). In conclusion, both immature and mature teratomas harbor frequent genetic homozygosity suggesting a common cellular origin involving germ cells at the same developmental stage. The difference in the rate of homozygosity and tumor recurrence between pure immature teratomas and mixed germ cell tumors suggests that the two entities may involve different pathogenetic pathways and likely pursue different biological behaviors.

Suboptimal care and perinatal mortality in ten European regions: methodology and evaluation of an international audit.

PubMed

Richardus, J H; Graafmans, W C; Bergsjø, P; Lloyd, D J; Bakketeig, L S; Bannon, E M; Borkent-Polet, M; Davidson, L L; Defoort, P; Leitão, A Esparteiro; Langhoff-Roos, J; Garcia, A Moral; Papantoniou, N E; Wennergren, M; Amelink-Verburg, M P; Verloove-Vanhorick, S P; Mackenbach, J P

2003-10-01

A European concerted action (the EuroNatal study) investigated differences in perinatal mortality between countries of Europe. This report describes the methods used in the EuroNatal international audit and discusses the validity of the results. Perinatal deaths between 1993 and 1998 in regions of ten European countries were identified. The categories of death chosen for the study were singleton fetal deaths at 28 or more weeks of gestational age, all intrapartum deaths at 28 or more weeks of gestational age and neonatal deaths at 34 or more weeks of gestational age. Deaths with major congenital anomalies were excluded. An international audit panel used explicit criteria to review all cases, which were blinded for region. Subjective interpretation was used in cases of events or interventions where explicit criteria did not exist. Suboptimal factors were identified in the antenatal, intrapartum and neonatal periods, and classified as 'maternal/social', due to 'infrastructure/service organization', or due to 'professional care delivery'. The contribution of each suboptimal factor to the fatal outcome was listed and consensus was reached on a final grade using a procedure that included correspondence and plenary meetings. In all regions combined, 90% of all known or estimated cases in the selected categories were included in the audit. In total, 1619 cases of perinatal death were audited. Consensus was reached in 1543 (95%) cases. In 75% of all cases, the grade was based on explicit criteria. In the remaining cases, consensus was reached within subpanels without reference to predefined criteria. There was reasonable to good agreement between and within subpanels, and within panel members. The international audit procedure proved feasible and led to consistent results. The results that relate to suboptimal care will need to be studied in depth in order to reach conclusions about their implications for assessing the quality of perinatal care in the individual regions.

Effect of Transcutaneous Electric Nerve Stimulation on Pain after Total Knee Arthroplasty: A Blind Randomized Controlled Trial.

PubMed

Beckwée, David; Bautmans, Ivan; Lefeber, Nina; Lievens, Pierre; Scheerlinck, Thierry; Vaes, Peter

2018-02-01

Transcutaneous electric nerve stimulation (TENS) has proven to be effective for postsurgical pain relief. However, there is a lack of well-constructed clinical trials investigating the effect of TENS after total knee arthroplasty (TKA). In addition, previous investigations reported that low- and high-frequency TENSs produced analgesic tolerance after 4 or 5 days of treatment. The aim of this study is to explore the effect of burst TENS on pain during hospitalization after TKA and to investigate whether burst TENS produces analgesic tolerance after 4 or 5 days of treatment. This stratified, triple blind, randomized controlled trial was approved by the University Hospital Brussels. Sixty-eight subjects were screened for eligibility before surgery; 54 were found eligible and 53 were included in the analyses. Patients were allocated to either a burst TENS or sham burst TENS group. TENS was applied daily during continuous passive mobilization. Knee pain intensity, knee range of motion, and analgesic consumption were assessed daily. Patients received burst TENS ( N  = 25) or sham burst TENS ( N  = 28). No significant differences in knee pain intensity were found between the groups ( p  > 0.05). Within the TENS and the sham TENS groups, the difference in knee pain before and after treatment did not evolve over time ( p  > 0.05). This study found no effects of burst TENS compared with sham burst TENS on pain during hospitalization after TKA. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

[A major outbreak of Legionnaire's disease due to a public bathhouse: clinical examination].

PubMed

Nakamura, Hiroyuki; Yagyu, Hisanaga; Tsuchida, Fumihiro; Sudou, Akihiko; Watanabe, Osamu; Kioi, Kiwamu; Kishi, Koji; Oh-ishi, Shuji; Kiguchi, Toshio; Yamaguchi, Keizo; Matsuoka, Takeshi

2003-05-01

The largest epidemic outbreak of legionnaires' disease occurred in Japan, where there were 45 cases, including three deaths. There was a high degree of homology at the genetic level between Legionella pneumophila sero-group 1 isolated from two patients and water samples collected from a public bath, and this highlighted the public bath visited by the patients as the source of the infection. We report our clinical observations of 34 cases with a pneumonia type (20 definite and 14 probable) of the 42 cases for whom a diagnosis was made and follow-up care was subsequently provided at our hospital or hospital-affiliated facilities, out of the initial total of 45 cases. Twenty-one cases had underlying diseases, but the disease was mild in all patients. Three cases showed different neuropsychiatric symptoms such as reduced capacity for memorization, somnolence or delirium. Diarrhea was found in three cases, and relative bradycardia in ten. Clinical laboratory test results indicated that a severe inflammatory reaction, renal or hepatic dysfunction, an electrolyte abnormality and abnormal urinalysis were common in the 34 cases. Chest radiography showed a shadow suggestive of infection of the pulmonary parenchyma with multilobar involvement in most cases and pleural effusion in nine cases.

Linear immunoglobulin A dermatosis mimicking toxic epidermal necrolysis: a case report of etanercept treatment.

PubMed

Prieto-Barrios, M; Velasco-Tamariz, V; Tous-Romero, F; Burillo-Martinez, S; Zarco-Olivo, C; Rodriguez-Peralto, J L; Ortiz-Romero, P L

2018-03-01

A 65-year-old pluripathological woman attended our hospital with a cutaneous eruption of sudden appearance after vancomycin treatment. She presented targetoid lesions affecting approximately 25-30% of her body surface, large erosions with mucosal lesions and positive Nikolsky sign. Under the initial clinical suspicion of toxic epidermal necrolysis (TEN), and considering the recent literature of successful use of etanercept in these cases, she was treated with a single dose of this antitumour necrosis factor (anti-TNF) agent. Subsequently, the exanthema progression stopped and resolution of the lesions happened in a few days. Later on, histopathology revealed a subepidermal blister with dense neutrophilic infiltrate and linear deposits of immunoglobulin A (IgA) on the dermoepidermal junction, allowing us to establish the diagnosis of drug-induced linear IgA dermatosis mimicking TEN. Linear IgA dermatosis can have severe clinical manifestations, even mimicking TEN, and can have high mortality, especially in drug-induced cases. We have not found any other report of linear IgA dermatosis treated with etanercept in the English literature. Anti-TNF medications could represent useful therapeutic alternatives in this dermatosis. © 2017 British Association of Dermatologists.

Lessons for the Global Spatial Data Infrastructure : international case study analysis

DOT National Transportation Integrated Search

2002-01-01

This report presents a RAND analysis of international collaboration for the Global Spatial Data Infrastructure (GSDI). Ten in-depth international and regional collaboration case studies were conducted to assess lessons learned for GSDI development an...

Helping Children Talk about Shapes: A Case Study with Ten Children in the Learning Support Programme

ERIC Educational Resources Information Center

Fong, Ng Swee

2006-01-01

This paper describes an activity which attempts to change the discourse of a mathematics classroom with the specific intent to help children who may have difficulties with mathematics and ways of communicating. Ten 8-year old children in the Learning Support Programme were engaged in an open-ended geometric task. In this paper a brief description…

Interest of Grade Ten Students toward Physics among Other Science Subjects, Case of Wolaita Soddo Town Governmental Secondary Schools, Ethiopia

ERIC Educational Resources Information Center

Hamelo, Shewangzaw

2016-01-01

This paper has proposed to investigate the interest in students towards physics among other science subjects. The investigation was carried out with 490 samples of grade ten students in Wolaita Soddo town governmental schools. Thus, overall result indicates that the interest in students towards physics is low and students hate to learn physics in…

The Effects of Mediated Learning Strategies on Teacher Practice and on Students at Risk of Academic Failure

ERIC Educational Resources Information Center

Mann, Deborah; Hinds, Janet L.

2007-01-01

The purpose of this case study was to determine the effects of Reuven Feuerstein's ten Mediated Learning Strategies on both teacher practice and on students that were at risk of academic failure. Changes in both teacher practice and student learning were analyzed to determine changes during the use of the ten Mediated Learning Strategies: Meaning,…

8 CFR 216.6 - Petition by entrepreneur to remove conditional basis of lawful permanent resident status.

Code of Federal Regulations, 2011 CFR

2011-01-01

... reasonable time ten full-time jobs for qualifying employees. In the case of a “troubled business” as defined... demonstrates to the director's satisfaction that failure to file a timely petition was for good cause and due... alien created or can be expected to create within a reasonable period of time ten full-time jobs to...

Pain clinic definitions in the medical literature and U.S. state laws: an integrative systematic review and comparison.

PubMed

Andraka-Christou, Barbara; Rager, Joshua B; Brown-Podgorski, Brittany; Silverman, Ross D; Watson, Dennis P

2018-05-22

In response to widespread opioid misuse, ten U.S. states have implemented regulations for facilities that primarily manage and treat chronic pain, called "pain clinics." Whether a clinic falls into a state's pain clinic definition determines the extent to which it is subject to oversight. It is unclear whether state pain clinic definitions model those found in the medical literature, and potential differences lead to discrepancies between scientific and professionally guided advice found in the medical literature and actual pain clinic practice. Identifying discrepancies could assist states to design laws that are more compatible with best practices suggested in the medical literature. We conducted an integrative systematic review to create a taxonomy of pain clinic definitions using academic medical literature. We then identified existing U.S. state pain clinic statutes and regulations and compared the developed taxonomy using a content analysis approach to understand the extent to which medical literature definitions are reflected in state policy. In the medical literature, we identified eight categories of pain clinic definitions: 1) patient case mix; 2) single-modality treatment; 3) multidisciplinary treatment; 4) interdisciplinary treatment; 5) provider supervision; 6) provider composition; 7) marketing; and 8) outcome. We identified ten states with pain clinic laws. State laws primarily include the following definitional categories: patient case mix; single-modality treatment, and marketing. Some definitional categories commonly found in the medical literature, such as multidisciplinary treatment and interdisciplinary treatment, rarely appear in state law definitions. This is the first study to our knowledge to develop a taxonomy of pain clinic definitions and to identify differences between pain clinic definitions in U.S. state law and medical literature. Future work should explore the impact of different legal pain clinic definitions on provider decision-making and state-level health outcomes.

[Narcotics and illicit drug market. Status and 10-year development].

PubMed

Lindholst, Christian; Andreasen, Mette Findal; Kaa, Elisabet

2008-01-07

A description of the illicit drug market in Denmark's second largest city is provided based upon the prevalence of narcotics and illicitly sold medicals during the years 2002 and 2003. The changes on the illicit drug market are described by comparing the results to a similar study conducted ten years earlier. The study is comprised of 469 cases of seized material by Aarhus Police during the period January 1st 2002-December 31st 2003. Additional information relating to the 341 persons charged is also included in the study. Heroine, cocaine and amphetamine were seized in 31%, 30% and 28% of the cases, respectively, and comprise the most frequently encountered hard drugs on the market. The prevalence of cocaine in Aarhus Police District has increased more than tenfold during the past ten years. The purity of the three drugs decreased significantly during the same period, although large variations in the quality of drugs were observed. Medicals were found in 16% of the seizures (containing 32 different active substances). The most frequent group of medicals was benzodiazepines, which made up a total of 74% of the medicals in the study. Anabolic steroids, ecstasy and methamphetamine were each found in 4% of the seizures. Men with an average age of 29.1 years comprised 92% of the persons charged in the study. Persons with a foreign nationality comprised 15% of the charged, while 25% had a birthplace outside Denmark. The prevalence of stimulants especially cocaine have increased significantly during the past ten years. Meanwhile the purity of the drugs has decreased. The benzodiazepines are still the most frequent group of medicals on the illicit market.

Snapshots of Student Thinking: An Exploration of Video Cases for Extending Prospective Teachers' Knowledge

ERIC Educational Resources Information Center

Pitts Bannister, Vanessa R.; Mariano, Gina J.

2013-01-01

The purpose of this article is to explore the relationships between prospective teachers' content knowledge, student understanding, and pedagogy using video cases. The emphasis was on the extent to which the participants utilized constructs of Technology Pedagogy And Content Knowledge. Ten prospective teachers viewed video cases of students…

A randomized trial to determine the duration of analgesia following a 15- and a 30-minute application of acupuncture-like TENS on patients with chronic low back pain.

PubMed

Tousignant-Laflamme, Yannick; Laroche, Claudia; Beaulieu, Christine; Bouchard, Ann-Julie; Boucher, Sabrina; Michaud-Létourneau, Mélanie

2017-05-01

Acupuncture-like TENS (AL-TENS) has been shown to produce prolonged pain relief, but no study has yet investigated its duration on a population suffering from chronic low back pain (CLPB). Our objective was to quantify the duration and magnitude of analgesia induced by a 15- or 30-minute application of AL-TENS. We recruited a sample of 11 participants presenting with CLBP and conducted a randomized, crossover study, where participants were given AL-TENS for 15 and 30 minutes on two separate occasions. The pain intensity of their CLBP was assessed with a visual analogue scale before, during, and after AL-TENS applications. Magnitude and duration of analgesia were determined for each subject and for both AL-TENS application times. The AL-TENS applications induced a clinically and statistically significant (p = 0.003) analgesia in all participants. Median duration of analgesia was 9 hours and 10 hours 30 minutes following the 15- and 30-minute AL-TENS applications, respectively; this 1.5-hour difference was not statistically significant (p = 0.55). Furthermore, we observed no significant difference in the magnitude of analgesia between both applications of AL-TENS (p > 0.56), suggesting that the duration of application of AL-TENS does not influence the magnitude of analgesia. Our results suggest that clinicians could use a 15-minute AL-TENS application to provide significant analgesia in patients presenting with low back pain since if provides a comparable analgesia versus a 30-minute application.

Federal Initiative: Tick-Borne Disease Integrated Pest Management White Paper

EPA Pesticide Factsheets

The numbers of human cases of Lyme disease and other tick-borne diseases (TBDs) reported each year to CDC have been increasing steadily in the United States (US), currently totaling tens of thousands of diagnosed human cases annually.

Dosimetric impact of different CT datasets for stereotactic treatment planning using 3D conformal radiotherapy or volumetric modulated arc therapy.

PubMed

Oechsner, Markus; Odersky, Leonhard; Berndt, Johannes; Combs, Stephanie Elisabeth; Wilkens, Jan Jakob; Duma, Marciana Nona

2015-12-01

The purpose of this study was to assess the impact on dose to the planning target volume (PTV) and organs at risk (OAR) by using four differently generated CT datasets for dose calculation in stereotactic body radiotherapy (SBRT) of lung and liver tumors. Additionally, dose differences between 3D conformal radiotherapy and volumetric modulated arc therapy (VMAT) plans calculated on these CT datasets were determined. Twenty SBRT patients, ten lung cases and ten liver cases, were retrospectively selected for this study. Treatment plans were optimized on average intensity projection (AIP) CTs using 3D conformal radiotherapy (3D-CRT) and volumetric modulated arc therapy (VMAT). Afterwards, the plans were copied to the planning CTs (PCT), maximum intensity projection (MIP) and mid-ventilation (MidV) CT datasets and dose was recalculated keeping all beam parameters and monitor units unchanged. Ipsilateral lung and liver volumes and dosimetric parameters for PTV (Dmean, D2, D98, D95), ipsilateral lung and liver (Dmean, V30, V20, V10) were determined and statistically analysed using Wilcoxon test. Significant but small mean differences were found for PTV dose between the CTs (lung SBRT: ≤2.5 %; liver SBRT: ≤1.6 %). MIPs achieved the smallest lung and the largest liver volumes. OAR mean doses in MIP plans were distinctly smaller than in the other CT datasets. Furthermore, overlapping of tumors with the diaphragm results in underestimated ipsilateral lung dose in MIP plans. Best agreement was found between AIP and MidV (lung SBRT). Overall, differences in liver SBRT were smaller than in lung SBRT and VMAT plans achieved slightly smaller differences than 3D-CRT plans. Only small differences were found for PTV parameters between the four CT datasets. Larger differences occurred for the doses to organs at risk (ipsilateral lung, liver) especially for MIP plans. No relevant differences were observed between 3D-CRT or VMAT plans. MIP CTs are not appropriate for OAR dose assessment. PCT, AIP and MidV resulted in similar doses. If a 4DCT is acquired PCT can be omitted using AIP or MidV for treatment planning.

Direct simulation of a self-similar plane wake

NASA Technical Reports Server (NTRS)

Moser, Robert D.; Rogers, Michael M.

1994-01-01

Direct simulations of two time-developing turbulent wakes have been performed. Initial conditions for the simulations were obtained from two realizations of a direct simulation of a turbulent boundary layer at momentum thickness Reynolds number 670. In addition, extra two dimensional disturbances were added in one of the cases to mimic two dimensional forcing. The unforced wake is allowed to evolve long enough to attain self similarity. The mass-flux Reynolds number (equivalent to the momentum thickness Reynolds number in spatially developing wakes) is 2000, which is high enough for a short k(exp -5/3) range to be evident in the streamwise one dimensional velocity spectrum. Several turbulence statistics have been computed by averaging in space and over the self-similar period in time. The growth rate in the unforced flow is low compared to experiments, but when this growth-rate difference is accounted for, the statistics of the unforced case are in reasonable agreement with experiments. However, the forced case is significantly different. The growth rate, turbulence Reynolds number, and turbulence intensities are as much as ten times larger in the forced case. In addition, the forced flow exhibits large-scale structures similar to those observed in transitional wakes, while the unforced flow does not.

Endothelial function and its relationship to leptin, homocysteine, and insulin resistance in lean and overweight eumenorrheic women and PCOS patients: a pilot study.

PubMed

Mancini, Fulvia; Cianciosi, Arianna; Reggiani, Giulio Marchesini; Facchinetti, Fabio; Battaglia, Cesare; de Aloysio, Domenico

2009-06-01

To verify if patients with polycystic ovarian syndrome (PCOS), have an increased cardiovascular risk compared with healthy controls. Prospective case-control study. University-based practice. Twenty eumenorrheic controls (ten lean [group A] and ten overweight [group B]) and 24 PCOS women (14 lean [group C] and ten overweight [group D]). Cardiovascular risk markers and hormonal parameters were assessed. Androgens, fasting glucose, insulin, leptin, fibrinogen, homocysteine, endothelin-1 and flow-mediated dilatation of the brachial artery were measured to investigate their relationship to weight and to PCOS. The brachial artery diameter and the pulsatility index, after the reactive hyperemia, showed in group A the most intense vasodilatation compared with the other groups. Homocysteine levels did not differ among the groups. Endothelin-1 was significantly higher in group A compared with groups B and D. Leptin was significantly lower in groups A and C compared with groups B and D. Insulin resistance was higher in groups B and D. Group A had significantly higher glucose-insulin ratio compared with all of the other groups; group C had significantly higher glucose-insulin ratio only compared with group D. Weight and PCOS are two independent variables affecting the endothelial function.

[Relationship between clinical features and prognosis of highly pathogenic avian influenza A/H5N1 infection in humans in mainland China].

PubMed

Li, Jia; Xu, Yu; Chen, Yu-qing; Ge, Yang; Zhang, Long-hui; Xu, Xiao-ling; Wu, Tong-sheng; Chen, Yu-sheng; Wang, Jing; Liu, Jian-nan; Wei, Li-ping; Qiu, Chen; Zhong, Xiao-ning; Huang, Mei-xing; Xin, Jian-bao; Luo, Ru-ping; Zhao, Ming-shun; Li, Zai-qing; Hu, Cheng-ping; Zhao, Wei; Wang, Hong; Zhang, Wei; Guo, Lu-sheng; Wang, Qiu-yue; Zhou, Long-nü; Liang, Zong-an; Ma, Jun-qing; Liu, Yue-jian; Jiang, Yuan-ming; Xie, Wan-sheng; Sheng, Ji-fang; Gao, Zhan-cheng

2009-05-01

To investigate the relationship between clinical features of patients with A/H5N1 infection and their prognosis in mainland China. This study included 28 human cases with A/H5N1 infection in mainland China from October 2005 to May 2008. Data were collected and reviewed from hospital medical records and publishied papers. A database was built by EPIDATA 3.02 and statistical analyses were performed with SPSS 13.0. The median age of the 28 cases was 29 years (range 6-62), and 15 were females. Ten patients survived, and 18 died. The typically clinical manifestations of human influenza A/H5N1 infection included fever and lower respiratory infection. The numbers of peripheral white blood cells, lymphocytes and platelets in the survival and non-survival groups were (4.01 +/- 1.86) x 10(9)/L vs (5.1 +/- 2.9) x 10(9)/L, (1.09 +/- 0.49) x 10(9)/L vs (0.98 +/- 0.44) x 10(9)/L, and (116 +/- 39) x 10(9)/L vs (101 +/- 40) x 10(9)/L, respectively; the differences were not statistically significant between the 2 groups (P>0.05). There was also no statistically significant difference in the increased serum enzymes, such as aspartate aminotransferase [(173 +/- 246) U/L vs (272 +/- 263) U/L], lactate dehydrogenase [(1016 +/- 568) U/L vs (1512 +/- 1052) U/L], creatine kinase [(1099 +/- 1590) U/L vs (2534 +/- 4281) U/L] and MB isoenzyme of creatine kinase [(28 +/- 30) U/L vs (125 +/- 197) U/L] (P>0.05) between the survival and the non-survival groups. However, there was a statistically significant difference in the number of patients with an initial LDH level more than 8 fold of the normal value between the survival and the non-survival groups (none vs 6, P<0.05). All of the 28 cases developed bilateral multiple infiltrates and consolidation in chest radiographs. Acute respiratory distress syndrome occurred in 22 cases, 17 of them died. All the 9 patients with acute kidney injury died. Ten patients received antiviral treatment with oseltamivir, and 6 of them survived. There was a statistical difference in the time of initiating oseltamivir treatment between the survival and the non-survival cases [(6.5 +/- 3.0) d vs (11.8 +/- 3.3) d, Z = 3.70, P<0.05]. Broad spectrum antibiotics and corticosteroids were administered in all of the 28 cases. There was no statistical difference between the survival and the non-survival groups regarding to the corticosteroid treatment (P>0.05). Initial LDH level reaching more than 8 fold of the normal value suggests a poor prognosis for human H5N1 infection. Patients complicated with either ARDS or acute kidney injury had a higher risk of death. Early administration of effective antiviral agents might improve the prognosis and decrease case fatality.

Upper trapezius relaxation induced by TENS and interferential current in computer users with chronic nonspecific neck discomfort: An electromyographic analysis.

PubMed

Acedo, Adriano Alexandre; Luduvice Antunes, Ana Carolina; Barros dos Santos, André; Barbosa de Olveira, Cintia; Tavares dos Santos, Claudia; Colonezi, Gustavo Lacreta Toledo; Fontana, Felipe Antonio Medeiros; Fukuda, Thiago Yukio

2015-01-01

Recent studies have shown that a transcutaneous electrical nerve stimulation (TENS) and interferential current (IFC) application reduces pain in subjects with musculoskeletal disorders. However there are no clinical trials evaluating or comparing the muscle relaxation generated for these devices. To compare the muscle relaxation of the upper trapezius induced by the application of TENS and IFC in females with chronic nonspecific neck discomfort. Sixty-four females between 18 and 40 years of age and a history of nonspecific neck discomfort were randomly assigned to a TENS or an IFC group. The women in the TENS (N = 32; mean age 22 years) and IFC (N = 32, mean age 23 years) group were submitted to current application during 3 consecutive days and were assessed by electromyography (EMG) in different times aiming to quantify the muscular tension of the upper trapezius. A visual analogue scale (VAS) was used as pain measure at baseline (before TENS or IFC application) and at the end of the study. At baseline, demographic, pain, and EMG assessment data were similar between groups. Those in the IFC group had a significant trapezius relaxation after 3 IFC applications when compared to baseline and intermediate evaluations (P < 0.05). In contrast, the same analysis showed no significant difference between all assessments in the TENS group (P >0.05). In relation to pain relief, both groups showed an improvement at the end of the study when compared to baseline (both,P <0.05). The between-group analysis showed no difference for the subjects who received such IFC as TENS application (P <0.05). IFC induced the upper trapezius relaxation after 3 sessions in females with neck discomfort, but the TENS application did not change the muscular tension. However, these results should be carefully interpreted due to the lack of differences between groups. A significant pain decrease was found in the subjects of both groups, however, only the IFC application presented a clinically important improvement.

Computer-aided assessment of pulmonary disease in novel swine-origin H1N1 influenza on CT

NASA Astrophysics Data System (ADS)

Yao, Jianhua; Dwyer, Andrew J.; Summers, Ronald M.; Mollura, Daniel J.

2011-03-01

The 2009 pandemic is a global outbreak of novel H1N1 influenza. Radiologic images can be used to assess the presence and severity of pulmonary infection. We develop a computer-aided assessment system to analyze the CT images from Swine-Origin Influenza A virus (S-OIV) novel H1N1 cases. The technique is based on the analysis of lung texture patterns and classification using a support vector machine (SVM). Pixel-wise tissue classification is computed from the SVM value. The method was validated on four H1N1 cases and ten normal cases. We demonstrated that the technique can detect regions of pulmonary abnormality in novel H1N1 patients and differentiate these regions from visually normal lung (area under the ROC curve is 0.993). This technique can also be applied to differentiate regions infected by different pulmonary diseases.

Transcutaneous Nerve Stimulation for Pain Relief During Office Hysteroscopy: A Randomized Controlled Trial.

PubMed

Lisón, Juan F; Amer-Cuenca, Juan J; Piquer-Martí, Silvia; Benavent-Caballer, Vicente; Biviá-Roig, Gemma; Marín-Buck, Alejandro

2017-02-01

To evaluate the pain-relieving effect of transcutaneous electrical nerve stimulation (TENS) during office-based hysteroscopy without sedation. We conducted a randomized, double-blind, placebo-controlled trial. Participants were randomly assigned to the active TENS, placebo TENS, or control group. The active TENS intervention consisted of a varying high-frequency (80-100 Hz), 400-microseconds, individually adjusted, high-intensity TENS application with two self-adhesive electrodes placed parallel to the spinal cord at the T10-L1 and S2-S4 levels. In the placebo group, participants were connected to the TENS unit but delivering no electrical stimulation. The primary outcome was self-reported pain intensity (0-100 mm) measured on a visual analog scale at several stages (entry, contact, biopsy, and residual). The minimum clinically relevant difference for the visual analog scale has been previously reported as 10 mm. Sample size was calculated to provide 80% power to show a 10-mm difference (α=0.0125) in the primary outcome. Secondary outcomes included duration of the procedure, vital parameters, vasovagal symptoms, and participant satisfaction index (0-10 rating scale). A total of 138 women (46 per group) participated in the study between January 2016 and April 2016. No differences were found between groups regarding age, weight, body mass index, parity status, menopausal status, or previous hysteroscopy status. Visual analog scale scores highlighted a decrease in pain in the active TENS group compared with the placebo group (entry: -11 mm, 95% confidence interval [CI] -17 to -5; contact: -21.9 mm, 95% CI -30 to -13.9; biopsy: -30.5 mm, 95% CI -47.1 to -13.8, P<.001). Moreover, the reduction in pain reached the minimum clinically relevant difference. Regarding satisfaction, results also revealed differences between active TENS and placebo groups (1.3, 95% CI 0.5-2.2, P=.001). Transcutaneous electrical nerve stimulation reduces pain and increases patient satisfaction during office hysteroscopy without sedation. ClinicalTrials.gov, www.clinicaltrials.gov, NCT02647008.

Incidence of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Nationwide Population-Based Study Using National Health Insurance Database in Korea.

PubMed

Yang, Min-Suk; Lee, Jin Yong; Kim, Jayeun; Kim, Gun-Woo; Kim, Byung-Keun; Kim, Ju-Young; Park, Heung-Woo; Cho, Sang-Heon; Min, Kyung-Up; Kang, Hye-Ryun

2016-01-01

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening diseases; however, it is hard to estimate their incidence due to the rarity of these diseases. We evaluated the incidence of SJS and TEN using a nationwide administrative database. We used a national medical insurance review system (Health Insurance Review and Assessment) database which contained the claim data of the entire nation from 2009 to 2013 to estimate the accurate incidence of SJS and TEN in Korea. The diagnostic codes of L511 (SJS) or L512 (TEN) from the International Classification of Diseases-10th revision were used to define the target study population. We also retrospectively followed up a 2011 SJS and TEN cohort for 24 months in order to assess the in-hospital mortality, related complications and total claims cost due to SJS and TEN. A total of 1,167 (938 SJS and 229 TEN) cases were newly diagnosed from 2010 to 2013. The age- and sex-standardized annual incidences estimated in this study were 3.96 to 5.03 in SJS and 0.94 to 1.45 in TEN per million. There was no significant change in annual incidence throughout the study periods. When analyzed by 10-year age groups, the annual incidence was the lowest in group 20-29 years and the highest in group 70 for both SJS and TEN. Based on the 2011 cohort analysis, the in-hospital mortality were 5.7 and 15.1% for SJS and TEN, respectively. The mortality increased with age, particularly, after 40 years of age. Among the complications related with SJS or TEN, ocular sequelae was the most common (43.1 and 43.4% of SJS and TEN patients, respectively) followed by urethral sequelae (5.7 and 9.4% of SJS and TEN patients, respectively). Overall, our data suggest that SJS, and TEN are infrequent but constantly arise throughout the years.

[Verifying the function of hepaticojejunostomies by scintigraphy of the bile ducts].

PubMed

Champetier, J; Busquet, G; Letoublon, C; Vigneau, B; Yver, R; Rambeaud, J J

1984-01-01

Thirty six hepatobiliary scintigraphies with 99mTc-Dimethyl IDA were performed in thirty patients with an hepaticojejunostomy one month to ten years after surgery. Twenty patients underwent surgery for biliary disease and ten for duodenal or pancreatic disease. In most cases (twenty three), the radionuclide study has been systematically performed to assess the scintigraphic pattern of a normal hepaticojejunostomy. In seven cases this pattern was abnormal. Four times the biliary enteric anastomosis was involved. Three times it showed an abnormal liver morphology. After an hepaticojejunostomy, hepatobiliary scintigraphy seems to be the only examination providing dynamic information for the biliary enteric anastomosis and the intestinal loop. But it sometimes is difficult to analyse in all cases, it must be the screening test in patients when symptoms occur after hepaticojejunostomy; but a percutaneous transhepatic cholangiogram cannot always be avoided.

Clinical evaluation of radiotherapy for advanced esophageal cancer after metallic stent placement

PubMed Central

Yu, You-Tao; Yang, Guang; Liu, Yan; Shen, Bao-Zhong

2004-01-01

AIM: To evaluate the therapeutic effect of radiotherapy for esophageal cancer after expandable metallic stent placement. METHODS: Ten cases of advanced esophageal cancer were evaluated, 7 having complete obstruction and 3 with digestive-respiratory fistula. Ten nitinol stents were placed at the site of stenosis. Patients were treated with a total dose of 1200 cGy divided into 3 fractions of 400 cGy 4-7 d after stents placement. RESULTS: All the 10 stents were placed successfully at one time. After radiotherapy for advanced esophageal cancer, the survival period of the cases ranged from 14 to 22 mo, with a mean survival of 17 mo. No re-stenosis occurred among all the 10 cases. CONCLUSION: Stent placement combined with radiotherapy for esophageal cancer is helpful to prolong patients’ survival and reduce occurrence of re-stenosis. PMID:15237455

Prospects of Using High-Intensity THz Pulses To Induce Ultrafast Temperature-Jumps in Liquid Water.

PubMed

Mishra, Pankaj Kr; Bettaque, Vincent; Vendrell, Oriol; Santra, Robin; Welsch, Ralph

2018-06-01

Ultrashort, high-intensity terahertz (THz) pulses, e.g., generated at free-electron laser facilities, allow for direct investigation as well as the driving of intermolecular modes in liquids like water and thus will deepen our understanding of the hydrogen bonding network. In this work, the temperature-jump (T-jump) of water induced by THz radiation is simulated for ten different THz frequencies in the range from 3 to 30 THz and five different pulse intensities in the range from 1 × 10 11 to 5 × 10 12 W/cm 2 employing both ab initio molecular dynamics (AIMD) and force field molecular dynamics (FFMD) approaches. The most efficient T-jump can be achieved with 16 THz pulses. Three distinct T-jump mechanisms can be uncovered. For all cases, the T-jump mechanism proceeds within tens of femtoseconds (fs). For frequencies between 10 and 25 THz, most of the energy is initially transferred to the rotational degrees of freedom. Subsequently, the energy is redistributed to the translational and intramolecular vibrational degrees of freedom within a maximum of 500 fs. For the lowest frequencies considered (7 THz and below), translational and rotational degrees of freedom are heated within tens of fs as the THz pulse also couples to the intermolecular vibrations. Subsequently, the intramolecular vibrational modes are heated within a few hundred fs. At the highest frequencies considered (25 THz and above), vibrational and rotational degrees of freedom are heated within tens of fs, and energy redistribution to the translational degrees of freedom happens within several hundred fs. Both AIMD and FFMD simulations show a similar dependence of the T-jump on the frequency employed. However, the FFMD simulations overestimate the total energy transfer around the main peak and drop off too fast toward frequencies higher and lower than the main peak. These differences can be rationalized by missing elements, such as the polarizability, in the TIP4P/2005f force field employed. The feasibility of performing experiments at the studied frequencies and intensities as well as important issues such as energy efficiency, penetration depth, and focusing are discussed.

Toxic epidermal necrolysis in a child 6 months post-hematopoietic stem cell transplantation.

PubMed

Oba, Utako; Yamada, Hiroshi; Suenobu, So-Ichi; Nakamura, Yusuke; Ito, Akiko; Hatano, Yutaka; Itonaga, Nobuyoshi; Ohshima, Kouichi; Koga, Yuhki; Ohga, Shouichi; Ihara, Kenji

2017-08-01

TEN is a rare and critical disease mostly caused by drugs. It is mediated by activated CD8+ T cells that cause keratinocyte apoptosis with the assistance of cytokines/chemokines. We herein report a pediatric case of TEN after allogeneic HSCT with precursor B-cell acute lymphoblastic leukemia (pre-B-ALL) in second complete remission. Although we did not evaluate the T-cell subpopulation in blood or skin lesion of the patient, an imbalanced immune reconstitution after HSCT might additively contribute to the development of TEN. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Stress-induced nematicity in EuFe 2 As 2 studied by Raman spectroscopy

DOE PAGES

Zhang, W. -L.; Sefat, Athena S.; Ding, H.; ...

2016-07-18

Here, we use polarized Raman scattering to study the structural phase transition in EuFe 2 As 2 , the parent compound of the 122-ferropnictide superconductors. The in-plane lattice anisotropy is characterized by measurements of the side surface with different strains induced by different preparation methods. We also show that while a fine surface polishing leaves the samples free of residual internal strain, in which case the onset of the C 4 symmetry breaking is observed at the nominal structural phase transition temperature T S , cutting the side surface induces a permanent fourfold rotational symmetry breaking spanning tens ofmore » degrees above T S .« less

An investigation into the effects of frequency-modulated transcutaneous electrical nerve stimulation (TENS) on experimentally-induced pressure pain in healthy human participants.

PubMed

Chen, Chih-Chung; Johnson, Mark I

2009-10-01

Frequency-modulated transcutaneous electrical nerve stimulation (TENS) delivers currents that fluctuate between preset boundaries over a fixed period of time. This study compared the effects of constant-frequency TENS and frequency-modulated TENS on blunt pressure pain in healthy human volunteers. Thirty-six participants received constant-frequency TENS (80 pps), frequency-modulated TENS (20 to 100 pps), and placebo (no current) TENS at a strong nonpainful intensity in a randomized cross-over manner. Pain threshold was taken from the forearm using pressure algometry. There were no statistical differences between constant-frequency TENS and frequency-modulated TENS after 20 minutes (OR = 1.54; CI, 0.29, 8.23, P = 1.0). Both constant-frequency TENS and frequency-modulated TENS were superior to placebo TENS (OR = 59.5, P < .001 and OR = 38.5, P < .001, respectively). Frequency-modulated TENS does not influence hypoalgesia to any greater extent than constant-frequency TENS when currents generate a strong nonpainful paraesthesia at the site of pain. The finding that frequency-modulated TENS and constant-frequency TENS were superior to placebo TENS provides further evidence that a strong yet nonpainful TENS intensity is a prerequisite for hypoalgesia. This study provides evidence that TENS, delivered at a strong nonpainful intensity, increases pain threshold to pressure algometry in healthy participants over and above that seen with placebo (no current) TENS. Frequency-modulated TENS does not increase hypoalgesia to any appreciable extent to that seen with constant-frequency TENS.

Moving to alternative refrigerants. Ten case histories. Comfort coolers, industrial process, and commercial refrigeration. Stratospheric ozone protection

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

Not Available

1993-11-01

Table of Contents: Case Histories: Comfort Coolers; Coventry Management Systems - Texaco Heritage Plaza; New York Life Insurance Company; and Westinghouse Electric Corporation. Case Histories: Industrial Process: Eastman Chemical Company; and DuPont. Case Histories: Commercial Refrigeration: Market Basket Supermarkets; Jitney Jungle Stores of America; Furr's Supermarkets; Emil Villa's Hick'ry Pit Restaurants; and Wawa Convenience Stores.

Students' Constitutional Right to a Sound Basic Education: New York State's Unfinished Agenda. Part 1. A Roadmap to Constitutional Compliance Ten Years after "CFE v. State"

ERIC Educational Resources Information Center

Rebell, Michael A.; Wolff, Jessica R.

2016-01-01

Ten years have passed since New York's highest court ruled in the landmark school-funding and educational-rights case, "Campaign for Fiscal Equity (CFE) v. State of New York," that the state was violating students' constitutional right to the "opportunity for a sound basic education" and ordered significant reforms of the…

Pediatric Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Halted by Etanercept.

PubMed

Gavigan, Geneviève M; Kanigsberg, Nordau D; Ramien, Michele L

2018-02-01

We report a case of an 11-year-old female with Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) overlap, most likely triggered by sulfamethoxazole-trimethoprim, who was treated with the combination of methylprednisolone, cyclosporine, and etanercept. Her condition stabilized and her skin involvement did not progress after the addition of etanercept. To our knowledge, this is the first report of etanercept for pediatric SJS/TEN.

Cancer patient experience, hospital performance and case mix: evidence from England.

PubMed

Abel, Gary A; Saunders, Catherine L; Lyratzopoulos, Georgios

2014-01-01

  This study aims to explore differences between crude and case mix-adjusted estimates of hospital performance with respect to the experience of cancer patients. This study analyzed the English 2011/2012 Cancer Patient Experience Survey covering all English National Health Service hospitals providing cancer treatment (n = 160). Logistic regression analysis was used to predict hospital performance for each of the 64 evaluative questions, adjusting for age, gender, ethnic group and cancer diagnosis. The degree of reclassification was explored across three categories (bottom 20%, middle 60% and top 20% of hospitals). There was high concordance between crude and adjusted ranks of hospitals (median Kendall's τ = 0.84; interquartile range: 0.82-0.88). Across all questions, a median of 5.0% (eight) of hospitals (interquartile range: 3.8-6.4%; six to ten hospitals) moved out of the extreme performance categories after case mix adjustment. In this context, patient case mix has only a small impact on measured hospital performance for cancer patient experience.

Low and high-frequency TENS in post-episiotomy pain relief: a randomized, double-blind clinical trial.

PubMed

Pitangui, Ana C R; Araújo, Rodrigo C; Bezerra, Michelle J S; Ribeiro, Camila O; Nakano, Ana M S

2014-01-01

To evaluate the effectiveness of low-frequency TENS (LFT) and high-frequency TENS (HFT) in post-episiotomy pain relief. A randomized, controlled, double-blind clinical trial with placebo composed of 33 puerperae with post-episiotomy pain. TENS was applied for 30 minutes to groups: HFT(100 Hz; 100 µs), LFT (5 Hz; 100 µs), and placebo (PT). Four electrodes were placed in parallel near the episiotomy and four pain evaluations were performed with the numeric rating scale. The first and the second evaluation took place before TENS application and immediately after its removal and were done in the resting position and in the activities of sitting and ambulating. The third and fourth evaluation took place 30 and 60 minutes after TENS removal, only in the resting position. Intragroup differences were verified using the Friedman and Wilcoxon tests, and the intergroup analysis employed the Kruskal-Wallis test. In the intragroup analysis, there was no significant difference in the PT during rest, sitting, and ambulation (P>0.05). In the HFT and LFT, a significant difference was observed in all activities (P<0.001). In the intergroup analysis, there was a significant difference in the resting position in the HFT and LFT (P<0.001). In the sitting activity, a significant difference was verified in the second evaluation in the HFT and LFT (P<0.008). No significant difference was verified among the groups in ambulation (P<0.20). LFT and HFT are an effective resource that may be included in the routine of maternity wards.

Condylar position analysis with a new electronic condylar position measuring instrument E-CPM: influence of different examiners and a working bite on reproducibility.

PubMed

Vahle-Hinz, K; Rybczynski, A; Jakstat, H; Ahlers, M O

2009-01-01

Condylar position analysis facilitates a quantitative comparison of the condylar position with and without a bite record, different records and changed influencing factors. Handling by the examiner when positioning the model is a significant factor with regard to the accuracy of the examination. Measurement accuracy could be improved when positioning the models by using special working bites, hence the objective of the experiments described in this study consisted in examining the extent to which the measuring results are influenced by different examiners and by using working bites. In the first trial, one examiner performed ten measurements without and with an interposed working bite for five model pairs in each case. In the second trial, nine examiners (three specialized dentists, three dental assistants, three students) performed ten measurements in each case without and with an interposed working bite. The three-dimensional position was read digitally with the E-CPM (Gamma Dental, Klosterneuburg/Vienna, Austria), recorded by means of spreadsheet software (Microsoft Excel) and diagnostic software (CMDfact, CMD3D module, dentaConcept, Hamburg), and evaluated with graphing software (Sigma Plot, Systat Software, USA). In the first trial, it was shown that the reproducibility of mounting was improved markedly (p <0.01) by using bite records in the form of working bites. In the second trial, it was shown that the mean error increased significantly (p <0.01) when several examiners performed the measurements compared with the results of one examiner alone. No significantly different results occurred (p < 0.01) in the comparison of the different groups of examiners with different educational and training backgrounds. This applied for the mounting methods without and with working bite. On the other hand, the reproducibility of mounting improved distinctly (p<0.01) in every group of examiners when working bites were used. Reproducibility of condylar position analysis was improved significantly by mounting the models with special working bites. This applied for operators of different professional background (dentists, dental assistants and dental students), while there were no significant differences between results of the three groups.

Whole genome sequencing as a tool to investigate a cluster of seven cases of listeriosis in Austria and Germany, 2011-2013.

PubMed

Schmid, D; Allerberger, F; Huhulescu, S; Pietzka, A; Amar, C; Kleta, S; Prager, R; Preußel, K; Aichinger, E; Mellmann, A

2014-05-01

A cluster of seven human cases of listeriosis occurred in Austria and in Germany between April 2011 and July 2013. The Listeria monocytogenes serovar (SV) 1/2b isolates shared pulsed-field gel electrophoresis (PFGE) and fluorescent amplified fragment length polymorphism (fAFLP) patterns indistinguishable from those from five food producers. The seven human isolates, a control strain with a different PFGE/fAFLP profile and ten food isolates were subjected to whole genome sequencing (WGS) in a blinded fashion. A gene-by-gene comparison (multilocus sequence typing (MLST)+) was performed, and the resulting whole genome allelic profiles were compared using SeqSphere(+) software version 1.0. On analysis of 2298 genes, the four human outbreak isolates from 2012 to 2013 had different alleles at ≤6 genes, i.e. differed by ≤6 genes from each other; the dendrogram placed these isolates in between five Austrian unaged soft cheese isolates from producer A (≤19-gene difference from the human cluster) and two Austrian ready-to-eat meat isolates from producer B (≤8-gene difference from the human cluster). Both food products appeared on grocery bills prospectively collected by these outbreak cases after hospital discharge. Epidemiological results on food consumption and MLST+ clearly separated the three cases in 2011 from the four 2012-2013 outbreak cases (≥48 different genes). We showed that WGS is capable of discriminating L. monocytogenes SV1/2b clones not distinguishable by PFGE and fAFLP. The listeriosis outbreak described clearly underlines the potential of sequence-based typing methods to offer enhanced resolution and comparability of typing systems for public health applications. © 2014 The Authors Clinical Microbiology and Infection © 2014 European Society of Clinical Microbiology and Infectious Diseases.

Transcutaneous Electrical Nerve Stimulation for Treating Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review.

PubMed

Gross, Tobias; Schneider, Marc P; Bachmann, Lucas M; Blok, Bertil F M; Groen, Jan; Hoen, Lisette A 't; Castro-Diaz, David; Padilla Fernández, Bárbara; Del Popolo, Giulio; Musco, Stefania; Hamid, Rizwan; Ecclestone, Hazel; Karsenty, Gilles; Phé, Véronique; Pannek, Jürgen; Kessler, Thomas M

2016-06-01

Transcutaneous electrical nerve stimulation (TENS) is a promising therapy for non-neurogenic lower urinary tract dysfunction and might also be a valuable option in patients with an underlying neurological disorder. We systematically reviewed all available evidence on the efficacy and safety of TENS for treating neurogenic lower urinary tract dysfunction. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. After screening 1943 articles, 22 studies (two randomised controlled trials, 14 prospective cohort studies, five retrospective case series, and one case report) enrolling 450 patients were included. Eleven studies reported on acute TENS and 11 on chronic TENS. In acute TENS and chronic TENS, the mean increase of maximum cystometric capacity ranged from 69ml to 163ml and from 4ml to 156ml, the mean change of bladder volume at first detrusor overactivity from a decrease of 13ml to an increase of 175ml and from an increase of 10ml to 120ml, a mean decrease of maximum detrusor pressure at first detrusor overactivity from 18 cmH20 to 72 cmH20 and 8 cmH20, and a mean decrease of maximum storage detrusor pressure from 20 cmH20 to 58 cmH2O and from 3 cmH20 to 8 cmH2O, respectively. In chronic TENS, a mean decrease in the number of voids and leakages per 24h ranged from 1 to 3 and from 0 to 4, a mean increase of maximum flow rate from 2ml/s to 7ml/s, and a mean change of postvoid residual from an increase of 26ml to a decrease of 85ml. No TENS-related serious adverse events have been reported. Risk of bias and confounding was high in most studies. Although preliminary data suggest TENS might be effective and safe for treating neurogenic lower urinary tract dysfunction, the evidence base is poor and more reliable data from well-designed randomised controlled trials are needed to make definitive conclusions. Early data suggest that transcutaneous electrical nerve stimulation might be effective and safe for treating neurogenic lower urinary tract dysfunction, but more reliable evidence is required. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

An Investigation of the Hypoalgesic Effects of TENS Delivered by a Glove Electrode

PubMed Central

Cowan, Stephen; McKenna, Joanne; McCrum-Gardner, Evie; Johnson, Mark I.; Sluka, Kathleen A.; Walsh, Deirdre M.

2009-01-01

This randomized, placebo-controlled, blinded study investigated the hypoalgesic effects of high-frequency transcutaneous electrical nerve stimulation (TENS) delivered via a glove electrode compared with standard self-adhesive electrodes. Fifty-six TENS-naïve, healthy individuals (18 to 50 years old; 28 men, 28 women) were randomly allocated to 1 of 4 groups (n = 14 per group): glove electrode; placebo TENS using a glove electrode; standard electrode; and no treatment control. Active TENS (continuous stimulus, 100 Hz, strong but comfortable intensity) was applied to the dominant forearm/hand for 30 minutes. Placebo TENS was applied using a burst stimulus, 100-Hz frequency, 5-second cycle time for 42 seconds, after which the current amplitude was automatically reset to 0 mA. Pressure pain thresholds (PPTs) were recorded from 3 points on the dominant and nondominant upper limbs before and after TENS. Statistical analyses of dominant PPT data using between-within groups ANOVA showed significant differences between groups at all 3 recording points (P = .01). Post hoc Scheffe tests indicated no significant difference between the standard electrode and glove electrode groups. There was a significant hypoalgesic effect in the standard electrode group compared with the control group and between the glove electrode group and both the control and placebo TENS groups. There was no significant interactive effect between time and group at any of the recording points (P > .05). Perspective This study presents a comparison of the hypoalgesic effects of 2 different types of TENS electrode, a novel glove electrode and standard self-adhesive rectangular electrodes. The glove electrode provides a larger contact area with the skin, thereby stimulating a greater number of nerve fibers. The results show that both electrodes have similar hypoalgesic effects and therefore give the clinician another choice in electrode. PMID:19398378

31 CFR 357.30 - Cases of delay or suspension of payment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Securities System (Legacy Treasury Direct) § 357.30 Cases of delay or suspension of payment. If evidence... ten (10) business days before the maturity date of the security, or if payment at maturity has been suspended pursuant to 31 CFR 370.10, in cases of reinvestment, the Department will redeem the security and...

Case-Based Instruction in Post-Secondary Education: Developing Students' Problem-Solving Expertise.

ERIC Educational Resources Information Center

Ertmer, Peggy A.; Stepich, Donald A.

This study was designed to explore changes in students' problem-solving skills as they analyzed instructional design case studies during a semester-long course. Nineteen students at two Midwestern universities analyzed six to ten case studies as part of their course assignments. Both quantitative and qualitative data were collected, with students'…

Moving beyond Mentoring: A Collective Case Study Examining the Perceived Characteristics of Positive Transformational Figures

ERIC Educational Resources Information Center

Bean, Brent W.; Kroth, Michael

2013-01-01

The purpose of this collective-case study was to explore the characteristics of transformational figures. This study revealed that interpersonal encounters were seen as a catalyst that assisted study participants through the process of transformation. Ten themes emerged from the cross-case analysis: Imposed and Intentional Influence; Metaphors of…

A case report on toxic epidermal necrolysis with etoricoxib

PubMed Central

Kameshwari, J. S.; Devde, Raju

2015-01-01

Etoricoxib is a selective cyclo-oxygenase 2 (COX-2) enzyme inhibitor and is exploited for its analgesic activity in various disease conditions like osteoarthritis, gouty arthritis, acute pain including postoperative dental pain and primary dysmenorrhea, etc. Although highly efficacious in pain management the safety profile of this COX-2 inhibitor is yet to be established in a broader sense. Short-term clinical trials and postmarketing surveillance have shown a very rare incidence of very serious skin reactions like Steven Johnson syndrome or toxic epidermal necrolysis (TEN). In this case report, we summarize regarding a patient who developed TEN after treatment with etoricoxib for osteoarthritis that later resolved in 15 days after withdrawal and symptomatic treatment. PMID:25878388

Transcutaneous Electrical Nerve Stimulation (TENS) for the Control of Pain during Rehabilitation Following Total Knee Arthroplasty (TKA): A Randomized, Blinded, Placebo-Controlled Trial

PubMed Central

Rakel, Barbara; Zimmerman, M. Bridget; Geasland, Katharine; Embree, Jennie; Clark, Charles R; Noiseux, Nicolas O; Callaghan, John J; Herr, Keela; Walsh, Deirdre; Sluka, Kathleen A

2014-01-01

This study evaluated the efficacy of TENS in reducing pain and hyperalgesia and increasing function following total knee arthroplasty (TKA). We hypothesized participants using TENS during rehabilitation exercises would: 1) report significantly lower pain during range-of-motion (ROM) and fast walking but not at rest; 2) have less hyperalgesia; and, 3) have better function than participants receiving Placebo-TENS or Standard Care. We also hypothesized that change in ROM pain would differ based on psychological characteristics (trait anxiety, pain catastrophizing and depression) and treatment group. This prospective, randomized study used intent-to-treat analyses on 317 subjects after primary, unilateral TKA. Assessors, blinded to treatment allocation, measured pain, function (ROM and gait speed), and hyperalgesia (quantitative sensory tests) postoperatively and 6 weeks after surgery. Analgesic intake, anxiety, depression, and pain catastrophizing were also assessed. TENS participants used it 1–2 times/day at 42 mA (on average) and had less pain postoperatively during active knee extension (p=0.019) and fast walking (p=0.006) than Standard Care participants. TENS and Placebo-TENS were not significantly different. TENS participants who scored low on anxiety and pain catastrophizing had a greater reduction in ROM pain at 6 weeks than those scoring high on these factors (p=0.002 and 0.03). Both TENS and Placebo-TENS participants had less postoperative mechanical hyperalgesia (p=0.03 – 0.01) than Standard Care participants. Supplementing pharmacologic analgesia with TENS during rehabilitation exercises reduces movement pain postoperatively but a placebo influence exists and the effect is gone by 6 weeks. Patients with low anxiety and pain catastrophizing may benefit most from TENS. PMID:25270585

Increase of cases of legionellosis in Latvia, 2011.

PubMed

Rozentale, B; Bormane, A; Perevosčikovs, J; Lucenko, I; Brila, A

2011-11-10

An increased number of legionellosis cases in 2011 has been reported in Latvia, compared to the ten previous years. A total of 30 legionellosis cases (1.35 per 100,000 inhabitants), including 19 females, have been confirmed until the end of September 2011. The majority of cases (n=23) were inhabitants of the capital city Riga. The reason for the increase in legionellosis is unclear. Twenty-six of the 30 cases are not travel-related.

Skin impedance is not a factor in transcutaneous electrical nerve stimulation effectiveness

PubMed Central

Vance, Carol GT; Rakel, Barbara A; Dailey, Dana L; Sluka, Kathleen A

2015-01-01

Objective Transcutaneous electrical nerve stimulation (TENS) is a nonpharmacological intervention used to manage pain using skin surface electrodes. Optimal electrode placement is unclear. We hypothesized that better analgesia would occur if electrodes were placed over sites with lower skin impedance. Optimal site selection (OSS) and sham site selection (SSS) electrode sites on the forearm were identified using a standard clinical technique. Methods Experiment 1 measured skin impedance in the forearm at OSS and SSS. Experiment 2 was a crossover design double-blind randomized controlled trial comparing OSS-TENS, SSS-TENS, and placebo TENS (P-TENS) to confirm differences in skin impedance between OSS and SSS, and measure change in pressure pain threshold (PPT) following a 30-minute TENS treatment. Healthy volunteers were recruited (ten for Experiment 1 [five male, five female] and 24 for Experiment 2 [12 male, 12 female]). TENS was applied for 30 minutes at 100 Hz frequency, 100 µs pulse duration, and “strong but nonpainful” amplitude. Results Experiment 1 results demonstrate significantly higher impedance at SSS (17.69±1.24 Ω) compared to OSS (13.53±0.57 Ω) (P=0.007). For Experiment 2, electrode site impedance was significantly higher over SSS, with both the impedance meter (P=0.001) and the TENS unit (P=0.012) compared to OSS. PPT change was significantly greater for both OSS-TENS (P=0.024) and SSS-TENS (P=0.025) when compared to P-TENS. PPT did not differ between the two active TENS treatments (P=0.81). Conclusion Skin impedance is lower at sites characterized as optimal using the described technique of electrode site selection. When TENS is applied at adequate intensities, skin impedance is not a factor in attainment of hypoalgesia of the forearm in healthy subjects. Further investigation should include testing in patients presenting with painful conditions. PMID:26316808

Mono and multi-objective optimization techniques applied to a large range of industrial test cases using Metamodel assisted Evolutionary Algorithms

NASA Astrophysics Data System (ADS)

Fourment, Lionel; Ducloux, Richard; Marie, Stéphane; Ejday, Mohsen; Monnereau, Dominique; Massé, Thomas; Montmitonnet, Pierre

2010-06-01

The use of material processing numerical simulation allows a strategy of trial and error to improve virtual processes without incurring material costs or interrupting production and therefore save a lot of money, but it requires user time to analyze the results, adjust the operating conditions and restart the simulation. Automatic optimization is the perfect complement to simulation. Evolutionary Algorithm coupled with metamodelling makes it possible to obtain industrially relevant results on a very large range of applications within a few tens of simulations and without any specific automatic optimization technique knowledge. Ten industrial partners have been selected to cover the different area of the mechanical forging industry and provide different examples of the forming simulation tools. It aims to demonstrate that it is possible to obtain industrially relevant results on a very large range of applications within a few tens of simulations and without any specific automatic optimization technique knowledge. The large computational time is handled by a metamodel approach. It allows interpolating the objective function on the entire parameter space by only knowing the exact function values at a reduced number of "master points". Two algorithms are used: an evolution strategy combined with a Kriging metamodel and a genetic algorithm combined with a Meshless Finite Difference Method. The later approach is extended to multi-objective optimization. The set of solutions, which corresponds to the best possible compromises between the different objectives, is then computed in the same way. The population based approach allows using the parallel capabilities of the utilized computer with a high efficiency. An optimization module, fully embedded within the Forge2009 IHM, makes possible to cover all the defined examples, and the use of new multi-core hardware to compute several simulations at the same time reduces the needed time dramatically. The presented examples demonstrate the method versatility. They include billet shape optimization of a common rail, the cogging of a bar and a wire drawing problem.

A case of survival of extreme vertical impact in seated position.

DOT National Transportation Integrated Search

1962-10-01

Physical, biophysical, and medical data are presented concerning the case of a 20-year-old male of excellent physical condition who jumped from the Golden Gate Bridge in San Francisco, surviving for ten days a free-fall deceleration in the seated pos...

Taxicab Regulation in U.S. Cities. Volume II, Case Studies

DOT National Transportation Integrated Search

1983-10-01

Volume II of the study, Taxicab Regulation in U.S. Cities, contains case study reports. Ten U.S. cities were visited in June and July, 1983, for more in-depth study of their experiences with taxicab regulation. These cities are Fayetteville and Charl...

Diagnosis of post-partum ovarian vein thrombophlebitis by color Doppler ultrasonography: about 10 cases.

PubMed

Giraud, J R; Poulain, P; Renaud-Giono, A; Darnault, J P; Proudhon, J F; Grall, J Y; Mocquet, P Y

1997-09-01

Post-partum ovarian vein thrombosis is often overlooked or mistaken for other complications such as endometritis. Color Doppler ultrasonography is a very good diagnostic method when properly indicated and correctly interpreted according to clinical data. This study reports ten cases that were retrospectively studied, during which color Doppler ultrasonography was used. The clinical signs and the results are reviewed. The lesions were clearly visualized in eight of the ten cases; one of the two failures resulted from a methodological fault (uninterpretable result); the other one was due to the lack of experience of the operator and nonrecognition of the clinical signs. Thrombosis appears as a hypoechogenic and tubular image. This type of examination is particularly indicated in the presence of certain clinical signs that were observed in our cases: fever and iliac pain are the main precursor signs, often associated with abdominal meteorism and slow digestive transit; provoked cul-de-sac pain during vaginal probing was the only constant sign, sometimes associated with painful swelling.

Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults.

PubMed

Gibson, William; Wand, Benedict M; O'Connell, Neil E

2017-09-14

Neuropathic pain, which is due to nerve disease or damage, represents a significant burden on people and society. It can be particularly unpleasant and achieving adequate symptom control can be difficult. Non-pharmacological methods of treatment are often employed by people with neuropathic pain and may include transcutaneous electrical nerve stimulation (TENS). This review supersedes one Cochrane Review 'Transcutaneous electrical nerve stimulation (TENS) for chronic pain' (Nnoaham 2014) and one withdrawn protocol 'Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults' (Claydon 2014). This review replaces the original protocol for neuropathic pain that was withdrawn. To determine the analgesic effectiveness of TENS versus placebo (sham) TENS, TENS versus usual care, TENS versus no treatment and TENS in addition to usual care versus usual care alone in the management of neuropathic pain in adults. We searched CENTRAL, MEDLINE, Embase, PsycINFO, AMED, CINAHL, Web of Science, PEDro, LILACS (up to September 2016) and various clinical trials registries. We also searched bibliographies of included studies for further relevant studies. We included randomised controlled trials where TENS was evaluated in the treatment of central or peripheral neuropathic pain. We included studies if they investigated the following: TENS versus placebo (sham) TENS, TENS versus usual care, TENS versus no treatment and TENS in addition to usual care versus usual care alone in the management of neuropathic pain in adults. Two review authors independently screened all database search results and identified papers requiring full-text assessment. Subsequently, two review authors independently applied inclusion/exclusion criteria to these studies. The same review authors then independently extracted data, assessed for risk of bias using the Cochrane standard tool and rated the quality of evidence using GRADE. We included 15 studies with 724 participants. We found a range of treatment protocols in terms of duration of care, TENS application times and intensity of application. Briefly, duration of care ranged from four days through to three months. Similarly, we found variation of TENS application times; from 15 minutes up to hourly sessions applied four times daily. We typically found intensity of TENS set to comfortable perceptible tingling with very few studies titrating the dose to maintain this perception. Of the comparisons, we had planned to explore, we were only able to undertake a quantitative synthesis for TENS versus sham TENS. Insufficient data and large diversity in the control conditions prevented us from undertaking a quantitative synthesis for the remaining comparisons.For TENS compared to sham TENS, five studies were suitable for pooled analysis. We described the remainder of the studies in narrative form. Overall, we judged 11 studies at high risk of bias, and four at unclear risk. Due to the small number of eligible studies, the high levels of risk of bias across the studies and small sample sizes, we rated the quality of the evidence as very low for the pooled analysis and very low individual GRADE rating of outcomes from single studies. For the individual studies discussed in narrative form, the methodological limitations, quality of reporting and heterogeneous nature of interventions compared did not allow for reliable overall estimates of the effect of TENS.Five studies (across various neuropathic conditions) were suitable for pooled analysis of TENS versus sham TENS investigating change in pain intensity using a visual analogue scale. We found a mean postintervention difference in effect size favouring TENS of -1.58 (95% confidence interval (CI) -2.08 to -1.09, P < 0.00001, n = 207, six comparisons from five studies) (very low quality evidence). There was no significant heterogeneity in this analysis. While this exceeded our prespecified minimally important difference for pain outcomes, we assessed the quality of evidence as very low meaning we have very little confidence in this effect estimate and the true effect is likely to be substantially different from that reported in this review. Only one study of these five investigated health related quality of life as an outcome meaning we were unable to report on this outcome in this comparison. Similarly, we were unable to report on global impression of change or changes in analgesic use in this pooled analysis.Ten small studies compared TENS to some form of usual care. However, there was great diversity in what constituted usual care, precluding pooling of data. Most of these studies found either no difference in pain outcomes between TENS versus other active treatments or favoured the comparator intervention (very low quality evidence). We were unable to report on other primary and secondary outcomes in these single trials (health-related quality of life, global impression of change and changes in analgesic use).Of the 15 included studies, three reported adverse events which were minor and limited to 'skin irritation' at or around the site of electrode placement (very low quality evidence). Three studies reported no adverse events while the remainder did not report any detail with regard adverse events. In this review, we reported on the comparison between TENS and sham TENS. The quality of the evidence was very low meaning we were unable to confidently state whether TENS is effective for pain control in people with neuropathic pain. The very low quality of evidence means we have very limited confidence in the effect estimate reported; the true effect is likely to be substantially different. We make recommendations with respect to future TENS study designs which may meaningfully reduce the uncertainty relating to the effectiveness of this treatment modality.

Microprobe investigation of brittle segregates in aluminum MIG and TIG welds

NASA Technical Reports Server (NTRS)

Larssen, P. A.; Miller, E. L.

1968-01-01

Quantitative microprobe analysis of segregated particles in aluminum MIG /Metal Inert Gas/ and TIG /Tungsten Inert Gas/ welds indicated that there were about ten different kinds of particles, corresponding to ten different intermetallic compounds. Differences between MIG and TIG welds related to the individual cooling rates of these welds.

Effects of transcutaneous electrical nerve stimulation (TENS) and interferential currents (IFC) in patients with nonspecific chronic low back pain: randomized clinical trial.

PubMed

Facci, Ligia Maria; Nowotny, Jean Paulus; Tormem, Fabio; Trevisani, Virgínia Fernandes Moça

2011-01-01

Transcutaneous electrical nerve stimulation (TENS) and interferential current are the most used electrotherapy methods, although there is little scientific evidence to support their use. The aim of this study was to compare the effects of TENS and interferential current among patients with nonspecific chronic low back pain. Single-blind randomized controlled trial in the Department of Physiotherapy, Centro Universitário de Maringá. One hundred and fifty patients were randomly divided into three groups: TENS (group 1), interferential current (group 2) and controls (group 3). The patients designated for electrotherapy received ten 30-minute sessions, while the control group remained untreated. All patients and controls were evaluated before and after treatment using a visual analog scale and the McGill Pain and Roland Morris questionnaires, and regarding their use of additional medications. There was a mean reduction on the visual analog scale of 39.18 mm with TENS, 44.86 mm with interferential current and 8.53 mm among the controls. In the Roland Morris questionnaire, group 1 had a mean reduction of 6.59; group 2, 7.20; and group 3, 0.70 points. In group 1, 84% of the patients stopped using medications after the treatment; in group 2, 75%; and in group 3, 34%. There was no statistically significant difference between the TENS and interferential current groups (P > 0.05); a difference was only found between these groups and the controls (P < 0.0001). There was no difference between TENS and interferential current for chronic low back pain treatment. NCT01017913.

SU-F-T-117: A Pilot Study of Organ Dose Reconstruction for Wilms Tumor Patients Treated with Radiation Therapy

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

Makkia, R; Pelletier, C; Jung, J

Purpose: To reconstruct major organ doses for the Wilms tumor pediatric patients treated with radiation therapy using pediatric computational phantoms, treatment planning system (TPS), and Monte Carlo (MC) dose calculation methods. Methods: A total of ten female and male pediatric patients (15–88 months old) were selected from the National Wilms Tumor Study cohort and ten pediatric computational phantoms corresponding to the patient’s height and weight were selected for the organ dose reconstruction. Treatment plans were reconstructed on the computational phantoms in a Pinnacle TPS (v9.10) referring to treatment records and exported into DICOM-RT files, which were then used to generatemore » the input files for XVMC MC code. The mean doses to major organs and the dose received by 50% of the heart were calculated and compared between TPS and MC calculations. The same calculations were conducted by replacing the computational human phantoms with a series of diagnostic patient CT images selected by matching the height and weight of the patients to validate the anatomical accuracy of the computational phantoms. Results: Dose to organs located within the treatment fields from the computational phantoms and the diagnostic patient CT images agreed within 2% for all cases for both TPS and MC calculations. The maximum difference of organ doses was 55.9 % (thyroid), but the absolute dose difference in this case was 0.33 Gy which was 0.96% of the prescription dose. The doses to ovaries and testes from MC in out-of-field provided more discrepancy (the maximum difference of 13.2% and 50.8%, respectively). The maximum difference of the 50% heart volume dose between the phantoms and the patient CT images was 40.0%. Conclusion: This study showed the pediatric computational phantoms are applicable to organ doses reconstruction for the radiotherapy patients whose three-dimensional radiological images are not available.« less

JOB REDESIGN FOR OLDER WORKERS, TEN CASE STUDIES.

ERIC Educational Resources Information Center

MITNICK, EDWARD; ROTHBERG, HERMAN

AFTER IDENTIFYING FIRMS WHICH HAD USED JOB REDESIGN TO SALVAGE THE SKILL OF OLDER EMPLOYEES, RESEARCH INVESTIGATORS MADE 10 INTENSIVE CASE STUDIES IN FIRMS PRODUCING AIRCRAFT ENGINES, ALUMINUM FRAMING, BUILDING MATERIALS, CARPETS, COMPUTERS, COPPER PIPE FITTINGS, FOOTWEAR, HEAVY IRON PIPE, PRECISION INSTRUMENTS, AND PRINTED NOVELTIES. EACH STUDY…

75 FR 59208 - Wooden Bedroom Furniture From the People's Republic of China: Notice of Court Decision Not in...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-27

... case is not in harmony with the Department's final results of the administrative review (``AR'') of the... response to Bon Ten's arguments in its administrative case brief, the Department determined not to rescind... provided any assertion prior to the submission of its case brief that it had no shipments during the 2007...

Transcutaneous electrical nerve stimulation for the control of pain during rehabilitation after total knee arthroplasty: A randomized, blinded, placebo-controlled trial.

PubMed

Rakel, Barbara A; Zimmerman, M Bridget; Geasland, Katharine; Embree, Jennie; Clark, Charles R; Noiseux, Nicolas O; Callaghan, John J; Herr, Keela; Walsh, Deirdre; Sluka, Kathleen A

2014-12-01

This study evaluated the efficacy of transcutaneous electrical nerve stimulation (TENS) in reducing pain and hyperalgesia and increasing function after total knee arthroplasty (TKA). We hypothesized that participants using TENS during rehabilitation exercises would report significantly lower pain during range-of-motion (ROM) activity and fast walking but not at rest, would have less hyperalgesia, and would have better function than participants receiving placebo-TENS or standard care. We also hypothesized that change in ROM pain would differ based on psychological characteristics (trait anxiety, pain catastrophizing, and depression) and treatment group. This prospective, randomized study used intent-to-treat analyses in 317 participants after primary, unilateral TKA. Assessors, blinded to treatment allocation, measured pain, function (ROM and gait speed), and hyperalgesia (quantitative sensory tests) postoperatively and 6 weeks after surgery. Analgesic intake, anxiety, depression, and pain catastrophizing were also assessed. TENS participants used it 1 to 2 times per day at 42 mA (on average) and had less pain postoperatively during active knee extension (P=.019) and fast walking (P=.006) than standard care participants. TENS and placebo-TENS were not significantly different. TENS participants who scored low on anxiety and pain catastrophizing had a greater reduction in ROM pain at 6 weeks than those who scored high on these factors (P=.002 and P=.03). Both TENS and placebo-TENS participants had less postoperative mechanical hyperalgesia (P=.03-.01) than standard care participants. Supplementing pharmacologic analgesia with TENS during rehabilitation exercises reduces movement pain postoperatively, but a placebo influence exists and the effect is gone by 6 weeks. Patients with low anxiety and pain catastrophizing may benefit most from TENS. Published by Elsevier B.V.

Decreased Opioid Utilization and Cost at One Year in Chronic Low Back Pain Patients Treated with Transcutaneous Electric Nerve Stimulation (TENS).

PubMed

Pivec, Robert; Minshall, Michael E; Mistry, Jaydev B; Chughtai, Morad; Elmallah, Randa K; Mont, Michael A

2015-11-01

Chronic low back pain (CLBP) may be treated without opioids through the use of transcutaneous electrical nerve stimulation (TENS). However, no study has evaluated its clinical effect and economic impact as measured by opioid utilization and costs. The purpose of this study was to evaluate patients who were given TENS for CLBP compared to a matched group without TENS at one-year follow-up, to determine differences between opioid consumption. Opioid utilization and costs in patients who did and did not receive TENS were extracted from a Medicare supplemental administrative claims database. Patients were selected if they had at least two ICD-9-CM coded claims for low back pain in a three-month period and were then propensity score matched at a 1:1 ratio between patients who received TENS and those who did not. There were 22,913 patients in each group who had a minimum follow-up of one year. There were no significant demographic or comorbidity differences with the exception that TENS patients had more episodes of back pain. Significantly fewer patients in the TENS group required opioids at final follow-up (57.7 vs. 60.3%). TENS patients also had significantly fewer annual per-patient opioid costs compared to non-TENS patients ($169 vs. $192). There were significantly lower event rates in TENS patients compared to non-TENS patients when measured by opioid utilization (characterized by frequency of prescription refills) (3.82 vs. 4.08, respectively) or pharmacy utilization (31.67 vs. 32.25). The TENS group also demonstrated a significantly lower cost of these utilization events ($44 vs. $49) and avoided more opioid events (20.4 events fewer per 100 patients annually). Treatment of CLBP with TENS demonstrated significantly fewer patients requiring opioids, fewer events where a patient required an opioid prescription, and lower per-patient costs. Since TENS is both non-invasive and a non-narcotic, it may potentially allow physicians to be more aggressive in treating CLBP patients.

Langerhans cell histiocytosis of skull: a retrospective study of 18 cases.

PubMed

Zhang, Xiang-Heng; Zhang, Ji; Chen, Zheng-He; Sai, Ke; Chen, Yin-Sheng; Wang, Jian; Ke, Chao; Guo, Chen-Chen; Chen, Zhong-Ping; Mou, Yong-Gao

2017-04-01

The present study presents 18 cases of Chinese patients harboring a Langerhans cell histiocytosis (LCH) of the skull. Eighteen consecutive patients were diagnosed as LCH of the skull and confirmed pathologically between March 2002 and February 2014. In the present study, the patients of LCH without skull involvement were excluded. According to disease extent at diagnosis, the 18 LCH patients with skull involvement were divided into three groups: (I) unifocal-monosystem group, including ten cases with solitary skull lesion; (II) multifocal-monosystem group, including two cases with multiple bone lesions and no extra-skeletal involvement; (III) multisystem group, including six cases with LCH lesions involving both skeletal and extra-skeletal system. In unifocal-monosystem group, excision of the skull lesion was performed in eight of ten cases, a low dosage of local radiotherapy and a purposeful observation was accept by the remaining two cases of this group after biopsy respectively. In multifocal-monosystem group, both of the two cases were received chemotherapy. In multi-system group, all the six cases were managed with systemic chemotherapy, after their diagnoses of LCH were confirmed. The mean age at the time of diagnosis was 9.4 years. There was a male predominance in this disease male/female ratio was 3.5:1. In our cases, a skull mass with or without tenderness was the most common chief complaint (13 cases, 72.2%), and frontal bone was the most frequent affected locations of skull (6 cases, 33.3%). In unifocal-monosystem group, nine of ten remained free from LCH, the remain one lesion recurred 22 months after his surgical excision. In multifocal-monosystem group, a complete response (CR) was obtained in one of them, and a stable disease (SD) of multiple osseous lesions was obtained in another one. In the multi-system group, a CR in four cases and a partial response (PR) in one case were obtained, and a progressive disease (PD) was observed in the remaining one. The unifocal-monosystem of LCH of the skull is a clinicopathological entity with a good outcome, and resection, irradiation or purposeful observation are also can be been utilized as the choice of treatment. For the multifocal bone lesions and multisystem lesions of LCH, chemotherapy is an effective treatment as a systemic therapy. There is no enough publication literature to determine guidelines or indications for managing this disease.

Vocal fold self-disruption after phonotrauma on a lead actor: a case presentation.

PubMed

Behlau, Mara; Oliveira, Gisele; Pontes, Paulo

2009-11-01

It is well known that phonotraumatic events may produce laryngeal inflammation, vocal fold hemorrhage and different types of mass lesions. This study describes a vocal fold self-disruption that occurred on stage to a lead actor in the role of Richard III. The study design is as case presentation. A 43-year-old actor presented with a sudden voice loss that first occurred on stage after a series of presentations. He also had a cold-like condition that had not been treated. His past medical history included an average of ten cigarettes per day for ten years and a 10-year history of gastritis and stomach ulcer. Perceptual, acoustic, and laryngeal analyses were performed following pharmacological and voice therapy. Perceptual and acoustic analyses showed mild deviations whereas laryngeal visual examination revealed a complete right vocal fold detachment from the anterior commissure to the vocal process, with generalized hyperemia. A mild diffuse Reinke's edema was observed on the left vocal fold. Mild discomfort was present only during the first day of the acute period. Modified vocal rest was recommended and a series of vocal exercises were administered. The patient performed again 4 days later, after following a series of behavioral modification techniques that included casting guidelines during the subsequent 15 days. Healing was exceptional and his voice returned to normal. This unique case with an exceptional recovery emphasizes the etiological aspects of scar formation after phonotrauma. Positive contributing factors may include a good vocal technique and adequate training as well as the protective upregulated genes present in Reinke's edema.

Don’t live in a town where there are no doctors: toxic epidermal necrolysis initially misdiagnosed as oral thrush

PubMed Central

Wani, Abdul Majid; Hussain, Waleed Mohd; Fatani, Mohamad Ibrahim; Ali, Khaled Shawkat; Khoujah, Amer Mohd; Akhtar, Mubeena; Maimani, Ghassan Adnan Al; Raja, Sadeya Hanif; Basraheel, Ashraf; Fareed, Khurram

2009-01-01

Toxic epidermal necrolysis (TEN) is a rare but life threatening skin disease that is most commonly drug induced. The exact pathogenesis of TEN is still unknown and many drugs, including prednisolone, cyclosporin and intravenous immunoglobulin (IVIG), have been used in an attempt to halt the disease process. The use of IVIG in particular is controversial. Recently, the US Food and Drug Administration (FDA) has made a labelling change to the drug information for carbamazepine. Owing to recent data implicating the HLA allele B*1502 as a marker for carbamazepine induced Stevens–Johnson syndrome and TEN in Han Chinese, the FDA recommends genotyping all Asians for the allele. We present an interesting case of carbamazepine induced TEN which was confused with oral thrush, had no skin lesions on presentation, and had an excellent response to a 5 day course of methylprednisolone and high dose IVIG in combination. PMID:22207871

Human Treponema pallidum 11q/j isolate belongs to subsp. endemicum but contains two loci with a sequence in TP0548 and TP0488 similar to subsp. pertenue and subsp. pallidum, respectively

PubMed Central

Mikalová, Lenka; Strouhal, Michal; Oppelt, Jan; Grange, Philippe Alain; Janier, Michel; Benhaddou, Nadjet; Dupin, Nicolas; Šmajs, David

2017-01-01

Background Treponema pallidum subsp. endemicum (TEN) is the causative agent of endemic syphilis (bejel). An unusual human TEN 11q/j isolate was obtained from a syphilis-like primary genital lesion from a patient that returned to France from Pakistan. Methodology/Principal findings The TEN 11q/j isolate was characterized using nested PCR followed by Sanger sequencing and/or direct Illumina sequencing. Altogether, 44 chromosomal regions were analyzed. Overall, the 11q/j isolate clustered with TEN strains Bosnia A and Iraq B as expected from previous TEN classification of the 11q/j isolate. However, the 11q/j sequence in a 505 bp-long region at the TP0488 locus was similar to Treponema pallidum subsp. pallidum (TPA) strains, but not to TEN Bosnia A and Iraq B sequences, suggesting a recombination event at this locus. Similarly, the 11q/j sequence in a 613 bp-long region at the TP0548 locus was similar to Treponema pallidum subsp. pertenue (TPE) strains, but not to TEN sequences. Conclusions/Significance A detailed analysis of two recombinant loci found in the 11q/j clinical isolate revealed that the recombination event occurred just once, in the TP0488, with the donor sequence originating from a TPA strain. Since TEN Bosnia A and Iraq B were found to contain TPA-like sequences at the TP0548 locus, the recombination at TP0548 took place in a treponeme that was an ancestor to both TEN Bosnia A and Iraq B. The sequence of 11q/j isolate in TP0548 represents an ancestral TEN sequence that is similar to yaws-causing treponemes. In addition to the importance of the 11q/j isolate for reconstruction of the TEN phylogeny, this case emphasizes the possible role of TEN strains in development of syphilis-like lesions. PMID:28263990

Models and impact of patient and public involvement in studies carried out by the Medical Research Council Clinical Trials Unit at University College London: findings from ten case studies.

PubMed

South, Annabelle; Hanley, Bec; Gafos, Mitzy; Cromarty, Ben; Stephens, Richard; Sturgeon, Kate; Scott, Karen; Cragg, William J; Tweed, Conor D; Teera, Jacqueline; Vale, Claire L

2016-07-29

Patient and public involvement (PPI) in studies carried out by the UK Medical Research Council Clinical Trials Unit (MRC CTU) at University College London varies by research type and setting. We developed a series of case studies of PPI to document and share good practice. We used purposive sampling to identify studies representing the scope of research at the MRC CTU and different approaches to PPI. We carried out semi-structured interviews with staff and patient representatives. Interview notes were analysed descriptively to categorise the main aims and motivations for involvement; activities undertaken; their impact on the studies and lessons learned. We conducted 19 interviews about ten case studies, comprising one systematic review, one observational study and 8 randomised controlled trials in HIV and cancer. Studies were either open or completed, with start dates between 2003 and 2011. Interviews took place between March and November 2014 and were updated in summer 2015 where there had been significant developments in the study (i.e. if the study had presented results subsequent to the interview taking place). A wide range of PPI models, including representation on trial committees or management groups, community engagement, one-off task-focused activities, patient research partners and participant involvement had been used. Overall, interviewees felt that PPI had a positive impact, leading to improvements, for example in the research question; study design; communication with potential participants; study recruitment; confidence to carry out or complete a study; interpretation and communication of results; and influence on future research. A range of models of PPI can benefit clinical studies. Researchers should consider different approaches to PPI, based on the desired impact and the people they want to involve. Use of multiple models may increase the potential impacts of PPI in clinical research.

SU-E-T-13: A Comparative Dosimetric Study On Radio-Dynamic Therapy for Pelvic Cancer Treatment: Strategies for Bone Marrow Dose and Volume Reduction

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

Li, C; Renmin Hospital of Wuhan University, Wuhan, Hubei Province; Wang, B

Purpose: Radio-dynamic therapy (RDT) is a potentially effective modality for local and systemic cancer treatment. Using RDT, the administration of a radio-sensitizer enhances the biological effect of high-energy photons. Although the sensitizer uptake ratio of tumor to normal tissue is normally high, one cannot simply neglect its effect on critical structures. In this study, we aim to explore planning strategies to improve bone marrow sparing without compromising the plan quality for RDT treatment of pelvic cancers. Methods: Ten cervical and ten prostate cancer patients who previously received radiotherapy at our institution were selected for this study. For each patient, ninemore » plans were created using the Varian Eclipse treatmentplanning-system (TPS) with 3D-CRT, IMRT, and VMAT delivery techniques containing various gantry angle combinations and optimization parameters (dose constraints to the bone marrow). To evaluate the plans for bone marrow sparing, the dose-volume parameters V5, V10, V15, V20, V30, and V40 for bone marrow were examined. Effective doseenhancement factors for the sensitizer were used to weigh the dose-volume histograms for various tissues from individual fractions. Results: The planning strategies had different impacts on bone marrow sparing for the cervical and prostate cases. For the cervical cases, provided the bone marrow constraints were properly set during optimization, the dose to bone marrow sparing was found to be comparable between different IMRT and VMAT plans regardless of the gantry angle selection. For the prostate cases, however, careful selection of gantry angles could dramatically improve the bone marrow sparing, although the dose distribution in bone marrow was clinically acceptable for all prostate plans that we created. Conclusion: For intensity-modulated RDT planning for cervical cancer, planners should set bone marrow constraints properly to avoid any adverse damage, while for prostate cancer one can carefully select gantry angles to improve bone marrow sparing when necessary.« less

The Least-Squares Calibration on the Micro-Arcsecond Metrology Test Bed

NASA Technical Reports Server (NTRS)

Zhai, Chengxing; Milman, Mark H.; Regehr, Martin W.

2006-01-01

The Space Interferometry Mission (S1M) will measure optical path differences (OPDs) with an accuracy of tens of picometers, requiring precise calibration of the instrument. In this article, we present a calibration approach based on fitting star light interference fringes in the interferometer using a least-squares algorithm. The algorithm is first analyzed for the case of a monochromatic light source with a monochromatic fringe model. Using fringe data measured on the Micro-Arcsecond Metrology (MAM) testbed with a laser source, the error in the determination of the wavelength is shown to be less than 10pm. By using a quasi-monochromatic fringe model, the algorithm can be extended to the case of a white light source with a narrow detection bandwidth. In SIM, because of the finite bandwidth of each CCD pixel, the effect of the fringe envelope can not be neglected, especially for the larger optical path difference range favored for the wavelength calibration.

Economic environmental dispatch using BSA algorithm

NASA Astrophysics Data System (ADS)

Jihane, Kartite; Mohamed, Cherkaoui

2018-05-01

Economic environmental dispatch problem (EED) is an important issue especially in the field of fossil fuel power plant system. It allows the network manager to choose among different units the most optimized in terms of fuel costs and emission level. The objective of this paper is to minimize the fuel cost with emissions constrained; the test is conducted for two cases: six generator unit and ten generator unit for the same power demand 1200Mw. The simulation has been computed in MATLAB and the result shows the robustness of the Backtracking Search optimization Algorithm (BSA) and the impact of the load demand on the emission.

Principled Principals? Values-Driven Leadership: Evidence from Ten Case Studies of 'Outstanding' School Leaders.

ERIC Educational Resources Information Center

Gold, Anne; Evans, Jennifer; Earley, Peter; Halpin, David; Collarbone, Patricia

2003-01-01

Case studies of English schools with "outstanding leaders" finds them avoiding doing "bastard leadership" by mediating government policy through their own values. Explores ways in which school leaders promote and encourage shared values. Discusses how these leaders enact values-driven leadership by, for example, developing…

Disseminated Mycobacterium chimaera Infection After Cardiothoracic Surgery

PubMed Central

Tan, Nicholas; Sampath, Rahul; Abu Saleh, Omar M.; Tweet, Marysia S.; Jevremovic, Dragan; Alniemi, Saba; Wengenack, Nancy L.; Sampathkumar, Priya; Badley, Andrew D.

2016-01-01

Ten case reports of disseminated Mycobacterium chimaera infections associated with cardiovascular surgery were published from Europe. We report 3 cases of disseminated M chimaera infections with histories of aortic graft and/or valvular surgery within the United States. Two of 3 patients demonstrated ocular involvement, a potentially important clinical finding. PMID:27703994

Disseminated Mycobacterium chimaera Infection After Cardiothoracic Surgery.

PubMed

Tan, Nicholas; Sampath, Rahul; Abu Saleh, Omar M; Tweet, Marysia S; Jevremovic, Dragan; Alniemi, Saba; Wengenack, Nancy L; Sampathkumar, Priya; Badley, Andrew D

2016-09-01

Ten case reports of disseminated Mycobacterium chimaera infections associated with cardiovascular surgery were published from Europe. We report 3 cases of disseminated M chimaera infections with histories of aortic graft and/or valvular surgery within the United States. Two of 3 patients demonstrated ocular involvement, a potentially important clinical finding.

A Business Casebook for Young Decision Makers.

ERIC Educational Resources Information Center

Tedesco, Paul H., Ed.; And Others

Ten case studies taken from the business world are presented to help secondary school students develop a realistic understanding of economic problems. Discussion of the cases can be integrated into economics or social studies programs. By studying concrete examples of business reacting to changing economic conditions, students should learn to…

Fungi as Endophytes in Artemisia thuscula: Juxtaposed Elements of Diversity and Phylogeny.

PubMed

Cosoveanu, Andreea; Rodriguez Sabina, Samuel; Cabrera, Raimundo

2018-01-27

Artemisia is a plant genus highly studied for its medicinal applications. The studies on the associated fungal endophytes are scarce. Ten plants specimens of Artemisia thuscula from Tenerife and La Palma were sampled to isolate the endophytic fungi. Identification of the endophytic fungi was based on morphology, Internal Transcribed Spacer (ITS) and Large Subunit (LSU) regions sequencing and indicates 37 fungal species affiliated to 25 fungal genera. Colonization rate varied among plants (CR = 25% to 92.11%). The most dominant colonizers found were Alternaria alternata (CF = 18.71%), Neofusicoccum sp. (CF = 8.39%) and Preussia sp. (CF = 3.23). Tendency for host specificity of most endophytic fungal species was observed. Sorensen-Dice index revealed that of 45 cases in the matrix, 27 of them were of zero similarity. Further, only one case was found to have 57% similarity (TF2 and TF7) and one case with 50% similarity (TF1 and TF4). The rest of the cases had values ranging between 11% and 40% similarity. Diversity indices like Brillouin, Margalef species richness, Simpson index of diversity and Fisher's alpha, revealed plants from La Palma with higher values than plants from Tenerife. Three nutrient media (i.e., potato dextrose agar-PDA, lignocellulose agar-LCA, and tomato juice agar-V8) were used in a case study and revealed no differences in terms of colonization rate when data was averaged. Colonization frequency showed several species with preference for nutrient medium (63% of the species were isolated from only one nutrient medium). For the phylogenetic reconstruction using the Bayesian method, 54 endophytic fungal ITS sequences and associated GenBank sequences were analyzed. Ten orders (Diaporthales, Dothideales, Botryosphaeriales, Hypocreales, Trichosphaeriales, Amphisphaeriales, Xylariales, Capnodiales, Pleosporales and Eurotiales) were recognized. Several arrangements of genera draw the attention, like Aureobasidium (Dothideales) and Aplosporella (Botryosphaeriales) which are clustered with a recent ancestor (BS = 0.97).

Developing and pretesting case studies in dental and dental hygiene education: using the diffusion of innovations model.

PubMed

Cragun, Deborah L; DeBate, Rita DiGioacchino; Severson, Herbert H; Shaw, Tracy; Christiansen, Steve; Koerber, Anne; Tomar, Scott L; Brown, Kelli McCormack; Tedesco, Lisa A; Hendricson, William D

2012-05-01

Case-based learning offers exposure to clinical situations that health professions students may not encounter in their training. The purposes of this study were to apply the Diffusion of Innovations conceptual framework to 1) identify characteristics of case studies that would increase their adoption among dental and dental hygiene faculty members and 2) develop and pretest interactive web-based case studies on sensitive oral-systemic health issues. The formative study spanned two phases using mixed methods (Phase 1: eight focus groups and four interviews; Phase 2: ten interviews and satisfaction surveys). Triangulation of quantitative and qualitative data revealed the following positive attributes of the developed case studies: relative advantage of active learning and modeling; compatibility with a variety of courses; observability of case-related knowledge and skills; independent learning; and modifiability for use with other oral-systemic health issues. These positive attributes are expected to increase the likelihood that dental and dental hygiene faculty members will adopt the developed case study once it is available for use. The themes identified in this study could be applied to the development of future case studies and may provide broader insight that might prove useful for exploring differences in case study use across dental and dental hygiene curricula.

Emergency care in case of acute psychotic and/or manic symptoms: Lived experiences of patients and their families with the first interventions of a mobile crisis team. A phenomenological study.

PubMed

Daggenvoorde, Thea H; Gijsman, Harm J; Goossens, Peter J J

2017-09-27

To explore the lived experiences of patients with a psychotic or bipolar disorder and their families with emergency care during the first contact with a mobile crisis team. Open individual interviews were held with ten patients and ten family members. Content data-analysis was conducted. Communication and cooperation was difficult in several cases. Personal crisis plans were not always used. Stigma was felt, especially when police-assistance was needed. A calm, understanding attitude was appreciated. Focus explicitly on communication with the patient, despite the acute condition, enhances the chance of cooperation. Taking time for contact is important. © 2017 Wiley Periodicals, Inc.

Griseofulvin and/or Terbinafine Induced Toxic Epidermal Necrolysis in an Adult Female Patient - A Case Report.

PubMed

Jadeja, Dharamvirsinh; Jaiswal, Chandra S; Panchasra, Ashwin; Tripathi, Chandrabhanu B

2016-01-01

An 18 years old female patient, who was taking treatment for tinea cruris developed Toxic Epidermal Necrolysis (TEN) due to therapeutic dose of griseofulvin with concomitant use of terbinafine. Both the drugs were stopped; patient's condition was gradually improved after starting the treatment. As per WHO-UMC causality assessment criteria, association between reaction and drug was possible (for both griseofulvin and terbinafine). Griseofulvin and terbinafine, both are widely used as an oral antifungal agent to treat fungal infections, careful monitoring is required in the initial periods of the treatment to prevent such type of serious adverse drug reaction. We report a case of TEN possibly caused by griseofulvin with concomitant use of terbinafine resulting in diagnostic difficulty.

Treatment of toxic epidermal necrolysis with moisture-retentive ointment: a case report and review of the literature.

PubMed

Atiyeh, Bishara S; Dham, Ruwayda; Yassin, M Fayez; El-Musa, Kusai A

2003-02-01

Toxic epidermal necrolysis (TEN) is a rare condition that was described by Lyell in 1956. It is a severe, acute, adverse, primarily drug-induced, potentially fatal, cutaneous reaction that is characterized by large areas of skin desquamation and sloughing, similar in many aspects to second-degree burns. The treatment of cutaneous drug reactions rests essentially on immediate diagnosis and recognition of the disease process, accurate history, thorough physical examination, prompt discontinuation of the offending drug, and supportive care. TEN patients are best managed in specialized burn units. Nevertheless, the management remains very much individualized, based on the clinical setting. Topical wound care remains an essential factor in the treatment of burn-like syndromes and is a main determining parameter for morbidity and mortality. As the value of moist environment in wound healing is being fully appreciated, we report on the use of a newly introduced ointment, the Moist Exposed Burn Ointment (Julphar; Gulf Pharmaceutical industries, Ras El-Khaymah, United Arab of Emirutes), a moisture-retentive ointment, in the successful management of a case of TEN.

Research funders' roles and perceived responsibilities in relation to the implementation of clinical research results: a multiple case study of Swedish research funders.

PubMed

Brantnell, Anders; Baraldi, Enrico; van Achterberg, Theo; Winblad, Ulrika

2015-07-17

Implementation of clinical research results is challenging, yet the responsibility for implementation is seldom addressed. The process from research to the use of clinical research results in health care can be facilitated by research funders. In this paper, we report the roles of ten Swedish research funders in relation to implementation and their views on responsibilities in implementation. Ten cases were studied and compared using semi-structured interviews. In addition, websites and key documents were reviewed. Eight facilitative roles for research funders in relation to the implementation of clinical research results were identified. Three of them were common for several funders: "Advocacy work," "Monitoring implementation outcomes," and "Dissemination of knowledge." Moreover, the research funders identified six different actors responsible for implementation, five of which belonged to the healthcare setting. Collective and organizational responsibilities were the most common forms of responsibilities among the identified actors responsible for implementation. The roles commonly identified by the Swedish funders, "Advocacy work," "Monitoring implementation outcomes," and "Dissemination of knowledge," seem feasible facilitative roles in relation to the implementation of clinical research results. However, many actors identified as responsible for implementation together with the fact that collective and organizational responsibilities were the most common forms of responsibilities entail a risk of implementation becoming no one's responsibility.

A Review of the Active Treatments for Toxic Epidermal Necrolysis.

PubMed

Kinoshita, Yuri; Saeki, Hidehisa

2017-01-01

Toxic epidermal necrolysis (TEN) is a severe adverse drug reaction associated with the separation of skin and mucous membranes at the dermal-epidermal junction. Although it is rare, many treatments have been trialed because of its high mortality rate. Active interventions performed to date include the use of systemic corticosteroids, intravenous immunoglobulins (IVIg), cyclosporine, plasmapheresis, anti-tumor necrosis factor drugs and N-acetylcysteine, but none has been established as the most effective therapy. IVIg and short-term high-dose corticosteroids were regarded as the most promising treatments for TEN in a comprehensive review of all reported TEN cases from 1975-2003. When used with an appropriate dose and timing, the beneficial effects of IVIg can be maximized. Although no randomized controlled trials have been conducted, cyclosporine and plasmapheresis are considered to be beneficial. As no gold standard for active intervention for TEN has been established, the choice of treatment relies partly on the available guidelines and the experience of the dermatologist. There is still much to be investigated regarding the pathogenesis of TEN, and new findings may contribute to the identification of an effective active intervention strategy.

Treatment of neuropathic pain in a patient with diabetic neuropathy using transcutaneous electrical nerve stimulation applied to the skin of the lumbar region.

PubMed

Somers, D L; Somers, M F

1999-08-01

Diabetic neuropathy can produce severe pain. The purpose of this case report is to describe the alteration of pain in a patient with severe, painful diabetic neuropathy following application of transcutaneous electrical nerve stimulation (TENS) to the low back. The patient was a 73-year-old woman with pain in the left lower extremity over the lateral aspect of the hip and the entire leg below the knee. The pain prevented sound sleep. The intensity of pain was assessed with a visual analog scale. The TENS (80 Hz) was delivered 1 to 2 hours a day and during the entire night through electrodes placed on the lumbar area of the back. Following 20 minutes of TENS on the first day of treatment, the patient reported a 38% reduction in intensity of pain. After 17 days, the patient reported no pain following 20 minutes of TENS and that she could sleep through the night. Application of TENS to the skin of the lumbar area may be an effective treatment for the pain of diabetic neuropathy.

Hemodynamic Effects Induced by Transcutaneous Electrical Nerve Stimulation in Apparently Healthy Individuals: A Systematic Review With Meta-Analysis.

PubMed

Campos, Filippe V; Neves, Laura M; Da Silva, Vinicius Z; Cipriano, Graziella F; Chiappa, Gaspar R; Cahalin, Lawrence; Arena, Ross; Cipriano, Gerson

2016-05-01

To determine the immediate effects of transcutaneous electrical nerve stimulation (TENS) on heart rate, systolic blood pressure (SBP), and diastolic blood pressure (DBP) in apparently healthy adults (age ≥18y). The Cochrane Library (online version 2014), PubMed (1962-2014), EMBASE (1980-2014), and LILACS (1980-2014) electronic databases were searched. Randomized controlled trials were included when TENS was administered noninvasively with surface electrodes during rest, and the effect of TENS was compared with that of control or placebo TENS. A sensitive search strategy for identifying randomized controlled trials was used by 2 independent reviewers. The initial search led to the identification of 432 studies, of which 5 articles met the eligibility criteria. Two independent reviewers extracted data from the selected studies. Quality was evaluated using the PEDro scale. Mean differences or standardized mean differences in outcomes were calculated. Five eligible articles involved a total of 142 apparently healthy individuals. Four studies used high-frequency TENS and 3 used low-frequency TENS and evaluated the effect on SBP. Three studies using high-frequency TENS and 2 using low-frequency TENS evaluated the effect on DBP. Three studies using high-frequency TENS and 1 study using low-frequency TENS evaluated the effect on heart rate. A statistically significant reduction in SBP (-3.00mmHg; 95% confidence interval [CI], -5.02 to -0.98; P=.004) was found using low-frequency TENS. A statistically significant reduction in DBP (-1.04mmHg; 95% CI, -2.77 to -0.03; I(2)=61%; P=.04) and in heart rate (-2.55beats/min; 95% CI, -4.31 to -0.78; I(2)=86%; P=.005]) was found using both frequencies. The median value on the PEDro scale was 7 (range, 4-8). TENS seems to promote a discrete reduction in SBP, DBP, and heart rate in apparently healthy individuals. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Enhancement of Entrepreneurial Leadership: A Case Focusing on a Model of Successful Conflict Management Skills

ERIC Educational Resources Information Center

Leffel, Anita; Hallam, Cory; Darling, John

2012-01-01

The purpose of this paper is to present a case study focusing on a new technology start-up firm, founded by two graduate students, an engineer and a business major, who met during their university studies. The case is timely, in that only ten percent of new product introductions result in a profitable business. The causes of failure are numerous…

The Influence of Online Teaching on Faculty Productivity

ERIC Educational Resources Information Center

Meyer, Katrina A.

2012-01-01

Ten faculty members with experience teaching online were interviewed about their motivation for teaching online and the effect of teaching online on their teaching and research productivity. They represented nine different states and 13 different fields, and all were tenured or tenure-track at master's or doctoral institutions. All ten mentioned…

Dengue burden in India: recent trends and importance of climatic parameters.

PubMed

Mutheneni, Srinivasa Rao; Morse, Andrew P; Caminade, Cyril; Upadhyayula, Suryanaryana Murty

2017-08-09

For the past ten years, the number of dengue cases has gradually increased in India. Dengue is driven by complex interactions among host, vector and virus that are influenced by climatic factors. In the present study, we focused on the extrinsic incubation period (EIP) and its variability in different climatic zones of India. The EIP was calculated by using daily and monthly mean temperatures for the states of Punjab, Haryana, Gujarat, Rajasthan and Kerala. Among the studied states, a faster/low EIP in Kerala (8-15 days at 30.8 and 23.4 °C) and a generally slower/high EIP in Punjab (5.6-96.5 days at 35 and 0 °C) were simulated with daily temperatures. EIPs were calculated for different seasons, and Kerala showed the lowest EIP during the monsoon period. In addition, a significant association between dengue cases and precipitation was also observed. The results suggest that temperature is important in virus development in different climatic regions and may be useful in understanding spatio-temporal variations in dengue risk. Climate-based disease forecasting models in India should be refined and tailored for different climatic zones, instead of use of a standard model.

Dengue burden in India: recent trends and importance of climatic parameters

PubMed Central

Mutheneni, Srinivasa Rao; Morse, Andrew P; Caminade, Cyril; Upadhyayula, Suryanaryana Murty

2017-01-01

For the past ten years, the number of dengue cases has gradually increased in India. Dengue is driven by complex interactions among host, vector and virus that are influenced by climatic factors. In the present study, we focused on the extrinsic incubation period (EIP) and its variability in different climatic zones of India. The EIP was calculated by using daily and monthly mean temperatures for the states of Punjab, Haryana, Gujarat, Rajasthan and Kerala. Among the studied states, a faster/low EIP in Kerala (8–15 days at 30.8 and 23.4 °C) and a generally slower/high EIP in Punjab (5.6–96.5 days at 35 and 0 °C) were simulated with daily temperatures. EIPs were calculated for different seasons, and Kerala showed the lowest EIP during the monsoon period. In addition, a significant association between dengue cases and precipitation was also observed. The results suggest that temperature is important in virus development in different climatic regions and may be useful in understanding spatio-temporal variations in dengue risk. Climate-based disease forecasting models in India should be refined and tailored for different climatic zones, instead of use of a standard model. PMID:28790459

Transcutaneous electrical nerve stimulation and temporary S3 neuromodulation in idiopathic detrusor instability.

PubMed

Hasan, S T; Robson, W A; Pridie, A K; Neal, D E

1996-06-01

We studied the effects of electrical stimulation on idiopathic detrusor instability. Between January 1993 and December 1994, 30 men and 41 women (mean age plus or minus standard deviation 48 +/- 16 years) underwent transcutaneous electrical nerve stimulation (TENS) of the S2-S3 dermatomes, and 13 men and 22 women (mean age 48 +/- 12 years) underwent S3 neuromodulation. Subjective assessment was performed using a diary and symptom score of 0 to 14. Objective outcome was analyzed with urodynamic studies. Mean duration of TENS was 3 +/- 1 weeks (range 2 to 4). Although there were no major complications 31% of the patients reported local skin irritation. The overall urinary symptom scores improved from 10 +/- 2 (range 5 to 14) before the study to 7 +/- 3 (range 1 to 14) during stimulation. Urodynamic analysis revealed significant (p < 0.05) improvements in total bladder capacity and voided volume, and decreases in the number and frequency of unstable contractions. Mean duration of S3 neuromodulation was 6 +/- 1 days (range 4 to 8 days). Four procedures failed due to electrode displacement in 3 cases and procedure intolerance in 1. Hemorrhage from the puncture site occurred in 1 patient. Overall urinary symptom scores were 10 +/- 3 (range 5 to 14) before the study and 5 +/- 2 (range 2 to 10) during stimulation. Although symptomatic relief was more pronounced with S3 neuromodulation, no statistically significant differences were found regarding urinary symptoms compared to TENS. In patients with severe detrusor instability refractory to conservative treatments the use of TENS and S3 neuromodulation produced significant changes in urodynamic parameters and presenting symptoms. Our results appear to justify evaluation with neuromodulatory techniques before definitive surgical intervention in these patients.

Efficacy of botulinum toxin in treating myofascial pain in bruxers: a controlled placebo pilot study.

PubMed

Guarda-Nardini, Luca; Manfredini, Daniele; Salamone, Milena; Salmaso, Luigi; Tonello, Stefano; Ferronato, Giuseppe

2008-04-01

The present investigation is a preliminary double-blind, controlled placebo, randomized clinical trial with a six month follow-up period. The study aimed to assess the efficacy of type A botulinum toxin (Botox, Allergan, Inc. Irvine, CA) to treat myofascial pain symptoms and to reduce muscle hyperactivity in bruxers. Twenty patients (ten males, ten females; age range 25-45) with a clinical diagnosis of bruxism and myofascial pain of the masticatory muscles were enrolled in a double-blind, controlled placebo, randomized clinical trial, with a treatment group (ten subjects treated with botulinum toxin injections- BTX-A) and a control group (ten subjects treated with saline placebo injections). A number of objective and subjective clinical parameters (pain at rest and during chewing; mastication efficiency; maximum nonassisted and assisted mouth opening, protrusive and laterotrusive movements; functional limitation during usual jaw movements; subjective efficacy of the treatment; tolerance of the treatment) were assessed at baseline time and at one week, one month, and six months follow-up appointments. Descriptive analysis showed that improvements in both objective (range of mandibular movements) and subjective (pain at rest; pain during chewing) clinical outcome variables were higher in the Botox treated group than in the placebo treated subjects. Patients treated with BTX-A had a higher subjective improvement in their perception of treatment efficacy than the placebo subjects. Differences were not significant in some cases due to the small sample size. Results from the present study supported the efficacy of BTX-A to reduce myofascial pain symptoms in bruxers, and provided pilot data which need to be confirmed by further research using larger samples.

Effects of Transcutaneous Electrical Nerve Stimulation on Pain, Pain Sensitivity, and Function in People With Knee Osteoarthritis: A Randomized Controlled Trial

PubMed Central

Vance, Carol Grace T.; Rakel, Barbara A.; Blodgett, Nicole P.; DeSantana, Josimari Melo; Amendola, Annunziato; Zimmerman, Miriam Bridget; Walsh, Deirdre M.

2012-01-01

Background Transcutaneous electrical nerve stimulation (TENS) is commonly used for the management of pain; however, its effects on several pain and function measures are unclear. Objective The purpose of this study was to determine the effects of high-frequency TENS (HF-TENS) and low-frequency TENS (LF-TENS) on several outcome measures (pain at rest, movement-evoked pain, and pain sensitivity) in people with knee osteoarthritis. Design The study was a double-blind, randomized clinical trial. Setting The setting was a tertiary care center. Participants Seventy-five participants with knee osteoarthritis (29 men and 46 women; 31–94 years of age) were assessed. Intervention Participants were randomly assigned to receive HF-TENS (100 Hz) (n=25), LF-TENS (4 Hz) (n=25), or placebo TENS (n=25) (pulse duration=100 microseconds; intensity=10% below motor threshold). Measurements The following measures were assessed before and after a single TENS treatment: cutaneous mechanical pain threshold, pressure pain threshold (PPT), heat pain threshold, heat temporal summation, Timed “Up & Go” Test (TUG), and pain intensity at rest and during the TUG. A linear mixed-model analysis of variance was used to compare differences before and after TENS and among groups (HF-TENS, LF-TENS, and placebo TENS). Results Compared with placebo TENS, HF-TENS and LF-TENS increased PPT at the knee; HF-TENS also increased PPT over the tibialis anterior muscle. There was no effect on the cutaneous mechanical pain threshold, heat pain threshold, or heat temporal summation. Pain at rest and during the TUG was significantly reduced by HF-TENS, LF-TENS, and placebo TENS. Limitations This study tested only a single TENS treatment. Conclusions Both HF-TENS and LF-TENS increased PPT in people with knee osteoarthritis; placebo TENS had no significant effect on PPT. Cutaneous pain measures were unaffected by TENS. Subjective pain ratings at rest and during movement were similarly reduced by active TENS and placebo TENS, suggesting a strong placebo component of the effect of TENS. PMID:22466027

Economic and clinical aspects of intravenous versus oral busulfan in adult patients for conditioning prior to HSCT.

PubMed

Berger, Karin; Schopohl, Dorothee; Rieger, Christina; Ostermann, Helmut

2015-12-01

Busulfan (BU) used as cytoreductive conditioning prior to hematopoietic stem cell transplantation (HSCT) is available as intravenous (IV) and oral (O) preparation. IV-BU has clinical advantages associated with relevant incremental costs. The aim was to determine the economic impact of IV-BU versus O-BU in adult HSCT recipients from a German health care providers' perspective. A budget-impact model (BIM) including costs and risks for oral mucositis (OM), infection with OM, and hepatic sinusoidal obstruction syndrome (SOS) was developed. Model inputs are literature data comparing clinical effects of IV-BU versus O-BU and German cost data (conditioning therapy, treatment of OM, infections, SOS without/with multiorgan failure) from literature and tariff lists. Base case calculations resulted the following: total costs of adverse events were €86,434 with O-BU and €44,376 with IV-BU for ten patients each. Considering costs of adverse events and drugs, about €5840 for ten patients receiving IV-BU are saved. Sensitivity analyses were conducted in several ways. Cost savings range between €4910 and €12,640 per ten patients for all adverse events and €2070 or €1140 per ten patients considering SOS only. Drug treatment of SOS and treatment of multiorgan failure during severe SOS are major cost drivers. Worst case scenario calculations (assuming -25% risk of all adverse events for O-BU and +25% for IV-BU) yield up to €27,570 per ten patients with IV-BU. Considering costs of adverse events and drugs, IV-BU is the dominant alternative from a German providers' perspective. For more comprehensive economic evaluations, additional epidemiological data, evidence on clinical outcomes, patient-reported outcomes, and treatment patterns are needed.

Final Jurisdictional Environmental Planning Technical Report. Peacekeeper in Minuteman Silos, 90th Strategic Missile Wing, F. E. Warren Air Force Base. Volume 1. Section 1.0 through 5.0

DTIC Science & Technology

1984-01-01

majority (93 percent) of cases are traffic cases . Of all traffic cases only a small portion (2.6 percent of the total) deal...Further, because the vast majority of cases are only normal traffic violations, only a small percentage of cases , about ten percent, feature a defendant...The remaining 35.3 percent of cases are nontraffic in nature. A majority of dispositions are by forfei- ture, guilty plea, and failure to

Hidden symmetries and Lie algebra structures from geometric and supergravity Killing spinors

NASA Astrophysics Data System (ADS)

Açık, Özgür; Ertem, Ümit

2016-08-01

We consider geometric and supergravity Killing spinors and the spinor bilinears constructed out of them. The spinor bilinears of geometric Killing spinors correspond to the antisymmetric generalizations of Killing vector fields which are called Killing-Yano forms. They constitute a Lie superalgebra structure in constant curvature spacetimes. We show that the Dirac currents of geometric Killing spinors satisfy a Lie algebra structure up to a condition on 2-form spinor bilinears. We propose that the spinor bilinears of supergravity Killing spinors give way to different generalizations of Killing vector fields to higher degree forms. It is also shown that those supergravity Killing forms constitute a Lie algebra structure in six- and ten-dimensional cases. For five- and eleven-dimensional cases, the Lie algebra structure depends on an extra condition on supergravity Killing forms.

Survival of cementless femoral components after osteonecrosis of the femoral head with different etiologies.

PubMed

Radl, Roman; Egner, Sigrun; Hungerford, Marc; Rehak, Peter; Windhager, Reinhard

2005-06-01

We reviewed 41 patients with 55 cementless total hip arthroplasty operated for advanced osteonecrosis. Patients were divided into 2 groups according to etiology of the osteonecrosis. The first group included 17 cases with osteonecrosis without a systemic disease and the second group 38 cases with osteonecrosis associated with a systemic disease. The follow-up was on average 6.4 years (range, 2-12.8). Eight (15.4%) stem revisions had to be performed; all of them were in the patients with a systemic disease. Ten-year survival rates with femoral revision as the endpoint were in the first group 100% and in the systemic disease group 68% (P = .03). The data of this retrospective study indicate a correlation between the survival of the femoral component and the etiology of the osteonecrosis.

Bone graft in the treatment of nonunion of the scaphoid with necrosis of the proximal pole: a literature review.

PubMed

Severo, Antônio Lourenço; Lemos, Marcelo Barreto; Lech, Osvandré Luiz Canfield; Barreto Filho, Danilo; Strack, Daniel Paulo; Candido, Larissa Knapp

2017-01-01

Scaphoid fractures are the most common fractures of the carpal bones, corresponding to 60%. Of these, 10% progress to nonunion; moreover, 3% can present necrosis of the proximal pole. There are various methods of treatment using vascularized and non-vascularized bone grafts. To evaluate and compare the rate of scaphoid consolidation with necrosis of the proximal pole using different surgical techniques. The authors conducted a review of the literature using the following databases: PubMed and BIREME/LILACS, where 13 case series were selected (ten with use of vascularized bone grafts and three of non-vascularized bone grafts), according to inclusion and exclusion criteria. In most cases VBGs were used, especially those based on the 1,2 intercompartmental supraretinacular artery, due to greater reproducibility in performing the surgical technique.

Effects of different frequencies of transcutaneous electrical nerve stimulation on venous vascular reactivity

PubMed Central

Franco, O.S.; Paulitsch, F.S.; Pereira, A.P.C.; Teixeira, A.O.; Martins, C.N.; Silva, A.M.V.; Plentz, R.D.M.; Irigoyen, M.C.; Signori, L.U.

2014-01-01

Transcutaneous electrical nerve stimulation (TENS) is a type of therapy used primarily for analgesia, but also presents changes in the cardiovascular system responses; its effects are dependent upon application parameters. Alterations to the cardiovascular system suggest that TENS may modify venous vascular response. The objective of this study was to evaluate the effects of TENS at different frequencies (10 and 100 Hz) on venous vascular reactivity in healthy subjects. Twenty-nine healthy male volunteers were randomized into three groups: placebo (n=10), low-frequency TENS (10 Hz, n=9) and high-frequency TENS (100 Hz, n=10). TENS was applied for 30 min in the nervous plexus trajectory from the superior member (from cervical to dorsal region of the fist) at low (10 Hz/200 μs) and high frequency (100 Hz/200 μs) with its intensity adjusted below the motor threshold and intensified every 5 min, intending to avoid accommodation. Venous vascular reactivity in response to phenylephrine, acetylcholine (endothelium-dependent) and sodium nitroprusside (endothelium-independent) was assessed by the dorsal hand vein technique. The phenylephrine effective dose to achieve 70% vasoconstriction was reduced 53% (P<0.01) using low-frequency TENS (10 Hz), while in high-frequency stimulation (100 Hz), a 47% increased dose was needed (P<0.01). The endothelium-dependent (acetylcholine) and independent (sodium nitroprusside) responses were not modified by TENS, which modifies venous responsiveness, and increases the low-frequency sensitivity of α1-adrenergic receptors and shows high-frequency opposite effects. These changes represent an important vascular effect caused by TENS with implications for hemodynamics, inflammation and analgesia. PMID:24820225

Hip fracture risk in relation to vitamin D supplementation and serum 25-hydroxyvitamin D levels: a systematic review and meta-analysis of randomised controlled trials and observational studies

PubMed Central

2010-01-01

Background Vitamin D supplementation for fracture prevention is widespread despite conflicting interpretation of relevant randomised controlled trial (RCT) evidence. This study summarises quantitatively the current evidence from RCTs and observational studies regarding vitamin D, parathyroid hormone (PTH) and hip fracture risk. Methods We undertook separate meta-analyses of RCTs examining vitamin D supplementation and hip fracture, and observational studies of serum vitamin D status (25-hydroxyvitamin D (25(OH)D) level), PTH and hip fracture. Results from RCTs were combined using the reported hazard ratios/relative risks (RR). Results from case-control studies were combined using the ratio of 25(OH)D and PTH measurements of hip fracture cases compared with controls. Original published studies of vitamin D, PTH and hip fracture were identified through PubMed and Web of Science databases, searches of reference lists and forward citations of key papers. Results The seven eligible RCTs identified showed no significant difference in hip fracture risk in those randomised to cholecalciferol or ergocalciferol supplementation versus placebo/control (RR = 1.13[95%CI 0.98-1.29]; 801 cases), with no significant difference between trials of <800 IU/day and ≥800 IU/day. The 17 identified case-control studies found 33% lower serum 25(OH)D levels in cases compared to controls, based on 1903 cases. This difference was significantly greater in studies with population-based compared to hospital-based controls (χ21 (heterogeneity) = 51.02, p < 0.001) and significant heterogeneity was present overall (χ216 (heterogeneity) = 137.9, p < 0.001). Serum PTH levels in hip fracture cases did not differ significantly from controls, based on ten case-control studies with 905 cases (χ29 (heterogeneity) = 149.68, p < 0.001). Conclusions Neither higher nor lower dose vitamin D supplementation prevented hip fracture. Randomised and observational data on vitamin D and hip fracture appear to differ. The reason for this is unclear; one possible explanation is uncontrolled confounding in observational studies. Post-fracture PTH levels are unrelated to hip fracture risk. PMID:20540727

Adaptation of biomixtures for carbofuran degradation in on-farm biopurification systems in tropical regions.

PubMed

Chin-Pampillo, Juan Salvador; Ruiz-Hidalgo, Karla; Masís-Mora, Mario; Carazo-Rojas, Elizabeth; Rodríguez-Rodríguez, Carlos E

2015-07-01

A biomixture constitutes the active core of the on-farm biopurification systems, employed for the detoxification of pesticide-containing wastewaters. As biomixtures should be prepared considering the available local materials, the present work aimed to evaluate the performance of ten different biomixtures elaborated with by-products from local farming, in the degradation of the insecticide/nematicide carbofuran (CFN), in order to identify suitable autochthonous biomixtures to be used in the tropics. Five different lignocellulosic materials mixed with either compost or peat and soil were employed in the preparation of the biomixtures. The comprehensive evaluation of the biomixtures included removal of the parent compound, formation of transformation products, mineralization of radiolabeled CFN, and determination of the residual toxicity of the process. Detoxification capacity of the matrices was high, and compost-based biomixtures showed better performance than peat-based biomixtures. CFN removal over 98.5% was achieved within 16 days (eight out of ten biomixtures), with half-lives below 5 days in most of the cases. 3-Hydroxycarbofuran and 3-ketocarbofuran were found as transformation products at very low concentrations suggesting their further degradation. Mineralization of CFN was also achieved after 64 days (2.9 to 15.1%); several biomixtures presented higher mineralization than the soil itself. Acute toxicity determinations with Daphnia magna revealed a marked detoxification in the matrices at the end of the process; low residual toxicity was observed only in two of the peat-based biomixtures. Overall best efficiency was achieved with the biomixture composed of coconut fiber-compost-soil; however, results suggest that in the case of unavailability of coconut fiber, other biomixtures may be employed with similar performance.

Case Study of Tenure-Track Early Career Faculty in a College of Education

ERIC Educational Resources Information Center

Esping, Gretchen Revay

2010-01-01

This dissertation examines an understudied group according to the American Council on Education: the tenure-track early career faculty (ECF). The focus is on the culturalization, socialization, academic culture, and emergent themes discerned from ten semi-structured interviews with tenure-track ECF. This qualitative bounded system case study…

Rift Valley Fever, Mayotte, 2007–2008

PubMed Central

Giry, Claude; Gabrie, Philippe; Tarantola, Arnaud; Pettinelli, François; Collet, Louis; D’Ortenzio, Eric; Renault, Philippe; Pierre, Vincent

2009-01-01

After the 2006–2007 epidemic wave of Rift Valley fever (RVF) in East Africa and its circulation in the Comoros, laboratory case-finding of RVF was conducted in Mayotte from September 2007 through May 2008. Ten recent human RVF cases were detected, which confirms the indigenous transmission of RFV virus in Mayotte. PMID:19331733

Inspecting Cases against Revans' "Gold Standard" of Action Learning

ERIC Educational Resources Information Center

Willis, Verna J.

2004-01-01

A purposive sampling and analysis of ten case histories of action learning in the US suggests that applications tend to be partial, hierarchical, and leader controlled, thus running counter in several significant ways to the gold standard of Revans' action learning theory and egalitarian rules of engagement. Using critical markers to inspect the…

Telecollaborative Desktop-Videoconferencing Exchange: The Case of Mark

ERIC Educational Resources Information Center

Martin, Véronique

2014-01-01

This presentation is a case study of the Intercultural Communicative Competence (ICC) development of Mark, one of ten American students engaged in a desktop-videoconferencing telecollaborative exchange with a class of French students. Due in part to its inherent complexity, this context has not been widely researched. To observe ICC development, I…

Foreign Language Anxiety in Female Arabs Learning English: Case Studies

ERIC Educational Resources Information Center

Al-Saraj, Taghreed M.

2014-01-01

A case study design was used to examine the experiences of female college students learning English as a Foreign Language in Saudi Arabia, where English is becoming an increasingly necessary skill and the culture is undergoing immense changes. Ten participants who reported experiencing moderate to high anxiety, five from the beginning level (Level…

Exploring Community College Peer Mentoring Practices within Central California: A Multiple Case Study

ERIC Educational Resources Information Center

Brown, Lenis Colton

2017-01-01

The purpose of this qualitative, multiple case study was to illuminate the prevalence and configurations of peer mentoring programs at Central California Community Colleges with emphasis on how the programs impacted student retention. The study's sample was drawn from ten campuses and five centers that operate within five California Community…

Problems, Solutions, and Strategies Reported by Users of Transcutaneous Electrical Nerve Stimulation for Chronic Musculoskeletal Pain: Qualitative Exploration Using Patient Interviews.

PubMed

Gladwell, Peter William; Badlan, Kathryn; Cramp, Fiona; Palmer, Shea

2016-07-01

Transcutaneous electrical nerve stimulation (TENS) could offer a non-drug form of pain relief, but there is no consensus regarding its effectiveness for chronic musculoskeletal pain or chronic low back pain. A recent review of previous trial methods identified significant problems with low treatment fidelity. There is little information available to inform the development of a pragmatic implementation design for a TENS evaluation. The aim of this study was to explore the experiences of patients who were receiving secondary care in a pain clinic and who had expertise in using TENS to manage chronic musculoskeletal pain. These key informants were selected because they had the potential to generate knowledge that could inform research design and clinical practice. A qualitative method using individual semistructured interviews with open questions was selected for its capacity to generate rich data. Semistructured interviews were conducted with 9 patients (6 women, 3 men). Thematic analysis was used as the primary data analysis method, and this analysis was enhanced by a case-level analysis of the context and processes of TENS use of each individual. Data analysis indicated that patients learned to address a range of problems in order to optimize TENS use. Patients may need to personalize the positioning of electrodes and the TENS settings and to readjust them over time. Patients learned to use TENS in a strategic manner, and the outcomes of each strategy varied. The findings indicated that a pragmatic TENS evaluation may need to incorporate a learning phase to allow patients to optimize this complex pattern of TENS usage, and evaluation may need to be sensitive to the outcomes of strategic use. These findings also have implications for clinical practice. © 2016 American Physical Therapy Association.

Asplenic fulminant sepsis secondary to a dog bite complicated by toxic epidermal necrolysis/Stevens-Johnson syndrome.

PubMed

Teo, Ken G; Anavekar, Namrata S; Yazdabadi, Anosha; Ricketts, Sophie

2012-07-29

We report a case of asplenic fulminant sepsis in Australia following a dog bite which was complicated by toxic epidermal necrolysis/Stevens-Johnson syndrome (TENS/SJS). Capnocytophaga canimorsus, the infective organism, is a rare cause of septicaemia: a high degree of suspicion of this unusual organism and its early aggressive management is paramount. The diagnostic and management difficulties of TENS/SJS in the context of a patient with fulminant sepsis, DIC and on inotropes are also highlighted.

Bayesian approach to the assessment of the population-specific risk of inhibitors in hemophilia A patients: a case study

PubMed Central

Cheng, Ji; Iorio, Alfonso; Marcucci, Maura; Romanov, Vadim; Pullenayegum, Eleanor M; Marshall, John K; Thabane, Lehana

2016-01-01

Background Developing inhibitors is a rare event during the treatment of hemophilia A. The multifacets and uncertainty surrounding the development of inhibitors further complicate the process of estimating inhibitor rate from the limited data. Bayesian statistical modeling provides a useful tool in generating, enhancing, and exploring the evidence through incorporating all the available information. Methods We built our Bayesian analysis using three study cases to estimate the inhibitor rates of patients with hemophilia A in three different scenarios: Case 1, a single cohort of previously treated patients (PTPs) or previously untreated patients; Case 2, a meta-analysis of PTP cohorts; and Case 3, a previously unexplored patient population – patients with baseline low-titer inhibitor or history of inhibitor development. The data used in this study were extracted from three published ADVATE (antihemophilic factor [recombinant] is a product of Baxter for treating hemophilia A) post-authorization surveillance studies. Noninformative and informative priors were applied to Bayesian standard (Case 1) or random-effects (Case 2 and Case 3) logistic models. Bayesian probabilities of satisfying three meaningful thresholds of the risk of developing a clinical significant inhibitor (10/100, 5/100 [high rates], and 1/86 [the Food and Drug Administration mandated cutoff rate in PTPs]) were calculated. The effect of discounting prior information or scaling up the study data was evaluated. Results Results based on noninformative priors were similar to the classical approach. Using priors from PTPs lowered the point estimate and narrowed the 95% credible intervals (Case 1: from 1.3 [0.5, 2.7] to 0.8 [0.5, 1.1]; Case 2: from 1.9 [0.6, 6.0] to 0.8 [0.5, 1.1]; Case 3: 2.3 [0.5, 6.8] to 0.7 [0.5, 1.1]). All probabilities of satisfying a threshold of 1/86 were above 0.65. Increasing the number of patients by two and ten times substantially narrowed the credible intervals for the single cohort study (1.4 [0.7, 2.3] and 1.4 [1.1, 1.8], respectively). Increasing the number of studies by two and ten times for the multiple study scenarios (Case 2: 1.9 [0.6, 4.0] and 1.9 [1.5, 2.6]; Case 3: 2.4 [0.9, 5.0] and 2.6 [1.9, 3.5], respectively) had a similar effect. Conclusion Bayesian approach as a robust, transparent, and reproducible analytic method can be efficiently used to estimate the inhibitor rate of hemophilia A in complex clinical settings. PMID:27822129

Bayesian approach to the assessment of the population-specific risk of inhibitors in hemophilia A patients: a case study.

PubMed

Cheng, Ji; Iorio, Alfonso; Marcucci, Maura; Romanov, Vadim; Pullenayegum, Eleanor M; Marshall, John K; Thabane, Lehana

2016-01-01

Developing inhibitors is a rare event during the treatment of hemophilia A. The multifacets and uncertainty surrounding the development of inhibitors further complicate the process of estimating inhibitor rate from the limited data. Bayesian statistical modeling provides a useful tool in generating, enhancing, and exploring the evidence through incorporating all the available information. We built our Bayesian analysis using three study cases to estimate the inhibitor rates of patients with hemophilia A in three different scenarios: Case 1, a single cohort of previously treated patients (PTPs) or previously untreated patients; Case 2, a meta-analysis of PTP cohorts; and Case 3, a previously unexplored patient population - patients with baseline low-titer inhibitor or history of inhibitor development. The data used in this study were extracted from three published ADVATE (antihemophilic factor [recombinant] is a product of Baxter for treating hemophilia A) post-authorization surveillance studies. Noninformative and informative priors were applied to Bayesian standard (Case 1) or random-effects (Case 2 and Case 3) logistic models. Bayesian probabilities of satisfying three meaningful thresholds of the risk of developing a clinical significant inhibitor (10/100, 5/100 [high rates], and 1/86 [the Food and Drug Administration mandated cutoff rate in PTPs]) were calculated. The effect of discounting prior information or scaling up the study data was evaluated. Results based on noninformative priors were similar to the classical approach. Using priors from PTPs lowered the point estimate and narrowed the 95% credible intervals (Case 1: from 1.3 [0.5, 2.7] to 0.8 [0.5, 1.1]; Case 2: from 1.9 [0.6, 6.0] to 0.8 [0.5, 1.1]; Case 3: 2.3 [0.5, 6.8] to 0.7 [0.5, 1.1]). All probabilities of satisfying a threshold of 1/86 were above 0.65. Increasing the number of patients by two and ten times substantially narrowed the credible intervals for the single cohort study (1.4 [0.7, 2.3] and 1.4 [1.1, 1.8], respectively). Increasing the number of studies by two and ten times for the multiple study scenarios (Case 2: 1.9 [0.6, 4.0] and 1.9 [1.5, 2.6]; Case 3: 2.4 [0.9, 5.0] and 2.6 [1.9, 3.5], respectively) had a similar effect. Bayesian approach as a robust, transparent, and reproducible analytic method can be efficiently used to estimate the inhibitor rate of hemophilia A in complex clinical settings.

Trueness of four different milling procedures used in dental CAD/CAM systems.

PubMed

Kirsch, Corinna; Ender, Andreas; Attin, Thomas; Mehl, Albert

2017-03-01

Milling is a crucial step in producing restorations using computer-aided design and computer-aided manufacturing (CAD/CAM) systems. In this study the trueness of currently available milling devices was evaluated. Thirty clinical cases (ten inlays, ten crowns, ten onlays) were milled from ceramic blocks using four different milling approaches: five axis with IMES CORiTEC 450i, four axis with CEREC MCXL, four axis with CEREC MCXL-EF and five axis with inLab MCX5. The milled restorations were scanned and the occlusal and inner surfaces compared to the originally calculated 3D surface using difference analysis software. The (90-10 %) / 2 percentile of the distances were calculated and analysed using one-way ANOVA with the post hoc Scheffé test (α = 0.05). Chipping of marginal areas were visually examined and analysed using one-way ANOVA with a post hoc Tamhane test (α = 0.05). At inner surfaces, the milling trueness of IMES (33.9 ± 16.3 μm), X5 (32.3 ± 9.7 μm) and MCXL-EF (34.4 ± 7.5 μm) was significantly better (p < 0.001) than that of MCXL (62.1 ± 17.1 μm). At occlusal surfaces, MCXL-EF (25.7 ± 9.3 μm) showed significant higher accuracy (p < 0.001) than MCXL (48.7 ± 23.3 μm) and X5 (40.9 ± 20.4 μm). IMES produced the most chipping (p < 0.001). Five-axis milling devices yield high trueness. MCXL-EF is competitive and may allow chairside fabrication with good milling results. Accurate milling is required for well-fitting restorations and thereby requires fewer manual finishing steps, yields smaller marginal gaps, resistance to secondary caries and longevity of restorations.

Qualitative analysis of connective tissue stroma in different grades of oral squamous cell carcinoma: A histochemical study.

PubMed

Kullage, Smitha; Jose, Maji; Shanbhag, Vagish Kumar L; Abdulla, Riaz

2017-01-01

Detection of oral cancer at an early stage is of utmost importance to decrease morbidity and mortality. Tumor stroma plays a critical role during carcinogenesis. There is lack of information regarding the characteristics of the stroma in relation to the invading malignant epithelial cells and the interdependence between stroma and tumor cells in different grades of oral squamous cell carcinoma (OSCC). The present study was aimed to analyze and compare the nature of stroma in the vicinity of invading tumor islands in different grades of OSCC, using a histochemical technique picrosirius-polarization method. The present study also evaluated and correlated the possible role of inflammatory response in determining the nature of the stroma. The study included thirty cases of different grades of histologically diagnosed OSCC and ten sections of normal buccal mucosa as a control group. Nature of collagen was analyzed using picrosirius-polarization method, and intensity of inflammatory cell infiltrate was recorded using ImageJ software (1.42q, NIH, USA). The results were tabulated and analyzed statistically. Normal oral mucosa showed predominantly reddish birefringence. All cases of well-differentiated OSCC showed reddish-orange color. Nearly 70% moderately differentiated cases showed yellowish-orange (YO) and 60% of poorly differentiated cases, showed greenish-yellow (GY). The mean inflammatory cell count was highest in well-differentiated group. There was shift to YO and GY collagen when the cell differentiation and inflammatory cell count decreased in moderate and poorly differentiated cases. Both inflammatory cells and tumor cells have a role in determining the nature of the collagen fibers in tumor stroma of OSCC, probably with opposing effects on stromal behavior and hence both are significant in predicting prognosis.

[Expression of PTEN in Myocardial Tissue in Coronary Heart Disease].

PubMed

Li, Xue-rong; He, Yong; Lei, Yu-jia; Qin, Xe-he; Wei, Qing-tao; Pan, Xin-min; Li, Li-juan; Zhang, Lin

2016-04-01

To observe the expression of phosphatase and tensin homology deleted on chromosome ten (PTEN) in myocardial tissue in patients with coronary heart disease, and explore the relevance between the expression of PTEN and the occurrence and development of coronary heart disease. A total of 16 death cases with pathological diagnosis of coronary heart disease were collected as experimental group, and 19 cases without myocardial lesions were selected as control group. The expression of PTEN protein and its mRNA were detected by immunohistochemistry and real-time fluorescence quantitative PCR respectively. The correlation between the expression of PTEN and the pathogenesis of coronary heart disease was analyzed. The expression of PTEN protein in myocardium in cases with coronary heart disease was significantly lower compared with the control group (P < 0.05). There was no statistical difference of the expression of PTEN mRNA between experimental and control group (P > 0.05). PTEN may be involved in the occurrence and development of coronary heart disease.

EEG Correlates of Ten Positive Emotions.

PubMed

Hu, Xin; Yu, Jianwen; Song, Mengdi; Yu, Chun; Wang, Fei; Sun, Pei; Wang, Daifa; Zhang, Dan

2017-01-01

Compared with the well documented neurophysiological findings on negative emotions, much less is known about positive emotions. In the present study, we explored the EEG correlates of ten different positive emotions (joy, gratitude, serenity, interest, hope, pride, amusement, inspiration, awe, and love). A group of 20 participants were invited to watch 30 short film clips with their EEGs simultaneously recorded. Distinct topographical patterns for different positive emotions were found for the correlation coefficients between the subjective ratings on the ten positive emotions per film clip and the corresponding EEG spectral powers in different frequency bands. Based on the similarities of the participants' ratings on the ten positive emotions, these emotions were further clustered into three representative clusters, as 'encouragement' for awe, gratitude, hope, inspiration, pride, 'playfulness' for amusement, joy, interest, and 'harmony' for love, serenity. Using the EEG spectral powers as features, both the binary classification on the higher and lower ratings on these positive emotions and the binary classification between the three positive emotion clusters, achieved accuracies of approximately 80% and above. To our knowledge, our study provides the first piece of evidence on the EEG correlates of different positive emotions.

Transcutaneous Electrical Nerve Stimulation and Conditioned Pain Modulation Influence the Perception of Pain in Humans

PubMed Central

Liebano, Richard E.; Vance, Carol G.T.; Rakel, Barbara; Lee, Jennifer E.; Cooper, Nicholas A.; Marchand, Serge; Walsh, Deirdre M.; Sluka, Kathleen A.

2013-01-01

Background Research in animal models suggest that transcutaneous electrical nerve stimulation (TENS) and conditioned pain modulation (CPM) produce analgesia via two different supraspinal pathways. No known studies have examined whether TENS and CPM applied simultaneously in human subjects will enhance the analgesic effect of either treatment alone. The purpose of the current study was to investigate whether the simultaneous application of TENS and CPM will enhance the analgesic effect of that produced by either treatment alone. Methods Sixty healthy adults were randomly allocated into 2 groups: 1) CPM plus Active TENS; 2) CPM plus Placebo TENS. Pain threshold for heat (HPT) and pressure (PPT) was recorded from subject’s left forearm at baseline, during CPM, during Active or Placebo TENS, and during CPM plus Active or Placebo TENS. CPM was induced by placing the subjects’ contralateral arm in a hot water bath (46.5°C) for two minutes. TENS (100µs, 100Hz) was applied to the forearm for 20 minutes at a strong but comfortable intensity. Results Active TENS alone increased PPT (but not HPT) more than Placebo TENS alone (p=0.011). Combining CPM and Active TENS did not significantly increase PPT (p=0.232) or HPT (p=0.423) beyond CPM plus Placebo TENS. There was a significant positive association between PPT during CPM and during Active TENS (r2=0.46, p=0.003). Conclusions TENS application increases PPT, however combining CPM and TENS does not increase the CPM’s hypoalgesic response. CPM effect on PPT is associated with effects of TENS on PPT. PMID:23650092

Endovascular treatment of false-aneurysm ten years after dacron patch aortoplasty for coarctation of the aortic isthmus. Report of a case.

PubMed

Illuminati, Giulio; Pacilè, Maria Antonietta; Palumbo, Piergaspare; Salvatori, Filippo Maria; Vietri, Francesco

2013-01-01

False aneurysm degeneration is a known complication of patch aortoplasty for coarctation of the aortic isthmus. Open surgical treatment consists of prosthetic graft repair of the involved aorta, often requires circulatory arrest to achieve a safe proximal aortic control and perform proximal anastomosis, and finally is associated with substantial perioperative morbidity. Endografting of the diseased aorta is a valuable alternative to open repair, when feasible, with good short and long term results. We now report one more case of false aneurysm ten years after Dacron patch aortoplasty for isthmic coarctation in a 26-year-old woman, successfully treated by endovascular repair via the left common iliac artery, and a complete exclusion of the aneurysm at two year follow-up.

Ten tools of continuous quality improvement: a review and case example of hospital discharge.

PubMed

Ziegenfuss, J T; McKenna, C K

1995-01-01

Concepts and methods of continuous quality improvement have been endorsed by quality specialists in American Health care, and their use has convinced CEOs that industrial methods can make a contribution to health and medical care. For all the quality improvement publications, there are still few that offer a clear, concise definition and an explanation of the primary tools for teaching purposes. This report reviews ten continuous quality improvement methods including: problem solving cycle, affinity diagrams, cause and effect diagrams, Pareto diagrams, histograms, bar charts, control charts, scatter diagrams, checklists, and a process decision program chart. These do not represent an exhaustive list, but a set of commonly used tools. They are applied to a case study of bed utilization in a university hospital.

A case study on modeling and independent practice cycles in teaching beginning science inquiry

NASA Astrophysics Data System (ADS)

Sadeghpour-Kramer, Margaret Ann Plattenberger

With increasing pressure to produce high standardized test scores, school systems will be looking for the surest ways to increase scores. Decision makers uninformed about the value of inquiry science may recommend more direct teaching methods and curricula in the hope that students will more quickly accumulate factual information for high test scores. This researcher and other proponents of inquiry science suggest that the best preparation for any test is the ability to use all available information and problem solving skills to think through to a solution. This study proposes to test the theory that inquiry problem solving skills need to be modeled and practiced in increasingly independent situations to be learned. Students tend to copy what they have been led to believe is correct, and to avoid continued copying, their skills must be applied in new situations requiring independent practice and improvement. This study follows ten sixth grade students, selected for maximum variation, as they participate in a series of five cycles of modeling and practicing inquiry science investigations as part of an ongoing unit on water quality. The cycles were designed to make the students increasingly independent in their use of inquiry. The results showed that all ten students made significant progress from copying teacher modeling in investigation #1 towards independent inquiry, with nine of the ten achieving acceptable to good beginning independent inquiry in investigation #5. Each case was analyzed independently using such case study methodology as pattern matching, case study protocols, and theoretical propositions. Constant comparison and other case study methods were used in a cross-case analysis. Eight cases confirmed a matching set of propositions and the hypothesis, in literal replication, and the other two cases confirmed a set of propositions and the hypothesis through theoretical replication. The study suggests to educators that repeated cycles of modeling and increasingly independent practice serve three purposes; first to develop independent inquiry skills by providing multiple opportunities with intermittent modeling, second to repeat the modeling initially in very similar situations and then encourage transfer to new situations, and third to provide repeated modeling for those students who do not grasp the concepts as quickly as do their classmates.

Scaling analysis of cloud and rain water in marine stratocumulus and implications for scale-aware microphysical parameterizations

NASA Astrophysics Data System (ADS)

Witte, M.; Morrison, H.; Jensen, J. B.; Bansemer, A.; Gettelman, A.

2017-12-01

The spatial covariance of cloud and rain water (or in simpler terms, small and large drops, respectively) is an important quantity for accurate prediction of the accretion rate in bulk microphysical parameterizations that account for subgrid variability using assumed probability density functions (pdfs). Past diagnoses of this covariance from remote sensing, in situ measurements and large eddy simulation output have implicitly assumed that the magnitude of the covariance is insensitive to grain size (i.e. horizontal resolution) and averaging length, but this is not the case because both cloud and rain water exhibit scale invariance across a wide range of scales - from tens of centimeters to tens of kilometers in the case of cloud water, a range that we will show is primarily limited by instrumentation and sampling issues. Since the individual variances systematically vary as a function of spatial scale, it should be expected that the covariance follows a similar relationship. In this study, we quantify the scaling properties of cloud and rain water content and their covariability from high frequency in situ aircraft measurements of marine stratocumulus taken over the southeastern Pacific Ocean aboard the NSF/NCAR C-130 during the VOCALS-REx field experiment of October-November 2008. First we confirm that cloud and rain water scale in distinct manners, indicating that there is a statistically and potentially physically significant difference in the spatial structure of the two fields. Next, we demonstrate that the covariance is a strong function of spatial scale, which implies important caveats regarding the ability of limited-area models with domains smaller than a few tens of kilometers across to accurately reproduce the spatial organization of precipitation. Finally, we present preliminary work on the development of a scale-aware parameterization of cloud-rain water subgrid covariability based in multifractal analysis intended for application in large-scale model microphysics schemes.

The Harvard case of Xu Xiping: exploitation of the people, scientific advance, or genetic theft?

PubMed

Sleeboom, Margaret

2005-04-01

A unique history and make-up of a population may make it an attractive research target for population geneticists and pharmaco-genomic investors. The promise of pharmaceutical profits and advances in medical knowledge attracted Harvard researchers and the company Millennium Pharmaceuticals to remote areas in Anhui Province, Central China, leading to international diplomatic disagreements about issues such as the ownership of genetic material and informed consent (IC). This article discusses the role of genomics and genetic sampling in China, the way it is related to population policies (the new eugenics), the national importance of genetic materials and the conflicts it led to between the Chinese government and Harvard University. Here many consider the Xu Xiping case as textbook example of ruthless Western exploitation of development countries, illustrating the cold rationality of science in the process of globalisation. Ten perspectives on this case show that this view is simplistic and contributes little to an understanding of bioethical issues important to the population actually donating the samples. Viewing the Xu Xiping case as the nexus of the intertwinement of international, transnational, national, and local interest groups shows how different interest groups make use of different units of analysis. It also clarifies why the same practice of genetic sampling continues under a different regime, and why the discussion about genetic sampling has shifted from a concern with health care of the poor to an issue of international exploitation, terrorism and development.

Heterogeneity of DNA methylation in multifocal prostate cancer.

PubMed

Serenaite, Inga; Daniunaite, Kristina; Jankevicius, Feliksas; Laurinavicius, Arvydas; Petroska, Donatas; Lazutka, Juozas R; Jarmalaite, Sonata

2015-01-01

Most prostate cancer (PCa) cases are multifocal, and separate foci display histological and molecular heterogeneity. DNA hypermethylation is a frequent alteration in PCa, but interfocal heterogeneity of these changes has not been extensively investigated. Ten pairs of foci from multifocal PCa and 15 benign prostatic hyperplasia (BPH) samples were obtained from prostatectomy specimens, resulting altogether in 35 samples. Methylation-specific PCR (MSP) was used to evaluate methylation status of nine tumor suppressor genes (TSGs), and a set of selected TSGs was quantitatively analyzed for methylation intensity by pyrosequencing. Promoter sequences of the RASSF1 and ESR1 genes were methylated in all paired PCa foci, and frequent (≥75 %) DNA methylation was detected in RARB, GSTP1, and ABCB1 genes. MSP revealed different methylation status of at least one gene in separate foci in 8 out of 10 multifocal tumors. The mean methylation level of ESR1, GSTP1, RASSF1, and RARB differed between the paired foci of all PCa cases. The intensity of DNA methylation in these TSGs was significantly higher in PCa cases than in BPH (p < 0.001). Hierarchical cluster analysis revealed a divergent methylation profile of paired PCa foci, while the foci from separate cases with biochemical recurrence showed similar methylation profile and the highest mean levels of DNA methylation. Our findings suggest that PCa tissue is heterogeneous, as between paired foci differences in DNA methylation status were found. Common epigenetic profile of recurrent tumors can be inferred from our data.

Estimated costs of postoperative wound infections. A case-control study of marginal hospital and social security costs.

PubMed Central

Poulsen, K. B.; Bremmelgaard, A.; Sørensen, A. I.; Raahave, D.; Petersen, J. V.

1994-01-01

A cohort of 4515 surgical patients in ten selected intervention groups was followed. Three hundred and seventeen developed postoperative wound infections, and 291 of these cases were matched 1:1 to controls by operation, sex and age. In comparison to the controls the cases stayed longer in hospital after the intervention and had more contact after discharge with the social security system. Using data from a national sentinel reference database of the incidence of postoperative wound infections, and using national activity data, we established an empirical cost model based on the estimated marginal costs of hospital resources and social sick pay. It showed that the hospital resources spent on the ten groups, which represent half of the postoperative wound infections in Denmark, amounted to approximately 0.5% of the annual national hospital budget. This stratified model creates a better basis for selecting groups of operations which need priority in terms of preventive measures. PMID:7925666

Organizing and delivering case management services: lessons from the National Long Term Care Channeling Demonstration.

PubMed

Christianson, J B; Applebaum, R; Carcagno, G; Phillips, B

1988-01-01

This article discusses issues relating to the design and internal administration of a case-management agency for community based home care for the elderly. Included in the article are issues relating to screening procedures, assessment and case management activities, cost controls, automated management information systems, and personnel matters. The analysis is based on the experience of the National Long Term Care Demonstration ("Channeling") which established and evaluated ten case management projects nationwide under federal funding.

Is TENS purely a placebo effect? A controlled study on chronic low back pain.

PubMed

Marchand, S; Charest, J; Li, J; Chenard, J R; Lavignolle, B; Laurencelle, L

1993-07-01

Although high-frequency low-intensity transcutaneous electric nerve stimulation (TENS) has been extensively used to relieve low back pain, experimental studies of its effectiveness have yielded contradictory findings mainly due to methodological problems in pain evaluation and placebo control. In the present study, separate visual analog scales (VAS) were used to measure the sensory-discriminative and motivational-affective components of low back pain. Forty-two subjects were randomly assigned to 1 of 3 groups: TENS, placebo-TENS, and no treatment (control). In order to measure the short-term effect of TENS, VAS pain ratings were taken before and after each treatment session. Also, to measure long-term effects, patients rated their pain at home every 2 h throughout a 3-day period before and 1 week, 3 months and 6 months after the treatment sessions. In comparing the pain evaluations made immediately before and after each treatment session, TENS and placebo-TENS significantly reduced both the intensity and unpleasantness of chronic low back pain. TENS was significantly more efficient than placebo-TENS in reducing pain intensity but not pain unpleasantness. TENS also produced a significant additive effect over repetitive treatment sessions for pain intensity and relative pain unpleasantness. This additive effect was not found for placebo-TENS. When evaluated at home, pain intensity was significantly reduced more by TENS than placebo-TENS 1 week after the end of treatment, but not 3 months and 6 months later. At home evaluation of pain unpleasantness in the TENS group was never different from the placebo-TENS group.(ABSTRACT TRUNCATED AT 250 WORDS)

Telangiectatic osteosarcoma: a review of 87 cases.

PubMed

Angelini, Andrea; Mavrogenis, Andreas F; Trovarelli, Giulia; Ferrari, Stefano; Picci, Piero; Ruggieri, Pietro

2016-10-01

Telangiectatic osteosarcoma (TOS) is a rare subtype of osteosarcoma. We analyzed (1) oncologic outcome in a large homogeneous series and (2) the role of prognostic factors on prognosis, local recurrence and metastasis. Eighty-seven patients (47 males, 54 %) were retrospectively analyzed. All except 4 had extracompartmental disease, and ten patients had lung metastasis at diagnosis. Pathologic fracture was present in 27 cases (31 %). Seventy-eight patients were treated with neoadjuvant chemotherapy; nine had surgery as first treatment. Limb-salvage surgery was performed in 71 cases, amputation in 14, and rotationplasty in one. One patient died before surgery. Possible prognostic factors were statistically evaluated. Overall survival was 60.7 % at 10 years of follow-up. Fifty-one patients were disease-free (58.6 %), 2 were alive with disease (2.3 %), 31 died with disease (35.6 %), and 3 died of other causes (3.4 %). Ten local recurrences were observed (11 %). Twenty-five patients (29 %) developed lung (22) or bone (3) metastases. No statistical difference was found considering age, metastases at diagnosis, gender, pathologic fracture, tumor volume, compartmental status, number of neoadjuvant chemotherapy agents and treatment. Induced necrosis was significant at both univariate and multivariate analysis (p < 0.0001). TOS does not have a poor prognosis as previously reported in literature, with a survival of about 60 % at 10 years. Most of patients can be cured with neoadjuvant chemotherapy plus surgery (limb sparing surgery is possible and safe). Tumor response to chemotherapy as induced necrosis was the only significant prognostic factors on survival, even if small tumor volume at diagnosis correlates with better prognosis at univariate analysis. IV.

First branchial cleft anomalies in children: Experience with 30 cases.

PubMed

Li, Wanpeng; Zhao, Liming; Xu, Hongming; Li, Xiaoyan

2017-07-01

First branchial cleft anomalies (FBCA) are rare in the clinical setting, as they account for 1 to 8% of all branchial abnormalities. The purpose of this study is to explore the relationship between the fistula tract and facial nerve and the surgical method of FBCA. This retrospective study included 30 cases of FBCA in children managed from 2009 to 2016. All patients underwent surgery to remove the tract of the FBCA. We reviewed the clinical data of the patients to obtain their demographics and management. Thirty patients (11 male and 19 female) with anomalies of FBCA were diagnosed. The ages ranged from 1 to 13 years (median, 3 years). Twenty cases had a close relationship with the parotid gland. The facial nerve was identified in 20 of the 30 patients. The tract ran deep to the facial nerve in 3 cases, superficial to it in 21 cases, and passed between the branches of the nerve in 6 cases. The facial nerve was not identified in ten patients, as the tract was superficial to it. There were 2 cases of postoperative temporary facial paralysis (2/30, 6.7%). The symptoms gradually improved after one month, 1 case had permanent facial paralysis (1/30, 3.3%), and 1 case had postoperative recurrence. Complete excision of the tract is the only way to manage FBCA, and the course of the tracts vary and have different relationships with the facial nerve. There are 3 types: Superficial, deep to the facial nerve, and between the branches of the nerve. Therefore, surgical approaches differ among the various types, and careful preoperative planning and protecting the facial nerve during resection of the tract are essential.

First branchial cleft anomalies in children: Experience with 30 cases

PubMed Central

Li, Wanpeng; Zhao, Liming; Xu, Hongming; Li, Xiaoyan

2017-01-01

First branchial cleft anomalies (FBCA) are rare in the clinical setting, as they account for 1 to 8% of all branchial abnormalities. The purpose of this study is to explore the relationship between the fistula tract and facial nerve and the surgical method of FBCA. This retrospective study included 30 cases of FBCA in children managed from 2009 to 2016. All patients underwent surgery to remove the tract of the FBCA. We reviewed the clinical data of the patients to obtain their demographics and management. Thirty patients (11 male and 19 female) with anomalies of FBCA were diagnosed. The ages ranged from 1 to 13 years (median, 3 years). Twenty cases had a close relationship with the parotid gland. The facial nerve was identified in 20 of the 30 patients. The tract ran deep to the facial nerve in 3 cases, superficial to it in 21 cases, and passed between the branches of the nerve in 6 cases. The facial nerve was not identified in ten patients, as the tract was superficial to it. There were 2 cases of postoperative temporary facial paralysis (2/30, 6.7%). The symptoms gradually improved after one month, 1 case had permanent facial paralysis (1/30, 3.3%), and 1 case had postoperative recurrence. Complete excision of the tract is the only way to manage FBCA, and the course of the tracts vary and have different relationships with the facial nerve. There are 3 types: Superficial, deep to the facial nerve, and between the branches of the nerve. Therefore, surgical approaches differ among the various types, and careful preoperative planning and protecting the facial nerve during resection of the tract are essential. PMID:28672934

Clinical analysis of 43 cases of chronic benzene poisoning.

PubMed

Kuang, Shouren; Liang, Weihui

2005-05-30

Benzene can result in bone marrow suppression. Chronic benzene poisoning (CBP) can be found among workers with excessive benzene exposure. CBP could give the appearance of different types of disorders such as leukopenia, agranulocytosis, anemia, pancytopenia, aplastic anemia (AA), myelodysplastic syndrome (MDS), and leukemia. This paper describes 43 CBP cases with the patients' ages ranging from 18 to 36 years (average: 23 years). Among them, 13 (30%) were male and 30 (70%) were female. Their job titles were furniture maker, shoemaker, industrial painter and metal shop worker. Their work durations ranged from 1.5 to 72 months (average: 14 months). Benzene levels in these workplaces exceeded 30 mg/m3. Ten of the 43 cases (23%) were diagnosed as mild cases of CBP, another 10 (23%) were moderate, and 23 (53%) were severe. Treatment for CBP included the following: cessation of benzene exposure, general supportive therapy, antibiotics, vitamins, corticosteroids, androgens, colony-stimulating factors (G-CSF, GM-CSF), blood component therapy, and traditional Chinese medicine. Thirty-three (77%) of the cases recovered completely, nine (21%) cases improved, and one (2%) died. In general, prognosis of CBP cases is optimistic when appropriate treatment is given. However, a few of the benzene-induced AA cases showed no response to treatment, which raises questions about the traditional view of the pathogenesis of the illness. Furthermore, only a part of the population with the same level of benzene exposure would suffer from the disease. Still, CBP cases with the same benzene exposure level exhibited different extents of severity of the illness. This evidence suggests strongly the existence of individual susceptibility. Detection of the biological markers regarding the individual susceptibility would be valuable for screening workers who are not suitable to be exposed to benzene.

Women Leaders in Student Affairs: A Case Study Exploring Career Choices

ERIC Educational Resources Information Center

Taylor-Costello, Julie

2009-01-01

This qualitative, multiple case study explored what women working in student affairs reported as influences on their career choices and the impact that the type and level of student interaction has on their careers. Data from semi-structured interviews and journal entries were obtained from ten women working in student affairs at private,…

78 FR 67253 - Improve Tracking of Workplace Injuries and Illnesses

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-08

... represent less than one in ten of the roughly 3 million annual recordable injury and illness cases. In.../illness outcomes of an OSHA intervention, as determined by a case-control study? 5. What are the common...(a)(1) iii. Alternative C--One-Year Phase-in of Electronic Reporting Under Proposed Sec. 1904.41(a)(1...

High School Learners' Mental Construction during Solving Optimisation Problems in Calculus: A South African Case Study

ERIC Educational Resources Information Center

Brijlall, Deonarain; Ndlovu, Zanele

2013-01-01

This qualitative case study in a rural school in Umgungundlovu District in KwaZulu-Natal, South Africa, explored Grade 12 learners' mental constructions of mathematical knowledge during engagement with optimisation problems. Ten Grade 12 learners who do pure Mathemat-ics participated, and data were collected through structured activity sheets and…

Using Narrative Case Studies in an Online World Religions Course to Stimulate Deep Learning about Islam

ERIC Educational Resources Information Center

Elliott, Sherman Lee

2010-01-01

The purpose of this action research was to examine how a narrative case study in an online asynchronous world religions course affected learners' understandings, appreciation, and respect for the beliefs and values of others. The world religions course examined a variety of religions including Islam. Ten participants received information about the…

Fusarium Osteomyelitis in a Patient With Pearson Syndrome: Case Report and Review of the Literature.

PubMed

Hiebert, Rachael M; Welliver, Robert C; Yu, Zhongxin

2016-10-01

Fusarium species are ubiquitous fungi causing a wide array of infections, including invasive disease in the immunosuppressed. We present a fusarium bone infection in a child with Pearson syndrome and review the literature. Ten cases of fusarium osteomyelitis were reported in the past 40 years, and we review the treatments.

22 CFR 96.48 - Preparation and training of prospective adoptive parent(s) in incoming cases.

Code of Federal Regulations, 2014 CFR

2014-04-01

... least ten hours (independent of the home study) of preparation and training, as described in paragraphs... cases where training cannot otherwise be provided, an extended home study process, with a system for..., and any other training or counseling needed in light of the child background study or the home study...

22 CFR 96.48 - Preparation and training of prospective adoptive parent(s) in incoming cases.

Code of Federal Regulations, 2012 CFR

2012-04-01

... least ten hours (independent of the home study) of preparation and training, as described in paragraphs... cases where training cannot otherwise be provided, an extended home study process, with a system for..., and any other training or counseling needed in light of the child background study or the home study...

22 CFR 96.48 - Preparation and training of prospective adoptive parent(s) in incoming cases.

Code of Federal Regulations, 2013 CFR

2013-04-01

... least ten hours (independent of the home study) of preparation and training, as described in paragraphs... cases where training cannot otherwise be provided, an extended home study process, with a system for..., and any other training or counseling needed in light of the child background study or the home study...

Safer Schools in the UK--A Case Study

ERIC Educational Resources Information Center

Hayden, Carol; Holt, Amanda; Martin, Denise; Nee, Claire

2011-01-01

This article reports a research that is based on a European Safer Schools Partnership that included ten countries and specifically the UK case study which was located in London. The initiators of this partnership had been involved in early SSPs in the UK and the educationalists were very much focussed on work that would address problematic…

Remnants of the devil's staircase of phase transitions in the model of dimer adsorption at nonzero temperature

NASA Astrophysics Data System (ADS)

Akimenko, S. S.; Fefelov, V. F.; Myshlyavtsev, A. V.; Stishenko, P. V.

2018-02-01

The model of dimers adsorption on hexagonal lattice with different orientations to surface and hard-spheres lateral interactions has been studied at nonzero temperature. The transfer-matrix method was used as the main one and the Monte Carlo method was used for checking of some extreme cases. Adsorption isotherms, dependencies of the entropy from the density of the adsorption layer and of the energy from the system temperature at certain points of the phase space, were computed. It was found that at least the first ten phases of the ground state still persist at nonzero temperatures.

Sphero-echinocytosis of human red blood cells caused by snake, red-back spider, bee and blue-ringed octopus venoms and its inhibition by snake sera.

PubMed

Flachsenberger, W; Leigh, C M; Mirtschin, P J

1995-06-01

It was found that bee (Apis mellifera) venom, red-back spider (Latrodectus mactans) venom, blue-ringed octopus (Hapalochlaena maculosa) venom, ten different snake venoms, phospholipase A2 and four snake toxins caused sphero-echinocytosis of human red blood cells at 200 ng/ml. Most venoms and toxins lost the ability to deform human red blood cells when their components of less than mol. wt 10,000 were applied. In a number of cases the sphero-echinocytotic effect was also inhibited by blood sera of Notechis scutatus and Pseudonaja textilis.

High- and low-frequency transcutaneous electrical nerve stimulation does not reduce experimental pain in elderly individuals

PubMed Central

Bergeron-Vézina, Kayla; Corriveau, Hélène; Martel, Marylie; Harvey, Marie-Philippe; Léonard, Guillaume

2015-01-01

Abstract Despite its widespread clinical use, the efficacy of transcutaneous electrical nerve stimulation (TENS) remains poorly documented in elderly individuals. In this randomized, double-blind crossover study, we compared the efficacy of high-frequency (HF), low-frequency (LF), and placebo (P) TENS in a group of 15 elderly adults (mean age: 67 ± 5 years). The effect of HF-, LF-, and P-TENS was also evaluated in a group of 15 young individuals (26 ± 5 years; same study design) to validate the effectiveness of the TENS protocols that were used in the elderly group. Each participant came to the laboratory on 3 separate occasions to receive, in random order, HF-, LF-, and P-TENS. Pain intensity and pain perception thresholds were assessed before, during, and after TENS, using an experimental heat pain paradigm. For the young group, there was a significant decrease in pain intensity during and after HF- and LF-TENS when compared with baseline, with both HF- and LF-TENS being superior to P-TENS. In the older group, HF- and LF-TENS did not reduce pain when compared with baseline and no difference was observed between the 2 active TENS sessions and P-TENS. High-frequency, LF-, and P-TENS all increased pain thresholds in young individuals, whereas in older individuals, only LF-TENS increased pain thresholds. Taken together, these results suggest that TENS is effective in young, but not in older, individuals. Future studies should be conducted to confirm these results in pain populations and to identify strategies that could enhance the effect of TENS in the elderly. PMID:26101836

Transcutaneous electrical nerve stimulation for acute pain.

PubMed

Johnson, Mark I; Paley, Carole A; Howe, Tracey E; Sluka, Kathleen A

2015-06-15

This is a second update of a Cochrane Review originally published in Issue 2, 2009. Transcutaneous Electrical Nerve Stimulation (TENS) is a non-pharmacological agent, based on delivering low voltage electrical currents to the skin. TENS is used by people to treat a variety of pain conditions. To assess the analgesic effectiveness of TENS, as a sole treatment, for acute pain in adults. We searched the following databases up to 3 December 2014: the Cochrane Central Register of Controlled Trials (CENTRAL), in the Cochrane Library; MEDLINE; EMBASE; CINAHL; and AMED. We also checked the reference lists of included trials. We included randomised controlled trials (RCTs) of adults with acute pain (< 12 weeks) if they examined TENS given as a sole treatment and assessed pain with subjective pain scales. Trials were eligible if they compared TENS to placebo TENS, no treatment controls, pharmacological interventions or non-pharmacological interventions. We excluded trials on experimental pain, case reports, clinical observations, letters, abstracts or reviews. Also we excluded trials investigating the effect of TENS on pain during childbirth (labour), primary dysmenorrhoea or dental procedures. Studies where TENS was given with another treatment as part of the formal trial design were excluded. We did not restrict any articles based on language of publication. Two review authors independently assessed study eligibility and carried out study selection, data extraction, 'Risk of bias' assessment and analyses of data. We extracted data on the following: types of participants and pain condition, trial design and methods, treatment parameters, adverse effects, and outcome measures. We contacted trial authors for additional information if necessary. We included 12 trials in the original review (2009) and included no further trials in the first update (2011). An additional seven new trials met the inclusion criteria in this second update. In total, we included 19 RCTs involving 1346 participants at entry, with 11 trials awaiting classification either because the full text was unavailable or information in the full text failed to clarify eligibility. We excluded most trials because TENS was given in combination with another treatment as part of the formal study design or TENS was not delivered using appropriate TENS technique. The types of acute pain included in this Cochrane Review were procedural pain, e.g. cervical laser treatment, venepuncture, screening flexible sigmoidoscopy and non-procedural pain, e.g. postpartum uterine contractions and rib fractures. We pooled data for pain intensity for six trials (seven comparisons) comparing TENS with placebo but the I(2) statistic suggested substantial heterogeneity. Mean difference (MD) with 95% confidence intervals (CIs) on a visual analogue scale (VAS, 100 mm) was -24.62 mm (95% CI -31.79 to -17.46) in favour of TENS. Data for the proportion of participants achieving ≥ 50% reduction in pain was pooled for four trials (seven comparisons) and relative risk was 3.91 (95% CI 2.42 to 6.32) in favour of TENS over placebo. We pooled data for pain intensity from five trials (seven comparisons) but the I(2) statistic suggested considerable heterogeneity. MD was -19.05 mm (95% CI -27.30 to -10.79) in favour of TENS using a random-effects model. It was not possible to pool other data. There was a high risk of bias associated with inadequate sample sizes in treatment arms and unsuccessful blinding of treatment interventions. Seven trials reported minor adverse effects, such as mild erythema and itching underneath the electrodes and participants disliking TENS sensation. This Cochrane Review update includes seven new trials, in addition to the 12 trials reviewed in the first update in 2011. The analysis provides tentative evidence that TENS reduces pain intensity over and above that seen with placebo (no current) TENS when administered as a stand-alone treatment for acute pain in adults. The high risk of bias associated with inadequate sample sizes in treatment arms and unsuccessful blinding of treatment interventions makes definitive conclusions impossible. There was incomplete reporting of treatment in many reports making replication of trials impossible.

Intensive Care in a Patient with Toxic Epidermal Necrolysis

PubMed Central

Fischer, M.

2017-01-01

Toxic epidermal necrolysis (TEN) is a serious adverse drug reaction with high lethality, which usually requires intensive-medical care. A 44-year-old man developed generalized exanthema with increasing exfoliation and mucosal involvement after taking allopurinol, ibuprofen, and etoricoxib. The clinical diagnosis of TEN was histologically confirmed. Prednisolone therapy with 3 mg/kg body weight (BW) was not able to prevent further progress to finally 80% of the body surface, and infliximab 5 mg/kg BW was given as a single dose. This prevented further progression of the TEN. Despite marked improvement in skin findings, the ICU stay was prolonged by a complex analgosedation, transient kidney failure, volume management, positioning therapy, and vegetatively impeded weaning. Moreover, there was colonization with multiresistant bacteria (MRSA and VRE). Nonetheless, the patient could be restored to health and was released after four weeks. Infliximab seems to be effective in the treatment of TEN, especially in cases of rapid progression. Moreover, patients with TEN are difficult to handle in intensive-medical care, whereby attention should especially be paid to sufficient pain therapy, and the positioning of the patient is a particular challenge. PMID:29225976

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

Roper, J; Bradshaw, B; Godette, K

Purpose: To create a knowledge-based algorithm for prostate LDR brachytherapy treatment planning that standardizes plan quality using seed arrangements tailored to individual physician preferences while being fast enough for real-time planning. Methods: A dataset of 130 prior cases was compiled for a physician with an active prostate seed implant practice. Ten cases were randomly selected to test the algorithm. Contours from the 120 library cases were registered to a common reference frame. Contour variations were characterized on a point by point basis using principle component analysis (PCA). A test case was converted to PCA vectors using the same process andmore » then compared with each library case using a Mahalanobis distance to evaluate similarity. Rank order PCA scores were used to select the best-matched library case. The seed arrangement was extracted from the best-matched case and used as a starting point for planning the test case. Computational time was recorded. Any subsequent modifications were recorded that required input from a treatment planner to achieve an acceptable plan. Results: The computational time required to register contours from a test case and evaluate PCA similarity across the library was approximately 10s. Five of the ten test cases did not require any seed additions, deletions, or moves to obtain an acceptable plan. The remaining five test cases required on average 4.2 seed modifications. The time to complete manual plan modifications was less than 30s in all cases. Conclusion: A knowledge-based treatment planning algorithm was developed for prostate LDR brachytherapy based on principle component analysis. Initial results suggest that this approach can be used to quickly create treatment plans that require few if any modifications by the treatment planner. In general, test case plans have seed arrangements which are very similar to prior cases, and thus are inherently tailored to physician preferences.« less

Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults.

PubMed

Robb, Karen A; Bennett, Michael I; Johnson, Mark I; Simpson, Karen J; Oxberry, Stephen G

2008-07-16

Cancer-related pain is complex and multi-dimensional but the mainstay of cancer pain management has predominately used a biomedical approach. There is a need for non-pharmacological and innovative approaches. Transcutaneous Electric Nerve Stimulation (TENS) may have a role for a significant number of patients but the effectiveness of TENS is currently unknown. The aim of this systematic review was to determine the effectiveness of TENS for cancer-related pain in adults. We searched The Cochrane Library, MEDLINE, EMBASE, CINAHL, PsychINFO, AMED and PEDRO databases (11/04/08). Only randomised controlled trials (RCTS) investigating the use of TENS for the management of cancer-related pain in adults were included. The search strategy identified 37 possible published studies which were divided between two pairs of review authors that decided on study selection. A study eligibility form was used to screen each abstract and where study eligibility could not be determined from the abstract, the full paper was obtained and assessed by one pair of review authors. A standardised data extraction sheet was used to collect information on the studies and the quality of the studies was assessed independently by two review authors using the validated five-point Oxford Quality Scale. Final scores were discussed and agreed between all four review authors. The small sample sizes and differences in patient study populations of the two included studies prevented meta-analysis. Only two RCTs met the eligibility criteria (64 participants). These studies were heterogenous with respect to study population, sample size, study design, methodological quality, mode of TENS, treatment duration, method of administration and outcome measures used. In one RCT, there were no significant differences between TENS and placebo in women with chronic pain secondary to breast cancer treatment. In the other RCT, there were no significant differences between acupuncture-type TENS and sham in palliative care patients; this study was underpowered. The results of this systematic review are inconclusive due to a lack of suitable RCTs. Large multi-centre RCTs are required to assess the value of TENS in the management of cancer-related pain in adults.

Hypomelanosis of Ito. Case report with involvement of the central nervous system and review of the literature.

PubMed

Rosemberg, S; Arita, F N; Campos, C; Alonso, F

1984-02-01

A case of hypomelanosis of Ito in a ten-year-old black boy with mental retardation, epilepsy and abnormalities of the white matter of the cerebral hemispheres revealed by a computerized tomography is presented. This is the 41st reported case on this disease, a number of which have shown neurological signs. A review of the literature with emphasis on the neurological manifestations is performed.

Indexes of the Proceedings for the Ten International Symposia on Detonation 1951-93

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

Deal, William E.; Ramsay, John B.; Roach, Alita M.

1998-09-01

The Proceedings of the ten Detonation Symposia have become the major archival source of information of international research in explosive phenomenology, theory, experimental techniques, numerical modeling, and high-rate reaction chemistry. In many cases, they contain the original reference or the only reference to major progress in the field. For some papers, the information is more complete than the complementary article appearing in a formal journal; yet for others, authors elected to publish only an abstract in the Proceedings. For the large majority of papers, the Symposia Proceedings provide the only published reference to a body of work. This report indexesmore » the ten existing Proceedings of the Detonation Symposia by paper titles, topic phrases, authors, and first appearance of acronyms and code names.« less

The use of conventional transcutaneous electrical nerve stimulation in chronic facial myalgia patients.

PubMed

De Giorgi, Ilaria; Castroflorio, Tommaso; Sartoris, Barbara; Deregibus, Andrea

2017-01-01

The aim of this study was to evaluate the efficacy of conventional TENS in women affected by chronic facial myalgia. The study was performed on 49 women affected by chronic facial myalgia randomly allocated in the TENS group (34 women) and the control group (15 women). The subjective level of pain was assessed by the Visual Analogue Scale indicating the mean (VAS MEAN), the maximum (VAS MAX) and the current intensity of pain (VAS NOW). The level of pain at the muscular palpation sites was assessed by the Pericranial Muscle Tenderness Score (PTS) and the Cervical Muscle Tenderness Score (CTS). The TENS therapy lasted for 10 weeks, and data were collected at baseline, after 5, 10, 15 and 25 weeks. The differences between groups before and after treatment were compared with the Mann-Whitney and the Kolmogorov-Smirnov tests. The intra-group differences were compared with the one-way ANOVA test. The results showed that the VAS MEAN, VAS MAX, PTS and CTS were significantly reduced in the TENS group compared to the control group after 10 weeks of TENS (p < 0.05). The intra-group analysis revealed a decreasing tendency of VAS MEAN, VAS MAX, VAS NOW, PTS and CTS in the TENS group in a 25-week period (p < 0.05). The study demonstrated the efficacy of conventional TENS in patients with chronic facial myalgia and the decrease in both subjective and objective pain. Conventional TENS is a safe, non-invasive, easy-to-administer therapy for chronic facial myalgia.

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

Hoder, T., E-mail: hoder@physics.muni.cz; Department of Physical Electronics, Faculty of Science, Masaryk University, Kotlářská 2, 611 37 Brno; Bonaventura, Z., E-mail: zbona@physics.muni.cz

Theoretical analysis of ultra-short phenomena occurring during the positive streamer propagation in atmospheric pressure air is presented. Motivated by experimental results obtained with tens-of-picoseconds and tens-of-microns precision, it is shown that when the streamer head passes a spatial coordinate, emission maxima from N{sub 2} and N{sub 2}{sup +} radiative states follow with different delays. These different delays are caused by differences in the dynamics of populating the radiative states, due to different excitation and quenching rates. Associating the position of the streamer head with the maximum value of the self-enhanced electric field, a delay of 160 ps was experimentally foundmore » for the peak emission of the first negative system of N{sub 2}{sup +}. A delay dilatation was observed experimentally on early-stage streamers and the general mechanism of this phenomenon is clarified theoretically. In the case of the second positive system of N{sub 2}, the delay can reach as much as 400 ps. In contrast to the highly nonlinear behavior of streamer events, it is shown theoretically that emission maximum delays linearly depend on the ratio of the streamer radius and its velocity. This is found to be one of the fundamental streamer features and its use in streamer head diagnostics is proposed. Moreover, radially resolved spectra are synthesized for selected subsequent picosecond moments in order to visualize spectrometric fingerprints of radial structures of N{sub 2}(C{sup 3}Π{sub u}) and N{sub 2}{sup +}(B{sup 2}Σ{sub u}{sup +}) populations created by streamer-head electrons.« less

Predictors of outcome in children and adolescents with overactive bladder treated with parasacral transcutaneous electrical nerve stimulation.

PubMed

Hoffmann, Anselmo; Sampaio, Clara; Nascimento, Ana Aparecida; Veiga, Maria Luiza; Barroso, Ubirajara

2018-02-01

Parasacral transcutaneous electrical nerve stimulation (TENS) has emerged as an effective treatment for overactive bladder (OAB) in view of its high success rates in improving lower urinary tract symptoms and constipation, with no direct side effects. However, the clinical characteristics associated with the outcomes remain to be established. The aim of this study was to evaluate potential predictors of outcome in children with OAB treated using parasacral TENS. This was a prospective study of children with symptoms of isolated OAB, enrolled consecutively to the study and treated with parasacral TENS (figure). Isolated OAB was defined as the presence of urinary urgency with no signs of dysfunctional voiding. The symptoms were considered completely resolved when a patient's parents/guardians or the patients themselves reported a 100% improvement. Parasacral TENS was performed twice weekly for a total of 20 sessions of 20 min each at 10 Hz. The potential predictive factors evaluated were: sex, age, daytime incontinence, nocturia, a prior history of urinary tract infection, the presence of nocturnal enuresis, constipation and holding maneuvers. Eighty-three patients with a mean age of 7.8 ± 2.8 years were included in the study. Complete resolution of symptoms was achieved in 47 (56.6%). Following parasacral TENS treatment, a significant response was reported in 96.4% of cases. Of the 55 patients with nocturnal enuresis, partial resolution was achieved in 30 cases (54.5%), with a statistically significant association between nocturnal enuresis and the patient's response to treatment (p < 0.004; OR = 4.4, 95% CI 1.5-12.5). No other factor was associated with response to treatment. To the best of our knowledge, this association between nocturnal enuresis and failure to respond to parasacral TENS treatment for lower urinary tract dysfunction has not previously been reported. The identification of factors capable of predicting therapeutic failure may allow professionals to select those specific patients who would benefit from a multimodal approach in the treatment of this pathology, which has such a significant impact on the quality of life of affected patients. Nocturnal enuresis was the only symptom associated with a poor outcome following parasacral TENS treatment in children with OAB. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Association of CYP2C9*3 with phenytoin-induced Stevens-Johnson syndrome and toxic epidermal necrolysis: A systematic review and meta-analysis.

PubMed

Wu, X; Liu, W; Zhou, W

2018-06-01

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse reactions that can be induced by phenytoin (PHT). CYP2C9*3 is the key enzyme in PHT metabolism. The aim of this meta-analysis was to evaluate the association between CYP2C9*3 and PHT-induced SJS/TEN. An extensive search was performed in multiple databases, including the Cochrane Library, EMBASE, PubMed, OVID and EBSCO. Studies exploring the relationship between CYP2C9*3 and PHT-induced SJS and TEN were included. Odds ratios (ORs) with corresponding 95% confidence intervals (CI) were calculated for dichotomous data. Data analysis was performed using Review Manager (version 5.3). Four studies, with 117 PHT-induced SJS/TEN cases and 338 matched controls (PHT-tolerant patients) or 4231 population controls (general population), were identified. SJS and TEN were found to be significantly associated with the CYP2C9*3 allele, comparing both matched controls (OR, 8.93; 95% CI, 2.63-30.36; P = .0005) with substantial heterogeneity (I 2  = 46%) and population controls (OR, 8.88; 95% CI, 5.01-15.74; P < .00001). A significant association between CYP2C9*3 and PHT-induced SJS/TEN was identified, especially in a Thai population. CYP2C9*3 is thus a credible predictive genetic marker of PHT-induced SJS/TEN. Further multicenter studies and large prospective observational studies are, however, still required to determine the influence of CYP2C*3 on blood levels of PHT and its metabolites, and their association with SJS/TEN. © 2017 John Wiley & Sons Ltd.

Nine years of a single referral center management of Stevens-Johnson syndrome and toxic epidermal necrolysis (Lyell's syndrome).

PubMed

Monteiro, Diana; Egipto, Paula; Barbosa, Julia; Horta, Ricardo; Amarante, Jose; Silva, Pedro; Silva, Alvaro

2017-06-01

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) corresponds to a rare and acute life-threatening mucocutaneous reactions characterized by extensive necrosis and epidermal detachment. There are no efficacious pharmaceutical interventions proven through large clinical trials. We sought to study clinical cases admitted in our institution in order to determine which drugs and medical comorbidities or treatments impacted the mortality. In a retrospective study over 9 years we evaluated all patients presenting biopsy-proven SJS or TEN for age, gender, total body surface area involved, causing agents, SCORTEN score, blood transfusion, steroid administration, intubation, length of intensive care stay and death rate. Statistical analysis was done using SPSS statistical software. The highest incidence of SJS and TEN was in age group of 71-80 years. Of the 30 patients, 30% died from SJS/TEN, mainly due sepsis. For each subgroup SJS/TEN overlap had the highest mortality. The highest mortality was from antibiotic treatment as causing agent. Step-wise regression analysis identified mechanical ventilation requirement and age over 65 years as mortality high-risk factors. The most crucial interventions are discontinuation of the offending drug and prompt referral to a burn unit, which helps in early diagnosis and decrease mortality in these diseases. When SJS/TEN is caused by antibiotics suspicion of developing fatal sepsis should be high, independently of patients' medical condition.

[Clinical analysis of pregnancies after vaginal radical trachelectomy].

PubMed

Ma, Liang-kun; Cao, Dong-yan; Yang, Jia-xin; Qi, Qing-wei; Gao, Jin-song; Liu, Jun-tao; Yang, Jian-qiu; Xiang, Yang; Shen, Keng; Lang, Jing-he

2012-12-01

To explore the pregnancy outcome and obstetric management of pregnancy and delivery after vaginal radical trachelectomy (VRT). Forty-two cases of VRT from December 2003 to May 2012 in Peking Union Medical College Hospital were analyzed retrospectively. Among them ten cases got pregnant successfully. The average age of patient at VRT surgery was (30.6 ± 3.7) years old and average follow-up time was 29.5 months. There were 31 patients attempted conception. Ten of them got fourteen conceptions successfully. Overall conception rate was 45% (14/31). There were four cases of first trimester abortion. Among them, two were miscarriage, two were elective abortion. There was one case of ectopic pregnancy operation and non of second trimester loss. Nine cases reached the third trimester. The total preterm delivery rate was 4/9. There were two cases delivered before 32 gestational weeks (2/9). Cesarean section was performed through a transverse incision in all of nine cases. No uterine rupture and postpartum hemorrhage occurred. All newborns had good outcomes. The average follow-up time after postpartum was 22.9 months. All cases were disease-free. The conception rate of patients after VRT in our series is 45%. The preterm birth rate of pregnancy after VRT is higher. Routine cerclage of cervix during VRT procedure and pregnancy is not necessary. Cesarean section shortly after full term pregnancy through a transverse incision should be considered as a suitable and safe procedure.

Fluoroscopically guided closed reduction and internal fixation of fractures of the lateral portion of the humeral condyle: prospective clinical study of the technique and results in ten dogs.

PubMed

Cook, J L; Tomlinson, J L; Reed, A L

1999-01-01

To report a technique for fluoroscopically guided closed reduction with internal fixation of fractures of the lateral portion of the humeral condyle (FLHC) and determine the long-term results in 10 clinical cases. Prospective clinical case study. Ten dogs with 11 fractures. Fractures of the lateral portion of the humeral condyle were stabilized with transcondylar screws and Kirschner wires. Closed reduction and implant placement were achieved using intraoperative fluoroscopic guidance. After fracture repair, postoperative radiographs were evaluated for articular alignment and implant placement. Dogs were evaluated after surgery by means of lameness scores, elbow range of motion (ROM), radiographic assessment, and owner evaluation of function. Postoperative reduction was considered anatomic in 6 fractures with all other fractures having <1.5 mm of malreduction. Follow-up was available for 9 patients from 9 to 21 months after surgery. All of the fractures had healed. One minor (wire migration) and one major (implant failure) complication occurred. Mean lameness scores were 0 (n = 6), 0.5 (n = 2), and 1 (n = 1) at the time of final follow-up. No significant differences were found in follow-up ROM values between affected and unaffected elbows. All of the dogs in this study regained 90-100% of full function, based on owner assessment. Fluoroscopic guidance for closed reduction and internal fixation of FLHC in dogs is an effective technique.

First series of total robotic hysterectomy (TRH) using new integrated table motion for the da Vinci Xi: feasibility, safety and efficacy.

PubMed

Giannini, Andrea; Russo, Eleonora; Mannella, Paolo; Palla, Giulia; Pisaneschi, Silvia; Cecchi, Elena; Maremmani, Michele; Morelli, Luca; Perutelli, Alessandra; Cela, Vito; Melfi, Franca; Simoncini, Tommaso

2017-08-01

To present the first case series of total robotic hysterectomy (TRH), using integrated table motion (ITM), which is a new feature comprising a unique operating table by Trumpf Medical that communicates wirelessly with the da Vinci Xi surgical system. ITM has been specifically developed to improve multiquadrant robotic surgery such as that conducted in colorectal surgery. Between May and October 2015, a prospective post-market study was conducted on ITM in the EU in 40 cases from different specialties. The gynecological study group comprised 12 patients. Primary endpoints were ITM feasibility, safety and efficacy. Ten patients underwent TRH. Mean number of ITM moves was three during TRH; there were 31 instances of table moves in the ten procedures. Twenty-eight of 31 ITM moves were made to gain internal exposure. The endoscope remained inserted during 29 of the 31 table movements (94%), while the instruments remained inserted during 27 of the 31 moves (87%). No external instrument collisions or other problems related to the operating table were noted. There were no ITM safety-related observations and no adverse events. This preliminary study demonstrated the feasibility, safety and efficacy of ITM for the da Vinci Xi surgical system in TRH. ITM was safe, with no adverse events related to its use. Further studies will be useful to define the real role and potential benefit of ITM in gynecological surgery.

Selecting registration schemes in case of interstitial lung disease follow-up in CT

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

Vlachopoulos, Georgios; Korfiatis, Panayiotis; Skiadopoulos, Spyros

Purpose: Primary goal of this study is to select optimal registration schemes in the framework of interstitial lung disease (ILD) follow-up analysis in CT. Methods: A set of 128 multiresolution schemes composed of multiresolution nonrigid and combinations of rigid and nonrigid registration schemes are evaluated, utilizing ten artificially warped ILD follow-up volumes, originating from ten clinical volumetric CT scans of ILD affected patients, to select candidate optimal schemes. Specifically, all combinations of four transformation models (three rigid: rigid, similarity, affine and one nonrigid: third order B-spline), four cost functions (sum-of-square distances, normalized correlation coefficient, mutual information, and normalized mutual information),more » four gradient descent optimizers (standard, regular step, adaptive stochastic, and finite difference), and two types of pyramids (recursive and Gaussian-smoothing) were considered. The selection process involves two stages. The first stage involves identification of schemes with deformation field singularities, according to the determinant of the Jacobian matrix. In the second stage, evaluation methodology is based on distance between corresponding landmark points in both normal lung parenchyma (NLP) and ILD affected regions. Statistical analysis was performed in order to select near optimal registration schemes per evaluation metric. Performance of the candidate registration schemes was verified on a case sample of ten clinical follow-up CT scans to obtain the selected registration schemes. Results: By considering near optimal schemes common to all ranking lists, 16 out of 128 registration schemes were initially selected. These schemes obtained submillimeter registration accuracies in terms of average distance errors 0.18 ± 0.01 mm for NLP and 0.20 ± 0.01 mm for ILD, in case of artificially generated follow-up data. Registration accuracy in terms of average distance error in clinical follow-up data was in the range of 1.985–2.156 mm and 1.966–2.234 mm, for NLP and ILD affected regions, respectively, excluding schemes with statistically significant lower performance (Wilcoxon signed-ranks test, p < 0.05), resulting in 13 finally selected registration schemes. Conclusions: Selected registration schemes in case of ILD CT follow-up analysis indicate the significance of adaptive stochastic gradient descent optimizer, as well as the importance of combined rigid and nonrigid schemes providing high accuracy and time efficiency. The selected optimal deformable registration schemes are equivalent in terms of their accuracy and thus compatible in terms of their clinical outcome.« less

Assisted living and nursing homes: apples and oranges?

PubMed

Zimmerman, Sheryl; Gruber-Baldini, Ann L; Sloane, Philip D; Eckert, J Kevin; Hebel, J Richard; Morgan, Leslie A; Stearns, Sally C; Wildfire, Judith; Magaziner, Jay; Chen, Cory; Konrad, Thomas R

2003-04-01

The goals of this study are to describe the current state of residential care/assisted living (RC/AL) care and residents in comparison with nursing home (NH) care and residents, identify different types of RC/AL care and residents, and consider how variation in RC/AL case-mix reflects differences in care provision and/or consumer preference. Data were derived from the Collaborative Studies of Long-Term Care, a four-state study of 193 RC/AL facilities and 40 NHs. Multivariate analyses examined differences in ten process of care measures between RC/AL facilities with less than 16 beds; traditional RC/AL with 16 or more beds; new-model RC/AL; and NHs. Generalized estimating equation models determined differences in resident case-mix across RC/AL facilities using data for 2,078 residents. NHs report provision of significantly more health services and have significantly more lenient admission policies than RC/AL facilities, but provide less privacy. They do not differ from larger RC/AL facilities in policy clarity or resident control. Differences within RC/AL types are evident, with smaller and for-profit facilities scoring lower than other facilities across multiple process measures, including those related to individual freedom and institutional order. Resident impairment is substantial in both NHs and RC/AL settings, but differs by RC/AL facility characteristics. Differences in process of care and resident characteristics by facility type highlight the importance of considering: (1) the adequacy of existing process measures for evaluating smaller facilities; (2) resident case-mix when comparing facility types and outcomes; and (3) the complexity of understanding the implication of the process of care, given the importance of person-environment fit. Work is continuing to clarify the role of RC/AL vis-à-vis NHs in our nation's system of residential long-term care.

Inquiry Teaching in High School Chemistry Classrooms: The Role of Knowledge and Beliefs

NASA Astrophysics Data System (ADS)

Roehrig, Gillian H.; Luft, Julie A.

2004-10-01

"Science as inquiry" is a key content standard in the National Science Education Standards, yet implementation of inquiry-based teaching is rare in secondary chemistry classrooms. This paper is the result of a study conducted to understand factors that effect the inquiry-based instruction of ten novice secondary chemistry teachers. The study focused on the influence of teaching beliefs and content knowledge on the instructional practices of these ten teachers. Case and cross-case comparisons revealed that chemistry teachers' intentions to implement inquiry teaching were strongly influenced by their teaching beliefs rather than their knowledge of chemistry. The quality of inquiry lessons, however, was found to depend on the teachers' knowledge of chemistry content. This study reinforces the need for chemistry-focused inservice training for beginning chemistry teachers that focuses on both inquiry teaching strategies and teaching beliefs.

[Contents of ten trace elements in Epimedium acuminatum Franch. and its different processed products].

PubMed

Chen, H L; Wang, J K; Ren, Y Q; Wu, Z Y

2001-03-01

Determine and compare the contents of ten trace elements in crude E. acuminatum and its three different processed products. Using flame atomic absorption spectrometry. The ten trace elements were found in both the crude drug and its three processed products, and in terms of contents some of the trace elements in all the three processed products are higher than those in the crude drug. According to the trace element contents, the three processed products of E. acuminatum have their own advantages. It is thus suggested that thoroughgoing clinical and experimental researches be performed anew for the long-shelved processing methods.

[Development of a Software for Automatically Generated Contours in Eclipse TPS].

PubMed

Xie, Zhao; Hu, Jinyou; Zou, Lian; Zhang, Weisha; Zou, Yuxin; Luo, Kelin; Liu, Xiangxiang; Yu, Luxin

2015-03-01

The automatic generation of planning targets and auxiliary contours have achieved in Eclipse TPS 11.0. The scripting language autohotkey was used to develop a software for automatically generated contours in Eclipse TPS. This software is named Contour Auto Margin (CAM), which is composed of operational functions of contours, script generated visualization and script file operations. RESULTS Ten cases in different cancers have separately selected, in Eclipse TPS 11.0 scripts generated by the software could not only automatically generate contours but also do contour post-processing. For different cancers, there was no difference between automatically generated contours and manually created contours. The CAM is a user-friendly and powerful software, and can automatically generated contours fast in Eclipse TPS 11.0. With the help of CAM, it greatly save plan preparation time and improve working efficiency of radiation therapy physicists.

Mathematical model for the Bridgman-Stockbarger crystal growing system

NASA Technical Reports Server (NTRS)

Roberts, G. O.

1986-01-01

In a major technical breakthrough, a computer model for Bridgman-Stockbarger crystal growth was developed. The model includes melt convection, solute effects, thermal conduction in the ampule, melt, and crystal, and the determination of the curved moving crystal-melt interface. The key to the numerical method is the use of a nonuniform computational mesh which moves with the interface, so that the interface is a mesh surface. In addition, implicit methods are used for advection and diffusion of heat, concentration, and vorticity, for interface movement, and for internal gracity waves. This allows large time-steps without loss of stability or accuracy. Numerical results are presented for the interface shape, temperature distribution, and concentration distribution, in steady-state crystl growth. Solutions are presented for two test cases using water, with two different salts in solution. The two diffusivities differ by a factor of ten, and the concentrations differ by a factor of twenty.

[Non-alcoholic fatty liver: 10 years' experience at the Insituto Nacional de la Nutrición Salvador Zubirán].

PubMed

de la Mora, G; Olivera, M; de la Cerda, R; Arista, J; Kershenobich, D; Uribe, M

1994-01-01

To describe the characteristics of non-alcoholic steatohepatitis (NASH) at the Instituto Nacional de la Nutricion Salvador Zubiran. We reviewed all liver biopsy reports from January 1982 to December 1991. From patient records we obtained the following data: clinical, biochemical, imaging studies and we reviewed the histological material. We correlated clinical, biochemical and histological data. From 2963 biopsies reviewed we obtained 16 cases of NASH. We found a 7:1 female/male ratio. Median age was 30 years and six patients were obese. Eleven patients had concomitant disease (diabetes in seven) and nine were using drugs. All had been studied for biochemical abnormalities and were asymptomatic. Ten patients had hepatomegaly and six splenomegaly. Ultrasound suggested the diagnosis in 50% of the cases. All had steatosis, inflammatory infiltrate, necrosis, fibrosis and Mallory bodies at different stages. One case had cirrhosis on initial biopsy and two developed cirrhosis on follow-up (one and eight years later). We did not find any correlation between clinical, biochemical or imaging characteristics and histological findings. When we compared these findings between obese and non obese patients and primary and secondary NASH we did not find any differences between groups. NASH is infrequent in our institution. The underlying pathogenesis seems to be multifactorial. There is no biochemical-histological correlation. Cirrhosis can develop in some cases.

Sources of heterogeneity in case-control studies on associations between statins, ACE-inhibitors, and proton pump inhibitors and risk of pneumonia.

PubMed

de Groot, Mark C H; Klungel, Olaf H; Leufkens, Hubert G M; van Dijk, Liset; Grobbee, Diederick E; van de Garde, Ewoudt M W

2014-10-01

The heterogeneity in case-control studies on the associations between community-acquired pneumonia (CAP) and ACE-inhibitors (ACEi), statins, and proton pump inhibitors (PPI) hampers translation to clinical practice. Our objective is to explore sources of this heterogeneity by applying a common protocol in different data settings. We conducted ten case-control studies using data from five different health care databases. Databases varied on type of patients (hospitalised vs. GP), level of case validity, and mode of exposure ascertainment (prescription or dispensing based). Identified CAP patients and controls were matched on age, gender, and calendar year. Conditional logistic regression was used to calculate odds ratios (OR) for the associations between the drugs of interest and CAP. Associations were adjusted by a common set of potential confounders. Data of 38,742 cases and 118,019 controls were studied. Comparable patterns of variation between case-control studies were observed for ACEi, statins and PPI use and pneumonia risk with adjusted ORs varying from 1.04 to 1.49, 0.82 to 1.50 and 1.16 to 2.71, respectively. Overall, higher ORs were found for hospitalised CAP patients matched to population controls versus GP CAP patients matched to population controls. Prevalence of drug exposure was higher in dispensing data versus prescription data. We show that case-control selection and methods of exposure ascertainment induce bias that cannot be adjusted for and to a considerable extent explain the heterogeneity in results obtained in case-control studies on statins, ACEi and PPIs and CAP. The common protocol approach helps to better understand sources of variation in observational studies.

EEG Correlates of Ten Positive Emotions

PubMed Central

Hu, Xin; Yu, Jianwen; Song, Mengdi; Yu, Chun; Wang, Fei; Sun, Pei; Wang, Daifa; Zhang, Dan

2017-01-01

Compared with the well documented neurophysiological findings on negative emotions, much less is known about positive emotions. In the present study, we explored the EEG correlates of ten different positive emotions (joy, gratitude, serenity, interest, hope, pride, amusement, inspiration, awe, and love). A group of 20 participants were invited to watch 30 short film clips with their EEGs simultaneously recorded. Distinct topographical patterns for different positive emotions were found for the correlation coefficients between the subjective ratings on the ten positive emotions per film clip and the corresponding EEG spectral powers in different frequency bands. Based on the similarities of the participants’ ratings on the ten positive emotions, these emotions were further clustered into three representative clusters, as ‘encouragement’ for awe, gratitude, hope, inspiration, pride, ‘playfulness’ for amusement, joy, interest, and ‘harmony’ for love, serenity. Using the EEG spectral powers as features, both the binary classification on the higher and lower ratings on these positive emotions and the binary classification between the three positive emotion clusters, achieved accuracies of approximately 80% and above. To our knowledge, our study provides the first piece of evidence on the EEG correlates of different positive emotions. PMID:28184194

Laser induced periodic surface structures on pyrolytic carbon prosthetic heart valve

NASA Astrophysics Data System (ADS)

Stepak, Bogusz D.; Łecka, Katarzyna M.; Płonek, Tomasz; Antończak, Arkadiusz J.

2016-12-01

Laser-induced periodic surface structures (LIPSS) can appear in different forms such as ripples, grooves or cones. Those highly periodic wavy surface features which are frequently smaller than incident light wavelength bring possibility of nanostructuring of many different materials. Furthermore, by changing laser parameters one can obtain wide spectrum of periodicities and geometries. The aim of this research was to determine possibility of nanostructuring pyrolytic carbon (PyC) heart valve leaflets using different irradiation conditions. The study was performed using two laser sources with different pulse duration (15 ps, 450 fs) as well as different wavelengths (1064, 532, 355 nm). Both low and high spatial frequency LIPSS were observed for each set of irradiation parameters. In case femtosecond laser pulses we obtained deep subwavelength ripple period which was even ten times smaller than applied wavelength. Obtained ripple period was ranging from 90 up to 860 nm. Raman spectra revealed the increase of disorder after laser irradiation which was comparable for both pico- and femtosecond laser.

The influence of transcutaneous electrical nerve stimulation parameters on the level of pain perceived by participants with painful diabetic neuropathy: A crossover study.

PubMed

Upton, Gabrielle A; Tinley, Paul; Al-Aubaidy, Hayder; Crawford, Rachel

This pilot study aimed to investigate and compare the perceived pain relief effectiveness of two different modes of TENS in people with painful diabetic neuropathy (PDN). A cross-over study was conducted at Charles Sturt University, Orange. Five participants with PDN were assessed with a McGill Pain Questionnaire before and after each of the two TENS treatments. Participants were randomly allocated to Traditional TENS (80Hz, 200ms) or Acupuncture-like TENS (2Hz, 200ms) and the treatments were applied daily for 30min over ten days. Following a seven day washout period, the alternate mode of TENS was carried out using the same method. Wilcoxon Signed Rank tests were used to statistically analyse the results. All five participants reported personally meaningful pain relief during one or both of the TENS treatments. The Wilcoxon signed rank testing showed no statistical significance, p=1, likely due to the small sample size. Acupuncture-like TENS had a large effect size (z=-1.625, r=0.514), whilst Traditional TENS produced a medium effect size (z=-1.214, r=0.384). No adverse effects were reported. Acupuncture-like TENS may be more effective for PDN than traditional TENS. A larger scale replication of this pilot study is warranted. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

75 FR 69439 - Notice of Public Information Collection(s) Being Reviewed by the Federal Communications...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-12

... authorizations with five- and ten-year benchmarks to place in operation their base stations that utilize...: Section 90.155, Time in Which Station Must Be Placed in Operation. Form No.: N/A. Type of Review... government entities to place their stations in operation on a case-by-case basis upon a showing of need. This...

[Management of requests for euthanasia. Discussion of cases].

PubMed

Englert, M

2008-09-01

Since September 2002, more than 2.000 legal euthanasia's were performed in Belgium. The present paper reviews the necessary steps to be followed by the physician for a correct achievement of the process initiated by the patient's demand to die. Interpretation of the legal conditions to be respected by the physician is discussed from reports of ten cases of requests for euthanasia.

A Case Study on Collective Cognition and Operation in Team-Based Computer Game Design by Middle-School Children

ERIC Educational Resources Information Center

Ke, Fengfeng; Im, Tami

2014-01-01

This case study examined team-based computer-game design efforts by children with diverse abilities to explore the nature of their collective design actions and cognitive processes. Ten teams of middle-school children, with a high percentage of minority students, participated in a 6-weeks, computer-assisted math-game-design program. Essential…

Socialism. Grade Ten, Unit Two, 10.2. Comprehensive Social Studies Curriculum for the Inner City.

ERIC Educational Resources Information Center

Malone, Helen

The socialism unit of the tenth grade level of the FICSS series (Focus on Inner City Social Studies -- see SO 008 271) explores a selected history of socialist thought and the theoretical model of socialism. Three case studies of socialism are explored: Great Britain, Sweden, and Israel. The case studies are designed to answer questions concerning…

Single-Parents' Persistence in Pursuit of Higher Education: A Case Study

ERIC Educational Resources Information Center

Poindexter, Beryle Jean

2017-01-01

The purpose of this qualitative case study is an exploratory study to examine what contributes to the failure of the persistence of non-residential single-parents pursuing a college degree. The participants of this study included ten non-residential single-parent students between the ages of 21 and 50. The site of the interviews was in the…

[Entomological investigations conducted around ten cases of yellow fever in 2009 in the Denguélé sanitary region, Côte-d'Ivoire].

PubMed

Konan, Y L; Fofana, D; Coulibaly, Z I; Diallo, A; Koné, A B; Doannio, J M C; Ekra, K D; Odéhouri-Koudou, P

2011-10-01

In November 2009, ten suspicious cases of yellow fever, including six deaths, were notified in the region of Denguélé, in the northwest of Côte-d'Ivoire. In order to evaluate the extent of yellow fever virus circulation and the risk for local people, a mission of entomological investigation was carried out by the Ministry of Health and Public Hygiene of Côte-d'Ivoire. Entomological investigations were conducted in the villages of confirmed cases (Banakoro and Tron-Touba) and the centers of consultation and hospitalization of cases during illness. Breteau index and recipient index were quasi nil. Aedes aegypti was absent among the captured mosquitoes. On the other hand, Aedes luteocephalus and Aedes opok were present at Banakoro and Tron-Touba with respective average biting rates of 0.8 and 0.6 bite/man/twilight. This situation of epidemic in the northwest of Côte-d'Ivoire could be explained by the deterioration of Denguélé region's health system which is a consequence of the war started in the country in 2002 and which has lowered the immunity of the population.

Identification of Urban Leprosy Clusters

PubMed Central

Paschoal, José Antonio Armani; Paschoal, Vania Del'Arco; Nardi, Susilene Maria Tonelli; Rosa, Patrícia Sammarco; Ismael, Manuela Gallo y Sanches; Sichieri, Eduvaldo Paulo

2013-01-01

Overpopulation of urban areas results from constant migrations that cause disordered urban growth, constituting clusters defined as sets of people or activities concentrated in relatively small physical spaces that often involve precarious conditions. Aim. Using residential grouping, the aim was to identify possible clusters of individuals in São José do Rio Preto, Sao Paulo, Brazil, who have or have had leprosy. Methods. A population-based, descriptive, ecological study using the MapInfo and CrimeStat techniques, geoprocessing, and space-time analysis evaluated the location of 425 people treated for leprosy between 1998 and 2010. Clusters were defined as concentrations of at least 8 people with leprosy; a distance of up to 300 meters between residences was adopted. Additionally, the year of starting treatment and the clinical forms of the disease were analyzed. Results. Ninety-eight (23.1%) of 425 geocoded cases were located within one of ten clusters identified in this study, and 129 cases (30.3%) were in the region of a second-order cluster, an area considered of high risk for the disease. Conclusion. This study identified ten clusters of leprosy cases in the city and identified an area of high risk for the appearance of new cases of the disease. PMID:24288467

Computer-aided classification of patients with dementia of Alzheimer's type based on cerebral blood flow determined with arterial spin labeling technique

NASA Astrophysics Data System (ADS)

Yamashita, Yasuo; Arimura, Hidetaka; Yoshiura, Takashi; Tokunaga, Chiaki; Magome, Taiki; Monji, Akira; Noguchi, Tomoyuki; Toyofuku, Fukai; Oki, Masafumi; Nakamura, Yasuhiko; Honda, Hiroshi

2010-03-01

Arterial spin labeling (ASL) is one of promising non-invasive magnetic resonance (MR) imaging techniques for diagnosis of Alzheimer's disease (AD) by measuring cerebral blood flow (CBF). The aim of this study was to develop a computer-aided classification system for AD patients based on CBFs measured by the ASL technique. The average CBFs in cortical regions were determined as functional image features based on the CBF map image, which was non-linearly transformed to a Talairach brain atlas by using a free-form deformation. An artificial neural network (ANN) was trained with the CBF functional features in 10 cortical regions, and was employed for distinguishing patients with AD from control subjects. For evaluation of the method, we applied the proposed method to 20 cases including ten AD patients and ten control subjects, who were scanned a 3.0-Tesla MR unit. As a result, the area under the receiver operating characteristic curve obtained by the proposed method was 0.893 based on a leave-one-out-by-case test in identification of AD cases among 20 cases. The proposed method would be feasible for classification of patients with AD.

[Management of displaced radial neck fractures in children: elastic stable intramedullary nailing vs K-wire fixation].

PubMed

Wu, Quan-Zhou; Huang, Shu-Ming; Cai, Qi-Xun; Chu, Xu-Feng

2017-01-25

To compare the complications and clinical outcome of titanium elastic nail(TEN) versus K-wire fixation(KW) for the treatment of displaced radial neck fractures in children. From January 2009 to December 2014, 56 children with displaced radial neck fractures were studied retrospectively according to the inclusion criteria. Based on the different methods of internal fixation, patients were divided into two groups: titanium elastic nail (TEN group) and K-wire fixation (KW group). Among 25 patients(15 males and 11 females, aged from 3 to 12 years old with an average of 8.6±2.1) treated with TEN, 16 patients had type III fractures, 19 patients had type IV fractures according to Metaizeau-Judet modified classification; 20 patients were treated with closed reduction and 5 patients were treated with open reduction; the time from injury to treatment ranged from 1 to 8 days with an average of (3.6±1.7) days. Among 31 patients (20 males and 11 females, aged from 3 to 11 years old with an average of 9.1±1.9 years old) treated with KW, 19 patients had type III fractures, 12 patients had type IV fractures; 22 patients were treated with closed reduction, and 9 patients were treated with open reduction; the time from injury to treatment ranged from 2 to 7 days with an average of (3.7±1.5) days. No significant differences between two groups were found in general data. Operative time, hospitalization time, healing time of fracture, internal fixation time, postoperative complications and function recovery of the two groups were compared and evaluated. The average follow-up period of the patients was 22.1 months in TEN group(ranged, 16 to 48 months), and 21.9 months in KW group(ranged, 13 to 48 months). There were no significant differences between these 2 groups in follow-up duration, average hospitalization time and fracture healing time. The operation time, hospital costs and internal fixation time in TEN group were (56.6±11.8) min, (18 000±3 000) Yuan(RMB), (9.1±2.5) weeks respectively; and in KW group were(45.5±10.3) min, (8 000±1 000) Yuan(RMB), (4.8±1.6) weeks respectively, there were significant differences between two groups( P <0.05). Outcome scores according to Metaizeau and Tibone-Stoltz had no significant differences between two groups( P >0.05). There is no significant difference of therapeutic effects between TEN and KW for children with displaced radial neck fractures. Because the removal of TEN fixation requires the secondary anesthesia, and the TEN costs significantly more than KW, TEN still can't replace the traditional KW for the treatment of radial neck fracture in children.

Comparison of effectiveness of Transcutaneous Electrical Nerve Stimulation and Kinesio Taping added to exercises in patients with myofascial pain syndrome.

PubMed

Azatcam, Gokmen; Atalay, Nilgun Simsir; Akkaya, Nuray; Sahin, Fusun; Aksoy, Sibel; Zincir, Ozge; Topuz, Oya

2017-01-01

Although there are several studies of Transcutaneous Electrical Nerve Stimulation (TENS) and exercise in myofascial pain syndrome, there are no studies comparing the effectiveness of Kinesio Taping (KT) and TENS in myofascial pain syndrome patients. To compare the early and late effects of TENS and KT on pain, disability and range of motion in myofascial pain syndrome patients. Sixty-nine patients were divided into three groups randomly as TENS+Exercise, KT+Exercise and exercise groups. Visual Analogue Scale (VAS), pain threshold, Neck Disability Index and cervical contralateral lateral flexion were employed in the evaluation of the patients performed before treatment, after treatment and 3rd month after treatment. The VAS, pain threshold, Neck Disability Index and contralateral lateral flexion values were improved in all groups both in after treatment and 3rd month after treatment (p< 0.01). In the comparison of after treatment vs. before treatment evaluations, VAS score was decreased in KT group compared to the TENS and control group (p= 0.001), in the TENS group compared to control group (p= 0.011). In the comparison of 3rd month and before treatment evaluations, VAS score was decreased in the TENS group compared to control group (p= 0.001) and in the KT group compared to the control group (p= 0.001). There was no significant difference between TENS and KT groups. All other parameters did not differ between the groups. TENS and KT added exercises can decrease pain severity and increase pain threshold, function and cervical range of motion in myofascial pain syndrome patients. Addition of TENS or KT to the exercise therapy resulted in more significant improvement compared to exercise therapy alone with a more pronounced improvement in KT group compared to the TENS group in the early period. Because KT was found to be more effective in decreasing the pain and had the advantage of being used in every 3 days, it seems to be beneficial in acute painful periods in myofascial pain syndrome patients.

Ten different hip resurfacing systems: biomechanical analysis of design and material properties.

PubMed

Heisel, Christian; Kleinhans, Jennifer A; Menge, Michael; Kretzer, Jan Philippe

2009-08-01

This study gives an overview of the main macro- and microstructural differences of ten commercially available total hip resurfacing implants. The heads and cups of resurfacing hip implants from ten different manufacturers were analysed. The components were measured in a coordinate measuring machine. The microstructure of the heads and cups was inspected by scanning electron microscopy. The mean radial clearance was 84.86 microm (range: 49.47-120.93 microm). The implants were classified into three groups (low, medium and high clearance). All implants showed a deviation of roundness of less than 10 microm. It was shown that all implants differ from each other and a final conclusion about the ideal design and material combination cannot be given based on biomechanical data. Widespread use of specific designs can only be recommended if clinical long-term follow-up studies are performed and analysed for each design.

Clinical evaluation of multi-atlas based segmentation of lymph node regions in head and neck and prostate cancer patients.

PubMed

Sjöberg, Carl; Lundmark, Martin; Granberg, Christoffer; Johansson, Silvia; Ahnesjö, Anders; Montelius, Anders

2013-10-03

Semi-automated segmentation using deformable registration of selected atlas cases consisting of expert segmented patient images has been proposed to facilitate the delineation of lymph node regions for three-dimensional conformal and intensity-modulated radiotherapy planning of head and neck and prostate tumours. Our aim is to investigate if fusion of multiple atlases will lead to clinical workload reductions and more accurate segmentation proposals compared to the use of a single atlas segmentation, due to a more complete representation of the anatomical variations. Atlases for lymph node regions were constructed using 11 head and neck patients and 15 prostate patients based on published recommendations for segmentations. A commercial registration software (Velocity AI) was used to create individual segmentations through deformable registration. Ten head and neck patients, and ten prostate patients, all different from the atlas patients, were randomly chosen for the study from retrospective data. Each patient was first delineated three times, (a) manually by a radiation oncologist, (b) automatically using a single atlas segmentation proposal from a chosen atlas and (c) automatically by fusing the atlas proposals from all cases in the database using the probabilistic weighting fusion algorithm. In a subsequent step a radiation oncologist corrected the segmentation proposals achieved from step (b) and (c) without using the result from method (a) as reference. The time spent for editing the segmentations was recorded separately for each method and for each individual structure. Finally, the Dice Similarity Coefficient and the volume of the structures were used to evaluate the similarity between the structures delineated with the different methods. For the single atlas method, the time reduction compared to manual segmentation was 29% and 23% for head and neck and pelvis lymph nodes, respectively, while editing the fused atlas proposal resulted in time reductions of 49% and 34%. The average volume of the fused atlas proposals was only 74% of the manual segmentation for the head and neck cases and 82% for the prostate cases due to a blurring effect from the fusion process. After editing of the proposals the resulting volume differences were no longer statistically significant, although a slight influence by the proposals could be noticed since the average edited volume was still slightly smaller than the manual segmentation, 9% and 5%, respectively. Segmentation based on fusion of multiple atlases reduces the time needed for delineation of lymph node regions compared to the use of a single atlas segmentation. Even though the time saving is large, the quality of the segmentation is maintained compared to manual segmentation.

Subdural Hematoma Associated With Labor Epidural Analgesia: A Case Series.

PubMed

Lim, Grace; Zorn, Jamie M; Dong, Yuanxu J; DeRenzo, Joseph S; Waters, Jonathan H

2016-01-01

This report aimed to describe the characteristics and impact of subdural hematoma (SDH) after labor epidural analgesia. Eleven obstetric patients had SDHs associated with the use of labor epidural analgesia over 7 years at a tertiary care hospital. Ten of 11 patients had signs consistent with postdural puncture headache before the diagnosis of SDH. Five patients (45%) had a recognized unintentional dural puncture, 1 (9%) had a combined spinal-epidural with a 24-gauge needle, and 5 (45%) had no recognized dural puncture. For 10 of the 11 cases, SDH was diagnosed at a mean of 4.1 days (range, 1-7 days) after performance of labor epidural analgesia; one case was diagnosed at 25 days. Ten (91%) of 11 cases had a second hospital stay for a mean of 2.8 days (range, 2-4 days) for observation, without further requirement for neurosurgical intervention. One case (9%) had decompressive hemicraniectomy after becoming unresponsive. The observed rate of labor epidural analgesia-associated SDH was 0.026% (11 in 42,969, approximately 1:3900), and the rate of SDH was 1.1% (5 in 437, approximately 1:87) if a recognized dural puncture occurred during epidural catheter placement. Subdural hematoma after labor epidural anesthesia is rare but potentially more common than historically estimated. Cases of postdural puncture headache after labor epidural anesthesia should be monitored closely for severe neurologic signs and symptoms that could herald SDH.

Effects of transcutaneous electrical nerve stimulation (TENS) on arterial stiffness and blood pressure in resistant hypertensive individuals: study protocol for a randomized controlled trial.

PubMed

Vilela-Martin, José Fernando; Giollo-Junior, Luiz Tadeu; Chiappa, Gaspar Rogério; Cipriano-Junior, Gerson; Vieira, Paulo José Cardoso; dos Santos Ricardi, Fábio; Paz-Landim, Manoel Ildefonso; de Andrade, Days Oliveira; Cestário, Elizabeth do Espírito Santo; Cosenso-Martin, Luciana Neves; Yugar-Toledo, Juan Carlos; Cipullo, José Paulo

2016-03-29

Resistant hypertension (RH) treatment requires an adequate and intense therapeutic approach. However, the results are not always satisfactory despite intensive treatment. Of the different pathophysiological mechanisms involved in the pathogenesis of RH, sympathetic overstimulation and therapies that block the sympathetic system have been widely studied. These approaches, however, are invasive and expensive. Another possible approach is by transcutaneous electrical nerve stimulation (TENS), a noninvasive method that modulates activity by using low-frequency transcutaneous electrical stimulation to inhibit primary afferent pathways. Thus, the current study will evaluate the effect of applying TENS in the cervicothoracic region of subjects with RH and will seek to develop a new low-cost and readily available therapy to treat this group of hypertensive individuals. This is a randomized, single blind (subject), parallel-assignment study controlled with a sham group and including participants aged 40 to 70 years with resistant hypertension. The trial has two arms: the treatment and control (sham group). The treatment group will be submitted to the stimulation procedure (TENS). The sham group will not be submitted to stimulation. The primary outcomes will be a reduction in the peripheral blood pressure and adverse events. The secondary outcomes will be a reduction the central blood pressure. The study will last 30 days. The sample size was calculated assuming an alpha error of 5 % to reject the null hypothesis with a statistical power of 80 %, thereby resulting in 28 participants per group (intervention versus sham). In recent decades, RH has become very common and costly. Adequate control requires several drugs, and in many cases, treatment is not successful. Sympathetic nervous system inhibition by renal denervation and central inhibition have significant effects in reducing BP; however, these treatments are costly and invasive. Another type of sympathetic nervous system inhibition can also be noninvasively achieved by electric current. Therefore, the application of TENS may be a new therapeutic option for treating resistant hypertensive individuals. Clinical Trials NCT02365974.

Comparative description of ten transcriptomes of newly sequenced invertebrates and efficiency estimation of genomic sampling in non-model taxa

PubMed Central

2012-01-01

Introduction Traditionally, genomic or transcriptomic data have been restricted to a few model or emerging model organisms, and to a handful of species of medical and/or environmental importance. Next-generation sequencing techniques have the capability of yielding massive amounts of gene sequence data for virtually any species at a modest cost. Here we provide a comparative analysis of de novo assembled transcriptomic data for ten non-model species of previously understudied animal taxa. Results cDNA libraries of ten species belonging to five animal phyla (2 Annelida [including Sipuncula], 2 Arthropoda, 2 Mollusca, 2 Nemertea, and 2 Porifera) were sequenced in different batches with an Illumina Genome Analyzer II (read length 100 or 150 bp), rendering between ca. 25 and 52 million reads per species. Read thinning, trimming, and de novo assembly were performed under different parameters to optimize output. Between 67,423 and 207,559 contigs were obtained across the ten species, post-optimization. Of those, 9,069 to 25,681 contigs retrieved blast hits against the NCBI non-redundant database, and approximately 50% of these were assigned with Gene Ontology terms, covering all major categories, and with similar percentages in all species. Local blasts against our datasets, using selected genes from major signaling pathways and housekeeping genes, revealed high efficiency in gene recovery compared to available genomes of closely related species. Intriguingly, our transcriptomic datasets detected multiple paralogues in all phyla and in nearly all gene pathways, including housekeeping genes that are traditionally used in phylogenetic applications for their purported single-copy nature. Conclusions We generated the first study of comparative transcriptomics across multiple animal phyla (comparing two species per phylum in most cases), established the first Illumina-based transcriptomic datasets for sponge, nemertean, and sipunculan species, and generated a tractable catalogue of annotated genes (or gene fragments) and protein families for ten newly sequenced non-model organisms, some of commercial importance (i.e., Octopus vulgaris). These comprehensive sets of genes can be readily used for phylogenetic analysis, gene expression profiling, developmental analysis, and can also be a powerful resource for gene discovery. The characterization of the transcriptomes of such a diverse array of animal species permitted the comparison of sequencing depth, functional annotation, and efficiency of genomic sampling using the same pipelines, which proved to be similar for all considered species. In addition, the datasets revealed their potential as a resource for paralogue detection, a recurrent concern in various aspects of biological inquiry, including phylogenetics, molecular evolution, development, and cellular biochemistry. PMID:23190771

Acute sterile endophthalmitis following intravitreal bevacizumab: case series

PubMed Central

Orozco-Hernández, Axel; Ortega-Larrocea, Ximena; Sánchez-Bermúdez, Gustavo; García-Aguirre, Gerardo; Cantón, Virgilio Morales; Velez-Montoya, Raul

2014-01-01

Background Since the ophthalmological community adopted the use of intravitreal bevacizumab as an accepted off-label treatment for neovascular diseases, the amount of knowledge regarding its effects and properties has been increasing continually. In the last few years, there have been an increasing number of reports about sterile intraocular inflammation and intraocular pressure elevations after intravitreal bevacizumab. In the following case series, we describe the clinical presentation and outcomes of ten consecutive cases of patients developing mild-to-severe sterile intraocular inflammation after intravitreal bevacizumab and their management. Methods This report presents a retrospective case series. We reviewed the medical records of ten consecutive patients from a group of 46, in whom repackaged bevacizumab in individual aliquots from two vials from the same batch were used. All surgical procedures were performed using standard sterile techniques in the operating room. At each follow-up visit, patients underwent a complete ophthalmological examination including visual acuity assessment, intraocular pressure, biomicroscopy, and posterior fundus examination. Results Ten patients presented sterile endophthalmitis with an onset time of 3.5±1.95 days. The clinical characteristics were mild pain, slight visual loss, conjunctival hyperemia, and various degrees of intraocular inflammation with microhypopyon. All cultures were negative. All patients were managed with topical steroids and antibiotics, except two, in whom, due to severe vitreous cells, intravitreal antibiotics were used. Three patients showed a transient elevation of intraocular pressure. Only 50% of the patients regained a visual acuity equal or better to the baseline visual acuity on file. Conclusion The increasing number of intravitreal injections of bevacizumab applied every day, due to its widespread acceptance, might be one reason why the number of cases of sterile endophthalmitis is rising. Fast recognition and accurate differential diagnosis is important to avoid unnecessary treatments and long-term complications. The low incidence of this event should not preclude the use of intravitreal injections in eyes that could benefit greatly from this therapy. PMID:25228797

10 CFR 429.14 - Residential refrigerators, refrigerator-freezers and freezers.

Code of Federal Regulations, 2012 CFR

2012-01-01

... anti-sweat heater control (in which case, manufacturers must also report the values of heater Watts at the ten humidity levels 5%, 15%, through 95% used to calculate the variable anti-sweat heater...

10 CFR 429.14 - Residential refrigerators, refrigerator-freezers and freezers.

Code of Federal Regulations, 2014 CFR

2014-01-01

... anti-sweat heater control (in which case, manufacturers must also report the values of heater Watts at the ten humidity levels 5%, 15%, through 95% used to calculate the variable anti-sweat heater...

10 CFR 429.14 - Residential refrigerators, refrigerator-freezers and freezers.

Code of Federal Regulations, 2013 CFR

2013-01-01

... anti-sweat heater control (in which case, manufacturers must also report the values of heater Watts at the ten humidity levels 5%, 15%, through 95% used to calculate the variable anti-sweat heater...

Improving mortality outcomes of Stevens Johnson syndrome/toxic epidermal necrolysis: A regional burns centre experience.

PubMed

Nizamoglu, M; Ward, J A; Frew, Q; Gerrish, H; Martin, N; Shaw, A; Barnes, D; Shelly, O; Philp, B; El-Muttardi, N; Dziewulski, P

2018-05-01

Stevens Johnson Syndrome/toxic epidermal necrolysis (SJS/TEN) are rare, potentially fatal desquamative disorders characterised by large areas of partial thickness skin and mucosal loss. The degree of epidermal detachment that occurs has led to SJS/TEN being described as a burn-like condition. These patients benefit from judicious critical care, early debridement and meticulous wound care. This is best undertaken within a multidisciplinary setting led by clinicians experienced in the management of massive skin loss and its sequelae. In this study, we examined the clinical outcomes of SJS/TEN overlap & TEN patients managed by our regional burns service over a 12-year period. We present our treatment model for other burn centres treating SJS/TEN patients. A retrospective case review was performed for all patients with a clinical diagnosis of TEN or SJS/TEN overlap admitted to our paediatric and adult burns centre between June 2004 and December 2016. Patient demographics, percentage total body surface area (%TBSA), mucosal involvement, causation, severity of illness score (SCORTEN), length of stay and survival were appraised with appropriate statistical analysis performed using Graph Pad Prism 7.02 Software. During the study period, 42 patients (M26; F: 16) with TEN (n=32) and SJS/TEN overlap (n=10) were managed within our burns service. Mean %TBSA of cutaneous involvement was 57% (range 10-100%) and mean length of stay (LOS) was 27 days (range 1-144 days). We observed 4 deaths in our series compared to 16 predicted by SCORTEN giving a standardised mortality ratio (SMR) of 24%. Management in our burns service with an aggressive wound care protocol involving debridement of blistered epidermis and wound closure with synthetic and biological dressings seems to have produced benefits in mortality when compared to predicted outcomes. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Assistive technology for promoting adaptive skills of children with cerebral palsy: ten cases evaluation.

PubMed

Stasolla, Fabrizio; Caffò, Alessandro O; Perilli, Viviana; Boccasini, Adele; Damiani, Rita; D'Amico, Fiora

2018-05-06

To extend the use of assistive technology for promoting adaptive skills of children with cerebral palsy. To assess its effects on positive participation of ten participants involved. To carry out a social validation recruiting parents, physiotherapists and support teachers as external raters. A multiple probe design was implemented for Studies I and II. Study I involved five participants exposed to a combined program aimed at enhancing choice process of preferred items and locomotion fluency. Study II involved five further children for a combined intervention finalized at ensuring them with literacy access and ambulation responses. Study III recruited 60 external raters for a social validation assessment. All participants improved their performance, although differences among children occurred. Indices of positive participation increased as well. Social raters favorably scored the use of both technology and programs. Assistive technology-based programs were effective for promoting independence of children with cerebral palsy. Implications for Rehabilitation A basic form of assistive technology such as a microswitch-based program may be useful and helpful for supporting adaptive skills of children with cerebral palsy and different levels of functioning. The same program may improve the participants' indices of positive participation and constructive engagement with beneficial effects on their quality of life. The positive social rating provided by external experts sensitive to the matter may recommend a favorable acceptance and implementation of the program in daily settings.

Lassa fever in post-conflict sierra leone.

PubMed

Shaffer, Jeffrey G; Grant, Donald S; Schieffelin, John S; Boisen, Matt L; Goba, Augustine; Hartnett, Jessica N; Levy, Danielle C; Yenni, Rachael E; Moses, Lina M; Fullah, Mohammed; Momoh, Mambo; Fonnie, Mbalu; Fonnie, Richard; Kanneh, Lansana; Koroma, Veronica J; Kargbo, Kandeh; Ottomassathien, Darin; Muncy, Ivana J; Jones, Abigail B; Illick, Megan M; Kulakosky, Peter C; Haislip, Allyson M; Bishop, Christopher M; Elliot, Deborah H; Brown, Bethany L; Zhu, Hu; Hastie, Kathryn M; Andersen, Kristian G; Gire, Stephen K; Tabrizi, Shervin; Tariyal, Ridhi; Stremlau, Mathew; Matschiner, Alex; Sampey, Darryl B; Spence, Jennifer S; Cross, Robert W; Geisbert, Joan B; Folarin, Onikepe A; Happi, Christian T; Pitts, Kelly R; Geske, F Jon; Geisbert, Thomas W; Saphire, Erica Ollmann; Robinson, James E; Wilson, Russell B; Sabeti, Pardis C; Henderson, Lee A; Khan, S Humarr; Bausch, Daniel G; Branco, Luis M; Garry, Robert F

2014-03-01

Lassa fever (LF), an often-fatal hemorrhagic disease caused by Lassa virus (LASV), is a major public health threat in West Africa. When the violent civil conflict in Sierra Leone (1991 to 2002) ended, an international consortium assisted in restoration of the LF program at Kenema Government Hospital (KGH) in an area with the world's highest incidence of the disease. Clinical and laboratory records of patients presenting to the KGH Lassa Ward in the post-conflict period were organized electronically. Recombinant antigen-based LF immunoassays were used to assess LASV antigenemia and LASV-specific antibodies in patients who met criteria for suspected LF. KGH has been reestablished as a center for LF treatment and research, with over 500 suspected cases now presenting yearly. Higher case fatality rates (CFRs) in LF patients were observed compared to studies conducted prior to the civil conflict. Different criteria for defining LF stages and differences in sensitivity of assays likely account for these differences. The highest incidence of LF in Sierra Leone was observed during the dry season. LF cases were observed in ten of Sierra Leone's thirteen districts, with numerous cases from outside the traditional endemic zone. Deaths in patients presenting with LASV antigenemia were skewed towards individuals less than 29 years of age. Women self-reporting as pregnant were significantly overrepresented among LASV antigenemic patients. The CFR of ribavirin-treated patients presenting early in acute infection was lower than in untreated subjects. Lassa fever remains a major public health threat in Sierra Leone. Outreach activities should expand because LF may be more widespread in Sierra Leone than previously recognized. Enhanced case finding to ensure rapid diagnosis and treatment is imperative to reduce mortality. Even with ribavirin treatment, there was a high rate of fatalities underscoring the need to develop more effective and/or supplemental treatments for LF.

Specific autoantibodies in dermatomyositis: a helpful tool to classify different clinical subsets.

PubMed

Merlo, Giulia; Clapasson, Andrea; Cozzani, Emanuele; Sanna, Luigi; Pesce, Giampaola; Bagnasco, Marcello; Burlando, Martina; Parodi, Aurora

2017-03-01

Autoantibodies are important in the diagnosis of dermatomyositis. They can be divided in two different groups: myositis-associated autoantibodies (MAA) prevailing in overlap syndromes, and myositis-specific autoantibodies (MSA), with diagnostic specificity exceeding 90%. Our purpose was to detect retrospectively the prevalence of the most common MSAs in a group of 19 adult DM patients (13 women, 6 men). A severe DM (SDM), with extensive cutaneous and muscular manifestations, dysphagia, and sometimes pneumopathy, was detected in ten cases. Three patients had a mild DM (MDM), with little muscle and skin impairment, and a short course. Four patients suffered from amyopathic DM (ADM), two from paraneoplastic DM (PDM). Each serum was tested for ANA, ENA, MAAs, MSAs. Myositis-specific autoantibodies were detected in 15 cases. The most frequent was anti-TIF1γ, associated with SDM or PDM in four out of seven cases. Anti-MDA5 antibodies were recorded in a SDM and in a ADM with lung fibrosis. Anti-Mi2 and anti-SRP antibodies were both detected in a MDM and in a SDM, whereas anti-SAE1 in a amyopathic form. Other antibodies (anti-NXP2, -Jo1, -PL7, -PL12, -OJ) were found in single patients with SDM. Our series confirmed that specific autoantibodies could be helpful to classify different clinical subsets, particularly in the case of paraneoplastic forms or association with pneumopathy. Moreover, they can help in predicting the disease evolution and influence therapeutic strategies. A greater number of cases should be useful to highlight the clinical and pathogenic role of these antibodies, and develop a homogeneous protocol for diagnosis and treatment.

Resource Use and Costs Associated with Coeliac Disease before and after Diagnosis in 3,646 Cases: Results of a UK Primary Care Database Analysis

PubMed Central

Violato, Mara; Gray, Alastair; Papanicolas, Irini; Ouellet, Melissa

2012-01-01

Background Despite the considerable health impact of coeliac disease (CD), reliable estimates of the impact of diagnosis on health care use and costs are lacking. Aims To quantify the volume, type and costs, in a United Kingdom primary care setting, of healthcare resources used by individuals diagnosed with CD up to ten years before and after diagnosis, and to estimate medical costs associated with CD. Methods A cohort of 3,646 CD cases and a parallel cohort of 32,973 matched controls, extracted from the General Practice Research Database (GPRD) over the period 1987–2005 were used i) to evaluate the impact of diagnosis on the average resource use and costs of cases; ii) to assess direct healthcare costs due to CD by comparing average resource use and costs incurred by cases vs. controls. Results Average annual healthcare costs per patient increased by £310 (95% CI £299, £320) after diagnosis. CD cases experienced higher healthcare costs than controls both before diagnosis (mean difference £91; 95% CI: £86, £97) and after diagnosis (mean difference £354; 95% CI: £347, £361). These differences were driven mainly by higher test and referral costs before diagnosis, and by increased prescription costs after diagnosis. Conclusions This study shows significant additional primary care costs associated with coeliac disease. It provides novel evidence that will assist researchers evaluating interventions in this area, and will challenge policymakers, clinicians, researchers and the public to develop strategies that maximise the health benefits of the resources associated with this disease. PMID:22815991

Experience with single photon emission computerized tomography (SPECT) in follow-up of sternotomy healing.

PubMed

Harjula, A; Järvinen, A; Mattila, S; Porkka, L

1985-01-01

Single photon emission computerized tomography (SPECT) was performed thrice in ten patients undergoing open-heart surgery--preoperatively and 2 and 12 weeks postoperatively. The operations were done for ischemic heart disease (5), aortic valvular stenosis (2), aortic valvular insufficiency (1), leaking mitral prosthetic valve (1) and combined aortic and mitral valvular stenosis and insufficiency (1). The healing process in the longitudinally divided sternum was evaluated from the SPECT study. Four conventional static images in two dimensions were registered in anteroposterior, posteroanterior and left and right lateral projections. A tomographic study was done. Quantitative analyses were performed. The ratio of the sternal counts to the counts from a thoracic vertebra was calculated for use as a reference. The activity ratios showed a similar pattern in six cases, with initial increases and at 12 weeks slight decrease compared with the preoperative values. In two cases the activity was still increasing after 12 postoperative weeks. One patient, with sternotomy also one year previously, showed only slightly increased activity. The activity at the areas of the sternal wires was increased in six cases. The study thus revealed differing patterns of isotope uptake, although recovery was uneventful in all patients. The differences may reflect the possibility that the operative course and the preoperative clinical status can influence the healing mechanisms.

Coexistence of gastrointestinal stromal tumor (GIST) and colorectal adenocarcinoma: A case report.

PubMed

Efstathios, Papalambros; Athanasios, Petrou; Papaconstantinou, Ioannis; Alexandros, Papalambros; Frangisca, Sigala; Sotirios, Georgopoulos; Evangelos, Felekouras; Athanasios, Giannopoulos

2007-08-21

Gastrointestinal stromal tumors (GIST) represent the most common mesenchymal tumors of the digestive tract. Over the last ten years the management of GISTs has dramatically altered but their coexistence with other gasrointesinal tumors of different histogenesis presents a special interest. The coexistence of GISTs with other primaries is usually discovered incidentally during GI surgery for carcinomas. We present here, a case of a 66-year-old patient with intestinal GIST and a synchronous colorectal adenocarcinoma discovered incidentally during surgical treatment of the recurrent GIST. Immunohistochemical examination revealed the concurrence of histologically proved GIST (strongly positive staining for c-kit, vimentin, SMA, and focal positive in S-100, while CD-34 was negative) and Dukes Stage C, (T3, N3, M0 according the TNM staging classification of colorectal cancer). The coexistence of GIST with either synchronous or metachronous colorectal cancer represents a phenomenon with increasing number of relative reports in the literature the last 5 years. In any case of GIST the surgeon should be alert to recognize a possible coexistent tumor with different histological origin and to perform a thorough preoperative and intraoperative control. The correct diagnosis before and at the time of the surgical procedure is the cornerstone that secures the patients' best prognosis.

Transcutaneous electrical nerve stimulation (TENS) for pain relief in labour.

PubMed

Dowswell, Therese; Bedwell, Carol; Lavender, Tina; Neilson, James P

2009-04-15

Transcutaneous nerve stimulation (TENS) has been proposed as a means of reducing pain in labour. The TENS unit emits low-voltage electrical impulses which vary in frequency and intensity. During labour, TENS electrodes are generally placed on the lower back, although TENS may be used to stimulate acupuncture points or other parts of the body. The physiological mechanisms whereby TENS relieves pain are uncertain. The TENS unit is frequently operated by women, which may increase sense of control in labour. To assess the effects of TENS on pain in labour. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (November 2008). Randomised controlled trials comparing women receiving TENS for pain relief in labour versus routine care, alternative pharmacological methods of pain relief, or placebo devices. We included all types of TENS machines. Two review authors assessed for inclusion all trials identified by the search strategy, carried out data extraction and assessed risk of bias. We have recorded reasons for excluding studies. The search identified 25 studies; we excluded six and included 19 studies including 1671 women. Fifteen examined TENS applied to the back, two to acupuncture points and two to the cranium. Overall, there was little difference in pain ratings between TENS and control groups, although women receiving TENS to acupuncture points were less likely to report severe pain (risk ratio 0.41, 95% confidence interval 0.32 to 0.55). The majority of women using TENS said they would be willing to use it again in a future labour. Where TENS was used as an adjunct to epidural analgesia there was no evidence that it reduced pain. There was no consistent evidence that TENS had any impact on interventions and outcomes in labour. There was little information on outcomes for mothers and babies. No adverse events were reported. There is only limited evidence that TENS reduces pain in labour and it does not seem to have any impact (either positive or negative) on other outcomes for mothers or babies. The use of TENS at home in early labour has not been evaluated. TENS is widely available in hospital settings and women should have the choice of using it in labour.

Does transcutaneous electrical nerve stimulation (TENS) alleviate the pain experienced during bone marrow sampling in addition to standard techniques? A randomised, double-blinded, controlled trial.

PubMed

Tucker, David L; Rockett, Mark; Hasan, Mehedi; Poplar, Sarah; Rule, Simon A

2015-06-01

Bone marrow aspiration and trephine (BMAT) biopsies remain important tests in haematology. However, the procedures can be moderately to severely painful despite standard methods of pain relief. To test the efficacy of transcutaneous electrical nerve stimulation (TENS) in alleviating the pain from BMAT in addition to standard analgesia using a numerical pain rating scale (NRS). 70 patients requiring BMAT were randomised (1:1) in a double-blind, placebo-controlled trial. -35 patients received TENS impulses at a strong but comfortable amplitude (intervention group) and 35 patients received TENS impulses just above the sensory threshold (control group) (median pulse amplitude 20 and 7 mA, respectively). Patients and operators were blinded to group allocation. Pain assessments were made using a numerical pain scale completed after the procedure. No significant difference in NRS pain recalled after the procedure was detected (median pain score 5.7 (95% CI 4.8 to 6.6) in control vs 5.6 (95% CI 4.8 to 6.4) in the intervention group). However, 100% of patients who had previous experience of BMAT and >94% of participants overall felt they benefited from using TENS and would recommend it to others for this procedure. There were no side effects from the TENS device, and it was well tolerated. TENS is a safe, non-invasive adjunct to analgesia for reducing pain during bone marrow biopsy and provides a subjective benefit to most users; however, no objective difference in pain scores was detected when using TENS in this randomised controlled study. NCT02005354. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Intraoperative visible bubbling of air may be the first sign of venous air embolism during posterior surgery for scoliosis.

PubMed

Wills, John; Schwend, Richard M; Paterson, Andrew; Albin, Maurice S

2005-10-15

Case report of two children sustaining venous air embolism (VAE) during posterior surgery for scoliosis. To report 2 cases where visible bubbling at the operative site was the first clinical indication of VAE-induced cardiovascular collapse and to raise the level of consciousness that VAE in the prone position can occur, often with serious consequences. Twenty-two cases of VAE during surgery for scoliosis in the prone position have been reported. Ten were fatal and ten were in children. Visible bubbling at the operative site was noted in two published cases. Retrospective study of 2 cases of VAE at one institution. Clinical, anesthetic, and radiographic features are presented. Details of previously published cases are reviewed and discussed. Both patients were girls with adolescent scoliosis who underwent prone positioned posterior spinal fusion with instrumentation. Visible bubbling of air at the thoracic aspect of the surgical site was noted near the completion of instrumentation and was the first indication of VAE. In both cases, this was clinically recognized and promptly treated. One patient survived normally and the other died. Visible air bubbling at the operative site may herald the onset of massive VAE during multilevel posterior spinal fusion and instrumentation. A prospective multicenter study using precordial Doppler, central venous catheter, and end-tidal CO2 is recommended to determine the true incidence of VAE in spinal deformity surgery and to evaluate monitoring and treatment methods.

Progressive multifocal leukoencephalopathy in patients treated with fumaric acid esters: a review of 19 cases.

PubMed

Gieselbach, Robbert-Jan; Muller-Hansma, Annemarie H; Wijburg, Martijn T; de Bruin-Weller, Marjolein S; van Oosten, Bob W; Nieuwkamp, Dennis J; Coenjaerts, Frank E; Wattjes, Mike P; Murk, Jean-Luc

2017-06-01

Progressive multifocal leukoencephalopathy (PML) is a rare and potentially fatal condition caused by a brain infection with JC polyomavirus (JCV). PML develops almost exclusively in immunocompromised patients and has recently been associated with use of fumaric acid esters (FAEs), or fumarates. We reviewed the literature and the Dutch and European pharmacovigilance databases in order to identify all available FAE-associated PML cases and distinguish possible common features among these patients. A total of 19 PML cases associated with FAE use were identified. Five cases were associated with FAE use for multiple sclerosis and 14 for psoriasis. Ten patients were male and nine were female. The median age at PML diagnosis was 59 years. The median duration of FAE therapy to PML symptom onset or appearance of first PML lesion on brain imaging was 31 months (range 6-110). In all cases a certain degree of lymphocytopenia was reported. The median duration of lymphocytopenia to PML symptom onset was 23 months (range 6-72). The median lymphocyte count at PML diagnosis was 414 cells/µL. CD4 and CD8 counts were reported in ten cases, with median cell count of 137 and 39 cells/µL, respectively. Three patients died (16% mortality). The association between occurrence of PML in patients with low CD4 and CD8 counts is reminiscent of PML cases in the HIV population and suggests that loss of T cells is the most important risk factor.

Subdural Hematoma Associated With Labor Epidural Analgesia: A Case Series

PubMed Central

Lim, Grace; Zorn, Jamie M.; Dong, Yuanxu J.; DeRenzo, Joseph S.; Waters, Jonathan H.

2016-01-01

Objective This report describes the characteristics and impact of subdural hematoma (SDH) after labor epidural analgesia. Case Reports Eleven obstetric patients had subdural hematomas (SDH) associated with the use of labor epidural analgesia over 7 years at a tertiary care hospital. Ten of 11 patients had signs consistent with post-dural puncture headache (PDPH) prior to the diagnosis of SDH. Five patients (45%) had a recognized unintentional dural puncture, 1 (9%) had a combined spinal-epidural with a 24-gauge needle, and 5 (45%) had no recognized dural puncture. For 10 of the 11 cases, SDH was diagnosed an average of 4.1 (range 1–7) days after performance of labor epidural analgesia; one case was diagnosed at 25 days. Ten of 11 (91%) cases had a second hospital stay for an average of 2.8 (range 2–4) days for observation, without further requirement for neurosurgical intervention. One case (9%) had decompressive hemicraniectomy after becoming unresponsive. The observed rate of labor epidural analgesia-associated SDH was 0.026% (11 in 42,969, about 1:3900), and the rate of SDH was 1.1% (5 in 437, about 1:87) if a recognized dural puncture occurred during epidural catheter placement. Conclusions SDH after labor epidural anesthesia is rare, but potentially more common than historically estimated. Cases of PDPH after labor epidural anesthesia should be monitored closely for severe neurologic signs and symptoms that could herald SDH. PMID:27512937

First-Trimester Maternal Serum Amino Acids and Acylcarnitines Are Significant Predictors of Gestational Diabetes

PubMed Central

Nevalainen, Jaana; Sairanen, Mikko; Appelblom, Heidi; Gissler, Mika; Timonen, Susanna; Ryynänen, Markku

2016-01-01

BACKGROUND: Current screening methods for gestational diabetes mellitus (GDM) are insufficient in detecting the risk of GDM in the first trimester of the pregnancy. Recent metabolomic studies have detected altered amino acid and acylcarnitine concentrations in type 2 diabetes (T2D). Because of the similarities between T2D and GDM, the determination of these metabolites may be useful in early screening for GDM. AIM: To evaluate the association between GDM and first-trimester maternal serum concentrations of ten amino acids and 31 acylcarnitines. METHODS: This retrospective case-control study included data from pregnant women screened at Oulu University Hospital between 1.1.2008 and 31.12.2011. A total of 31,146 women participated voluntarily in a first-trimester combined screening (for chromosomal abnormalities). The study population included 69 women who developed GDM during pregnancy and 295 women without diabetes before or after pregnancy. The serum concentrations of ten amino acids and 31 acylcarnitines were analyzed from frozen serum samples taken in the first-trimester screening. Multiple of median (MoM) values were compared between the two groups. RESULTS: In the GDM group, serum levels of arginine were significantly higher (1.13 MoM vs. 0.97 MoM), and those of glycine (0.93 MoM vs. 1.03 MoM) and 3-hydroxy-isovalerylcarnitine (0.86 MoM vs. 1.03 MoM) significantly lower compared to the control group (all p < 0.01). In each case, arginine, glycine, and 3-hydroxy-isovaleryl-carnitine would have detected 46%, 32%, and 39% of GDM cases, with a false-positive rate of 20%. Combining these three metabolites with the first-trimester serum marker pregnancy-associated plasma protein A (PAPP-A) and prior risk (age, BMI, and smoking) achieved a detection rate of 72%. CONCLUSION: There are significant differences in the serum levels of arginine, glycine, and 3-hydroxy-isovalerylcarnitine between controls and women who subsequently develop GDM. These differences were already existent in the first trimester of the pregnancy. The use of metabolites in combination with prior risk and first-trimester PAPP-A represents a reliable method to identify women at risk of GDM. PMID:28278310

Biochemical typing of pathological prion protein in aging cattle with BSE

PubMed Central

Tester, Seraina; Juillerat, Valerie; Doherr, Marcus G; Haase, Bianca; Polak, Miroslaw; Ehrensperger, Felix; Leeb, Tosso; Zurbriggen, Andreas; Seuberlich, Torsten

2009-01-01

Background The broad enforcement of active surveillance for bovine spongiform encephalopathy (BSE) in 2000 led to the discovery of previously unnoticed, atypical BSE phenotypes in aged cattle that differed from classical BSE (C-type) in biochemical properties of the pathological prion protein. Depending on the molecular mass and the degree of glycosylation of its proteinase K resistant core fragment (PrPres), mainly determined in samples derived from the medulla oblongata, these atypical cases are currently classified into low (L)-type or high (H)-type BSE. In the present study we address the question to what extent such atypical BSE cases are part of the BSE epidemic in Switzerland. Results To this end we analyzed the biochemical PrPres type by Western blot in a total of 33 BSE cases in cattle with a minimum age of eight years, targeting up to ten different brain regions. Our work confirmed H-type BSE in a zebu but classified all other cases as C-type BSE; indicating a very low incidence of H- and L-type BSE in Switzerland. It was documented for the first time that the biochemical PrPres type was consistent across different brain regions of aging animals with C-type and H-type BSE, i.e. independent of the neuroanatomical structure investigated. Conclusion Taken together this study provides further characteristics of the BSE epidemic in Switzerland and generates new baseline data for the definition of C- and H-type BSE phenotypes, thereby underpinning the notion that they indeed represent distinct prion disease entities. PMID:19470160

Completeness of T, N, M and stage grouping for all cancers in the Mallorca Cancer Registry.

PubMed

Ramos, M; Franch, P; Zaforteza, M; Artero, J; Durán, M

2015-11-04

TNM staging of cancer is used to establish the treatment and prognosis for cancer patients, and also allows the assessment of screening programmes and hospital performance. Collection of staging data is becoming a cornerstone for cancer registries. The objective of the study was to assess the completeness of T, N, M and stage grouping registration for all cancers in the Mallorca Cancer Registry in 2006-2008 and to explore differences in T, N, M and stage grouping completeness by site, gender, age and type of hospital. All invasive cancer cases during the period 2006-2008 were selected. DCO, as well as children's cancers, CNS, unknown primary tumours and some haematological cases were excluded. T, N, M and stage grouping were collected separately and followed UICC (International Union Against Cancer) 7th edition guidelines. For T and N, we registered whether they were pathological or clinical. Ten thousand two hundred fifty-seven cases were registered. After exclusions, the study was performed with 9283 cases; 39.4 % of whom were women and 60.6 % were men. T was obtained in 48.6 % cases, N in 36.5 %, M in 40 % and stage in 37.9 %. T and N were pathological in 71 % of cases. Stage completeness exceeded 50 % in lung, colon, ovary and oesophagus, although T also exceeded 50 % at other sites, including rectum, larynx, colon, breast, bladder and melanoma. No differences were found in TNM or stage completeness by gender. Completeness was lower in younger and older patients, and in cases diagnosed in private clinics. T, N, M and stage grouping data collection in population-based cancer registries is feasible and desirable.

A simple method for the computation of first neighbour frequencies of DNAs from CD spectra

PubMed Central

Marck, Christian; Guschlbauer, Wilhelm

1978-01-01

A procedure for the computation of the first neighbour frequencies of DNA's is presented. This procedure is based on the first neighbour approximation of Gray and Tinoco. We show that the knowledge of all the ten elementary CD signals attached to the ten double stranded first neighbour configurations is not necessary. One can obtain the ten frequencies of an unknown DNA with the use of eight elementary CD signals corresponding to eight linearly independent polymer sequences. These signals can be extracted very simply from any eight or more CD spectra of double stranded DNA's of known frequencies. The ten frequencies of a DNA are obtained by least square fit of its CD spectrum with these elementary signals. One advantage of this procedure is that it does not necessitate linear programming, it can be used with CD data digitalized using a large number of wavelengths, thus permitting an accurate resolution of the CD spectra. Under favorable case, the ten frequencies of a DNA (not used as input data) can be determined with an average absolute error < 2%. We have also observed that certain satellite DNA's, those of Drosophila virilis and Callinectes sapidus have CD spectra compatible with those of DNA's of quasi random sequence; these satellite DNA's should adopt also the B-form in solution. PMID:673843

[Comparison of the analgesic effect of interferential current (IFC) and TENS in patients with low back pain].

PubMed

Grabiańska, Ewa; Leśniewicz, Joanna; Pieszyński, Ireneusz; Kostka, Joanna

2015-01-01

Electrotherapy, including theTENS and interferential current (IFC) is one of the most frequently used treatments in physical therapy in patients with low back pain. The aim of this study was to assess the influence of TENS and IFC on pain relief and to compare the analgesic efficacy of the two currents. Sixty patients aged 53.5 ± 12.5, with low back pain, were randomly divided into two groups: IFC (gr. I) and TENS (gr. II). Depending on the groups, patients were given series of ten 20-minute sessions using either IF orTENS currents. In all patients VAS and Laitinen modified scale were taken before and after treatment. After 2-weeks therapy there was improvement in the VAS and Laitinen scale (all components) in both groups, except for the part of the Laitinen scale on the reduction of activity in the group II (TENS). There was no statistically significant difference between the TENS and IF groups in reducing the intensity and other aspects of pain (frequency, pain medication and activity limitation) under the influence of therapy (p > 0.05). Interferential current and TENS therapy are effective for pain relief in patients with low back pain. The study showed equal analgesic efficacy of both treatments.

Intensity matters: Therapist-dependent dose of spinal transcutaneous electrical nerve stimulation.

PubMed

Serrano-Muñoz, Diego; Gómez-Soriano, Julio; Bravo-Esteban, Elisabeth; Vázquez-Fariñas, María; Taylor, Julian; Avendaño-Coy, Juan

2017-01-01

The intensity used during transcutaneous electrical nerve stimulation (TENS) in both, clinical practice and research studies, is often based on subjective commands such as "strong but comfortable sensation". There is no consensus regarding the effectiveness dose of TENS. The objective was to determine the difference in the effect of spinal TENS on soleus H-reflex modulation when applied by two therapists instructed to apply the stimulation at a "strong but comfortable" intensity. Twenty healthy volunteers divided into two groups: Therapist 1 (n = 10) and Therapist 2 (n = 10). Both therapist applied spinal TENS and sham stimulation at the T10-12 spinal level for 40min in random order to each subject, at an intensity designed to produce a "strong but comfortable" sensation. To avoid habituation, the intensity was adjusted every 2min. Soleus H-reflex was recorded before, during, and 10min after TENS by an observer blinded to the stimulus applied. Despite the instruction to apply TENS at a "strong comfortable" level, a significant difference in current density was identified: Therapist 1 (0.67mA/cm2, SD 0.54) applied more than Therapist 2 (0.53mA/cm2, SD 0.57; p<0.001) at the onset of the intervention. Maximal peak-to-peak H-reflex amplitude was inhibited significantly more 10min following TENS applied by Therapist 1 (-0.15mV, SD 0.16) compared with Therapist 2 (0.04mV, SD 0.16; p = 0.03). Furthermore, current density significantly correlated with the inhibitory effect on peak-to-peak Soleus H-reflex amplitude 10 min after stimulation (Rho = -0.38; p = 0.04). TENS intensity dosage by the therapist based on the subjective perception of the participants alone is unreliable and requires objective standardization. In addition, higher current density TENS produced greater inhibition of the Soleus H-reflex.

Intensity matters: Therapist-dependent dose of spinal transcutaneous electrical nerve stimulation

PubMed Central

Bravo-Esteban, Elisabeth; Vázquez-Fariñas, María; Taylor, Julian

2017-01-01

The intensity used during transcutaneous electrical nerve stimulation (TENS) in both, clinical practice and research studies, is often based on subjective commands such as “strong but comfortable sensation”. There is no consensus regarding the effectiveness dose of TENS. The objective was to determine the difference in the effect of spinal TENS on soleus H-reflex modulation when applied by two therapists instructed to apply the stimulation at a “strong but comfortable” intensity. Twenty healthy volunteers divided into two groups: Therapist 1 (n = 10) and Therapist 2 (n = 10). Both therapist applied spinal TENS and sham stimulation at the T10–12 spinal level for 40min in random order to each subject, at an intensity designed to produce a “strong but comfortable” sensation. To avoid habituation, the intensity was adjusted every 2min. Soleus H-reflex was recorded before, during, and 10min after TENS by an observer blinded to the stimulus applied. Despite the instruction to apply TENS at a “strong comfortable” level, a significant difference in current density was identified: Therapist 1 (0.67mA/cm2, SD 0.54) applied more than Therapist 2 (0.53mA/cm2, SD 0.57; p<0.001) at the onset of the intervention. Maximal peak-to-peak H-reflex amplitude was inhibited significantly more 10min following TENS applied by Therapist 1 (-0.15mV, SD 0.16) compared with Therapist 2 (0.04mV, SD 0.16; p = 0.03). Furthermore, current density significantly correlated with the inhibitory effect on peak-to-peak Soleus H-reflex amplitude 10 min after stimulation (Rho = -0.38; p = 0.04). TENS intensity dosage by the therapist based on the subjective perception of the participants alone is unreliable and requires objective standardization. In addition, higher current density TENS produced greater inhibition of the Soleus H-reflex. PMID:29244850

Response to Nuclear Regulatory Commission`s ten questions pertaining to site-specific models for use in the license termination rule: Multimedia Environmental Pollutant Assessment System (MEPAS)

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

Buck, J.W.; Whelan, G.; Strenge, D.L.

This paper is in response to the US Nuclear Regulatory Commission (NRC) ten questions posed at the Modeling Workshop held November 13 and 14, 1997. The ten questions were developed in advance of the workshop to allow model developers to prepare a presentation at the Workshop. This paper is an expanded version of the Multimedia Environmental Pollutant Assessment System (MEPAS) presentation given at the Modeling Workshop by Pacific Northwest National Laboratory (PNNL) staff. This paper is organized by the ten questions asked by the NRC, each section devoted to a single question. The current version of methodology is MEPAS 3.2more » (NRC 1997) and the discussion in this paper will pertain to that version. In some cases, MEPAS 4.0, which is currently being developed under the Framework for Risk Analysis in Multimedia Environmental Systems (FRAMES) (Whelan et al. 1997), will be referenced to inform the reader of potential capabilities in the near future. A separate paper is included in the document that discusses the FRAMES concept.« less

Optimal trajectories for the aeroassisted flight experiment. Part 4: Data, tables, and graphs

NASA Technical Reports Server (NTRS)

Miele, A.; Wang, T.; Lee, W. Y.; Wang, H.; Wu, G. D.

1989-01-01

The determination of optimal trajectories for the aeroassisted flight experiment (AFE) is discussed. Data, tables, and graphs relative to the following transfers are presented: (IA) indirect ascent to a 178 NM perigee via a 197 NM apogee; and (DA) direct ascent to a 178 NM apogee. For both transfers, two cases are investigated: (1) the bank angle is continuously variable; and (2) the trajectory is divided into segments along which the bank angle is constant. For case (2), the following subcases are studied: two segments, three segments, four segments, and five segments; because the time duration of each segment is optimized, the above subcases involve four, six, eight, and ten parameters, respectively. Presented here are systematic data on a total of ten optimal trajectories (OT), five for Transfer IA and five for Transfer DA. For comparison purposes and only for Transfer IA, a five-segment reference trajectory RT is also considered.

Single visit nonsurgical endodontic therapy for periapical cysts: A clinical study

PubMed Central

Maity, Ipsita; Meena, N.; Kumari, R. Anitha

2014-01-01

Aims: The aim of this study was to assess the outcome of single sitting root canal treatment (RCT) of asymptomatic teeth with periapical cysts. Materials and Methods: Ten maxillary anterior teeth showing periapical lesion on the radiograph was further screened by ultrasound with color power Doppler (CPD) for confirmation of a cyst. The average dimension of the lesions ranged from 1.3 to 1.9 cm. Single sitting RCT was performed on all the selected teeth. Postoperative healing was monitored at regular interval of 3 months, 6 months, and 1 year by using subjective feedback, radiograph, and ultrasound with CPD study. Results: Eight among the ten cases showed either signs of complete healing or healing in progress by the end of 6-12 months. Conclusions: It was observed that single sitting nonsurgical endodontic management of asymptomatic teeth with periapical cyst confirmed by ultrasound was successful in selected cases. PMID:24963246

Single visit nonsurgical endodontic therapy for periapical cysts: A clinical study.

PubMed

Maity, Ipsita; Meena, N; Kumari, R Anitha

2014-04-01

The aim of this study was to assess the outcome of single sitting root canal treatment (RCT) of asymptomatic teeth with periapical cysts. Ten maxillary anterior teeth showing periapical lesion on the radiograph was further screened by ultrasound with color power Doppler (CPD) for confirmation of a cyst. The average dimension of the lesions ranged from 1.3 to 1.9 cm. Single sitting RCT was performed on all the selected teeth. Postoperative healing was monitored at regular interval of 3 months, 6 months, and 1 year by using subjective feedback, radiograph, and ultrasound with CPD study. Eight among the ten cases showed either signs of complete healing or healing in progress by the end of 6-12 months. It was observed that single sitting nonsurgical endodontic management of asymptomatic teeth with periapical cyst confirmed by ultrasound was successful in selected cases.

Wildlife DNA forensics against crime: resolution of a case of tortoise theft.

PubMed

Mucci, Nadia; Mengoni, Chiara; Randi, Ettore

2014-01-01

A paternity test was used to investigate a robbery case involving captive individuals of Greek tortoise (Testudo graeca). Six tortoises were allegedly stolen from a private breeder and offered for sale on the web by the supposed thief. The stolen tortoises were confiscated by the rangers of the State Forestry Corps (CFS). A panel of 14 autosomal microsatellite loci was used to genotype the seized tortoises and ten individuals assumed to be legally owned by the breeder. Kinship analyses reliably reconstructed the tortoise pedigree, demonstrating parent-offspring relationships among the owned and the stolen tortoises. As correctly declared by the breeder, four of the six stolen individuals belonged to the same family group of the ten legally owned tortoises. Results indicate that genetic identification procedures can provide valuable evidence and give useful support against illegal wildlife traffic. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

"Undoing" (or Symbolic Reversal) at Homicide Crime Scenes.

PubMed

Russell, Maria; Schlesinger, Louis B; Leon, Maria; Holdren, Samantha

2018-03-01

A closed case file review of a nonrandom national sample of 975 homicides disclosed 11 cases (1.13%) of undoing, wherein offenders engaged in crime scene behavior that has been considered an attempt to symbolically reverse the murder. The frequency of the various methods of undoing involved the use of blankets to cover the victim's body (55%), positioning the body (55%), use of a bed or couch (42%), washing the body (36%), using pillows (36%), as well as removing clothing and adding other types of adornments (27%). Ten of the 11 offenders were male, and one was female; all 12 victims were female. Ten of the 12 victims were family members or relationship intimates. These findings are consistent with prior reports which concluded that the motivation for undoing behavior is an attempt to compensate for guilt or remorse for having committed the homicide. © 2017 American Academy of Forensic Sciences.

Occupational protein contact dermatitis in food handlers.

PubMed

Hjorth, N; Roed-Petersen, J

1976-02-01

The preparation of food in restaurant kitchens carries a high risk of occupational dermatoses. Analysis of 33 cases revealed four different etiological types. Simple irritant dermatitis was rare (2 cases), plain contact dermatitis was more common (6 cases). Fifteen patients had relevant patch tests and scratch tests; ten had positive scratch tests only to explain the cause of their dermatitis. The last type was termed protein contact dermatitis. The major type IV allergens incriminated were metals, onion and garlic. The major proteinaceous allergens indicated by history and test results were fish and shell-fish. Open patch tests with the incriminated foods may cause erythema or oedema on normal skin after 20 minutes. Previously eczematous, now normal looking, skin often responds with a crop of dyshidrotic vesicles preceded by erythema and itching 30 minutes after the application of an open test. Examination for specific IgE is not always positive in such cases. Inhalant allergy was rare. The results indicate that food handlers are sensitized by the protein they touch, and then react to later contact with the proteins. Protein contact dermatitis is similarly common among veterinary surgeons, while the importance in other occupational groups remains to be studied.

Novel OTOF mutations in Brazilian patients with auditory neuropathy.

PubMed

Romanos, Jihane; Kimura, Lilian; Fávero, Mariana Lopes; Izarra, Fernanda Attanasio R; de Mello Auricchio, Maria Teresa Balester; Batissoco, Ana Carla; Lezirovitz, Karina; Abreu-Silva, Ronaldo Serafim; Mingroni-Netto, Regina Célia

2009-07-01

The OTOF gene encoding otoferlin is associated with auditory neuropathy (AN), a type of non-syndromic deafness. We investigated the contribution of OTOF mutations to AN and to non-syndromic recessive deafness in Brazil. A test for the Q829X mutation was carried out on a sample of 342 unrelated individuals with non-syndromic hearing loss, but none presented this mutation. We selected 48 cases suggestive of autosomal recessive inheritance, plus four familial and seven isolated cases of AN, for genotyping of five microsatellite markers linked to the OTOF gene. The haplotype analysis showed compatibility with linkage in 11 families (including the four families with AN). Samples of the 11 probands from these families and from seven isolated cases of AN were selected for an exon-by-exon screening for mutations in the OTOF gene. Ten different pathogenic variants were detected, among which six are novel. Among the 52 pedigrees with autosomal recessive inheritance (including four familial cases of AN), mutations were identified in 4 (7.7%). Among the 11 probands with AN, seven had at least one pathogenic mutation in the OTOF gene. Mutations in the OTOF gene are frequent causes of AN in Brazil and our results confirm that they are spread worldwide.

TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION AT BOTH HIGH AND LOW FREQUENCIES ACTIVATES VENTROLATERAL PERIAQUEDUCTAL GREY TO DECREASE MECHANICAL HYPERALGESIA IN ARTHRITIC RATS

PubMed Central

Desantana, J. M.; Da Silva, L. F. S.; De Resende, M. A.; Sluka, K. A.

2014-01-01

Transcutaneous electric nerve stimulation (TENS) is widely used for the treatment of pain. TENS produces an opioid-mediated antinociception that utilizes the rostroventromedial medulla (RVM). Similarly, antinociception evoked from the periaqueductal grey (PAG) is opioid-mediated and includes a relay in the RVM. Therefore, we investigated whether the ventrolateral or dorsolateral PAG mediates antinociception produced by TENS in rats. Paw and knee joint mechanical withdrawal thresholds were assessed before and after knee joint inflammation (3% kaolin/carrageenan), and after TENS stimulation (active or sham). Cobalt chloride (CoCl2; 5 mM) or vehicle was microinjected into the ventrolateral periaqueductal grey (vlPAG) or dorsolateral periaqueductal grey (dlPAG) prior to treatment with TENS. Either high (100 Hz) or low (4 Hz) frequency TENS was then applied to the inflamed knee for 20 min. Active TENS significantly increased withdrawal thresholds of the paw and knee joint in the group microinjected with vehicle when compared to thresholds prior to TENS (P<0.001) or to sham TENS (P<0.001). The increases in withdrawal thresholds normally observed after TENS were prevented by microinjection of CoCl2 into the vlPAG, but not the dlPAG prior to TENS and were significantly lower than controls treated with TENS (P<0.001). In a separate group of animals, microinjection of CoCl2 into the vlPAG temporarily reversed the decreased mechanical withdrawal threshold suggesting a role for the vlPAG in the facilitation of joint pain. No significant difference was observed for dlPAG. We hypothesize that the effects of TENS are mediated through the vlPAG that sends projections through the RVM to the spinal cord to produce an opioid-mediated analgesia. PMID:19576962

A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain.

PubMed

Deyo, R A; Walsh, N E; Martin, D C; Schoenfeld, L S; Ramamurthy, S

1990-06-07

A number of treatments are widely prescribed for chronic back pain, but few have been rigorously evaluated. We examined the effectiveness of transcutaneous electrical nerve stimulation (TENS), a program of stretching exercises, or a combination of both for low back pain. Patients with chronic low back pain (median duration, 4.1 years) were randomly assigned to receive daily treatment with TENS (n = 36), sham TENS (n = 36), TENS plus a program of exercises (n = 37), or sham TENS plus exercises (n = 36). After one month no clinically or statistically significant treatment effect of TENS was found on any of 11 indicators of outcome measuring pain, function, and back flexion; there was no interactive effect of TENS with exercise. Overall improvement in pain indicators was 47 percent with TENS and 42 percent with sham TENS (P not significant). The 95 percent confidence intervals for group differences excluded a major clinical benefit of TENS for most outcomes. By contrast, after one month patients in the exercise groups had significant improvement in self-rated pain scores, reduction in the frequency of pain, and greater levels of activity as compared with patients in the groups that did not exercise. The mean reported improvement in pain scores was 52 percent in the exercise groups and 37 percent in the nonexercise groups (P = 0.02). Two months after the active intervention, however, most patients had discontinued the exercises, and the initial improvements were gone. We conclude that for patients with chronic low back pain, treatment with TENS is no more effective than treatment with a placebo, and TENS adds no apparent benefit to that of exercise alone.

Study on Quality of IUD Services Provided by Trained Professionals at Teaching Institutes.

PubMed

Prasad, Noopur; Jain, M L; Meena, B S

2018-06-01

Access the completeness in IUD services provided by trained professionals and find out the weak links. Study was conducted on 100 IUD trained professionals of tertiary care hospital and nursing teaching institute. All were given questionnaire that was duly filled by them. Data obtained were analysed. Protocols of case selection, pre-insertion counselling, insertion process and follow-up were assessed. All the four criteria were assessed on score of ten. Study group could not get ten points under any of the set criteria. Average of 53% case selection, 31.4% pre-insertion counselling, 42.5% insertion protocols and 46.1% follow-up counselling criteria were observed by study group. Highest compliance of protocols was seen among postgraduate students. Although IUD training is given to all medical professionals and IUD facility is available up to subcentres but the study shows that completeness in services is still lacking. Ensuring ideal place for IUD insertion, proper case selection, use of specific instruments for insertion and observance of insertion protocols are very vital for the success of IUD.

Seat-belt injuries of the spine in young children.

PubMed

Rumball, K; Jarvis, J

1992-07-01

Seat-belt fractures of the lumbar spine in adolescents and adults are well recognised but there are few reports of these injuries in young children. We reviewed all seat-belt injuries in skeletally immature patients (Risser 0), seen at a tertiary referral centre between 1974 and 1991. There were ten cases, eight girls and two boys, with an average age of 7.5 years (3 to 13). Four distinct patterns of injury were observed, most commonly at the L2 to L4 level. Paraplegia, which is thought to be uncommon, occurred in three of our ten cases. Four children had intra-abdominal injuries requiring laparotomy. There was a delay in diagnosis either of the spinal or of the intra-abdominal injury in five cases, although all had contusion of the abdominal wall, the 'seat-belt sign'. Treatment of the fractures was conservative, by bed rest and then hyperextension casts. The incidence of this potentially devastating injury can be reduced by the optimal use of restraints, but there is often a delay in diagnosis. Our classification system may aid in the early detection and evaluation of this injury.

Comparison of the class and individual characteristics of Turkish 7.65 mm Browning/.32 Automatic caliber self-loading pistols with consecutive serial numbers.

PubMed

Sarıbey, Aylin Yalçin; Hannam, Abigail Grace

2013-01-01

Firearms identification is based on the fundamental principle that it is impossible to manufacture two identical items at the microscopic level. As firearm manufacturing technologies and quality assurance are improving, it is necessary to continually challenge this principle. In this study, two different makes of 7.65 mm Browning/.32 Automatic caliber self-loading pistols of Turkish manufacture were selected and examined. Ten pistols with consecutive serial numbers were examined and each fired 10 times. The fired cartridge cases were recovered for comparison purposes. It was found that for each make of pistol, the individual characteristics within the firing pin impression, ejector, and breech face marks of all 10 pistols were found to be significantly different. © 2012 American Academy of Forensic Sciences.

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

Levin, I.; Laws, W. J.; Wang, D.

A crystal-chemical framework has been proposed for the design of pseudocubic perovskites with nanoscale ferroelectric order, and its applicability has been demonstrated using a series of representative solid solutions that combined ferroelectric (K0.5Bi0.5TiO3, BaTiO3, and PbTiO3) and antiferroelectric (Nd-substituted BiFeO3) end members. The pseudocubic structures obtained in these systems exhibited distortions that were coherent on a scale ranging from sub-nanometer to tens of nanometers, but, in all cases, the macroscopic distortion remained unresolvable even if using high-resolution X-ray powder diffraction. Different coherence lengths for the local atomic displacements account for the distinctly different dielectric, ferroelectric, and electromechanical properties exhibited bymore » the samples. The guidelines identified provide a rationale for chemically tuning the coherence length to obtain the desired functional response.« less

Solving crimes with hypnosis.

PubMed

Wester, William C; Hammond, D Corydon

2011-04-01

Following a brief review of the literature on hypnosis and memory, this paper overviews the procedures that are used in conducting forensic hypnosis interviews. Ten forensic hypnosis cases are then described. These real world cases are in stark contrast to research done in an artificial laboratory setting where the information to be recalled lacks personal relevance and was not associated with emotionally arousing situations. These cases illustrate how forensic hypnosis can result in obtaining important additional investigative leads which lead to the solving of crimes.

ANTIBIOTICS IN MANAGEMENT OF STAPHYLOCOCCAL ENDOCARDITIS—With Special Reference to Increasing Bacterial Resistance

PubMed Central

Levinson, David C.; Griffith, George C.; Pearson, Harold E.

1951-01-01

Eighteen patients with staphylococcal endocarditis were observed at the Los Angeles County Hospital over a 3-year period (1947-49, inclusive). Twelve died. Bacterial sensitivity studies were carried out in 15 of the cases, and there was resistance to penicillin in ten. Aureomycin was effective in two cases of Staphylococcus aureus endocarditis in which there was no response to penicillin therapy. In one case of Staphylococcus aureus endocarditis the organism was resistant to penicillin and developed increasing resistance to aureomycin. PMID:14812349

An Investigation of the Artifacts and Process of Constructing Computers Games about Environmental Science in a Fifth Grade Classroom

ERIC Educational Resources Information Center

Baytak, Ahmet; Land, Susan M.

2011-01-01

This study employed a case study design (Yin, "Case study research, design and methods," 2009) to investigate the processes used by 5th graders to design and develop computer games within the context of their environmental science unit, using the theoretical framework of "constructionism." Ten fifth graders designed computer games using "Scratch"…

Possibilities of Preoperative Medical Models Made by 3D Printing or Additive Manufacturing.

PubMed

Salmi, Mika

2016-01-01

Most of the 3D printing applications of preoperative models have been focused on dental and craniomaxillofacial area. The purpose of this paper is to demonstrate the possibilities in other application areas and give examples of the current possibilities. The approach was to communicate with the surgeons with different fields about their needs related preoperative models and try to produce preoperative models that satisfy those needs. Ten different kinds of examples of possibilities were selected to be shown in this paper and aspects related imaging, 3D model reconstruction, 3D modeling, and 3D printing were presented. Examples were heart, ankle, backbone, knee, and pelvis with different processes and materials. Software types required were Osirix, 3Data Expert, and Rhinoceros. Different 3D printing processes were binder jetting and material extrusion. This paper presents a wide range of possibilities related to 3D printing of preoperative models. Surgeons should be aware of the new possibilities and in most cases help from mechanical engineering side is needed.

How could she? Psychosocial analysis of ten homicide cases committed by women.

PubMed

Hellen, Florence; Lange-Asschenfeldt, Christian; Ritz-Timme, Stefanie; Verhülsdonk, Sandra; Hartung, Benno

2015-11-01

Ten percent of all homicide perpetrators are female and homicidal acts committed by women are mostly a result of interpersonal conflicts. We carried out a retrospective psychosocial analysis of ten homicide cases committed by women with an urban mid-European background. We evaluated characteristic determinants regarding 1) deed circumstances and motives, 2) the perpetrators, and 3) the victims. Results were compared with the literature on female and male homicides. Autopsy records of the Institute of Legal Medicine of the University Hospital of Düsseldorf, Germany, during the time period from 2006 to 2011 were searched for homicides committed by female perpetrators. Prosecution files were reviewed for further information. The sample comprised N = 10 female homicide perpetrators and eleven victims. The mentioned determinants of the homicide were fairly consistent. All deeds occurred in the domestic context; they were mostly unplanned. All perpetrators were socially isolated and faced socially challenging situations. Most perpetrators were of low socioeconomic status. Furthermore, all victims were helpless and/or dependent on the perpetrator. The presence of a major psychiatric disorder was uncommon and, in contrast to male perpetrators, most women had no previous convictions. The potential value of these core findings in our sample regarding prevention is discussed. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Small Aircraft RF Interference Path Loss

NASA Technical Reports Server (NTRS)

Nguyen, Truong X.; Koppen, Sandra V.; Ely, Jay J.; Szatkowski, George N.; Mielnik, John J.; Salud, Maria Theresa P.

2007-01-01

Interference to aircraft radio receivers is an increasing concern as more portable electronic devices are allowed onboard. Interference signals are attenuated as they propagate from inside the cabin to aircraft radio antennas mounted on the outside of the aircraft. The attenuation level is referred to as the interference path loss (IPL) value. Significant published IPL data exists for transport and regional category airplanes. This report fills a void by providing data for small business/corporate and general aviation aircraft. In this effort, IPL measurements are performed on ten small aircraft of different designs and manufacturers. Multiple radio systems are addressed. Along with the typical worst-case coupling values, statistical distributions are also reported that could lead to better interference risk assessment.

The use of chemical dispersants to combat oil spills at sea: A review of practice and research needs in Europe.

PubMed

Chapman, Helen; Purnell, Karen; Law, Robin J; Kirby, Mark F

2007-07-01

In order to better understand the practice of dispersant use, a review has been undertaken of marine oil spills over a 10 year period (1995-2005), looking in particular at variations between different regions and oil-types. This viewpoint presents and analyses the review data and examines a range of dispersant use policies. The paper also discusses the need for a reasoned approach to dispersant use and introduces past cases and studies to highlight lessons learned over the past ten years, focussing on dispersant effectiveness and monitoring; toxicity and environmental effects; the use of dispersants in low salinity waters; response planning and future research needs.

A patient with mitochondrial disorder due to a novel mutation in MRPS22.

PubMed

Kılıç, Mustafa; Oğuz, Kader-Karli; Kılıç, Esra; Yüksel, Deniz; Demirci, Hüseyin; Sağıroğlu, Mahmut Şamil; Yücel-Yılmaz, Didem; Özgül, Rıza Köksal

2017-10-01

MRPS22 gene defect is a very rare newly discovered mitochondrial disorder. We report a 4-month-old severely affected male infant with MRPS22 mutation. Whole exome sequencing revealed a novel homozygous splicing mutation c.339 + 5 G > A in MRPS22 gene. He has mild dysmorphism, hypotonia, developmental delay but not hypertrophic cardiomyopathy and tubulopathy which differ from other majority of reported patients. Therefore, hypertrophic cardiomyopathy and tubulopathy may not be considered as constant features of MRPS22. With this case report, we also present first symmetrical bilateral brainstem and medial thalamic lesions, and cerebellar and cerebral atrophy on a brain MR imaging follow-up of ten months.

Following electron impact excitations of Rn, Ra, Th, U and Pu single atom L sub-shells ionization cross section calculations by using Lotz’s equation

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

Ayinol, M., E-mail: aydinolm@dicle.edu.tr; Aydeniz, D., E-mail: daydeniz@hotmail.com

L shell ionization cross section and L{sub i} subshells ionization cross sections of Rn, Ra, Th, U, Pu atoms calculated. For each of atoms, ten different electron impact energy values (E{sub o}) are used. Calculations carried out by using Lotz equation in Matlab. First, calculations done for non-relativistic case by using non-relativistic Lotz equation then repeated with relativistic Lotz equation. σ{sub L} total and σ{sub Li}(i = 1,2,3) subshells ionisation cross section values obtained for E{sub o} values in the energy range of E{sub Li}

Innovations in Advanced Materials and Metals Manufacturing Project (IAM2)

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

Scott, Elizabeth

This project, under the Jobs and Innovation Accelerator Challenge, Innovations in Advanced Materials and Metals Manufacturing Project, contracted with Cascade Energy to provide a shared energy project manager engineer to work with five different companies throughout the Portland metro grant region to implement ten energy efficiency projects and develop a case study to analyze the project model. As a part of the project, the energy project manager also looked into specific new technologies and methodologies that could change the way energy is consumed by manufacturers—from game-changing equipment and technology to monitor energy use to methodologies that change the way companiesmore » interact and use their machines to reduce energy consumption.« less

Intravascular low-intensity He-Ne laser irradiation therapy on idiopathic edema

NASA Astrophysics Data System (ADS)

Gao, Yunqing; Liu, T. C.; Tang, Xiang-Jun

1998-11-01

194 patients with psoriasis were treated by intravascular low level laser irradiation combined with Vit C 2.0g iv and O2 inhale to the nose. An hour once a day, for 5-40 times, and 13.06 times in average, ten times with 4-7 days intervals. The results: cured 23 cases, good effected 61 cases, improved 110 cases, relapsed 10 cases. Curative effect was related to treatment times, cured and good effected 5 times 12.5 percent, 10 times 31 percent, 15 times 94 percent. A matched control group in 17 patients was treated by drug. The results: good effected 1 case, improved 13 cases, not effected 3 cases.

PRESERVATION OF AS(III) AND AS(V) IN DRINKING WATER SUPPLY SAMPLES FROM ACROSS THE UNITED STATES USING EDTA AND ACETIC ACID AS A MEANS OF MINIMIZING IRON-ARSENIC CO-PRECIPITATION

EPA Science Inventory

This paper evaluates seven different treatment/storage conditions for the preservation of the native As(III)/As(V) found in ten drinking water supplies from across the US. These ten waters were chosen because they have different As(III)/As(V) distributions; six of these waters c...

A case-control study on risk factors of breast cancer in Han Chinese women.

PubMed

Liu, Li-Yuan; Wang, Fei; Cui, Shu-De; Tian, Fu-Guo; Fan, Zhi-Min; Geng, Cui-Zhi; Cao, Xu-Chen; Yang, Zhen-Lin; Wang, Xiang; Liang, Hong; Wang, Shu; Jiang, Hong-Chuan; Duan, Xue-Ning; Wang, Hai-Bo; Li, Guo-Lou; Wang, Qi-Tang; Zhang, Jian-Guo; Jin, Feng; Tang, Jin-Hai; Li, Liang; Zhu, Shi-Guang; Zuo, Wen-Shu; Yu, Li-Xiang; Xiang, Yu-Juan; Zhou, Fei; Li, Liang; Zhang, Qiang; Fu, Qin-Ye; Ma, Zhong-Bing; Gao, De-Zong; Li, Yu-Yang; Liu, Lu; Ye, Chun-Miao; Wang, Yong-Jiu; Zhou, Wen-Zhong; Yu, Zhi-Gang

2017-11-14

This study aimed to investigate risk factors associated with breast cancer among Han Chinese women in northern and eastern China. A matched case-control study involving 1489 patients with breast cancer and 1489 controls was conducted across 21 hospitals in 11 provinces in China, from April 2012 to April 2013. We developed a structured questionnaire to record information from face-to-face interviews with participants. Student's t-tests, Pearson's chi-square tests, and univariate and multivariate conditional logistic regression analyses were used to identify variables with significant differences between the case and control groups. Ten variables were identified (P < 0.05): location, economic status, waist-to-hip ratio, menopause, family history of breast cancer, present life satisfaction, sleep satisfaction, milk products, behavior prevention scores, and awareness of breast cancer. We identified a comprehensive range of factors related to breast cancer, among which several manageable factors may contribute to breast cancer prevention. Further prospective studies concerning psychological interventions, sleep regulation, health guidance, and physical exercise are required. A screening model for high-risk populations should be put on the agenda.

Cytokeratin characterization of human prostatic carcinoma and its derived cell lines.

PubMed

Nagle, R B; Ahmann, F R; McDaniel, K M; Paquin, M L; Clark, V A; Celniker, A

1987-01-01

Two murine monoclonal anti-cytokeratin antibodies with defined specificity were shown to distinguish between basal cells and luminal cells in human prostate tissue. Forty-one biopsies or transurethral resection specimens were characterized using these two antibodies. In cases of benign prostatic hyperplasia, focal loss of the basal cell layer was noted in areas of glandular proliferation. Ten cases of adenocarcinoma of the prostate, varying in Gleason's histological grade from 2 to 4, were also studied. In each case the carcinoma was shown to represent the luminal cell phenotype with no evidence of involvement of the basal cell phenotype. An analysis of three established metastatic prostatic carcinoma cell lines (DU-145, PC-3, and LNCaP) using two-dimensional electrophoresis showed that the cytokeratin complement of each cell line was slightly different but retained the phenotype of the luminal cell. It was concluded that during both hyperplasia and neoplastic transformation of the prostate, the luminal cell phenotype is primarily involved and that the basal cell phenotype does not appear to contribute to either intraluminal proliferation or invasive cell populations.

Stress and serum TNF-alpha levels may predict disease outcome in patients with pemphigus: a preliminary study.

PubMed

Ragab, Nader; Abdallah, Marwa; El-Gohary, Eman; Elewa, Rana

2011-04-01

The aim of the current preliminary case-control study was to estimate the initial serum levels of tumor necrosis factor alpha (TNF-alpha) in case patients with pemphigus vulgaris (PV) and pemphigus foliaceus (PF) and correlate them with history of stress, body surface area (BSA) affected, disease severity, and disease outcome. Ten PV and 4 PF case patients as well as 7 healthy matched controls had their serum levels of TNF-alpha measured by an enzyme-linked immunosorbent assay. Case patients were treated and followed up for 2 months. A statistically significant elevation in serum levels of TNF-alpha in PV case patients compared with controls and in PV case patients compared with PF case patients was detected (P < .05), with no significant difference between PF case patients and controls (P > .05). No significant correlation was detected between the serum levels of TNF-alpha and the BSA affected (P > .05). Four PV case patients had a bad disease outcome, of which 3 had severe emotional stress a month prior to the onset of the attack. All 4 showed significantly elevated initial serum levels of TNF-alpha compared with those who had a good disease outcome (P < .05). Emotional stress is a factor affecting prognosis of the disease. Pretreatment assessment of serum TNF-alpha levels in patients with pemphigus may be a guide to the expected prognosis and selection of the proper treatment regimen.

Van Allen Probes Measurements of Energetic Particle Deep Penetration Into the Low L Region (L < 4) During the Storm on 8 April 2016

NASA Astrophysics Data System (ADS)

Zhao, H.; Baker, D. N.; Califf, S.; Li, X.; Jaynes, A. N.; Leonard, T.; Kanekal, S. G.; Blake, J. B.; Fennell, J. F.; Claudepierre, S. G.; Turner, D. L.; Reeves, G. D.; Spence, H. E.

2017-12-01

Using measurements from the Van Allen Probes, a penetration event of tens to hundreds of keV electrons and tens of keV protons into the low L shells (L < 4) is studied. Timing and magnetic local time (MLT) differences of energetic particle deep penetration are unveiled and underlying physical processes are examined. During this event, both proton and electron penetrations are MLT asymmetric. The observed MLT difference of proton penetration is consistent with convection of plasma sheet protons, suggesting enhanced convection during geomagnetic active times to be the cause of energetic proton deep penetration during this event. The observed MLT difference of tens to hundreds of keV electron penetration is completely different from tens of keV protons and cannot be well explained by inward radial diffusion, convection of plasma sheet electrons, or transport of trapped electrons by enhanced convection electric field represented by the Volland-Stern model or a uniform dawn-dusk electric field model based on the electric field measurements. It suggests that the underlying physical mechanism responsible for energetic electron deep penetration, which is very important for fully understanding energetic electron dynamics in the low L shells, should be MLT localized.

Experimental attempts to evoke a differential response to different stressors.

DOT National Transportation Integrated Search

1978-04-01

Ten paid male subjects each worked at a physical task with no competitive element (treadmill) and a competitive task ('Pong') with minimal physical activity. There were three work periods, each 50 min long. Ten minutes were allowed for rest and urine...

Missing data imputation of solar radiation data under different atmospheric conditions.

PubMed

Turrado, Concepción Crespo; López, María Del Carmen Meizoso; Lasheras, Fernando Sánchez; Gómez, Benigno Antonio Rodríguez; Rollé, José Luis Calvo; Juez, Francisco Javier de Cos

2014-10-29

Global solar broadband irradiance on a planar surface is measured at weather stations by pyranometers. In the case of the present research, solar radiation values from nine meteorological stations of the MeteoGalicia real-time observational network, captured and stored every ten minutes, are considered. In this kind of record, the lack of data and/or the presence of wrong values adversely affects any time series study. Consequently, when this occurs, a data imputation process must be performed in order to replace missing data with estimated values. This paper aims to evaluate the multivariate imputation of ten-minute scale data by means of the chained equations method (MICE). This method allows the network itself to impute the missing or wrong data of a solar radiation sensor, by using either all or just a group of the measurements of the remaining sensors. Very good results have been obtained with the MICE method in comparison with other methods employed in this field such as Inverse Distance Weighting (IDW) and Multiple Linear Regression (MLR). The average RMSE value of the predictions for the MICE algorithm was 13.37% while that for the MLR it was 28.19%, and 31.68% for the IDW.

Missing Data Imputation of Solar Radiation Data under Different Atmospheric Conditions

PubMed Central

Turrado, Concepción Crespo; López, María del Carmen Meizoso; Lasheras, Fernando Sánchez; Gómez, Benigno Antonio Rodríguez; Rollé, José Luis Calvo; de Cos Juez, Francisco Javier

2014-01-01

Global solar broadband irradiance on a planar surface is measured at weather stations by pyranometers. In the case of the present research, solar radiation values from nine meteorological stations of the MeteoGalicia real-time observational network, captured and stored every ten minutes, are considered. In this kind of record, the lack of data and/or the presence of wrong values adversely affects any time series study. Consequently, when this occurs, a data imputation process must be performed in order to replace missing data with estimated values. This paper aims to evaluate the multivariate imputation of ten-minute scale data by means of the chained equations method (MICE). This method allows the network itself to impute the missing or wrong data of a solar radiation sensor, by using either all or just a group of the measurements of the remaining sensors. Very good results have been obtained with the MICE method in comparison with other methods employed in this field such as Inverse Distance Weighting (IDW) and Multiple Linear Regression (MLR). The average RMSE value of the predictions for the MICE algorithm was 13.37% while that for the MLR it was 28.19%, and 31.68% for the IDW. PMID:25356644

A Meta-Analysis of Transcutaneous Electrical Nerve Stimulation for Chronic Low Back Pain.

PubMed

Jauregui, Julio J; Cherian, Jeffrey J; Gwam, Chukwuweike U; Chughtai, Morad; Mistry, Jaydev B; Elmallah, Randa K; Harwin, Steven F; Bhave, Anil; Mont, Michael A

2016-04-01

Transcutaneous electrical nerve stimulation (TENS) may provide a safe alternative to current side-effect-heavy narcotics and anti-inflammatories utilized in chronic low back pain. Therefore, we performed a meta-analysis to evaluate the efficacy of TENS for the treatment of chronic low back pain. We included randomized controlled trials (RCTs), cohort studies, and randomized crossover studies on TENS for the management of low back pain. We utilized a visual analogue scale (VAS) for pain as our primary outcome. Effectiveness of treatment was quantified using improvement in outcome scores for each study. Of the studies that met the criteria, 13 allowed for calculation of weighted mean differences in pain reduction. We used a random model effect to evaluate changes in pain produced by the intervention. Included were nine level I and four level II, encompassing 267 patients (39% male) who had a mean follow-up of seven weeks (range; 2 to 24 weeks). The mean duration of treatment was six weeks (range; 2 to 24 weeks). The standardized mean difference in pain from pre- to post-treatment for TENS was 0.844, which demonstrated significant improvement of TENS on pain reduction. When subdividing treatment duration, patients that were treated for < 5 weeks had significant effects on pain, while those treated for > 5 weeks did not. Treatment of chronic low back pain with TENS demonstrated significant pain reduction. The application of TENS may lead to less pain medication usage and should be incorporated into the treatment armamentarium for chronic low back pain.

Neuralgia associated with transcutaneous electrical nerve stimulation therapy in a patient initially diagnosed with temporomandibular disorder.

PubMed

Omolehinwa, Temitope T; Musbah, Thamer; Desai, Bhavik; O'Malley, Bert W; Stoopler, Eric T

2015-03-01

Head and neck neoplasms may be difficult to detect because of wide-ranging symptoms and the presence of overlapping anatomic structures in the region. This case report describes a patient with chronic otalgia and temporomandibular disorder, who developed sudden-onset neuralgia while receiving transcutaneous electrical nerve stimulation (TENS) therapy. Further diagnostic evaluation revealed a skull base tumor consistent with adenoid cystic carcinoma. To our knowledge, this is the first report of TENS-associated neuralgia leading to a diagnosis of primary intracranial adenoid cystic carcinoma. Copyright © 2015 Elsevier Inc. All rights reserved.

Piscine mycobacteriosis - Involvement of bacterial species and reflection in pathology.

PubMed

Keller, C; Wenker, C; Jermann, T; Hirschi, R; Schildger, B; Meier, R; Schmidt-Posthaus, H

2018-06-01

Piscine mycobacteriosis is a lethal disease with zoonotic potential, found worldwide in both fresh and marine fish. More than 20 strains of Mycobacterium spp. are known to persist in fish so far, but the pathogenicity is currently unknown for most of them. However, M. marinum is reported as one of the most pathogenic agents for fish and is involved in zoonotic cases. We examined 47 different cases from two zoological gardens, where fish tuberculosis was identified or previously suspected during the last ten years. We collected PCR and sequencing data, which were then compared to previously collected clinical data and pathology. The clinical signs caused by Mycobacterium spp. were similar in all the cases, except for cases infected by M. marinum, which lacked the presence of skin lesions. Lesions seen in histology caused by M. marinum tended to be more acute and severe compared lesions caused by other Mycobacterium spp. The majority of M. marinum cases have been reported within marine fish. In contrast to previous studies we detected this species to be the predominant bacteria present within freshwater fish. Interestingly, we detected M. holsaticum in one of the seawater systems used in this project, being the first report of this Mycobacterium species shown to be present in a fish.

[Correlation analysis of bone marrow edema degree and serum inflammatory factors change with knee joint pain symptoms in patients with bone contusion around the knee joint].

PubMed

Li, Songiun; An, Rongze; Wang, Zhaojie; Kuang, Lipeng; Tan, Weiyuan; Fang, Cunxun

2014-05-01

To explore the correlation between the degree of bone marrow edema (BME) and the content change of tumor necrosis factor alpha (TNF-alpha) and matrix metalloproteinase 3 (MMP-3) and the knee pain symptoms in patients with bone contusion around the knee joint. Thirty patients (30 knees) of bone contusion around the knee joint were chosen as the trial group between October 2009 and April 2012. According to visual analogue scale (VAS), 30 patients were divided into mild group (10 cases), moderate group (10 cases), and severe group (10 cases); according to MRI morphological changes, the patients were divided into type I group (12 cases), type II group (11 cases), and type III group (7 cases). Ten patients (10 knees) with soft tissue injury of the knee were chosen as control group. No significant difference was found (P > 0.05) in gender, age, causes, side, and admission time after injury between 2 groups. The serum contents of MMP-3 and TNF-alpha were detected and statistically analysed between different degrees of pain groups and between different degrees of BME groups. Correlation was analysed between BME and inflammatory factor changes and VAS score. The MMP-3 and TNF-alpha contents in trial group [(29.580 +/- 6.870) (microg/L and (23.750 +/- 7.096) ng/L] were significantly higher than those in control group [(8.219 +/- 1.355) microg/L and (6.485 +/- 1.168) ng/L] (t = 9.686, P = 0.000; t = 7.596, P =0.000). The MMP-3 and TNF-alpha contents in patients with different degrees of pain and BME were significantly higher than those in patients of control group (P < 0.05), and significant difference was found between patients with different degrees of pain (P < 0.05), but no significant difference between patients with different degrees of BME (P > 0.05). Multiple linear regression analysis showed that TNF-alpha content was significantly correlated with VAS score (P = 0.000). Knee pain symptoms are not related to the degree of BME in patients with bone contusion around the knee joint. Inflammatory factor TNF-alpha content is the main influence factor of knee joint pain symptoms.

Pathological characteristics and clinical specifications in gastroenteropancreatic neuroendocrine tumors: a study of 68 cases.

PubMed

Stoica-Mustafa, Elena; Pechianu, C; Iorgescu, Andreea; Hortopan, Monica; Dima, Simona Olimpia; Tomulescu, V; Dumitraşcu, T; Ungureanu, C; Andronesi, D; Popescu, I; Herlea, V

2012-01-01

Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) represent a group of tumors, having their origin in cells of diffuse endocrine system, with particular clinical course, diagnosis and treatment. In our study, were included 68 patients with neuroendocrine digestive tumors admitted, diagnosed and treated in Fundeni Clinical Institute, Bucharest, in the last ten years--2000-2010 (retrospective study). Thirty-three (49%) patients were males, 35 (51%) females, and the main age was 58.9 years. In 62 (90.3%) cases was possible to find the primary tumor. The examined tumors had different localizations: pancreas--32 (47.04%) cases (head--17 (24.99%) cases, and body and tail--15 (22.05%) cases), stomach--7 (10.29%) cases, small intestine--7 (10.29%) cases, 6 (8.82%) cases--unknown primary site (diagnosis was established on metastases), right colon--6 (8.82%) cases, liver--6 (8.82%) cases, rectum--2 (2.94%) cases, and retroperitoneum--2 (2.94%) cases. Microscopic examination revealed 59 (86.8%) malignant tumors and 9 (13.2%) benign tumors. Using WHO 2000 Classification, 28 cases of malignant tumors were well-differentiated neuroendocrine carcinomas, and 31 cases were poor differentiated neuroendocrine carcinomas. From malignant cases, 25 (42.3%) have distant metastases and 15 (25.9%) lymph node metastases. Cases of gastroenteropancreatic neuroendocrine tumors included in our study had clinical and histopathological features in correspondence with data from literature--slight predominance in women, predominance in 5th and 6th decades of life, the most frequent localizations were at pancreatic level--both head and body and tail, but the rarest were in colon and retroperitoneum. Most of the cases studied, were malignant tumors, from these more than a half were poor differentiated, and a quarter of them having lymph node or distant metastases.

Direct and Indirect Benefits Reported by Users of Transcutaneous Electrical Nerve Stimulation for Chronic Musculoskeletal Pain: Qualitative Exploration Using Patient Interviews.

PubMed

Gladwell, Peter William; Badlan, Kathryn; Cramp, Fiona; Palmer, Shea

2015-11-01

There is no consensus regarding the effectiveness of transcutaneous electrical nerve stimulation (TENS) for management of chronic musculoskeletal pain or chronic low back pain. A recent review of previous trial methodology identified significant problems with low treatment fidelity. There is little information available to guide selection of patient-reported outcome measures appropriate for TENS evaluation. The purpose of this study was to explore the experiences of patients at a secondary care pain clinic who successfully used TENS to help manage chronic musculoskeletal pain. These key informants were selected because they had the potential to generate knowledge that could inform research design and clinical practice. A qualitative method using individual semistructured interviews with open questions was selected for its capacity to generate rich data. A mini focus group informed the development of a discussion guide for semistructured interviews with 9 patients (6 women, 3 men). Thematic analysis was used as the primary data analysis method, and this analysis was enhanced by a case-level analysis of the context and processes of TENS use of each individual. Data analysis indicated that distraction from pain and a reduction in the sensations associated with muscle tension or spasm should be considered as separate outcomes from pain relief. These direct benefits led to a wide range of indirect benefits dependent on patient decision making, including medication reduction, enhanced function, psychological benefits, and enhanced ability to rest. The findings indicate that evaluating TENS using a unidimensional pain scale is likely to overlook potential benefits. The complex pattern of TENS usage, as well as multiple direct and indirect outcomes, indicates that TENS could be considered as a complex intervention. © 2015 American Physical Therapy Association.

Racial disparities in the risk of Stevens-Johnson Syndrome and toxic epidermal necrolysis as urate-lowering drug adverse events in the United States.

PubMed

Lu, Na; Rai, Sharan K; Terkeltaub, Robert; Kim, Seoyoung C; Menendez, Mariano E; Choi, Hyon K

2016-10-01

HLA-B*5801 allele carriage (a strong determinant of allopurinol hypersensitivity syndrome) varies substantially among races, which may lead to racial disparities in the risk of Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) in the context of urate-lowering drug adverse events (ULDAEs). We examined this hypothesis in a large, racially diverse, and generalizable setting. Using a database representative of US hospitalizations (2009-2013), we investigated the racial distribution of hospitalized SJS/TEN (principal discharge diagnosis) as ULDAEs (ICD-9-CM Classification of External Causes). Our reference groups included the US Census population, US allopurinol users, and ULDAE hospitalizations without SJS/TEN. We identified 606 cases hospitalized for SJS/TEN as ULDAEs (mean age = 68 years; 44% male), among which there was an overrepresentation of Asians (27%) and Blacks (26%), and an underrepresentation of Whites (29%) and Hispanics (% too-low-to-report), compared with the US Census population (5%, 12%, 67%, and 15%, respectively). The hospitalization rate ratios for SJS/TEN among Asians, Blacks, and Whites were 11.9, 5.0, and 1.0 (referent), respectively. These associations persisted using other national referents. According to the NHANES 2009-2012, allopurinol constituted 96.8% of urate-lowering drug use, followed by probenecid (2.1%). These national data indicate that Asians and Blacks have a substantially higher risk of SJS/TEN as ULDAEs than Whites (or Hispanics), correlating well with corresponding frequencies of HLA-B*5801 in the US population (i.e., 7.4%, 4%, 1%, and 1%, respectively). Given its market dominance and established association with SJS/TEN, our findings support the use of vigilance in these minorities when considering allopurinol. Copyright © 2016 Elsevier Inc. All rights reserved.

COMPREHENSIVE STANDARDS: THE POWER GENERATION CASE

EPA Science Inventory

This study presents an illustrative data base of material quantities and environmental effluents in the fuel cycles for alternative technologies of thermally generated power. The entire fuel cycle for each of the alternative ten technologies is outlined for a representative power...

Tetanus after blunt lawn mower trauma.

PubMed

Normand, Camilla; Fostervold, Aasmund; Haarr, Elin; Skontorp, Marie; Berg, Åse

2015-01-01

A patient presented with tetanus ten days after blunt trauma with a lawn mower. Our case describes the diagnosis and treatment of this patient with an infectious disease commonly seen in the developing world but rarely seen in the developed world.

A novel computer algorithm for modeling and treating mandibular fractures: A pilot study.

PubMed

Rizzi, Christopher J; Ortlip, Timothy; Greywoode, Jewel D; Vakharia, Kavita T; Vakharia, Kalpesh T

2017-02-01

To describe a novel computer algorithm that can model mandibular fracture repair. To evaluate the algorithm as a tool to model mandibular fracture reduction and hardware selection. Retrospective pilot study combined with cross-sectional survey. A computer algorithm utilizing Aquarius Net (TeraRecon, Inc, Foster City, CA) and Adobe Photoshop CS6 (Adobe Systems, Inc, San Jose, CA) was developed to model mandibular fracture repair. Ten different fracture patterns were selected from nine patients who had already undergone mandibular fracture repair. The preoperative computed tomography (CT) images were processed with the computer algorithm to create virtual images that matched the actual postoperative three-dimensional CT images. A survey comparing the true postoperative image with the virtual postoperative images was created and administered to otolaryngology resident and attending physicians. They were asked to rate on a scale from 0 to 10 (0 = completely different; 10 = identical) the similarity between the two images in terms of the fracture reduction and fixation hardware. Ten mandible fracture cases were analyzed and processed. There were 15 survey respondents. The mean score for overall similarity between the images was 8.41 ± 0.91; the mean score for similarity of fracture reduction was 8.61 ± 0.98; and the mean score for hardware appearance was 8.27 ± 0.97. There were no significant differences between attending and resident responses. There were no significant differences based on fracture location. This computer algorithm can accurately model mandibular fracture repair. Images created by the algorithm are highly similar to true postoperative images. The algorithm can potentially assist a surgeon planning mandibular fracture repair. 4. Laryngoscope, 2016 127:331-336, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Some notes on an early nineteenth century manuscript medical receipt book.

PubMed

Jackson, W A

2003-06-01

There are 97 remedies listed, including 11 veterinary ones. These numbers include several that are duplicates. The commonest types of medicament are salves or ointments, of which there are ten, but these ten do not include ointments for specific complaints such as haemorrhoids or scurvy. The most frequently found cures are for the itch (10), rheumatism (5), gravel (4), pain (4), and piles (3), all the others having only one or two entries. They were intended to treat 39 human complaints and 9 animal ones. In addition there were formulae for killing lice, making rat poison, and preparing damson wine! The number of different medicaments that were used in the recipes was relatively small, but more than were to be found in the smaller sizes of domestic medicine cabinet. In 1820 Reece's Traveller's Dispensary that was flat and would fit in the pocket of a carriage, only contained ten drugs plus court plaster, lint, scales and weights with a book of directions and cost L3.10s.0d. (L3.50). The Lady's Dispensary which contained twenty medicines, including two pills, with some dispensing equipment and a book of directions cost L5.10s.0d. (L5.50). In all, he listed twenty different cabinets and a sea medicine chest ranging in price from L3.10s.0d. to L32.10s.0d. They included ones suitable for the family, country clergymen, and travellers on the continent and in the tropics. In 1862 Savory and Moore stocked a range of sixty-seven different medicine chests and cases in rosewood, mahogany, walnut, boxwood and leather that were fitted with 'modern appliances and conveniences adapted for the requirements of families, clergymen, officers, owners of yachts, and travellers.' Unfortunately no prices are quoted. I think that we can safely assume that the treatment received at the hands of Evan Jones was likely to be rather rough and ready when compared to the ministrations of a physician, surgeon, clergyman or local 'Lady Bountiful', but, nevertheless, must have been of great value to those who could not afford professional treatment.

Ten cases of severe oral lichen planus showing granular C3 deposition in oral mucosal basement membrane zone.

PubMed

Hashimoto, Takashi; Fukuda, Aoi; Himejima, Akio; Morita, Shosuke; Tsuruta, Daisuke; Koga, Hiroshi; Krol, Rafal P; Ishii, Norito

2015-01-01

Oral lichen planus (OLP) may show depositions of immunoglobulins and complement components in oral mucosal basement membrane zone (BMZ) in direct immunofluorescence, although these finding are not frequently seen. We collected and examined ten cases of severe OLP showing granular C3 deposition in BMZ. In addition to clinical, histopathological and direct immunofluorescence assessments, we performed various immune-serological tests, including indirect immunofluorescence of normal human skin and 1M NaCl-split skin, immunoblotting of normal human epidermal and dermal extracts, recombinant proteins of BP180 NC16a and C-terminal domains, concentrated culture supernatant of HaCaT cells and purified human laminin-332, and enzyme-linked immunosorbent assays for BP230 and BP180. Direct immunofluorescence showed C3 deposition in BMZ exclusively of granular pattern in 7 cases and of both granular and linear patterns in 3 cases. The 10 cases showed no positive reactivity for either IgG or IgA antibodies in any immuno-serological tests. Detailed analyses of clinical, histopathological and immunological findings revealed striking female prevalence, although other parameters were in general characteristic of OLP. Granular C3 deposition in oral BMZ may be one of the characteristic features of severe OLP, although mechanisms for C3 deposition and its pathogenic role in OLP are currently unknown.

Transcutaneous electrical nerve stimulation (TENS) for pain management in labour

PubMed Central

Dowswell, Therese; Bedwell, Carol; Lavender, Tina; Neilson, James P

2014-01-01

Background Transcutaneous nerve stimulation (TENS) has been proposed as a means of reducing pain in labour. The TENS unit emits low-voltage electrical impulses which vary in frequency and intensity. During labour, TENS electrodes are generally placed on the lower back, although TENS may be used to stimulate acupuncture points or other parts of the body. The physiological mechanisms whereby TENS relieves pain are uncertain. TENS machines are frequently operated by women, which may increase a sense of control in labour. Objectives To assess the effects of TENS on pain in labour. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (30 April 2011) and reference lists of retrieved papers. Selection criteria Randomised controlled trials comparing women receiving TENS for pain management in labour versus routine care, alternative non-pharmacological methods of pain relief, or placebo devices. We included all types of TENS machines. Data collection and analysis Two review authors assessed for inclusion all trials identified by the search strategy, carried out data extraction and assessed risk of bias. We have recorded reasons for excluding studies. Main results Seventeen trials with 1466 women contribute data to the review. Thirteen examined TENS applied to the back, two to acupuncture points, and two to the cranium. Overall, there was little difference in pain ratings between TENS and control groups, although women receiving TENS to acupuncture points were less likely to report severe pain (average risk ratio 0.41, 95% confidence interval 0.31 to 0.54; measured in two studies). The majority of women using TENS said they would be willing to use it again in a future labour. Where TENS was used as an adjunct to epidural analgesia there was no evidence that it reduced pain. There was no consistent evidence that TENS had any impact on interventions and outcomes in labour. There was little information on outcomes for mothers and babies. No adverse events were reported. Authors’ conclusions There is only limited evidence that TENS reduces pain in labour and it does not seem to have any impact (either positive or negative) on other outcomes for mothers or babies. The use of TENS at home in early labour has not been evaluated. TENS is widely available in hospital settings and women should have the choice of using it in labour. PMID:19370680

Hard X-ray and radio emission at the onset of great solar flares

NASA Technical Reports Server (NTRS)

Klein, K.-L.; Pick, M.; Magun, A.; Dennis, B. R.

1987-01-01

A study of the onset phase of ten great hard X-ray bursts is presented. It is shown from hard X-ray and radio observations in different wavelength ranges that the energization of the electrons proceeds on a global time-scale for some tens of seconds. In nine of the bursts, two phases of emission can be distinguished during the onset phase: the preflash phase (during which emission up to an energy limit ranging from some tens of keV to 200 keV is observed) followed ten to some tens of seconds later by the flash phase (where the count rate in all detector channels rises simultaneously to within some seconds). For two of the events, strong gamma-ray line emission is observed and is shown to start close to the onset of the flash phase.

Fear of Circumcision in Boys Considerably Vanishes within Ten Days of Procedure.

PubMed

Sancar, Serpil; Demirci, Hakan; Guzelsoy, Muhammet; Coban, Soner; Askin, Rustem; Uzun, Mehmet Erdem; Turkoglu, Ali Riza

2016-03-05

To compare fear of circumcision, before, immediately after, and ten days after the operation. This was a case-control study in which participants in the operation group consisted of children admitted for circumcision at the outpatient clinics of a hospital. The Children's Fear Scale and the Venham Picture Test were administered by face-to-face interviews. The sample consisted of 100 boys who were circumcised and 99 who have not been circumcised yet. Children's Fear Scale scores measured before (P = .000) and immediately after the operation (P = .000) were significantly different from scores obtained on the 10th day after the operation. Total fear scores of the Venham Picture Test of boys whose families were in the higher economic level were higher than those of boys from low-income families (P < .05). The primary reason for admission for circumcision was religious, and the reason for the remaining boys was a combination of religious and hygienic factors. The boys who came to have circumcision solely because of religious reasons were found to be less fearful compared with the boys who were brought to surgery for both religious and medical reasons (P < .05). The lowest fear scores were obtained for boys who were six years of age or older. Boys who knew what the circumcision meant were less afraid of circumcision compared with those who were unaware of the procedure. Fear from circumcision does not persist; it considerably vanishes within ten days. It seems reasonable to recommend circumcision for boys six years of age or older. Pre-operative education may help boys to overcome fear originated from circumcision.

Triazolam blood concentrations in forensic cases in Canada.

PubMed

Joynt, B P

1993-01-01

Triazolam has been a controversial drug since its appearance on world markets as a hypnotic more than ten years ago. Whole blood concentrations of triazolam as found in forensic cases are cited in several categories; that is, impaired driving: 17 cases; sexual assault: four cases; death due to drugs: 45 cases; drug-related death (drugs contributed to the death but were not the ultimate cause): 20 cases; drug-involved death (drugs were present but were not felt to be a contributing factor): six cases; miscellaneous: one case. The data was gleaned from a forensic toxicology database designed and used by the Forensic Toxicology Sections of the Royal Canadian Mounted Police (RCMP) laboratories in Canada. Triazolam concentrations from selected references are included for comparison.

Apoptosis as a Mechanism for Keratinocyte Death in Canine Toxic Epidermal Necrolysis.

PubMed

Banovic, F; Dunston, S; Linder, K E; Rakich, P; Olivry, T

2017-03-01

In humans and dogs, toxic epidermal necrolysis (TEN) is a life-threatening dermatosis characterized by sudden epidermal death resulting in extensive skin detachment. There is little information on the pathogenesis of keratinocyte cell death in canine TEN. We studied the occurrence of apoptosis in skin lesions of dogs with TEN to determine if apoptosis contributes to the pathogenesis of this disease. Immunostaining with antibodies to activated caspase-3 and the terminal deoxynucleotidyl-transferase (TdT)-mediated deoxyuridine triphosphate (dUTP) nick-end labeling technique revealed positive apoptotic keratinocytes in basal and suprabasal epidermal compartments in 17 biopsy specimens collected from 3 dogs with TEN and 16 from 3 dogs with erythema multiforme (EM). There was no significant difference in the number of positively stained epidermal cells between TEN and EM. These results suggest that apoptosis of epidermal keratinocytes and lymphocytic satellitosis represent one of the early steps in the pathogenesis of canine TEN, as in the human disease counterpart.

Assessing the effects of transcutaneous electrical nerve stimulation (TENS) in post-thoracotomy analgesia.

PubMed

Ferreira, Fabiana Cristina; Issy, Adriana Machado; Sakata, Rioko Kimiko

2011-01-01

Transcutaneous electrical nerve stimulation (TENS) is commonly used to treat musculoskeletal pain, but it may also be indicated for postoperative analgesia. The objective of this study was to evaluate the analgesic effects of TENS on post-thoracotomy. Thirty patients between 18 and 60 years of age undergoing thoracotomy for lung cancer resection on the second postoperative day were included in this study. Patients were divided into two groups (G1 and G2). G1 patients were treated with TENS; and in G2 (without TENS) electrodes were placed but the equipment was not turned on. TENS was maintained for one hour. The visual analogue scale was used to evaluate the analgesic effects on three moments: before TENS (M0), immediately after TENS (M1), and one hour later (M2), with the patient at rest, elevation of the upper limbs, change in decubitus, and coughing. The intensity of pain at rest was higher in G2 immediately after TENS, but not one hour after the procedure. There was no difference between both groups with elevation of the upper limbs, decubitus change, and coughing. With the use of TENS for one hour on the second post-thoracotomy day in patients who received fentanyl (50 μg) associated with bupivacaine (5 mL), a reduction in pain intensity was observed at rest immediately after TENS; with elevation of the upper limbs, change in decubitus, and coughing, a reduction in pain severity was not observed. Copyright © 2011 Elsevier Editora Ltda. All rights reserved.

Knowledge-based IMRT treatment planning for prostate cancer.

PubMed

Chanyavanich, Vorakarn; Das, Shiva K; Lee, William R; Lo, Joseph Y

2011-05-01

To demonstrate the feasibility of using a knowledge base of prior treatment plans to generate new prostate intensity modulated radiation therapy (IMRT) plans. Each new case would be matched against others in the knowledge base. Once the best match is identified, that clinically approved plan is used to generate the new plan. A database of 100 prostate IMRT treatment plans was assembled into an information-theoretic system. An algorithm based on mutual information was implemented to identify similar patient cases by matching 2D beam's eye view projections of contours. Ten randomly selected query cases were each matched with the most similar case from the database of prior clinically approved plans. Treatment parameters from the matched case were used to develop new treatment plans. A comparison of the differences in the dose-volume histograms between the new and the original treatment plans were analyzed. On average, the new knowledge-based plan is capable of achieving very comparable planning target volume coverage as the original plan, to within 2% as evaluated for D98, D95, and D1. Similarly, the dose to the rectum and dose to the bladder are also comparable to the original plan. For the rectum, the mean and standard deviation of the dose percentage differences for D20, D30, and D50 are 1.8% +/- 8.5%, -2.5% +/- 13.9%, and -13.9% +/- 23.6%, respectively. For the bladder, the mean and standard deviation of the dose percentage differences for D20, D30, and D50 are -5.9% +/- 10.8%, -12.2% +/- 14.6%, and -24.9% +/- 21.2%, respectively. A negative percentage difference indicates that the new plan has greater dose sparing as compared to the original plan. The authors demonstrate a knowledge-based approach of using prior clinically approved treatment plans to generate clinically acceptable treatment plans of high quality. This semiautomated approach has the potential to improve the efficiency of the treatment planning process while ensuring that high quality plans are developed.

The effect of vortex merging and non-merging on the transfer of modal turbulent kinetic energy content

NASA Astrophysics Data System (ADS)

Ground, Cody; Vergine, Fabrizio; Maddalena, Luca

2016-08-01

A defining feature of the turbulent free shear layer is that its growth is hindered by compressibility effects, thus limiting its potential to sufficiently mix the injected fuel and surrounding airstream at the supersonic Mach numbers intrinsic to the combustor of air-breathing hypersonic vehicles. The introduction of streamwise vorticity is often proposed in an attempt to counteract these undesired effects. This fact makes the strategy of introducing multiple streamwise vortices and imposing upon them certain modes of mutual interaction in order to potentially enhance mixing an intriguing concept. However, many underlying fundamental characteristics of the flowfields in the presence such interactions are not yet well understood; therefore, the fundamental physics of these flowfields should be independently investigated before the explicit mixing performance is characterized. In this work, experimental measurements are taken with the stereoscopic particle image velocimetry technique on two specifically targeted modes of vortex interaction—the merging and non-merging of two corotating vortices. The fluctuating velocity fields are analyzed utilizing the proper orthogonal decomposition (POD) in order to identify the content, organization, and distribution of the modal turbulent kinetic energy content of the fluctuating velocity eigenmodes. The effects of the two modes of vortex interaction are revealed by the POD analysis which shows distinct differences in the modal features of the two cases. When comparing the low-order eigenmodes of the two cases, the size of the structures contained within the first ten modes is seen to increase as the flow progresses downstream for the merging case, whereas the opposite is true for the non-merging case. Additionally, the relative modal energy contribution of the first ten eigenmodes increases as the vortices evolve downstream for the merging case, whereas in the non-merging case the relative modal energy contribution decreases. The POD results show that the vortex merging process reorients and redistributes the relative turbulent kinetic energy content toward the larger-scale structures within the low-order POD eigenmodes. This result suggests that by specifically designing the vortex generation system to impose preselected modes of vortex interaction upon the flow it is possible to exert some form of control over the downstream evolution and distribution of the global and modal turbulent kinetic energy content.

[Research on prevalence and related factors in allergic rhinitis].

PubMed

Wang, Ze-hai; Lin, Wen-sen; Li, Shu-yan; Zhao, Shao-cheng; Wang, Li; Yang, Zhong-gang; Chen, Jie; Zhang, Zhen-fu; Yu, Jin-zhen

2011-03-01

To obtain the prevalence and related factors in allergic rhinitis (AR) and other allergic diseases in rural area in China through epidemiological investigation with large sample and multi-faceted survey data. Face to face survey was conducted in different regions (rural areas of Cangzhou, Hebei, coastal fishing village of Bohai Bay, area of Wuling Mountain, Chengde, urban areas of Tianjin) from April 2007 to May 2009. In the same time, serum specific IgE (sIgE) was detected in the digits of every 0, 1or 5 in them. SPSS 13.0 software was used to analyze the data. Five thousand and ten cases were investigated. There were 823 cases with the symptoms or signs of AR (16.4%). Four hundred and two cases were found to have positive serum sIgE antibody in 1576 detected cases (25.5%). One hundred and fourty-six cases with nasal allergic symptoms or signs were diagnosed as AR. The incidence of AR was 9.3% (146/1576). The occurrence of allergic symptoms or signs had a significant statistical difference with factors such as age, occupation, atopic constitution (χ(2) value were 7.96, 9.73, 16.53, 8.95 respectively, all P < 0.05), and it was closely related to lower respiratory tract allergies (β = 2.544, P < 0.01). The most common allergens were dog and cat epithelium in rural areas and dust mites in city. The incidence of AR is higher whether in urban or rural areas, it should be taken seriously as the impact on human health. The occurrence is closely related to physical characteristics and environmental factors.

[Combined surgical intervention treatments for lung cancer and coronary heart disease patients].

PubMed

Ma, Xuchen; Zhang, Zhitai; Hu, Yansheng; Song, Feiqiang; Zhang, Shaoyan; Ou, Songlei

2012-10-01

The number of patients with both lung cancer and coronary heart disease has increased for the last ten years. The aim of this study is to analyze the outcome of the combined treatment of radical surgery and off-pump coronary artery bypass grafting (OPCABG) for patients with both lung cancer and coronary heart disease. The clinical data of 18 patients (16 males and 2 females, mean age of 66.11 years) with both lung cancer and coronary heart disease who went through combined surgical interventions between 2003 and 2012 were summarized and analyzed. The lung cancer in these patients was predominantly at stages I and II (TNM). All patients' cardio-pulmonary function was favorable. All the patients survived the operation, without any recorded death and new myocardial infarction occurrence during the perioperative period. Squamous carcinoma and adenocarcinoma were found in 10 and 8 patients, respectively. Pathological lung cancer stage was Ia in 2 cases, Ib in 8 cases, IIa in 3 cases, II b in 3 cases, and IIIa in 2 cases. The most frequently observed complications were cardiac arrhythmias, atelectasis, and pulmonary infections. The mean values of operating room time, postoperative drainage, drainage tube time, and blood transfusion were significantly different between video-assisted thoracoscopic surgery (VATS) groups and thoractomy groups. No significant differences in survival rate were found (P=0.187). The combined method of OPCABG and pulmonary resection is a safe and effective treatment for patients with both lung cancer and coronary heart disease. VATS lobectomy is beneficial for lung cancer patients because it reduces lesions.

TEN RILLINGTON PLACE AND THE CHANGING POLITICS OF ABORTION IN MODERN BRITAIN.

PubMed

Jones, Emma L; Pemberton, Neil

2014-12-01

This article addresses the social, cultural, and political history of backstreet abortion in post-war Britain, focusing on the murders of Beryl Evans and her daughter Geraldine, at Ten Rillington Place in 1949. It shows how the commonplace connection of John Christie to abortion and Beryl Evan's death was not a given in the wider public, legal, political, and forensic imagination of the time, reflecting the multi-layered and shifting meanings of abortion from the date of the original trials in the late 1940s and 1950s, through the subsequent judicial and literary reinvestigations of the case in the 1960s, to its cinematic interpretation in the 1970s. Exploring the language of abortion used in these different contexts, the article reveals changes in the gendering of abortionists, the increasing power and presence of abortion activists and other social reformers, the changing representation of working-class women and men, and the increasing critique of the practice of backstreet abortion. The case is also made for a kind of societal blind spot on abortion at the time of both the Evans and Christie trials; in particular, a reluctance to come to terms with the concept of the male abortionist, which distorted the criminal investigations and the trials themselves. Only when public acceptance for legalizing abortion grew in the more liberal climate of the 1960s and beyond did a revisionist understanding of the murder of Beryl Evans, in which abortion came to be positioned as a central element, gain a sustained hearing.

Anti-stress effects of transcutaneous electrical nerve stimulation (TENS) on colonic motility in rats.

PubMed

Yoshimoto, Sazu; Babygirija, Reji; Dobner, Anthony; Ludwig, Kirk; Takahashi, Toku

2012-05-01

Disorders of colonic motility may contribute to symptoms in patients with irritable bowel syndrome (IBS), and stress is widely believed to play a major role in developing IBS. Stress increases corticotropin releasing factor (CRF) of the hypothalamus, resulting in acceleration of colonic transit in rodents. In contrast, hypothalamic oxytocin (OXT) has an anti-stress effect via inhibiting CRF expression and hypothalamic-pituitary-adrenal axis activity. Although transcutaneous electrical nerve stimulation (TENS) and acupuncture have been shown to have anti-stress effects, the mechanism of the beneficial effects remains unknown. We tested the hypothesis that TENS upregulates hypothalamic OXT expression resulting in reduced CRF expression and restoration of colonic dysmotility in response to chronic stress. Male SD rats received different types of stressors for seven consecutive days (chronic heterotypic stress). TENS was applied to the bilateral hind limbs every other day before stress loading. Another group of rats did not receive TENS treatment. TENS significantly attenuated accelerated colonic transit induced by chronic heterotypic stress, which was antagonized by a central injection of an OXT antagonist. Immunohistochemical study showed that TENS increased OXT expression and decreased CRF expression at the paraventricular nucleus (PVN) following chronic heterotypic stress. It is suggested that TENS upregulates hypothalamic OXT expression which acts as an anti-stressor agent and mediates restored colonic dysmotility following chronic stress. TENS may be useful to treat gastrointestinal symptoms associated with stress.

Plantar pressures are higher in cases with diabetic foot ulcers compared to controls despite a longer stance phase duration.

PubMed

Fernando, Malindu E; Crowther, Robert G; Lazzarini, Peter A; Sangla, Kunwarjit S; Wearing, Scott; Buttner, Petra; Golledge, Jonathan

2016-09-15

Current international guidelines advocate achieving at least a 30 % reduction in maximum plantar pressure to reduce the risk of foot ulcers in people with diabetes. However, whether plantar pressures differ in cases with foot ulcers to controls without ulcers is not clear. The aim of this study was to assess if plantar pressures were higher in patients with active plantar diabetic foot ulcers (cases) compared to patients with diabetes without a foot ulcer history (diabetes controls) and people without diabetes or a foot ulcer history (healthy controls). Twenty-one cases with diabetic foot ulcers, 69 diabetes controls and 56 healthy controls were recruited for this case-control study. Plantar pressures at ten sites on both feet and stance phase duration were measured using a pre-established protocol. Primary outcomes were mean peak plantar pressure, pressure-time integral and stance phase duration. Non-parametric analyses were used with Holm's correction to correct for multiple testing. Binary logistic regression models were used to adjust outcomes for age, sex and body mass index. Median differences with 95 % confidence intervals and Cohen's d values (standardised mean difference) were reported for all significant outcomes. The majority of ulcers were located on the plantar surface of the hallux and toes. When adjusted for age, sex and body mass index, the mean peak plantar pressure and pressure-time integral of toes and the mid-foot were significantly higher in cases compared to diabetes and healthy controls (p < 0.05). The stance phase duration was also significantly higher in cases compared to both control groups (p < 0.05). The main limitations of the study were the small number of cases studied and the inability to adjust analyses for multiple factors. This study shows that plantar pressures are higher in cases with active diabetic foot ulcers despite having a longer stance phase duration which would be expected to lower plantar pressure. Whether plantar pressure changes can predict ulcer healing should be the focus of future research. These results highlight the importance of offloading feet during active ulceration in addition to before ulceration.

Spatial and temporal distribution of rabies in northern Tanzania in the period of 1993-2002.

PubMed

Swai, E S; Moshy, W E; Kaaya, J E; Mtui, P F

2010-01-01

A retrospective study was carried out to investigate the occurrence and distribution patterns of rabies cases in northern Tanzania. Data on laboratory confirmed brain samples and associated case reports submitted to the Arusha Veterinary Investigation Centre, for a period of ten years (1993-2002) was retrieved and reviewed. A total of 98 suspected rabies brain specimens from different animal species and geographical areas were submitted and processed during the period under review. Rabies was confirmed using Fluorescent Antibody Technique test. Of the 98 brain specimens processed, 65 (66.3%) were confirmed to be rabies cases. Canine rabies accounted for 73.8% of the cases and was diagnosed in dogs (43), jackals (4) and hyenas (1). Rabies in wildlife accounted for 5 out of 48 canine confirmed cases. Most of the cases were from Arusha Municipality (20) followed by Arumeru (19), Ngorongoro (9) and Moshi (8) districts. Rabies positive cases in other animal species were in the following order of frequencies: bovine (9 out of 11); feline (5 out of 10); equine (1 out of 2); caprine (2 out of 2). One porcine brain specimen was rabies negative. The high proportion of rabies positive cases confirmed suggests the level of their endemicity in the northern regions of Tanzania. Moreover, the findings highlights the need for sustained surveillance and institution of control measures among dog population and awareness creation particularly among general public and children whom are at high risk of contracting rabies because of their close contact with dogs.

Effect of Periodontal Disease on Preeclampsia

PubMed Central

Sayar, F; Hoseini, M Sadat; Abbaspour, S

2011-01-01

Background: A lot of studies have shown periodontal diseases as a risk factor for adverse pregnancy outcomes. The association between periodontitis and preeclampsia has been studied recently with controversy. Considering the importance of preventing preeclampsia as a dangerous and life-threatening disease in pregnant women, the present study was carried out. Methods: Two hundred and ten pregnant women participated in this case-control study (105 controls & 105 cases) during years 2007 and 2008. Preeclamptic cases were defined as blood pressure ≥140/90mmHg and proteinuria +1. Control group were pregnant women with normal blood pressure without proteinuria. Both groups were examined during 48 hours after child delivery. Plaque Index (PLI), Pocket Depth (PD), Clinical Attachment Level (CAL), Bleeding On Probing (BOP), Gingival Recession (GR) were measured on all teeth except for third molars and recorded as periodontal examination. Data was analyzed using t-test, chi-square, and Mann-Whitney U statistical tests. Results: There was no significant difference between the two study groups for PD. CAL, GR, BOP significantly increased in the case group (P< 0.02). This study showed that preeclamptic cases were more likely to develop periodontal disease (P< 0.0001). Eighty three percent of the control group and 95% of the case group had periodontal disease (P< 0.005) which had shown that preeclamptic cases were 4.1 times more likely to have periodontal disease (OR= 4.1). Conclusion: Preeclamptic cases significantly had higher attachment loss and gingival recession than the control group. PMID:23113094

The Considerations of the Superintendent in the Development of the School Budget during Times of Fiscal Constraint: A Case Study

ERIC Educational Resources Information Center

Witt, Jeffrey

2012-01-01

John Smith is the superintendent of Green Hill Public Schools. This case study follows John through the whole budget process from July 2011 to July 2012. An interpretative perspective was used to tell his story. Ten interviews were given from October 2011 to July 2012. Newspaper articles and the minutes from meetings were analyzed and used as…

MALIGNANT PLEURAL MESOTHELIOMA TREATED IN CLINIC FOR PULMONARY DISEASES AND TUBERCULOSIS “PODHRASTOVI” IN TEN-YEAR PERIOD (FROM 1998 TO 2007)

PubMed Central

Čukić, Vesna; Ustamujić, Aida; Lovre, VLAdimir; Žutić, Hasan; Genjac, Sadika; Mašić - Zečević, Mína

2008-01-01

Malignant pleural mesothelioma (MPM) is the most common primary malign tumour of pleura. The aim of this study was to evaluate cases of MPM diagnosed and treated in Clinic for Pulmonary Diseases and Tuberculosis “Podhrastovi” during ten-year period (1998-2007). Study is retrospective. The patients were analysed according to age, sex, histopathologic type of the tumour, cantonal distribution in Federation of Bosnia and Herzegovina and regimen of treatment. MPM presented 0,72% (0-1,56% per year) of all hospitalised malignant patients, and the greatest number of registered cases was in the year of 2007. The series included 16 male (57,14%) and 12 female (42,86%). Cases over 64 years old were the most frequent (14-50%) than 45-54 years (7--25%). Histopathology types of hospitalised cases of MPM: epitheloid form (8- 28,57%); sarcomatoid form (2- 7,14 %); other forms (18-64,29%). The most patients came from Canton Sarajevo (12-42,86%); ZE-DO canton (8-28,57%) and the UNA-SANA canton (5-17,86%). The therapy applied: chemotherapy (11-39,29%); radiotherapy (3-10,71%); chemotherapy + radiotherapy (4-14,29%); symptomatic therapy (10-35,71 %). PMID:19125709

Pregnancy outcome and obstetric management after vaginal radical trachelectomy.

PubMed

Ma, L-K; Cao, D-Y; Yang, J-X; Liu, J-T; Shen, K; Lang, J-H

2014-10-01

Radical vaginal trachelectomy (VRT) is widely prescribed as a surgical procedure to treat early-stage cervical cancer while preserving fertility. However, the ideal obstetric standard of care for patients who have undergone VRT has not yet been established. Aim of this rerport is to analyze pregnancy outcomes and optimal obstetric management during pregnancy and delivery after vaginal radical trachelectomy (VRT). Forty-six cases of VRT from December 2003 to April 2013 in Peking Union Medical College Hospital were analyzed. The mean age of the patients at the time of VRT was 30.6 years and the mean follow-up time was 39.5 months. Of the 32 patients who attempted to conceive, 12 had 16 successful conceptions. There were two miscarriages and two elective abortions. One case of ectopic pregnancy and one case of second trimester loss occurred in this cohort. Ten cases reached the third trimester. Two patients delivered before 32 weeks, and four before 37 weeks. The total preterm delivery rate was 60%. All ten patients delivered by Cesarean section through a high transverse uterine incision. No uterine rupture or postpartum hemorrhage occurred. There is an increased occurrence of preterm delivery after VRT. Cesarean section after full term pregnancy through a high transverse incision should be considered as a suitable and safe procedure.

Impact of timing of sex education on teenage pregnancy in Nigeria: cross-sectional survey of secondary school students.

PubMed

Ochiogu, Ifeoma N; Miettola, Juhani; Ilika, Amobi L; Vaskilampi, Tuula

2011-06-01

The objective of this study was to explore whether the time at which sex education was provided had any impact on reported cases of unintended pregnancies. A cross-sectional survey of secondary school students and their teachers was conducted using self-administered questionnaires. The participants were 1,234 students aged 14-17 years and 46 teachers in 5 secondary schools in South Eastern Nigeria. The outcome measures were reported pregnancies within the last 3 years by type of school and class level; class level at the time of receiving sex education at school; and age at the time of receiving sex education at home. In all schools, sex education was provided at all the junior and senior secondary school levels (JSS and SSS, respectively). Overall, reported cases of unintended pregnancies were highest among the junior students. In the private schools, four in ten teachers reported pregnancies among JSS 3 students. Almost four in ten teachers in public schools reported pregnancies among JSS 2 students. Of all the students, about three in ten reported pregnancies among JSS 2 and 3 students respectively. At home, sex education was provided at the mean age of 16 years (SD ± 2.2). All participants cited financial need and marital promise as major predisposing factors. About four in ten students did not use contraceptives during their first sexual experience. This study highlights the need to introduce sex education much earlier, possibly before the JSS levels. At home, sex education may have greater impact if provided before the age of 14 years. Efforts should be made to address the factors predisposing to teenage pregnancy.

Local connected fractal dimension analysis in gill of fish experimentally exposed to toxicants.

PubMed

Manera, Maurizio; Giari, Luisa; De Pasquale, Joseph A; Sayyaf Dezfuli, Bahram

2016-06-01

An operator-neutral method was implemented to objectively assess European seabass, Dicentrarchus labrax (Linnaeus, 1758) gill pathology after experimental exposure to cadmium (Cd) and terbuthylazine (TBA) for 24 and 48h. An algorithm-derived local connected fractal dimension (LCFD) frequency measure was used in this comparative analysis. Canonical variates (CVA) and linear discriminant analysis (LDA) were used to evaluate the discrimination power of the method among exposure classes (unexposed, Cd exposed, TBA exposed). Misclassification, sensitivity and specificity, both with original and cross-validated cases, were determined. LCFDs frequencies enhanced the differences among classes which were visually selected after their means, respective variances and the differences between Cd and TBA exposed means, with respect to unexposed mean, were analyzed by scatter plots. Selected frequencies were then scanned by means of LDA, stepwise analysis, and Mahalanobis distance to detect the most discriminative frequencies out of ten originally selected. Discrimination resulted in 91.7% of cross-validated cases correctly classified (22 out of 24 total cases), with sensitivity and specificity, respectively, of 95.5% (1 false negative with respect to 21 really positive cases) and 75% (1 false positive with respect to 3 really negative cases). CVA with convex hull polygons ensured prompt, visually intuitive discrimination among exposure classes and graphically supported the false positive case. The combined use of semithin sections, which enhanced the visual evaluation of the overall lamellar structure; of LCFD analysis, which objectively detected local variation in complexity, without the possible bias connected to human personnel; and of CVA/LDA, could be an objective, sensitive and specific approach to study fish gill lamellar pathology. Furthermore this approach enabled discrimination with sufficient confidence between exposure classes or pathological states and avoided misdiagnosis. Copyright © 2016 Elsevier B.V. All rights reserved.

[Extranodal nasal type NK/T-cell lymphoma: the expression of Epstein-Barr virus latent membrane protein 1 and its significance of prognosis].

PubMed

Zhao, Sha; Liu, Wei-ping; Zhang, Wen-yan; Li, Gan-di

2005-05-01

To investigate the expression and prognostic significance of Epstein-Barr virus latent membrane protein 1 in extranodal nasal type NK/T-cell lymphoma in the Chengdu area. The expression of latent membrane protein-1 (LMP1) was detected by immunohistochemistry (IHC) and DNA-PCR in 67 cases of extranodal nasal type NK/T-cell lymphoma, and the differences in survival rate between positive and negative expression groups of LMP1-protien and LMP1-DNA were analyzed respectively. Ten (14.93%) cases were positive at LMP1-protein level, and fifty-six (83.58%) were positive at LMP1-DNA level. The total expression rate of LMP1 was 83.58%. No statistically significant difference was observed between the expression of LMP1 and prognosis (P = 0.678) and between the expression of LMP1-DNA and prognosis (P = 0.943). LMP1 was shown to be closely associated with extranodal nasal type NK/T-cell lymphoma in Chengdu. The expression rate of LMP1 at protein level was different from that at DNA level. No relationship was found between the prognosis and the LMP1 expression in extranodal nasal type NK/T-cell lymphoma.

Integrating hydrologic and geophysical data to constrain coastal surficial aquifer processes at multiple spatial and temporal scales

USGS Publications Warehouse

Schultz, Gregory M.; Ruppel, Carolyn; Fulton, Patrick; Hyndman, David W.; Day-Lewis, Frederick D.; Singha, Kamini

2007-01-01

Since 1997, repeated, coincident geophysical surveys and extensive hydrologic studies in shallow monitoring wells have been used to study static and dynamic processes associated with surface water-groundwater interaction at a range of spatial scales at the estuarine and ocean boundaries of an undeveloped, permeable barrier island in the Georgia part of the U.S. South Atlantic Bight. Because geophysical and hydrologic data measure different parameters, at different resolution and precision, and over vastly different spatial scales, reconciling the coincident data or even combining complementary inversion, hydrogeochemcial analyses and well-based groundwater monitoring, and, in some cases, limited vegetation mapping to demonstrate the utility of an integrative, multidisciplinary approach for elucidating groundwater processes at spatial scales (tens to thousands of meters) that are often difficult to capture with traditional hydrologic approaches. The case studies highlight regional aquifer characteristics, varying degrees of lateral saltwater intrusion at estuarine boundaries, complex subsurface salinity gradients at the ocean boundary, and imaging of submarsh groundwater discharge and possible free convection in the pore waters of a clastic marsh. This study also documents the use of geophysical techniques for detecting temporal changes in groundwater salinity regimes under natural (not forced) gradients at intratidal to interannual (1998-200 Southeastern U.S.A. drought) time scales.

Macroscopic and histopathological aspects of chemical damage to human tissues depending on the survival time.

PubMed

Amadasi, Alberto; Gentile, Guendalina; Rancati, Alessandra; Zoja, Riccardo

2016-05-01

The ingestion of corrosive substances is a widely treated topic in clinical and forensic practice, as an accidental event or as a consequence of voluntary assumption to commit suicide. However, thorough macroscopic and microscopic surveys focused on the correlation between the ingestion of the substance and different survival times have never been performed. Are the ingestion and the metabolism of the substance within the human tissues still recognizable? How could it be related to death? The study concerns a retrospective analysis on ten cases (two accidental, eight suicides) of lethal ingestion of different types of liquid caustic substances, without instant death and survival times ranging from 12 h to 6 months. For each case, a full autopsy and histological examination of the internal organs were performed. The results showed that the early direct effect of the substances is exerted mainly on the gastrointestinal tract, but as survival time increased, the metabolism of the substance exerted its effects in different target organs. When the cause of death was not directly linkable to the ingestion of the substance (i.e., related to cardiac stress, electrolyte disorders, pneumonia) and macroscopic findings were nonspecific, histological analyses allowed for providing crucial elements towards a link between death and assumption of the substance.

Single-center experience of N-linked Congenital Disorders of Glycosylation with a Summary of Molecularly Characterized Cases in Arabs.

PubMed

Bastaki, Fatma; Bizzari, Sami; Hamici, Sana; Nair, Pratibha; Mohamed, Madiha; Saif, Fatima; Malik, Ethar Mustafa; Al-Ali, Mahmoud Taleb; Hamzeh, Abdul Rezzak

2018-01-01

Congenital disorders of glycosylation (CDG) represent an expanding group of conditions that result from defects in protein and lipid glycosylation. Different subgroups of CDG display considerable clinical and genetic heterogeneity due to the highly complex nature of cellular glycosylation. This is further complicated by ethno-geographic differences in the mutational landscape of each of these subgroups. Ten Arab CDG patients from Latifa Hospital in Dubai, United Arab Emirates, were assessed using biochemical (glycosylation status of transferrin) and molecular approaches (next-generation sequencing [NGS] and Sanger sequencing). In silico tools including CADD and PolyPhen-2 were used to predict the functional consequences of uncovered mutations. In our sample of patients, five novel mutations were uncovered in the genes: MPDU1, PMM2, MAN1B1, and RFT1. In total, 9 mutations were harbored by the 10 patients in 7 genes. These are missense and nonsense mutations with deleterious functional consequences. This article integrates a single-center experience within a list of reported CDG mutations in the Arab world, accompanied by full molecular and clinical details pertaining to the studied cases. It also sheds light on potential ethnic differences that were not noted before in regards to CDG in the Arab world. © 2017 John Wiley & Sons Ltd/University College London.

The First Ten Months of the Rubella Living-Unit

ERIC Educational Resources Information Center

Dolan, William S.

1972-01-01

The first 10 months of a residential school's educational program for preschool rubella children are described, followed by the case studies of the original six children in the program who are all multiply handicapped (deaf blind and mentally handicapped). (CB)

Knowledge Transfer in Electronics: A North African Case.

ERIC Educational Resources Information Center

Benazzouz, Abderrahmane; Baez, Albert

1978-01-01

Describes a project designed to equip Algeria with a training institute for engineers and technicians based on the American experience. Initial and implementation phases of this institute established with the cooperation of ten American universities and industrial firms are presented. (HM)

Case Studies in CAL!

ERIC Educational Resources Information Center

Rogers, David F., Ed.; Smith, P. R., Ed.

1984-01-01

Ten papers focus on applications in specific curriculum areas, modelling and simulation, and computer managed learning. Projects described include voice support for the visually handicapped, distance education, and industrial training, as well as teaching applied mathematics, several facets of engineering, zoology, and, with videodisc, observation…

Hybrid Laser/GMAW of High Strength Steel Gas Transmission Pipelines

DOT National Transportation Integrated Search

2008-07-01

Pipelines will be an integral part of our energy distribution systems for the foreseeable future. Operators are currently considering the installation of tens of billions of dollars of pipeline infrastructure. In a number of cases, the cost of export...

Tetanus after blunt lawn mower trauma

PubMed Central

Normand, Camilla; Fostervold, Aasmund; Haarr, Elin; Skontorp, Marie; Berg, Åse

2015-01-01

A patient presented with tetanus ten days after blunt trauma with a lawn mower. Our case describes the diagnosis and treatment of this patient with an infectious disease commonly seen in the developing world but rarely seen in the developed world. PMID:26793459

Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study.

PubMed

Granerod, Julia; Ambrose, Helen E; Davies, Nicholas Ws; Clewley, Jonathan P; Walsh, Amanda L; Morgan, Dilys; Cunningham, Richard; Zuckerman, Mark; Mutton, Ken J; Solomon, Tom; Ward, Katherine N; Lunn, Michael Pt; Irani, Sarosh R; Vincent, Angela; Brown, David Wg; Crowcroft, Natasha S

2010-12-01

Encephalitis has many causes, but for most patients the cause is unknown. We aimed to establish the cause and identify the clinical differences between causes in patients with encephalitis in England. Patients of all ages and with symptoms suggestive of encephalitis were actively recruited for 2 years (staged start between October, 2005, and November, 2006) from 24 hospitals by clinical staff. Systematic laboratory testing included PCR and antibody assays for all commonly recognised causes of infectious encephalitis, investigation for less commonly recognised causes in immunocompromised patients, and testing for travel-related causes if indicated. We also tested for non-infectious causes for acute encephalitis including autoimmunity. A multidisciplinary expert team reviewed clinical presentation and hospital tests and directed further investigations. Patients were followed up for 6 months after discharge from hospital. We identified 203 patients with encephalitis. Median age was 30 years (range 0-87). 86 patients (42%, 95% CI 35-49) had infectious causes, including 38 (19%, 14-25) herpes simplex virus, ten (5%, 2-9) varicella zoster virus, and ten (5%, 2-9) Mycobacterium tuberculosis; 75 (37%, 30-44) had unknown causes. 42 patients (21%, 15-27) had acute immune-mediated encephalitis. 24 patients (12%, 8-17) died, with higher case fatality for infections from M tuberculosis (three patients; 30%, 7-65) and varicella zoster virus (two patients; 20%, 2-56). The 16 patients with antibody-associated encephalitis had the worst outcome of all groups-nine (56%, 30-80) either died or had severe disabilities. Patients who died were more likely to be immunocompromised than were those who survived (OR = 3·44). Early diagnosis of encephalitis is crucial to ensure that the right treatment is given on time. Extensive testing substantially reduced the proportion with unknown cause, but the proportion of cases with unknown cause was higher than that for any specific identified cause. The Policy Research Programme, Department of Health, UK. Copyright © 2010 Elsevier Ltd. All rights reserved.

Evaluation of a Mesoscale Atmospheric Dispersion Modeling System with Observations from the 1980 Great Plains Mesoscale Tracer Field Experiment. Part I: Datasets and Meteorological Simulations.

NASA Astrophysics Data System (ADS)

Moran, Michael D.; Pielke, Roger A.

1996-03-01

The Colorado State University mesoscale atmospheric dispersion (MAD) numerical modeling system, which consists of a prognostic mesoscale meteorological model coupled to a mesoscale Lagrangian particle dispersion model, has been used to simulate the transport and diffusion of a perfluorocarbon tracer-gas cloud for one afternoon surface release during the July 1980 Great Plains mesoscale tracer field experiment. Ground-level concentration (GLC) measurements taken along arcs of samplers 100 and 600 km downwind of the release site at Norman, Oklahoma, up to three days after the tracer release were available for comparison. Quantitative measures of a number of significant dispersion characteristics obtained from analysis of the observed tracer cloud's moving GLC `footprint' have been used to evaluate the modeling system's skill in simulating this MAD case.MAD is more dependent upon the spatial and temporal structure of the transport wind field than is short-range atmospheric dispersion. For the Great Plains mesoscale tracer experiment, the observations suggest that the Great Plains nocturnal low-level jet played an important role in transporting and deforming the tracer cloud. A suite of ten two- and three-dimensional numerical meteorological experiments was devised to investigate the relative contributions of topography, other surface inhomogeneities, atmospheric baroclinicity, synoptic-scale flow evolution, and meteorological model initialization time to the structure and evolution of the low-level mesoscale flow field and thus to MAD. Results from the ten mesoscale meteorological simulations are compared in this part of the paper. The predicted wind fields display significant differences, which give rise in turn to significant differences in predicted low-level transport. The presence of an oscillatory ageostrophic component in the observed synoptic low-level winds for this case is shown to complicate initialization of the meteorological model considerably and is the likely cause of directional errors in the predicted mean tracer transport. A companion paper describes the results from the associated dispersion simulations.

Pain relief by transcutaneous electric nerve stimulation with bidirectional modulated sine waves in patients with chronic back pain: a randomized, double-blind, sham-controlled study.

PubMed

Shimoji, Koki; Takahashi, Norio; Nishio, Yasuyuki; Koyanagi, Mika; Aida, Sumihisa

2007-01-01

Objectives.  Newly developed bidirectional modulated sine waves (BMW) might provide some derived benefit to patients with low back pain. Pain relief by transcutaneous electric nerve stimulation (TENS) with BMWs was tested. Materials and Methods.  Analgesic effects of BMWs and conventional bidirectional pulsed waves on chronic back pain in 28 patients were compared, and effects of repeated TENS using BMWs on chronic back pain were investigated in 21 patients by means of a randomized double-blind, sham-controlled, parallel-group method. Pain intensity was assessed using numerical rating scale (NRS). Results.  There was significant immediate reduction in NRS in patients receiving BMWs, and 60 min after treatment compared to sham TENS. Weekly repeated treatments using massage and TENS with BMWs for 5 weeks resulted in a decrease of NRS, but there were no significant differences between the TENS plus massage and sham TENS plus massage groups. Conclusions.  This study shows that TENS with BMWs significantly inhibits chronic back pain, and treatment effects are attained within a day. The results also suggest that there were no statistically significant long-term effects of TENS with BMW in the repeated treatment.

A Varian DynaLog file-based procedure for patient dose-volume histogram-based IMRT QA.

PubMed

Calvo-Ortega, Juan F; Teke, Tony; Moragues, Sandra; Pozo, Miquel; Casals-Farran, Joan

2014-03-06

In the present study, we describe a method based on the analysis of the dynamic MLC log files (DynaLog) generated by the controller of a Varian linear accelerator in order to perform patient-specific IMRT QA. The DynaLog files of a Varian Millennium MLC, recorded during an IMRT treatment, can be processed using a MATLAB-based code in order to generate the actual fluence for each beam and so recalculate the actual patient dose distribution using the Eclipse treatment planning system. The accuracy of the DynaLog-based dose reconstruction procedure was assessed by introducing ten intended errors to perturb the fluence of the beams of a reference plan such that ten subsequent erroneous plans were generated. In-phantom measurements with an ionization chamber (ion chamber) and planar dose measurements using an EPID system were performed to investigate the correlation between the measured dose changes and the expected ones detected by the reconstructed plans for the ten intended erroneous cases. Moreover, the method was applied to 20 cases of clinical plans for different locations (prostate, lung, breast, and head and neck). A dose-volume histogram (DVH) metric was used to evaluate the impact of the delivery errors in terms of dose to the patient. The ionometric measurements revealed a significant positive correlation (R² = 0.9993) between the variations of the dose induced in the erroneous plans with respect to the reference plan and the corresponding changes indicated by the DynaLog-based reconstructed plans. The EPID measurements showed that the accuracy of the DynaLog-based method to reconstruct the beam fluence was comparable with the dosimetric resolution of the portal dosimetry used in this work (3%/3 mm). The DynaLog-based reconstruction method described in this study is a suitable tool to perform a patient-specific IMRT QA. This method allows us to perform patient-specific IMRT QA by evaluating the result based on the DVH metric of the planning CT image (patient DVH-based IMRT QA).

Role of transcutaneous electric nerve stimulation in the management of trigeminal neuralgia.

PubMed

Singla, Sanju; Prabhakar, Vikram; Singla, Rajan Kumar

2011-07-01

Trigeminal neuralgia typically involves nerves supplying teeth, jaws and face of older females. Though the etiology is usually obscure, different treatment modalities have been tried for it viz. medicinal treatment, injection alcohol, peripheral neurectomy, rhizotomy, and microvascular decompression etc. Transcutaneous electric nerve stimulation (TENS) is an emerging and promising option for management of such patients. The present study was designed with an aim to study the efficacy of TENS in management of trigeminal neuralgia. The study was conducted on 30 patients of trigeminal neuralgia confirmed by diagnostic nerve block. They were given bursts of TENS for 20-40 days over the path of the affected nerve and subsequently evaluated at 1 month and 3 month intervals by visual analogue scale (VAS), verbal pain scale (VPS), a functional outcome scales for main daily activities like sleep, chewing, talking, or washing face. The results showed that, on VAS, the score decreased from 8.9 (Pre TENS) to 3.1 at 1 month and 1.3 at 3 months, and on VPS, the score decreased from 3.5 (Pre TENS) to 1.2 at 1 month and 0.3 at 3 months. Similarly, a considerable decrease in scores was seen on functional outcome scale for different activities. No side effects like irritation or redness of skin were seen in any of the patients. Thus, TENS was found to be a safe, easily acceptable, and non-invasive outdoor patient department procedure for management of trigeminal neuralgia.

Affordances: Ten Years On

ERIC Educational Resources Information Center

Brown, Jill P.; Stillman, Gloria

2014-01-01

Ten years ago the construct, affordance, was rising in prominence in scholarly literature. A proliferation of different uses and meanings was evident. Beginning with its origin in the work of Gibson, we traced its development and use in various scholarly fields. This paper revisits our original question with respect to its utility in mathematics…

Ten Inquiry Methods Used in Curriculum Studies.

ERIC Educational Resources Information Center

Short, Edmund C.

Ten different methods of inquiry are outlined in this overview of research methodologies currently being employed in the field of curriculum studies: (1) philosophical, (2) historical, (3) scientific, (4) artistic, (5) moral, (6) religious, (7) interpretive, (8) instrumental, (9) deliberative, and (10) action oriented. Each of the 10 methods is…

A Phenomenological Study of an Indonesian Cohort Group's Transformative Learning

ERIC Educational Resources Information Center

Budiraharjo, Markus

2013-01-01

This study was set to investigate how a cohort of ten Indonesian teachers experienced transformations in their teaching professionalism upon receiving an assignment of instructional leadership training to other school leaders. These ten teachers, who came from three different Indonesian Jesuit high schools and one archdiocese-based educational…

Zilpaterol hydrochloride affects cellular muscle metabolism and lipid components of ten different muscles in feedlot heifers

USDA-ARS?s Scientific Manuscript database

This study determined if zilpaterol hydrochloride (ZH) altered muscle metabolism and lipid components of ten muscles. Crossbred heifers were either supplemented with ZH (n = 9) or not (Control; n = 10). Muscle tissue was collected (adductor femoris, biceps femoris, gluteus medius, infraspinatus, lat...

At-Risk Phenotype of Neurofibromatose-1 Patients: A Multicentre Case-Control Study

PubMed Central

2011-01-01

Objectives To assess associations between subcutaneous neurofibromas (SC-NFs) and internal neurofibromas in patients with neurofibromatosis type 1 (NF-1) and to determine whether the association between SC-NFs and peripheral neuropathy was ascribable to internal neurofibromas. Patients and methods Prospective multicentre case-control study. Between 2005 and 2008, 110 NF-1 adults having two or more SC-NFs were individually matched for age, sex and hospital with 110 controls who had no SC-NF. Patients underwent standardized MRI of the spinal cord, nerve roots and sciatic nerves and an electrophysiological study. Analyses used adjusted multinomial logistic regression (ORa) to estimate the risk of the presence of internal neurofibromas or peripheral neuropathies associated with patients presented 2 to 9 SC-NFs, at least 10 SC-NFs as compared to patients without any (referential category). Results Cases had a mean age of 41 (± 13) years; 85 (80%) had two to nine SC-NFs and 21 (19%) at least ten SC-NFs. SC-NFs were more strongly associated with internal neurofibromas in patients with ten or more SC-NFs than in patients with fewer NF-SCs (e.g., sciatic nerve, aOR = 29.1 [8.5 to 100] vs. 4.3 [2.1 to 9.0]). The association with SC-NFs was stronger for diffuse, intradural, and > 3 cm internal neurofibromas than with other internal neurofibromas. Axonal neuropathy with slowed conduction velocities (SCV) was more strongly associated with having at least ten SC-NFs (aOR = 29.9, 5.5 to 162.3) than with having fewer SC-NFs (aOR = 4.4, 0.9 to 22.0). Bivariate analyses showed that the association between axonal neuropathy with SCV and sciatic neurofibromas was mediated by the association between SC-NFs and sciatic neurofibromas. Conclusion The at-risk phenotype of NF-1 patients (i.e. NF-1 patients with SC-NFs) is ascribable to associations linking SC-NFs to internal neurofibromas at risk for malignant transformation and to axonal neuropathies with slowed conduction velocities. Axonal neuropathies with SCV are particularly common in patients with at least ten SC-NFs. Registration details ORPHA86301 PMID:21752287

At-risk phenotype of neurofibromatose-1 patients: a multicentre case-control study.

PubMed

Sbidian, Emilie; Bastuji-Garin, Sylvie; Valeyrie-Allanore, Laurence; Ferkal, Salah; Lefaucheur, Jean P; Drouet, Alain; Brugière, Pierre; Vialette, Cédric; Combemale, Patrick; Barbarot, Sébastien; Wolkenstein, Pierre

2011-07-13

To assess associations between subcutaneous neurofibromas (SC-NFs) and internal neurofibromas in patients with neurofibromatosis type 1 (NF-1) and to determine whether the association between SC-NFs and peripheral neuropathy was ascribable to internal neurofibromas. Prospective multicentre case-control study. Between 2005 and 2008, 110 NF-1 adults having two or more SC-NFs were individually matched for age, sex and hospital with 110 controls who had no SC-NF. Patients underwent standardized MRI of the spinal cord, nerve roots and sciatic nerves and an electrophysiological study. Analyses used adjusted multinomial logistic regression (ORa) to estimate the risk of the presence of internal neurofibromas or peripheral neuropathies associated with patients presented 2 to 9 SC-NFs, at least 10 SC-NFs as compared to patients without any (referential category). Cases had a mean age of 41 (± 13) years; 85 (80%) had two to nine SC-NFs and 21 (19%) at least ten SC-NFs. SC-NFs were more strongly associated with internal neurofibromas in patients with ten or more SC-NFs than in patients with fewer NF-SCs (e.g., sciatic nerve, aOR = 29.1 [8.5 to 100] vs. 4.3 [2.1 to 9.0]). The association with SC-NFs was stronger for diffuse, intradural, and > 3 cm internal neurofibromas than with other internal neurofibromas. Axonal neuropathy with slowed conduction velocities (SCV) was more strongly associated with having at least ten SC-NFs (aOR = 29.9, 5.5 to 162.3) than with having fewer SC-NFs (aOR = 4.4, 0.9 to 22.0). Bivariate analyses showed that the association between axonal neuropathy with SCV and sciatic neurofibromas was mediated by the association between SC-NFs and sciatic neurofibromas. The at-risk phenotype of NF-1 patients (i.e. NF-1 patients with SC-NFs) is ascribable to associations linking SC-NFs to internal neurofibromas at risk for malignant transformation and to axonal neuropathies with slowed conduction velocities. Axonal neuropathies with SCV are particularly common in patients with at least ten SC-NFs.

Age Group Comparisons of TENS Response Among Individuals With Chronic Axial Low Back Pain.

PubMed

Simon, Corey B; Riley, Joseph L; Fillingim, Roger B; Bishop, Mark D; George, Steven Z

2015-12-01

Chronic low back pain (CLBP) is a highly prevalent and disabling musculoskeletal pain condition among older adults. Transcutaneous electrical nerve stimulation (TENS) is commonly used to treat CLBP, however response to TENS in older adults compared with younger adults is untested. In a dose-response study stratified by age, 60 participants with axial CLBP (20 young, 20 middle-aged, 20 older) received four 20-minute sessions of high-frequency high-intensity TENS over a 2- to 3-week period in a laboratory-controlled setting. Experimental measures of pain sensitivity (mechanical pressure pain detection threshold) and central pain excitability (phasic heat temporal summation and heat aftersensations) were assessed before and after TENS. Episodic or immediate axial CLBP relief was assessed after TENS via measures of resting pain, movement-evoked-pain, and self-reported disability. Cumulative or prolonged axial CLBP relief was assessed by comparing daily pain reports across sessions. Independent of age, individuals experienced episodic increase in the pressure pain detection threshold and reduction in aftersensation after TENS application. Similarly, all groups, on average, experienced episodic axial CLBP relief via improved resting pain, movement-evoked pain, and disability report. Under this design, no cumulative effect was observed as daily pain did not improve for any age group across the 4 sessions. However, older adults received higher TENS amplitude across all sessions to achieve TENS responses similar to those in younger adults. These findings suggest that older adults experience similar episodic axial CLBP relief to that of younger individuals after high-frequency, high-intensity TENS when higher dose parameters are used. This study examined age group differences in experimental and axial CLBP response to TENS, delivered under the current recommended parameters of strong, but tolerable amplitude. Older adults had comparable TENS response although at higher TENS amplitude than younger adults, which may have important mechanistic and clinical implications. Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.

Domestic violence in Singapore: a ten year comparison of victim profile.

PubMed

Foo, C L; Seow, E

2005-02-01

To investigate whether the profile of female victims of domestic violence in Singapore has changed over the past ten years. 163 female victims of domestic violence presenting to an emergency department in Singapore were surveyed. The survey included information on the victims' demographics, assault characteristics and knowledge of help services. The results were compared against a similar survey done locally ten years ago, which involved 233 victims. There were no significant differences in the racial composition, marital status, weapon use and admission rates of victims ten years on. However, a significantly higher proportion of female victims in 2002 knew where to seek help, compared to a decade ago (50.9 percent versus 20.6 percent, p-value is less than 0.0001). The proportion of victims with an awareness of community and legal help services has more than doubled over the past ten years.

Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults.

PubMed

Hurlow, Adam; Bennett, Michael I; Robb, Karen A; Johnson, Mark I; Simpson, Karen H; Oxberry, Stephen G

2012-03-14

Cancer-related pain is complex and multi-dimensional but the mainstay of cancer pain management has predominantly used a biomedical approach. There is a need for non-pharmacological and innovative approaches. Transcutaneous Electric Nerve Stimulation (TENS) may have a role in pain management but the effectiveness of TENS is currently unknown. This is an update of the original review published in Issue 3, 2008. The aim of this systematic review was to determine the effectiveness of TENS for cancer-related pain in adults. The initial review searched The Cochrane Library, MEDLINE, EMBASE, CINAHL, PsychINFO, AMED and PEDRO databases in April 2008. We performed an updated search of CENTRAL, MEDLINE, EMBASE, CINAHL and PEDRO databases in November 2011. We included only randomised controlled trials (RCTS) investigating the use of TENS for the management of cancer-related pain in adults. The search strategy identified a further two studies for possible inclusion. One of the review authors screened each abstract using a study eligibility tool. Where eligibility could not be determined, a second author assessed the full paper. One author used a standardised data extraction sheet to collect information on the studies and independently assess the quality of the studies using the validated five-point Oxford Quality Scale. The small sample sizes and differences in patient study populations of the three included studies (two from the original review and a third included in this update) prevented meta-analysis. For the original review the search strategy identified 37 possible published studies; we divided these between two pairs of review authors who decided on study selection; all four review authors discussed and agreed final scores. Only one additional RCT met the eligibility criteria (24 participants) for this updated review. Although this was a feasibility study, not designed to investigate intervention effect, it suggested that TENS may improve bone pain on movement in a cancer population. The initial review identified two RCTs (64 participants) therefore this review now includes a total of three RCTs (88 participants). These studies were heterogenous with respect to study population, sample size, study design, methodological quality, mode of TENS, treatment duration, method of administration and outcome measures used. In one RCT, there were no significant differences between TENS and placebo in women with chronic pain secondary to breast cancer treatment. In the other RCT, there were no significant differences between acupuncture-type TENS and sham in palliative care patients; this study was underpowered. Despite the one additional RCT, the results of this updated systematic review remain inconclusive due to a lack of suitable RCTs. Large multi-centre RCTs are required to assess the value of TENS in the management of cancer-related pain in adults.

A comparison study of immune-inflammatory response in electroacupuncture and transcutaneous electrical nerve stimulation for patients undergoing supratentorial craniotomy

PubMed Central

Li, Guoyan; Li, Shuqin; Sun, Lizhi; Lin, Fangcai; Wang, Baoguo

2015-01-01

Objective: The effect of transcutaneous electrical nerve stimulation (TENS) on immuno-inflammatory response was tested and the differences between electroacupuncture (EA) and TENS in immuno-inflammatory response in patients undergoing supratentorial craniotomy were explored. Methods: 51 patients received craniotomy were randomly divided into 3 groups: control (group C, n=18), EA (group A, n=19) and TENS (group T, n=14) groups. Blood samples were collected before anesthesia (T0) and 30 min (T1), 2 h (T2) and 4 h (T3) after induction of anesthesia to measure the levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-8, IL-10, IgM, IgA and IgG. Results: No significant difference existed between group A and group T during craniotomy. IgM and IgA decreased significantly in group C compared with groups A and T at T2 and T3 time points. Compared with group C, there were significant differences in TNF-α, IgM and IgA levels at T0 in groups A and T; no significant difference was found in the levels of IgG, IL-10 and IL-8. Conclusion: EA and TENS could reduce immunosuppression in patients undergoing supratentorial craniotomy and it has significance in choice of treatment in immunosuppressive therapy. PMID:25785107

A comparison study of immune-inflammatory response in electroacupuncture and transcutaneous electrical nerve stimulation for patients undergoing supratentorial craniotomy

PubMed Central

Li, Guoyan; Li, Shuqin; Sun, Lizhi; Lin, Fangcai; Wang, Baoguo

2015-01-01

Objective: The effect of transcutaneous electrical nerve stimulation (TENS) on immuno-inflammatory response was tested and the differences between electroacupuncture (EA) and TENS in immuno-inflammatory response in patients undergoing supratentorial craniotomy were explored. Methods: 51 patients received craniotomy were divided randomly into 3 groups: control (group C, n=18), EA (group A, n=19) and TENS (group T, n=14) groups. Blood samples were collected before anesthesia (T0) and 30 min (T1), 2 h (T2) and 4 h (T3) after induction of anesthesia to measure the levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-8, IL-10, IgM, IgA and IgG.. Results: No significant difference existed between groups A and group T during craniotomy. IgM and IgA decreased significantly in group C compared with groups A and T at T2 and T3 time points. Compared with group C, there were significant difference in TNF-α, IgM and IgA level at T0 in groups A and T; no significant difference was found in the levels of IgG, IL-10 and IL-8. Conclusion: EA and TENS could reduce immunosuppression in patients undergoing supratentorial craniotomy and it has significance in choice of treatment in immunosuppressive therapy. PMID:25932216

Group A streptococcal infections during the seasonal influenza outbreak 2010/11 in South East England.

PubMed

Scaber, J; Saeed, S; Ihekweazu, C; Efstratiou, A; McCarthy, N; O'Moore, E

2011-02-03

We present a series of 19 cases of invasive Group A streptococcal (iGAS) infection reported to the Thames Valley Health Protection Unit from 1 December 2010 to 15 January 2011. Ten patients died and a prodrome of influenza-like illness was reported in 14 cases.Influenza B co-infection was confirmed in four cases,three of which were fatal. Our report provides further evidence that influenza B co-infection with iGAS has the potential to cause significant morbidity and mortality.

Nineteen Cases of Plague in Arizona

PubMed Central

Welty, Thomas K.; Grabman, James; Kompare, Edward; Wood, Garland; Welty, Edith; Van Duzen, Jean; Rudd, Patrick; Poland, Jack

1985-01-01

We review the cases of 19 successfully treated plague patients, with emphasis on the clinical and epidemiologic features of the disease. Proper staining and culturing of bubo aspirates; prompt institution of streptomycin, chloramphenicol or tetracycline therapy in presumptive cases, and supportive care are the crucial factors in the treatment of plague. This disease should be considered in patients in a toxic condition who have lymphadenitis, pneumonia or septic shock and who have been in endemic areas within the past ten days. ImagesFigure 1.Figure 2.Figure 3.Figure 4. PMID:4013279

Modulation of spinal inhibitory reflexes depends on the frequency of transcutaneous electrical nerve stimulation in spastic stroke survivors.

PubMed

Koyama, Soichiro; Tanabe, Shigeo; Takeda, Kazuya; Sakurai, Hiroaki; Kanada, Yoshikiyo

2016-03-01

Neurophysiological studies in healthy subjects suggest that increased spinal inhibitory reflexes from the tibialis anterior (TA) muscle to the soleus (SOL) muscle might contribute to decreased spasticity. While 50 Hz is an effective frequency for transcutaneous electrical nerve stimulation (TENS) in healthy subjects, in stroke survivors, the effects of TENS on spinal reflex circuits and its appropriate frequency are not well known. We examined the effects of different frequencies of TENS on spinal inhibitory reflexes from the TA to SOL muscle in stroke survivors. Twenty chronic stroke survivors with ankle plantar flexor spasticity received 50-, 100-, or 200-Hz TENS over the deep peroneal nerve (DPN) of the affected lower limb for 30 min. Before and immediately after TENS, reciprocal Ia inhibition (RI) and presynaptic inhibition of the SOL alpha motor neuron (D1 inhibition) were assessed by adjusting the unconditioned H-reflex amplitude. Furthermore, during TENS, the time courses of spinal excitability and spinal inhibitory reflexes were assessed via the H-reflex, RI, and D1 inhibition. None of the TENS protocols affected mean RI, whereas D1 inhibition improved significantly following 200-Hz TENS. In a time-series comparison during TENS, repeated stimulation did not produce significant changes in the H-reflex, RI, or D1 inhibition regardless of frequency. These results suggest that the frequency-dependent effect of TENS on spinal reflexes only becomes apparent when RI and D1 inhibition are measured by adjusting the amplitude of the unconditioned H-reflex. However, 200-Hz TENS led to plasticity of synaptic transmission from the antagonist to spastic muscles in stroke survivors.

Reconstructing recent volcanic histories from high-resolution AUV sidescan sonar imagery

NASA Astrophysics Data System (ADS)

Yeo, I. A.

2016-12-01

Detecting high-resolution differences in age between young basaltic lava flows on the seafloor is notoriously difficult. However, using sediment thickness as a proxy for age it is possible to derive information on spatial extents, surface morphologies and lava flow age simultaneously using high-resolution sidescan sonar imagery. Ground truthing of this new method on cruise POS502 (July 2016) using photogrammetry from ROV cameras has provided constraints on the method allowing the detailed morphological changes and sediment cover thicknesses to be calibrated to produce reliable, quantitative ages for individual flow units. Sediment thickness is shown to be the primary controlling factor in backscatter intensity in most cases, although sediment redistribution by different flow morphologies can also affect the recorded reflection amplitudes. Seafloor lava flows were found to be very morphologically complicated on small scales, which may explain their relative unimportance when amplitude values are averaged over several tens of meters.

Impairment of retinal increment thresholds in Huntington's disease.

PubMed

Paulus, W; Schwarz, G; Werner, A; Lange, H; Bayer, A; Hofschuster, M; Müller, N; Zrenner, E

1993-10-01

We have investigated detection thresholds for a foveal blue test light using a Maxwellian view system in 61 normal subjects, 19 patients with Huntington's chorea, 14 patients with Tourette's syndrome, and 20 patients with schizophrenia. Ten measurements were made: The blue test light (1 degree diameter, 500 msec duration) was presented either superimposed on a yellow adaptation field (5 degree diameter) or 500 msec after switching off this field (transient tritanopia effect). In both cases five different background intensities were presented. The only abnormality found was in patients with Huntington's chorea. During adaptation these patients' thresholds are significantly higher than normal (p < 0.005). No change was found in the transient tritanopia effect. Huntington's disease causes degeneration of several different transmitter systems in the brain. Increment threshold testing allows for noninvasive investigation of patients and confirms the involvement of the retina in the degenerative process in Huntington's chorea.

The Effects of Domestic Energy Consumption on Urban Development Using System Dynamics

NASA Astrophysics Data System (ADS)

Saryazdi, M. D.; Homaei, N.; Arjmand, A.

2018-05-01

In developed countries, people have learned to follow efficient consumption patterns, while in developing countries, such as Iran, these patterns are not well executed. A large amount of energy is almost consumed in buildings and houses and though the consumption patterns varies in different societies, various energy policies are required to meet the consumption challenges. So far, several papers and more than ten case studies have worked on the relationship between domestic energy consumption and urban development, however these researches did not analyzed the impact of energy consumption on urban development. Therefore, this paper attempts to examine the interactions between the energy consumption and urban development by using system dynamics as the most widely used methods for complex problems. The proposed approach demonstrates the interactions using causal loop and flow diagrams and finally, suitable strategies will be proposed for urban development through simulations of different scenarios.

Forensic SNP Genotyping with SNaPshot: Development of a Novel In-house SBE Multiplex SNP Assay.

PubMed

Zar, Mian Sahib; Shahid, Ahmad Ali; Shahzad, Muhammad Saqib; Shin, Kyoung-Jin; Lee, Hwan Young; Lee, Sang-Seob; Israr, Muhammad; Wiegand, Peter; Kulstein, Galina

2018-04-10

This study introduces a newly developed in-house SNaPshot single-base extension (SBE) multiplex assay for forensic single nucleotide polymorphism (SNP) genotyping of fresh and degraded samples. The assay was validated with fresh blood samples from four different populations. In addition, altogether 24 samples from skeletal remains were analyzed with the multiplex. Full SNP profiles could be obtained from 14 specimens, while ten remains showed partial SNP profiles. Minor allele frequencies (MAF) of bone samples and different populations were compared and used for association of skeletal remains with a certain population. The results reveal that the SNPs of the bone samples are genetically close to the Pathan population. The findings show that the new multiplex system can be utilized for SNP genotyping of degraded and forensic relevant skeletal material, enabling to provide additional investigative leads in criminal cases. © 2018 American Academy of Forensic Sciences.

Cariogenic potential of stored human milk--an in-vitro study.

PubMed

Hegde, Amitha M; Vikyath, Rani

2007-01-01

Human milk samples collected from ten lactating mothers in the K. S. Hegde Medical Hospital, Mangalore were divided into five different parts and stored at different temperatures for varying durations. The pH, buffer capacity and growth of Streptococcus mutans were assessed in each of these samples. There was a fall in pH of human milk stored at various temperatures. The buffer capacity of human milk increased with duration of storage. There was an increase in Streptococcus colony count in stored human milk proportional to the duration of storage and it increased more rapidly in case of milk stored at higher temperatures (0 degrees C - 4 degrees C) compared to the milk stored in the freezer (-19 degrees C). Milk samples stored at room temperature for 6 hours and in the freezer at -19 degrees C for 2 weeks were found to be relatively safe.

[Imaging of surface cell antigens on the tumor sections of lymph nodes using fluorescence quantum dots].

PubMed

Rafalovskaia-Orlovskaia, E P; Gorgidze, L A; Gladkikh, A A; Tauger, S M; Vorob'ev, I A

2012-01-01

The usefulness of quantum dots for the immunofluorescent detection of surface antigens on the lymphoid cells has been studied. To optimize quantum dots detection we have upgraded fluorescent microscope that allows obtaining multiple images from different quantum dots from one section. Specimens stained with quantum dots remained stable over two weeks and practically did not bleach under mercury lamp illumination during tens of minutes. Direct conjugates of primary mouse monoclonal antibodies with quantum dots demonstrated high specificity and sufficient sensitivity in the case of double staining on the frozen sections. Because of the high stability of quantum dots' fluorescence, this method allows to analyze antigen coexpression on the lymphoid tissue sections for diagnostic purposes. The spillover of fluorescent signals from quantum dots into adjacent fluorescent channels, with maxima differing by 40 nm, did not exceed 8%, which makes the spectral compensation is practically unnecessary.

Optimization algorithms for large-scale multireservoir hydropower systems

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

Hiew, K.L.

Five optimization algorithms were vigorously evaluated based on applications on a hypothetical five-reservoir hydropower system. These algorithms are incremental dynamic programming (IDP), successive linear programing (SLP), feasible direction method (FDM), optimal control theory (OCT) and objective-space dynamic programming (OSDP). The performance of these algorithms were comparatively evaluated using unbiased, objective criteria which include accuracy of results, rate of convergence, smoothness of resulting storage and release trajectories, computer time and memory requirements, robustness and other pertinent secondary considerations. Results have shown that all the algorithms, with the exception of OSDP converge to optimum objective values within 1.0% difference from one another.more » The highest objective value is obtained by IDP, followed closely by OCT. Computer time required by these algorithms, however, differ by more than two orders of magnitude, ranging from 10 seconds in the case of OCT to a maximum of about 2000 seconds for IDP. With a well-designed penalty scheme to deal with state-space constraints, OCT proves to be the most-efficient algorithm based on its overall performance. SLP, FDM, and OCT were applied to the case study of Mahaweli project, a ten-powerplant system in Sri Lanka.« less

Malformation of the eighth cranial nerve in children.

PubMed

de Paula-Vernetta, Carlos; Muñoz-Fernández, Noelia; Mas-Estellés, Fernando; Guzmán-Calvete, Abel; Cavallé-Garrido, Laura; Morera-Pérez, Constantino

2016-01-01

Prevalence of congenital sensorineural hearing loss (SNHL) is approximately 1.5-6 in every 1,000 newborns. Dysfunction of the auditory nerve (auditory neuropathy) may be involved in up to 1%-10% of cases; hearing losses because of vestibulocochlear nerve (VCN) aplasia are less frequent. The objectives of this study were to describe clinical manifestations, hearing thresholds and aetiology of children with SNHL and VCN aplasia. We present 34 children (mean age 20 months) with auditory nerve malformation and profound HL taken from a sample of 385 children implanted in a 10-year period. We studied demographic characteristics, hearing, genetics, risk factors and associated malformations (Casselman's and Sennaroglu's classifications). Data were processed using a bivariate descriptive statistical analysis (P<.05). Of all the cases, 58.8% were bilateral (IIa/IIa and I/I were the most common). Of the unilateral cases, IIb was the most frequent. Auditory screening showed a sensitivity of 77.4%. A relationship among bilateral cases and systemic pathology was observed. We found a statistically significant difference when comparing hearing loss impairment and patients with different types of aplasia as defined by Casselman's classification. Computed tomography (CT) scan yielded a sensitivity of 46.3% and a specificity of 85.7%. However, magnetic resonance imaging (MRI) was the most sensitive imaging test. Ten percent of the children in a cochlear implant study had aplasia or hypoplasia of the auditory nerve. The degree of auditory loss was directly related to the different types of aplasia (Casselman's classification) Although CT scan and MRI are complementary, the MRI is the test of choice for detecting auditory nerve malformation. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

INTEROCC case-control study: lack of association between glioma tumors and occupational exposure to selected combustion products, dusts and other chemical agents.

PubMed

Lacourt, Aude; Cardis, Elisabeth; Pintos, Javier; Richardson, Lesley; Kincl, Laurel; Benke, Geza; Fleming, Sarah; Hours, Martine; Krewski, Daniel; McLean, Dave; Parent, Marie-Elise; Sadetzki, Siegal; Schlaefer, Klaus; Schlehofer, Brigitte; Lavoue, Jerome; van Tongeren, Martie; Siemiatycki, Jack

2013-04-12

The aim was to investigate possible associations between glioma (an aggressive type of brain cancer) and occupational exposure to selected agents: combustion products (diesel and gasoline exhaust emissions, benzo(a)pyrene), dusts (animal dust, asbestos, crystalline silica, wood dust) and some other chemical agents (formaldehyde, oil mist, sulphur dioxide). The INTEROCC study included cases diagnosed with glioma during 2000-2004 in sub-regions of seven countries. Population controls, selected from various sampling frames in different centers, were frequency or individually matched to cases by sex, age and center. Face-to-face interviews with the subject or a proxy respondent were conducted by trained interviewers. Detailed information was collected on socio-economic and lifestyle characteristics, medical history and work history. Occupational exposure to the 10 selected agents was assessed by a job exposure matrix (JEM) which provides estimates of the probability and level of exposure for different occupations. Using a 25% probability of exposure in a given occupation in the JEM as the threshold for considering a worker exposed, the lifetime prevalence of exposure varied from about 1% to about 15% for the different agents. Associations between glioma and each of the 10 agents were estimated by conditional logistic regression, and using three separate exposure indices: i) ever vs. never; ii) lifetime cumulative exposure; iii) total duration of exposure. The study sample consisted of 1,800 glioma cases and 5,160 controls. Most odds ratio estimates were close to the null value. None of the ten agents displayed a significantly increased odds ratio nor any indication of dose-response relationships with cumulative exposure or with duration of exposure. Thus, there was no evidence that these exposures influence risk of glioma.

RFI flagging implications for short-duration transients

NASA Astrophysics Data System (ADS)

Cendes, Y.; Prasad, P.; Rowlinson, A.; Wijers, R. A. M. J.; Swinbank, J. D.; Law, C. J.; van der Horst, A. J.; Carbone, D.; Broderick, J. W.; Staley, T. D.; Stewart, A. J.; Huizinga, F.; Molenaar, G.; Alexov, A.; Bell, M. E.; Coenen, T.; Corbel, S.; Eislöffel, J.; Fender, R.; Grießmeier, J.-M.; Jonker, P.; Kramer, M.; Kuniyoshi, M.; Pietka, M.; Stappers, B.; Wise, M.; Zarka, P.

2018-04-01

With their wide fields of view and often relatively long coverage of any position in the sky in imaging survey mode, modern radio telescopes provide a data stream that is naturally suited to searching for rare transients. However, Radio Frequency Interference (RFI) can show up in the data stream in similar ways to such transients, and thus the normal pre-treatment of filtering RFI (flagging) may also remove astrophysical transients from the data stream before imaging. In this paper we investigate how standard flagging affects the detectability of such transients by examining the case of transient detection in an observing mode used for Low Frequency Array (LOFAR; van Haarlem et al., 2013) surveys. We quantify the fluence range of transients that would be detected, and the reduction of their SNR due to partial flagging. We find that transients with a duration close to the integration sampling time, as well as bright transients with durations on the order of tens of seconds, are completely flagged. For longer transients on the order of several tens of seconds to minutes, the flagging effects are not as severe, although part of the signal is lost. For these transients, we present a modified flagging strategy which mitigates the effect of flagging on transient signals. We also present a script which uses the differences between the two strategies, and known differences between transient RFI and astrophysical transients, to notify the observer when a potential transient is in the data stream.

Diode laser surgery. Ab interno and ab externo versus conventional surgery in rabbits.

PubMed

Karp, C L; Higginbotham, E J; Edward, D P; Musch, D C

1993-10-01

Fibroblastic proliferation of subconjunctival tissues remains a primary mechanism of failure in filtration surgery. Minimizing the surgical manipulation of episcleral tissues may reduce scarring. Laser sclerostomy surgery involves minimal tissue dissection, and is gaining attention as a method of potentially improving filter duration in high-risk cases. Twenty-five New Zealand rabbits underwent filtration surgery in one eye, and the fellow eye remained as the unoperated control. Ten rabbits underwent ab externo diode laser sclerostomy surgery, ten underwent ab interno diode sclerostomy surgery, and five had posterior sclerostomy procedures. Filtration failure was defined as a less-than-4-mmHg intraocular pressure (IOP) difference between the operative and control eyes. The mean time to failure for the ab externo, ab interno, and conventional posterior sclerostomy techniques measured 17.4 +/- 11.5, 13.1 +/- 6.7, and 6.0 +/- 3.1 days, respectively. In a comparison of the laser-treated groups with the conventional procedure, the time to failure was significantly longer (P = 0.02) for the ab externo filter. The mean ab interno sclerostomy duration was longer than the posterior lip procedure, but this difference was not statistically significant (P = 0.15). The overall level of IOP reduction was similar in the three groups. These data suggest that diode laser sclerostomy is a feasible technique in rabbits, and the ab externo approach resulted in longer filter duration than the conventional posterior lip procedure in this model.

Technology Enabled Learning. Symposium.

ERIC Educational Resources Information Center

2002

This document contains three papers on technology-enabled learning and human resource development. Among results found in "Current State of Technology-enabled Learning Programs in Select Federal Government Organizations: a Case Study of Ten Organizations" (Letitia A. Combs) are the following: the dominant delivery method is traditional…

High-frequency transcutaneous electrical nerve stimulation alleviates spasticity after spinal contusion by inhibiting activated microglia in rats.

PubMed

Hahm, Suk-Chan; Yoon, Young Wook; Kim, Junesun

2015-05-01

Transcutaneous electrical nerve stimulation (TENS) can be used as a physical therapy for spasticity, but the effects of TENS on spasticity and its underlying mechanisms remain unclear. The purpose of this study was to test the effects of TENS on spasticity and the role of activated microglia as underlying mechanisms of TENS treatment for spasticity in rats with a 50-mm contusive spinal cord injury (SCI). A spinal contusion was made at the T12 spinal segment in adult male Sprague-Dawley rats using the NYU impactor. Behavioral tests for motor function were conducted before and after SCI and before and after TENS application. To assess spasticity, the modified Ashworth scale (MAS) was used before and after SCI, high-frequency (HF)/low-frequency (LF) TENS application at 3 different intensities (motor threshold [MT], 50% and 90% MT) or minocycline administration. Immunohistochemistry for microglia was performed at the lumbar spinal segments. Motor recovery reached a plateau approximately 28 days after SCI. Spasticity was well developed and was sustained above the MAS grade of 3, beginning at 28 days after SCI. HF-TENS at 90% MT significantly alleviated spasticity. Motor function did not show any significant changes with LF- or HF-TENS treatment. HF-TENS significantly reduced the proportion of activated microglia observed after SCI. Minocycline, the microglia inhibitor, also significantly alleviated spasticity with the reduction of activated microglia expression. These results suggest that HF-TENS at 90% MT alleviates spasticity in rats with SCI by inhibiting activated microglia. © The Author(s) 2014.

Electrical stimulation of acupuncture points and blood pressure responses to postural changes: a pilot study.

PubMed

Jones, Alice Y M; Kwan, Y L; Leung, Nathan T F; Yu, Rachel P W; Wu, Cindy M Y; Warburton, Darren E R

2011-05-01

Application of transcutaneous electrical stimulation over acupuncture points (Acu-TENS) facilitates heart rate recovery after exercise and restores hemodynamic stability after open heart surgery. The role of Acu-TENS on cardiovascular parameters in response to postural changes has not been reported. To investigate (1) the effect of Acu-TENS on blood pressure responses to -10º head-down postural change and (2) whether such effects were associated with modulation by the autonomic nervous system. Sixteen healthy volunteers, mean age 22.8 (SD, 3.1) years, were subjected to a -10º head-down tilt from the supine position on 3 separate occasions and received in random order the following 3 intervention protocols for 40 minutes before the postural change: Acu-TENS (over bilateral acupuncture points, PC6), sham-TENS (TENS applied to the skin over the patellae), and control (no electrical output from the TENS device applied at PC6). Mean arterial pressure, large artery elasticity index, cardiac output, and heart rate were recorded and compared at different stimulation protocols in the supine and -10º head-down tilt positions. Spectral analysis of heart rate variability was used to determine any modulation by the autonomic nervous system. Change in large artery elasticity index was observed only in the Acu-TENS group (P < .05) and mean arterial pressure appeared most stable during Acu-TENS. Autonomic nervous system modulation was not apparent with spectral analysis, irrespective of intervention. Sympathetic activity predominated in all positions. Acu-TENS seems to reduce blood pressure changes with -10º head-down tilt with concomitant changes in arterial vessel tone.

Effectiveness of diadynamic currents and transcutaneous electrical nerve stimulation in disc disease lumbar part of spine.

PubMed

Ratajczak, Barbara; Hawrylak, Arletta; Demidaś, Aneta; Kuciel-Lewandowska, Jadwiga; Boerner, Ewa

2011-01-01

Back pain has multi-factorial etiology and is modified by environmental influences, character of work, and individual predispositions. The aim of this study was to compare the efficiency of analgesic DD current therapy and TENS in low back discopathy. Eighty patients (age, 45-60 years) with diagnosed low back pain syndrome due to discopathy were subjected to therapy. In the first group (DD) of 40 people, DD current therapy was applied. In the second group (TENS) of 40 people, TENS was applied. The third group of 40 people was a control group in which a functional fitness test was performed for comparison purposes. The control group was in this case an equivalent to a norm. Before the beginning and on the completion of therapy in all patients, a pain level measurement and functional fitness test were performed. On the basis of research conducted it was stated that both therapies reduce pain level effectively. Obtained analyzed results conclude that both therapies applied have an analgesic effect. DD current and TENS therapies in low back discopathy have an analgesic impact and improve functional fitness. The applied therapies have a comparable impact on researched parameters.

A case of metastatic lobular breast carcinoma with detection of the primary tumor after ten years.

PubMed

Kobayashi, Tetsuro; Adachi, Shiro; Matsuda, Yasuki; Tominaga, Syusei

2007-01-01

Lobular carcinoma of the breast is known to metastasize to unusual sites such as the gastrointestinal tract, peritoneum, and gynecologic organs. We report a patient with intraperitoneal metastases from lobular carcinoma who was originally treated for an unknown primary cancer. Ten years later, a tumor was found in her left breast and the diagnosis was changed to peritoneal metastases from invasive lobular carcinoma. Immunohistochemistry revealed that the metastases were high molecular weight cytokeratin (CK34betaE12) and estrogen receptor-positive, but were E-cadherin-negative. These results assisted in diagnosis. Surgeons should be aware of the characteristics of metastasis lobular carcinoma.

Elastic Stable Intramedullary Nailing (ESIN), Orthoss® and Gravitational Platelet Separation - System (GPS®): An effective method of treatment for pathologic fractures of bone cysts in children

PubMed Central

2011-01-01

Background The different treatment strategies for bone cysts in children are often associated with persistence and high recurrence rates of the lesions. The safety and clinical outcomes of a combined mechanical and biological treatment with elastic intramedullary nailing, artificial bone substitute and autologous platelet rich plasma are evaluated. Methods From 02/07 to 01/09 we offered all children with bone cysts the treatment combination of elastic intramedullary nailing (ESIN), artificial bone substitute (Orthoss®) and autologous platelet rich plasma, concentrated by the Gravitational Platelet Separation (GPS®) - System. All patients were reviewed radiologically for one year following the removal of the intramedullary nailing, which was possible because of cyst obliteration. Results A cohort of 12 children (4 girls, 8 boys) was recruited. The mean patient age was 11.4 years (range 7-15 years). The bone defects (ten humeral, two femoral) included eight juvenile and four aneurysmal bone cysts. Five patients suffered from persistent cysts following earlier unsuccessful treatment of humeral bone cyst after pathologic fracture; the other seven presented with acute pathologic fractures. No peri- or postoperative complications occurred. The radiographic findings showed a total resolution of the cysts in ten cases (Capanna Grade 1); in two cases a small residual cyst remained (Capanna Grade 2). The intramedullary nails were removed six to twelve months (mean 7.7) after the operation; in one case, a fourteen year old boy (Capanna Grade 2), required a further application of GPS® and Orthoss® to reach a total resolution of the cyst. At follow-up (20-41 months, mean 31.8 months) all patients showed very good functional results and had returned to sporting activity. No refracture occurred, no further procedure was necessary. Conclusions The combination of elastic intramedullary nailing, artificial bone substitute and autologous platelet rich plasma (GPS®) enhances the treatment of bone cysts in children, with no resulting complications. PMID:21314981

Incidence of gastric dilatation-volvulus following a splenectomy in 238 dogs.

PubMed

Maki, Lynn C; Males, Kristina N; Byrnes, Madeline J; El-Saad, Anthony A; Coronado, George S

2017-12-01

There is contradicting information in the veterinary literature regarding canine splenectomy and the increased risk for subsequent gastric dilatation-volvulus. The main purpose of this study was to determine the rate of occurrence of gastric dilatation-volvulus following splenectomy in medium to large breed dogs compared with a control group undergoing other abdominal procedures. Follow-up was performed by reviewing the medical records and conducting phone interviews. Weight, gender, and presence of a hemoabdomen at the time of surgery were not significantly associated with occurrence of gastric dilatation-volvulus, while increasing age was. Ten of 238 (4%) dogs in the splenectomy group and 3/209 (1.4%) dogs in the control group subsequently developed gastric dilatation-volvulus, which was not significantly different ( P = 0.08). While the findings approach significance and support a need for future investigation, the current recommendation for gastropexy at time of splenic removal should be made on a case by case basis and while considering previously documented risk factors.

Quantification of beta A4 protein deposition in the medial temporal lobe: a comparison of Alzheimer's disease and senile dementia of the Lewy body type.

PubMed

Gentleman, S M; Williams, B; Royston, M C; Jagoe, R; Clinton, J; Perry, R H; Ince, P G; Allsop, D; Polak, J M; Roberts, G W

1992-08-03

The distribution of beta-amyloid protein (beta A4) was examined in the medial temporal lobes from cases of Alzheimer's disease (AD) (n = 13), senile dementia of Lewy body type (SDLT) (n = 12) and age matched controls (n = 9). Using a previously described image analysis technique the extent of beta A4 pathology was determined in ten distinct anatomical sites within the medial temporal lobe. AD and SDLT cases contained very similar amounts of beta A4 in the areas sampled and both contained significantly more beta A4 than the age matched controls, particularly in the dentate and parahippocampal gyri. The similarity of the beta A4 load in the two conditions is in contrast to reported differences in the number of neurofibrillary tangles which can be observed. It is suggested that AD and SDLT represent a spectrum of pathology which centres around the aberrant processing of the beta A4 precursor protein.

[Ten years of emergency attendances for cocaine-users in Spain].

PubMed

Galicia, Miguel; Nogué, Santiago; Burillo-Putze, Guillermo

2014-10-07

Cocaine is the second most consumed illegal drug in the western world, following cannabis. Since 1998, it is also the drug that more attendances generate in different emergency devices, and it is responsible for more of 60% of the emergencies directly related to drug consumption. This work reviews the main Spanish scientific articles published in the last 10 years, in which different factors related to the use of this drug have been analyzed in relation to the use of emergency by cocaine users. A total of 8,795 patients were included (interval 57-1,755), with an average age of 32.64 years (SD 3.02), and an average percentage of positives to cocaine of 54.78% (SD 47.03); there were 7 works with 100% of subjects being positive to cocaine. Males predominated with an average of 78.69% (SD 12). They presented cardiovascular symptoms in 30% cases (SD 22.7), neurological symptoms in 11.6% cases (SD 4.28) and psychiatric symptoms in 49.32% cases (SD 23.87). There was a multiple consumption in 49.02% of patients (interval 4.3-76.2), fundamentally associated with alcohol (57.78%, SD 6.18) and cannabis (21.56%, SD 10.72). Two hundred and forty-six patients (2.8%) needed admission and 8 died (0.09%). Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Possible etiologic heterogeneity of vulvar intraepithelial neoplasia. A correlation of pathologic characteristics with human papillomavirus detection by in situ hybridization and polymerase chain reaction.

PubMed

Park, J S; Jones, R W; McLean, M R; Currie, J L; Woodruff, J D; Shah, K V; Kurman, R J

1991-03-15

A correlated histopathologic and molecular virologic study of 30 cases of vulvar intraepithelial neoplasia Grade 3 (VIN 3) and six associated invasive vulvar carcinomas was performed. Paraffin sections were examined for human papillomavirus (HPV) types 6, 11, 16, and 18 by in situ hybridization for viral transcripts and by polymerase chain reaction (PCR) for amplification of HPV and of the beta-globin gene. Vulvar intraepithelial neoplasia Grade 3 was histologically subclassified into warty (bowenoid) (20 cases) and basaloid (undifferentiated) (ten cases) types. Warty VIN characteristically was composed of squamous cells displaying abnormal proliferation and maturation and an undulating or spiked surface creating a "condylomatous" appearance whereas basaloid VIN had a smooth surface and was composed of undifferentiated basaloid cells resembling carcinoma in situ of the cervix. Human papillomavirus-16 was the only type detected in 16 of 30 VIN 3 and in five of six invasive carcinomas. The HPV-positive women were younger than HPV-negative women (mean age at diagnosis, 49 versus 60 years), their lesions more frequently demonstrated koilocytotic atypia (94% versus 43%), and they were more likely to have warty compared with basaloid VIN lesions (65% versus 30%). These findings suggest that there are at least two different types of VIN which have differing clinical, pathologic, and viral profiles.

Templating effect of the substrate on the structure of Cu-phthalocyanine thin film

NASA Astrophysics Data System (ADS)

Pierantozzi, Gian Marco; Sbroscia, Marco; Ruocco, Alessandro

2018-03-01

An experimental study of electronic properties, structure and morphology of Copper-phthalocyanine films deposited onto Al(100) and Au(110), as a function of thickness up to tens of nanometers, is presented. The monolayers grown on these two model substrates are already known to exhibit very different behavior for what concerns both the degree of interaction with the substrate and the formation of long range order; in this experiment, by means of low energy electron scattering and Electron Energy Loss Spectroscopy (EELS), remarkable differences are revealed also in the successive growth. Exploiting the link between the crystal structure and the lineshape of HOMO-LUMO transition in EELS spectrum, two different structural phases are identified, compatible with α and β phases, respectively in the case of the film grown on aluminum and on gold. Besides, the evolution of the specular reflection elastic peak indicates the formation of islands on the gold substrate and a more homogeneous growth on the aluminum one.

[Categorization in infancy: differentiation of global object classes].

PubMed

Pauen, S

1996-01-01

Two studies tested whether preverbal children distinguish global categories (animal and furniture) on a conceptual basis. A total of 59 eleven-month-olds solved an object examination task. During habituation, infants freely explored different natural-looking toy models from the same category. In Study 1, the same series of four different examplars was presented twice. In Study 2, ten different exemplares were presented. In both cases, a significant habituation effect could be observed. When a perceptually new object of the same category was presented on the first test trial after habituation, a significant increase in examination time from the last habituation trial to the first test trial could be observed in Study 1. When a new object of the contrasting category was presented on the second test trial, examination times increased significantly from the first to the second test trial in both studies. These results support earlier findings suggesting that preverbal infants are able to distinguish global categories on a conceptual basis.

Inguinal and anorectal Lymphogranuloma Venereum: a case series from a sexually transmitted disease center in Rome, Italy.

PubMed

Latini, Alessandra; Zaccarelli, Mauro; Paglia, Maria Grazia; Donà, Maria Gabriella; Giglio, Amalia; Moretto, Domenico; Vulcano, Antonella; Giuliani, Massimo; Colafigli, Manuela; Ambrifi, Marina; Pimpinelli, Fulvia; Cristaudo, Antonio

2017-06-02

Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by L1, L2, L3 serovars of C. trachomatis (CT). Since 2003, LGV cases have been increasing in Europe. Aim of this report is to describe the LGV cases diagnosed in the largest STI center in Rome, Italy, from 2000 to 2016. This report shows that two clinically and epidemiologically different series of cases exist, and that, at present, the ano-rectal LGV represents the clinical variant occurring more frequently among men having sex with men (MSM), particularly those HIV-infected. Ten cases of LGV were observed. Three were diagnosed in 2009 in HIV-negative heterosexuals patients that presented the classical genito-ulcerative form with lymphadenopathy. Seven cases were observed in 2015-2016 in HIV-infected MSM, that presented the rectal variant and L2b serovar infection; 4 of these had been misclassified as a chronic bowel disease. Chlamydia infection was confirmed by CT-specific PCR (ompA gene nested PCR), followed by sequence analysis to identify the serovar. All the patients were treated with doxycycline for 3 weeks, obtaining a complete response with healing of both clinical symptoms and dermatological lesions. Our findings suggest that, in case of persistent rectal symptoms in HIV-infected MSM, LGV should be taken into account and investigated through molecular analyses, in order to achieve a correct diagnosis and management of the patients.

Taste intensities of ten vegetables commonly consumed in the Netherlands.

PubMed

van Stokkom, V L; Teo, P S; Mars, M; de Graaf, C; van Kooten, O; Stieger, M

2016-09-01

Bitterness has been suggested to be the main reason for the limited palatability of several vegetables. Vegetable acceptance has been associated with preparation method. However, the taste intensity of a variety of vegetables prepared by different methods has not been studied yet. The objective of this study is to assess the intensity of the five basic tastes and fattiness of ten vegetables commonly consumed in the Netherlands prepared by different methods using the modified Spectrum method. Intensities of sweetness, sourness, bitterness, umami, saltiness and fattiness were assessed for ten vegetables (cauliflower, broccoli, leek, carrot, onion, red bell pepper, French beans, tomato, cucumber and iceberg lettuce) by a panel (n=9) trained in a modified Spectrum method. Each vegetable was assessed prepared by different methods (raw, cooked, mashed and as a cold pressed juice). Spectrum based reference solutions were available with fixed reference points at 13.3mm (R1), 33.3mm (R2) and 66.7mm (R3) for each taste modality on a 100mm line scale. For saltiness, R1 and R3 differed (16.7mm and 56.7mm). Mean intensities of all taste modalities and fattiness for all vegetables were mostly below R1 (13.3mm). Significant differences (p<0.05) within vegetables between preparation methods were found. Sweetness was the most intensive taste, followed by sourness, bitterness, fattiness, umami and saltiness. In conclusion, all ten vegetables prepared by different methods showed low mean intensities of all taste modalities and fattiness. Preparation method affected taste and fattiness intensity and the effect differed by vegetable type. Copyright © 2016 Elsevier Ltd. All rights reserved.

SU-F-J-97: A Joint Registration and Segmentation Approach for Large Bladder Deformations in Adaptive Radiotherapy

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

Derksen, A; Koenig, L; Heldmann, S

Purpose: To improve results of deformable image registration (DIR) in adaptive radiotherapy for large bladder deformations in CT/CBCT pelvis imaging. Methods: A variational multi-modal DIR algorithm is incorporated in a joint iterative scheme, alternating between segmentation based bladder matching and registration. Using an initial DIR to propagate the bladder contour to the CBCT, in a segmentation step the contour is improved by discrete image gradient sampling along all surface normals and adapting the delineation to match the location of each maximum (with a search range of +−5/2mm at the superior/inferior bladder side and step size of 0.5mm). An additional graph-cutmore » based constraint limits the maximum difference between neighboring points. This improved contour is utilized in a subsequent DIR with a surface matching constraint. By calculating an euclidean distance map of the improved contour surface, the new constraint enforces the DIR to map each point of the original contour onto the improved contour. The resulting deformation is then used as a starting guess to compute a deformation update, which can again be used for the next segmentation step. The result is a dense deformation, able to capture much larger bladder deformations. The new method is evaluated on ten CT/CBCT male pelvis datasets, calculating Dice similarity coefficients (DSC) between the final propagated bladder contour and a manually delineated gold standard on the CBCT image. Results: Over all ten cases, an average DSC of 0.93±0.03 is achieved on the bladder. Compared with the initial DIR (0.88±0.05), the DSC is equal (2 cases) or improved (8 cases). Additionally, DSC accuracy of femoral bones (0.94±0.02) was not affected. Conclusion: The new approach shows that using the presented alternating segmentation/registration approach, the results of bladder DIR in the pelvis region can be greatly improved, especially for cases with large variations in bladder volume. Fraunhofer MEVIS received funding from a research grant by Varian Medical Systems.« less

Prescription-event monitoring: developments in signal detection.

PubMed

Ferreira, Germano

2007-01-01

Prescription-event monitoring (PEM) is a non-interventional intensive method for post-marketing drug safety monitoring of newly licensed medicines. PEM studies are cohort studies where exposure is obtained from a centralised service and outcomes from simple questionnaires completed by general practitioners. Follow-up forms are sent for selected events. Because PEM captures all events and not only the suspected adverse drug reactions, PEM cohorts potentially differ in respect to the distribution of number of events per person depending on the nature of the drug under study. This variance can be related either with the condition for which the drug is prescribed (e.g. a condition causing high morbidity will have, in average, a higher number of events per person compared with a condition with lower morbidity) or with the drug effect itself. This paper describes an exploratory investigation of the distortion caused by product-related variations of the number of events to the interpretation of the proportional reporting ratio (PRR) values ("the higher the PRR, the greater the strength of the signal") computed using drug-cohort data. We studied this effect by assessing the agreement between the PRR based on events (event of interest vs all other events) and PRR based on cases (cases with the event of interest vs cases with any other events). PRR were calculated for all combinations reported to ten selected drugs against a comparator of 81 other drugs. Three of the ten drugs had a cohort with an apparent higher proportion of patients with lower number of events. The PRRs based on events were systematically higher than the PRR based on cases for the combinations reported to these three drugs. Additionally, when applying the threshold criteria for signal screening (n > or =3, PRR > or =1.5 and Chi-squared > or =4), the binary agreement was generally high but apparently lower for these three drugs. In conclusion, the distribution of events per patient in drug cohorts shall be examined when comparing the 'strength of the signals' across drugs using PRR values. Further research will be required to address the sensitivity and specificity of the two ways of calculating PRR using data derived from drug cohorts.

[Streptococcal toxic shock syndrome: ten years' experience at a tertiary hospital].

PubMed

Vallalta-Morales, Manuel; Salavert-Lletí, Miguel; Artero-Mora, Arturo; Mahiques-Santos, Laura; Solaz-Moreno, Elena; Pérez-Bellés, Carmen

2005-11-01

In the last two decades there has been a reported increase in the incidence of streptococcal toxic shock syndrome (STSS). The objective of this study was to determine the clinical and epidemiological characteristics of this infection. Retrospective study of all cases of STSS diagnosed at a single tertiary hospital over the last ten years. We report 13 cases of STSS (8 men, mean age 62 years). The mean annual incidence was 0.19 episodes/100,000 population from 1994 to 1998 and 0.53 episodes/100,000 population from 1999 to 2003 (p = 0.059). All patients had at least one underlying disease and there were no intravenous drug users. The most common portals of entry were the skin and soft tissues (85%) and all but one patient had a positive blood culture. Two cases were nosocomial and five patients required surgery (amputation and/or debridement). There was a high mortality rate (85%) and a rapid course from onset to death; nine patients died within four days after establishing the diagnosis. The incidence of SSTS has increased over the last five years at our hospital. Elderly patients with underlying medical conditions were more susceptible to acquiring this infection. Early mortality was very high.

Simultaneous detection of periodontal pathogens in subgingival plaque and placenta of women with hypertension in pregnancy.

PubMed

Swati, P; Thomas, Betsy; Vahab, Saadi Abdul; Kapaettu, Satyamoorthy; Kushtagi, Pralhad

2012-03-01

There are many studies documenting increased prevalence of periodontal infection in women with preeclampsia. But, very few studies have attempted to establish causal relationship between the two. To find out causal circumstantial evidence by isolating specific periodontal pathogens in oral and placental samples. Antenatal periodontal screening and subgingival plaque collection was carried out in ten women with hypertension in pregnancy and ten normotensive controls on their hospital admission at term for cesarean delivery. Placental biopsy was obtained after aseptic placental collection at the time of elective cesarean delivery. Subgingival plaque and placental biopsy were studied for Porphyromonas gingivalis, Fusobacterium nucleatum, Treponema denticola, Prevotella intermedia and Aggregatibacter actinomycetemcomitans using quantitative polymerase chain reaction technique. Periodontist and laboratory personnel were unaware of case or control status. Periodontal status was not informed to the obstetrician recruiting the cases and laboratory. Microbiology report was not revealed till end of the study. Periodontal pathogens were found to be high in the group with hypertension than the controls. P gingivalis was found in all the samples from subgingival plaque and placenta, irrespective of the periodontal disease status. In cases with hypertension, periodontal pathogens are present in higher proportion in subgingival plaque and placenta.

Accurate green water loads calculation using naval hydro pack

NASA Astrophysics Data System (ADS)

Jasak, H.; Gatin, I.; Vukčević, V.

2017-12-01

An extensive verification and validation of Finite Volume based CFD software Naval Hydro based on foam-extend is presented in this paper for green water loads. Two-phase numerical model with advanced methods for treating the free surface is employed. Pressure loads on horizontal deck of Floating Production Storage and Offloading vessel (FPSO) model are compared to experimental results from [1] for three incident regular waves. Pressure peaks and integrals of pressure in time are measured on ten different locations on deck for each case. Pressure peaks and integrals are evaluated as average values among the measured incident wave periods, where periodic uncertainty is assessed for both numerical and experimental results. Spatial and temporal discretization refinement study is performed providing numerical discretization uncertainties.

A comparison of glass cermet cement and amalgam restorations in primary molars.

PubMed

Hickel, R; Voss, A

1990-01-01

The aim of this clinical study was to compare the efficacy of GCC with amalgam as a filling material in primary molars. Two hundred fifteen restorations were placed in the first and second primary molars of seventy-four patients, ranging in age from four to ten years. The overall failure rate of amalgam is lower than that of GCC, but not significantly different. In older children, amalgam has greater advantages. An advantage of GCC is the short time required to fill the cavity. This might be an important factor in young and/or difficult children. In these cases amalgam cannot be placed under optimal conditions and, therefore, the results are less satisfactory. GCC is a viable alternative filling material.

Small Aircraft RF Interference Path Loss Measurements

NASA Technical Reports Server (NTRS)

Nguyen, Truong X.; Koppen, Sandra V.; Ely, Jay J.; Szatkowski, George N.; Mielnik, John J.; Salud, Maria Theresa P.

2007-01-01

Interference to aircraft radio receivers is an increasing concern as more portable electronic devices are allowed onboard. Interference signals are attenuated as they propagate from inside the cabin to aircraft radio antennas mounted on the outside of the aircraft. The attenuation level is referred to as the interference path loss (IPL) value. Significant published IPL data exists for transport and regional category airplanes. This report fills a void by providing data for small business/corporate and general aviation aircraft. In this effort, IPL measurements are performed on ten small aircraft of different designs and manufacturers. Multiple radio systems are addressed. Along with the typical worst-case coupling values, statistical distributions are also reported that could lead to more meaningful interference risk assessment.

A LISA Interferometry Primer

NASA Technical Reports Server (NTRS)

Thorpe, James Ira

2010-01-01

A key challenge for all gravitational wave detectors in the detection of changes in the fractional difference between pairs of test masses with sufficient precision to measure astrophysical strains with amplitudes on the order of approx.10(exp -21). ln the case of the five million km arms of LISA, this equates to distance measurements on the ten picometer level. LISA interferometry utilizes a decentralized topology, in which each of the sciencecraft houses its own light sources, detectors, and electronics. The measurements made at each of the sciencecraft are then telemetered to ground and combined to extract the strain experienced by the constellation as a whole. I will present an overview of LISA interferometry and highlight some of the key components and technologies that make it possible.

Relative crater production rates on planets

NASA Technical Reports Server (NTRS)

Hartmann, W. K.

1977-01-01

The relative numbers of impacts on different planets, estimated from the dynamical histories of planetesimals in specified orbits (Wetherill, 1975), are converted by a described procedure to crater production rates. Conversions are dependent on impact velocity and surface gravity. Crater retention ages can then be derived from the ratio of the crater density to the crater production rate. The data indicate that the terrestrial planets have crater production rates within a factor ten of each other. As an example, for the case of Mars, least-squares fits to crater-count data suggest an average age of 0.3 to 3 billion years for two types of channels. The age of Olympus Mons is discussed, and the effect of Tharsis volcanism on channel formation is considered.

Identification of Childhood Disability in Jamaica: The Ten Question Screen.

ERIC Educational Resources Information Center

Thorburn, Marigold; And Others

1992-01-01

This study evaluated use of the Ten Question Screen (TQ) to identify disability in a 2-stage population-based survey of 5,478 children aged 2-9 years in Clarendon, Jamaica. Findings indicated varied sensitivity by different subgroups (age, gender, and disability) and an unacceptably high false positive rate. (Author/DB)

The physiological diversity and similarity of ten Quercus species

Treesearch

Shi-Jean S. Sung; M.N. Angelov; R.R. Doong; W.R. Harms; Paul P. Kormanik; C.C. Black

1994-01-01

Based on anatomical, photosynthetic, and biochemical data, the range of physiological differences and similarities was defined for ten Quercus species. There were no correlations between species' site adaptability, leaf anatomy and photosynthetic rate (A). It is concluded from these data that each oak species must be treated individually when incorporated into...

Ten-year earnings from two small woodlands

Treesearch

Wilfred C. Mitchell; Henry H. Webster

1961-01-01

Ten years ago, management was started on two 30-acre demonstration woodlots on the Fernow Experimental Forest near Parsons, West Virginia. These were designated as Farm Woodlots, on the assumption that there was something significantly different between management incentives and opportunities for small holdings owned by farmers and for those owned by non-farmers.

Cortical Reorganization of Language Functioning Following Perinatal Left MCA Stroke

ERIC Educational Resources Information Center

Tillema, Jan-Mendelt; Byars, Anna W.; Jacola, Lisa M.; Schapiro, Mark B.; Schmithorst, Vince J.; Szaflarski, Jerzy P.; Holland, Scott K.

2008-01-01

Objective: Functional MRI was used to determine differences in patterns of cortical activation between children who suffered perinatal left middle cerebral artery (MCA) stroke and healthy children performing a silent verb generation task. Methods: Ten children with prior perinatal left MCA stroke (age 6-16 years) and ten healthy age matched…

Effect of TENS on pain relief in patients with degenerative disc disease in lumbosacral spine.

PubMed

Pop, Teresa; Austrup, Heiner; Preuss, Rudolf; Niedziałek, Marta; Zaniewska, Anna; Sobolewski, Marek; Dobrowolski, Tomasz; Zwolińska, Jolanta

2010-01-01

The study sought to evaluate the impact of long-term TENS therapy on pain relief in patients with degenerative disc disease in the lumbosacral spine. The study involved 39 patients with lumbosacral pain who were receiving treatment in the Regional Hospital No 2 in Rzeszów and in Winsen Hospital. The experimental group consisted of 16 patients who were fitted with L-S orthoses with a built-in OmniTens plus mini-device for long-term application (3 times a day, for 20 minutes) of TENS currents with a frequency of 35 Hz and impulse duration of 150µsec. The control group consisted of 23 patients who received conventional TENS therapy once a day for 20 minutes, with a frequency of 35 Hz and impulse duration of 150 µsec. The results were assessed with the Oswestry Questionnaire, a visual analogue scale (VAS), as well as Schober's Test. Tests were performed before and on completion of the therapy. All participants reported pain relief and improved spinal function and mobility. Statistically significant differences were obtained in the group of patients treated with low frequency pulsed TENS currents administered via the orthosis. 1. TENS therapy contributed to pain relief and improvement of function and mobility of the lumbosacral spine 2. Representing an appropriate and effective technique, TENS stimulation via an orthosis should be more commonly prescribed.

Comparison of plantar pressure distribution between three different shoes and three common movements in futsal.

PubMed

Teymouri, Meghdad; Halabchi, Farzin; Mirshahi, Maryam; Mansournia, Mohammad Ali; Mousavi Ahranjani, Ali; Sadeghi, Amir

2017-01-01

Analysis of in-shoe pressure distribution during sport-specific movements may provide a clue to improve shoe design and prevent injuries. This study compared the mean and the peak pressures over the whole foot and ten separate areas of the foot, wearing different shoes during specific movements. Nine male adult recreational futsal players performed three trials of three sport-specific movements (shuffle, sprint and penalty kick), while they were wearing three brands of futsal shoes (Adidas, Lotto and Tiger). Plantar pressures on dominant feet were collected using the F-SCAN system. Peak and mean pressures for whole foot and each separate area were extracted. For statistical analysis, the mean differences in outcome variables between different shoes and movements were estimated using random-effects regression model using STATA ver.10. In the average calculation of the three movements, the peak pressure on the whole foot in Adidas shoe was less than Lotto [8.8% (CI95%: 4.1-13.6%)] and Tiger shoes [11.8% (CI95%:7-16.7%)], (P<0.001). Also, the recorded peak pressure on the whole foot in penalty kick was 61.1% (CI95%: 56.3-65.9%) and 57.6% (CI95%: 52.8-62.3%) less than Shuffle and Sprint tests, respectively (P<0.001). Areas with the highest peak pressure during all 3 movements were not different between all shoes. This area was medial forefoot in cases of shuffle and sprint movements and medial heel in case of penalty kick.

Transforming Professional Learning into Practice

ERIC Educational Resources Information Center

Sahin, Iclal; Yildirim, Ali

2016-01-01

In this qualitative case study, we explored how ten EFL teachers who attended an in-service staff development programme subsequently integrated professional learning into their classroom practice, and which staff development practices were effective in this process. We triangulated data from interviews, observations, and document analysis. The…

Science Education Notes.

ERIC Educational Resources Information Center

School Science Review, 1979

1979-01-01

Included is information regarding: the adaptation of microcomputer materials in physics curricula; a school-industry liaison case study involving basic electronics for teachers; the use of language in science lessons; problems in teaching image-synthesis skills; and tabulated results of a questionnaire concerning a ten-year span of organic…

Principal Experiences of Succession

ERIC Educational Resources Information Center

Steele, Farla Gay

2015-01-01

This multiple case study explored the experiences of school principals and the usefulness of Peters' (2011) succession planning model. Ten purposefully selected principals from varying grade levels were interviewed; none reported a formal succession plan, and all had been assistant principals. The study concluded the assistant principal position…

The Uses Of State DOT Research: Customer Use Of Completed Projects From NJDOT's Research Bureau

DOT National Transportation Integrated Search

2000-01-01

Based on case-study synthesis of ten projects completed between 1991-1998, this report explores factors that relate to how internal customers use the work completed for them by the New Jersey Department of Transportation's (NJDOT's) Research Bureau. ...

[Treatment of an old Achilles tendon rupture with allografts. Report of case series].

PubMed

Matus-Jiménez, J; Martínez-Arredondo, H

2011-01-01

Rupture of Achilles tendon occurs at 2-6 cm from its attachment in the calcaneus; its frequency is estimated at 7-18 cases per 100,000 population in the United States and it occurs more frequently in males. The diagnosis is made clinically and with ultrasound or magnetic resonance imaging and treatment may be divided into acute or late. We present herein the use of allograft to treat patients with ruptures more than six weeks old; several techniques were used depending on the rupture site and the available allograft. Ten plasties were performed in ten patients with ruptures that occurred a mean of 8 months back; early rehabilitation was instituted and weight bearing was allowed at 4 weeks with a brace, which was removed at 12 weeks; patients could run at 12 weeks. Four wound dehiscence complications were reported, which resolved with second intention healing without the need for any other surgery, with good results and patient satisfaction.

The use of transcutaneous electrical nerve stimulation (TENS) for pain relief in labour: a review of the evidence.

PubMed

Bedwell, Carol; Dowswell, Therese; Neilson, James P; Lavender, Tina

2011-10-01

to assess the effects of transcutaneous electrical nerve stimulation (TENS) for pain relief in labour. studies were identified from a search of the Cochrane Pregnancy and Childbirth Group's Trials Register (November 2008). randomised controlled trials comparing women receiving TENS for pain relief in labour vs routine care or placebo devices. All types of TENS machines were included. two review authors assessed all trials identified by the search strategy, carried out data extraction and assessed risk of bias. 14 studies including 1256 women were included: 11 examined TENS applied to the back, two to acupuncture points and one to the cranium. Overall, there was little difference in satisfaction with pain relief or in pain ratings between TENS and control groups, although women receiving TENS to acupuncture points were less likely to report severe pain (risk ratio 0.41, 95% confidence interval 0.32-0.55). The majority of women using TENS would use it again in a future labour. There was no evidence that TENS had any impact on interventions and outcomes in labour. There was little information on outcomes for mothers and infants. No adverse events were reported. there is only limited evidence that TENS reduces pain in labour and it does not seem to have any impact on other outcomes for mothers or infants. The use of TENS at home in early labour has not been evaluated. Although the guidelines of the National Institute for Health and Clinical Excellence recommend that TENS should not be offered to women in labour, women appear to be choosing it and midwives are supporting them in their choice. Given the absence of adverse effects and the limited evidence base, it seems unreasonable to deny women that choice. More robust studies of effectiveness are needed. Copyright © 2009 Elsevier Ltd. All rights reserved.

Attributional style in a case of Cotard delusion.

PubMed

McKay, Ryan; Cipolotti, Lisa

2007-06-01

Young and colleagues (e.g. Young, A. W., & Leafhead, K. M. (1996). Betwixt life and death: case studies of the Cotard delusion. In P. W. Halligan & J. C. Marshall (Eds.), Method in madness: Case studies in cognitive neuropsychiatry. Mahway, NJ: Lawrence Erlbaum Associates.) have suggested that cases of the Cotard delusion (the belief that one is dead) result when a particular perceptual anomaly (caused by a disruption to the affective component of visual recognition) occurs in the context of an internalising attributional style. This hypothesis has not previously been tested directly. We report here an investigation of attributional style in a 24-year-old woman with Cotard delusion ("LU"). LU's attributional style (and that of ten healthy control participants) was assessed using the Internal, Personal and Situational Attributions Questionnaire (Kinderman, P., & Bentall, R. P. (1996). A new measure of causal locus: the internal, personal and situational attributions questionnaire. Personality and Individual Differences, 20(2), 261-264.). LU showed a significantly greater proportion of internalising attributions than the control group, both overall and for negative events specifically. The results obtained thus support an association of Cotard delusion with an internalising attributional style, and are therefore consistent with the account of Young and colleagues. The potential brain basis of Cotard delusion is discussed.

The influence of the day of the week of hospital admission on the prognosis of stroke patients.

PubMed

Barros, Juliana B; Goulart, Alessandra Carvalho; Alencar, Airlane P; Lotufo, Paulo A; Bensenor, Isabela M

2013-04-01

This study aimed to evaluate the weekday and weekend distribution of stroke case hospital admissions and their respective prognosis based on a sample from the Estudo de Mortalidade e Morbidade do Acidente Vascular Cerebral (EMMA), a cohort of stroke patients admitted to a community hospital in the city of São Paulo, Brazil. We ascertained all consecutive cases of first-time strokes between April 2006 and December 2008 and performed a subsequent one-year follow-up. No association was found between frequency of hospital admissions due to ischemic and hemorrhagic strokes and the specific day of the week on which the admission occurred. However, ten-day and twelve-month case-fatality was higher in hemorrhagic stroke patients admitted at the weekend. We also found that intracerebral hemorrhage patients admitted on weekends had a worse survival rate (50%) compared with those admitted during weekdays (25.6%, P log-rank = 0.03). We found a multivariate hazard ratio of 2.49 (95%CI: 1.10-5.81, P trend = 0.03) for risk of death at the weekend compared to weekdays for intracerebral hemorrhage cases. No difference in survival was observed with respect to the overall sample of stroke or ischemic stroke patients.

[The prevalence of type 2 diabetes mellitus and prediabetes in children].

PubMed

Jin, Yan-Yan; Liang, Li; Fu, Jun-Fen; Wang, Xiu-Min

2011-02-01

To investigate the incident and prevalence of type 2 diabetes mellitus (T2DM) and prediabetes in obese children in the last ten years. The clinical data of hospitalized children with newly diagnosed diabetes mellitus (DM) or obesity between October 2000 and September 2011 were retrospectively studied. A total of 503 newly onset cases were diagnosed as DM in the past ten years, of which 31 were diagnosed as T2DM. The prevalence of T2DM in the second five-year duration increased significantly compared with that in the first five-year duration (0.18‰ vs 0.05‰; P<0.01). The number of cases of type 1 diabetes mellitus (T1DM) and T2DM increased by 1.35 fold and 4.20 fold, respectively in the second five-year duration. A total of 1301 obese patients received oral glucose tolerance tests, and 29 cases were diagnosed with T2DM and 255 cases with prediabetes. Of the 255 cases of prediabetes, 133 had dyslipidemia, 138 had non-alcoholic fatty liver disease and 53 had hypertension. The prevalence rates of T1DM and T2DM increased significantly in the last 5 years. The prevalence of T2DM increased more significantly than T1DM. There was a higher prevalence of prediabetes in obese children. Childhood obesity predicts a higher risk of T2DM and cardiovascular disease in the future.

Tick-borne Relapsing Fever in the Pacific Northwest: An Underdiagnosed Illness?

PubMed Central

Fihn, Stephan; Larson, Eric B.

1980-01-01

Some 30 cases of tick-borne relapsing fever due to Borrelia are known to have occurred between 1965 and 1978 in the Pacific Northwest. This disease was found more frequently in young men with a history of wilderness exposure during the summer months. Recurrent fever was the most common symptom with temperatures reaching higher than 39.5° C (103.1° F) in all cases, and many patients had three or more febrile episodes. Splenomegaly was the second most common finding reported. Diagnosis of relapsing fever was made in 20 cases by identifying spirochetes on peripheral blood smears. In ten remaining cases the diagnosis was made on clinical and epidemiologic grounds. Information regarding therapy was available in 21 cases. Ten patients received a tetracycline drug and all had a prompt response without relapse. Two of the patients died, a 68-year-old woman with possible myocardial involvement and a newborn infant with infection acquired in utero and meningeal involvement. The diagnosis was often delayed in spite of outpatient evaluation and admittance to hospital, probably because borreliosis was not considered in the differential diagnosis. Because tick-borne relapsing fever is eventually a self-limited disease in most patients, it is probably not recognized often enough. Awareness of this disease and examination of the peripheral blood smear for spirochetes will lead to earlier diagnosis. Prompt initiation of tetracycline therapy should reduce morbidity associated with borreliosis. ImagesFigure 3. PMID:7415171

Case conferences between general practitioners and specialist teams to plan end of life care of people with end stage heart failure and lung disease: an exploratory pilot study

PubMed Central

2014-01-01

Background Most people die of non-malignant disease, but most patients of specialist palliative care services have cancer. Adequate end of life care for people with non-malignant disease requires acknowledgement of their limited prognosis and appropriate care planning. Case conferences between specialist palliative care services and GPs improve outcomes in cancer-based populations. We report a pilot study of case conferences between the patient’s GP and specialist staff to facilitate care planning for people with end stage heart failure or non-malignant lung disease in a regional health service in Queensland Australia. Methods Single face to face case conferences about patients with a primary diagnosis of advanced heart failure or respiratory failure from non-malignant disease were conducted between a palliative care consultant, a case management nurse and the patient’s GP. Annualised rates of service utilisation (emergency department [ED] presentations, ED discharges back to home, hospital admissions, and admission length of stay) before and after case conference were calculated. Content and counts of case conference recommendations, and the rate of adherence to recommendations were also assessed. A process evaluation of case conferences was undertaken. Results Twenty-three case conferences involving 21 GPs were conducted between November 2011 and November 2012. One GP refused to participate. Ten patients died, three at home. Of 82 management recommendations made, 55 (67%) were enacted. ED admissions fell from 13.9 per annum (pa) to 2.1 (difference 11.8, 95% CI 2.2-21.3, p = 0.001); ED admissions leading to discharge home from 3.9 to 0.4 pa (difference 3.5, 95% CI -0.4-7.5, p = 0.05); hospital admissions from 11.4 to 3.5 pa (difference 7.9, 95% CI 2.2-13.7, p = 0.002); and length of stay from 7.0 to 3.7 days (difference 3.4, 95% CI 0.9-5.8, p = 0.007). Participating health professionals were enthusiastic about the process. Conclusions This pilot is the initial step in the development and testing of a complex intervention based on a model of integrated care. A single case conference involving the patient’s heart or lung failure team is associated with significant reductions in service utilization, apparently by improving case coordination, enhancing symptom management and assessing and managing carer needs. A randomized controlled trial is being developed. Trial registration Australian and New Zealand Controlled Trials Register ACTRN12613001377729: Registered 16/12/2013. PMID:24829539

Binding characteristics of Cu2+ to natural humic acid fractions sequentially extracted from the lake sediments.

PubMed

He, En; Lü, Changwei; He, Jiang; Zhao, Boyi; Wang, Jinghua; Zhang, Ruiqing; Ding, Tao

2016-11-01

Humic acids (HAs) determine the distribution, toxicity, bioavailability, and ultimate fate of heavy metals in the environment. In this work, ten HA fractions (F1-F10) were used as adsorbent, which were sequentially extracted from natural sediments of Lake Wuliangsuhai, to investigate the binding characteristics of Cu 2+ to HA. On the basis of the characterization results, differences were found between the ten extracted HA fractions responding to their elemental compositions and acidic functional groups. The characterization results reveal that the responses of ten extracted HA fractions to their elemental compositions and acidic functional groups were different. The O/C and (O + N)/C ratio of F1-F8 approximately ranged from 0.66 to 0.53 and from 0.72 to 0.61, respectively; the measured results showed that the contents of phenolic groups and carboxyl groups decreased from 4.46 to 2.60 mmol/g and 1.60 to 0.58 mmol/g, respectively. The binding characteristics of Cu 2+ to the ten HA fractions were well modeled by the bi-Langmuir model; the binding behavior of Cu 2+ to all the ten HA fractions were strongly impacted by pH and ionic strength. The FTIR and SEM-EDX image of HA fractions (pre- and post-adsorption) revealed that carboxyl and phenolic groups were responsible for the Cu 2+ sorption on the ten sequentially extracted HA fractions process, which is the same with the analysis of the ligand binding and bi-Langmuir models Accordingly, the adsorption capacity of the former HA fractions on Cu 2+ were higher than the latter ones, which may be attributed to the difference of carboxyl and phenolic group contents between the former and latter extracted HA fractions. Additionally, the functional groups with N and S should not be neglected. This work is hopeful to understand the environmental effect of humic substances, environmental geochemical behavior, and bioavailability of heavy metals in lakes.

Role of transcutaneous electric nerve stimulation in the management of trigeminal neuralgia

PubMed Central

Singla, Sanju; Prabhakar, Vikram; Singla, Rajan Kumar

2011-01-01

Background: Trigeminal neuralgia typically involves nerves supplying teeth, jaws and face of older females. Though the etiology is usually obscure, different treatment modalities have been tried for it viz. medicinal treatment, injection alcohol, peripheral neurectomy, rhizotomy, and microvascular decompression etc. Transcutaneous electric nerve stimulation (TENS) is an emerging and promising option for management of such patients. Aims and Design: The present study was designed with an aim to study the efficacy of TENS in management of trigeminal neuralgia. Materials and Methods: The study was conducted on 30 patients of trigeminal neuralgia confirmed by diagnostic nerve block. They were given bursts of TENS for 20-40 days over the path of the affected nerve and subsequently evaluated at 1 month and 3 month intervals by visual analogue scale (VAS), verbal pain scale (VPS), a functional outcome scales for main daily activities like sleep, chewing, talking, or washing face. Results: The results showed that, on VAS, the score decreased from 8.9 (Pre TENS) to 3.1 at 1 month and 1.3 at 3 months, and on VPS, the score decreased from 3.5 (Pre TENS) to 1.2 at 1 month and 0.3 at 3 months. Similarly, a considerable decrease in scores was seen on functional outcome scale for different activities. No side effects like irritation or redness of skin were seen in any of the patients. Conclusions: Thus, TENS was found to be a safe, easily acceptable, and non-invasive outdoor patient department procedure for management of trigeminal neuralgia. PMID:21897677

Effects of acupuncture and placebo TENS in addition to exercise in treatment of rotator cuff tendinitis.

PubMed

Razavi, Mahnaz; Jansen, Gunilla Brodda

2004-12-01

To compare the effect of acupuncture with placebo transcutaneous electrical nerve stimulation (TENS) when added to the exercise treatment of rotator cuff tendinitis with respect to pain, shoulder movements and function. Prospective alternate allocation controlled trial. Outpatient department. Thirty-three patients (12 women and 21 men) were included in the study. All had clinically diagnosed rotator cuff tendinitis. Both groups underwent a standardized training programme. Each patient received in addition either 10 treatments with acupuncture or placebo TENS, 1-2 times per week. The parameters investigated were intensity of pain (measured with visual analogue scale), active, passive as well as functional movements in the shoulder (hand in neck (HIN) and pour out of a pot (POP)). Patients were tested before treatment, after treatment and at a six-month follow-up. Medicine intake, ability to lie on the affected side and sleep disturbances were evaluated. A subjective assessment was made after the treatment and at follow-up. Sixteen patients had acupuncture, 17 placebo TENS. Eight patients endured pain at rest in the placebo TENS group, and 10 in the acupuncture group. After treatment both groups improved, the improvement persisted at the six-month follow-up. Both groups increased range of movement. Except for the functional test HIN in the acupuncture group, there were no differences between the groups regarding other parameters investigated directly after treatment or at six-month follow-up. There is no difference between the effect of additional acupuncture treatment and placebo TENS in the treatment of rotator cuff tendinitis.

[Etiological analysis of 264 cases with chronic kidney disease stage 2 to 5 in children].

PubMed

Miao, Qianfan; Shen, Qian; Xu, Hong; Sun, Li; Tang, Xiaoshan; Fang, Xiaoyan; Liu, Haimei; Zhai, Yihui; Bi, Yunli; Wang, Xiang; Chen, Hong

2015-09-01

To study and summarize the etiology of children patients with chronic kidney disease (CKD) stage 2 to 5 seen in Children's Hospital of Fudan University from Jan. 2004 to Dec. 2013. By complying with the NKF-K/DOQI guidelines, we collected data of 264 cases of children patients with CKD stage 2-5 from Jan. 2004 to Dec. 2013 in the medical record system of Children's Hospital of Fudan University. And we retrospectively analyzed their age and CKD stage at first diagnosis, primary diseases, complications, etc. In the collected 264 cases, 52 cases (19.7%) were diagnosed at stage 2, 67 (25.4%) at stage 3, 52 (19.7%) at stage 4 and 93 (35.2%) at stage 5. For disease causes, 116 cases (43.9%) had congenital anomalies of the kidney and urinary tract (CAKUT), 61 cases (23.1%) had glomerular disease, 15 (5.7%) had hereditary kidney disease, 14 (5.3%) had other diseases and in 58 cases (22.0%) the causes of disease were unknown. In the group with age between 0 and 3.0 and 3.1 and 6.0 years, 57.1% (24 cases) and 60.0% (30 cases) had primary disease with CAKUT. In the group with age older than 10 years, 49.2% (30 cases) had primary disease with glomerular disease and 32.0% (32 cases) with unknown causes. The major cause of CKD stage 2-5 in children in our hospital during the last ten years was CAKUT (43.9%), followed by glomerular disease (23.1%). The primary diseases of CKD were significantly different between the 2 age groups. CAKUT was more common in infants and preschool children while for adolescents, glomerular disease was the major cause.

Determining Financial Capability of SSI/SSDI Beneficiaries with Psychiatric Disabilities: A Case Series

PubMed Central

Lazar, Christina M.; Black, Anne C.; McMahon, Thomas J; O’Shea, Kevin; Rosen, Marc I.

2015-01-01

Objective Social Security beneficiaries’ liberty is constrained if they are judged incapable of managing their disability payments and are assigned a fiduciary to manage benefit payments on their behalf. Conversely, beneficiaries’ well-being may be compromised if they misspend money that they need to survive. Several studies have shown that determinations of financial capability are made inconsistently and capability guidelines appear to be applied inconsistently in practice. This case series describes the ambiguities remaining for a small number of individuals even after published criteria for capability— failing to meet basic needs and/or harmful spending on drugs— are applied. Methods Trained, experienced assessors rated the financial capability of 119 individuals in intensive outpatient or inpatient psychiatric facilities who received SSI or SSDI payments. Ten individuals’ cases were determined difficult to judge. Results Six sources of ambiguity were identified by case review: distinguishing incapability from the challenges of navigating poverty, the amount of nonessential spending needed to be considered incapable, the amount of spending on harmful things needed to be considered incapable, how intermittent periods of capability and incapability should be considered, the relative weighting of past behavior and future plans to change, and discrepancies between different sources of information. Conclusion The cases raise fundamental questions about what financial incapability is, but also illustrate how detailed consideration of beneficiaries’ living situations and decision making can inform the difficult dichotomous decision about capability. PMID:25727116

Scleral patch grafts in the management of uveal and ocular surface tumors.

PubMed

Barman, Manabjyoti; Finger, Paul T; Milman, Tatyana

2012-12-01

To evaluate the outcome of scleral patch grafts in a series of patients undergoing management for uveal and ocular surface tumors. Case series. Ten patients underwent scleral patch grafting. Five patients had uveal melanoma with extrascleral extension, 2 patients had scleromalacia secondary to plaque radiotherapy for uveal melanoma, 2 patients had suspicious uveoscleral nevi, and 1 patient had invasive conjunctival squamous cell carcinoma with scleral necrosis. Retrospective, interventional, noncomparative chart review of patients undergoing treatment for ocular tumors followed by scleral grafts in a tertiary eye care center in the United States between September 2003 and January 2011. Sclera was reconstructed with allogenic scleral grafts. Clinical observations were performed after grafting. Structural integrity, appearance, and stability of the grafts. Ten patients were reviewed. All melanoma cases received plaque radiotherapy with palladium 103. The cases with nevi and squamous cell carcinoma underwent local resection with cryotherapy as primary treatment. In 8 cases, scleral grafting was performed as part of the initial surgery. In all of these cases, satisfactory anatomic and functional outcomes were achieved. In 2 cases with scleromalacia secondary to radiotherapy for uveal melanoma, grafts were placed several years after the initial treatment. In these 2 cases, one showed signs of graft retraction, whereas another showed graft thinning. No patients experienced graft infection, rejection, or tumor recurrence. In this series, scleral grafts were well accepted when placed as part of the primary tumor management despite synchronous radiotherapy, scleral resection, or cryotherapy. Grafting was less successful when performed as a late procedure for radiation-induced scleromalacia. The author(s) have no proprietary or commercial interest in any materials discussed in this article. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Severe acute pulmonary haemorrhage and haemoptysis in ten dogs following eastern brown snake (Pseudonaja textilis) envenomation: Clinical signs, treatment and outcomes.

PubMed

Leong, Oriana S; Padula, Andrew M; Leister, Ellie

2018-05-29

This report describes a series of ten cases of fulminant pulmonary haemorrhage in dogs following envenomation by the eastern brown snake (Pseudonaja textilis) in south eastern Queensland, Australia. All cases were presented for veterinary treatment during 2011-2018 at a specialist veterinary emergency centre. Each case received prompt antivenom treatment and supportive care. Pulmonary haemorrhage was diagnosed based on clinical examination; overt haemoptysis; thoracic radiographic demonstration of a diffuse alveolar pattern; and, the presence of venom induced consumptive coagulopathy. The median elapsed time from hospital admission to onset of haemoptysis was 2 h (range 0-18 h). In 80% (8/10) of cases endotracheal intubation was required, whilst 20% (2/10) were successfully treated with mask oxygen supplementation alone, and 40% (4/10) received mechanical ventilation; but only 25% (1/4) of these survived to hospital discharge. Fresh frozen canine plasma was administered to 70% (7/10) of cases and 43% (3/7) of these survived. Of the total number of cases presented for treatment, 30% (3/10) survived to hospital discharge, 60% (6/10) were euthanised due to poor prognosis and 10% (1/10) died from cardiac arrest. Initial serum brown snake venom antigen levels were retrospectively measured from frozen serum samples by venom specific sandwich ELISA in two dogs at 154 ng/mL (survived) and 3607 ng/mL (euthanised); no free venom was detected post-antivenom. Dogs that survived were discharged from hospital without apparent complications. Pulmonary haemorrhage is an uncommon event following envenomation by P. textilis in dogs and has not been described in similarly envenomed humans. This case series highlights the potential for fulminant and fatal pulmonary haemorrhage in dogs following eastern brown snake envenomation. Copyright © 2018 Elsevier Ltd. All rights reserved.

Effectiveness of high-frequency transcutaneous electrical nerve stimulation at tender points as adjuvant therapy for patients with fibromyalgia.

PubMed

Carbonario, F; Matsutani, L A; Yuan, S L K; Marques, A P

2013-04-01

Fibromyalgia is a chronic pain syndrome associated with sleep disorders, fatigue and psychological symptoms. Combinations therapies, such as electrotherapy and therapeutic exercises have been used in the clinical practice. To assess the efficacy of high-frequency transcutaneous electrical nerve stimulation (TENS) as an adjuvant therapy to aerobic and stretching exercises, for the treatment of fibromyalgia. Controlled clinical trial. Unit of rehabilitation of a public hospital. Twenty-eight women aged 52.4±7.5 years, with fibromyalgia. A visual analogue scale measured pain intensity; tender points pain threshold, by dolorimetry; and quality of life, by the Fibromyalgia Impact Questionnaire. All subjects participated in an eight-week program consisting of aerobic exercises, followed by static stretching of muscle chains. In TENS group, high-frequency (150 Hz) was applied on bilateral tender points of trapezium and supraspinatus. TENS group had a greater pain reduction (mean change score=-2.0±2.9 cm) compared to Without TENS group (-0.7±3.7 cm). There was a difference between mean change scores of each group for pain threshold (right trapezium: 0.2±1 kg/cm² in TENS group and -0.2±1.2 kg/cm² in Without TENS group). In the evaluation of clinically important changes, patients receiving TENS had relevant improvement of pain, work performance, fatigue, stiffness, anxiety and depression compared to those not receiving TENS. It has suggested that high-frequency TENS as an adjuvant therapy is effective in relieving pain, anxiety, fatigue, stiffness, and in improving ability to work of patients with fibromyalgia. High-frequency TENS may be used as a short-term complementary treatment of fibromyalgia.

Stress echocardiography with smartphone: real-time remote reading for regional wall motion.

PubMed

Scali, Maria Chiara; de Azevedo Bellagamba, Clarissa Carmona; Ciampi, Quirino; Simova, Iana; de Castro E Silva Pretto, José Luis; Djordjevic-Dikic, Ana; Dodi, Claudio; Cortigiani, Lauro; Zagatina, Angela; Trambaiolo, Paolo; Torres, Marco R; Citro, Rodolfo; Colonna, Paolo; Paterni, Marco; Picano, Eugenio

2017-11-01

The diffusion of smart-phones offers access to the best remote expertise in stress echo (SE). To evaluate the reliability of SE based on smart-phone filming and reading. A set of 20 SE video-clips were read in random sequence with a multiple choice six-answer test by ten readers from five different countries (Italy, Brazil, Serbia, Bulgaria, Russia) of the "SE2020" study network. The gold standard to assess accuracy was a core-lab expert reader in agreement with angiographic verification (0 = wrong, 1 = right). The same set of 20 SE studies were read, in random order and >2 months apart, on desktop Workstation and via smartphones by ten remote readers. Image quality was graded from 1 = poor but readable, to 3 = excellent. Kappa (k) statistics was used to assess intra- and inter-observer agreement. The image quality was comparable in desktop workstation vs. smartphone (2.0 ± 0.5 vs. 2.4 ± 0.7, p = NS). The average reading time per case was similar for desktop versus smartphone (90 ± 39 vs. 82 ± 54 s, p = NS). The overall diagnostic accuracy of the ten readers was similar for desktop workstation vs. smartphone (84 vs. 91%, p = NS). Intra-observer agreement (desktop vs. smartphone) was good (k = 0.81 ± 0.14). Inter-observer agreement was good and similar via desktop or smartphone (k = 0.69 vs. k = 0.72, p = NS). The diagnostic accuracy and consistency of SE reading among certified readers was high and similar via desktop workstation or via smartphone.

Polymerase chain reaction (PCR) in ocular and ganglionar toxoplasmosis and the effect of therapeutics for prevention of ocular involvement in South American setting.

PubMed

Gómez Marín, Jorge Enrique; Zuluaga, Juan David; Pechené Campo, Eunice Julied; Triviño, Jessica; de-la-Torre, Alejandra

2018-08-01

Cases of toxoplasmosis present in South America tend to be more severe than that found in other continents. Here, we present our clinical experience of ocular and ganglionar toxoplasmosis in the use of PCR, and of the treatment to prevent ocular involvement. Retrospective analysis of clinical charts of patients with ocular and lymphadenitic toxoplasmosis at the parasitology and tropical medicine consultation in the "Universidad del Quindio" in Colombia. In total, 91 records of cases with ocular toxoplasmosis and 17 with lymphadenitis that underwent PCR analysis for B1 repeated sequence in blood, were compared to the results of 104 people with chronic asymptomatic toxoplasmosis. In addition, 41 clinical records were included from patients with confirmed toxoplasmic lymphadenitis: 10 untreated, 6 that begun treatment after four months of symptoms, and 25 that were treated during the first four months of symptoms and had a follow-up during at least one year. Patients with ocular toxoplasmosis or lymphadenitis had a higher probability of PCR positivity in peripheral blood than chronic asymptomatic people. There were no cases of retinochoroiditis in 25 patients with toxoplasmic lymphadenitis treated before 4 months of symptoms and followed during at least 12 months. In four out of ten untreated cases, new lesions of retinochoroiditis presented after the symptoms of lymphadenitis. Toxoplasmosisin South America exhibits different clinical behavior and this influences the laboratory results as well as the need for treatment in the case of lymphadenitis. Clinicians should be aware of the geographical origin of the infection in order to adopt different therapeutic and diagnostic approaches. Copyright © 2018 Elsevier B.V. All rights reserved.

Comparison of Transcutaneous Electrical Nerve Stimulation and Parasternal Block for Postoperative Pain Management after Cardiac Surgery

PubMed Central

Ozturk, Nilgun Kavrut; Baki, Elif Dogan; Kavakli, Ali Sait; Sahin, Ayca Sultan; Ayoglu, Raif Umut; Karaveli, Arzu; Emmiler, Mustafa; Inanoglu, Kerem; Karsli, Bilge

2016-01-01

Background. Parasternal block and transcutaneous electrical nerve stimulation (TENS) have been demonstrated to produce effective analgesia and reduce postoperative opioid requirements in patients undergoing cardiac surgery. Objectives. To compare the effectiveness of TENS and parasternal block on early postoperative pain after cardiac surgery. Methods. One hundred twenty patients undergoing cardiac surgery were enrolled in the present randomized, controlled prospective study. Patients were assigned to three treatment groups: parasternal block, intermittent TENS application, or a control group. Results. Pain scores recorded 4 h, 5 h, 6 h, 7 h, and 8 h postoperatively were lower in the parasternal block group than in the TENS and control groups. Total morphine consumption was also lower in the parasternal block group than in the TENS and control groups. It was also significantly lower in the TENS group than in the control group. There were no statistical differences among the groups regarding the extubation time, rescue analgesic medication, length of intensive care unit stay, or length of hospital stay. Conclusions. Parasternal block was more effective than TENS in the management of early postoperative pain and the reduction of opioid requirements in patients who underwent cardiac surgery through median sternotomy. This trial is registered with Clinicaltrials.gov number NCT02725229. PMID:27445610

Ten years of health workforce planning in the Netherlands: a tentative evaluation of GP planning as an example

PubMed Central

2012-01-01

Introduction In many countries, health-care labour markets are constantly being challenged by an alternation of shortage and oversupply. Avoiding these cyclic variations is a major challenge. In the Netherlands, a workforce planning model has been used in health care for ten years. Case description Since 1970, the Dutch government has explored different approaches to determine the inflow in medical schools. In 2000, a simulation model for health workforce planning was developed to estimate the required and available capacity of health professionals in the Netherlands. In this paper, this model is explained, using the Dutch general practitioners as an example. After the different steps in the model are clarified, it is shown how elements can be added to arrive at different versions of the model, or ‘scenarios’. A comparison is made of the results of different scenarios for different years. In addition, the subsequent stakeholder decision-making process is considered. Discussion and evaluation Discussion of this paper shows that workforce planning in the Netherlands is a complex modelling task, which is sensitive to different developments influencing the balance between supply and demand. It seems plausible that workforce planning has resulted in a balance between supply and demand of general practitioners. Still, it remains important that the modelling process is accepted by the different stakeholders. Besides calculating the balance between supply and demand, there needs to be an agreement between the stakeholders to implement the advised training inflow. The Dutch simulation model was evaluated using six criteria to be met by models suitable for policy objectives. This model meets these criteria, as it is a comprehensive and parsimonious model that can include all relevant factors. Conclusion Over the last decade, health workforce planning in the Netherlands has become an accepted instrument for calculating the required supply of health professionals on a regular basis. One of the strengths of the Dutch model is that it can be used for different types of medical and allied health professionals. A weakness is that the model is not yet fully capable of including substitutions between different medical professions to plan from a skill-mix perspective. Several improvements remain possible. PMID:22888974

Trends and differences in tuberculosis incidences and clustering among natives in Denmark, Sweden and Finland: comparison of native incidences and molecular epidemiology among three low-incidence countries.

PubMed

Pedersen, M K; Lillebaek, T; Andersen, A B; Soini, H; Haanperä, M; Groenheit, R; Jonsson, J; Svensson, E

2018-07-01

To compare the epidemiology of tuberculosis (TB) in Denmark, Sweden and Finland, by focusing on the native population in order to identify epidemiologic differences and thus indirectly possible differences in TB control. TB incidence trends from 1990 through 2015 were compared among the countries. In addition, for the periods 2012-2013 and 2014-2015, genotyping data were compared. Genotyping was performed using the 24-locus mycobacterial interspersed repetitive unit-variable number of tandem repeat (MIRU-VNTR) method in Denmark and Sweden. For Finland, spoligotyping in conjunction with the 15-locus MIRU-VNTR method was used for 2012-2013 and translated into the 24-locus MIRU-VNTR when feasible, and for 2014-2015 only MIRU-VNTR was used. Both incidence trends and molecular epidemiology were assessed for native cases. The average annual rate of change in TB incidence for native Danes was -2.4% vs. -6.1% and -6.9% for native Swedes and Finns respectively. In 2012-2013 Denmark had 52 native cases in the largest transmission chain vs. three cases in Sweden and ten in Finland, and during the same period the clustering rate for native Danes was 48.8% vs. 6.5% and 18.2% for native Swedes and Finns respectively. For 2014-2015, a similar pattern was seen. The decline of TB among natives in Denmark is slower than for Sweden and Finland, and it seems Denmark has more active transmission among natives. The focused assessment on basic native TB epidemiology reveals striking differences in TB transmission among otherwise similar low-TB-incidence countries. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Emotional Intelligence in Patients with Spinal Cord Injury (SCI)

PubMed Central

SABERI, Hooshang; GHAJARZADEH, Mahsa

2017-01-01

Background: Spinal Cord Injury (SCI) is a devastating situation. Spinal Cord Injury affects functional, psychological and socioeconomic aspects of patients’ lives. The ability to accomplish and explicate the one’s own and other’s feelings and emotions to spread over appropriate information for confirming thoughts and actions is defined as emotional intelligence (EI). The goal of this study was to evaluate depression and EI in SCI patients in comparison with healthy subjects. Methods: One-hundred-ten patients with SCI and 80 healthy subjects between Aug 2014 and Aug 2015 were enrolled. The study was conducted in Imam Hospital, Tehran, Iran. All participants were asked to fill valid and reliable Persian version Emotional Quotient inventory (EQ-i) and Beck Depression Inventory (BDI). All data were analyzed using SPSS. Data were presented as Mean±SD for continuous or frequencies for categorical variables. Continuous variables compared by means of independent sample t-test. P-values less than 0.05 were considered as significant. Results: Mean age of patients was 28.7 and mean age of controls was 30.2 yr. Spinal cord injury in 20 (18.3%) were at cervical level, in 83 (75.4%) were thoracic and in 7 (6.3%) were lumbar. Mean values of independence, stress tolerance, self-actualization, emotional Self-Awareness, reality testing, Impulse Control, flexibility, responsibility, and assertiveness were significantly different between cases and controls. Mean values of stress tolerance, optimism, self-regard, and responsibility were significantly different between three groups with different injury level. Most scales were not significantly different between male and female cases. Conclusion: Emotional intelligence should be considered in SCI cases as their physical and psychological health is affected by their illness. PMID:28560199

Emotional Intelligence in Patients with Spinal Cord Injury (SCI).

PubMed

Saberi, Hooshang; Ghajarzadeh, Mahsa

2017-05-01

Spinal Cord Injury (SCI) is a devastating situation. Spinal Cord Injury affects functional, psychological and socioeconomic aspects of patients' lives. The ability to accomplish and explicate the one's own and other's feelings and emotions to spread over appropriate information for confirming thoughts and actions is defined as emotional intelligence (EI). The goal of this study was to evaluate depression and EI in SCI patients in comparison with healthy subjects. One-hundred-ten patients with SCI and 80 healthy subjects between Aug 2014 and Aug 2015 were enrolled. The study was conducted in Imam Hospital, Tehran, Iran. All participants were asked to fill valid and reliable Persian version Emotional Quotient inventory (EQ-i) and Beck Depression Inventory (BDI). All data were analyzed using SPSS. Data were presented as Mean±SD for continuous or frequencies for categorical variables. Continuous variables compared by means of independent sample t -test. P -values less than 0.05 were considered as significant. Mean age of patients was 28.7 and mean age of controls was 30.2 yr. Spinal cord injury in 20 (18.3%) were at cervical level, in 83 (75.4%) were thoracic and in 7 (6.3%) were lumbar. Mean values of independence, stress tolerance, self-actualization, emotional Self-Awareness, reality testing, Impulse Control, flexibility, responsibility, and assertiveness were significantly different between cases and controls. Mean values of stress tolerance, optimism, self-regard, and responsibility were significantly different between three groups with different injury level. Most scales were not significantly different between male and female cases. Emotional intelligence should be considered in SCI cases as their physical and psychological health is affected by their illness.

Results from the Hawaii domestic violence fatality review, 2000-2009

PubMed Central

Pobutsky, Ann; Brown, Melissa; Nakao, Lisa; Reyes-Salvail, Florentina

2014-01-01

Abstract: Background: Patterns of domestic violence fatalities and agency responses in Hawaii have not been explicated. Methods: Retrospective reviews of events leading up to domestic violence related fatalities in Hawaii were assessed from 45 adjudicated cases that resulted in 62 fatalities for the ten year period from 2000-2009. Results: Almost one-half of the fatalities were homicide/suicide combinations. Females were disproportionately more likely to be fatal victims of domestic violence relative to their proportion in the population. Those aged 21-40 years and those over 80 years were more likely to be fatal victims of domestic violence, relative to their proportion in the population. Filipinas and ‘Other” ethnic groups are disproportionately more likely to be fatal victims of domestic violence while Native Hawaiians and Japanese are less likely to be fatal victims, relative to their proportions in the population. In more than two-thirds of the cases, the victim had made some attempt to leave the relationship prior to the fatality. Conclusions: In the majority of cases there was agency involvement in some form: either the victim alone or the perpetrator alone, or both. However, less than one-third (31.1%) of the cases over the past ten years had documentation of prior violence from medical reports, so this may be an area to further document and address domestic violence. PMID:24292165

Results from the Hawaii domestic violence fatality review, 2000-2009.

PubMed

Pobutsky, Ann; Brown, Melissa; Nakao, Lisa; Reyes-Salvail, Florentina

2014-07-01

Patterns of domestic violence fatalities and agency responses in Hawaii have not been explicated. Retrospective reviews of events leading up to domestic violence related fatalities in Hawaii were assessed from 45 adjudicated cases that resulted in 62 fatalities for the ten year period from 2000-2009. Almost one-half of the fatalities were homicide/suicide combinations. Females were disproportionately more likely to be fatal victims of domestic violence relative to their proportion in the population. Those aged 21-40 years and those over 80 years were more likely to be fatal victims of domestic violence, relative to their proportion in the population. Filipinas and 'Other" ethnic groups are disproportionately more likely to be fatal victims of domestic violence while Native Hawaiians and Japanese are less likely to be fatal victims, relative to their proportions in the population. In more than two-thirds of the cases, the victim had made some attempt to leave the relationship prior to the fatality. In the majority of cases there was agency involvement in some form: either the victim alone or the perpetrator alone, or both. However, less than one-third (31.1%) of the cases over the past ten years had documentation of prior violence from medical reports, so this may be an area to further document and address domestic violence. © 2014 KUMS, All rights reserved.

Arthrodesis of the knee following failed arthroplasty.

PubMed

Van Rensch, P J H; Van de Pol, G J; Goosen, J H M; Wymenga, A B; De Man, F H R

2014-08-01

Primary stability in arthrodesis of the knee can be achieved by external fixation, intramedullary nailing or plate fixation. Each method has different features and results. We present a practical algorithm for arthrodesis of the knee following a failed (infected) arthroplasty, based on our own results and a literature review. Between 2004 and 2010, patients were included with an indication for arthrodesis after failed (revision) arthroplasty of the knee. Patients were analyzed with respect to indication, fusion method and bone contact. End-point was solid fusion. Twenty-six arthrodeses were performed. Eighteen patients were treated because of an infected arthroplasty. In total, ten external fixators, ten intramedullary nails and six plate fixations were applied; solid fusion was achieved in 3/10, 8/10 and 3/6, respectively. There is no definite answer as to which method is superior in performing an arthrodesis of the knee. Intramedullary nailing achieved the best fusion rates, but was used most in cases without--or cured--infection. Our data and the contemporary literature suggest that external fixation can be abandoned as standard fusion method, but can be of use following persisting infection. The Ilizarov circular external fixator, however, seems to render high fusion rates. Good patient selection and appropriate individual treatment are the key to a successful arthrodesis. Based upon these findings, a practical algorithm was developed.

Acoustic cue weighting in the singleton vs geminate contrast in Lebanese Arabic: The case of fricative consonants.

PubMed

Al-Tamimi, Jalal; Khattab, Ghada

2015-07-01

This paper is the first reported investigation of the role of non-temporal acoustic cues in the singleton-geminate contrast in Lebanese Arabic, alongside the more frequently reported temporal cues. The aim is to explore the extent to which singleton and geminate consonants show qualitative differences in a language where phonological length is prominent and where moraic structure governs segment timing and syllable weight. Twenty speakers (ten male, ten female) were recorded producing trochaic disyllables with medial singleton and geminate fricatives preceded by phonologically short and long vowels. The following acoustic measures were applied on the medial fricative and surrounding vowels: absolute duration; intensity; fundamental frequency; spectral peak and shape, dynamic amplitude, and voicing patterns of medial fricatives; and vowel quality and voice quality correlates of surrounding vowels. Discriminant analysis and receiver operating characteristics (ROC) curves were used to assess each acoustic cue's contribution to the singleton-geminate contrast. Classification rates of 89% and ROC curves with an area under the curve rate of 96% confirmed the major role played by temporal cues, with non-temporal cues contributing to the contrast but to a much lesser extent. These results confirm that the underlying contrast for gemination in Arabic is temporal, but highlight [+tense] (fortis) as a secondary feature.

Evolution of Capsaicinoids in Peter Pepper (Capsicum annuum var. annuum) During Fruit Ripening.

PubMed

Barbero, Gerardo F; de Aguiar, Ana C; Carrera, Ceferino; Olachea, Ángel; Ferreiro-González, Marta; Martínez, Julian; Palma, Miguel; Barroso, Carmelo G

2016-08-01

The evolution of individual and total contents of capsaicinoids present in Peter peppers (Capsicum annuum var. annuum) at different ripening stages has been studied. Plants were grown in a glasshouse and the new peppers were marked in a temporal space of ten days. The extraction of capsaicinoids was performed by ultrasound-assisted extraction with MeOH. The capsaicinoids nordihydrocapsaicin (n-DHC), capsaicin, dihydrocapsaicin, homocapsaicin, and homodihydrocapsaicin were analyzed by ultraperformance liquid chromatography (UHPLC)-fluorescence and identified by UHPLC-Q-ToF-MS. The results indicate that the total capsaicinoids increase in a linear manner from the first point of harvest at ten days (0.283 mg/g FW) up to 90 days, at which point they reach a concentration of 1.301 mg/g FW. The evolution as a percentage of the individual capsaicinoids showed the initial predominance of capsaicin, dihydrocapsaicin, and n-DHC. Dihydrocapsaicin was the major capsaicinoid up to day 50 of maturation. After 50 days, capsaicin became the major capsaicinoid as the concentration of dihydrocapsaicin fell slightly. The time of harvest of Peter pepper based on the total capsaicinoids content should be performed as late as possible. In any case, harvesting should be performed before overripening of the fruit is observed. © 2016 Wiley-VHCA AG, Zürich.

[Background and perspectives of opioid analgesics for the treatment of chronic pain in cancer patients in Russia].

PubMed

Abuzarova, G R; Khoronenko, V E; Sarmanaeva, R R

2015-01-01

The article deals with an analysis of availability of narcotic analgesics for the patients in the Russian Federation. The analysis was based on datafrom official sources on the scopes of opioids delivery in different regions of the Russian Federation and showed an extremely limited availability of narcotic analgesics for the patients in the Russian Federation. We found that availability of narcotic analgesics in Russia is hundreds times lower than the same indexes in European countries with various level of economic activity and in the USA. The analysis showed ten most progressive Russian regions where the use of opioids in the noninvasive forms has become part of systematic clinical practice according to WHO recommendations as well as 10 ten most backward regions where these drugs are hardly used despite of high figures of case death rates from cancer. We made a list of most needed modern Russian and internationally produced drugs according to international data and personal experience. Drugs from this list can be effectually used for the chronic pain therapy in oncology. The most advanced drugs that are soon will be produced are also named. The article describes high priority measures that have already been done to improve current situation and measures to be executed in the future.

Intrinsic and Extrinsic Motivation Among Adolescent Ten-Pin Bowlers in Kuala Lumpur, Malaysia

PubMed Central

Teo, Eng-Wah; Khoo, Selina; Wong, Rebecca; Wee, Eng-Hoe; Lim, Boon-Hooi; Rengasamy, Shabesan Sit

2015-01-01

Motivation has long been associated with sports engagement. However, to date no research has been performed to understand the domain of motivation among ten-pin bowlers. The purpose of this study was to investigate different types of motivation (i.e., intrinsic vs. extrinsic) based on self-determination theory from the perspective of gender and the bowler type (competitive vs. casual). A total of 240 bowlers (104 male, 136 female; 152 competitive, 88 casual) with a mean age of 16.61 ± 0.78 years were recruited in Kuala Lumpur. The Sport Motivation Scale, a 28-item self-report questionnaire measuring seven subscales (i.e., intrinsic motivation to know, intrinsic motivation to accomplish, intrinsic motivation to experience stimulation, extrinsic motivation to identify regulation, extrinsic motivation for introjection regulation, extrinsic motivation to external regulation, and amotivation) was administered. Results showed significant differences (t=10.43, df=239, p=0.01) between total scores of intrinsic and extrinsic motivation among ten-pin bowlers. There were significant gender differences with respect to intrinsic motivation to know, intrinsic motivation to accomplish, intrinsic motivation to experience stimulation, and extrinsic motivation to identify regulation. However, no significant bowler type differences were found for either the intrinsic (t=−1.15, df=238, p=0.25) or extrinsic (t=−0.51, df=238, p=0.61) motivation dimensions. In conclusion, our study demonstrated substantial intrinsic motivation for gender effects, but no bowler type effects among adolescent ten-pin bowlers. PMID:25964827

Intrinsic and extrinsic motivation among adolescent ten-pin bowlers in kuala lumpur, malaysia.

PubMed

Teo, Eng-Wah; Khoo, Selina; Wong, Rebecca; Wee, Eng-Hoe; Lim, Boon-Hooi; Rengasamy, Shabesan Sit

2015-03-29

Motivation has long been associated with sports engagement. However, to date no research has been performed to understand the domain of motivation among ten-pin bowlers. The purpose of this study was to investigate different types of motivation (i.e., intrinsic vs. extrinsic) based on self-determination theory from the perspective of gender and the bowler type (competitive vs. casual). A total of 240 bowlers (104 male, 136 female; 152 competitive, 88 casual) with a mean age of 16.61 ± 0.78 years were recruited in Kuala Lumpur. The Sport Motivation Scale, a 28-item self-report questionnaire measuring seven subscales (i.e., intrinsic motivation to know, intrinsic motivation to accomplish, intrinsic motivation to experience stimulation, extrinsic motivation to identify regulation, extrinsic motivation for introjection regulation, extrinsic motivation to external regulation, and amotivation) was administered. Results showed significant differences (t=10.43, df=239, p=0.01) between total scores of intrinsic and extrinsic motivation among ten-pin bowlers. There were significant gender differences with respect to intrinsic motivation to know, intrinsic motivation to accomplish, intrinsic motivation to experience stimulation, and extrinsic motivation to identify regulation. However, no significant bowler type differences were found for either the intrinsic (t=-1.15, df=238, p=0.25) or extrinsic (t=-0.51, df=238, p=0.61) motivation dimensions. In conclusion, our study demonstrated substantial intrinsic motivation for gender effects, but no bowler type effects among adolescent ten-pin bowlers.

Deductive Puzzling

ERIC Educational Resources Information Center

Wanko, Jeffrey J.

2010-01-01

To help fifth- through eighth-grade students develop their deductive reasoning skills, the author used a ten-week supplementary curriculum so that students could answer logic questions. The curriculum, a series of lessons built around language-independent logic puzzles, has been used in classrooms of fifth through eighth grades. In most cases,…

RESOLVING NEIGHBORHOOD-SCALE AIR TOXICS MODELING: A CASE STUDY IN WILMINGTON, CALIFORNIA

EPA Science Inventory

Air quality modeling is useful for characterizing exposures to air pollutants. While models typically provide results on regional scales, there is a need for refined modeling approaches capable of resolving concentrations on the scale of tens of meters, across modeling domains 1...

Azo dyes and related compounds as important aquatic contaminants: a ten-year case study

EPA Science Inventory

Mutagenicity has been found in several aquatic systems in the world; however, this activity usually is not associated with any of the compounds that are currently regulated. Attempting to identify these hazardous compounds, an integrated study was conducted, employing several dif...

Microblogging Activities: Language Play and Tool Transformation

ERIC Educational Resources Information Center

Hattem, David

2014-01-01

The following is a qualitative case study presenting three vignettes exploring the use of language play while microblogging during an academically sanctioned task. Ten students and one teacher used "Twitter" in an intensive, English as a second language advanced grammar course to practice writing sentences with complex grammatical…

Desensitization of Fire Bell Phobia

ERIC Educational Resources Information Center

O'Reilly, Patricia P.

1971-01-01

This case study presents an example of how one school psychologist helped a child and an entire class solve a problem. Although the techniques used are not unique to school psychological practice, the problems presented by their use are. The procedure consisted of a desensitization process lasting ten weeks. (Author)

An alternative transportation fuels update : a case study of the developing E85 industry.

DOT National Transportation Integrated Search

2011-10-01

As the United States imports more than half of its oil and overall consumption continues to climb, : the 1992 Energy Policy Act established the goal of having alternative fuels replace at least ten : percent of petroleum fuels used in the trans...

SPATIAL ASSOCIATION BETWEEN SPECIATED FINE PARTICLES AND MORTALITY

EPA Science Inventory

Particulate matter (PM) has been linked to a range of serious cardiovascular and respiratory health problems. Some of the recent epidemiologic studies suggest that exposures to PM may result in tens of thousands of excess deaths per year and many more cases of illness among the ...

User Interaction in Semi-Automatic Segmentation of Organs at Risk: a Case Study in Radiotherapy.

PubMed

Ramkumar, Anjana; Dolz, Jose; Kirisli, Hortense A; Adebahr, Sonja; Schimek-Jasch, Tanja; Nestle, Ursula; Massoptier, Laurent; Varga, Edit; Stappers, Pieter Jan; Niessen, Wiro J; Song, Yu

2016-04-01

Accurate segmentation of organs at risk is an important step in radiotherapy planning. Manual segmentation being a tedious procedure and prone to inter- and intra-observer variability, there is a growing interest in automated segmentation methods. However, automatic methods frequently fail to provide satisfactory result, and post-processing corrections are often needed. Semi-automatic segmentation methods are designed to overcome these problems by combining physicians' expertise and computers' potential. This study evaluates two semi-automatic segmentation methods with different types of user interactions, named the "strokes" and the "contour", to provide insights into the role and impact of human-computer interaction. Two physicians participated in the experiment. In total, 42 case studies were carried out on five different types of organs at risk. For each case study, both the human-computer interaction process and quality of the segmentation results were measured subjectively and objectively. Furthermore, different measures of the process and the results were correlated. A total of 36 quantifiable and ten non-quantifiable correlations were identified for each type of interaction. Among those pairs of measures, 20 of the contour method and 22 of the strokes method were strongly or moderately correlated, either directly or inversely. Based on those correlated measures, it is concluded that: (1) in the design of semi-automatic segmentation methods, user interactions need to be less cognitively challenging; (2) based on the observed workflows and preferences of physicians, there is a need for flexibility in the interface design; (3) the correlated measures provide insights that can be used in improving user interaction design.