Science.gov

Sample records for gasto total por

  1. FACTORS RELATED TO TOTAL ENERGY EXPENDITURE IN OLDER ADULTS (CHILE).

    PubMed

    Pakozdi, Tamara; Leiva, Laura; Bunout, Daniel; Barrera, Gladys; de la Maza, María Pía; Henriquez, Sandra; Hirsch, Sandra

    2015-10-01

    Objetivo: evaluar el Gasto Energético Total (GET) en ancianos sanos que viven institucionalizados o independientes en Chile. Método: se evaluaron veintisiete jovenes (27-30 años), 27 adultos mayores institucionalizados (> 65 años ) y 27 ancianos independientes (> 65 años). Se midió la composición corporal utilizando absorciometría bifotónica de rayos X. Se calculó el gasto energético por actividad física (GEAF) y el gasto energético total (GET) utilizando acelerómetros Actiheart; se aplicó Mini Nutritional Assessment (MNA) y se midió el Timed Up and Go (TUG). Resultados: el GEAF fue 171, 320 y 497 kcal/día en ancianos institucionalizados, independientes y jóvenes, respectivamente (p.

  2. jPOR: An ImageJ macro to quantify total optical porosity from blue-stained thin sections

    NASA Astrophysics Data System (ADS)

    Grove, Clayton; Jerram, Dougal A.

    2011-11-01

    A fast and effective method has been developed to measure total optical porosity (TOP) of blue resin-impregnated thin sections. This utilises a macro file (jPOR.txt) for ImageJ, which can be used on digital photomicrographs of thin sections. The method requires no specialised scientific equipment and can be run entirely using free to download software. Digital images are acquired from blue resin-impregnated thin sections using a conventional film scanner in the present study, though the technique can be applied to any high resolution colour digital acquired by different means (e.g., flat bed scanning, digital capture). Images are preprocessed using a newly developed custom 8-bit palette and analysed for porosity in ImageJ using the simple to use jPOR macro. Our method rapidly calculates TOP for batches of images with or without the option of user adjustment. Results are compared with conventional methods (e.g., to point counting), and tested with several users to estimate any user variability. jPOR provided comparable results to more time-consuming point counting, but with significantly less "counting error" and less interoperator variability than published point counting studies. The jPOR macro has been integrated into a macro tool set that can be configured to be run on ImageJ start up.

  3. Impacto del Seguro Popular en el gasto catastrófico y de bolsillo en el México rural y urbano, 2005–2008

    PubMed Central

    Sosa-Rubí, Sandra G; Salinas-Rodríguez, Aarón; Galárraga, Omar

    2016-01-01

    Objetivo Estimar el efecto del Seguro Popular (SP) sobre la incidencia del gasto catastrófico en salud (GCS) y sobre el gasto de bolsillo en salud (GBS) en el mediano plazo. Material y métodos Con base en la Encuesta de Evaluación del Seguro Popular (2005–2008), se analizaron los resultados del efecto del SP en la cohorte rural para dos años de seguimiento (2006 y 2008) y en la cohorte urbana para un año (2008). Resultados A nivel conglomerado no se detectaron efectos del SP. A nivel hogar se encontró que el SP tiene un efecto protector en el GCS y en el GBS en consulta externa y hospitalización en zonas rurales; y efectos significativos en la reducción de GBS en consulta externa en zonas urbanas. Conclusiones El SP se muestra como un programa efectivo para proteger a los hogares contra gastos de bolsillo por motivos de salud en el mediano plazo. PMID:22282205

  4. A SIMPLIFIED EQUATION FOR TOTAL ENERGY EXPENDITURE IN MECHANICALLY VENTILATED CRITICALLY ILL PATIENTS.

    PubMed

    Raurich, Joan Maria; Llompart-Pou, Juan Antonio; Ferreruela, Mireia; Riera, Maria; Homar, Javier; Marsé, Pere; Colomar, Asunción; Ayestarán, Ignacio

    2015-09-01

    Introducción: el concepto de “control calorico estricto” surgio para evitar la excesiva y la deficiente nutricion de los pacientes. Objetivo: describir y validar una ecuacion simplificada para el calculo del gasto energetico total (GET) en pacientes criticos con ventilacion mecanica. Métodos: analisis secundario de las mediciones de GET por calorimetria indirecta en pacientes criticos. Los pacientes fueron asignados de forma 2:1 por un paquete estadistico; el primer grupo se empleo para desarrollar la nueva ecuacion predictiva del GET (grupo predictivo) y el segundo para validarla (grupo validacion). La calorimetria indirecta se realizo con tres calorimetros diferentes: la bolsa de Douglas, un computador metabolico y el equipo CalorimetR. Hemos desarrollado la nueva ecuacion predictiva del GET utilizando el GET medido (en kcal/kg/d), como variable dependiente, y como variables independientes los diferentes factores que influyen en el gasto energetico: edad, genero, indice de masa corporal (IMC) y tipo de lesion. Resultados: el grupo de prediccion incluyo 179 pacientes y el de validacion 91 pacientes. La ecuacion predictiva fue: GETEP = 33 - (3 x E) - (3 x IMC) - (1 x G). Donde: E (edad en anos): ≤ 50 = 0; > 50 = 1. IMC (kg / m2): 18,5- 24,9 = 0; 25-29,9 = 1; 30-34,9 = 2; 35-39,9 = 3. G (genero): hombre = 0; mujer = 1. El sesgo (IC del 95%) entre el GET medido y el predicho fue de -0,1 (-1,0 a 0,7) kcal/ kg/dia y los limites de acuerdo (} 2SD) fueron -8,0 a 7,8 kcal/kg/d. El GET por la ecuacion predictiva fue preciso (entre el 85% y el 115%) en el 73,6% de los pacientes. Conclusiones: La nueva ecuacion predictiva fue aceptable para predecir el GET de la mayoria de pacientes criticos con ventilacion mecanica en la practica clinica.

  5. Total protein

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/003483.htm Total protein To use the sharing features on this page, please enable JavaScript. The total protein test measures the total amount of two classes ...

  6. Portable exhausters POR-004 SKID B, POR-005 SKID C, POR-006 SKID D storage plan

    SciTech Connect

    Nelson, O.D.

    1997-09-04

    This document provides a storage plan for portable exhausters POR-004 SKID B, POR-005 SKID C, AND POR-006 SKID D. The exhausters will be stored until they are needed by the TWRS (Tank Waste Remediation Systems) Saltwell Pumping Program. The storage plan provides criteria for portable exhauster storage, periodic inspections during storage, and retrieval from storage.

  7. [Risk factors for catheter-related bloodstream infection in non-critical patients with total parenteral nutrition].

    PubMed

    Ocón Bretón, María Julia; Mañas Martínez, Ana Belén; Medrano Navarro, Ana Lidia; García García, Blanca; Gimeno Orna, José Antonio

    2013-01-01

    Introducción: La bacteriemia asociada al catéter (BAC) es una de las complicaciones más importantes en pacientes portadores de un catéter venoso central (CVC) debido a su asociación con un incremento en la mortalidad, morbilidad y gasto sanitario. La administración de nutrición parenteral total (NPT) aumenta el riesgo de aparición de BAC. El objetivo de nuestro estudio fue determinar la tasa de incidencia y los factores de riesgo de BAC en pacientes con NPT hospitalizados en plantas médico-quirúrgicas. Métodos: Estudio observacional, analítico, retrospectivo donde se analizaron a todos los pacientes adultos no críticos que precisaron NPT desde enero de 2010 hasta noviembre de 2011. El punto final clínico fue la BAC. La tasa de incidencia de BAC se calculó en forma de episodios por cada 1.000 pacientes-día de cateterización. Los factores predictivos independientes de BAC se determinaron mediante regresión logística. Resultados: Durante el periodo de estudio precisaron NPT un total de 331 pacientes. La duración media del CVC fue de 12,4 (DE 8,7) días y la NPT fue infundida durante un periodo medio de 10,4 (DE 8,3) días. 47 pacientes presentaron BAC, con una tasa de incidencia de 11,4/1.000 pacientes- día de CVC y de 13,7/1.000 pacientes-día de NPT. Los factores predictores univariantes de aparición de BAC fueron la permanencia del CVC superior a 20 días (OR = 2,48; IC 95%: 1,16-5,26), la duración de la NPT superior a 2 semanas (OR = 4,63; IC 95%: 2,16-9,90) y la presencia de fístulas (OR = 3,08; IC 95%: 1,24-7,63). En análisis multivariante, el único predictor independiente de BAC fue la duración de la NPT (OR para una duración superior a 14 días = 4,9; IC 95%: 2,2-10,9; p < 0,0001). Conclusiones: En pacientes adultos hospitalizados en plantas diferentes a UCI, hemos demostrado que la duración de la infusión de la NPT incrementa el riesgo de BAC. El incremento de riesgo es especialmente marcado, llegando a multiplicarse por 5, con

  8. Total Energy Systems.

    ERIC Educational Resources Information Center

    Hick, Basil L.

    A total energy system is a means for providing all of the varied energy requirements for a total plant from a single fuel source. This report evaluates some of the factors which are related to the development and use of total energy systems. The factors include--(1) initial and ultimate size of plant, (2) type and source of fuel, (3)…

  9. Parallel Total Energy

    2004-10-21

    This is a total energy electronic structure code using Local Density Approximation (LDA) of the density funtional theory. It uses the plane wave as the wave function basis set. It can sue both the norm conserving pseudopotentials and the ultra soft pseudopotentials. It can relax the atomic positions according to the total energy. It is a parallel code using MP1.

  10. Total Quality Leadership

    NASA Technical Reports Server (NTRS)

    1991-01-01

    More than 750 NASA, government, contractor, and academic representatives attended the Seventh Annual NASA/Contractors Conference on Quality and Productivity. The panel presentations and Keynote speeches revolving around the theme of total quality leadership provided a solid base of understanding of the importance, benefits, and principles of total quality management (TQM). The presentations from the conference are summarized.

  11. Total arm flap.

    PubMed

    Becker, D W

    1987-11-01

    The development of an unusual and rarely indicated total arm flap is described in the context of widely indicated and automatically used principles passed down by the recognized father of plastic surgery, Sir Harold G. Gillies.

  12. Total Water Management - slides

    EPA Science Inventory

    Total Water Management (TWM) examines urban water systems in an interconnected manner. It encompasses reducing water demands, increasing water recycling and reuse, creating water supply assets from stormwater management, matching water quality to end-use needs, and achieving envi...

  13. [Total temporomandibular joint prostheses].

    PubMed

    Zwetyenga, N; Amroun, S; Wajszczak, B-L; Moris, V

    2016-09-01

    The temporomandibular joint (TMJ) is probably the most complex human joint. As in all joints, its prosthetic replacement may be indicated in selected cases. Significant advances have been made in the design of TMJ prostheses during the last three decades and the indications have been clarified. The aim of our work was to make an update on the current total TMJ total joint replacement. Indications, contraindications, prosthetic components, advantages, disadvantages, reasons for failure or reoperation, virtual planning and surgical protocol have been exposed.

  14. Total lymphoid irradiation

    SciTech Connect

    Sutherland, D.E.; Ferguson, R.M.; Simmons, R.L.; Kim, T.H.; Slavin, S.; Najarian, J.S.

    1983-05-01

    Total lymphoid irradiation by itself can produce sufficient immunosuppression to prolong the survival of a variety of organ allografts in experimental animals. The degree of prolongation is dose-dependent and is limited by the toxicity that occurs with higher doses. Total lymphoid irradiation is more effective before transplantation than after, but when used after transplantation can be combined with pharmacologic immunosuppression to achieve a positive effect. In some animal models, total lymphoid irradiation induces an environment in which fully allogeneic bone marrow will engraft and induce permanent chimerism in the recipients who are then tolerant to organ allografts from the donor strain. If total lymphoid irradiation is ever to have clinical applicability on a large scale, it would seem that it would have to be under circumstances in which tolerance can be induced. However, in some animal models graft-versus-host disease occurs following bone marrow transplantation, and methods to obviate its occurrence probably will be needed if this approach is to be applied clinically. In recent years, patient and graft survival rates in renal allograft recipients treated with conventional immunosuppression have improved considerably, and thus the impetus to utilize total lymphoid irradiation for its immunosuppressive effect alone is less compelling. The future of total lymphoid irradiation probably lies in devising protocols in which maintenance immunosuppression can be eliminated, or nearly eliminated, altogether. Such protocols are effective in rodents. Whether they can be applied to clinical transplantation remains to be seen.

  15. Total Energy Monitor

    SciTech Connect

    Friedrich, S

    2008-08-11

    The total energy monitor (TE) is a thermal sensor that determines the total energy of each FEL pulse based on the temperature rise induced in a silicon wafer upon absorption of the FEL. The TE provides a destructive measurement of the FEL pulse energy in real-time on a pulse-by-pulse basis. As a thermal detector, the TE is expected to suffer least from ultra-fast non-linear effects and to be easy to calibrate. It will therefore primarily be used to cross-calibrate other detectors such as the Gas Detector or the Direct Imager during LCLS commissioning. This document describes the design of the TE and summarizes the considerations and calculations that have led to it. This document summarizes the physics behind the operation of the Total Energy Monitor at LCLS and derives associated engineering specifications.

  16. Total colonoscopy in children.

    PubMed Central

    Williams, C. B.; Laage, N. J.; Campbell, C. A.; Douglas, J. R.; Walker-Smith, J. A.; Booth, I. W.; Harries, J. T.

    1982-01-01

    One hundred and twenty-three total colonoscopies were performed on 115 children with ages ranging from 3 months to 16 years. The major indications were suspected inflammatory bowel disease and unexplained rectal bleeding. Ninety-seven per cent of all procedures were carried out with sedation only. Adult colonoscopes were used in most of the patients but in babies and small children paediatric instruments were preferable. Total colonoscopy was possible in all patients with a patent colon. The terminal ileum was examined in 63 patients. Endoscopic snare polypectomy was successfully carried out in 8 children and multiple haemangiomas were electrocoagulated in one. Total colonoscopy in this paediatric series proved to be at least as easy, rapid, well-tolerated, and safe as in adults. In selected patients as single colonoscopy can give an accurate diagnosis with biopsy proof and sometimes the opportunity for definitive treatment. PMID:7065694

  17. Total Synthesis of (+)-Acutiphycin

    PubMed Central

    Moslin, Ryan M.; Jamison, Timothy F.

    2011-01-01

    Synthetic studies toward the total synthesis of (+)-acutiphycin (1) resulted in the discovery of additive-free, highly regioselective nickel-catalyzed reductive coupling reactions of aldehydes and 1,6-enynes and the construction of an advanced intermediate in studies directed toward the synthesis of 1. Ultimately, though not employing the nickel-catalyzed reaction, a highly convergent total synthesis of (+)-acutiphycin featuring an intermolecular SmI2-mediated Reformatsky coupling reaction and macrolactonization initiated by a retro-ene reaction of an alkoxyalkyne was achieved. The resulting synthesis was 18 steps in the longest linear sequence from either methyl acetoacetate or isobutyraldehyde. PMID:17985925

  18. [Total temporomandibular joint prostheses].

    PubMed

    Zwetyenga, N; Amroun, S; Wajszczak, B-L; Moris, V

    2016-09-01

    The temporomandibular joint (TMJ) is probably the most complex human joint. As in all joints, its prosthetic replacement may be indicated in selected cases. Significant advances have been made in the design of TMJ prostheses during the last three decades and the indications have been clarified. The aim of our work was to make an update on the current total TMJ total joint replacement. Indications, contraindications, prosthetic components, advantages, disadvantages, reasons for failure or reoperation, virtual planning and surgical protocol have been exposed. PMID:27554487

  19. Total synthesis of (-)-lepistine.

    PubMed

    Kitabayashi, Yusuke; Yokoshima, Satoshi; Fukuyama, Tohru

    2014-06-01

    The first total synthesis of (-)-lepistine has been accomplished in 11 steps from (S)-glycidol. The synthesis features construction of the 10-membered ring via an intramolecular epoxide opening by nosylamide, regioselective dehydration to form an enol ether, and construction of the aminal moiety induced by cleavage of the nosyl groups.

  20. Total Technology Immersion

    ERIC Educational Resources Information Center

    Vaughn, Sandy

    2010-01-01

    Total technology immersion doesn't happen overnight, but with vision and determination, transformation can take hold and start to grow. Floydada Independent School District (FISD), winner of the 2010 Sylvia Charp Award for District Innovation in Technology, is a great example of what a district can achieve when starting with a modest tech…

  1. "Total Deposition (TDEP) Maps"

    EPA Science Inventory

    The presentation provides an update on the use of a hybrid methodology that relies on measured values from national monitoring networks and modeled values from CMAQ to produce of maps of total deposition for use in critical loads and other ecological assessments. Additionally, c...

  2. Estuarine Total Ecosystem Metabolism

    EPA Science Inventory

    Total ecosystem metabolism (TEM), both as discrete measurements and as a theoretical concept, has an important history in ecosystem ecology, particularly in estuaries. Some of the earliest ecological studies were developed to determine how energy flowed through an ecosystem and w...

  3. Total synthesis of (+)-sundiversifolide.

    PubMed

    Yokoe, Hiromasa; Sasaki, Hiroyuki; Yoshimura, Tomoyuki; Shindo, Mitsuru; Yoshida, Masahiro; Shishido, Kozo

    2007-03-15

    The first, enantiocontrolled total synthesis of (+)-sundiversifolide has been accomplished using the sequential ring-closing metathesis, [3,3]-sigmatropic rearrangement, and iodolactonization for the key assembly of the cis-fused oxabicyclo[5.3.0]decene framework of the natural product. [structure: see text

  4. Total Precipitable Water

    SciTech Connect

    2012-01-01

    The simulation was performed on 64K cores of Intrepid, running at 0.25 simulated-years-per-day and taking 25 million core-hours. This is the first simulation using both the CAM5 physics and the highly scalable spectral element dynamical core. The animation of Total Precipitable Water clearly shows hurricanes developing in the Atlantic and Pacific.

  5. Total Water Management - Report

    EPA Science Inventory

    There is a growing need for urban water managers to take a more holistic view of their water resource systems as population growth, urbanization, and current operations put different stresses on the environment and urban infrastructure. Total Water Management (TWM) is an approac...

  6. Total Water Management

    EPA Science Inventory

    This project will investigate total water management (TWM) as a way of improving water resource management and reducing waste streams. This project will also improve management of potable water, wastewater and wet-weather flow through combined management, reuse and recycling wil...

  7. Total Synthesis of Nosiheptide.

    PubMed

    Wojtas, K Philip; Riedrich, Matthias; Lu, Jin-Yong; Winter, Philipp; Winkler, Thomas; Walter, Sophia; Arndt, Hans-Dieter

    2016-08-01

    Total synthesis of the bismacrocyclic thiopeptide antibiotic nosiheptide was achieved through the assembly of a fully functionalized linear precursor followed by consecutive macrocyclizations. Key features are a critical macrothiolactonization and a mild deprotection strategy for the 3-hydroxypyridine core. The natural product was identical to isolated authentic material in terms of spectral data and antibiotic activity. PMID:27345011

  8. CSF total protein

    MedlinePlus

    CSF total protein is a test to determine the amount of protein in your spinal fluid, also called cerebrospinal fluid (CSF). ... The normal protein range varies from lab to lab, but is typically about 15 to 60 mg/dL. Note: mg/dL = ...

  9. Guidance for Total Development.

    ERIC Educational Resources Information Center

    Van Hoose, William H.

    Elementary guidance, deriving much of its content from the developmental phenomena of middle childhood, is viewed as the maximization of human potentiality in the total range of the population. Included in the list of elementary school guidance objectives are (1) aiding academic development, (2) helping children develop health self-concepts, (3)…

  10. Total Quality Management Seminar.

    ERIC Educational Resources Information Center

    Massachusetts Career Development Inst., Springfield.

    This booklet is one of six texts from a workplace literacy curriculum designed to assist learners in facing the increased demands of the workplace. The booklet contains seven sections that cover the following topics: (1) meaning of total quality management (TQM); (2) the customer; (3) the organization's culture; (4) comparison of management…

  11. Total Quality Management Simplified.

    ERIC Educational Resources Information Center

    Arias, Pam

    1995-01-01

    Maintains that Total Quality Management (TQM) is one method that helps to monitor and improve the quality of child care. Lists four steps for a child-care center to design and implement its own TQM program. Suggests that quality assurance in child-care settings is an ongoing process, and that TQM programs help in providing consistent, high-quality…

  12. Portable exhauster POR-007/Skid E and POR-008/Skid F storage plan

    SciTech Connect

    Nelson, O.D.

    1998-07-25

    This document provides storage requirements for 1,000 CFM portable exhausters POR-O07/Skid E and POR-008/Skid F. These requirements are presented in three parts: preparation for storage, storage maintenance and testing, and retrieval from storage. The exhauster component identification numbers listed in this document contain the prefix POR-007 or POR-008 depending on which exhauster is being used.

  13. [Total thyroidectomy treatment of bening multinodular goiter].

    PubMed

    Palas, César; Álvarez, Facundo; Ferreira, Gastón; Gramática, Luis h

    2014-01-01

    Introducción. El tratamiento del bocio multinodular beningo (BMNB) es motivo de continuo debate en las últimas décadas pese a la evidencia de que la tiroidectomía total (TT) está relacionada a una reducción significativa en la recurrencia de la enfermedad y a una mínima morbilidad en manos entrenadas. Objetivo. Determinar la recurrencia del BMNB al cabo de 10 años en 100 pacientes tratados con TT y evaluar las complicaciones relacionadas a la técnica.Diseño. Prospectivo no randomizado.Material y métodos. Desde marzo del 1999 a marzo del 2001, cien pacientes, 95 del sexo femenino, con un promedio de edad de 42,4 años (rango: 23-67), fueron sometidos a una TT por padecer un BMNB, el cual fue confirmado por la ecografía cervical, la que además sirvió de guía para realizar la punción aspiración con aguja fina (PAAF). En todos los casos se realizó un laringoscopía inderecta pre y post postquirúrgica. Resultados. El tiempo operatorio promedio fue de 49 minutos (rango: 35-58). Registramos una parálisis recurrencial (1%) y cinco hipoparatiroidismos (5%), ambos transitorios y ningún caso definitivo. Todos los pacientes fueron dados de alta antes de las 24 horas de la cirugía. No objetivamos ninguna recurrencia del BMNB en un período de seguimiento de más de 10 años.Conclusión. La TT es el tratamiento elección del BMNB, por ser un procedimiento eficaz, seguro, con mínimas tasas de complicaciones y por evitar o reducir significativamente la recurrencia de esta enfermedad.

  14. Totally parallel multilevel algorithms

    NASA Technical Reports Server (NTRS)

    Frederickson, Paul O.

    1988-01-01

    Four totally parallel algorithms for the solution of a sparse linear system have common characteristics which become quite apparent when they are implemented on a highly parallel hypercube such as the CM2. These four algorithms are Parallel Superconvergent Multigrid (PSMG) of Frederickson and McBryan, Robust Multigrid (RMG) of Hackbusch, the FFT based Spectral Algorithm, and Parallel Cyclic Reduction. In fact, all four can be formulated as particular cases of the same totally parallel multilevel algorithm, which are referred to as TPMA. In certain cases the spectral radius of TPMA is zero, and it is recognized to be a direct algorithm. In many other cases the spectral radius, although not zero, is small enough that a single iteration per timestep keeps the local error within the required tolerance.

  15. Total synthesis of clostrubin

    PubMed Central

    Yang, Ming; Li, Jian; Li, Ang

    2015-01-01

    Clostrubin is a potent antibiotic against methicillin- and vancomycin-resistant bacteria that was isolated from a strictly anaerobic bacterium Clostridium beijerinckii in 2014. This polyphenol possesses a fully substituted arene moiety on its pentacyclic scaffold, which poses a considerable challenge for chemical synthesis. Here we report the first total synthesis of clostrubin in nine steps (the longest linear sequence). A desymmetrization strategy is exploited based on the inherent structural feature of the natural product. Barton–Kellogg olefination forges the two segments together to form a tetrasubstituted alkene. A photo-induced 6π electrocyclization followed by spontaneous aromatization constructs the hexasubstituted B ring at a late stage. In total, 200 mg of clostrubin are delivered through this approach. PMID:25759087

  16. Total Synthesis of Isokidamycin

    PubMed Central

    O’Keefe, B. Michael; Mans, Douglas M.; Kaelin, David E.; Martin, Stephen F.

    2010-01-01

    The synthesis of isokidamycin, which represents the first total synthesis of a bis-C-aryl glycoside natural product in the pluramycin family, has been completed. The synthesis features the use of a silicon tether as a disposable regiocontrol element in an intramolecular Diels-Alder reaction between a substituted naphthyne and a glycosyl furan and a subsequent O → C-glycoside rearrangement. PMID:20958036

  17. Total Synthesis of Millingtonine.

    PubMed

    Brown, Patrick D; Lawrence, Andrew L

    2016-07-11

    Millingtonine is a glycosidic alkaloid that exists as a pair of pseudo-enantiomeric diastereomers. Consideration of the likely biosynthetic origins of this unusual natural product has resulted in the development of a seven-step total synthesis. Results from this synthetic work provide evidence in support of a proposed network of biosynthetic pathways that can account for the formation of several phenylethanoid natural products. PMID:27249628

  18. Total synthesis of ochnaflavone.

    PubMed

    Ndoile, Monica M; van Heerden, Fanie R

    2013-01-01

    The first total syntheses of ochnaflavone, an asymmetric biflavone consisting of apigenin and luteolin moieties, and the permethyl ether of 2,3,2'',3''-tetrahydroochnaflavone have been achieved. The key steps in the synthesis of ochnaflavone were the formation of a diaryl ether and ring cyclization of an ether-linked dimeric chalcone to assemble the two flavone nuclei. Optimal experimental conditions for the oxidative cyclization to form ochnaflavone were established.

  19. Total synthesis of ochnaflavone

    PubMed Central

    Ndoile, Monica M

    2013-01-01

    Summary The first total syntheses of ochnaflavone, an asymmetric biflavone consisting of apigenin and luteolin moieties, and the permethyl ether of 2,3,2'',3''-tetrahydroochnaflavone have been achieved. The key steps in the synthesis of ochnaflavone were the formation of a diaryl ether and ring cyclization of an ether-linked dimeric chalcone to assemble the two flavone nuclei. Optimal experimental conditions for the oxidative cyclization to form ochnaflavone were established. PMID:23946830

  20. Total synthesis of teixobactin

    NASA Astrophysics Data System (ADS)

    Jin, Kang; Sam, Iek Hou; Po, Kathy Hiu Laam; Lin, Du'an; Ghazvini Zadeh, Ebrahim H.; Chen, Sheng; Yuan, Yu; Li, Xuechen

    2016-08-01

    To cope with the global bacterial multidrug resistance, scientific communities have devoted significant efforts to develop novel antibiotics, particularly those with new modes of actions. Teixobactin, recently isolated from uncultured bacteria, is considered as a promising first-in-class drug candidate for clinical development. Herein, we report its total synthesis by a highly convergent Ser ligation approach and this strategy allows us to prepare several analogues of the natural product.

  1. Total femoral replacement.

    PubMed

    Nerubay, J; Katznelson, A; Tichler, T; Rubinstein, Z; Morag, B; Bubis, J J

    1988-04-01

    Between 1973 and 1983, 19 patients with sarcoma of the femur were treated by adjuvant chemotherapy, excision of the entire femur, and replacement by a total femoral prosthesis. Five patients had excellent and nine had good functional results. Twelve patients died an average of 23 months after the procedure and seven are at present disease free. This limb-saving procedure permits rapid rehabilitation, prevents severe psychological problems, and improves the quality of life.

  2. Total synthesis of teixobactin.

    PubMed

    Jin, Kang; Sam, Iek Hou; Po, Kathy Hiu Laam; Lin, Du'an; Ghazvini Zadeh, Ebrahim H; Chen, Sheng; Yuan, Yu; Li, Xuechen

    2016-01-01

    To cope with the global bacterial multidrug resistance, scientific communities have devoted significant efforts to develop novel antibiotics, particularly those with new modes of actions. Teixobactin, recently isolated from uncultured bacteria, is considered as a promising first-in-class drug candidate for clinical development. Herein, we report its total synthesis by a highly convergent Ser ligation approach and this strategy allows us to prepare several analogues of the natural product. PMID:27484680

  3. Total synthesis of teixobactin

    PubMed Central

    Jin, Kang; Sam, Iek Hou; Po, Kathy Hiu Laam; Lin, Du'an; Ghazvini Zadeh, Ebrahim H.; Chen, Sheng; Yuan, Yu; Li, Xuechen

    2016-01-01

    To cope with the global bacterial multidrug resistance, scientific communities have devoted significant efforts to develop novel antibiotics, particularly those with new modes of actions. Teixobactin, recently isolated from uncultured bacteria, is considered as a promising first-in-class drug candidate for clinical development. Herein, we report its total synthesis by a highly convergent Ser ligation approach and this strategy allows us to prepare several analogues of the natural product. PMID:27484680

  4. Physician Update: Total Health

    PubMed Central

    Tuso, Phillip

    2014-01-01

    As an integrated prepaid health care system, Kaiser Permanente (KP) is in a unique position to demonstrate that affordability in health care can be achieved by disease prevention. During the past decade, KP has significantly improved the quality care outcomes of its members with preventable diseases. However, because of an increase in the incidence of preventable disease, and the potential long-term and short-term costs associated with the treatment of preventable disease, KP has developed a new strategy called Total Health to meet the current and future needs of its patients. Total Health means healthy people in healthy communities. KP’s strategic vision is to be a leader in Total Health by making lives better. KP hopes to make lives better by 1) measuring vital signs of health, 2) promoting healthy behaviors, 3) monitoring disease incidence, 4) spreading leading practices, and 5) creating healthy environments with our community partners. Best practices, spread to the communities we serve, will make health care more affordable, prevent preventable diseases, and save lives. PMID:24694316

  5. Total Shoulder Arthroplasty

    PubMed Central

    Sanchez-Sotelo, Joaquin

    2011-01-01

    Shoulder arthroplasty has been the subject of marked advances over the last few years. Modern implants provide a wide range of options, including resurfacing of the humeral head, anatomic hemiarthroplasty, total shoulder arthroplasty, reverse shoulder arthroplasty and trauma-specific implants for fractures and nonunions. Most humeral components achieve successful long-term fixation without bone cement. Cemented all-polyethylene glenoid components remain the standard for anatomic total shoulder arthroplasty. The results of shoulder arthroplasty vary depending on the underlying diagnosis, the condition of the soft-tissues, and the type of reconstruction. Total shoulder arthroplasty seems to provide the best outcome for patients with osteoarthritis and inflammatory arthropathy. The outcome of hemiarthroplasty for proximal humerus fractures is somewhat unpredictable, though it seems to have improved with the use of fracture-specific designs, more attention to tuberosity repair, and the selective use of reverse arthroplasty, as well as a shift in indications towards internal fixation. Reverse shoulder arthroplasty has become extremely popular for patients with cuff-tear arthropathy, and its indications have been expanded to the field of revision surgery. Overall, shoulder arthroplasty is a very successful procedure with predictable pain relief and substantial improvements in motion and function. PMID:21584206

  6. Modular total absorption spectrometer

    NASA Astrophysics Data System (ADS)

    Karny, M.; Rykaczewski, K. P.; Fijałkowska, A.; Rasco, B. C.; Wolińska-Cichocka, M.; Grzywacz, R. K.; Goetz, K. C.; Miller, D.; Zganjar, E. F.

    2016-11-01

    The design and performance of the Modular Total Absorption Spectrometer built and commissioned at the Oak Ridge National Laboratory is presented. The active volume of the detector is approximately one ton of NaI(Tl), which results in very high full γ energy peak efficiency of 71% at 6 MeV and nearly flat efficiency of around 81.5% for low energy γ-rays between 300 keV and 1 MeV. In addition to the high peak efficiency, the modular construction of the detector permits the use of a γ-coincidence technique in data analysis as well as β-delayed neutron observation.

  7. Total Synthesis of Teixobactin.

    PubMed

    Giltrap, Andrew M; Dowman, Luke J; Nagalingam, Gayathri; Ochoa, Jessica L; Linington, Roger G; Britton, Warwick J; Payne, Richard J

    2016-06-01

    The first total synthesis of the cyclic depsipeptide natural product teixobactin is described. Synthesis was achieved by solid-phase peptide synthesis, incorporating the unusual l-allo-enduracididine as a suitably protected synthetic cassette and employing a key on-resin esterification and solution-phase macrolactamization. The synthetic natural product was shown to possess potent antibacterial activity against a range of Gram-positive pathogenic bacteria, including a virulent strain of Mycobacterium tuberculosis and methicillin-resistant Staphylococcus aureus (MRSA). PMID:27191730

  8. The Total Eclipse 1999

    NASA Astrophysics Data System (ADS)

    Gaina, Alexei B.

    1999-01-01

    The article represents an interview to the journalist Irina A. Anatol'eva (Subbotovich) from the "Nezavisimaya Moldova" Newspaper, concerning the Total Eclipse of the Sun from August 11, 1999. One discusses also about History of Astronomy, particularly about the Astronomer Alexander Nikolaevich Deutsch (31.12.1900/1.01.1901-1986), astrometrist, professor and director of the Observatory in Pulkovo, born in the town of Reni (South Bessarabia). Another subjects were concerned to manifestations of gravity at cosmic scales (Time-mashine) and astrology.

  9. Total Synthesis of (-)-Daphenylline.

    PubMed

    Yamada, Ryosuke; Adachi, Yohei; Yokoshima, Satoshi; Fukuyama, Tohru

    2016-05-10

    Total synthesis of (-)-daphenylline, a hexacyclic Daphniphyllum alkaloid, was achieved. Construction of the tricyclic DEF ring system was initiated by asymmetric Negishi coupling followed by an intramolecular Friedel-Crafts reaction. Installation of a side chain onto the tricyclic core was carried out through Sonogashira coupling, stereocontrolled Claisen rearrangement by taking advantage of the characteristic conformation of the tricyclic DEF core, and the stereoselective alkylation of a lactone. After the introduction of a glycine unit, the ABC ring system was stereoselectively constructed through intramolecular cycloaddition of the cyclic azomethine ylide. PMID:27062676

  10. Cementless total knee arthroplasty

    PubMed Central

    Risitano, Salvatore; Sabatini, Luigi; Giachino, Matteo; Agati, Gabriele; Massè, Alessandro

    2016-01-01

    Interest for uncemented total knee arthroplasty (TKA) has greatly increased in recent years. This technique, less used than cemented knee replacement in the last decades, sees a revival thanks an advance in prosthetic design, instrumentation and operative technique. The related literature in some cases shows conflicting data on survival and on the revision’s rate, but in most cases a success rate comparable to cemented TKA is reported. The optimal fixation in TKA is a subject of debate with the majority of surgeons favouring cemented fixation. PMID:27162779

  11. Total ankle joint replacement.

    PubMed

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications.

  12. Total Synthesis of Hyperforin.

    PubMed

    Ting, Chi P; Maimone, Thomas J

    2015-08-26

    A 10-step total synthesis of the polycyclic polyprenylated acylphloroglucinol (PPAP) natural product hyperforin from 2-methylcyclopent-2-en-1-one is reported. This route was enabled by a diketene annulation reaction and an oxidative ring expansion strategy designed to complement the presumed biosynthesis of this complex meroterpene. The described work enables the preparation of a highly substituted bicyclo[3.3.1]nonane-1,3,5-trione motif in only six steps and thus serves as a platform for the construction of easily synthesized, highly diverse PPAPs modifiable at every position. PMID:26252484

  13. TOTAL user manual

    NASA Technical Reports Server (NTRS)

    Johnson, Sally C.; Boerschlein, David P.

    1994-01-01

    Semi-Markov models can be used to analyze the reliability of virtually any fault-tolerant system. However, the process of delineating all of the states and transitions in the model of a complex system can be devastatingly tedious and error-prone. Even with tools such as the Abstract Semi-Markov Specification Interface to the SURE Tool (ASSIST), the user must describe a system by specifying the rules governing the behavior of the system in order to generate the model. With the Table Oriented Translator to the ASSIST Language (TOTAL), the user can specify the components of a typical system and their attributes in the form of a table. The conditions that lead to system failure are also listed in a tabular form. The user can also abstractly specify dependencies with causes and effects. The level of information required is appropriate for system designers with little or no background in the details of reliability calculations. A menu-driven interface guides the user through the system description process, and the program updates the tables as new information is entered. The TOTAL program automatically generates an ASSIST input description to match the system description.

  14. Laparoscopic Total Mesorectum Excision

    PubMed Central

    Quilici, F.A.; Cordeiro, F.; Reis, J.A.; Kagohara, O.; Simões Neto, J.

    2002-01-01

    The main controversy of colon-rectal laparoscopic surgery comes from its use as a cancer treatment. Two points deserve special attention: the incidence of portsite tumor implantation and the possibility of performing radical cancer surgery, such as total mesorectum excision. Once these points are addressed, the laparoscopic approach will be used routinely to treat rectal cancer. To clarify these points, 32 patients with cancer of the lower rectum participated in a special protocol that included preoperative radiotherapy and laparoscopic total mesorectum excision. All data were recorded. At the same time, all data recorded from the experience of a multicenter laparoscopic group (Brazilian Colorectal Laparoscopic Surgeons – 130 patients with tumor of the lower rectum) were analyzed and compared with the data provided by our patients. Analysis of the results suggests that a laparoscopic approach allows the same effective resection as that of conventional surgery and that preoperative irradiation does not influence the incidence of intraoperative complications. The extent of lymph nodal excision is similar to that obtained with open surgery, with an average of 12.3 lymph nodes dissected per specimen. The rate of local recurrence was 3.12%. No port site implantation of tumor was noted in this series of patients with cancer of the lower rectum. PMID:12113422

  15. Anisotropic Total Variation Filtering

    SciTech Connect

    Grasmair, Markus; Lenzen, Frank

    2010-12-15

    Total variation regularization and anisotropic filtering have been established as standard methods for image denoising because of their ability to detect and keep prominent edges in the data. Both methods, however, introduce artifacts: In the case of anisotropic filtering, the preservation of edges comes at the cost of the creation of additional structures out of noise; total variation regularization, on the other hand, suffers from the stair-casing effect, which leads to gradual contrast changes in homogeneous objects, especially near curved edges and corners. In order to circumvent these drawbacks, we propose to combine the two regularization techniques. To that end we replace the isotropic TV semi-norm by an anisotropic term that mirrors the directional structure of either the noisy original data or the smoothed image. We provide a detailed existence theory for our regularization method by using the concept of relaxation. The numerical examples concluding the paper show that the proposed introduction of an anisotropy to TV regularization indeed leads to improved denoising: the stair-casing effect is reduced while at the same time the creation of artifacts is suppressed.

  16. Total synthesis of atropurpuran.

    PubMed

    Gong, Jing; Chen, Huan; Liu, Xiao-Yu; Wang, Zhi-Xiu; Nie, Wei; Qin, Yong

    2016-01-01

    Due to their architectural intricacy and biological significance, the synthesis of polycyclic diterpenes and their biogenetically related alkaloids have been the subject of considerable interest over the last few decades, with progress including the impressive synthesis of several elusive targets. Despite tremendous efforts, conquering the unique structural types of this large natural product family remains a long-term challenge. The arcutane diterpenes and related alkaloids, bearing a congested tetracyclo[5.3.3.0(4,9).0(4,12)]tridecane unit, are included in these unsolved enigmas. Here we report a concise approach to the construction of the core structure of these molecules and the first total synthesis of (±)-atropurpuran. Pivotal features of the synthesis include an oxidative dearomatization/intramolecular Diels-Alder cycloaddition cascade, sequential aldol and ketyl-olefin cyclizations to assemble the highly caged framework, and a chemoselective and stereoselective reduction to install the requisite allylic hydroxyl group in the target molecule. PMID:27387707

  17. Total synthesis of atropurpuran

    PubMed Central

    Gong, Jing; Chen, Huan; Liu, Xiao-Yu; Wang, Zhi-Xiu; Nie, Wei; Qin, Yong

    2016-01-01

    Due to their architectural intricacy and biological significance, the synthesis of polycyclic diterpenes and their biogenetically related alkaloids have been the subject of considerable interest over the last few decades, with progress including the impressive synthesis of several elusive targets. Despite tremendous efforts, conquering the unique structural types of this large natural product family remains a long-term challenge. The arcutane diterpenes and related alkaloids, bearing a congested tetracyclo[5.3.3.04,9.04,12]tridecane unit, are included in these unsolved enigmas. Here we report a concise approach to the construction of the core structure of these molecules and the first total synthesis of (±)-atropurpuran. Pivotal features of the synthesis include an oxidative dearomatization/intramolecular Diels-Alder cycloaddition cascade, sequential aldol and ketyl-olefin cyclizations to assemble the highly caged framework, and a chemoselective and stereoselective reduction to install the requisite allylic hydroxyl group in the target molecule. PMID:27387707

  18. Total organic carbon analyzer

    NASA Technical Reports Server (NTRS)

    Godec, Richard G.; Kosenka, Paul P.; Smith, Brian D.; Hutte, Richard S.; Webb, Johanna V.; Sauer, Richard L.

    1991-01-01

    The development and testing of a breadboard version of a highly sensitive total-organic-carbon (TOC) analyzer are reported. Attention is given to the system components including the CO2 sensor, oxidation reactor, acidification module, and the sample-inlet system. Research is reported for an experimental reagentless oxidation reactor, and good results are reported for linearity, sensitivity, and selectivity in the CO2 sensor. The TOC analyzer is developed with gravity-independent components and is designed for minimal additions of chemical reagents. The reagentless oxidation reactor is based on electrolysis and UV photolysis and is shown to be potentially useful. The stability of the breadboard instrument is shown to be good on a day-to-day basis, and the analyzer is capable of 5 sample analyses per day for a period of about 80 days. The instrument can provide accurate TOC and TIC measurements over a concentration range of 20 ppb to 50 ppm C.

  19. Total parenteral nutrition.

    PubMed

    Domínguez-Cherit, Guillermo; Borunda, Delia; Rivero-Sigarroa, Eduardo

    2002-08-01

    In recent months, numerous reports concerning total parenteral nutrition in critically ill patients have been published, including the guidelines and recommendations of the American Society for Parenteral and Enteral Nutrition. The old controversy regarding the use of the enteral versus parenteral route still exists. Although the enteral route is indicated in those patients with normal gastrointestinal function, the parenteral route is obviously beneficial in several clinical conditions and appears to be associated with few procedure-related complications when performed by experienced clinicians. There is also continued interest in the supplementation of parenteral formulas with nutrients that were previously considered nonessential, such as arginine, glutamine, and omega-3 fatty acids, but that may become essential in the setting of critical illness.

  20. Total Energy CMR Production

    SciTech Connect

    Friedrich, S; Kolagani, R M

    2008-08-11

    The following outlines the optimized pulsed laser deposition (PLD) procedure used to prepare Nd{sub 0.67}Sr{sub 0.33}MnO{sub 3} (NSMO) temperature sensors at Towson University (Prof. Rajeswari Kolagani) for the LCLS XTOD Total Energy Monitor. The samples have a sharp metal/insulator transition at T {approx} 200 K and are optimized for operation at T {approx} 180 K, where their sensitivity is the highest. These samples are epitaxial multilayer structures of Si/YSZ/CeO/NSMO, where these abbreviations are defined in table 1. In this heterostructure, YSZ serves as a buffer layer to prevent deleterious chemical reactions, and also serves to de-oxygenate the amorphous SiO{sub 2} surface layer to generate a crystalline template for epitaxy. CeO and BTO serve as template layers to minimize the effects of thermal and lattice mismatch strains, respectively. More details on the buffer and template layer scheme are included in the attached manuscript accepted for publication in Sensor Letters (G. Yong et al., 2008).

  1. The total artificial heart

    PubMed Central

    Cook, Jason A.; Shah, Keyur B.; Quader, Mohammed A.; Cooke, Richard H.; Kasirajan, Vigneshwar; Rao, Kris K.; Smallfield, Melissa C.; Tchoukina, Inna

    2015-01-01

    The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient’s native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review. PMID:26793338

  2. Total Solar Eclipse 2001

    NASA Astrophysics Data System (ADS)

    Craig, Nahide; Hawkins, Isabel

    Evaluation and assessments of informal education programs small or large such as science museum traveling exhibits interpretive kiosks hands-on activities and very large public programs have been challenging due to the diverse nature of objectives setups and expected outcomes of these programs. Almost all institutions that develop and present such programs include in their staff evaluation specialists. However for very large public outreach efforts which include participation of multi institutions located across the country larger evaluation groups/institutions can contribute more objective and extensive evaluation and assessment instruments that will help to identify weather the program was successful and if the learning objectives were achieved. Total Solar Eclipse 2001 event was participated by approximately 42000 people at museums science centers and Planetaria all over the world. I will share with you the results of an evaluation of this event that was surveyed and reported by an independent evaluation company. I will expand further on the properties of this program that helps to determine weather the program was successful or not including the discussion on how personal interest in the content publicity connectivity to a group educational as well as entertainment value and the challenges of using high technology can define success.

  3. Total disc replacement.

    PubMed

    Vital, J-M; Boissière, L

    2014-02-01

    Total disc replacement (TDR) (partial disc replacement will not be described) has been used in the lumbar spine since the 1980s, and more recently in the cervical spine. Although the biomechanical concepts are the same and both are inserted through an anterior approach, lumbar TDR is conventionally indicated for chronic low back pain, whereas cervical TDR is used for soft discal hernia resulting in cervicobrachial neuralgia. The insertion technique must be rigorous, with precise centering in the disc space, taking account of vascular anatomy, which is more complex in the lumbar region, particularly proximally to L5-S1. All of the numerous studies, including prospective randomized comparative trials, have demonstrated non-inferiority to fusion, or even short-term superiority regarding speed of improvement. The main implant-related complication is bridging heterotopic ossification with resulting loss of range of motion and increased rates of adjacent segment degeneration, although with an incidence lower than after arthrodesis. A sufficiently long follow-up, which has not yet been reached, will be necessary to establish definitively an advantage for TDR, particularly in the cervical spine. PMID:24412045

  4. Consequences of POR mutations and polymorphisms

    PubMed Central

    Miller, Walter L.; Agrawal, Vishal; Sandee, Duanpen; Tee, Meng Kian; Huang, Ningwu; Choi, Ji Ha; Morrissey, Kari; Giacomini, Kathleen M.

    2015-01-01

    P450 oxidoreductase (POR) transports electrons from NADPH to all microsomal cytochrome P450 enzymes, including steroidogenic P450c17, P450c21 and P450aro. Severe POR mutations A287P (in Europeans) and R457H (in Japanese) cause the Antley-Bixler skeletal malformation syndrome (ABS) plus impaired steroidogenesis (causing genital anomalies), but the basis of ABS is unclear. We have characterized the activities of ~40 POR variants, showing that assays based on P450c17 activities, but not cytochrome c assays, correlate with the clinical phenotype. The human POR gene is highly polymorphic: the A503V sequence variant, which decreases P450c17 activities to ~60%, is found on ~28% of human alleles. A promoter polymorphism (~8% of Asians and ~13% of Caucasians) at −152 reduces transcriptional activity by half. Screening of 35 POR variants showed that most mutants lacking activity with P450c17 or cytochrome c also lacked activity to support CYP1A2 and CYP2C19 metabolism of EOMCC (a fluorogenic non-drug substrate), although there were some remarkable differences: Q153R causes ABS and has ~30% of wild-type activity with P450c17 but had 144% of WT activity with CYP1A2 and 284% with CYP2C19. The effects of POR variants on CYP3A4, which metabolizes nearly 50% of clinically used drugs, was examined with multiple, clinically-relevant drug substrates, showing that A287P and R457H dramatically reduce drug metabolism, and that A503V variably impairs drug metabolism. The degree of activity can vary with the drug substrate assayed, as the drugs can influence the conformation of the P450. POR is probably an important contributor to genetic variation in both steroidogenesis and drug metabolism. PMID:21070833

  5. Determination of Total Petroleum Hydrocarbons (TPH) Using Total Carbon Analysis

    SciTech Connect

    Ekechukwu, A.A.

    2002-05-10

    Several methods have been proposed to replace the Freon(TM)-extraction method to determine total petroleum hydrocarbon (TPH) content. For reasons of cost, sensitivity, precision, or simplicity, none of the replacement methods are feasible for analysis of radioactive samples at our facility. We have developed a method to measure total petroleum hydrocarbon content in aqueous sample matrixes using total organic carbon (total carbon) determination. The total carbon content (TC1) of the sample is measured using a total organic carbon analyzer. The sample is then contacted with a small volume of non-pokar solvent to extract the total petroleum hydrocarbons. The total carbon content of the resultant aqueous phase of the extracted sample (TC2) is measured. Total petroleum hydrocarbon content is calculated (TPH = TC1-TC2). The resultant data are consistent with results obtained using Freon(TM) extraction followed by infrared absorbance.

  6. Desigualdades por cáncer

    Cancer.gov

    Información básica de las desigualdades en salud por cáncer en EE. UU., factores que contribuyen a la carga desproporcionada del cáncer en algunos grupos y ejemplos de desigualdades en incidencia y mortalidad entre ciertos grupos de la población.

  7. Total Quality and Organization Development. Total Quality Series.

    ERIC Educational Resources Information Center

    Lindsay, William M.; Petrick, Joseph A.

    As the global business environment becomes more turbulent, quality management seems more indispensable. This book offers strategies for integrating the theory and practice of Total Quality Management (TQM) with organizational-development (OD) theory at all organizational levels. Chapter 1 answers the question "Why Total Quality Management and…

  8. Structural Insights into the PorK and PorN Components of the Porphyromonas gingivalis Type IX Secretion System

    PubMed Central

    Gorasia, Dhana G.; Veith, Paul D.; Hanssen, Eric G.; Glew, Michelle D.; Sato, Keiko; Yukitake, Hideharu; Nakayama, Koji; Reynolds, Eric C.

    2016-01-01

    The type IX secretion system (T9SS) has been recently discovered and is specific to Bacteroidetes species. Porphyromonas gingivalis, a keystone pathogen for periodontitis, utilizes the T9SS to transport many proteins including the gingipain virulence factors across the outer membrane and attach them to the cell surface via a sortase-like mechanism. At least 11 proteins have been identified as components of the T9SS including PorK, PorL, PorM, PorN and PorP, however the precise roles of most of these proteins have not been elucidated and the structural organization of these components is unknown. In this study, we purified PorK and PorN complexes from P. gingivalis and using electron microscopy we have shown that PorN and the PorK lipoprotein interact to form a 50 nm diameter ring-shaped structure containing approximately 32–36 subunits of each protein. The formation of these rings was dependent on both PorK and PorN, but was independent of PorL, PorM and PorP. PorL and PorM were found to form a separate stable complex. PorK and PorN were protected from proteinase K cleavage when present in undisrupted cells, but were rapidly degraded when the cells were lysed, which together with bioinformatic analyses suggests that these proteins are exposed in the periplasm and anchored to the outer membrane via the PorK lipid. Chemical cross-linking and mass spectrometry analyses confirmed the interaction between PorK and PorN and further revealed that they interact with the PG0189 outer membrane protein. Furthermore, we established that PorN was required for the stable expression of PorK, PorL and PorM. Collectively, these results suggest that the ring-shaped PorK/N complex may form part of the secretion channel of the T9SS. This is the first report showing the structural organization of any T9SS component. PMID:27509186

  9. Structural Insights into the PorK and PorN Components of the Porphyromonas gingivalis Type IX Secretion System.

    PubMed

    Gorasia, Dhana G; Veith, Paul D; Hanssen, Eric G; Glew, Michelle D; Sato, Keiko; Yukitake, Hideharu; Nakayama, Koji; Reynolds, Eric C

    2016-08-01

    The type IX secretion system (T9SS) has been recently discovered and is specific to Bacteroidetes species. Porphyromonas gingivalis, a keystone pathogen for periodontitis, utilizes the T9SS to transport many proteins including the gingipain virulence factors across the outer membrane and attach them to the cell surface via a sortase-like mechanism. At least 11 proteins have been identified as components of the T9SS including PorK, PorL, PorM, PorN and PorP, however the precise roles of most of these proteins have not been elucidated and the structural organization of these components is unknown. In this study, we purified PorK and PorN complexes from P. gingivalis and using electron microscopy we have shown that PorN and the PorK lipoprotein interact to form a 50 nm diameter ring-shaped structure containing approximately 32-36 subunits of each protein. The formation of these rings was dependent on both PorK and PorN, but was independent of PorL, PorM and PorP. PorL and PorM were found to form a separate stable complex. PorK and PorN were protected from proteinase K cleavage when present in undisrupted cells, but were rapidly degraded when the cells were lysed, which together with bioinformatic analyses suggests that these proteins are exposed in the periplasm and anchored to the outer membrane via the PorK lipid. Chemical cross-linking and mass spectrometry analyses confirmed the interaction between PorK and PorN and further revealed that they interact with the PG0189 outer membrane protein. Furthermore, we established that PorN was required for the stable expression of PorK, PorL and PorM. Collectively, these results suggest that the ring-shaped PorK/N complex may form part of the secretion channel of the T9SS. This is the first report showing the structural organization of any T9SS component. PMID:27509186

  10. Structural Insights into the PorK and PorN Components of the Porphyromonas gingivalis Type IX Secretion System.

    PubMed

    Gorasia, Dhana G; Veith, Paul D; Hanssen, Eric G; Glew, Michelle D; Sato, Keiko; Yukitake, Hideharu; Nakayama, Koji; Reynolds, Eric C

    2016-08-01

    The type IX secretion system (T9SS) has been recently discovered and is specific to Bacteroidetes species. Porphyromonas gingivalis, a keystone pathogen for periodontitis, utilizes the T9SS to transport many proteins including the gingipain virulence factors across the outer membrane and attach them to the cell surface via a sortase-like mechanism. At least 11 proteins have been identified as components of the T9SS including PorK, PorL, PorM, PorN and PorP, however the precise roles of most of these proteins have not been elucidated and the structural organization of these components is unknown. In this study, we purified PorK and PorN complexes from P. gingivalis and using electron microscopy we have shown that PorN and the PorK lipoprotein interact to form a 50 nm diameter ring-shaped structure containing approximately 32-36 subunits of each protein. The formation of these rings was dependent on both PorK and PorN, but was independent of PorL, PorM and PorP. PorL and PorM were found to form a separate stable complex. PorK and PorN were protected from proteinase K cleavage when present in undisrupted cells, but were rapidly degraded when the cells were lysed, which together with bioinformatic analyses suggests that these proteins are exposed in the periplasm and anchored to the outer membrane via the PorK lipid. Chemical cross-linking and mass spectrometry analyses confirmed the interaction between PorK and PorN and further revealed that they interact with the PG0189 outer membrane protein. Furthermore, we established that PorN was required for the stable expression of PorK, PorL and PorM. Collectively, these results suggest that the ring-shaped PorK/N complex may form part of the secretion channel of the T9SS. This is the first report showing the structural organization of any T9SS component.

  11. Dislocation after total knee arthroplasty.

    PubMed

    Wazir, N N; Shan, Y; Mukundala, V V; Gunalan, R

    2007-05-01

    Two cases of dislocation of total knee arthroplasty presented to us within the same week. The first patient is a 71-year-old woman who underwent bilateral primary total knee arthroplasty. The left knee dislocated three weeks after the surgery. Due to failure of conservative measures, she underwent revision total knee arthroplasty. The other patient is a 72-year-old woman presenting ten years after primary total knee arthroplasty, with a traumatic dislocation of the knee joint. She was treated as an outpatient with closed manipulative reduction.

  12. Scheme for total quantum teleportation

    PubMed

    DelRe; Crosignani; Di Porto P

    2000-03-27

    We address the issue of totally teleporting the quantum state of an external particle, as opposed to studies on partial teleportation of external single-particle states, total teleportation of coherent states and encoded single-particle states, and intramolecular teleportation of nuclear spin states. We find a set of commuting observables whose measurement directly projects onto the Bell basis and discuss a possible experiment, based on two-photon absorption, allowing, for the first time, total teleportation of the state of a single external photon through a direct projective measurement.

  13. Fracture After Total Hip Replacement

    MedlinePlus

    ... er Total Hip Replacement cont. • Dislocation • Limb length inequality • Poor fracture healing • Repeat fracture • Lack of in- ... Surgeons (AAOS). To learn more about your orthopaedic health, please visit orthoinfo.org. Page ( 5 ) AAOS does ...

  14. Total arsenic in rice milk.

    PubMed

    Shannon, Ron; Rodriguez, Jose M

    2014-01-01

    Rice milk and its by-products were tested for total arsenic concentration. Total arsenic concentration was determined using graphite-furnace atomic absorption spectrometry. The arsenic concentrations ranged from 2.7 ± 0.3 to 17.9 ± 0.5 µg L(-1). Rice milk and its by-products are not clearly defined as food, water or milk substitute. The US Environmental Protection Agency (EPA), the European Union (EU) and the World Health Organization (WHO) have set a level of 10 µg L(-1) for total arsenic concentrations in drinking water. The EU and the US regulatory agencies do not provide any guidelines on total arsenic concentrations in foods. This study provides us with a starting point to address this issue in the State of Mississippi, USA.

  15. March 8 Solar Eclipse Totality

    NASA Video Gallery

    The moon passes in front of the sun, creating a total solar eclipse visible in parts of Southeast Asia. This video. taken from a live broadcast from the Exploratorium Science Center, shows the peri...

  16. [Total knee and hip prosthesis: variables associated with costs].

    PubMed

    Herrera-Espiñeira, Carmen; Escobar, Antonio; Navarro-Espigares, José Luis; Castillo, Juan de Dios Lunadel; García-Pérez, Lidia; Godoy-Montijano, Amparo

    2013-01-01

    antecedentes: la alta prevalencia de artrosis en los países occidentales, el elevado costo de las intervenciones de artroplastia de cadera y rodilla y las amplias variaciones en la práctica médica generan gran interés por comparar los costos asociados antes y después de la cirugía. Objetivo: conocer el costo de las intervenciones de reemplazo total de cadera y rodilla durante la estancia hospitalaria y al año de seguimiento posterior al alta. material y métodos: estudio multicéntrico y prospectivo efectuado en 15 hospitales de tres comunidades autónomas. La relación entre las variables independientes con el costo de la estancia y costo post-alta, se analizó con modelos multinivel y para agrupar los casos se utilizó la variable "hospital." Las variables independientes fueron: edad, sexo, índice de masa corporal, calidad de vida prequirúrgica (cuestionarios ED-5D, SF-12 y Womac), intervención (cadera-rodilla), índice Charlson, complicaciones, número de camas y dependencia económico-institucional del hospital, comunidad autó-noma y presencia de cuidador. Resultados: el costo promedio por paciente, sin incluir el costo de la prótesis, fue de 4,734 Euros ± 2,136 y el costo del seguimiento post alta de 554 Euros ± 509. Si se incluye el costo de la prótesis, al final del año el costo total asciende a 7,645 Euros ± 2,248. Conclusiones: existe un margen considerable en la reducción de los costos de estancia; más de 44% de la variabilidad observada no está determinada por las condiciones clínicas de los pacientes sino por el comportamiento de los centros hospitalarios.

  17. Total eclipses of the sun.

    PubMed

    Zirker, J B

    1980-12-19

    Total eclipses of the sun offer research opportunities in a variety of sciences. Some of the advances in solar physics resulting from eclipse observations are discussed. Experiments at the total eclipse of 16 February 1980 in India are also described. These included a test of general relativity, studies in coronal physics, investigations of solar prominences, diameter measurements, a search for interplanetary dust, a study of the gravity waves in the earth's atmosphere, and experiments on the biological effects on animals and humans.

  18. Total Quality in Higher Education. Total Quality Series.

    ERIC Educational Resources Information Center

    Lewis, Ralph G.; Smith, Douglas H.

    This volume offers a detailed argument for and description of Total Quality Management (TQM) for institutions of higher education. Chapter 1 elaborates on why TQM is good for higher education and includes some warning as to why implementation at colleges and universities may not be easy. Chapter 2 provides an overview of the history of the TQM…

  19. Total body water and total body potassium in anorexia nervosa

    SciTech Connect

    Dempsey, D.T.; Crosby, L.O.; Lusk, E.; Oberlander, J.L.; Pertschuk, M.J.; Mullen, J.L.

    1984-08-01

    In the ill hospitalized patient with clinically relevant malnutrition, there is a measurable decrease in the ratio of the total body potassium to total body water (TBK/TBW) and a detectable increase in the ratio of total exchangeable sodium to total exchangeable potassium (Nae/Ke). To evaluate body composition analyses in anorexia nervosa patients with chronic uncomplicated semistarvation, TBK and TBW were measured by whole body K40 counting and deuterium oxide dilution in 10 females with stable anorexia nervosa and 10 age-matched female controls. The ratio of TBK/TBW was significantly (p less than 0.05) higher in anorexia nervosa patients than controls. The close inverse correlation found in published studies between TBK/TBW and Nae/Ke together with our results suggest that in anorexia nervosa, Nae/Ke may be low or normal. A decreased TBK/TBW is not a good indicator of malnutrition in the anorexia nervosa patient. The use of a decreased TBK/TBW ratio or an elevated Nae/Ke ratio as a definition of malnutrition may result in inappropriate nutritional management in the patient with severe nonstressed chronic semistarvation.

  20. Total Quality Management Is Total at Fox Valley Technical College.

    ERIC Educational Resources Information Center

    Tyler, Carol R.

    1993-01-01

    At Fox Valley Technical College (Wisconsin), application of Total Quality Management (TQM) brought positive outcomes and other effects. Areas in which TQM was used are considered, including admissions, employee safety, customer focus, policy formation, management performance appraisal, student services, creation of a self-managing class, TQM for…

  1. Total eclipses of the sun.

    PubMed

    Zirker, J B

    1980-12-19

    Total eclipses of the sun offer research opportunities in a variety of sciences. Some of the advances in solar physics resulting from eclipse observations are discussed. Experiments at the total eclipse of 16 February 1980 in India are also described. These included a test of general relativity, studies in coronal physics, investigations of solar prominences, diameter measurements, a search for interplanetary dust, a study of the gravity waves in the earth's atmosphere, and experiments on the biological effects on animals and humans. PMID:17817829

  2. Total Library Computerization for Windows.

    ERIC Educational Resources Information Center

    Combs, Joseph, Jr.

    1999-01-01

    Presents a general review of features of version 2.1 of Total Library Computerization (TLC) for Windows from On Point, Inc. Includes information about pricing, hardware and operating systems, modules/functions available, user interface, security, on-line catalog functions, circulation, cataloging, and documentation and online help. A table…

  3. Total Quality Management for Schools.

    ERIC Educational Resources Information Center

    Greenwood, Malcolm S.; Gaunt, Helen J.

    Education in the United Kingdom has been shaped by the advent of local school management and the rapid growth of grant-maintained schools. Total Quality Management (TQM) offers a new way of looking at management principles and structures by identifying the needs of both internal and external customers. This book applies principles of TQM…

  4. The Total Cost of Technology.

    ERIC Educational Resources Information Center

    Freeman, Jim

    2002-01-01

    Presents overview of areas to consider when planning for the total cost of technology, including a brief look at the planning needed, equipment that should be considered, infrastructure needs, software considerations, maintenance issues, training, upgrades, and planning for system failures. (Author/PKP)

  5. Osteonecrosis: avoiding total hip arthroplasty.

    PubMed

    Hungerford, David S

    2002-06-01

    Osteonecrosis of the femoral head afflicts approximately 20,000 new patients per year, at an average age of 38. Of the patients seen in our institution, 25% are <25 years old. Without treatment, most of these patients can be expected to need a total hip arthroplasty. Joint-preserving procedures have a significant failure rate, and some have significant morbidity. It is desirable to avoid or delay total hip arthroplasty because most patients with osteonecrosis outlive the current state-of-the-art prostheses. Four issues need to be weighed to arrive at a reasonable algorithm for the preservative treatment of osteonecrosis: i) patient risk factors, ii) morbidity of the proposed procedure, iii) size of the lesion, and iv) stage of the lesion. All of the issues must be considered to make sense out of a complex clinical situation.

  6. Total synthesis of (-)-caprazamycin A.

    PubMed

    Nakamura, Hugh; Tsukano, Chihiro; Yasui, Motohiro; Yokouchi, Shinsuke; Igarashi, Masayuki; Takemoto, Yoshiji

    2015-03-01

    Caprazamycin A has significant antibacterial activity against Mycobacterium tuberculosis (TB). The first total synthesis is herein reported and features a) the scalable preparation of the syn-β-hydroxy amino acid with a thiourea-catalyzed diastereoselective aldol reaction, b) construction of a diazepanone with an unstable fatty-acid side chain, and c) global deprotection with hydrogenation. This report provides a route for the synthesis of related liponucleoside antibiotics with fatty-acid side chains.

  7. Diastereoselective Total Synthesis of (-)-Galiellalactone.

    PubMed

    Kim, Taewoo; Han, Young Taek; An, Hongchan; Kim, Kyeojin; Lee, Jeeyeon; Suh, Young-Ger

    2015-12-18

    An enantioselective total synthesis of (-)-galiellalactone has been accomplished. The key features of the synthesis involve the highly stereoselective construction of the cis-trisubstituted cyclopentane intermediate by a Pd(0)-catalyzed cyclization, the stereospecific introduction of an angular hydroxyl group by Riley oxidation, and the efficient construction of the tricyclic system of (-)-galiellalactone via a combination of diastereoselective Hosomi-Sakurai crotylation and ring-closing metathesis (RCM). PMID:26544529

  8. Intrathoracic Hernia after Total Gastrectomy.

    PubMed

    Tashiro, Yoshihiko; Murakami, Masahiko; Otsuka, Koji; Saito, Kazuhiko; Saito, Akira; Motegi, Kentaro; Date, Hiromi; Yamashita, Takeshi; Ariyoshi, Tomotake; Goto, Satoru; Yamazaki, Kimiyasu; Fujimori, Akira; Watanabe, Makoto; Aoki, Takeshi

    2016-01-01

    Intrathoracic hernias after total gastrectomy are rare. We report the case of a 78-year-old man who underwent total gastrectomy with antecolic Roux-Y reconstruction for residual gastric cancer. He had alcoholic liver cirrhosis and received radical laparoscopic proximal gastrectomy for gastric cancer 3 years ago. Early gastric cancer in the remnant stomach was found by routine upper gastrointestinal endoscopy. We initially performed endoscopic submucosal dissection, but the vertical margin was positive in a pathological result. We performed total gastrectomy with antecolic Roux-Y reconstruction by laparotomy. For adhesion of the esophageal hiatus, the left chest was connected with the abdominal cavity. A pleural defect was not repaired. Two days after the operation, the patient was suspected of having intrathoracic hernia by chest X-rays. Computed tomography showed that the transverse colon and Roux limb were incarcerated in the left thoracic cavity. He was diagnosed with intrathoracic hernia, and emergency reduction and repair were performed. Operative findings showed that the Roux limb and transverse colon were incarcerated in the thoracic cavity. After reduction, the orifice of the hernia was closed by suturing the crus of the diaphragm with the ligament of the jejunum and omentum. After the second operation, he experienced anastomotic leakage and left pyothorax. Anastomotic leakage was improved with conservative therapy and he was discharged 76 days after the second operation. PMID:27403095

  9. Intrathoracic Hernia after Total Gastrectomy

    PubMed Central

    Tashiro, Yoshihiko; Murakami, Masahiko; Otsuka, Koji; Saito, Kazuhiko; Saito, Akira; Motegi, Kentaro; Date, Hiromi; Yamashita, Takeshi; Ariyoshi, Tomotake; Goto, Satoru; Yamazaki, Kimiyasu; Fujimori, Akira; Watanabe, Makoto; Aoki, Takeshi

    2016-01-01

    Intrathoracic hernias after total gastrectomy are rare. We report the case of a 78-year-old man who underwent total gastrectomy with antecolic Roux-Y reconstruction for residual gastric cancer. He had alcoholic liver cirrhosis and received radical laparoscopic proximal gastrectomy for gastric cancer 3 years ago. Early gastric cancer in the remnant stomach was found by routine upper gastrointestinal endoscopy. We initially performed endoscopic submucosal dissection, but the vertical margin was positive in a pathological result. We performed total gastrectomy with antecolic Roux-Y reconstruction by laparotomy. For adhesion of the esophageal hiatus, the left chest was connected with the abdominal cavity. A pleural defect was not repaired. Two days after the operation, the patient was suspected of having intrathoracic hernia by chest X-rays. Computed tomography showed that the transverse colon and Roux limb were incarcerated in the left thoracic cavity. He was diagnosed with intrathoracic hernia, and emergency reduction and repair were performed. Operative findings showed that the Roux limb and transverse colon were incarcerated in the thoracic cavity. After reduction, the orifice of the hernia was closed by suturing the crus of the diaphragm with the ligament of the jejunum and omentum. After the second operation, he experienced anastomotic leakage and left pyothorax. Anastomotic leakage was improved with conservative therapy and he was discharged 76 days after the second operation. PMID:27403095

  10. Urinary Total Hydroxyproline: Creatinine Ratio

    PubMed Central

    Wharton, B. A.; Gough, G.; Williams, Angela; Kitts, Sheila; Pennock, C. A.

    1972-01-01

    The total hydroxyproline: creatinine ratio has been determined in random samples of urine collected from 1577 normal Bristol children and from children with hypothyroidism, growth hormone deficiency, coeliac disease, and rickets. The results in normal children had a profile similar to that of length velocity. When specific therapy was given to the children with growth failure there was a prompt increase in the total hydroxyproline: creatinine ratio, which occurred well before a growth spurt could be detected by anthropometry. The ratio could be a useful chemical adjunct to anthropometry and radiology in the assessment of normal and abnormal growth. The prompt response of the ratio to changes in growth rate suggests that it may be particularly useful in studying physiological variation in growth over short periods of time and in close monitoring of treatment regimens for growth failure. Random samples of urine may be used, automated methods of analysis are available, and other specialities find the investigation a useful one, so that for the paediatrician the urine total hydroxyproline: creatinine ratio has a potentially wide application. PMID:5018659

  11. Total Pancreatectomy With Islet Autotransplantation

    PubMed Central

    Bellin, Melena D.; Gelrud, Andres; Arreaza-Rubin, Guillermo; Dunn, Ty B.; Humar, Abhinav; Morgan, Katherine A.; Naziruddin, Bashoo; Rastellini, Cristiana; Rickels, Michael R.; Schwarzenberg, Sarah J.; Andersen, Dana K.

    2015-01-01

    A workshop sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases focused on research gaps and opportunities in total pancreatectomy with islet autotransplantation (TPIAT) for the management of chronic pancreatitis. The session was held on July 23, 2014 and structured into 5 sessions: (1) patient selection, indications, and timing; (2) technical aspects of TPIAT; (3) improving success of islet autotransplantation; (4) improving outcomes after total pancreatectomy; and (5) registry considerations for TPIAT. The current state of knowledge was reviewed; knowledge gaps and research needs were specifically highlighted. Common themes included the need to identify which patients best benefit from and when to intervene with TPIAT, current limitations of the surgical procedure, diabetes remission and the potential for improvement, opportunities to better address pain remission, GI complications in this population, and unique features of children with chronic pancreatitis considered for TPIAT. The need for a multicenter patient registry that specifically addresses the complexities of chronic pancreatitis and total pancreatectomy outcomes and postsurgical diabetes outcomes was repeatedly emphasized. PMID:25599324

  12. Venus - A total mass estimate

    NASA Technical Reports Server (NTRS)

    Sjogren, W. L.; Trager, G. B.; Roldan, G. R.

    1990-01-01

    Reductions of four independent blocks of Pioneer Venus Orbiter Doppler radio tracking data have produced very consistent determinations of the GM of Venus (the product of the universal gravitational constant and total mass of Venus). These estimates have uncertainties that are significantly smaller than any values published to date. The value of GM is also consistent with previously published results in that it falls within their one-sigma uncertainties. The value of 324858.60 + or - 0.05 cu km/sec sq is the best estimate.

  13. Total Synthesis of Gombamide A.

    PubMed

    Garcia-Barrantes, Pedro M; Lindsley, Craig W

    2016-08-01

    The first total synthesis of Gombamide A (1), a cytotoxic cyclic thiopeptide from the sponge Clathria gombawuiensis, has been achieved. Highlights of the convergent synthesis feature a disulfide bond forming cascade to close the 17-membered macrocycle and a selenoazidylation procedure to access the unusual para-hydroxystyrlyamide (pHSA) moiety. The synthesis required 18 steps, 11 steps in its longest linear sequence, and proceeded in 9.1% overall yield. This work will facilitate the study of the biological effects of Gombamide A and provide groundwork to explore the structure-activity relationship around this rare natural product. PMID:27442228

  14. Total synthesis of the ammosamides.

    PubMed

    Hughes, Chambers C; Fenical, William

    2010-03-01

    The ammosamides A-C are chlorinated pyrrolo[4,3,2-de]quinoline metabolites isolated from the marine-derived Streptomyces strain CNR-698. The natural products, which possess a dense array of heteroatoms, were synthesized in 17-19 steps from 4-chloroisatin. That the five nitrogen atoms were introduced at the appropriate time and in a suitable oxidation state was key to the success of the total synthesis. Compared to synthetic deschloro ammosamide B, natural ammosamide B is much less susceptible to oxidative degradation.

  15. Antarctic total ozone in 1958

    SciTech Connect

    Newman, P.A. )

    1994-04-22

    The Antarctic ozone hole results from catalytic destruction of ozone by chlorine radicals. The hole develops in August, reaches its full depth in early October, and is gone by early December of each year. Extremely low total ozone measurements were made at the Antarctic Dumont d'Urville station in 1958. These measurements were derived from spectrographic plates of the blue sky, the moon, and two stars. These Dumont plate data are inconsistent with 1958 Dobson spectrophotometer ozone measurements, inconsistent with present-day Antarctic observations, and inconsistent with meteorological and theoretical information. There is no credible evidence for an ozone hole in 1958.

  16. The total synthesis of (-)-nitidasin.

    PubMed

    Hog, Daniel T; Huber, Florian M E; Mayer, Peter; Trauner, Dirk

    2014-08-01

    Nitidasin is a pentacyclic sesterterpenoid with a rare 5-8-6-5 carbon skeleton that was isolated from the Peruvian folk medicine "Hercampuri". It belongs to a small class of sesterterpenoids that feature an isopropyl trans-hydrindane moiety fused to a variety of other ring systems. As a first installment of our general approach toward these natural products, we report the total synthesis of the title compound. Our stereoselective, convergent route involves the addition of a complex alkenyl lithium compound to a trans-hydrindanone, followed by chemoselective epoxidation, ring-closing olefin metathesis, and redox adjustment.

  17. Total Synthesis of the Hamigerans.

    PubMed

    Li, Xiaojun; Xue, Dongsheng; Wang, Cheng; Gao, Shuanhu

    2016-08-16

    The first total synthesis of hamigerans D, G, L, and N-Q has been accomplished. A convergent approach was used to build the basic tricarbocyclic ring system bearing a 5-6-6 structure. A sequence of oxidative cleavage, homologation, and ring regeneration provided access to the 5-7-6 skeleton of hamigeran G. Based on the biogenetic hypothesis, elegant and highly efficient biomimetic transformations of hamigeran G into hamigerans D, N-Q, and L were achieved. PMID:27390907

  18. Development of a totally implantable total artificial heart controller.

    PubMed

    Lee, S H; Choi, W W; Min, B G

    1991-01-01

    Using a one chip microcontroller, 87C196 (One chip EPROM), and an erasable and programmable logic device (EPLD), an implantable control system to drive a pendulum type electromechanical total artificial heart was developed. This control system consists of four parts: a main management system, a motor driver with power regulator, a state monitoring system, and a communication portion. The main system has a speed detector, proportional and integral (PI) control, pulse width modulation (PWM) generation, serial communication, and an analog data processor. Two kinds of power system are used, separated by eight photocoupler arrays to improve system stability. When the performance of each compartment was compared with that of the previously used Z80 microprocessor based control system, good correspondence was shown. Logic power consumption was reduced to one third that of the previous controller. Using mock circulation tests, the overall performance of the control system was evaluated.

  19. CLINICAL OUTCOME AFTER INFECTED TOTAL KNEE AND TOTAL HIP ARTHROPLASTY

    PubMed Central

    Mittag, Falk; Leichtle, Carmen Ina; Schlumberger, Michael; Leichtle, Ulf Gunther; Wünschel, Markus

    2016-01-01

    ABSTRACT Objective: Infection after total hip (THA) and knee arthroplasty (TKA) is a serious complication which typically leads to a long lasting and intensive surgical and medicamentous treatment. The aim of this study was to identify factors that influence outcome after revision surgery caused by prosthetic infection. Methods: We retrospectively analyzed 64 patients who had revision surgery between 1989 and 2009 due to periprosthetic infection. We examined a total of 69 joints (TKA: 36%, THA: 64%), follow-up 5.1 years (0.5-21 years) after the initial surgical intervention. The mean patient age at time of surgery was 67 years old (43-79 years old). Clinical data and scores including the Western Ontario and McMaster Universities (WOMAC)-Index, the Harris Hip Score (HHS) and the Hospital for Special Surgery Score (HSS) were surveyed. Results: There was no difference in clinical scores regarding treatment between a single and a multiple stage treatment regime. Infections with multiple microorganisms and Enterococcus spp. lead to a significantly higher number of interventions. Using a modified Tsukayama system we classified 24% as type I, 34% type II and 42% type III- infections, with no differences in clinical outcome. Overweight patients had a significantly lower HHS and WOMAC-score. Immunosuppression leads to a worse WOMAC and HSS-Score. An increased number of procedures was associated to a limping gait. Conclusion: Thorough surgical technique leads to good clinical results independent of infection-type and treatment philosophy. Level of Evidence III, Case Control Study. PMID:26997914

  20. Humeral fracture between a total elbow and total shoulder arthroplasty.

    PubMed

    Mavrogenis, Andreas F; Angelini, Andrea; Guerra, Enrico; Rotini, Roberto

    2011-04-01

    This article presents a case of a 71-year-old woman with a humeral fracture between a cementless reverse total shoulder arthroplasty and a cemented total elbow arthroplasty and discusses our treatment plan. Surgical treatment was performed after the patient was informed of possible complications and the benefits of surgery including: early, complete restoration of arm anatomy, greater functional improvement of the adjacent joints, and increased risk of nonunion with nonoperative treatment.The fracture was comminuted and extended proximally around the shoulder prosthesis. Through the posterior approach, the radial nerve was identified and protected. Both prostheses were found firmly fixed to bone. The fracture around the shoulder prosthesis was reduced first using a strut allograft and reduction clamps. Next, arm alignment restoration and distal humerus reduction were performed. The construct was neutralized with a 3.5-mm locking plate spanning the whole length of the humerus. The locking plate was positioned posterolaterally and the strut medially in a 90° to 90° configuration secured with wires and cables.A hinged elbow brace was applied for 6 weeks postoperatively. Active range of motion exercises of the wrist and hand and passive motion of the elbow and shoulder were started at 4 to 5 days postoperatively. At 2 weeks postoperatively, passive motion of the elbow and shoulder progressed to strengthening exercises. Thereafter, the patient underwent several weeks of physical therapy to restore motion, strength, and function of the upper extremity with instructions not to overload the arm and avoid heavy work and sports for as long as 1 year. At 10 months postoperatively, radiographs of the arm showed a stable construct; the patient had resumed full activities of daily living. PMID:21469626

  1. Total synthesis of (+)-blasticidin s.

    PubMed

    Ichikawa, Yoshiyasu; Hirata, Keiko; Ohbayashi, Masayoshi; Isobe, Minoru

    2004-07-01

    The first total synthesis of the peptidyl nucleoside antibiotic, blasticidin S (1), has been achieved by the coupling reaction of cytosinine (3) and blastidic acid (2). A key step in the synthesis of cytosinine (3) is the sigmatropic rearrangement of allyl cyanate 24; this reaction provided efficient and stereoselective access to 2,3-dideoxy-4-amino-D-hex-2-enopyranose (26 a). Further elaboration of 26 a gave methyl hex-2-enopyranouronate 29, and cytosine N-glycosylation of 31 using the Vorbrüggen conditions for the silyl Hilbert-Johnson reaction furnished the differentially protected cytosinine (32) in 11 steps from 2-acetoxy-D-glucal (14) (4.0 % overall yield). Synthesis of the Boc-protected blastidic acid 47 in nine steps starting from chiral carboxylic acid 35 (23 % overall yield) utilized Weinreb's protocol for the preparation of benzyl amide 38 and Fukuyama's protocol for the synthesis of the secondary amine 40. Assembly of the protected cytosinine (32) and blastidic acid (47) by the BOP method in the presence of HOBt, and finally elaboration to 1 by deprotection of the fully protected 54 established the total synthesis of blasticidin S (1).

  2. Hyperglycemia During Total Parenteral Nutrition

    PubMed Central

    Pasquel, Francisco J.; Spiegelman, Ronnie; McCauley, Megan; Smiley, Dawn; Umpierrez, Denise; Johnson, Rachel; Rhee, Mary; Gatcliffe, Chelsea; Lin, Erica; Umpierrez, Erica; Peng, Limin; Umpierrez, Guillermo E.

    2010-01-01

    OBJECTIVE To determine the effect of total parenteral nutrition (TPN)-induced hyperglycemia on hospital outcome. RESEARCH DESIGN AND METHODS The study determined whether blood glucose values before, within 24 h, and during days 2–10 of TPN are predictive of hospital complications and mortality. RESULTS Subjects included a total of 276 patients receiving TPN for a mean duration of 15 ± 24 days (±SD). In multiple regression models adjusted for age, sex, and diabetes status, mortality was independently predicted by pre-TPN blood glucose of 121–150 mg/dl (odds ratio [OR] 2.2, 95% CI 1.1–4.4, P = 0.030), 151–180 mg/dl (3.41, 1.3–8.7, P = 0.01), and >180 mg/dl (2.2, 0.9–5.2, P = 0.077) and by blood glucose within 24 h of >180 mg/dl (2.8, 1.2–6.8, P = 0.020). A blood glucose within 24 h of >180 mg/dl was associated with increased risk of pneumonia (OR 3.1, 95% CI 1.4–7.1) and acute renal failure (2.3, 1.1–5.0). CONCLUSIONS Hyperglycemia is associated with increased hospital complications and mortality in patients receiving TPN. PMID:20040658

  3. Total Value of Phosphorus Recovery.

    PubMed

    Mayer, Brooke K; Baker, Lawrence A; Boyer, Treavor H; Drechsel, Pay; Gifford, Mac; Hanjra, Munir A; Parameswaran, Prathap; Stoltzfus, Jared; Westerhoff, Paul; Rittmann, Bruce E

    2016-07-01

    Phosphorus (P) is a critical, geographically concentrated, nonrenewable resource necessary to support global food production. In excess (e.g., due to runoff or wastewater discharges), P is also a primary cause of eutrophication. To reconcile the simultaneous shortage and overabundance of P, lost P flows must be recovered and reused, alongside improvements in P-use efficiency. While this motivation is increasingly being recognized, little P recovery is practiced today, as recovered P generally cannot compete with the relatively low cost of mined P. Therefore, P is often captured to prevent its release into the environment without beneficial recovery and reuse. However, additional incentives for P recovery emerge when accounting for the total value of P recovery. This article provides a comprehensive overview of the range of benefits of recovering P from waste streams, i.e., the total value of recovering P. This approach accounts for P products, as well as other assets that are associated with P and can be recovered in parallel, such as energy, nitrogen, metals and minerals, and water. Additionally, P recovery provides valuable services to society and the environment by protecting and improving environmental quality, enhancing efficiency of waste treatment facilities, and improving food security and social equity. The needs to make P recovery a reality are also discussed, including business models, bottlenecks, and policy and education strategies.

  4. Total Value of Phosphorus Recovery.

    PubMed

    Mayer, Brooke K; Baker, Lawrence A; Boyer, Treavor H; Drechsel, Pay; Gifford, Mac; Hanjra, Munir A; Parameswaran, Prathap; Stoltzfus, Jared; Westerhoff, Paul; Rittmann, Bruce E

    2016-07-01

    Phosphorus (P) is a critical, geographically concentrated, nonrenewable resource necessary to support global food production. In excess (e.g., due to runoff or wastewater discharges), P is also a primary cause of eutrophication. To reconcile the simultaneous shortage and overabundance of P, lost P flows must be recovered and reused, alongside improvements in P-use efficiency. While this motivation is increasingly being recognized, little P recovery is practiced today, as recovered P generally cannot compete with the relatively low cost of mined P. Therefore, P is often captured to prevent its release into the environment without beneficial recovery and reuse. However, additional incentives for P recovery emerge when accounting for the total value of P recovery. This article provides a comprehensive overview of the range of benefits of recovering P from waste streams, i.e., the total value of recovering P. This approach accounts for P products, as well as other assets that are associated with P and can be recovered in parallel, such as energy, nitrogen, metals and minerals, and water. Additionally, P recovery provides valuable services to society and the environment by protecting and improving environmental quality, enhancing efficiency of waste treatment facilities, and improving food security and social equity. The needs to make P recovery a reality are also discussed, including business models, bottlenecks, and policy and education strategies. PMID:27214029

  5. Total ozone trend over Cairo

    NASA Technical Reports Server (NTRS)

    Hassan, G. K. Y.

    1994-01-01

    A world wide interest in protecting ozone layer against manmade effects is now increasing. Assessment of the ozone depletion due to these activities depends on how successfully we can separate the natural variabilities from the data. The monthly mean values of total ozone over Cairo (30 05N) for the period 1968-1988, have been analyzed using the power spectral analysis technique. The technique used in this analysis does not depend on a pre-understanding of the natural fluctuations in the ozone data. The method depends on increasing the resolution of the spectral peaks in order to obtain the more accurate sinusoidal fluctuations with wavelength equal to or less than record length. Also it handles the possible sinusoidal fluctuations with wavelength equal to or less than record length. The results show that it is possible to detect some of the well known national fluctuations in the ozone record such as annual, semiannual, quasi-biennial and quasi-quadrennial oscillations. After separating the natural fluctuations from the ozone record, the trend analysis of total ozone over Cairo showed that a decrease of about -1.2% per decade has occurred since 1979.

  6. TVD: Total Variation Diminishing code

    NASA Astrophysics Data System (ADS)

    Pen, Ue-Li; Arras, Phil; Wong, ShingKwong

    2013-04-01

    TVD solves the magnetohydrodynamic (MHD) equations by updating the fluid variables along each direction using the flux-conservative, second-order, total variation diminishing (TVD), upwind scheme of Jin & Xin. The magnetic field is updated separately in two-dimensional advection-constraint steps. The electromotive force (EMF) is computed in the advection step using the TVD scheme, and this same EMF is used immediately in the constraint step in order to preserve \\Downtriangle B=0 without the need to store intermediate fluxes. The code is extended to three dimensions using operator splitting, and Runge-Kutta is used to get second-order accuracy in time. TVD offers high-resolution per grid cell, second-order accuracy in space and time, and enforcement of the \\Downtriangle B=0 constraint to machine precision. Written in Fortran, It has no memory overhead and is fast. It is also available in a fully scalable message-passing parallel MPI implementation.

  7. Total Synthesis of Bryostatin 1

    PubMed Central

    Keck, Gary E.; Poudel, Yam B.; Cummins, Thomas J.; Rudra, Arnab; Covel, Jonathan A.

    2010-01-01

    Bryostatin 1 is a marine natural product that is a very promising lead compound due to the potent biological activity it displays against a variety of human disease states. We describe herein the first total synthesis of this agent. The synthetic route adopted is a highly convergent one in which preformed and heavily functionalized pyran rings A and C are united by “pyran annulation”: the TMSOTf promoted reaction between a hydroxy allylsilane appended to the A ring fragment and an aldehyde contained in the C ring fragment, with concomitant formation of the B ring. Further elaborations of the resulting very highly functionalized intermediate include macrolactonization and selective cleavage of just one of five ester linkages present. PMID:21175177

  8. Total synthesis of maoecrystal V.

    PubMed

    Zhang, Wei-Bin; Lin, Guang; Shao, Wen-Bin; Gong, Jian-Xian; Yang, Zhen

    2015-04-01

    Maoecrystal V (1) is a novel diterpenoid, which was originally isolated from the leaves of the Chinese medicinal herb Isodon eriocalyx in 2004 by Sun et al.1 It has been found to be selectively cytotoxic towards HeLa cells, with an IC50 value of 20 ng mL(-1) . Significant research efforts have been devoted to the synthesis of maoecrystal V because of its intriguing biological properties, rarity in nature, and complex structural features. Herein, we describe our recent investigations, which have culminated in the total synthesis of (±)-maoecrystal V. The current strategy involved three key steps for the successful construction of the key tetrahydrofuran oxa-bridge skeleton, including a Wessely oxidative dearomatization, a novel intramolecular Diels-Alder reaction, and a Rh(II) -catalyzed O - H insertion reaction. PMID:25504983

  9. Total quality management implementation guidelines

    SciTech Connect

    Not Available

    1993-12-01

    These Guidelines were designed by the Energy Quality Council to help managers and supervisors in the Department of Energy Complex bring Total Quality Management to their organizations. Because the Department is composed of a rich mixture of diverse organizations, each with its own distinctive culture and quality history, these Guidelines are intended to be adapted by users to meet the particular needs of their organizations. For example, for organizations that are well along on their quality journeys and may already have achieved quality results, these Guidelines will provide a consistent methodology and terminology reference to foster their alignment with the overall Energy quality initiative. For organizations that are just beginning their quality journeys, these Guidelines will serve as a startup manual on quality principles applied in the Energy context.

  10. NAVIGATION IN TOTAL KNEE ARTHROPLASTY

    PubMed Central

    da Mota e Albuquerque, Roberto Freire

    2015-01-01

    Navigation was the most significant advance in instrumentation for total knee arthroplasty over the last decade. It provides surgeons with a precision tool for carrying out surgery, with the possibility of intraoperative simulation and objective control over various anatomical and surgical parameters and references. Since the first systems, which were basically used to control the alignment of bone cutting referenced to the mechanical axis of the lower limb, many other surgical steps have been incorporated, such as component rotation, ligament balancing and arranging the symmetry of flexion and extension spaces, among others. Its efficacy as a precision tool with an effective capacity for promoting better alignment of the lower-limb axis has been widely proven in the literature, but the real value of optimized alignment and the impact of navigation on clinical results and the longevity of arthroplasty have yet to be established. PMID:27026979

  11. Total Synthesis of Glycosylated Proteins

    PubMed Central

    Brailsford, John; Zhang, Qiang; Shieh, Jae-Hung; Moore, Malcolm A.S.

    2016-01-01

    Glycoproteins are an important class of naturally occurring biomolecules which play a pivotal role in many biological processes. They are biosynthesized as complex mixtures of glycoforms through post-translational protein glycosylation. This fact, together with the challenges associated with producing them in homogeneous form, has hampered detailed structure-function studies of glycoproteins as well as their full exploitation as potential therapeutic agents. By contrast, chemical synthesis offers the unique opportunity to gain access to homogeneous glycoprotein samples for rigorous biological evaluation. Herein, we review recent methods for the assembly of complex glycopeptides and glycoproteins and present several examples from our laboratory towards the total chemical synthesis of clinically relevant glycosylated proteins that have enabled synthetic access to full-length homogeneous glycoproteins. PMID:25805144

  12. Total Synthesis of Fijiolide A.

    PubMed

    Heinz, Christoph; Cramer, Nicolai

    2016-01-01

    Fijiolide A is a secondary metabolite isolated from a marine-derived actinomycete of the genus Nocardiopsis. It was found to significantly reduce the TNF-α induced activity of the transcription factor NFκB, which is considered a promising target for the treatment of cancer and inflammation-related diseases. We disclose an enantioselective synthesis of fijiolide A enabled by a fully intermolecular, yet regioselective cyclotrimerization of three unsymmetrical alkynes to construct its tetra-substituted arene core. An atropselective macroetherification enables the assembly of the strained [2.6]paracyclophane motif. A late-stage glycosylation of the macrocyclic aglycone at its tertiary alcohol position allowed for the first total synthesis of fijiolide A.

  13. Asymmetric total synthesis of halicholactone.

    PubMed

    Baba, Y; Saha, G; Nakao, S; Iwata, C; Tanaka, T; Ibuka, T; Ohishi, H; Takemoto, Y

    2001-01-12

    The asymmetric total synthesis of the marine metabolite, halicholactone 1, is described. The bisallylic triol 6 with three chiral centers at C8, C12, and C15 was constructed by [2,3]-sigmatropic rearrangement of the sulfoxide 18, which was prepared stereoselectively using the chirality of (diene)Fe(CO)3 complexes. Introduction of the trans-substituted cyclopropane subunit into 21 was successfully achieved using the modified regio- and stereoselective Simmons-Smith reaction. The use of RCM (ring-closing metathesis) methodology (4-->35) was pivotal for the formation of a nine-membered unsaturated lactone fragment of halicholactone 1. As this approach is flexible and stereoselective, other oxylipins could be synthesized by the protocol described herein.

  14. Total quality management program planning

    SciTech Connect

    Thornton, P.T.; Spence, K.

    1994-05-01

    As government funding grows scarce, competition between the national laboratories is increasing dramatically. In this era of tougher competition, there is no for resistance to change. There must instead be a uniform commitment to improving the overall quality of our products (research and technology) and an increased focus on our customers` needs. There has been an ongoing effort to bring the principles of total quality management (TQM) to all Energy Systems employees to help them better prepare for future changes while responding to the pressures on federal budgets. The need exists for instituting a vigorous program of education and training to an understanding of the techniques needed to improve and initiate a change in organizational culture. The TQM facilitator is responsible for educating the work force on the benefits of self-managed work teams, designing a program of instruction for implementation, and thus getting TQM off the ground at the worker and first-line supervisory levels so that the benefits can flow back up. This program plan presents a conceptual model for TQM in the form of a hot air balloon. In this model, there are numerous factors which can individually and collectively impede the progress of TQM within the division and the Laboratory. When these factors are addressed and corrected, the benefits of TQM become more visible. As this occurs, it is hoped that workers and management alike will grasp the ``total quality`` concept as an acceptable agent for change and continual improvement. TQM can then rise to the occasion and take its rightful place as an integral and valid step in the Laboratory`s formula for survival.

  15. Total chemical synthesis of crambin.

    PubMed

    Bang, Duhee; Chopra, Neeraj; Kent, Stephen B H

    2004-02-11

    Crambin is a small (46 amino acids) protein isolated from the seeds of the plant Crambe abyssinica. Crambin has been extensively used as a model protein for the development of advanced crystallography and NMR techniques and for computational folding studies. We set out to establish synthetic access to crambin. Initially, we synthesized the 46 amino acid polypeptide by native chemical ligation of two distinct sets of peptide segments (15 + 31 and 31 + 15 residues). The synthetic polypeptide chain folded in good yield to give native crambin containing three disulfide bonds. The chemically synthesized crambin was characterized by LC-MS and by 2D-NMR. However, the 31-residue peptide segments were difficult to purify, and this caused an overall low yield for the synthesis. To overcome this problem, we synthesized crambin by the native chemical ligation of three segments (15 + 16 + 15 residues). Total synthesis using the ligation of three segments gave more than a 10-fold increase in yield and a protein product of exceptionally high purity. This work demonstrates the efficacy of chemical protein synthesis by the native chemical ligation of three segments and establishes efficient synthetic access to the important model protein crambin for experimental studies of protein folding and stability.

  16. Stiffness after total knee arthroplasty.

    PubMed

    Manrique, Jorge; Gomez, Miguel M; Parvizi, Javad

    2015-04-01

    Stiffness after total knee arthroplasty (TKA) adversely affects outcome and impacts patient function. Various risk factors for stiffness after TKA have been identified, including reduced preoperative knee range of motion, history of prior knee surgery, etiology of arthritis, incorrect positioning or oversizing of components, and incorrect gap balancing. Mechanical and associated causes, such as infection, arthrofibrosis, complex regional pain syndrome, and heterotopic ossification, secondary gain issues have also been identified. Management of stiffness following TKA can be challenging. The condition needs to be assessed and treated in a staged manner. A nonsurgical approach is the first step. Manipulation under anesthesia may be considered within the first 3 months after the index TKA, if physical therapy fails to improve the range of motion. Beyond this point, consideration should be given to surgical intervention such as lysis of adhesions, either arthroscopically or by open arthrotomy. If the cause of stiffness is deemed to be surgical error, such as component malpositioning, revision arthroplasty is indicated. The purpose of this article is to evaluate the various aspects of management of stiffness after TKA.

  17. Asymmetric total synthesis of vindoline.

    PubMed

    Kato, Daisuke; Sasaki, Yoshikazu; Boger, Dale L

    2010-03-24

    A concise asymmetric total synthesis of (-)-vindoline (1) is detailed based on a tandem intramolecular [4+2]/[3+2] cycloaddition cascade of a 1,3,4-oxadiazole inspired by the natural product structure, in which the tether linking the initiating dienophile and oxadiazole bears a chiral substituent that controls the facial selectivity of the initiating Diels-Alder reaction and sets absolute stereochemistry of the remaining six stereocenters in the cascade cycloadduct. This key reaction introduces three rings and four C-C bonds central to the pentacyclic ring system setting all six stereocenters and introducing essentially all the functionality found in the natural product in a single step. Implementation of the approach also required the development of a unique ring expansion reaction to provide a six-membered ring suitably functionalized for introduction of the Delta (6, 7)-double bond found in the core structure of vindoline and defined our use of a protected hydroxymethyl group as the substituent used to control the stereochemical course of the cycloaddition cascade.

  18. Total hydrocarbon analyzer evaluation study

    SciTech Connect

    Shamat, N. ); Crumpler, E. ); Roddan, A. )

    1991-10-01

    Measuring and controlling organic emissions from incineration processes has become a major environmental concern in recent years. The US Environmental Protection Agency (EPA) recently proposed a regulation for sewage sludge incinerators under section 405(d) of the Clean Water Act that will require all sludge incinerators to monitor total hydrocarbon emissions (THCs) on a continuous basis. Such a requirement would be part of National Pollutant Discharge Elimination (NPDES) permits and site-specific THC limits would be established for facilities based on a risk assessment of organic emissions. Before EPA can finalize the proposed requirement, THC monitoring must be successfully conducted in a plant environment and the system required by any final regulation must be kept in operation so that facilities can comply with their permits. The Metropolitan Waste Control Commission (MWCC) in St. Paul, Minn., and Rosemount Analytical Division in La Habre, Calif., entered into a joint agreement with EPA to demonstrate a hot' THC monitoring system to detect THCs in stack gases. The objectives of the study are to determine the feasibility of THC monitoring of sludge incinerator emissions; evaluate the long term reliability, cost of operation, and consistency of a continuous THC monitoring system in an incinerator environment; and determine the correlation of THC stack concentration to incinerator and scrubber operating conditions, carbon monoxide concentration, and specific VOC emissions.

  19. Total joint replacement preadmission programs.

    PubMed

    Messer, B

    1998-01-01

    Patients begin to formulate their expectations of the postoperative hospitalization during the preadmission program. The challenge is to better understand the factors patients consider when formulating judgments about the quality of preadmission education. For example, it may be that perceptions of the preadmission program are influenced by what patients believe about their postoperative pain and functional abilities. Specific attention needs to be given both preoperatively and postoperatively to instructing patients on realistic expectations for recovery. One other method of measuring patient outcomes is with the Health Status Profile (SF-36) (Response Healthcare Information Management, 1995). The SF-36 approach emphasizes the outcome of medical care as the patient sees it, in addition to a clinical evaluation of successful health care. This form is currently initiated in the physician's office and returned for scanning at the preadmission class. The patient then completes another SF-36 at 6 months and every year thereafter to compare measurable outcomes. Patients intending to have elective total joint replacements experience anxiety and require much support and education. An effective preadmission program is a major investment in a patient's recovery, as well as a unique marketing tool to customers. Preadmission programs can be viewed as an opportunity to enhance customer satisfaction. Preadmission clinics are an excellent means for nurses to improve the quality of patient care through patient education. the overall goal of preadmission testing programs is to ensure patient preparedness while increasing quality health care and overall customer satisfaction. To enhance program effectiveness, health care providers must lead collaborative efforts to improve the efficiency of systems. PMID:9601410

  20. Total joint replacement preadmission programs.

    PubMed

    Messer, B

    1998-01-01

    Patients begin to formulate their expectations of the postoperative hospitalization during the preadmission program. The challenge is to better understand the factors patients consider when formulating judgments about the quality of preadmission education. For example, it may be that perceptions of the preadmission program are influenced by what patients believe about their postoperative pain and functional abilities. Specific attention needs to be given both preoperatively and postoperatively to instructing patients on realistic expectations for recovery. One other method of measuring patient outcomes is with the Health Status Profile (SF-36) (Response Healthcare Information Management, 1995). The SF-36 approach emphasizes the outcome of medical care as the patient sees it, in addition to a clinical evaluation of successful health care. This form is currently initiated in the physician's office and returned for scanning at the preadmission class. The patient then completes another SF-36 at 6 months and every year thereafter to compare measurable outcomes. Patients intending to have elective total joint replacements experience anxiety and require much support and education. An effective preadmission program is a major investment in a patient's recovery, as well as a unique marketing tool to customers. Preadmission programs can be viewed as an opportunity to enhance customer satisfaction. Preadmission clinics are an excellent means for nurses to improve the quality of patient care through patient education. the overall goal of preadmission testing programs is to ensure patient preparedness while increasing quality health care and overall customer satisfaction. To enhance program effectiveness, health care providers must lead collaborative efforts to improve the efficiency of systems.

  1. The unstable total hip replacement

    PubMed Central

    D'Angelo, F; Murena, L; Zatti, G; Cherubino, P

    2008-01-01

    Background: Dislocation is one of the most common complications of total hip arthroplasty with a reported dislocation rate of 3.2%. Despite increased experience with hip replacement, the overall rate has not yet changed. The aim of this paper is to review the most recent literature published on this topic and indexed in Medline, in order to clarify the main risk factors, and to standardize a treatment protocol of such an important complication of prosthetic surgery. Materials and Methods: Medline database was searched using key words: “hip dislocation”, “hip instability” from 1980-2007. Studies were eligible for review and included if they met the following criteria: (1) publication in English, (2) clinical trials (3) review papers. Results: The risk of first-time dislocation as a function of time after the surgery is not well understood. Most, but not all, series have demonstrated that the risk of dislocation is highest during the first few months after hip arthroplasty; however, first-time late dislocation can also occur many years after the procedure. Several risk factors were described, including the surgical approach, the diameter of the head, impingement, component malposition, insufficient abductor musculature. In addition, there are also many treatment options, such as long-term bracing after closed reduction, component reorientation, capsulorraphy, trochanteric advancement, increasing offset, exchange of the modular head and the polyethylene liner, insertion of constrained liner. Conclusion: Preventing hip dislocation is obviously the best strategy. Surgeons must take into account patient and surgical risk factors. For patients at high risk for dislocation the surgeon should accurately restore leg length and femoral offset; the use of larger femoral heads, posterior transosseous repair of the capsulotendinous envelope if posterior approach is chosen or the use of a lateral approach should be considered. Proper patient education and postoperative

  2. The PorX Response Regulator of the Porphyromonas gingivalis PorXY Two-Component System Does Not Directly Regulate the Type IX Secretion Genes but Binds the PorL Subunit

    PubMed Central

    Vincent, Maxence S.; Durand, Eric; Cascales, Eric

    2016-01-01

    The Type IX secretion system (T9SS) is a versatile multi-protein complex restricted to bacteria of the Bacteriodetes phylum and responsible for the secretion or cell surface exposition of diverse proteins that participate to S-layer formation, gliding motility or pathogenesis. The T9SS is poorly characterized but a number of proteins involved in the assembly of the secretion apparatus in the oral pathogen Porphyromonas gingivalis have been identified based on genome substractive analyses. Among these proteins, PorY, and PorX encode typical two-component system (TCS) sensor and CheY-like response regulator respectively. Although the porX and porY genes do not localize at the same genetic locus, it has been proposed that PorXY form a bona fide TCS. Deletion of porX in P. gingivalis causes a slight decrease of the expression of a number of other T9SS genes, including sov, porT, porP, porK, porL, porM, porN, and porY. Here, we show that PorX and the soluble cytoplasmic domain of PorY interact. Using electrophoretic mobility shift, DNA-protein co-purification and heterologous host expression assays, we demonstrate that PorX does not bind T9SS gene promoters and does not directly regulate expression of the T9SS genes. Finally, we show that PorX interacts with the cytoplasmic domain of PorL, a component of the T9SS membrane core complex and propose that the CheY-like PorX protein might be involved in the dynamics of the T9SS. PMID:27630829

  3. The PorX Response Regulator of the Porphyromonas gingivalis PorXY Two-Component System Does Not Directly Regulate the Type IX Secretion Genes but Binds the PorL Subunit.

    PubMed

    Vincent, Maxence S; Durand, Eric; Cascales, Eric

    2016-01-01

    The Type IX secretion system (T9SS) is a versatile multi-protein complex restricted to bacteria of the Bacteriodetes phylum and responsible for the secretion or cell surface exposition of diverse proteins that participate to S-layer formation, gliding motility or pathogenesis. The T9SS is poorly characterized but a number of proteins involved in the assembly of the secretion apparatus in the oral pathogen Porphyromonas gingivalis have been identified based on genome substractive analyses. Among these proteins, PorY, and PorX encode typical two-component system (TCS) sensor and CheY-like response regulator respectively. Although the porX and porY genes do not localize at the same genetic locus, it has been proposed that PorXY form a bona fide TCS. Deletion of porX in P. gingivalis causes a slight decrease of the expression of a number of other T9SS genes, including sov, porT, porP, porK, porL, porM, porN, and porY. Here, we show that PorX and the soluble cytoplasmic domain of PorY interact. Using electrophoretic mobility shift, DNA-protein co-purification and heterologous host expression assays, we demonstrate that PorX does not bind T9SS gene promoters and does not directly regulate expression of the T9SS genes. Finally, we show that PorX interacts with the cytoplasmic domain of PorL, a component of the T9SS membrane core complex and propose that the CheY-like PorX protein might be involved in the dynamics of the T9SS. PMID:27630829

  4. The PorX Response Regulator of the Porphyromonas gingivalis PorXY Two-Component System Does Not Directly Regulate the Type IX Secretion Genes but Binds the PorL Subunit.

    PubMed

    Vincent, Maxence S; Durand, Eric; Cascales, Eric

    2016-01-01

    The Type IX secretion system (T9SS) is a versatile multi-protein complex restricted to bacteria of the Bacteriodetes phylum and responsible for the secretion or cell surface exposition of diverse proteins that participate to S-layer formation, gliding motility or pathogenesis. The T9SS is poorly characterized but a number of proteins involved in the assembly of the secretion apparatus in the oral pathogen Porphyromonas gingivalis have been identified based on genome substractive analyses. Among these proteins, PorY, and PorX encode typical two-component system (TCS) sensor and CheY-like response regulator respectively. Although the porX and porY genes do not localize at the same genetic locus, it has been proposed that PorXY form a bona fide TCS. Deletion of porX in P. gingivalis causes a slight decrease of the expression of a number of other T9SS genes, including sov, porT, porP, porK, porL, porM, porN, and porY. Here, we show that PorX and the soluble cytoplasmic domain of PorY interact. Using electrophoretic mobility shift, DNA-protein co-purification and heterologous host expression assays, we demonstrate that PorX does not bind T9SS gene promoters and does not directly regulate expression of the T9SS genes. Finally, we show that PorX interacts with the cytoplasmic domain of PorL, a component of the T9SS membrane core complex and propose that the CheY-like PorX protein might be involved in the dynamics of the T9SS.

  5. The PorX Response Regulator of the Porphyromonas gingivalis PorXY Two-Component System Does Not Directly Regulate the Type IX Secretion Genes but Binds the PorL Subunit

    PubMed Central

    Vincent, Maxence S.; Durand, Eric; Cascales, Eric

    2016-01-01

    The Type IX secretion system (T9SS) is a versatile multi-protein complex restricted to bacteria of the Bacteriodetes phylum and responsible for the secretion or cell surface exposition of diverse proteins that participate to S-layer formation, gliding motility or pathogenesis. The T9SS is poorly characterized but a number of proteins involved in the assembly of the secretion apparatus in the oral pathogen Porphyromonas gingivalis have been identified based on genome substractive analyses. Among these proteins, PorY, and PorX encode typical two-component system (TCS) sensor and CheY-like response regulator respectively. Although the porX and porY genes do not localize at the same genetic locus, it has been proposed that PorXY form a bona fide TCS. Deletion of porX in P. gingivalis causes a slight decrease of the expression of a number of other T9SS genes, including sov, porT, porP, porK, porL, porM, porN, and porY. Here, we show that PorX and the soluble cytoplasmic domain of PorY interact. Using electrophoretic mobility shift, DNA-protein co-purification and heterologous host expression assays, we demonstrate that PorX does not bind T9SS gene promoters and does not directly regulate expression of the T9SS genes. Finally, we show that PorX interacts with the cytoplasmic domain of PorL, a component of the T9SS membrane core complex and propose that the CheY-like PorX protein might be involved in the dynamics of the T9SS.

  6. Transient hyperthyroidism after total laryngectomy for laryngeal cancer.

    PubMed

    Salazar Thieroldt, Eduardo; Boado Lama, Jorge; Molinero Abad, Sheila; Miján de la Torre, Alberto

    2014-10-24

    Introducción: La tiroitidis postquirúrgica es una complicación de la laringectomía total (TL) y pueden ser causada por manipulación de la glándula. Existen descripciones aisladas en la literatura referentes a hipertiroidismo transitorio (HT) en el postoperatorio de cirugía de cabeza y cuello. El objetivo del presente estudio es relacionar la frecuencia de HT tras TL y evaluar su relación con el procedimiento quirúrgico. Métodos: Estudio de cohorte retrospectiva. Se incluyeron 44 pacientes y se estratificaron en Grupo 1 (TL y faringectomía), y grupo 2 (TL y disección cervical). Se midió la función tiroidea postoperatoria a todos los pacientes. Los resultados fueron analizados con el test de chi cuadrado con corrección de Yates y OR (p.

  7. Defense meteorological satellite measurements of total ozone

    NASA Technical Reports Server (NTRS)

    Lovill, J. E.; Ellis, J. S.; Luther, F. M.; Sullivan, T. J.; Weichel, R. L.

    1982-01-01

    A multichannel filter radiometer (MFR) on Defense Meteorological Satellites (DMS) that measured total ozone on a global-scale from March 1977 - February 1980 is described. The total ozone data measured by the MFR were compared with total ozone data taken by surfaced-based Dobson spectrophotometers. When comparisons were made for five months, the Dobson spectrophotometer measured 2-5% more total ozone than the MFR. Comparisons between the Dobson spectrophotometer and the MFR showed a reduced RMS difference as the comparisons were made at closer proximity. A Northern Hemisphere total ozone distribution obtained from MFR data is presented.

  8. Trends in total column ozone measurements

    NASA Technical Reports Server (NTRS)

    Rowland, F. S.; Angell, J.; Attmannspacher, W.; Bloomfield, P.; Bojkov, R. D.; Harris, N.; Komhyr, W.; Mcfarland, M.; Mcpeters, R.; Stolarski, R. S.

    1989-01-01

    It is important to ensure the best available data are used in any determination of possible trends in total ozone in order to have the most accurate estimates of any trends and the associated uncertainties. Accordingly, the existing total ozone records were examined in considerable detail. Once the best data set has been produced, the statistical analysis must examine the data for any effects that might indicate changes in the behavior of global total ozone. The changes at any individual measuring station could be local in nature, and herein, particular attention was paid to the seasonal and latitudinal variations of total ozone, because two dimensional photochemical models indicate that any changes in total ozone would be most pronounced at high latitudes during the winter months. The conclusions derived from this detailed examination of available total ozone can be split into two categories, one concerning the quality and the other the statistical analysis of the total ozone record.

  9. System design description for portable 1,000 CFM exhauster Skids POR-007/Skid E and POR-008/Skid F

    SciTech Connect

    Nelson, O.D.

    1998-07-25

    The primary purpose of the two 1,000 CFM Exhauster Skids, POR-007-SKID E and POR-008-SKID F, is to provide backup to the waste tank primary ventilation systems for tanks 241-C-106 and 241-AY-102, and the AY-102 annulus in the event of a failure during the sluicing of tank 241-C-106 and subsequent transfer of sluiced waste to 241-AY-102. This redundancy is required since both of the tank ventilation systems have been declared as Safety Class systems.

  10. Identification of Porphyromonas gingivalis proteins secreted by the Por secretion system.

    PubMed

    Sato, Keiko; Yukitake, Hideharu; Narita, Yuka; Shoji, Mikio; Naito, Mariko; Nakayama, Koji

    2013-01-01

    The Gram-negative bacterium Porphyromonas gingivalis possesses a number of potential virulence factors for periodontopathogenicity. In particular, cysteine proteinases named gingipains are of interest given their abilities to degrade host proteins and process other virulence factors such as fimbriae. Gingipains are translocated on the cell surface or into the extracellular milieu by the Por secretion system (PorSS), which consists of a number of membrane or periplasmic proteins including PorK, PorL, PorM, PorN, PorO, PorP, PorQ, PorT, PorU, PorV (PG27, LptO), PorW and Sov. To identify proteins other than gingipains secreted by the PorSS, we compared the proteomes of P. gingivalis strains kgp rgpA rgpB (PorSS-proficient strain) and kgp rgpA rgpB porK (PorSS-deficient strain) using two-dimensional gel electrophoresis and peptide-mass fingerprinting. Sixteen spots representing 10 different proteins were present in the particle-free culture supernatant of the PorSS-proficient strain but were absent or faint in that of the PorSS-deficient strain. These identified proteins possessed the C-terminal domains (CTDs), which had been suggested to form the CTD protein family. These results indicate that the PorSS is used for secretion of a number of proteins other than gingipains and that the CTDs of the proteins are associated with the PorSS-dependent secretion. PMID:23075153

  11. Identification of Porphyromonas gingivalis proteins secreted by the Por secretion system.

    PubMed

    Sato, Keiko; Yukitake, Hideharu; Narita, Yuka; Shoji, Mikio; Naito, Mariko; Nakayama, Koji

    2013-01-01

    The Gram-negative bacterium Porphyromonas gingivalis possesses a number of potential virulence factors for periodontopathogenicity. In particular, cysteine proteinases named gingipains are of interest given their abilities to degrade host proteins and process other virulence factors such as fimbriae. Gingipains are translocated on the cell surface or into the extracellular milieu by the Por secretion system (PorSS), which consists of a number of membrane or periplasmic proteins including PorK, PorL, PorM, PorN, PorO, PorP, PorQ, PorT, PorU, PorV (PG27, LptO), PorW and Sov. To identify proteins other than gingipains secreted by the PorSS, we compared the proteomes of P. gingivalis strains kgp rgpA rgpB (PorSS-proficient strain) and kgp rgpA rgpB porK (PorSS-deficient strain) using two-dimensional gel electrophoresis and peptide-mass fingerprinting. Sixteen spots representing 10 different proteins were present in the particle-free culture supernatant of the PorSS-proficient strain but were absent or faint in that of the PorSS-deficient strain. These identified proteins possessed the C-terminal domains (CTDs), which had been suggested to form the CTD protein family. These results indicate that the PorSS is used for secretion of a number of proteins other than gingipains and that the CTDs of the proteins are associated with the PorSS-dependent secretion.

  12. Disminuyen en los Estados Unidos las infecciones por VPH.

    Cancer.gov

    La infección por los tipos del virus del papiloma humano (VPH) en el blanco de la vacuna cuadrivalente se redujo en casi dos tercios en las adolescentes desde que se recomendó la vacunación en los Estados Unidos.

  13. Centros oncológicos designados por el NCI

    Cancer.gov

    El programa de centros oncológicos designados por el Instituto Nacional del Cáncer (NCI) reconoce a los centros de todo el país que cumplen con rigurosos criterios para participar en proyectos avanzados de primer nivel para la investigación multidisciplinaria del cáncer.

  14. Total solar eclipse of 3 November 1994

    NASA Technical Reports Server (NTRS)

    Espenak, Fred; Anderson, Jay

    1993-01-01

    A total eclipse of the Sun will be visible from the southern half of the Western Hemisphere on 3 November 1994. The path of the Moon's shadow passes through Peru, Chile, Bolivia, Paraguay, and Brazil. Detailed predictions for this event are presented and include tables of geographic coordinates of the path of totality, local circumstances for hundreds of cities, maps of the path of total and partial eclipse, weather prospects, and the lunar limb profile.

  15. Water-Cooled Total-Temperature Probe

    NASA Technical Reports Server (NTRS)

    Lagen, Nicholas T.; Reece, Garland D.

    1992-01-01

    Water-cooled supersonic total-pressure, static-pressure, and total-temperature probes developed to study high-temperature jet plumes. Total-temperature probe tested up to 2,000 degrees F incorporates annular cooling system up to thermocouple lead. Lead extends into test chamber to sense temperature of supersonic external flow. Design novel and significant. Applicable in development of jet engines and in research on fast flows of hot gases.

  16. Computation of orbits using total energy

    NASA Technical Reports Server (NTRS)

    Bond, Victor R.; Mulcihy, David D.

    1988-01-01

    The computation of orbits can be done more efficiently by the use of any of several new formulations of the perturbed two body problem which consider the total energy of the orbital system as one of the dependent variables. The total energy is the osculating two body energy plus the potential energy due to perturbing masses. The use of the total energy as the dependent variable instead of the two body energy is a relatively new idea. The advantage of using total energy arises from the fact that the more perturbing potential energy that is accounted for in the total energy variable, the more nearly constant is the total energy. In fact, except for dissipative forces such as drag, the only reason for the total energy not being constant is the rotation or revolution of the perturbing mass. This near constancy of the total energy has the effect of inhibiting error growth during numerical solution. This paper will present the results of an application of total energy formulation to the problem of the precise computation of orbits.

  17. EVALUATION OF TOTAL ORGANIC EMISSIONS ANALYSIS METHODS

    EPA Science Inventory

    The rationale and supporting experimental data for revising EPA's 1996 "Guidance for Total Organics" are summarized in this document. It reports the results of reseach and investigation of improvements to the Total Organic Emissions (TOE) guidance used by EPA to measure recovera...

  18. Energy expenditure in children with cerebral palsy and moderate / severe malnutrition during nutritional recovery.

    PubMed

    García-Contreras, Andrea A; Vásquez-Garibay, Edgar M; Romero-Velarde, Enrique; Ibarra-Gutierrez, Ana I; Troyo-Sanroman, Rogelio

    2015-05-01

    Objetivo: Analizar el gasto energético total (GET) y gasto energético basal (GEB) en niños con parálisis cerebral infantil (PCI) y desnutrición moderada o grave durante la recuperación nutricia. Métodos: En un estudio de intervención, se incluyeron trece sujetos con PCI (10 mujeres y 3 hombres, con una edad promedio de 9a11m±2a3m), pertenecían al nivel V del Sistema de Clasificación de la Función Motora Gruesa y desnutrición moderada o grave. Ocho fueron alimentados por sonda nasogástrica y cinco por gastrostomía. Se compararon con 57 participantes sanos (31 mujeres y 26 varones con una edad promedio de 8a7m±10m). Se realizaron mediciones antropométricas, de composición corporal y de gasto energético mediante el análisis de impedancia bio-eléctrica (IBE) y calorimetría indirecta (CI) en ambos grupos. Resultados: El GET y GEB fueron mayores en los niños sanos que en los niños con parálisis cerebral en kcal/d y kcal/cm/d, pero fueron menores en kcal/kg/día (p.

  19. Single-Incision Laparoscopic Total Colectomy

    PubMed Central

    Ojo, Oluwatosin J.; Carne, David; Guyton, Daniel

    2012-01-01

    Background and Objectives: To present our experience with a single-incision laparoscopic total colectomy, along with a literature review of all published cases on single-incision laparoscopic total colectomy. Methods: A total of 22 cases were published between 2010 and 2011, with our patient being case 23. These procedures were performed in the United States and United Kingdom. Surgical procedures included total colectomy with end ileostomy, proctocolectomy with ileorectal anastomosis, and total proctocolectomy with ileopouch-anal anastomosis. Intraoperative and postoperative data are analyzed. Results: Twenty-two of the 23 cases were performed for benign cases including Crohns, ulcerative colitis, and familial adenomatous polyposis. One case was performed for adenocarcinoma of the cecum. The mean age was 35.3 years (range, 13 to 64), the mean body mass index was 20.1 (range, 19 to 25), mean operative time was 175.9 minutes (range, 139 to 216), mean blood loss was 95.3mL (range, 59 to 200), mean incision length was 2.61cm (range, 2 to 3). Average follow-up was 4.6 months with 2 reported complications. Conclusions: Single-incision laparoscopic total colectomy is feasible and safe in the hands of an experienced surgeon. It has been performed for both benign and malignant cases. It is comparable to the conventional multi-port laparoscopic total colectomy. PMID:22906326

  20. Anaerobic threshold in total artificial heart animals.

    PubMed

    Chiang, B Y; Pantalos, G; Burns, G L; Long, J W; Khanwilkar, P S; Everett, S D; Mohammad, S F; Olsen, D B

    1994-01-01

    The anaerobic threshold represents an objective measure of functional capacity and is useful in assessment of pulmonary and cardiovascular dysfunction. This study determined the anaerobic threshold in total artificial heart animals and evaluated the performance of the total artificial heart system. Five animals with total artificial hearts were put under incremental exercise testing after exercise training. The intensity of exercise ranged from 2.0 to 4.5 km/hr, with an increment of 0.5 km/hr every 3 min. The anaerobic threshold was 6.72 +/- 0.84 ml/kg/min as detected by the lactate method, and 6.48 +/- 0.79 by the CO2 method. The value of the anaerobic threshold in total artificial heart animals implies that the performance capacity of a total artificial heart is not sufficient to meet the oxygen requirements of vigorously exercising skeletal muscle. The protocol does not allow for driving parameter changes during exercise, and this situation, combined with the manual mode of the control system used, was inadequate to allow the total artificial heart animals to exercise more vigorously. Using an automatic control mode might be helpful, as well as considering the relationship between indices of oxygen metabolism, such as oxygen delivery, oxygen consumption, and oxygen extraction rate, in the control algorithms in total artificial heart control systems.

  1. Se evitaron casi 800 000 muertes por descenso del tabaquismo

    Cancer.gov

    Programas y estrategias de control del tabaco del siglo XX fueron responsables de la prevención de más de 795 000 muertes por cáncer de pulmón en Estados Unidos de 1975 al 2000. Si todo el tabaquismo en este país hubiera cesado después de la publicación d

  2. 2016 Total Solar Eclipse Expedition of KASI

    NASA Astrophysics Data System (ADS)

    Bong, Su-Chan; Choi, SeongHwan; Jang, Bi-Ho; Park, Jongyeob; Jeon, Young-Beom; Cho, Kyuhyoun; Chae, Jongchul

    2016-05-01

    A total solar eclipse occurred on March 9 along the path through Indonesia and the Pacific. KASI organized an expedition team for total solar eclipse observation. The main purpose of this observation is to test the coronal temperature and outflow velocity diagnostics based on filter observation, which is proposed for the next generation coronagraph. In addition, various white light observations were tried. Although we could not get satisfactory data for the quantitative diagnostics due to system problem and weather, we could get some useful experimental data and nice white light images. We plan next expedition for 2017 total solar eclipse in USA.

  3. Total solar eclipse of 1995 October 24

    NASA Technical Reports Server (NTRS)

    Espenak, Fred; Anderson, Jay

    1994-01-01

    A total eclipse of the sun will be visible from Asia and the Pacific Ocean on 24 Oct. 1995. The path of the moon's shadow begins in the Middle East and sweeps across India, Southeast Asia, and the waters of the Indonesian archipelago before ending at sunset in the Pacific. Detailed predictions for this event are presented and include besselian elements, geographic coordinates of the path of totality, physical ephemeris of the umbra, topocentric limb profile corrections, local circumstances for 400 cities, maps of the eclipse path, weather prospects, the lunar limb profile, and the sky during totality.

  4. Total body calcium analysis. [neutron irradiation

    NASA Technical Reports Server (NTRS)

    Lewellen, T. K.; Nelp, W. B.

    1974-01-01

    A technique to quantitate total body calcium in humans is developed. Total body neutron irradiation is utilized to produce argon 37. The radio argon, which diffuses into the blood stream and is excreted through the lungs, is recovered from the exhaled breath and counted inside a proportional detector. Emphasis is placed on: (1) measurement of the rate of excretion of radio argon following total body neutron irradiation; (2) the development of the radio argon collection, purification, and counting systems; and (3) development of a patient irradiation facility using a 14 MeV neutron generator. Results and applications are discussed in detail.

  5. The POR rs1057868–rs2868177 GC-GT diplotype is associated with high tacrolimus concentrations in early post-renal transplant recipients

    PubMed Central

    Liu, Shu; Chen, Rong-xin; Li, Jun; Zhang, Yu; Wang, Xue-ding; Fu, Qian; Chen, Ling-yan; Liu, Xiao-man; Huang, Hong-bing; Huang, Min; Wang, Chang-xi; Li, Jia-li

    2016-01-01

    Aim: Cytochrome P450 oxidoreductase (POR) is the only flavoprotein that donates electrons to all microsomal P450 enzymes (CYP), and several POR SNPs have been shown to be important contributors to altered CYP activity or CYP-mediated drug metabolism. In this study we examined the association between 6 POR SNPs and tacrolimus concentrations in Chinese renal transplant recipients. Methods: A total of 154 renal transplant recipients were enrolled. Genotyping of CYP3A5*3 and 6 POR SNPs was performed. All patients received a triple immunosuppressive regimen comprising tacrolimus, mycophenolate mofetil and prednisone. Dose-adjusted tacrolimus trough concentrations were obtained on d 7 (C0D7/D) after transplantation when steady-state concentration of tacrolimus was achieved (dosage had been unchanged for more than 3 d). Results: Tacrolimus C0D7/D in CYP3A5*3/*3/ POR rs1057868–rs2868177 GC-GT diplotype carriers was 1.62- and 2.72-fold higher than those in CYP3A5*3/*3/ POR rs1057868–rs2868177 GC-GT diplotype non-carriers and CYP3A5*1 carriers (220.17±48.09 vs 135.69±6.86 and 80.84±5.27 ng/mL/mg/kg, respectively, P<0.0001). Of CYP3A5*3/*3/ POR rs1057868-rs2868177GC-GT diplotype carriers, 85.71% exceeded the upper limit of the target range (8 ng/mL), which was also significantly higher compared with the latter two groups (14.29% and 0.00%, respectively, P<0.0001). The CYP3A5*3 and POR rs1057868–rs2868177 GC-GT diplotype explained 31.7% and 5.7%, respectively, of the inter-individual variability of tacrolimus C0D7/D, whereas the POR rs1057868–rs2868177 GC-GT diplotype could explain 10.9% of the inter-individual variability of tacrolimus C0D7/D in CYP3A5 non-expressers. Conclusion: The CYP3A5*3 and POR rs1057868–rs2868177 GC-GT diplotype accounted for the inter-individual variation of tacrolimus C0D7/D. Genotyping of POR rs1057868–rs2868177 diplotypes would help to differentiate initial tacrolimus dose requirements and to achieve early target C0 ranges in Chinese

  6. Outdoor Activities for a Total Lunar Eclipse

    ERIC Educational Resources Information Center

    Glenn, William H.

    1977-01-01

    Describes several activities involving a total eclipse of the moon. Included are observations with binoculars, naked eye, and telescope; timing activities and observations of color changes during penumbral and umbral phases; and photography activities. (CS)

  7. UNDERSTANDING CHILDREN'S TOTAL DIETARY EXPOSURE TO PESTICIDES

    EPA Science Inventory

    Recent residential monitoring studies have demonstrated that significant portion of total exposure of infants and children to environmental contaminants can result from contamination of food in the home. Children's foods become contaminated through handling and contact with surf...

  8. Concise Enantiospecific Total Synthesis of Tubingensin A

    PubMed Central

    2015-01-01

    We report the enantiospecific total synthesis of (+)-tubingensin A. Our synthesis features an aryne cyclization to efficiently introduce the vicinal quaternary stereocenters of the natural product and proceeds in only nine steps (longest linear sequence) from known compounds. PMID:24524351

  9. Total Solar Eclipse Australia - Nov. 13, 2012

    NASA Video Gallery

    On Nov. 13, 2012, a narrow corridor in the southern hemisphere experienced a total solar eclipse. The corridor lay mostly over the ocean but also cut across the northern tip of Australia where both...

  10. Total Solar Eclipse--A Caribbean Adventure.

    ERIC Educational Resources Information Center

    Green, Steven; Tunstall, Louisa; Tunstall, Neil

    1999-01-01

    Describes the experiences of two high school students who traveled to the Caribbean island of Curacao to view a total solar eclipse and prepare methods for teaching classmates about the eclipse the following school year. (Author/WRM)

  11. Total lymphoid irradiation in alloimmunity and autoimmunity

    SciTech Connect

    Strober, S.

    1987-12-01

    Total lymphoid irradiation has been used as an immunosuppressive regimen in autoimmune disease and organ transplantation. The rationale for its use originated from studies of patients with Hodgkin disease, in whom this radiotherapy regimen was noted to induce profound and long-lasting immune suppression and yet was well tolerated, with few long-term side effects. Total lymphoid irradiation is a unique immunosuppressive regimen that produces a selective (and long-lasting) reduction in the number and function of helper T cells and certain subsets of B cells. Conventional immunosuppressive drugs show little selectivity, and their effects are short-lived. The most important aspect of total lymphoid irradiation is the potential for achieving transplantation tolerance and permanent remissions in autoimmune disease in laboratory animals. Attempts are being made to achieve similar goals in humans given total lymphoid irradiation, so that immunosuppressive drugs can be ultimately withdrawn from transplant recipients and patients with lupus nephritis. 28 references.

  12. Total quality management in the HMO environment.

    PubMed

    Omachonu, V K; Johnson, J A

    1993-01-01

    Increasing numbers of healthcare organization are turning to total quality management (TQM) to contain costs and improve quality. This article describes the implication of TQM for health maintenance organizations.

  13. NEW BEARING SURFACES IN TOTAL HIP REPLACEMENT

    PubMed Central

    Schwartsmann, Carlos Roberto; Boschin, Leonardo Carbonera; Gonçalves, Ramiro Zilles; Yépez, Anthony Kerbes; de Freitas Spinelli, Leandro

    2015-01-01

    Total hip arthroplasty is being increasingly indicated for younger and more active patients, in addition to a naturally growing demand for the procedure because of increasing life expectancy among patients. The high costs of this surgery and the controversies regarding implant performance have made this topic the subject of constant research, seeking new materials with better resistance to wear and better biocompatibility. The present article provides a review of new surfaces in total hip arthroplasty. PMID:27042614

  14. Total antioxidant capacity of the Korean diet

    PubMed Central

    Han, Jeong-Hwa; Lee, Hye-Jin; Cho, Mi Ran; Chang, Namsoo; Kim, Yuri; Oh, Se-Young

    2014-01-01

    BACKGROUND/OBJECTIVES The objective of this study was to measure and/or estimate the total antioxidant capacity of the Korean diet. MATERIALS/METHODS Eighty-one plant foods that were expected to exhibit rather high antioxidant activities were selected from the Korean diet using the Fifth Korean National Health and Nutrition Survey (KNHANES V). These foods were categorized into 11 food groups: cereals, potatoes, legumes, nuts, vegetables, kimchies, mushrooms, fruits, fruit juices, sea weeds, and oils. The foods were mixed in the proportions specified in traditional Korean recipes and analyzed. The measured indicators for antioxidant capacities were total phenolics, 2,2-diphenyl-1-picrylhydrazyl (DPPH), oxygen radical absorbance capacity (ORAC), and Trolox equivalent antioxidant capacity (TEAC). RESULTS Total phenolics were high in the fruit juices, nuts, vegetables, and fruits; and the average DPPH, ORAC, and TEAC values were high in the vegetables, fruits, fruit juices, and nuts. The correlation coefficient between the content of total phenolics of each food and the in vitro antioxidant capacity was relatively high at 0.851. The intake of total phenolics per capita per day in the Republic of Korea was estimated to be 127 mg. The total dietary antioxidant capacity (TDAC) values, which were obtained from the total antioxidant capacity of each food, taking into account the intake of each food, were 20,763, 54,335, and 876.4 µmol of Trolox equivalents using the DPPH, ORAC, and TEAC methods, respectively. The food group that contributed the most to the Korean TDAC was cereals at 39.7%, followed by fruits and vegetables at 27.8% and 13.9%, respectively. The contribution of legumes, nuts, fruit juices, and mushrooms was quite minimal at less than 2% each. CONCLUSIONS The content of total phenolics and the antioxidant capacity of the Korean diet are significantly correlated and the high contributing food groups are cereals, fruits, and vegetables. PMID:24741403

  15. Total water withdrawals in Mississippi, 1990

    USGS Publications Warehouse

    Johnson, P.M.

    1994-01-01

    During 1990, the amount of water withdrawn from ground- and surface-water sources in Mississippi was about 3,600 Mgal/d (million gallons per day). Of this amount, 91 percent, or 3,300 Mgal/d, was withdrawn from freshwater sources. Of the total freshwater withdrawals, about 82 percent, or 2,700 Mgal/d, was withdrawn from ground-water sources. Total water withdrawals in Mississippi in 1990 for eight categories of use were as follows: irrigation, 1,900 Mgal/d; thermoelectric power, 700 Mgal/d; aquaculture, 400 Mgal/d; public supply, 320 Mgal/d; industrial and mining, 270 Mgal/d; domestic, 33 Mgal/d; commercial, 16 Mgal/d; and livestock, 16 Mgal/d. Overall, total withdrawals increased by 20 percent from 1985 to 1990, although the total population decreased about 2 percent. During the same period, total freshwater withdrawals increased by about 17 percent. Total saline with- drawals increased by about 60 percent from 1985 due to an increase in salin withdrawals for thermo- electric power generation. Total fresh and saline surface-water withdrawals decreased by about 6 percent from 1985, due to decrease in surface-water withdrawals for irrigation. Fresh ground-water withdrawals in Mississippi increased by about 33 percent, primarily due to an increase in irrigation. Since 1960, total ground- and surface-water with- drawals increased 70 percent for the same period. Irrigation had the greatest increase in with- drawals since 1960, with a 269 percent increase. Public supply had the second greatest, with a 178 percent increase.

  16. Proximal tibial fracture following total knee arthroplasty.

    PubMed

    Krause, Heike; Dunleavy, Kim

    2011-09-01

    The patient was a 74-year-old man, with a history of total knee arthoplasty 14 years earlier, after having sustained a pathological fracture of the proximal diaphysis of the left tibia following a fall. Given the unstable nature of the fracture and the severe osteolysis noted below the total knee arthroplasty, surgical management 1 day after the fall entailed packing cancellous bone graft into the defect and realigning the fracture. PMID:21885911

  17. Stereoselective Total Synthesis of (-)-Renieramycin T.

    PubMed

    Yokoya, Masashi; Toyoshima, Ryoko; Suzuki, Toshihiro; Le, Vy H; Williams, Robert M; Saito, Naoki

    2016-05-20

    A stereoselective total synthesis of (-)-Renieramycin T (1t) from a key tetrahydroisoquinoline intermediate previously utilized in our formal total synthesis of Ecteinascidin 743 is described. The synthesis features a concise approach for construction of the pentacyclic framework using a Pictet-Spengler cyclization of bromo-substituted carbinolamine 17, which obviates the regioselectivity problem of the Pictet-Spengler cyclization. The results of cytotoxicity studies are also presented. PMID:27019081

  18. Effects of xenobiotics on total antioxidant capacity

    PubMed Central

    2012-01-01

    The objective of this article was to review the effects of xenobiotics on total antioxidant capacity (TAC). Measurement of TAC is appropriate for evaluation of the total antioxidant defenses of blood, cells, and different kinds of tissues and organs. TAC is reduced by alcoholism, smoking, and exposure to radiation, herbicides, carbon monoxide, carbon tetrachloride, lead, arsenic, mercury, cadmium, aluminum, and other toxic elements. The test is also an important tool in evaluating environmental and occupational exposure. PMID:23554550

  19. Total lymphoid irradiation and discordant cardiac xenografts

    SciTech Connect

    Kaplan, E.; Dresdale, A.R.; Diehl, J.T.; Katzen, N.A.; Aronovitz, M.J.; Konstam, M.A.; Payne, D.D.; Cleveland, R.J. )

    1990-01-01

    Total lymphoid irradiation can prolong concordant cardiac xenografts. The effects of total lymphoid irradiation in a discordant xenograft model (guinea pig to rat) were studied with and without adjuvant pharmacologic immunosuppression. Inbred Lewis rats were randomly allocated to one of four groups. Group 1 (n = 6) served as a control group and rats received no immunosuppression. Group 2 (n = 5) received triple-drug therapy that consisted of intraperitoneal azathioprine (2 mg/kg), cyclosporine (20 mg/kg), and methylprednisolone (1 mg/kg) for 1 week before transplantation. Group 3 animals (n = 5) received 15 Gy of total lymphoid irradiation in 12 divided doses over a 3-week period. Group 4 (n = 6) received both triple-drug therapy and total lymphoid irradiation as described for groups 2 and 3. Complement-dependent cytotoxicity assay was performed to determine if a correlation between complement-dependent cytotoxicity and rejection-free interval existed. Rejection was defined as cessation of graft pulsation and was confirmed by histologic test results. Only groups 1 and 2 showed a difference in survival (group 1, 6.9 +/- 1.0 minutes; group 2, 14.2 +/- 2.7 minutes, p = 0.02). Although total lymphoid irradiation did decrease complement-dependent cytotoxicity, linear regression revealed no correlation between complement-dependent cytotoxicity and graft survival (coefficient of correlation, 0.30). Unlike concordant cardiac xenografts, total lymphoid irradiation with or without triple-drug therapy does not prolong graft survival.

  20. Total OH reactivity emissions from Norway spruce

    NASA Astrophysics Data System (ADS)

    Nölscher, Anke; Bourtsoukidis, Efstratios; Bonn, Boris; Kesselmeier, Jürgen; Lelieveld, Jos; Williams, Jonathan

    2013-04-01

    Forest emissions represent a strong potential sink for the main tropospheric oxidant, the hydroxyl radical (OH). In forested environments, the comparison of the directly determined overall sink of OH radicals, the total OH reactivity, and the individually measured OH sink compounds often exposes a significant gap. This "missing" OH reactivity can be high and influenced by both direct biogenic emissions and secondary photo-oxidation products. To investigate the source of the missing OH sinks in forests, total OH reactivity emission rates were determined for the first time from a Norway spruce (Picea abies) throughout spring, summer and autumn 2011. The total OH reactivity was measured inside a branch enclosure using the Comparative Reactivity Method (CRM) with a Proton Transfer Reaction-Mass Spectrometer (PTR-MS) as the detector. In parallel, separate volatile organic compounds (VOC) emission rates were monitored by a second PTR-MS, including the signal of isoprene, acetaldehyde, total monoterpenes and total sesquiterpenes. The comparison of known and PTR-MS detected OH sink compounds and the directly measured total OH reactivity emitted from Norway spruce revealed unmeasured and possibly unknown primary biogenic emissions. These were found to be highest in late summer during daytime coincident with highest temperatures and ozone levels.

  1. Improved survival for anatomic total shoulder prostheses

    PubMed Central

    Fevang, Bjørg T S; Nystad, Tone W; Skredderstuen, Arne; Furnes, Ove N; Havelin, Leif I

    2015-01-01

    Background and purpose Previously, implant survival of total shoulder prostheses was reported to be inferior to that of hemiprostheses. However, the use of total prostheses has increased in Norway due to reported good functional results. On this background, we wanted to study implant survival of 4 major shoulder prosthesis types in Norway between 1994 and 2012. Patients and methods The study population comprised 4,173 patients with shoulder replacements reported to the Norwegian Arthroplasty Register, including 2,447 hemiprostheses (HPs), 444 anatomic total prostheses (ATPs), 454 resurfacing prostheses (RPs), and 828 reversed total prostheses (RTPs). Three time periods were compared: 1994–1999, 2000–2005, and 2006–2012. Kaplan-Meier failure curves were used to compare implant failure rates for subgroups of patients, and adjusted risks of revision were calculated using Cox regression analysis. Results For prostheses inserted from 2006 through 2012, the 5-year survival rates were 95% for HPs (as opposed to 94% in 1994–1999), 95% for ATPs (75% in 1994–1999), 87% for RPs (96% in 1994–1999), and 93% for RTPs (91% in 1994–1999). During the study period, the implant survival improved significantly for ATPs (p < 0.001). A tendency of better results with acute fracture and worse results in sequelae after previous fractures was seen in all time periods. Interpretation The 5-year implant survival rates were good with all prosthesis types, and markedly improved for anatomic total prostheses in the last 2 study periods. The better functional results with total shoulder prostheses than with hemiprostheses support the trend towards increased use of total shoulder prostheses. PMID:25386737

  2. A high performance totally ordered multicast protocol

    NASA Technical Reports Server (NTRS)

    Montgomery, Todd; Whetten, Brian; Kaplan, Simon

    1995-01-01

    This paper presents the Reliable Multicast Protocol (RMP). RMP provides a totally ordered, reliable, atomic multicast service on top of an unreliable multicast datagram service such as IP Multicasting. RMP is fully and symmetrically distributed so that no site bears un undue portion of the communication load. RMP provides a wide range of guarantees, from unreliable delivery to totally ordered delivery, to K-resilient, majority resilient, and totally resilient atomic delivery. These QoS guarantees are selectable on a per packet basis. RMP provides many communication options, including virtual synchrony, a publisher/subscriber model of message delivery, an implicit naming service, mutually exclusive handlers for messages, and mutually exclusive locks. It has commonly been held that a large performance penalty must be paid in order to implement total ordering -- RMP discounts this. On SparcStation 10's on a 1250 KB/sec Ethernet, RMP provides totally ordered packet delivery to one destination at 842 KB/sec throughput and with 3.1 ms packet latency. The performance stays roughly constant independent of the number of destinations. For two or more destinations on a LAN, RMP provides higher throughput than any protocol that does not use multicast or broadcast.

  3. Total Solar Eclipse of 2008 August 01

    NASA Technical Reports Server (NTRS)

    Espenak, F.; Anderson, J.

    2007-01-01

    On 2008 August 01, a total eclipse of the Sun is visible from within a narrow corridor that traverses half the Earth. The path of the Moon's umbral shadow begins in northern Canada and extends across Greenland, the Arctic, central Russia, Mongolia, and China. A partial eclipse is seen within the much broader path of the Moon's penumbral shadow, which includes northeastern North America, most of Europe and Asia. Detailed predictions for this event are presented and include besselian elements, geographic coordinates of the path of totality, physical ephemeris of the umbra, topocentric limb profile corrections, local circumstances for 308 cities, maps of the eclipse path, weather prospects, the lunar limb profile and the sky during totality. Information on safe eclipse viewing and eclipse photography is included.

  4. Assay development status report for total cyanide

    SciTech Connect

    Simpson, B.C.; Jones, T.E.; Pool, K.H.

    1993-02-01

    A validated cyanide assay that is applicable to a variety of tank waste matrices is necessary to resolve certain waste tank safety issues and for purposes of overall waste characterization. The target for this effort is an assay with an applicable range of greater than 1,000 ppM (0.10 wt%) total cyanide and a confidence level greater than 80%. Figure 1 illustrates the operating regime of the proposed cyanide assay method. The Assay Development Status Report for Total Cyanide will summarize the past experience with cyanide analyses on-tank waste matrices and will rate the status of the analytical methods used to assay total cyanide (CN{sup {minus}} ion) in the tank waste matrices as acceptable or unacceptable. This paper will also briefly describe the current efforts for improving analytical resolution of the assays and the attempts at speciation.

  5. Total Solar Eclipse of 2001 June 21

    NASA Technical Reports Server (NTRS)

    Espenak, Fred; Anderson, Jay

    1999-01-01

    On 2001 June 21, a total eclipse of the Sun will be visible from within a narrow corridor which traverses the Southern Hemisphere. The path of the Moon's umbral shadow begins in the South Atlantic, crosses southern Africa and Madagascar, and ends at sunset in the Indian Ocean. A partial eclipse will be seen within the much broader path of the Moon's penumbral shadow, which includes eastern South America and the southern two thirds of Africa. Detailed predictions for this event are presented and include besselian elements, geographic coordinates of the path of totality, physical ephemeris of the umbra, topocentric limb profile corrections, local circumstances for approximately 350 cities, maps of the eclipse path, weather prospects, the lunar limb profile and the sky during totality. Tips and suggestions are also given on how to safely view and photograph the eclipse.

  6. Total Solar Eclipse of 2002 December 04

    NASA Technical Reports Server (NTRS)

    Espenak, Fred; Anderson, Jay

    2001-01-01

    On 2002 December 04, a total eclipse of the Sun will be visible from within a narrow corridor which traverses the Southern Hemisphere. The path of the Moon's umbral shadow begins in the South Atlantic, crosses southern Africa and the Indian Ocean, and ends at sunset in southern Australia. A partial eclipse will be seen within the much broader path of the Moon's penumbral shadow, which includes the southern two thirds of Africa, Antarctica, Indian Ocean and Australia. Detailed predictions for this event are presented and include besselian elements, geographic coordinates of the path of totality, physical ephemeris of the umbra, topocentric limb profile corrections, local circumstances for approximately 400 cities, maps of the eclipse path, weather prospects, the lunar limb profile and the sky during totality. Information on safe eclipse viewing and eclipse photography is included.

  7. Total Solar Eclipse of 2006 March 29

    NASA Technical Reports Server (NTRS)

    Espenak, F.; Anderson, J.

    2004-01-01

    On 2006 March 29, a total eclipse of the Sun will be visible from within a narrow corridor which traverses half the Earth. The path of the Moon's umbral shadow begins in Brazil and extends across the Atlantic, northern Africa, and central Asia where it ends at sunset in western Mongolia. A partial eclipse will be seen within the much broader path of the Moon's penumbral shadow, which includes the northern two thirds of Africa, Europe, and central Asia.Detailed predictions for this event are presented and include besselian elements, geographic coordinates of the path of totality, physical ephemeris of the umbra, topocentric limb profile corrections, local circumstances for approximately 350 cities, maps of the eclipse path, weather prospects, the lunar limb profile, and the sky during totality. Information on safe eclipse viewing and eclipse photography is included.

  8. Total quadruple photoionization cross section of beryllium

    SciTech Connect

    Emmanouilidou, Agapi

    2007-11-15

    In a quasiclassical framework, we formulate the quadruple ionization by single-photon absorption of the Coulomb five-body problem. We present the quadruple photoionization total cross section of the ground state of beryllium for energies up to 620 eV. Our results for energies close to threshold are in agreement with the Wannier threshold law for four-electron escape. In addition, the agreement of our results with a shape formula provides support for the overall shape of our total quadruple cross section. Finally, we find that the photon energy where the maximum of the total photoionization cross section occurs for single, double, triple, and quadruple photoionization of H, He, Li, and Be, respectively, seems to follow a linear relation with the threshold energy for complete breakup of the respective element.

  9. Total Solar Eclipse of 1997 March 9

    NASA Technical Reports Server (NTRS)

    Espenak, Fred; Anderson, Jay

    1995-01-01

    A total eclipse of the Sun will be visible from Asia and the Pacific Ocean on 1997 March 9. The path of the Moon's umbral shadow begins in eastern Kazakhstan and travels through Mongolia and eastern Siberia, where it swings northward to end at sunset in the Arctic Ocean. A partial eclipse will be seen within the much broader path of the Moon's penumbral shadow, which includes eastern Asia, the northern Pacific, and the northwest corner of North America. Detailed predictions for this event are presented and include besselian elements, geographic coordinates of the path of totality, physical ephemeris of the umbra, topocentric limb profile corrections, local circumstances for 280 cities, maps of the eclipse path, weather prospects, the lunar limb profile, and the sky during totality. Tips and suggestions are also given on how to safely view and photograph the eclipse.

  10. Total Solar Eclipse of 1999 August 11

    NASA Technical Reports Server (NTRS)

    Espenak, Fred; Anderson, Jay

    1997-01-01

    On 1999 August 11, a total eclipse of the Sun will be visible from within a narrow corridor which traverses the Eastern Hemisphere. The path of the Moon's umbral shadow begins in the Atlantic and crosses central Europe, the Middle East, and India, where it ends at sunset in the Bay of Bengal. A partial eclipse will be seen within the much broader path of the Moon's penumbral shadow, which includes northeastern North America, all of Europe, northern Africa, and the western half of Asia. Detailed predictions for this event are presented and include besselian elements, geographic coordinates of the path of totality, physical ephemeris of the umbra, topocentric limb profile corrections, local circumstances for approximately 1400 cities, maps of the eclipse path, weather prospects, the lunar limb profile, and the sky during totality. Tips and suggestions are also given on how to safely view and photograph the eclipse.

  11. The US 2017 Total Solar Eclipse Workshops

    NASA Astrophysics Data System (ADS)

    Arndt, Martina B.; Habbal, S. R.; Wind Sherpas, Solar

    2012-05-01

    In preparation for the Total Solar Eclipse that will span across the United States in 2017, multiple eclipse workshops are being planned to bring together professional and amateur researchers, educators, and imagers. Our ultimate goal with these workshops is to maximize the amount and quality of data we can collect during the eclipse as well as to leverage this exciting event to educate and inspire people of all ages. Part of the workshops will be dedicated to discussing the science that can be learned from observing total solar eclipses, and part of the workshops will be dedicated to strategizing about how to mobilize and prepare communities in the path of totality. In this poster, we will share our preliminary results from the inaugural workshop in Maryland, April 2012.

  12. An Operational Perspective of Total Lightning Information

    NASA Technical Reports Server (NTRS)

    Nadler, David J.; Darden, Christopher B.; Stano, Geoffrey; Buechler, Dennis E.

    2009-01-01

    The close and productive collaborations between the NWS Warning and Forecast Office, the Short Term Prediction and Research Transition Center at NASA Marshall Space Flight Center and the University of Alabama in Huntsville have provided a unique opportunity for science sharing and technology transfer. One significant technology transfer that has provided immediate benefits to NWS forecast and warning operations is the use of data from the North Alabama Lightning Mapping Array. This network consists of ten VHF receivers deployed across northern Alabama and a base station located at the National Space Science and Technology Center. Preliminary investigations done at WFO Huntsville, along with other similar total lightning networks across the country, have shown distinct correlations between the time rate-of-change of total lightning and trends in intensity/severity of the parent convective cell. Since May 2003 when WFO HUN began receiving these data - in conjunction with other more traditional remotely sensed data (radar, satellite, and surface observations) -- have improved the situational awareness of the WFO staff. The use of total lightning information, either from current ground based systems or future space borne instrumentation, may substantially contribute to the NWS mission, by enhancing severe weather warning and decision-making processes. Operational use of the data has been maximized at WFO Huntsville through a process that includes forecaster training, product implementation, and post event analysis and assessments. Since receiving these data, over 50 surveys have been completed highlighting the use of total lightning information during significant events across the Tennessee Valley. In addition, around 150 specific cases of interest have been archived for collaborative post storm analysis. From these datasets, detailed trending information from radar and total lightning can be compared to corresponding damage reports. This presentation will emphasize

  13. Failure of aseptic revision total knee arthroplasties

    PubMed Central

    Leta, Tesfaye H; Lygre, Stein Håkon L; Skredderstuen, Arne; Hallan, Geir; Furnes, Ove

    2015-01-01

    Background and purpose In Norway, the proportion of revision knee arthroplasties increased from 6.9% in 1994 to 8.5% in 2011. However, there is limited information on the epidemiology and causes of subsequent failure of revision knee arthroplasty. We therefore studied survival rate and determined the modes of failure of aseptic revision total knee arthroplasties. Method This study was based on 1,016 aseptic revision total knee arthroplasties reported to the Norwegian Arthroplasty Register between 1994 and 2011. Revisions done for infections were not included. Kaplan-Meier and Cox regression analyses were used to assess the survival rate and the relative risk of re-revision with all causes of re-revision as endpoint. Results 145 knees failed after revision total knee arthroplasty. Deep infection was the most frequent cause of re-revision (28%), followed by instability (26%), loose tibial component (17%), and pain (10%). The cumulative survival rate for revision total knee arthroplasties was 85% at 5 years, 78% at 10 years, and 71% at 15 years. Revision total knee arthroplasties with exchange of the femoral or tibial component exclusively had a higher risk of re-revision (RR = 1.7) than those with exchange of the whole prosthesis. The risk of re-revision was higher for men (RR = 2.0) and for patients aged less than 60 years (RR = 1.6). Interpretation In terms of implant survival, revision of the whole implant was better than revision of 1 component only. Young age and male sex were risk factors for re-revision. Deep infection was the most frequent cause of failure of revision of aseptic total knee arthroplasties. PMID:25267502

  14. Determination of total solutes in synfuel wastewaters

    SciTech Connect

    Wallace, J.R.; Bonomo, F.S.

    1984-03-01

    Efforts to investigate both lyophilization and the measurement of colligative properties as an indication of total solute content are described. The objective of the work described is to develop a method for measuring total dissolved material in retort wastewaters which is simple and rugged enough to be performed in a field laboratory in support of pollution control tests. The analysis should also be rapid enough to provide timely and pertinent data to the pollution control plant operator. To be of most value, the technique developed also should be applicable to other synfuel wastewaters, most of which contain similar major components as oil shale retort waters. 4 references, 1 table.

  15. The total nasal defect and reconstruction.

    PubMed

    Cannady, Steven B; Cook, Ted A; Wax, Mark K

    2009-05-01

    The structures of the nose are arguably the most complex within the face to reconstitute when absent. Total nasal reconstruction has evolved to encompass advanced surgical techniques in an effort to achieve increasingly satisfactory cosmetic results while restoring nasal function that mimics the function of a patient's natural nose. In this article, the history of total nasal defects and their reconstruction, relevant nasal anatomy, etiologies of the defect, and the surgical approaches to reconstructing each of the three-layered structure of the nose (ie, nasal skin, cartilage/bone, and lining mucosa) are explored.

  16. Measuring Total and Germinable Spore Populations

    NASA Technical Reports Server (NTRS)

    Noell, A.C.; Yung, P.T.; Yang, W.; Lee, C.; Ponce, A.

    2011-01-01

    It has been shown that bacterial endospores can be enumerated using a microscopy based assay that images the luminescent halos from terbium ions bound to dipicolinic acid, a spore specific chemical marker released upon spore germination. Further development of the instrument has simplified it towards automation while at the same time improving image quality. Enumeration of total spore populations has also been developed allowing measurement of the percentage of viable spores in any population by comparing the germinable/culturable spores to the total. Percentage viability will allow a more quantitative comparison of the ability of spores to survive across a wide range of extreme environments.

  17. Neisseria meningitidis Lacking the Major Porins PorA and PorB Is Viable and Modulates Apoptosis and the Oxidative Burst of Neutrophils.

    PubMed

    Peak, Ian R; Chen, Adrienne; Jen, Freda E-C; Jennings, Courtney; Schulz, Benjamin L; Saunders, Nigel J; Khan, Arshad; Seifert, H Steven; Jennings, Michael P

    2016-08-01

    The bacterial pathogen Neisseria meningitidis expresses two major outer-membrane porins. PorA expression is subject to phase-variation (high frequency, random, on-off switching), and both PorA and PorB are antigenically variable between strains. PorA expression is variable and not correlated with meningococcal colonisation or invasive disease, whereas all naturally-occurring strains express PorB suggesting strong selection for expression. We have generated N. meningitidis strains lacking expression of both major porins, demonstrating that they are dispensable for bacterial growth in vitro. The porAB mutant strain has an exponential growth rate similar to the parental strain, as do the single porA or porB mutants, but the porAB mutant strain does not reach the same cell density in stationary phase. Proteomic analysis suggests that the double mutant strain exhibits compensatory expression changes in proteins associated with cellular redox state, energy/nutrient metabolism, and membrane stability. On solid media, there is obvious growth impairment that is rescued by addition of blood or serum from mammalian species, particularly heme. These porin mutants are not impaired in their capacity to inhibit both staurosporine-induced apoptosis and a phorbol 12-myristate 13-acetate-induced oxidative burst in human neutrophils suggesting that the porins are not the only bacterial factors that can modulate these processes in host cells.

  18. The technology behind Colgate Total Advanced Fresh.

    PubMed

    Williams, Malcolm I; Cummins, Diane

    2003-09-01

    In the early 1990s, a breakthrough toothpaste, Colgate Total, was launched with documented long-lasting activity against plaque, gingivitis, calculus, tooth decay, and bad breath. The technology behind this toothpaste is the combination of triclosan, a polyvinylmethylether/maleic acid copolymer, and sodium fluoride. The copolymer ensures maximal oral retention and subsequent release of the antibacterial triclosan. Effective levels of triclosan have been observed in the oral cavity 12 hours after brushing the teeth, allowing prolonged control of oral bacteria that may cause the most common dental problems, including bad breath. Similarly, the enhanced retention of triclosan to oral surfaces after using this revolutionary toothpaste for up to 2 years has led to significantly reduced incremental coronal caries compared to an American Dental Association-Approved anticavity fluoride toothpaste. Furthermore, significantly less calcium remained in dental plaque after brushing the teeth with the triclosan/copolymer toothpaste, resulting in the formation of less tartar. In keeping with the multiple oral health benefits provided by Colgate Total, consumers are now offered a new dentifrice, Colgate Total Advanced Fresh, which provides the numerous therapeutic and esthetic benefits that are the hallmark of Colgate Total. The new dentifrice, which contains an impactful breath-freshening flavor, has been documented to provide sustained control of bad breath over 12 hours.

  19. Total Quality Management Goes to Community College.

    ERIC Educational Resources Information Center

    DeCosmo, Richard D.; And Others

    1991-01-01

    This article details the four-year implementation of Total Quality Management at Delaware County Community College (Pennsylvania) to conserve resources, improve effectiveness, assure quality, and increase participation in decision making. Reported are planning, execution, and monitoring activities of the Implementation Team; specific problems…

  20. Bladder management after total joint arthroplasty.

    PubMed

    Knight, R M; Pellegrini, V D

    1996-12-01

    This study was undertaken to determine the impact of an indwelling Foley catheter on bladder dysfunction and incidence of urinary tract infections after total joint arthroplasty. A prospective randomized controlled trial was conducted assigning use of an indwelling Foley catheter (group 1) or intermittent catheterization (group 2) for 48 hours following operation. Postoperative cultures were obtained on days 2 and 5, and the number of intermittent catheterization events and void and catheterization volumes were recorded. Concurrent cost-effectiveness analysis was conducted. One hundred nineteen of 174 consecutive patients having elective primary total joint arthroplasty completed the study. Five of 62 patients (8%) in group 1 and 7 of 57 patients (12%) in group 2 developed urinary tract infections (NS, P = 45). Twenty patients (35%) in group 2 and 12 (19%) in group 1 required straight catheterization for inability to void 48 hours after surgery (P = .05). Seventeen patients (35%) in group 2 and eight patients (16%) in group 1 required straight catheterization after epidural analgesia was discontinued (P = .024). Bladder management by indwelling Foley catheter saved more than 150 minutes of direct nursing contact per patient and $3,000 in total hospital costs. Indwelling Foley catheters reduced the frequency of postoperative urinary retention, were less labor intensive than intermittent straight catheterization, and were not associated with an increased risk of urinary infection. In the setting of epidural anesthesia and postoperative analgesia for total joint arthroplasty, management by indwelling catheter is a cost-effective strategy to facilitate postoperative return of normal bladder function.

  1. Applying Total Quality Management to Business Education.

    ERIC Educational Resources Information Center

    Brown, Daniel J.; Koenig, Harold F.

    1993-01-01

    Responses from 390 business school alumni (60%) show that students want educators to consider their opinions about their overall educational experience and what happens after graduation. A total quality management approach can help discover customer/student needs, establish a focus on improvement, and implement a process orientation. (SK)

  2. PROCEDURE FOR ESTIMATING PERMANENT TOTAL ENCLOSURE COSTS

    EPA Science Inventory

    The paper discusses a procedure for estimating permanent total enclosure (PTE) costs. (NOTE: Industries that use add-on control devices must adequately capture emissions before delivering them to the control device. One way to capture emissions is to use PTEs, enclosures that mee...

  3. Total energy calculations and bonding at interfaces

    SciTech Connect

    Louie, S.G.

    1984-08-01

    Some of the concepts and theoretical techniques employed in recent ab initio studies of the electronic and structural properties of surfaces and interfaces are discussed. Results of total energy calculations for the 2 x 1 reconstructed diamond (111) surface and for stacking faults in Si are reviewed. 30 refs., 8 figs.

  4. The total synthesis of (-)-cryptocaryol A.

    PubMed

    Dias, L C; Kuroishi, P K; de Lucca, E C

    2015-03-28

    A stereoselective total synthesis of (-)-cryptocaryol A (1) is described. Key features of the 17-step route include the use of three boron-mediated aldol reaction-reduction sequences to control all stereocenters and an Ando modification of the Horner-Wadsworth-Emmons olefination that permitted the installation of the Z double bond of the α-pyrone ring. PMID:25695350

  5. [Open total dislocation of the talus].

    PubMed

    Grabski, R S; Sosiński, R

    1992-01-01

    A case of 35 years old patient with open, total, fixed dislocation of the talus reduced with heel traction is presented. The Sudeck syndrome subsided after one year. Weight bearing was not allowed for 7 months. An examination after 2.5 years revealed minor osteoarthritis, full range of movement in the foot but limited walking capability. PMID:7555299

  6. Total Synthesis of (±)-Maoecrystal V

    PubMed Central

    Peng, Feng; Danishefsky, Samuel J.

    2012-01-01

    The total synthesis of racemic maoecrystal V has been accomplished. Key steps include an intramolecular Diels-Alder cyclization to rapidly construct the core system from simple starting materials and the creation of the A–C ring trans-fusion through intramolecular delivery of a hydrogen to the hindered β-face of the ring system. PMID:23126440

  7. Total main rotor isolation system analysis

    NASA Technical Reports Server (NTRS)

    Halwes, D. R.

    1981-01-01

    The requirements for a preliminary design study and verification procedure for a total main rotor isolation system at n/rev are established. The system is developed and analyzed, and predesign drawings are created for an isolation system that achieves over 95 percent isolation of all six degrees of freedom.

  8. Total Quality Management: Implications for Higher Education.

    ERIC Educational Resources Information Center

    Hoffman, Allan M., Ed.; Julius, Daniel J., Ed.

    This book contains 19 papers describing the implementation of Total Quality Management in a variety of higher education settings. Following a Foreword by Peter Likins and a Preface by Daniel J. Julius, the chapter titles and authors are: (1) "TQM: Implications for Higher Education--A Look Back to the Future" (Allan M. Hoffman and Randall Summers);…

  9. Mineral Analysis of Whole Grain Total Cereal

    ERIC Educational Resources Information Center

    Hooker, Paul

    2005-01-01

    The quantitative analysis of elemental iron in Whole Grain Total Cereal using visible spectroscopy is suitable for a general chemistry course for science or nonscience majors. The more extensive mineral analysis, specifically for the elements iron, calcium and zinc, is suitable for an instrumental or quantitative analysis chemistry course.

  10. Endocrine deficit after fractionated total body irradiation.

    PubMed

    Ogilvy-Stuart, A L; Clark, D J; Wallace, W H; Gibson, B E; Stevens, R F; Shalet, S M; Donaldson, M D

    1992-09-01

    Endocrine function was assessed in 31 children (17 boys) after fractionated total body irradiation used in the preparative regimen for bone marrow transplantation. Endocrine dysfunction was present in 25 children. Fifteen of 29 had growth hormone insufficiency 0.9-4.9 years after total body irradiation, yet only three of the 15 had received previous cranial irradiation. Five of 30 had thyroid dysfunction: two with a low thyroxine and raised thyroid stimulating hormone (TSH) concentration and three with a raised TSH and normal thyroxine concentration. Thus the incidence of thyroid dysfunction (16%) is much lower than that reported after single fraction total body irradiation (39-59%). In only two children were abnormalities of the hypothalamic-pituitary-adrenal axis demonstrated. The majority of pubertal children assessed (n = 15) showed evidence of gonadal damage. All the pubertal girls (n = 5) had ovarian failure, although there was evidence of recovery of ovarian function in one girl. All seven boys in late puberty showed evidence of damage to the germinal epithelium, and two of three in early puberty had raised follicle stimulating hormone concentrations. Despite the use of a fractionated total body irradiation regimen, endocrine morbidity is substantial and children undergoing such procedures will require long term endocrine review and management.

  11. A Campus Is a Total Community.

    ERIC Educational Resources Information Center

    Hunt, Robert E.

    1979-01-01

    Described are the various components of the total college or university community and their associated environmental health and safety problems. Included are food service, insect and rodent control, multi-use athletic facilities, housing, laboratory animal facilities, laboratory biosafety, radiological health, fire protection, and emergency…

  12. 2 CFR 170.330 - Total compensation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Subawards and Executive Compensation. a. Reporting of first-tier subawards. 1. Applicability. Unless you are... Compensation of Recipient Executives. 1. Applicability and what to report. You must report total compensation... information about the compensation of the executives through periodic reports filed under section 13(a) or...

  13. [A case of recurrent total ophthalmoplegia].

    PubMed

    Meller, M

    1994-01-01

    The author presented a case of a girl, aged 10, with total ophthalmoplegia of the right eye, recurring 4 times. The onset of the disease was preceded by nausea, vomits and headache. The symptoms of the palsy released spontaneously after 2-3 weeks. PMID:7897986

  14. Learning Language through Total Physical Response.

    ERIC Educational Resources Information Center

    Marlatt, Edward A.

    1995-01-01

    The Total Physical Response (TPR) method of language instruction is introduced, and guidelines for designing and implementing TPR lessons for students with hearing impairments are provided. In TPR instruction, students develop understanding before speech or signing, understanding is demonstrated through actions, and new vocabulary is developed…

  15. Coordinating Council. Ninth Meeting: Total Quality Management

    NASA Technical Reports Server (NTRS)

    1992-01-01

    This report summarizes the 9th meeting of the STI Coordinating Council. The council listened to the speakers' understanding of Total Quality Management (TQM) principles and heard stories of successful applications of these principles. Definitions of quality stated were focused on customer satisfaction. Reports presented by the speakers are also included.

  16. What Is a Total Artificial Heart?

    MedlinePlus

    ... that the CardioWest is connected to an outside power source and the AbioCor isn't. The CardioWest ... run from inside the chest to an outside power source. Normal Heart and CardioWest Total Artificial Heart ...

  17. Total Quality Management. ERIC Digest, Number 73.

    ERIC Educational Resources Information Center

    Weaver, Tyler

    The Japanese success story has made W. Edwards Deming's Total Quality Management (TQM) theory increasingly popular among American managers, from car manufacturers to educational leaders. TQM is based on two tenets: the primacy of customer satisfaction and the necessity of tapping nontraditional sources (especially employee ideas) to institute…

  18. Total Quality Management: Institutional Research Applications.

    ERIC Educational Resources Information Center

    Heverly, Mary Ann

    Total Quality Management (TQM), a technique traditionally reserved for the manufacturing sector, has recently spread to service companies, government agencies, and educational institutions. TQM places responsibility for quality problems with management rather than on the workers. A principal concept of TQM is the management of Process Variation,…

  19. Revitalizing Space Operations through Total Quality Management

    NASA Technical Reports Server (NTRS)

    Baylis, William T.

    1995-01-01

    The purpose of this paper is to show the reader what total quality management (TQM) is and how to apply TQM in the space systems and management arena. TQM is easily understood, can be implemented in any type of business organization, and works.

  20. The Total Solar Eclipse, March 1970

    ERIC Educational Resources Information Center

    Glenn, William H.

    1970-01-01

    Describes the circumstances of the total and partial solar eclipse of March 7, 1970 in certain American cities. Also discussed are (1) a classroom demonstration of the cause of solar eclipses, (2) techniques for safely observing the eclipse, and (3) what to observe during the eclipse. Bibliography. (LC)

  1. Total Quality Management: The Emperor's Tailor.

    ERIC Educational Resources Information Center

    Alexander, Gary C.; Keeler, Carolyn M.

    Conversations among educators, business leaders, legislators, and educational reformers have generated support for the application of Total Quality Management (TQM) to education. This paper considers whether TQM is indeed the solution to education's problems. After a brief explanation of TQM theory, the paper is organized around four broad issues…

  2. Total Synthesis of (±)-Gracilioether F.

    PubMed

    Shen, Xin-Yue; Peng, Xiao-Shui; Wong, Henry N C

    2016-03-01

    Total synthesis of (±)-gracilioether F was achieved via a pivotal reductive cleavage of 1,2-dioxane from allenic ester in 11 steps. The key 1,2-dioxane species, derived from singlet oxygen and a diene, could be used as a common precursor for a stereocontrolled formation of the crucial 1,4-diol through a reductive cleavage. PMID:26878903

  3. Total Quality Management in Libraries. ERIC Digest.

    ERIC Educational Resources Information Center

    Masters, Denise G.

    Total Quality Management (TQM) is "a system of continuous improvement employing participative management and centered on the needs of customers." Key components of TQM are employee involvement and training, problem-solving teams, statistical methods, long-term goals and thinking, and recognition that the system, not people, produces…

  4. Production Function Geometry with "Knightian" Total Product

    ERIC Educational Resources Information Center

    Truett, Dale B.; Truett, Lila J.

    2007-01-01

    Authors of principles and price theory textbooks generally illustrate short-run production using a total product curve that displays first increasing and then diminishing marginal returns to employment of the variable input(s). Although it seems reasonable that a temporary range of increasing returns to variable inputs will likely occur as…

  5. Total internal reflection laser tools and methods

    DOEpatents

    Zediker, Mark S.; Faircloth, Brian O.; Kolachalam, Sharath K.; Grubb, Daryl L.

    2016-02-02

    There is provided high power laser tools and laser heads that utilize total internal reflection ("TIR") structures to direct the laser beam along a laser beam path within the TIR structure. The TIR structures may be a TIR prism having its hypotenuse as a TIR surface.

  6. Realizing Financial Savings through Total Quality Management.

    ERIC Educational Resources Information Center

    Miselis, Karen Archambault

    1993-01-01

    At the University of Pennsylvania, Total Quality Management (TQM) principles were applied to its financial functions to ensure timely recovery of sponsored research funding and reduce research account overdrafts. TQM implementation both saved money and highlighted how important careful formation of the quality improvement team is. (MSE)

  7. Total synthesis: Towards artificial terpene cyclases

    NASA Astrophysics Data System (ADS)

    Willot, Matthieu; Christmann, Mathias

    2010-07-01

    The plant-derived sesquiterpene englerin A is a potent inhibitor of several renal cancer cell lines. Two recent total syntheses have utilized cationic gold(I)-complexes to coax readily available open-chain precursors into englerin's challenging oxotricyclic core with enzyme-like precision.

  8. Total Synthesis of (-)-Nemorosone and (+)-Secohyperforin.

    PubMed

    Sparling, Brian A; Tucker, James K; Moebius, David C; Shair, Matthew D

    2015-07-17

    A general strategy for the synthesis of polycyclic polyprenylated acylphloroglucinols is described in which a scalable, Lewis acid catalyzed epoxide-opening cascade cyclization is used to furnish common intermediate 4. The utility of this approach is exemplified by the total syntheses of both ent-nemorosone and (+)-secohyperforin, which were each accomplished in four steps from this intermediate. PMID:26125288

  9. Total synthesis of aeruginosin 98B.

    PubMed

    Trost, Barry M; Kaneko, Toshiyuki; Andersen, Neil G; Tappertzhofen, Christoph; Fahr, Bruce

    2012-11-21

    The first total synthesis of aeruginosin 98B was accomplished. The key step is a highly diastereoselective Pd-catalyzed intramolecular asymmetric allylic alkylation reaction of a diastereomeric mixture of allylic carbonates that is enabled by the use of racemic phosphine ligand L1.

  10. Implementing Total Quality Management in Vocational Education.

    ERIC Educational Resources Information Center

    Navaratnam, K. K.; Mountney, Peter

    In an internationally competitive training environment, implementation of Total Quality Management (TQM) in vocational education can provide a comparative advantage in preparing the type of work force required for micro and macro economic reforms. The concept of TQM can be used as a management tool to improve the standards of vocational training.…

  11. Application of Total Quality Management in Education

    ERIC Educational Resources Information Center

    Farooq, M. S.; Akhtar, M. S.; Ullah, S. Zia; Memon, R. A.

    2007-01-01

    The purpose of the paper is to analyzing thoughts of the modern management paradigm "Total Quality Management" (TQM), and its application in the field of education. The basic theme of TQM is participatory approach to address the question(s) of quality in business aswell as in the field of education. Reviewing fresh literature from the internet …

  12. Total Quality Management (TQM) in Higher Education.

    ERIC Educational Resources Information Center

    Sullivan, Michael F.

    This document consists largely of paper versions of the transparencies used by the author to give his conference paper on Total Quality Management (TQM) in the college and university setting. An introduction lists a series of definitional phrases, a list of what TQM is not, and 11 fundamental principles describing what TQM is. The three major…

  13. Total Quality Management in Libraries: A Sourcebook.

    ERIC Educational Resources Information Center

    O'Neil, Rosanna M., Comp.

    Total Quality Management (TQM) brings together the best aspects of organizational excellence by driving out fear, offering customer-driven products and services, doing it right the first time by eliminating error, and maintaining inventory control without waste. Libraries are service organizations which are constantly trying to improve service.…

  14. Early Predictors of Hypocalcemia After Total Thyroidectomy

    PubMed Central

    Noureldine, Salem I.; Genther, Dane J.; Lopez, Michael; Agrawal, Nishant; Tufano, Ralph P.

    2015-01-01

    IMPORTANCE Postoperative hypocalcemia is common after total thyroidectomy, and perioperative monitoring of serum calcium levels is arguably the primary reason for overnight hospitalization. Confidently predicting which patients will not develop significant hypocalcemia may allow for a safe earlier discharge. OBJECTIVE To examine associations of patient characteristics with hypocalcemia, duration of hospitalization, and postoperative intact parathyroid hormone (IPTH) level after total thyroidectomy. DESIGN, SETTING, AND PARTICIPANTS Retrospective study of consecutive patients who underwent total thyroidectomy by a single high-volume surgeon between February 1, 2010, and November 30, 2012. Postoperative serum 25-hydroxyvitamin D (vitamin D), calcium, and IPTH levels were tested within 6 to 8 hours after surgery. Mild hypocalcemia was defined as any postoperative serum calcium level of less than 8.4 to 8.0 mg/dL. Significant hypocalcemia was defined as any postoperative serum calcium level of less than 8.0 mg/dL or the development of hypocalcemia-related symptoms. INTERVENTIONS Total thyroidectomy. MAIN OUTCOMES AND MEASURES Associations of patient demographic and clinical characteristics and laboratory values with postoperative mild and significant hypocalcemia were examined using univariate analysis, and independent predictors of hypocalcemia, duration of hospitalization, and IPTH level were determined using multivariate analysis. RESULTS Overall, 304 total thyroidectomies were performed. Mild and significant hypocalcemia occurred in 68 (22.4%) and 91 (29.9%) patients, respectively, of which the majority were female (P = .003). The development of significant hypocalcemia was associated with postoperative IPTH level (P < .001). On multivariate analysis, males had a decreased risk of developing mild (odds ratio, 0.37 [95% CI, 0.16–0.85]) and significant (odds ratio, 0.57 [95% CI, 0.09–0.78]) hypocalcemia. Every 10-pg/mL increase in postoperative IPTH level

  15. [J-pouch after total gastrectomy].

    PubMed

    Prete, F; Montemurro, S; Rucci, A; Rinaldi, S; Liguori, P

    1992-04-01

    The Authors report their initial experience with the construction of a J-pouch as restorative surgery following total gastrectomy (TG) for malignant neoplasms. In the last 10 months of the 1990 upon 52 interventions for gastric cancer 31 TG were performed, and in 13 cases a J-pouch on the proximal end of the jejunal segment was constructed. No mortality or specific morbidity was registered using the totally stapled technique. Within one month 3/4 of the patients had normal meals as far as quantity and quality; also the foamy regurgitation seemed to be minimal. The ease of the reconstructive technique and the short term results obtained encourage the use of such approach.

  16. Temporal bone chondroblastoma totally invisible on MRI.

    PubMed

    Hiraumi, Harukazu; Arakawa, Yoshiki; Yamamoto, Norio; Sakamoto, Tatsunori; Ito, Juichi

    2016-08-01

    We report a case of temporal bone chondroblastoma that was totally invisible on MRI. The patient was a 64-year-old man who presented with several months history of vertigo. The CT scan with bone window setting showed destruction of the temporomandibular joint, the floor of the middle cranial fossa, and the superior semicircular canal. Calcific foci were seen within the tumor. On MR imaging, the tumor, situating mainly medial to the temporomandibular joint, showed no signal on both T1- and T2-weighted images. The tumor was not enhanced with gadolinium. In summary, the tumor was totally signal negative or "invisible" on pre- and postcontrast T1- and T2-weighted images. The tumor was resected through transpetrosal - transzygomatic approach.

  17. Temporal bone chondroblastoma totally invisible on MRI.

    PubMed

    Hiraumi, Harukazu; Arakawa, Yoshiki; Yamamoto, Norio; Sakamoto, Tatsunori; Ito, Juichi

    2016-08-01

    We report a case of temporal bone chondroblastoma that was totally invisible on MRI. The patient was a 64-year-old man who presented with several months history of vertigo. The CT scan with bone window setting showed destruction of the temporomandibular joint, the floor of the middle cranial fossa, and the superior semicircular canal. Calcific foci were seen within the tumor. On MR imaging, the tumor, situating mainly medial to the temporomandibular joint, showed no signal on both T1- and T2-weighted images. The tumor was not enhanced with gadolinium. In summary, the tumor was totally signal negative or "invisible" on pre- and postcontrast T1- and T2-weighted images. The tumor was resected through transpetrosal - transzygomatic approach. PMID:26743837

  18. Total positive curvature of circular DNA.

    PubMed

    Bohr, Jakob; Olsen, Kasper W

    2013-11-01

    The properties of double-stranded DNA and other chiral molecules depend on the local geometry, i.e., on curvature and torsion, yet the paths of closed chain molecules are globally restricted by topology. When both of these characteristics are to be incorporated in the description of circular chain molecules, e.g., plasmids, it is shown to have implications for the total positive curvature integral. For small circular micro-DNAs it follows as a consequence of Fenchel's inequality that there must exist a minimum length for the circular plasmids to be double stranded. It also follows that all circular micro-DNAs longer than the minimum length must be concave, a result that is consistent with typical atomic force microscopy images of plasmids. Predictions for the total positive curvature of circular micro-DNAs are given as a function of length, and comparisons with circular DNAs from the literature are presented.

  19. Total Cellular RNA Modulates Protein Activity.

    PubMed

    Majumder, Subhabrata; DeMott, Christopher M; Reverdatto, Sergey; Burz, David S; Shekhtman, Alexander

    2016-08-16

    RNA constitutes up to 20% of a cell's dry weight, corresponding to ∼20 mg/mL. This high concentration of RNA facilitates low-affinity protein-RNA quinary interactions, which may play an important role in facilitating and regulating biological processes. In the yeast Pichia pastoris, the level of ubiquitin-RNA colocalization increases when cells are grown in the presence of dextrose and methanol instead of methanol as the sole carbon source. Total RNA isolated from cells grown in methanol increases β-galactosidase activity relative to that seen with RNA isolated from cells grown in the presence of dextrose and methanol. Because the total cellular RNA content changes with growth medium, protein-RNA quinary interactions can alter in-cell protein biochemistry and may play an important role in cell adaptation, critical to many physiological and pathological states. PMID:27456029

  20. Total positive curvature of circular DNA

    NASA Astrophysics Data System (ADS)

    Bohr, Jakob; Olsen, Kasper W.

    2013-11-01

    The properties of double-stranded DNA and other chiral molecules depend on the local geometry, i.e., on curvature and torsion, yet the paths of closed chain molecules are globally restricted by topology. When both of these characteristics are to be incorporated in the description of circular chain molecules, e.g., plasmids, it is shown to have implications for the total positive curvature integral. For small circular micro-DNAs it follows as a consequence of Fenchel's inequality that there must exist a minimum length for the circular plasmids to be double stranded. It also follows that all circular micro-DNAs longer than the minimum length must be concave, a result that is consistent with typical atomic force microscopy images of plasmids. Predictions for the total positive curvature of circular micro-DNAs are given as a function of length, and comparisons with circular DNAs from the literature are presented.

  1. Fall 2010 Total Solar Irradiance Calibration Workshop

    NASA Astrophysics Data System (ADS)

    Morrill, J. S.; Socker, D. G.; Willson, R. C.; Kopp, G.

    2010-12-01

    As part of a NASA-Sponsored program to understand the differences in Total Solar Irradiance (TSI) results reported by various space-based radiometers, the Naval Research Laboratory is hosting a Total Solar Irradiance Calibration Workshop. This workshop is a follow-on meeting to a similar workshop hosted by the National Institute for Standards and Technology in 2005. These workshops have been attended by many of the PI teams of the past and current TSI measuring instruments. The discussions at these workshops have addressed calibration methods and the numerous instrumental differences that need to be understood in order to bring the complete ensemble of results onto a common scale. In this talk we will present an overview of the NRL Calibration Workshop which will include results of recent calibration studies at various laboratories and have involved several TSI instruments.

  2. Frustrated total internal reflection acoustic field sensor

    DOEpatents

    Kallman, Jeffrey S.

    2000-01-01

    A frustrated total internal reflection acoustic field sensor which allows the acquisition of the acoustic field over an entire plane, all at once. The sensor finds use in acoustic holography and acoustic diffraction tomography. For example, the sensor may be produced by a transparent plate with transparent support members tall enough to support one or more flexible membranes at an appropriate height for frustrated total internal reflection to occur. An acoustic wave causes the membrane to deflect away from its quiescent position and thus changes the amount of light that tunnels through the gap formed by the support members and into the membrane, and so changes the amount of light reflected by the membrane. The sensor(s) is illuminated by a uniform tight field, and the reflection from the sensor yields acoustic wave amplitude and phase information which can be picked up electronically or otherwise.

  3. Generalized principles of unchanging total concentration.

    PubMed

    Kottke, Peter A; Fedorov, Andrei G

    2005-09-01

    We consider the transport of multiple reacting species under the continuum assumption in situations such as those that frequently arise in electroanalytical chemistry. Under certain limitations, it has been shown that the total species concentration (as defined by Oldham and Feldberg) of such a system is uniform and constant. In this work, we extend the limits of the previous analysis to enable greater applicability. This is accomplished by using either of two new dependent variables, which are generalizations of the concept of total concentration. Then, conditions are determined under which the dependent variable will be uniform and constant in time. From a practical viewpoint, the described formalism allows one to simplify the multispecies transport problem formulation by eliminating one equation from the system of governing equations.

  4. Total laparoscopic reversal of Hartmann's procedure.

    PubMed

    Masoni, Luigi; Mari, Francesco Saverio; Nigri, Giuseppe; Favi, Francesco; Pindozzi, Fioralba; Dall'Oglio, Anna; Pancaldi, Alessandra; Brescia, Antonio

    2013-01-01

    Hartmann's procedure is still performed in those cases in which colorectal anastomosis might be unsafe. Reversal of Hartmann's procedure (HR) is considered a major surgical procedure with a high morbidity (55 to 60%) and mortality rate (0 to 4%). To decrease these rates, laparoscopic Hartmann's reversal procedure was successfully experienced. We report our totally laparoscopic Hartmann's reversal technique. Between 2004 and 2010 we performed 27 HRs with a totally laparoscopic approach. The efficacy and safety of this technique were demonstrated evaluating the operative data, postoperative complications, and the outcome of the patients. There were no open conversions or major intraoperative complications. Anastomotic leaking occurred in one patient requiring an ileostomy; one patient needed a blood transfusion and one had a nosocomial pneumonia. The mean postoperative hospitalization was 5.7 days. Laparoscopic HR is a feasible and safe procedure and can be considered a valid alternative to open HR.

  5. A Modern Approach to Total Wellbeing

    NASA Astrophysics Data System (ADS)

    Hadzic, Maja; Chen, Meifania; Brouwer, Rick; Dillon, Tharam

    The events of the last decades have impacted our lives and our health significantly. We expected that the technology boom will improve our lives. While this may be true in a specific context, generally speaking our societies are suffering from moral decays, terrorism fears, wars, financial crisis and unpredictable acts of nature that are increasing in frequency and in intensity. The complex nature of the world we live is impacting our health and wellbeing considerably. Our health is not only determined by our physical health but is the end product of the interplay of the physical, mental, emotional, financial, relational and spiritual events of a lifetime. In this paper we develop a framework that will help us define and measure total wellbeing of individuals in our volatile societies. This framework will help us better understand the complex nature of total wellbeing and develop effective prevention and intervention strategies.

  6. Increasing productivity through Total Reuse Management (TRM)

    NASA Technical Reports Server (NTRS)

    Schuler, M. P.

    1991-01-01

    Total Reuse Management (TRM) is a new concept currently being promoted by the NASA Langley Software Engineering and Ada Lab (SEAL). It uses concepts similar to those promoted in Total Quality Management (TQM). Both technical and management personnel are continually encouraged to think in terms of reuse. Reuse is not something that is aimed for after a product is completed, but rather it is built into the product from inception through development. Lowering software development costs, reducing risk, and increasing code reliability are the more prominent goals of TRM. Procedures and methods used to adopt and apply TRM are described. Reuse is frequently thought of as only being applicable to code. However, reuse can apply to all products and all phases of the software life cycle. These products include management and quality assurance plans, designs, and testing procedures. Specific examples of successfully reused products are given and future goals are discussed.

  7. Feminist leadership through total quality management.

    PubMed

    Lanza, M L

    1997-01-01

    Feminist leadership in nursing can be achieved through Total Quality Management. Total Quality Management (TQM) is a philosophy and technology that represents the foundation of a continuously improving organization. The feminist leadership ideas practiced by nurses, such as empowering staff and decision by consensus, are also central to TQM. Feminist leadership utilizing TQM enables employees to creatively contribute to the system without fear or intimidation. Employees at all levels in the organization are then empowered. The role of the feminist leader using TQM is one of facilitator rather than authority figure. Feminist leadership in nursing can spearhead the opportunity for improvement to provide high-quality, cost-effective health care in a troubled and complex economic environment.

  8. Total Hip Joint Replacement Biotelemetry System

    NASA Technical Reports Server (NTRS)

    Boreham, J. F.; Postal, R. B.; Luntz, R. A.

    1981-01-01

    The development of a biotelemetry system that is hermetically sealed within a total hip replacement implant is reported. The telemetry system transmits six channels of stress data to reconstruct the major forces acting on the neck of the prosthesis and uses an induction power coupling technique to eliminate the need for internal batteries. The activities associated with the telemetry microminiaturization, data recovery console, hardware fabrications, power induction systems, electrical and mechanical testing and hermetic sealing test results are discussed.

  9. Total Lightning Activity as Observed from Space

    NASA Technical Reports Server (NTRS)

    Christian, Hugh J.

    2004-01-01

    Our knowledge of the global distribution of lightning has improved dramatically since the 1995 launch of the Optical Transient Detector (OTD), followed in 1997 by the launch of the Lightning Imaging Sensor (LIS). Together, these instruments have generated a continuous seven-year record of global lightning activity. These lightning observations have provided a new global perspective on total lightning activity. For the first time, total lightning activity (CG and IC) has been observed over large regions with high detection efficiencies and accurate geographic location. This has produced new insights into lightning distributions, times of occurrence and variability. It has produced a revised global flash rate estimate (44 flashes per second) and has lead to a new realization of the significance of total ligh&g activity in severe weather. Accurate flash rate estimates are now available for areas of the earth (+/- 72 deg. latitude). Ocean-land contrasts as a function of season are clearly reveled, as are orographic effects and seasonal and interannual variability. The data set indicates that air mass thunderstorms, not large storm system dominate global activity. The ability of LIS and OTD to detect total lightning has lead to improved insight into the correlation between lightning and storm development. The relationship between updraft development and lightning activity is now well established and presents an opportunity for providing a new mechanism for remotely monitoring storm development. In this concept, lightning would serve as a surrogate for updraft velocity. It is anticipated that this capability could lead to significantly improved severe weather warning times and reduced false warning rates.

  10. Total Lightning Activity as Observed from Space

    NASA Technical Reports Server (NTRS)

    Christian, Hugh J.

    2004-01-01

    ABSTRACT: Our knowledge of the global distribution of lightning has improved dramatically since the 1995 launch of the Optical Transient Detector (OTD), followed in 1997 by the launch of the Lightning Imaging Sensor (LIS). Together, these instruments have generated a continuous seven-year record of global lightning activity. These lightning observations have provided a new global perspective on total lightning activity. For the first time, total lightning activity (CG and IC) has been observed over large regions with high detection efficiencies and accurate geographic location. This has produced new insights into lightning distributions, times of occurrence and variability. It has produced a revised global flash rate estimate (44 flashes per second) and has lead to a new realization of the significance of total ligh&g activity in severe weather. Accurate flash rate estimates are now available for areas of the earth (+/- 72 deg. latitude). Ocean-land contrasts as a function of season are clearly reveled, as are orographic effects and seasonal and interannual variability. The data set indicates that air mass thunderstorms, not large storm system dominate global activity. The ability of LIS and OTD to detect total lightning has lead to improved insight into the correlation between lightning and storm development. The relationship between updraft development and lightning activity is now well established and presents an opportunity for providing a new mechanism for remotely monitoring storm development. In this concept, lightning would serve as a surrogate for updraft velocity. It is anticipated that this capability could lead to significantly improved severe weather warning times and reduced false warning rates.

  11. Renal function after elective total hip replacement.

    PubMed

    Perregaard, Helene; Damholt, Mette B; Solgaard, Søren; Petersen, Morten B

    2016-06-01

    Background and purpose - Acute kidney injury (AKI) is associated with increased short-term and long-term mortality in intensive care populations and in several surgical specialties, but there are very few data concerning orthopedic populations. We have studied the incidence of AKI and the prevalence of chronic kidney disease (CKD) in an elective population of orthopedic patients undergoing primary total hip replacement, hypothesizing that chronic kidney disease predisposes to AKI. Patients and methods - This was a single-center, population-based, retrospective, registry-based cohort study involving all primary elective total hip replacements performed from January 2003 through December 2012. Patient demographics and creatinine values were registered. We evaluated the presence of CKD and AKI according to the international guidelines for kidney disease (KDIGO Acute Kidney Injury Workgroup 2013 ). Results - 3,416 patients were included (2,064 females (60%)). AKI (according to KDIGO criteria) was seen in 75 patients (2.2%, 95% CI: 1.7-2.7) in the course of primary total hip replacement. Of these, 26 had pre-existing CKD of class 3-5. Pre-existing CKD of class 3-5, indicating moderately to severely reduced kidney function, was seen in 374 individuals (11%). Interpretation - Development of acute kidney injury appears to be a substantial problem compared to other complications related to elective total hip arthroplasty, i.e. luxation and infection. Patients with pre-existing chronic kidney disease may be especially vulnerable. The clinical impact of acute kidney injury in an elective orthopedic population remains to be elucidated. PMID:26937782

  12. The Anterior Approach for Total Hip Replacement.

    PubMed

    Hochfelder, Jason P; Davidovitch, Roy I

    2016-03-01

    The anterior approach for total hip replacements has recently gained popularity. Some authors report faster recoveries and decreased dislocation rated with no increased risk of complications. However others claim no difference in outcomes when compared to other approaches yet an increase in complication rates. This paper provides a brief history of the approach, discusses various indications and contraindications, preoperative considerations, surgical techniques, and postoperative protocols. PMID:26977549

  13. Measurement of total organic concentration in water

    NASA Technical Reports Server (NTRS)

    Winkler, E.

    1978-01-01

    Instrument for determining total organic concentration in water uses no corrosive reagents or gases. Instead continuous ultraviolet photolysis process converts organic compounds to carbon dioxide (CO2). CO2 electrode is used to measure CO2 content. Only reagent necessary is oxygen, generated in situ by electrolyzing some water. In addition to application in aerospace industry, system has potential uses in pollution monitoring and in laboratory analyses.

  14. [Nurses' role in cases of total pain].

    PubMed

    Sánchez Castilla, M José; Calderón Carrasco, Justo

    2009-06-01

    Health professional daily confront the pain and suffering persons who need our help undergo. From a nurse's methodology this article describes a new perspective about nurses' role regarding total pain, employing as a tool to deal with this topic the AREA holistic pain model, a model which centers on the person and his/her family permanently seeking results derived from a plan which joins together all treatments and based on the creation of a reasoning network that will provide prioritized nursing diagnoses.

  15. Total Synthesis of the Akuammiline Alkaloid Picrinine

    PubMed Central

    2015-01-01

    We report the first total synthesis of the complex akuammiline alkaloid picrinine, which was first isolated nearly five decades ago. Our synthetic approach features a concise assembly of the [3.3.1]-azabicyclic core, a key Fischer indolization reaction to forge the natural product’s carbon framework, and a series of delicate late-stage transformations to complete the synthesis. Our synthesis of picrinine also constitutes a formal synthesis of the related polycyclic alkaloid strictamine. PMID:24597784

  16. Total Synthesis of (−)-Calyciphylline N

    PubMed Central

    Shvartsbart, Artem; Smith, Amos B.

    2014-01-01

    The total synthesis of the architecturally complex Daphniphyllum alkaloid (−)-calyciphylline N has been achieved. Highlights of the synthesis include a Et2AlCl promoted, highly stereoselective susbtrate controlled intramolecular Diels-Alder reaction, a transannular enolate alkylation, an effective Stille carbonylation/Nazarov cyclization sequence, and a high risk dia-stereoselective hydrogenation of a fully substituted conjugated diene ester. PMID:24319987

  17. Assessing Operational Total Lightning Visualization Products

    NASA Technical Reports Server (NTRS)

    Stano, Geoffrey T.; Darden, Christopher B.; Nadler, David J.

    2010-01-01

    In May 2003, NASA's Short-term Prediction Research and Transition (SPoRT) program successfully provided total lightning data from the North Alabama Lightning Mapping Array (NALMA) to the National Weather Service (NWS) office in Huntsville, Alabama. The major accomplishment was providing the observations in real-time to the NWS in the native Advanced Weather Interactive Processing System (AWIPS) decision support system. Within days, the NALMA data were used to issue a tornado warning initiating seven years of ongoing support to the NWS' severe weather and situational awareness operations. With this success, SPoRT now provides real-time NALMA data to five forecast offices as well as working to transition data from total lightning networks at Kennedy Space Center and the White Sands Missile Range to the surrounding NWS offices. The only NALMA product that has been transitioned to SPoRT's partner NWS offices is the source density product, available at a 2 km resolution in 2 min intervals. However, discussions with users of total lightning data from other networks have shown that other products are available, ranging from spatial and temporal variations of the source density product to the creation of a flash extent density. SPoRT and the Huntsville, Alabama NWS are evaluating the utility of these variations as this has not been addressed since the initial transition in 2003. This preliminary analysis will focus on what products will best support the operational warning decision process. Data from 19 April 2009 are analyzed. On this day, severe thunderstorms formed ahead of an approaching cold front. Widespread severe weather was observed, primarily south of the Tennessee River with multiple, weak tornadoes, numerous severe hail reports, and wind. This preliminary analysis is the first step in evaluation which product(s) are best suited for operations. The ultimate goal is selecting a single product for use with all total lightning networks to streamline training and

  18. Femoral Bone Plug in Total Knee Replacement.

    PubMed

    Vulcano, Ettore; Regazzola, Gianmarco M V; Murena, Luigi; Ronga, Mario; Cherubino, Paolo; Surace, Michele F

    2015-10-01

    The intramedullary alignment guides used in total knee replacement disrupt the intramedullary vessels, resulting in greater postoperative blood loss. The use of an autologous bone plug to seal the intramedullary femoral canal has been shown to be effective in reducing postoperative bleeding. The authors present a simple technique to create a bone plug from the anterior chamfer femoral cut to perfectly seal the intramedullary canal of the femur. PMID:26488774

  19. NASA total quality management 1990 accomplishments report

    NASA Technical Reports Server (NTRS)

    1991-01-01

    NASA's efforts in Total Quality Management are based on continuous improvement and serve as a foundation for NASA's present and future endeavors. Given here are numerous examples of quality strategies that have proven effective and efficient in a time when cost reduction is critical. These accomplishment benefit our Agency and help to achieve our primary goal, keeping American in the forefront of the aerospace industry.

  20. Techniques in Total Mesorectal Excision Surgery

    PubMed Central

    Lichliter, Warren E.

    2015-01-01

    Advances in the surgical management of rectal cancer have placed the quality of total mesorectal excision (TME) as the major predictor in overall survival. A standardized TME technique along with quality increases the percentage of patients undergoing a complete TME. Quality measurements of TME will place increasing demands on surgeons maintaining competence with present and future techniques. These efforts will improve the outcome of the rectal cancer patients. PMID:25733970

  1. NASA total quality management 1989 accomplishments report

    NASA Technical Reports Server (NTRS)

    1990-01-01

    Described here are the accomplishments of NASA as a result of the use of Total Quality Management (TQM). The principles in practice which led to these process refinements are important cultural elements to any organization's productivity and quality efforts. The categories of TQM discussed here are top management leadership and support, strategic planning, focus on the customer, employee training and recognition, employee empowerment and teamwork, measurement and analysis, and quality assurance.

  2. Enantioselective Total Synthesis of (+)-Psiguadial B.

    PubMed

    Chapman, Lauren M; Beck, Jordan C; Wu, Linglin; Reisman, Sarah E

    2016-08-10

    The first enantioselective total synthesis of the cytotoxic natural product (+)-psiguadial B is reported. Key features of the synthesis include (1) the enantioselective preparation of a key cyclobutane intermediate by a tandem Wolff rearrangement/asymmetric ketene addition, (2) a directed C(sp(3))-H alkenylation reaction to strategically forge the C1-C2 bond, and (3) a ring-closing metathesis to build the bridging bicyclo[4.3.1]decane terpene framework. PMID:27452034

  3. Total synthesis of hapalindoles J and U.

    PubMed

    Rafferty, Ryan J; Williams, Robert M

    2012-01-01

    The total synthesis of D,L-hapalindoles J and U has been accomplished. Hapalindole J was prepared in 11% overall yield over 11 synthetic steps and hapalindole U was prepared in 25% overall yield over 13 synthetic steps from commercially available materials. The route employs a novel silyl ether-based strategy for accessing the 6:5:6:6 ring system of the hapalindoles rapidly and in good yields.

  4. Advanced lymphosarcoma treated by total body irradiation.

    PubMed Central

    Chaffey, J. T.; Rosenthal, D. S.; Pinkus, F.; Hellman, S.

    1975-01-01

    Twenty-five cases of clinical Stage III and Stage IV lymphosarcoma primarily treated by total body irradiation (TBI) are reported. Fifteen cases demonstrated nodular histology and 10 demonstrated diffuse histology by the Rappaport criteria. Treatments were 15 rad given twice weekly, calculated to midpelvis, to a total dose of 150 rad. Toxicity was confined to thrombocytopenia, one-third of patients requiring interruptions in the treatment course to allow platelet count recovery. Five patients had additional local irradiation. Complete responses were seen in 80% of patients and partial responses in 20%. Sixteen patients (64%) have been in continuous, unmaintained remission since treatments for variable periods to 39 months. Of 9 patients with clinically recurrent disease, 3 received further TBI and are in remission, 3 are in remission on chemotherapy, one patient has died, failing on all therapy, and 2 have not been treated. One patient died of pneumonia at 12 months, without clinical evidence of disease. Overall, actuarial survival is 87% at 2 years and compares well with survival in a sequential combination drug treated group of patients matched for age, sex, and histology, though differences are not statistically significant in these small groups. Total body irradiation is an effective systemic agent in the management of advanced lymphosarcoma and should be considered in treating this disease. PMID:810155

  5. Total Lightning Activity Associated with Tornadic Storms

    NASA Technical Reports Server (NTRS)

    Goodman, Steven J.; Buechler, Dennis; Hodanish, Stephen; Sharp, David; Williams, Earle; Boldi, Bob; Matlin, Anne; Weber, Mark

    1999-01-01

    Severe storms often have high flash rates (in excess of one flash per second) and are dominated by intracloud lightning activity. In addition to the extraordinary flash rates, there is a second distinguishing lightning characteristic of severe storms that seems to be important. When the total lightning history is examined, one finds sudden increases in the lightning rate, which we refer to as lightning "jumps," that precede the occurrence of severe weather by ten or more minutes. These jumps are typically 30-60 flashes/min, and are easily identified as anomalously large derivatives in the flash rate. This relationship is associated with updraft intensification and updraft strength is an important factor in storm severity (through the accumulation of condensate aloft and the stretching of vorticity). In several cases, evidence for diminishment of midlevel rotation and the descent of angular momentum from aloft is present prior to the appearance of the surface tornado. Based on our experience with severe and tornadic storms in Central Florida, we believe the total lightning may augment the more traditional use of NEXRAD radars and storm spotters. However, a more rigorous relation of these jumps to storm kinematics is needed if we are to apply total lightning in a decision tree that leads to improved warning lead times and decreased false alarm rates.

  6. Magnetic resonance imaging of total body fat.

    PubMed

    Thomas, E L; Saeed, N; Hajnal, J V; Brynes, A; Goldstone, A P; Frost, G; Bell, J D

    1998-11-01

    In this study we assessed different magnetic resonance imaging (MRI) scanning regimes and examined some of the assumptions commonly made for measuring body fat content by MRI. Whole body MRI was used to quantify and study different body fat depots in 67 women. The whole body MRI results showed that there was a significant variation in the percentage of total internal, as well as visceral, adipose tissue across a range of adiposity, which could not be predicted from total body fat and/or subcutaneous fat. Furthermore, variation in the amount of total, subcutaneous, and visceral adipose tissue was not related to standard anthropometric measurements such as skinfold measurements, body mass index, and waist-to-hip ratio. Finally, we show for the first time subjects with a percent body fat close to the theoretical maximum (68%). This study demonstrates that the large variation in individual internal fat content cannot be predicted from either indirect methods or direct imaging techniques, such as MRI or computed tomography, on the basis of a single-slice sampling strategy. PMID:9804581

  7. Total antioxidant response in patients with schizophrenia.

    PubMed

    Ustundag, Bilal; Atmaca, Murad; Kirtas, Ozlem; Selek, Sahabettin; Metin, Kerem; Tezcan, Ertan

    2006-08-01

    There is a large amount of convincing data demonstrating that reactive oxygen species (ROS) are involved in initiation and development of many different forms of neuropsychiatric disorders. The levels of oxidants and antioxidants in schizophrenia have been evaluated. However, measurements of total antioxidant response (TAR) were not evaluated up to now. Therefore, the objectives of this study are to investigate plasma TAR levels in schizophrenia subtypes. A total of 76 patients with schizophrenia and 25 healthy volunteers were included in the study. Positive and Negative Syndrome Scale (SANS and SAPS, respectively) were applied to patients. TAR values were determined in the plasma of normal healthy controls and patients with schizophrenia. Plasma TAR levels of each schizophrenia subtype were significantly lower than healthy controls (P < 0.01 for disorganized, residual and undifferentiated subtypes and P < 0.01 for paranoid subtype). When intragroup comparisons were performed, paranoid subtype had higher plasma TAR levels compared to other subtypes (P < 0.01). Accordingly, as a whole group, patients with schizophrenia had lower plasma TAR levels compared to controls. Plasma TAR levels were significantly and negatively correlated with SANS scores, and duration of illness was evaluated but not related to other parameters. Consequently, the present study further emphasizes the growing consideration that free radical damage may have an important etiopathogenetic role on the development of schizophrenia and suggests that decreased plasma total antioxidant levels may be related to the progression of illness.

  8. Total parenteral nutrition in acute illness.

    PubMed

    Phillips, G D

    1985-08-01

    Successful total parenteral nutrition in acute illness requires an appreciation of the pathophysiology of the illness and an understanding of the nutritional state of the patient, as well as a knowledge of the principles of total parenteral nutrition. Management of the acutely ill patient's general condition is essential prior to the introduction of nutritional support. A basic regimen which includes administration of 1-2g/kg/day of protein, and 8,400 kJ (2,000 kcal)/day of energy, part glucose and part lipid, together with all minerals, vitamins and zinc, in an appropriate amount of water, should be provided. Modifications to this regimen may be indicated to accommodate cardiac, respiratory, liver or renal failure. The questions of the optimum mix of carbohydrate and lipid, the ideal amount of protein and the correct mix of amino acids for a particular period in an individual patient's illness, are still debated. The fact that recent research supports many of the postulates of the Scandinavian pioneers of total parenteral nutrition suggests we may be returning to a correct approach.

  9. The Error in Total Error Reduction

    PubMed Central

    Witnauer, James E.; Urcelay, Gonzalo P.; Miller, Ralph R.

    2013-01-01

    Most models of human and animal learning assume that learning is proportional to the discrepancy between a delivered outcome and the outcome predicted by all cues present during that trial (i.e., total error across a stimulus compound). This total error reduction (TER) view has been implemented in connectionist and artificial neural network models to describe the conditions under which weights between units change. Electrophysiological work has revealed that the activity of dopamine neurons is correlated with the total error signal in models of reward learning. Similar neural mechanisms presumably support fear conditioning, human contingency learning, and other types of learning. Using a computational modelling approach, we compared several TER models of associative learning to an alternative model that rejects the TER assumption in favor of local error reduction (LER), which assumes that learning about each cue is proportional to the discrepancy between the delivered outcome and the outcome predicted by that specific cue on that trial. The LER model provided a better fit to the reviewed data than the TER models. Given the superiority of the LER model with the present data sets, acceptance of TER should be tempered. PMID:23891930

  10. Magnetic resonance imaging of total body fat.

    PubMed

    Thomas, E L; Saeed, N; Hajnal, J V; Brynes, A; Goldstone, A P; Frost, G; Bell, J D

    1998-11-01

    In this study we assessed different magnetic resonance imaging (MRI) scanning regimes and examined some of the assumptions commonly made for measuring body fat content by MRI. Whole body MRI was used to quantify and study different body fat depots in 67 women. The whole body MRI results showed that there was a significant variation in the percentage of total internal, as well as visceral, adipose tissue across a range of adiposity, which could not be predicted from total body fat and/or subcutaneous fat. Furthermore, variation in the amount of total, subcutaneous, and visceral adipose tissue was not related to standard anthropometric measurements such as skinfold measurements, body mass index, and waist-to-hip ratio. Finally, we show for the first time subjects with a percent body fat close to the theoretical maximum (68%). This study demonstrates that the large variation in individual internal fat content cannot be predicted from either indirect methods or direct imaging techniques, such as MRI or computed tomography, on the basis of a single-slice sampling strategy.

  11. Salivary total protein and experimental Coriolis sickness.

    PubMed

    Igarashi, M; Reschke, M F; Henley, C; MacDonald, S; Kohl, R; Mizukoshi, K

    1993-01-01

    Symptomatic reporting has been used in quantifying the severity of motion sickness including Coriolis sickness. This study was designed to objectively examine if the dynamic changes of salivary protein concentration relate to the severity of Coriolis sickness. Healthy adults with normal vestibular function underwent a modified Coriolis Sickness Susceptibility Index (CSSI) test, utilizing a staircase profile. Salivary samples were obtained prior to stimulation, 15, 30, and 45 min following stimulus onset, and/or upon reaching "nausea-II" endpoint. Total protein concentration tended to rise over the initial 30 min of stimulation, and then level off or decline. A statistically significant difference was found between the pre-stimulation and 30 min samples. Although some variability existed among the subjects, the general pattern of changes along the time course was similar. An inverse correlation approaching statistical significance was found between control (non-stimulus) total protein levels, and minutes of Coriolis stimulation required to reach the "nausea-II" endpoint. Thus, baseline salivary total protein levels can be of use in predicting susceptibility of Coriolis sickness and other forms of motion sickness.

  12. Total hip arthroplasty revision in elderly patients.

    PubMed

    Gasbarra, Elena; Perrone, Fabio Luigi; Celi, Monica; Rao, Cecilia; Feola, Maurizio; Cuozzo, Nicola; Tarantino, Umberto

    2013-10-01

    In the last years, the number of total hip arthroplasty is increased both in young patients and elderly with a poor bone quality due to extension of surgical indications. According to this trend, also revision surgery showed a growth of its number, especially in elderly patients, because of implant loosening, failed osseointegration of prosthetic components, errors in biomechanical restoration and infections. The aim of this study is to analyze life quality improvement through evaluation of articular functionality and postoperative pain, and to examine osseointegration of implant components with periprosthetic bone. During total hip arthroplasty revision, the orthopedic surgeon often has to face complex cases, especially in elderly patients with a preexisting status of poor bone quality and sarcopenia. In these cases, a correct planning and a surgical procedure well-executed are able to ensure a good outcome that led to pain relief and functional recovery. Furthermore anti-osteoporotic therapy surely represents a useful resource both in primary total hip arthroplasty and in revisions, mainly for elderly patients with a poor bone quality. PMID:24046034

  13. Total quantum coherence and its applications

    NASA Astrophysics Data System (ADS)

    Yu, Chang-shui; Yang, Si-ren; Guo, Bao-qing

    2016-09-01

    Quantum coherence is the most fundamental feature of quantum mechanics. The usual understanding of it depends on the choice of the basis, that is, the coherence of the same quantum state is different within different reference framework. To reveal all the potential coherence, we present the total quantum coherence measures in terms of two different methods. One is optimizing maximal basis-dependent coherence with all potential bases considered and the other is quantifying the distance between the state and the incoherent state set. Interestingly, the coherence measures based on relative entropy and l_2 norm have the same form in the two different methods. In particular, we show that the measures based on the non-contractive l_2 norm are also a good measure different from the basis-dependent coherence. In addition, we show that all the measures are analytically calculable and have all the good properties. The experimental schemes for the detection of these coherence measures are also proposed by multiple copies of quantum states instead of reconstructing the full density matrix. By studying one type of quantum probing schemes, we find that both the normalized trace in the scheme of deterministic quantum computation with one qubit and the overlap of two states in quantum overlap measurement schemes can be well described by the change of total coherence of the probing qubit. Hence the nontrivial probing always leads to the change of the total coherence.

  14. Total quality management -- Remedial actions planning program

    SciTech Connect

    Petty, J.L.; Horne, T.E.

    1989-01-01

    This paper describes the management approach being taken within the Hazardous Waste Remedial Actions Program (HAZWRAP) Support Contractor Office (SCO) to ensure quality of services in a highly competitive waste management environment. An overview is presented of the contractor support role assigned to Martin Marietta Energy Systems, Inc., by the Department of Energy (DOE) national program for managing hazardous waste. The HAZWRAP SCO mission, organizational structure, and major programs are outlined, with emphasis on waste management planning for the DOE Work for Others (WFO) Program. The HAZWRAP SCO provides waste management technical support, via interagency agreements between DOE and various Department of Defense (DOD) agencies for DOD sponsors planning remedial response actions. The remainder of the paper focuses on how the concept of Total Quality Management is applied to the HAZWRAP Remedial Actions Planning (RAP) Program. The management challenge is to achieve quality on a ''system'' basis where all functional elements of program management synergistically contribute to the total quality of the effort. The quality assurance (QA) program requirements applied to the RAP Program and its subcontractors are discussed. The application of management principles in the areas of program management, procurement, and QA to achieve total quality is presented. 3 refs.

  15. Fluorogenic membrane overlays to enumerate total coliforms, Escherichia coli, and total Vibrionaceae in shellfish and seawater

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Three assays were developed to enumerate total coliforms, Escherichia coli, and total Vibrionaceae in shellfish and other foods and in seawater and other environmental samples. Assays involve membrane overlays of overnight colonies on non-selective agar plates to detect ß-glucuronidase and lysyl am...

  16. Observation of the total solar eclipsis. L'observation des eclipses totales solaires

    SciTech Connect

    Koutchmy, S.

    1987-03-01

    A brief historical account of the solar-total-eclipses events is presented to show their importance, including their use for the scientific analysis of the solar corona, since 1848. The main parameters and a schema of the eclipses are given. Several examples of investigations performed during a solar total eclipse are discussed.

  17. Compton imaging with the PorGamRays spectrometer

    NASA Astrophysics Data System (ADS)

    Judson, D. S.; Boston, A. J.; Coleman-Smith, P. J.; Cullen, D. M.; Hardie, A.; Harkness, L. J.; Jones, L. L.; Jones, M.; Lazarus, I.; Nolan, P. J.; Pucknell, V.; Rigby, S. V.; Seller, P.; Scraggs, D. P.; Simpson, J.; Slee, M.; Sweeney, A.; PorGamRays Collaboration

    2011-10-01

    The PorGamRays project aims to develop a portable gamma-ray detection system with both spectroscopic and imaging capabilities. The system is designed around a stack of thin Cadmium Zinc Telluride (CZT) detectors. The imaging capability utilises the Compton camera principle. Each detector is segmented into 100 pixels which are read out through custom designed Application Specific Integrated Circuits (ASICs). This device has potential applications in the security, decommissioning and medical fields. This work focuses on the near-field imaging performance of a lab-based demonstrator consisting of two pixelated CZT detectors, each of which is bonded to a NUCAM II ASIC. Measurements have been made with point 133Ba and 57Co sources located ˜35 mm from the surface of the scattering detector. Position resolution of ˜20 mm FWHM in the x and y planes is demonstrated.

  18. Acceptance test report for portable exhauster POR-007/Skid E

    SciTech Connect

    Kriskovich, J.R.

    1998-07-24

    This document describes Acceptance Testing performed on Portable Exhauster POR-007/Skid E. It includes measurements of bearing vibration levels, pressure decay testing, programmable logic controller interlocks, high vacuum, flow and pressure control functional testing. The purpose of Acceptance testing documented by this report was to demonstrate compliance of the exhausters with the performance criteria established within HNF-0490, Rev. 1 following a repair and upgrade effort at Hanford. In addition, data obtained during this testing is required for the resolution of outstanding Non-conformance Reports (NCR), and finally, to demonstrate the functionality of the associated software for the pressure control and high vacuum exhauster operating modes provided for by W-320. Additional testing not required by the ATP was also performed to assist in the disposition and close out of receiving inspection report and for application design information (system curve). Results of this testing are also captured within this document.

  19. Assessment of total efficiency in adiabatic engines

    NASA Astrophysics Data System (ADS)

    Mitianiec, W.

    2016-09-01

    The paper presents influence of ceramic coating in all surfaces of the combustion chamber of SI four-stroke engine on working parameters mainly on heat balance and total efficiency. Three cases of engine were considered: standard without ceramic coating, fully adiabatic combustion chamber and engine with different thickness of ceramic coating. Consideration of adiabatic or semi-adiabatic engine was connected with mathematical modelling of heat transfer from the cylinder gas to the cooling medium. This model takes into account changeable convection coefficient based on the experimental formulas of Woschni, heat conductivity of multi-layer walls and also small effect of radiation in SI engines. The simulation model was elaborated with full heat transfer to the cooling medium and unsteady gas flow in the engine intake and exhaust systems. The computer program taking into account 0D model of engine processes in the cylinder and 1D model of gas flow was elaborated for determination of many basic engine thermodynamic parameters for Suzuki DR-Z400S 400 cc SI engine. The paper presents calculation results of influence of the ceramic coating thickness on indicated pressure, specific fuel consumption, cooling and exhaust heat losses. Next it were presented comparisons of effective power, heat losses in the cooling and exhaust systems, total efficiency in function of engine rotational speed and also comparison of temperature inside the cylinder for standard, semi-adiabatic and full adiabatic engine. On the basis of the achieved results it was found higher total efficiency of adiabatic engines at 2500 rpm from 27% for standard engine to 37% for full adiabatic engine.

  20. The 2012 Total Eclipse Expeditions in Queensland

    NASA Astrophysics Data System (ADS)

    Pasachoff, Jay M.; Babcock, B. A.; Lu, M.; Dantowitz, R.; Lucas, R.; Seiradakis, J. H.; Voulgaris, A.; Gaintatzis, P.; Steele, A.; Sterling, A. C.; Rusin, V.; Saniga, M.

    2013-07-01

    A total eclipse swept across Queensland and other sites in northeastern Australia on the early morning of 14 November 2012, local time. We mounted equipment to observe coronal images and spectra during the approximately 2 minutes of totality, the former for comparison with spacecraft images and to fill in the doughnut of imaging not well covered with space coronagraphs. Matching weather statistics, viewing was spotty, and our best observations were from a last-minute inland site on the Tablelands, with some observations from a helicopter at 9000 feet altitude over our original viewing site at Miallo. Only glimpses of the corona were visible at our Port Douglas and Trinity Beach, Cairns, locations, with totality obscured from our sites at Newell and Miallo, though some holes in the clouds provided coronal views from Palm Cove and elsewhere along the coast. Preliminary analysis of the spectra again shows Fe XIV stronger than Fe X, as in 2010 but not earlier, a sign of solar maximum, as was the coronal shape. An intriguing CME is discernible in the SE. Acknowledgments: We thank Terry Cuttle, Aram Friedman, Michael Kentrianakis, and Nicholas Weber for assistance and collaboration in Australia and Wendy Carlos for image processing. Our expedition was supported in part by NSF grant AGS-1047726 from Solar Terrestrial Research of the Atmospheric and Geospace Sciences Division, and by the Rob Spring Fund and Science Center funds at Williams College. ML was also supported in part by a Grant-In-Aid of Research from the National Academy of Sciences, administered by Sigma Xi, The Scientific Research Society (Grant ID: G20120315159311). VR and MS acknowledge support from projects VEGA 2/0003/13 and NGS-3139-12 of the National Geographic Society. We are grateful to K. Shiota (Japan) for kindly providing us with some of his 2012 eclipse coronal images.

  1. [Dosimetry of total skin electron irradiation

    PubMed

    Kontra, Gábor; Horváth, Akos; Bajcsay, András; Németh, György

    2000-07-01

    Elaboration of such a simple technique for total skin electron irradiation which ensures good dose homogeneity and minimal x-ray background dose. MATERIALS AND METHODS: We started large electron field irradiations with the Neptun 10p linear accelerator in the National Institute of Oncology -Budapest in 1986. After the installation of the Siemens Mevatron KD linear accelerator it was possible to introduce the modified Stanford technique. This technique satisfies better the requirements given in the objective. The required field size of 200x75 cm is produced as a result of two fields with 30 degrees angular separation (dual field) at a source skin distance of 465 cm. The patient's body is exposed to six dual electron fields. The electron energy is 6 MeV. Despite the long source skin distance the treatment time is relatively short due to the high dose rate (940 mu/min) capability of our Mevatron KD. The in air dose profiles were measured in miniphantom with semiconductor detector. Depth dose curves were measured in water and in polystyrene phantom with semiconductor detector and with films. RESULTS: The measured dose homogeneity of the 6 MeV energy dual field with 30 degrees angular separation is within +/- 5%in a 200x75cm plane field. The depth of dose maximum of the resulting dose distribution of six dual field irradiation is between 2 mm and 5 mm, while the depth of 80% isodose curve is about 8 mm. The total body x-ray background dose is less than 1% of the skin dose. CONCLUSION: The modified Stanford technique adapted to our Mevatron KD linear accelerator is suitable for total skin electron beam therapy. PMID:12050758

  2. Total on-line purchasing system (TOPS)

    SciTech Connect

    Collins, N.

    1995-11-01

    The Information Management Division (IMD) at LLNL is developing a new purchasing system for the Procurement Department. The first major development of this new system is called, {open_quotes}Total On-Line Purchasing System{close_quotes} (TOPS). TOPS will help speed up the requisitioning process by having requisitions electronically entered by requesters and electronically sent to buyers to be put on Purchase Orders. The new purchasing system will use Electronic Commerce (EC)/Electronic Data Interchange (EDI), to help increase transaction flows for shipping notices, RFQs, Quotes, Purchase Orders, and Invoices. ANSI X.12 is the EDI standard that this new EC will use.

  3. Total skin electron irradiation techniques: a review

    PubMed Central

    Milecki, Piotr; Skórska, Małgorzata; Fundowicz, Dorota

    2013-01-01

    Total skin electron irradiation (TSEI) has been employed as one of the methods of mycosis fungoides treatment since the mid-twentieth century. In order to improve the effects and limit the complications following radiotherapy, a number of varieties of the TSEI method, frequently differing in the implementation mode have been developed. The paper provides a systematic review of the different varieties of TSEI. The discussed differences concerned especially: (i) technological requirements and geometric conditions, (ii) the alignment of the patient, (iii) the number of treatment fields, and (iv) dose fractionation scheme. PMID:24278046

  4. Total parenteral nutrition, An important therapeutic advance.

    PubMed

    Hodges, R E

    1979-03-01

    Total parenteral nutrition (TPN) is a potent form of therapy. It is particularly useful in patients who must undergo surgery or those with conditions that preclude normal feeding. The procedure is not without risk, but better understanding of the basic principles involved, refinements in technique, and experience with its use in different situations have combined to improve the results of therapy over those first obtained. TPN represents an important therapeutic advance and emphasizes the need for an undertanding of nutritional principles by physicians and for a team approach to the management of complicated conditions.

  5. Total parenteral nutrition. Conquering the complexities.

    PubMed

    McClave, S A; Short, A F; Mattingly, D B; Fitzgerald, P D

    1990-07-01

    Delivery of total parenteral nutrition (TPN) is a complex procedure requiring a basic knowledge of nutritional physiology and an understanding of the impact of various disease states on utilization of nutrient substrates. The goals of TPN are to reverse catabolism, promote anabolism, and build structural protein. It is important to infuse an adequate amount of calories and protein but to avoid the stress of overfeeding. Various laboratory values may be monitored to ensure that each of the nutrients administered is being adequately tolerated by the patient. Keeping these principles in mind, primary care physicians can deliver a TPN regimen specifically suited for individual patients and can anticipate and prevent any potential complications.

  6. The Total Solar Irradiance Climate Data Record

    NASA Astrophysics Data System (ADS)

    Dewitte, Steven; Nevens, Stijn

    2016-10-01

    We present the composite measurements of total solar irradiance (TSI) as measured by an ensemble of space instruments. The measurements of the individual instruments are put on a common absolute scale, and their quality is assessed by intercomparison. The composite time series is the average of all available measurements. From 1984 April to the present the TSI shows a variation in phase with the 11 yr solar cycle and no significant changes of the quiet-Sun level in between the three covered solar minima.

  7. Pathologic Processing of the Total Mesorectal Excision

    PubMed Central

    Campa-Thompson, Molly; Weir, Robert; Calcetera, Natalie; Quirke, Philip; Carmack, Susanne

    2015-01-01

    Total mesorectal excision (TME) is the current optimal surgical treatment for patients with rectal carcinoma. A complete TME is related to lower local recurrence rates and increased patient survival. Many confounding factors in the patient's anatomy and prior therapy can make it difficult to obtain a perfect plane, and thus a complete TME. The resection specimen can be thoroughly evaluated, grossly and microscopically, to identify substandard surgical outcomes and increased risk of local recurrence. Complete and accurate data reporting is critical for patient care and helps surgeons improve their technique. PMID:25733973

  8. The Catalytic Enantioselective Total Synthesis of (+)-Liphagal**

    PubMed Central

    Day, Joshua J.; McFadden, Ryan M.; Virgil, Scott C.; Kolding, Helene; Alleva, Jennifer L.; Stoltz, Brian M.

    2012-01-01

    Ring a ding: The first catalytic enantioselective total synthesis of the meroterpenoid natural product (+)-liphagal is disclosed. The approach showcases a variety of technology including enantioselective enolate alkylation, a photochemical alkyne-alkene [2+2] reaction, microwave-assisted metal catalysis, and an intramolecular aryne capture cyclization reaction. Pivotal to the successful completion of the synthesis was a sequence involving ring expansion from a [6-5-4] tricycle to a [6-7] bicyclic core followed by stereoselective hydrogenation of a sterically occluded tri-substituted olefin to establish the trans homodecalin system found in the natural product. PMID:21671325

  9. Total synthesis and biological investigation of (-)-promysalin.

    PubMed

    Steele, Andrew D; Knouse, Kyle W; Keohane, Colleen E; Wuest, William M

    2015-06-17

    Compounds that specifically target pathogenic bacteria are greatly needed, and identifying the method by which they act would provide new avenues of treatment. Herein we report the concise, high-yielding total synthesis (eight steps, 35% yield) of promysalin, a natural product that displays antivirulence phenotypes against pathogenic bacteria. Guided by bioinformatics, four diastereomers were synthesized, and the relative and absolute stereochemistries were confirmed by spectral and biological analysis. Finally, we show for the first time that promysalin displays two antivirulence phenotypes: the dispersion of mature biofilms and the inhibition of pyoverdine production, hinting at a unique pathogenic-specific mechanism of action.

  10. Total-variation regularization with bound constraints

    SciTech Connect

    Chartrand, Rick; Wohlberg, Brendt

    2009-01-01

    We present a new algorithm for bound-constrained total-variation (TV) regularization that in comparison with its predecessors is simple, fast, and flexible. We use a splitting approach to decouple TV minimization from enforcing the constraints. Consequently, existing TV solvers can be employed with minimal alteration. This also makes the approach straightforward to generalize to any situation where TV can be applied. We consider deblurring of images with Gaussian or salt-and-pepper noise, as well as Abel inversion of radiographs with Poisson noise. We incorporate previous iterative reweighting algorithms to solve the TV portion.

  11. Total body nitrogen analysis. [neutron activation analysis

    NASA Technical Reports Server (NTRS)

    Palmer, H. E.

    1975-01-01

    Studies of two potential in vivo neutron activation methods for determining total and partial body nitrogen in animals and humans are described. A method using the CO-11 in the expired air as a measure of nitrogen content was found to be adequate for small animals such as rats, but inadequate for human measurements due to a slow excretion rate. Studies on the method of measuring the induced N-13 in the body show that with further development, this method should be adequate for measuring muscle mass changes occurring in animals or humans during space flight.

  12. Soft tissue balancing in total shoulder replacement.

    PubMed

    Mueller, Maike; Hoy, Gregory

    2014-03-01

    Total shoulder arthroplasty is now capable of recreating near anatomic reproduction of native bony shoulder anatomy, but the function and longevity of anatomic shoulder replacement is dependent on a competent soft tissue envelope and adequate motoring of all musculo-tendinous units about the shoulder. Balancing the soft tissues requires understanding of the anatomy and pathology, as well as technical skills. The advent of reverse shoulder biomechanics has brought with it special requirements of understanding of the soft tissue elements still left in the shoulder despite major rotator cuff deficiency.

  13. Total synthesis and biological investigation of (-)-promysalin.

    PubMed

    Steele, Andrew D; Knouse, Kyle W; Keohane, Colleen E; Wuest, William M

    2015-06-17

    Compounds that specifically target pathogenic bacteria are greatly needed, and identifying the method by which they act would provide new avenues of treatment. Herein we report the concise, high-yielding total synthesis (eight steps, 35% yield) of promysalin, a natural product that displays antivirulence phenotypes against pathogenic bacteria. Guided by bioinformatics, four diastereomers were synthesized, and the relative and absolute stereochemistries were confirmed by spectral and biological analysis. Finally, we show for the first time that promysalin displays two antivirulence phenotypes: the dispersion of mature biofilms and the inhibition of pyoverdine production, hinting at a unique pathogenic-specific mechanism of action. PMID:26024439

  14. Enantioselective Total Synthesis of (+)-Lyngbyabellin M

    PubMed Central

    Pirovani, Rodrigo V.; Brito, Gilmar A.; Barcelos, Rosimeire C.; Pilli, Ronaldo A.

    2015-01-01

    Lyngbyabellin M is a non-ribosomal peptide synthetase/polyketide synthase derived metabolite isolated from the cyanobacterium M. bouillonii displaying thiazole rings and a distinct chlorinated octanoic acid chain. Its absolute configuration was proposed based on the comparison of its spectroscopic data with those of other representatives of this family of marine natural products, as well as degradation and derivatization studies. Here the first total synthesis of (+)-lyngbyabellin M is described based on the coupling of three key intermediates: two chiral thiazole moieties and an anti hydroxycarboxylic acid prepared stereoselectively via a boron enolate mediated aldol reaction directed by Masamune’s chiral auxiliary. PMID:26023838

  15. Transanal total mesorectal excision: Myths and reality

    PubMed Central

    Buchs, Nicolas C; Penna, Marta; Bloemendaal, Alexander L; Hompes, Roel

    2016-01-01

    Transanal total mesorectal excision (TaTME) is a new and promising approach for the treatment of rectal cancer. Whilst the experience is still limited, there are growing evidences that this approach might overcome the limits of standard low anterior resection. TaTME might help to decrease the conversion rate especially in difficult patients, and to improve the pathological results, while preserving the urogenital function. Evaluation of data from large registries and randomized studies should help to draw firmer conclusions. Beyond these technical considerations, the next challenge seems to be clearly the safe introduction of this approach, motivating the development of dedicated courses. PMID:27777876

  16. Total Ankle Arthroplasty: An Imaging Overview

    PubMed Central

    Kim, Da-Rae; Potter, Hollis G.; Li, Angela E.; Chun, Ka-Young; Jung, Yoon Young; Kim, Jin-Su; Young, Ki-Won

    2016-01-01

    With advances in implant technology, total ankle arthroplasty (TAA) has become an increasingly popular alternative to arthrodesis for the management of end-stage ankle arthritis. However, reports in the literature do not focus on the imaging features of TAA. Through a literature review, we demonstrate basic design features of the current ankle arthroplasty system, and the normal and abnormal postoperative imaging features associated with such devices. Pre- and postoperative evaluations of ankle arthroplasty mainly include radiography; in addition, computed tomography and magnetic resonance imaging provide further characterization of imaging abnormalities. Familiarization with multimodal imaging features of frequent procedural complications at various postoperative intervals is important in radiological practice. PMID:27134529

  17. Total Ankle Arthroplasty: An Imaging Overview.

    PubMed

    Kim, Da-Rae; Choi, Yun Sun; Potter, Hollis G; Li, Angela E; Chun, Ka-Young; Jung, Yoon Young; Kim, Jin-Su; Young, Ki-Won

    2016-01-01

    With advances in implant technology, total ankle arthroplasty (TAA) has become an increasingly popular alternative to arthrodesis for the management of end-stage ankle arthritis. However, reports in the literature do not focus on the imaging features of TAA. Through a literature review, we demonstrate basic design features of the current ankle arthroplasty system, and the normal and abnormal postoperative imaging features associated with such devices. Pre- and postoperative evaluations of ankle arthroplasty mainly include radiography; in addition, computed tomography and magnetic resonance imaging provide further characterization of imaging abnormalities. Familiarization with multimodal imaging features of frequent procedural complications at various postoperative intervals is important in radiological practice.

  18. A journey into TQM (total quality management).

    PubMed

    Jackson, M B

    1994-01-01

    Total quality management (TQM) which has been implemented for some time in industry and more recently in hospitals is just beginning to come to long term care organizations. Directors of Nursing can prepare themselves for such a program in their facility by learning from the experience of long term care facilities that have implemented TQM. This is part one of a two part series which describes the implementation process used and a discussion of problems encountered. The second article which will appear in a later issue describes the experience and findings of one project team-the nursing documentation team.

  19. Typing and surface charges of the variable loop regions of PorB from Neisseria meningitidis.

    PubMed

    Stefanelli, Paola; Neri, Arianna; Tanabe, Mikio; Fazio, Cecilia; Massari, Paola

    2016-06-01

    PorB is a pan-Neisserial major outer membrane protein with a trimeric β-barrel structure. Each monomer presents eight periplasmic turns and eight surface exposed loop regions with sequence variability. PorB induces activation of host cell responses via a TLR2-dependent mechanism likely mediated by electrostatic interactions between TLR2 and PorB surface exposed loops. Variability in the loop amino acid sequence is known to influence cell responses to PorB in vitro, particularly for the residues in L5 and L7. In this work, the sequence of the porB gene and the electrostatic surface charges of PorB from 35 invasive meningococcal isolates belonging to the main clonal complexes identified in Italy and from five carriage genomes available on the website http://pubmlst.org/neisseria/ were examined. Analysis of the porB encoding regions from the invasive meningococci has identified four new alleles and a potential association between porB alleles, serogroup, and clonal complexes. Through computer-based modeling and analysis of the electrostatic surface charges of PorB from these strains, loop charge segregation between PorB from invasive serogroups B and C was observed. Specifically, loops 1, 4, and 7 were negatively charged and L2 and L8 were mostly neutral in serogroup B isolates, while an overall homogeneous positive surface charge was present in PorB from invasive serogroup C strains. A higher PorB sequence variability was observed among carriage genomes, and a general prevalence of negative loop surface charges. The surface charge differences in PorB from serogroups B and C invasive and carriage strains may, in part, influence the outcomes of Neisseriae interactions with host cells. © 2016 IUBMB Life, 68(6):488-495, 2016. PMID:27156582

  20. Typing and surface charges of the variable loop regions of PorB from Neisseria meningitidis.

    PubMed

    Stefanelli, Paola; Neri, Arianna; Tanabe, Mikio; Fazio, Cecilia; Massari, Paola

    2016-06-01

    PorB is a pan-Neisserial major outer membrane protein with a trimeric β-barrel structure. Each monomer presents eight periplasmic turns and eight surface exposed loop regions with sequence variability. PorB induces activation of host cell responses via a TLR2-dependent mechanism likely mediated by electrostatic interactions between TLR2 and PorB surface exposed loops. Variability in the loop amino acid sequence is known to influence cell responses to PorB in vitro, particularly for the residues in L5 and L7. In this work, the sequence of the porB gene and the electrostatic surface charges of PorB from 35 invasive meningococcal isolates belonging to the main clonal complexes identified in Italy and from five carriage genomes available on the website http://pubmlst.org/neisseria/ were examined. Analysis of the porB encoding regions from the invasive meningococci has identified four new alleles and a potential association between porB alleles, serogroup, and clonal complexes. Through computer-based modeling and analysis of the electrostatic surface charges of PorB from these strains, loop charge segregation between PorB from invasive serogroups B and C was observed. Specifically, loops 1, 4, and 7 were negatively charged and L2 and L8 were mostly neutral in serogroup B isolates, while an overall homogeneous positive surface charge was present in PorB from invasive serogroup C strains. A higher PorB sequence variability was observed among carriage genomes, and a general prevalence of negative loop surface charges. The surface charge differences in PorB from serogroups B and C invasive and carriage strains may, in part, influence the outcomes of Neisseriae interactions with host cells. © 2016 IUBMB Life, 68(6):488-495, 2016.

  1. Total Lightning Activity Associated with Tornadic Storms

    NASA Technical Reports Server (NTRS)

    Goodman, Steven J.; Buechler, Dennis; Hodanish, Stephen; Sharpe, David; Williams, Earle R.; Boldi, Bob; Matlin, Anne; Weber, Mark

    1999-01-01

    Prior studies have examined the association of lightning activity with the occurrence of severe weather. Severe storms often have high flash rates (in excess of one flash per second) and are dominated by intracloud lightning activity. Most recently, we have identified a rapid change (referred to as a "jump") in total flash rate which precedes the occurrence of severe weather by ten or more minutes. This relationship is associated with updraft intensification. In this paper we examine whether there exist unique characteristics of the total lightning and the lightning jumps associated with tornadoes in Florida, and explain how they might relate to the interaction of mesocyclonic shear, the rear flank downdraft and outflow boundaries that can lead to tornadogenesis. In several cases, evidence for diminishment of midlevel rotation and the descent of angular momentum from aloft is present prior to the appearance of the surface tornado. The relatively long lead time between the lighting jump and the occurrence of the tornado is attributed to the time lag between updraft invigoration and the boundary layer spin up of vorticity.

  2. Dual mobility cups in total hip arthroplasty

    PubMed Central

    De Martino, Ivan; Triantafyllopoulos, Georgios Konstantinos; Sculco, Peter Keyes; Sculco, Thomas Peter

    2014-01-01

    Total hip arthroplasty (THA) is considered one of the most successful surgical procedures in orthopaedics. With the increase in the number of THAs performed in the world in the next decades, reducing or preventing medical and mechanical complications such as post-operative THA instability will be of paramount importance, particularly in an emerging health care environment based on quality control and patient outcome. Dual mobility acetabular component (also known as unconstrained tripolar implant) was introduced in France at the end of the 1970s as an alternative to standard sockets, to reduce the risk of THA dislocation in patients undergoing primary THA in France. Dual mobility cups have recently gained wider attention in the United States as an alternative option in the prevention and treatment of instability in both primary and revision THA and offer the benefit of increased stability without compromising clinical outcomes and implant longevity. In this article, we review the use of dual mobility cup in total hip arthroplasty in terms of its history, biomechanics, outcomes and complications based on more than 20 years of medical literature. PMID:25035820

  3. Surgical approaches for total knee arthroplasty.

    PubMed

    Vaishya, Raju; Vijay, Vipul; Demesugh, Daniel Mue; Agarwal, Amit Kumar

    2016-01-01

    There are various surgical approaches to the knee joint and its surrounding structures and such approaches are generally designed to allow the best access to an area of pathology whilst safeguarding important surrounding structures. Controversy currently surrounds the optimal surgical approach for total knee arthroplasty (TKA). The medial parapatellar arthrotomy, or anteromedial approach, has been the most used and has been regarded as the standard approach for exposure of the knee joint. It provides extensive exposure and is useful for open anterior cruciate ligament reconstruction, total knee replacement, and fixation of intra-articular fractures. Because this approach has been implicated in compromise of the patellar circulation, some authors have advocated the subvastus, midvastus, and trivector approaches for exposure of the knee joint. While these approaches expose the knee from the medial side, the anterolateral approach exposes the knee joint from the lateral side. With careful planning and arthrotomy selection, the anterior aspect of the joint can be adequately exposed for TKA in different clinical scenarios. PMID:27182142

  4. Lubrication regimes in lumbar total disc arthroplasty.

    PubMed

    Shaheen, A; Shepherd, D E T

    2007-08-01

    A number of total disc arthroplasty devices have been developed. Some concern has been expressed that wear may be a potential failure mode for these devices, as has been seen with hip arthroplasty. The aim of this paper was to investigate the lubrication regimes that occur in lumbar total disc arthroplasty devices. The disc arthroplasty was modelled as a ball-and-socket joint. Elastohydrodynamic lubrication theory was used to calculate the minimum film thickness of the fluid between the bearing surfaces. The lubrication regime was then determined for different material combinations, size of implant, and trunk velocity. Disc arthroplasties with a metal-polymer or metal-metal material combination operate with a boundary lubrication regime. A ceramic-ceramic material combination has the potential to operate with fluid-film lubrication. Disc arthroplasties with a metal-polymer or metal-metal material combination are likely to generate wear debris. In future, it is worth considering a ceramic-ceramic material combination as this is likely to reduce wear.

  5. Footprint mismatch in lumbar total disc arthroplasty

    PubMed Central

    Michaela, Gstoettner; Denise, Heider; Liebensteiner, Michael

    2008-01-01

    Lumbar disc arthroplasty has become a popular modality for the treatment of degenerative disc disease. The dimensions of the implants are based on early published geometrical measurements of vertebrae; the majority of these were cadaver studies. The fit of the prosthesis in the intervertebral space is of utmost importance. An undersized implant may lead to subsidence, loosening and biomechanical failure due to an incorrect center of rotation. The aim of the present study was to measure the dimensions of lumbar vertebrae based on CT scans and assess the accuracy of match in currently available lumbar disc prostheses. A total of 240 endplates of 120 vertebrae were included in the study. The sagittal and mediolateral diameter of the upper and lower endplates were measured using a digital measuring system. For the levels L4/L5 and L5/S1, an inappropriate size match was noted in 98.8% (Prodisc L) and 97.6% (Charite) with regard to the anteroposterior diameter. Mismatch in the anterior mediolateral diameter was noted in 79.3% (Prodisc L) and 51.2% (Charite) while mismatch in the posterior mediolateral diameter was observed in 91.5% (Prodisc L) and 78% (Charite) of the endplates. Surgeons and manufacturers should be aware of the size mismatch of currently available lumbar disc prostheses, which may endanger the safety and efficacy of the procedure. Larger footprints of currently available total disc arthroplasties are required. PMID:18791748

  6. Kelvin waves in total column ozone

    NASA Technical Reports Server (NTRS)

    Ziemke, J. R.; Stanford, J. L.

    1994-01-01

    Tropical Kelvin waves have been observed previously in ozone mixing ratio data from the SBUV (Solar Backscatter Ultraviolet) and LIMS (Limb Infrared Monitor of the Stratosphere) instruments on board the Nimbus-7 satellite. The present study investigates Kelvin wave features in total column ozone, using version 6 data from the Total Ozone Mapping Spectrometer (TOMS) instrument (also on Nimbus-7). Results show eastward-propagating zonal waves 1-2 with periods approx. 5-15 days, amplitudes approx. 3-5 Dobson Units (1-2% of the time mean), and latitudinal symmetry typical of Kelvin waves. The analyses and a linear model in this study suggest that the primary source of the perturbations is slow Kelvin waves in the lower-to-middle stratosphere. Maximum Kelvin wave signatures occur in conjunction with westward lower-to-middle stratospheric equatorial zonal winds (a quasi-biennial oscillation (QBO) wind modulation effect). The significance of these results is that the TOMS data are shown to be useful for investigations with global coverage of a major component of tropical stratospheric dynamics, Kelvin waves. The TOMS data set with its excellent coverage and high quality should be useful in validating model studies in the relatively data sparse and dynamically difficult tropical region.

  7. Annular and Total Solar Eclipses of 2010

    NASA Technical Reports Server (NTRS)

    Espenak, Fred; Anderson, J.

    2008-01-01

    While most NASA eclipse bulletins cover a single eclipse, this publication presents predictions for two solar eclipses during 2010. This has required a different organization of the material into the following sections. Section 1 -- Eclipse Predictions: The section consists of a general discussion about the eclipse path maps, Besselian elements, shadow contacts, eclipse path tables, local circumstances tables, and the lunar limb profile. Section 2 -- Annular Solar Eclipse of 2010 Ja n 15: The section covers predictions and weather prospects for the annular eclipse. Section 3 -- Total Solar Eclipse of 2010 Jul 11: The se ction covers predictions and weather prospects for the total eclipse. Section 4 -- Observing Eclipses: The section provides information on eye safety, solar filters, eclipse photography, and making contact timings from the path limits. Section 5 -- Eclipse Resources: The final section contains a number of resources including information on the IAU Working Group on Eclipses, the Solar Eclipse Mailing List, the NASA eclipse bulletins on the Internet, Web sites for the two 2010 eclipses, and a summary identifying the algorithms, ephemerides, and paramete rs used in the eclipse predictions.

  8. Preoperative Planning in Primary Total Knee Arthroplasty.

    PubMed

    Tanzer, Michael; Makhdom, Asim M

    2016-04-01

    Preoperative planning is of paramount importance in primary total knee arthroplasty. A thorough preoperative analysis helps the surgeon envision the operation, anticipate any potential issues, and minimize the risk of premature implant failure. Obtaining a thorough history is critical for appropriate patient selection. The physical examination should evaluate the integrity of the soft tissues, the neurovascular status, range of motion, limb deformity, and the status of the collateral ligaments to help determine the soft-tissue balancing and constraint strategy required. Standard radiographs, with a known magnification, should be obtained for preoperative total knee arthroplasty templating. Routine standing AP, lateral, and skyline radiographs of the knee can help the surgeon plan the bone cuts and tibial slope as well as the implant size and position at the time of surgery. In certain circumstances, such as severe coronal deformities, bone deficiencies, and/or extra-articular deformities, additional measures are frequently necessary to successfully reconstruct the knee. Constrained implants, metal augments, and bone graft must be part of the surgeon's armamentarium. PMID:26990712

  9. Laparoscopic Total Extraperitoneal Hernia Repair Outcomes

    PubMed Central

    Bresnahan, Erin R.

    2016-01-01

    Background and Objectives: Laparoscopic inguinal hernia repair has become increasingly popular as an alternative to open surgery. The purpose of this study was to evaluate the safety and effectiveness of the laparoscopic total extraperitoneal procedure with the use of staple fixation and polypropylene mesh. Methods: A retrospective chart review examined outcomes of 1240 laparoscopic hernia operations in 783 patients, focusing on intraoperative and early postoperative complications, pain, and time until return to work and normal physical activities. Results: There were no intraoperative complications in this series; 106 patients experienced early postoperative complications across 8 evaluated categories: urinary retention (4.1%), seroma (3.0%), testicular/hemiscrotal swelling (1.9%), testicular atrophy (0%), hydrocele (0.6%), mesh infection (0.1%), and neurological symptoms (transient, 1.0%; persistent, 0.2%). Patients used an average of 5.6 Percocet pills after the procedure, and mean times until return to work and normal activities, including their routine exercise regimen, were 3.0 and 3.8 days, respectively. Conclusion: Complication rates and convalescence times were considered equivalent or superior to those found in other studies assessing both laparoscopic and open techniques. The usage of multiple Endostaples did not result in increased neurologic complications in the early postoperative period when compared with findings in the literature. In the hands of an experienced surgeon, total extraperitoneal repair is a safe, effective alternative to open inguinal hernia repair. PMID:27493471

  10. Methods development for total organic carbon accountability

    NASA Technical Reports Server (NTRS)

    Benson, Brian L.; Kilgore, Melvin V., Jr.

    1991-01-01

    This report describes the efforts completed during the contract period beginning November 1, 1990 and ending April 30, 1991. Samples of product hygiene and potable water from WRT 3A were supplied by NASA/MSFC prior to contract award on July 24, 1990. Humidity condensate samples were supplied on August 3, 1990. During the course of this contract chemical analyses were performed on these samples to qualitatively determine specific components comprising, the measured organic carbon concentration. In addition, these samples and known standard solutions were used to identify and develop methodology useful to future comprehensive characterization of similar samples. Standard analyses including pH, conductivity, and total organic carbon (TOC) were conducted. Colorimetric and enzyme linked assays for total protein, bile acid, B-hydroxybutyric acid, methylene blue active substances (MBAS), urea nitrogen, ammonia, and glucose were also performed. Gas chromatographic procedures for non-volatile fatty acids and EPA priority pollutants were also performed. Liquid chromatography was used to screen for non-volatile, water soluble compounds not amenable to GC techniques. Methods development efforts were initiated to separate and quantitate certain chemical classes not classically analyzed in water and wastewater samples. These included carbohydrates, organic acids, and amino acids. Finally, efforts were initiated to identify useful concentration techniques to enhance detection limits and recovery of non-volatile, water soluble compounds.

  11. Calculation of the total and total ionization cross sections for positron scattering on atomic hydrogen

    SciTech Connect

    Bray, I. ); Stelbovics, A.T. )

    1994-04-01

    The total and total ionization cross sections for positron scattering on atomic hydrogen are calculated by applying the convergent-close-coupling method to the model where positronium-formation channels are omitted. This model accurately describes the physics of the scattering whenever the positronium formation cross section is negligible, in particular, above 100 eV for this system. The total ionization cross section results in this energy region are in excellent agreement with the recent measurements of Jones [ital et] [ital al]. [J. Phys. B 26, L483 (1993)], and so lie below the earlier measurements of Spicher [Phys. Rev. Lett. 64, 1019 (1990)], and the recent calculations of Acacia [ital et] [ital al]. [Phys. Rev. Lett. (to be published)]. The total cross section is in very good agreement with the recent measurements of Zhou [ital et] [ital al]. (unpublished) down to 30 eV.

  12. Tracer monitored titrations: measurement of total alkalinity.

    PubMed

    Martz, Todd R; Dickson, Andrew G; DeGrandpre, Michael D

    2006-03-15

    We introduce a new titration methodology, tracer monitored titration (TMT), in which analyses are free of volumetric and gravimetric measurements and insensitive to pump precision and reproducibility. Spectrophotometric monitoring of titrant dilution, rather than volume increment, lays the burden of analytical performance solely on the spectrophotometer. In the method described here, the titrant is a standardized mixture of acid-base indicator and strong acid. Dilution of a pulse of titrant in a titration vessel is tracked using the total indicator concentration measured spectrophotometrically. The concentrations of reacted and unreacted indicator species, derived from Beer's law, are used to calculate the relative proportions of titrant and sample in addition to the equilibrium position (pH) of the titration mixture. Because the method does not require volumetric or gravimetric additions of titrant, simple low-precision pumps can be used. Here, we demonstrate application of TMT for analysis of total alkalinity (A(T)). High-precision, high-accuracy seawater A(T) measurements are crucial for understanding, for example, the marine CaCO3 budget and saturation state, anthropogenic CO2 penetration into the oceans, calcareous phytoplankton blooms, and coral reef dynamics. We present data from 286 titrations on three types of total alkalinity standards: Na2CO3 in 0.7 mol kg x soln(-1) NaCl, NaOH in 0.7 mol kg x soln(-1) NaCl, and a seawater Certified Reference Material (CRM). Based on Na2CO3 standards, the accuracy and precision are +/-0.2 and +/-0.1% (4 and 2 micromol kg x soln(-1) for A(T) approximately 2100-2500 micromol kg x soln(-1), n = 242), using low-precision solenoid pumps to introduce sample and titrant. Similar accuracy and precision were found for analyses run 42 days after the initial experiments. Excellent performance is achieved by optimizing the spectrophotometric detection system and relying upon basic chemical thermodynamics for calculating the

  13. Positron interactions with water-total elastic, total inelastic, and elastic differential cross section measurements.

    PubMed

    Tattersall, Wade; Chiari, Luca; Machacek, J R; Anderson, Emma; White, Ron D; Brunger, M J; Buckman, Stephen J; Garcia, Gustavo; Blanco, Francisco; Sullivan, James P

    2014-01-28

    Utilising a high-resolution, trap-based positron beam, we have measured both elastic and inelastic scattering of positrons from water vapour. The measurements comprise differential elastic, total elastic, and total inelastic (not including positronium formation) absolute cross sections. The energy range investigated is from 1 eV to 60 eV. Comparison with theory is made with both R-Matrix and distorted wave calculations, and with our own application of the Independent Atom Model for positron interactions.

  14. Total chemical management in photographic processing

    USGS Publications Warehouse

    Luden, Charles; Schultz, Ronald

    1985-01-01

    The mission of the U. S. Geological Survey's Earth Resources Observation Systems (EROS) Data Center is to produce high-quality photographs of the earth taken from aircraft and Landsat satellite. In order to meet the criteria of producing research-quality photographs, while at the same time meeting strict environmental restrictions, a total photographic chemical management system was installed. This involved a three-part operation consisting of the design of a modern chemical analysis laboratory, the implementation of a chemical regeneration system, and the installation of a waste treatment system, including in-plant pretreatment and outside secondary waste treatment. Over the last ten years the result of this program has yielded high-quality photographs while saving approximately 30,000 per year and meeting all Environmental Protection Agency (EPA) restrictions.

  15. Potential Modulation on Total Internal Reflection Ellipsometry.

    PubMed

    Liu, Wei; Niu, Yu; Viana, A S; Correia, Jorge P; Jin, Gang

    2016-03-15

    Electrochemical-total internal reflection ellipsometry (EC-TIRE) has been proposed as a technique to observe the redox reactions on the electrode surface due to its high phase sensitivity to the electrolyte/electrode interface. In this paper, we mainly focus on the influence of the potential modulation on the TIRE response. The analysis suggests that both dielectric constant variation of gold and the electric double layer transformation would modulate the reflection polarization of the surface. For a nonfaradaic process, the signal of TIRE would be proportional to the potential modulation. To testify the analysis, linear sweep voltammetry and open circuit measurement have been performed. The results strongly support the system analysis. PMID:26889871

  16. Subacute pain after total knee arthroplasty.

    PubMed

    Sauter, Axel; Breivik, Harald

    2014-06-01

    Acute pain during and immediately after total knee arthroplasty (TKA) can be well controlled by spinal anesthesia, local infiltration analgesia, and peripheral nerve blocks; this enables early or fast-track rehabilitation. However, about half of patients have clinically significant pain in the following weeks. Active movements and rehabilitation of joint function, muscle strength, and ability to maintain balance and prevent falls all become more difficult when the joint is painful on movement. Intensive analgesic and antihyperalgesic treatment during the first few weeks after TKA surgery may reduce the risk of chronic pain after this operation, which is itself intended to remove the patient's chronic osteoarthritis pain. Spinal cord stimulation may be an effective option for patients with mainly neuropathic pain after TKA surgery.

  17. [Decreasing total fertility rates in Europe].

    PubMed

    Zakee, R

    1994-04-01

    "Due to an almost overall decrease during the last four decades total (period) fertility rates have reached values below the replacement level of 2.07 in most European countries. Only in Albania (2.8 in 1991), on the Faroe Islands (2.7 in 1990) and Iceland (2.3 in 1992) the last known values are higher. In most other European countries values between 1.4 and 2.0 are registered, but in Italy, Spain and Germany the TFR is about 1.2. Especially in the former German Democratic Republic (0.7), San Marino and most northern Italian regions (1.0) the TFR is low." (SUMMARY IN ENG)

  18. Total quality management in clinical virology laboratories.

    PubMed

    Tibbets, M W; Gomez, R; Kannangai, R; Sridharan, G

    2006-10-01

    The diagnostic laboratories in India are progressively promoting higher standards and are moving towards accreditation and international acceptance. Hence, the concept of "Quality" will need to be understood and implemented. Total quality management (TQM) in a laboratory is an integrated program involving all laboratory staff and management. TQM is a framework to operate and it is aiming for integration, consistency, increase in efficiency and a continuous drive for improvement. A well structured clinical virology service will include serology setup, cell culture facility and capacity for molecular diagnosis. The quality of results from the laboratory is significantly influenced by many pre-analytical and post-analytical factors which needed attention. The end goal of the TQM should be to provide the best care possible for the patient.

  19. Predictors of Satisfaction Following Total Knee Arthroplasty.

    PubMed

    Maratt, Joseph D; Lee, Yuo-yu; Lyman, Stephen; Westrich, Geoffrey H

    2015-07-01

    Despite the success of total knee arthroplasty (TKA), numerous studies report that nearly one in five patients who underwent TKA was unsatisfied with their outcome. The purpose of our study was to identify the preoperative factors predictive of satisfaction following well-performed TKA. Using improvement in patient-reported outcomes less than the minimally clinically important change as an indicator of dissatisfaction in a cohort of primary TKA patients, we found that patients with greater preoperative pain and disability with less severe degradation in health-related quality of life were more likely to be satisfied with the result of TKA. Balancing severity of symptoms and impact to quality of life is important when counseling patients considering TKA.

  20. Subwavelength total acoustic absorption with degenerate resonators

    NASA Astrophysics Data System (ADS)

    Yang, Min; Meng, Chong; Fu, Caixing; Li, Yong; Yang, Zhiyu; Sheng, Ping

    2015-09-01

    We report the experimental realization of perfect sound absorption by sub-wavelength monopole and dipole resonators that exhibit degenerate resonant frequencies. This is achieved through the destructive interference of two resonators' transmission responses, while the matching of their averaged impedances to that of air implies no backscattering, thereby leading to total absorption. Two examples, both using decorated membrane resonators (DMRs) as the basic units, are presented. The first is a flat panel comprising a DMR and a pair of coupled DMRs, while the second one is a ventilated short tube containing a DMR in conjunction with a sidewall DMR backed by a cavity. In both examples, near perfect absorption, up to 99.7%, has been observed with the airborne wavelength up to 1.2 m, which is at least an order of magnitude larger than the composite absorber. Excellent agreement between theory and experiment is obtained.

  1. Blood Management Strategies in Total Knee Arthroplasty

    PubMed Central

    Dan, Michael; Martinez Martos, Sara; Beller, Elaine

    2016-01-01

    A perioperative blood management program is one of a number of important elements for successful patient care in total knee arthroplasty (TKA) and surgeons should be proactive in its application. The aims of blood conservation are to reduce the risk of blood transfusion whilst at the same time maximizing hemoglobin (Hb) in the postoperative period, leading to a positive effect on outcome and cost. An individualized strategy based on patient specific risk factors, anticipated blood loss and comorbidities are useful in achieving this aim. Multiple blood conservation strategies are available in the preoperative, intraoperative and postoperative periods and can be employed in various combinations. Recent literature has highlighted the importance of preoperative Hb optimization, minimizing blood loss and evidence-based transfusion guidelines. Given TKA is an elective procedure, a zero allogenic blood transfusion rate should be the aim and an achievable goal.

  2. Total synthesis of the Daphniphyllum alkaloid daphenylline

    NASA Astrophysics Data System (ADS)

    Lu, Zhaoyong; Li, Yong; Deng, Jun; Li, Ang

    2013-08-01

    The Daphniphyllum alkaloids are a large class of natural products isolated from a genus of evergreen plants widely used in Chinese herbal medicine. They display a remarkable range of biological activities, including anticancer, antioxidant, and vasorelaxation properties as well as elevation of nerve growth factor. Daphenylline is a structurally unique member among the predominately aliphatic Daphniphyllum alkaloids, and contains a tetrasubstituted arene moiety mounted on a sterically compact hexacyclic scaffold. Herein, we describe the first total synthesis of daphenylline. A gold-catalysed 6-exo-dig cyclization reaction and a subsequent intramolecular Michael addition reaction, inspired by Dixon's seminal work, were exploited to construct the bridged 6,6,5-tricyclic motif of the natural product at an early stage, and the aromatic moiety was forged through a photoinduced olefin isomerization/6π-electrocyclization cascade followed by an oxidative aromatization process.

  3. Total Laryngectomy – Past, Present, Future

    PubMed Central

    CEACHIR, Octavian; HAINAROSIE, Razvan; ZAINEA, Viorel

    2014-01-01

    In a period in which therapeutic approaches for malignant laryngeal tumors are focused on the principle of "organ preservation", total laryngectomy is a well coded surgical procedure, addressed to the advanced laryngeal cancer which is not suitable for conservative techniques or in case of their failure. The main objective of this work is to summarize the important events that have marked the evolution of this surgical technique to the current formula. Also this paper aims to identify, in our own casuistry, some elements of strategy and surgical technique required, in our opinion, for a successful therapeutic intervention. The fundamental significance of the study is that we must learn from the past, perform our surgeries at contemporary standards and look to the future for new solutions and approaches of the advanced laryngeal malignancies. PMID:25705281

  4. Total pressure averaging in pulsating flows

    NASA Technical Reports Server (NTRS)

    Krause, L. N.; Dudzinski, T. J.; Johnson, R. C.

    1972-01-01

    A number of total-pressure tubes were tested in a non-steady flow generator in which the fraction of period that pressure is a maximum is approximately 0.8, thereby simulating turbomachine-type flow conditions. Most of the tubes indicated a pressure which was higher than the true average. Organ-pipe resonance which further increased the indicated pressure was encountered within the tubes at discrete frequencies. There was no obvious combination of tube diameter, length, and/or geometry variation used in the tests which resulted in negligible averaging error. A pneumatic-type probe was found to measure true average pressure, and is suggested as a comparison instrument to determine whether nonlinear averaging effects are serious in unknown pulsation profiles. The experiments were performed at a pressure level of 1 bar, for Mach number up to near 1, and frequencies up to 3 kHz.

  5. Total Synthesis of Alkaloid 205B

    PubMed Central

    2015-01-01

    Concise and highly stereocontrolled total syntheses of racemic and enantiopure frog alkaloid 205B (1) were accomplished in 11 steps from 4-methoxypyridines 6 and 7 in overall yields of 8 and 8%, respectively. The assembly of the core of the natural product relies on a stereoselective Tsuji–Trost allylic amination reaction and a ring-closing metathesis. The synthesis features the use of an N-acylpyridinium salt reaction to introduce the first stereocenter and an unprecedented trifluoroacetic anhydride-mediated addition of an allylstannane to a vinylogous amide with complete facial selectivity. Deoxygenation of the C4 ketone proved difficult but was accomplished via a modified Barton–McCombie reaction in the presence of a catalytic amount of diphenyl diselenide. PMID:25180567

  6. p-MOSFET total dose dosimeter

    NASA Technical Reports Server (NTRS)

    Buehler, Martin G. (Inventor); Blaes, Brent R. (Inventor)

    1994-01-01

    A p-MOSFET total dose dosimeter where the gate voltage is proportional to the incident radiation dose. It is configured in an n-WELL of a p-BODY substrate. It is operated in the saturation region which is ensured by connecting the gate to the drain. The n-well is connected to zero bias. Current flow from source to drain, rather than from peripheral leakage, is ensured by configuring the device as an edgeless MOSFET where the source completely surrounds the drain. The drain junction is the only junction not connected to zero bias. The MOSFET is connected as part of the feedback loop of an operational amplifier. The operational amplifier holds the drain current fixed at a level which minimizes temperature dependence and also fixes the drain voltage. The sensitivity to radiation is made maximum by operating the MOSFET in the OFF state during radiation soak.

  7. Material Science in Cervical Total Disc Replacement

    PubMed Central

    Pham, Martin H.; Mehta, Vivek A.; Tuchman, Alexander; Hsieh, Patrick C.

    2015-01-01

    Current cervical total disc replacement (TDR) designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti), and cobalt-chrome (CoCr). These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common materials used in cervical TDR prosthetic devices, examine their bearing surfaces, describe the construction of the seven current cervical TDR devices that are approved for use in the United States, and discuss known adverse biological effects associated with long-term implantation of these materials. It is important to appreciate and understand the variety of biomaterials available in the design and construction of these prosthetics and the considerations which guide their implementation. PMID:26523281

  8. The total synthesis of Isodon diterpenes.

    PubMed

    Lazarski, Kiel E; Moritz, Benjamin J; Thomson, Regan J

    2014-09-26

    Families of structurally related molecules often provide stimulating targets for organic chemists that are engaged in the development of new methods and strategies for natural product synthesis. While typically focused on specific molecules, these synthetic investigations often lead to generalizable concepts and significant opportunities for learning in a greater sense. Historically well-investigated families of natural products, such as the prostanoids, indole alkaloids, and macrolide antibiotics, provide ample evidence for the enduring value of these collective activities. In this Minireview, we turn our attention to the polycyclic family of diterpenes isolated from the Isodon genus of plants and provide an account of the recent methods and strategies utilized for their total synthesis. PMID:25159338

  9. Total hip arthroplasty after rotational acetabular osteotomy.

    PubMed

    Ito, Hideya; Takatori, Yoshio; Moro, Toru; Oshima, Hirofumi; Oka, Hiroyuki; Tanaka, Sakae

    2015-03-01

    In this study, we aimed to determine whether the outcomes of total hip arthroplasty (THA) after rotational acetabular osteotomy (RAO) are equal to those of primary THA, and to elucidate the characteristics of THA after RAO. The clinical and radiographic findings of THA after RAO (44 hips), with minimum 24 months of follow-up, were compared with a matched control group of 58 hips without prior RAO. We found that the outcomes in terms of functional scores and complication rates did not differ between THA after RAO and THA without previous pelvic osteotomy, indicating that the results of THA after RAO are equivalent to those of primary THA. Although THA after RAO requires technical considerations, similar clinical outcomes to primary THA can be expected. PMID:25456635

  10. Total Mercury in Six Antarctic Notothenioid Fishes.

    PubMed

    Wintle, Nathan J P; Sleadd, Isaac M; Gundersen, Deke T; Kohl, Kristina; Buckley, Bradley A

    2015-11-01

    We analyzed white muscle samples from six species of Antarctic fish (suborder Notothenioidei) collected in 2011 from McMurdo Sound, Ross Sea, Antarctica, to assess levels of total mercury (THg). Gymnodraco acuticeps and Trematomus bernacchii exhibited the highest concentrations of THg followed by Trematomus pennellii, Trematomus nicolai, Trematomus newnesi and Pagothenia borchgrevinki, (71.3, 53.9±32.1, 45.8±27.3, 37.2±18.6, 35.7±23.6, and 21.9±2.8 ng/g wet weight, respectively). The results from this study suggest that THg has the potential to bioaccumulate from various marine Antarctic ecosystems into biota.

  11. Changes in total body water during spaceflight

    NASA Technical Reports Server (NTRS)

    Leach, Carolyn S.; Inners, L. D.; Charles, John B.

    1991-01-01

    Total body water (TBW) changes occurring in humans as a consequence of prolonged exposure to microgravity were measured in five male crewmembers of Space Shuttle missions STS-61C and STS-26. It was found that the inflight mean TBW values were significantly different from the preflight and postflight values, while the preflight TBW values were not significantly different from the postflight values. It was also found that individuals may differ in the rate at which they respond to weightlessness. Of the three crewmen who reported experiencing no symptoms of space motion sickness (SMS), two had not exhibited a decrease of TBW at the time of measurements (24 hrs after launch), while the two crewmen who reported SMS of intermediate severity showed a decrease of several kg by 24 hrs, suggesting that dehydration might be an important factor affecting the rate of TBW decrease.

  12. UPRE method for total variation parameter selection

    SciTech Connect

    Wohlberg, Brendt; Lin, Youzuo

    2008-01-01

    Total Variation (TV) Regularization is an important method for solving a wide variety of inverse problems in image processing. In order to optimize the reconstructed image, it is important to choose the optimal regularization parameter. The Unbiased Predictive Risk Estimator (UPRE) has been shown to give a very good estimate of this parameter for Tikhonov Regularization. In this paper we propose an approach to extend UPRE method to the TV problem. However, applying the extended UPRE is impractical in the case of inverse problems such as de blurring, due to the large scale of the associated linear problem. We also propose an approach to reducing the large scale problem to a small problem, significantly reducing computational requirements while providing a good approximation to the original problem.

  13. Total Monte Carlo evaluation for dose calculations.

    PubMed

    Sjöstrand, H; Alhassan, E; Conroy, S; Duan, J; Hellesen, C; Pomp, S; Österlund, M; Koning, A; Rochman, D

    2014-10-01

    Total Monte Carlo (TMC) is a method to propagate nuclear data (ND) uncertainties in transport codes, by using a large set of ND files, which covers the ND uncertainty. The transport code is run multiple times, each time with a unique ND file, and the result is a distribution of the investigated parameter, e.g. dose, where the width of the distribution is interpreted as the uncertainty due to ND. Until recently, this was computer intensive, but with a new development, fast TMC, more applications are accessible. The aim of this work is to test the fast TMC methodology on a dosimetry application and to propagate the (56)Fe uncertainties on the predictions of the dose outside a proposed 14-MeV neutron facility. The uncertainty was found to be 4.2 %. This can be considered small; however, this cannot be generalised to all dosimetry applications and so ND uncertainties should routinely be included in most dosimetry modelling.

  14. Total nitrogen content of deep sea basalts

    NASA Technical Reports Server (NTRS)

    Norris, T. L.; Schaeffer, O. A.

    1982-01-01

    An estimate of the total nitrogen content of the earth's mantle, aimed at furnishing a further constraint for earth atmosphere origin and evolution models, was attempted through thermal neutron activation analysis via N-14(n,p)C-14 for the case of deep sea basalt glasses from the East Pacific Rise, the Mid-Atlantic Rift, and the Juan de Fuca Ridge. The increased nitrogen abundance of matrix material from the same samples as the glasses may be due to the incorporation of chemically-bound nitrogen from sea water, rather than dissolved molecular nitrogen. A discussion is presented of factors affecting observed basalt nitrogen content and its interpretation in terms of mantle nitrogen abundance. A 2 ppm N lower limit is estimated for the mantle.

  15. Aggregated Total Internal Reflection Optics for Solar

    NASA Astrophysics Data System (ADS)

    Schultz, David; Grimmer, Chris; Fine, Kevin; Evans, Matt; Ghosh, Shondip

    2010-10-01

    An agglomeration of factors has stifled the economic promise of CPV. Foremost among these factors are: insufficient optical efficiency, misfit with existing solar infrastructure, high costs, and inadequate reliability of the optic-receiver package. These difficulties are significantly driven by the choice of optic. The CPV industry is constrained in a paradigm of bulky reflective or refractive optics that operate best at either low concentration (2-5x) or high concentration (100x and above). Low concentration approaches are plagued by marginal economics, while high concentration approaches face technical risks and do not fit well with the existing solar infrastructure. Using total internal reflection as the primary optical mechanism, a cost effective, line-focus optic can be produced at scale to provide superior optical performance in a flat profile and operate at a mid level of concentration to optimize the tradeoff between economic benefit and adoptability.

  16. NASA total quality management 1989 accomplishments report

    NASA Technical Reports Server (NTRS)

    Tai, Betty P. (Editor); Stewart, Lynne M. (Editor)

    1990-01-01

    NASA and contractor employees achieved many notable improvements in 1989. The highlights of those improvements, described in this seventh annual Accomplishments Report, demonstrate that the people who support NASA's activities are getting more involved in quality and continuous improvement efforts. Their gains solidly support NASA's and this Nation's goal to remain a leader in space exploration and in world-wide market competition, and, when communicated to others through avenues such as this report, foster improvement efforts across government and industry. The principles in practice which led to these process refinements are important cultural elements to any organization's productivity and quality efforts. The categories in this report reflect NASA principles set forth in the 1980's and are more commonly known today as Total Quality Management (TQM): top management leadership and support; strategic planning; focus on the customer; employee training and recognition; employee empowerment and teamwork; measurement and analysis; and quality assurance.

  17. Asymmetric Total Synthesis of (-)-Lycospidine A.

    PubMed

    Xu, Shiyan; Zhang, Jing; Ma, Donghui; Xu, Dengyu; Xie, Xingang; She, Xuegong

    2016-09-16

    The first asymmetric total synthesis of the structurally unique Lycopodium alkaloid (-)-lycospidine A, containing an unprecedented five-membered ring, has been accomplished in only 10 steps with 21.6% overall yield from the known conveniently available sulfoxide. This protecting-group-free short synthesis relied on the use of a key amidation/aza-Prins domino cyclization reaction to rapidly construct the tricyclic skeleton and two continuous stereocenters (one of which is a bridged quaternary stereocenter). An intramolecular aldol condensation was successfully utilized to establish the unique five-membered ring, and a late-stage oxidation inspired by biosynthesis pathway was adopted to synthesize the diosphenol ring of (-)-lycospidine A. PMID:27565006

  18. Enantioselective Total Synthesis of (-)-Alstoscholarisine A.

    PubMed

    Liang, Xiao; Jiang, Shi-Zhi; Wei, Kun; Yang, Yu-Rong

    2016-03-01

    We report a concise and highly enantioselective total synthesis of (-)-alstoscholarisine A (1), a recently isolated monoterpenoid indole alkaloid that has significant bioactivity in promoting adult neuronal stem cells proliferation. A highly enantioselective (99% ee), intramolecular Ir-catalyzed Friedel-Crafts alkylation of indole 9 with a secondary allylic alcohol was utilized to establish the first stereogenic center upon which the other three contiguous chiral centers were readily set by a highly stereoselective tandem 1,4-addition and aldol reaction. The key tetrahydropyran was constructed through a hemiacetal reduction, and the final aminal bridge was forged by a one-pot reductive amination/cyclization. The conciseness of this approach was highlighted by building core bonds in each step with a minimalist protecting group strategy. PMID:26882407

  19. Ovarian vein thrombosis following total laparoscopic hysterectomy.

    PubMed

    Tanaka, Yusuke; Kato, Hiroyasu; Hosoi, Ayako; Isobe, Masanori; Koyama, Shinsuke; Shiki, Yasuhiko

    2012-11-01

    Ovarian vein thrombosis usually occurs in pregnant patients, especially during the postpartum period. However, it is a rare complication following laparoscopic surgery in gynecology. The risk of a thromboembolic event is not well defined, and evidence-based guidelines regarding deep vein thrombosis prophylaxis in gynecological laparoscopic surgery are still lacking. Herein we report a rare case of ovarian vein thrombosis following total laparoscopic hysterectomy in a 35-year-old woman who developed a fever of unknown origin on postoperative day 3. A complete fever work-up was done. Her urine, vaginal stump and blood culture were all negative, and her white blood cell count was normal. CT revealed left ovarian vein thrombosis. The patient responded well to anticoagulation in conjunction with antibiotic therapy.

  20. Patellofemoral resurfacing at total knee arthroplasty.

    PubMed

    Harwin, S F; Stein, A J; Stern, R E

    1994-10-01

    A retrospective review of 268 primary total knee arthroplasties (TKAs) with a mean follow-up of four years is presented. The patellae were resurfaced in all cases. There were six complications (2.2%) referable to the patellofemoral articulation: three subluxations, one patellar fracture, one loosening of a metal-backed patellar component, and one patellar tendon avulsion. Successful patellofemoral resurfacing (PFR) can be accomplished with minimal complications if the following technical considerations are met: 5-7 degrees of valgus alignment; medial placement of the patellar component; taking care not to increase either the AP diameter of the knee or the thickness of the patella; avoiding internal rotation of either the tibial or femoral components and proper soft tissue balancing. A thorough review of patellofemoral complications after TKA is presented, and technical considerations relevant to the successful performance of PFR are discussed.

  1. Total least squares for anomalous change detection

    NASA Astrophysics Data System (ADS)

    Theiler, James; Matsekh, Anna M.

    2010-04-01

    A family of subtraction-based anomalous change detection algorithms is derived from a total least squares (TLSQ) framework. This provides an alternative to the well-known chronochrome algorithm, which is derived from ordinary least squares. In both cases, the most anomalous changes are identified with the pixels that exhibit the largest residuals with respect to the regression of the two images against each other. The family of TLSQbased anomalous change detectors is shown to be equivalent to the subspace RX formulation for straight anomaly detection, but applied to the stacked space. However, this family is not invariant to linear coordinate transforms. On the other hand, whitened TLSQ is coordinate invariant, and special cases of it are equivalent to canonical correlation analysis and optimized covariance equalization. What whitened TLSQ offers is a generalization of these algorithms with the potential for better performance.

  2. Fracture Blisters After Primary Total Knee Arthroplasty.

    PubMed

    Halawi, Mohamad J

    2015-08-01

    Fracture blisters are tense vesicles that arise on markedly swollen skin overlying traumatized soft tissue. While this relatively uncommon complication has been well described in the trauma literature, this article reports for the first time a case of fracture blisters after primary total knee arthroplasty. The fracture blisters developed within 36 hours of surgery and were associated with profound swelling and erythema. There was no evidence of vascular injury, compartment syndrome, iatrogenic fracture, or deep venous thrombosis. The patient was treated with leg elevation, loosely applied nonadhesive dressings, and a short course of oral antibiotics after skin desquamation. Blood-filled blisters required longer time to reepithelialization than fluid-filled blisters. Knee stiffness developed because of pain and fear of participation with physical therapy, but the patient was able to resume intensive rehabilitation after resolution of the blisters. Patient factors, surgical factors, and review of the literature are discussed. PMID:26251947

  3. Fixed flexion deformity and total knee arthroplasty.

    PubMed

    Su, E P

    2012-11-01

    Fixed flexion deformities are common in osteoarthritic knees that are indicated for total knee arthroplasty. The lack of full extension at the knee results in a greater force of quadriceps contracture and energy expenditure. It also results in slower walking velocity and abnormal gait mechanics, overloading the contralateral limb. Residual flexion contractures after TKA have been associated with poorer functional scores and outcomes. Although some flexion contractures may resolve with time after surgery, a substantial percentage will become permanent. Therefore, it is essential to correct fixed flexion deformities at the time of TKA, and be vigilant in the post-operative course to maintain the correction. Surgical techniques to address pre-operative flexion contractures include: adequate bone resection, ligament releases, removal of posterior osteophytes, and posterior capsular releases. Post-operatively, extension can be maintained with focused physiotherapy, a specially modified continuous passive motion machine, a contralateral heel lift, and splinting.

  4. Trends in total knee arthroplasty implant utilization.

    PubMed

    Nguyen, Long-Co L; Lehil, Mandeep S; Bozic, Kevin J

    2015-05-01

    The incidence of total knee arthroplasty (TKA) has increased alongside our knowledge of knee physiology, kinematics, and technology resulting in an evolution of TKA implants. This study examines the trends in TKA implant utilization. Data was extracted from The Orthopedic Research Network to evaluate trends in level of constraint, fixed vs. mobile bearing, fixation, and type of polyethylene in primary TKAs. In 2012, 88% used cemented femoral and tibial implants, and 96% involved patellar resurfacing. 38% of implants were cruciate retaining, 53% posterior stabilized or condylar stabilized, 3% constrained. 91% were fixed-bearing, 7% mobile-bearing. 52% of tibial inserts were HXLPE. TKA implant trends demonstrate a preference for cemented femoral and tibial components, patellar resurfacing, fixed-bearing constructs, metal-backed tibial components, patellar resurfacing, and increased usage of HXLPE liners. PMID:25613663

  5. Blood Management Strategies in Total Knee Arthroplasty

    PubMed Central

    Dan, Michael; Martinez Martos, Sara; Beller, Elaine

    2016-01-01

    A perioperative blood management program is one of a number of important elements for successful patient care in total knee arthroplasty (TKA) and surgeons should be proactive in its application. The aims of blood conservation are to reduce the risk of blood transfusion whilst at the same time maximizing hemoglobin (Hb) in the postoperative period, leading to a positive effect on outcome and cost. An individualized strategy based on patient specific risk factors, anticipated blood loss and comorbidities are useful in achieving this aim. Multiple blood conservation strategies are available in the preoperative, intraoperative and postoperative periods and can be employed in various combinations. Recent literature has highlighted the importance of preoperative Hb optimization, minimizing blood loss and evidence-based transfusion guidelines. Given TKA is an elective procedure, a zero allogenic blood transfusion rate should be the aim and an achievable goal. PMID:27595070

  6. Material Science in Cervical Total Disc Replacement.

    PubMed

    Pham, Martin H; Mehta, Vivek A; Tuchman, Alexander; Hsieh, Patrick C

    2015-01-01

    Current cervical total disc replacement (TDR) designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti), and cobalt-chrome (CoCr). These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common materials used in cervical TDR prosthetic devices, examine their bearing surfaces, describe the construction of the seven current cervical TDR devices that are approved for use in the United States, and discuss known adverse biological effects associated with long-term implantation of these materials. It is important to appreciate and understand the variety of biomaterials available in the design and construction of these prosthetics and the considerations which guide their implementation.

  7. Blood Management Strategies in Total Knee Arthroplasty.

    PubMed

    Liu, David; Dan, Michael; Martinez Martos, Sara; Beller, Elaine

    2016-09-01

    A perioperative blood management program is one of a number of important elements for successful patient care in total knee arthroplasty (TKA) and surgeons should be proactive in its application. The aims of blood conservation are to reduce the risk of blood transfusion whilst at the same time maximizing hemoglobin (Hb) in the postoperative period, leading to a positive effect on outcome and cost. An individualized strategy based on patient specific risk factors, anticipated blood loss and comorbidities are useful in achieving this aim. Multiple blood conservation strategies are available in the preoperative, intraoperative and postoperative periods and can be employed in various combinations. Recent literature has highlighted the importance of preoperative Hb optimization, minimizing blood loss and evidence-based transfusion guidelines. Given TKA is an elective procedure, a zero allogenic blood transfusion rate should be the aim and an achievable goal. PMID:27595070

  8. Total parenteral nutrition-induced cyclic hypercapnia.

    PubMed

    Jannace, P W; Lerman, R H; Dennis, R C; Aalyson, M; Yeston, N S

    1988-07-01

    Excessive rates of carbohydrate infusion during total parenteral nutrition (TPN) have been reported to cause hypercapnia leading to respiratory failure or inability to wean from a ventilator. This case history illustrates the hitherto unreported syndrome of cyclic hypercapnia resulting from high rates of carbohydrate infusion during peak TPN flow rates when TPN was provided in a cyclic fashion. The patient was given TPN daily over an 18 1/2-h period followed by 5 1/2 h without nutritional support. Elevated CO2 production, increased respiratory quotient, hypercapnia, and inability to wean from a ventilator occurred during peak cycle TPN flow rates. When the same carbohydrate load was infused continuously over a 24-h period, CO2 production, respiratory quotient and PaCO2 were reduced. The patient was then able to tolerate periods of unassisted ventilation.

  9. Development of a totally implantable artificial heart.

    PubMed

    Rowles, J R; Khanwilkar, P S; Diegel, P D; Hansen, A C; Bearnson, G B; Smith, K D; Tatsumi, E; Olsen, D B

    1992-01-01

    The first generation of an integrated, totally implantable electrohydraulic total artificial heart was designed for long-term cardiac replacement. The system consists of an elliptical blood pump with an interatrial shunt, Medtronic-Hall 27 mm and 25 mm inflow and outflow valves, respectively, an energy converter consisting of an axial-flow, hydraulic pump driven by a brushless DC motor, and an electronics system with transcutaneous energy transmission and telemetry. Energy is supplied by internal nickel-cadmium rechargeable batteries that supply power for 20 min and external silver-zinc batteries that are designed to supply energy to run the system for 5 hr. The blood pump consists of a single layer diaphragm cast from Biolon, with joined right and left ventricles sharing a common base. The dynamic stroke volume is 84 ml, and maximum cardiac output is 9.2 L/min at a heart rate of 110 beats/min on the mock circulation. A 4.3 mm diameter interatrial shunt is used to balance the volumetrically coupled ventricles. The energy converter pumps hydraulic fluid alternately between ventricles, with controlled, active filling in one ventricle during the systolic phase of the other ventricle. Internal or external controllers adjust the heart rate and motor speed to maintain normal atrial filling pressures and full stroke. Electromagnetic induction is used to transfer energy through the skin and a bidirectional infrared data link incorporated within the transcutaneous energy transmission coils is used to transmit information. The entire system is being assembled and refined for long-term animal implant studies. PMID:1457955

  10. Total hip arthroplasty and bone fragility.

    PubMed

    Cherubino, Paolo; Ratti, Chiara; Fagetti, Alessandro; Binda, Tommaso

    2011-04-01

    The number of elderly people is steadily increasing: in the United States it will increase from 12.9% to 20% in 2030 with respect to the total population. Italy, with UK, Denmark and Sweden are the countries with the largest number of octogenarians (about 4% of the population) and it is estimated that this rate will increase by 300% over the next 50 years. The number of people affected by osteoarthritis will increase significantly and therefore the number of total hip arthroplasties will progressively increase. The success of an implant depends firstly by a flawless surgical technique, a correct and stable implant fixation and an optimal preoperative planning that should consider the bone quality of the patient, in order to choose a proper implant design. Different approaches could be followed to achieve adequate fixation: northern Europe surgeons prefer the cemented implant, instead American orthopedics generally use systems that allow a direct biological osteointegration. Elderly patients often present with multiple local and general problems that could affect significantly the normal course of a prosthetic surgery procedure and its results: they have bone tissue changes that lead to increased bone fragility and, consequently, difficulties to obtain primary stability. Osteoporotic bone is characterized by reduction of bone mass, decrease of cancellous bone trabeculae and by increased porosity of cortical bone. The bone fragility implies a greater risk of iatrogenic intraoperative fractures. Furthermore, difficulties linked to bone stock deficiencies become even more significant in revision surgery, where cortical bone thinning is associated with enlargement of the isthmus thus making more difficult to obtain distal fixation of prosthetic stems. At the moment, the role played by the drugs used for the treatment of osteoporosis during implant osteointegration is still not clearly understood and is still under investigation.

  11. Minimally invasive total hip arthroplasty: in opposition.

    PubMed

    Hungerford, David S

    2004-06-01

    At the Knee Society Winter Meeting in 2003, Seth Greenwald and I debated about whether there should be new standards (ie, regulations) applied to the release of information to the public on "new developments." I argued for the public's "right to know" prior to the publication of peer-reviewed literature. He argued for regulatory constraint or "proving by peer-reviewed publication" before alerting the public. It is not a contradiction for me to currently argue against the public advertising of minimally invasive (MIS) total hip arthroplasty as not yet being in the best interest of the public. It is hard to remember a concept that has so captured both the public's and the surgical community's fancy as MIS. Patients are "demanding" MIS without knowing why. Surgeons are offering it as the next best, greatest thing without having developed the skill and experience to avoid the surgery's risks. If you put "minimally invasive hip replacement" into the Google search engine (http://www.google.com), you get 5,170 matches. If you put the same words in PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi), referencing the National Library of Medicine database, you get SEVENTEEN; none is really a peer-reviewed article. Most are 1 page papers in orthopedics from medical education meetings. On the other hand, there are over 6,000 peer-reviewed articles on total hip arthroplasty. Dr. Thomas Sculco, my couterpart in this debate, wrote an insightful editorial in the American Journal of Orthopedic Surgery in which he stated: "Although these procedures have generated incredible interest and enthusiasm, I am concerned that they may be performed to the detriment of our patients." I couldn't agree with him more. Smaller is not necessarily better and, when it is worse, it will be the "smaller" that is held accountable.

  12. Total ankle prostheses in rheumatoid arthropathy

    PubMed Central

    Schutte, Bernard; Louwerens, Jan Willem K; van den Hoogen, Frank H J; de Waal Malefijt, Maarten C

    2009-01-01

    Background and purpose The first generations of total ankle replacements (TARs) showed a high rate of early failure. In the last decades, much progress has been made in the development of TARs, with the newer generation showing better results. We evaluated TARs implanted with rheumatoid arthritis (RA) or juvenile inflammatory arthritis (JIA) as indication. Patients and methods 58 total ankle prostheses (Buechel-Pappas and STAR type) were implanted in patients with RA (n = 53) or JIA (n = 5) in 54 patients (4 bilateral). After a mean follow-up of 2.7 (1–9) years, all patients were reviewed by two orthopedic surgeons who were not the surgeons who performed the operation. Standard AP and lateral radiographs were taken and a Kofoed ankle score was obtained; this is a clinical score ranging from 0–100 and consists of sub-scores for pain, disability, and range of motion. Results 2 patients died of unrelated causes. Of the 52 patients who were alive (56 prostheses), 51 implants were still in place and showed no signs of loosening on the most recent radiographs. The mean Kofoed score at follow-up was 73 points (SD 16, range 21–92). 4 patients showed a poor result (score < 50) with persistent pain for which no obvious reason could be found. 5 implants were removed, 4 because of infection and 1 because of aseptic loosening. Interpretation Medium-term results of the STAR and BP types of TAR in RA were satisfactory. The main reason for failure of the implant was infection. PMID:19634020

  13. Total Percutaneous Aortic Repair: Midterm Outcomes

    SciTech Connect

    Bent, Clare L. Fotiadis, Nikolas; Renfrew, Ian; Walsh, Michael; Brohi, Karim; Kyriakides, Constantinos; Matson, Matthew

    2009-05-15

    The purpose of this study was to examine the immediate and midterm outcomes of percutaneous endovascular repair of thoracic and abdominal aortic pathology. Between December 2003 and June 2005, 21 patients (mean age: 60.4 {+-} 17.1 years; 15 males, 6 females) underwent endovascular stent-graft insertion for thoracic (n = 13) or abdominal aortic (n = 8) pathology. Preprocedural computed tomographic angiography (CTA) was performed to assess the suitability of aorto-iliac and common femoral artery (CFA) anatomy, including the degree of CFA calcification, for total percutaneous aortic stent-graft repair. Percutaneous access was used for the introduction of 18- to 26-Fr delivery devices. A 'preclose' closure technique using two Perclose suture devices (Perclose A-T; Abbott Vascular) was used in all cases. Data were prospectively collected. Each CFA puncture site was assessed via clinical examination and CTA at 1, 6, and 12 months, followed by annual review thereafter. Minimum follow-up was 36 months. Outcome measures evaluated were rates of technical success, conversion to open surgical repair, complications, and late incidence of arterial stenosis at the site of Perclose suture deployment. A total of 58 Perclose devices were used to close 29 femoral arteriotomies. Outer diameters of stent-graft delivery devices used were 18 Fr (n = 5), 20 Fr (n = 3), 22 Fr (n = 4), 24 Fr (n = 15), and 26 Fr (n = 2). Percutaneous closure was successful in 96.6% (28/29) of arteriotomies. Conversion to surgical repair was required at one access site (3.4%). Mean follow-up was 50 {+-} 8 months. No late complications were observed. By CT criteria, no patient developed a >50% reduction in CFA caliber at the site of Perclose deployment during the study period. In conclusion, percutaneous aortic stent-graft insertion can be safely performed, with a low risk of both immediate and midterm access-related complications.

  14. Activation of Complement Following Total Hip Replacement.

    PubMed

    Thordardottir, S; Vikingsdottir, T; Bjarnadottir, H; Jonsson, H; Gudbjornsson, B

    2016-03-01

    The aim of this study was to investigate whether complement activation, via the classical and alternative pathways, occurs following a cemented total hip replacement (THR) surgery due to osteoarthritis. Blood samples were collected systematically from 12 patients - six male and six women, with a median age of 75 (range: 59-90 years) - preoperatively, 6 h post-operatively and on the first, second and third post-operative day. Total function of classical (CH50) and alternative pathways (AH50) was evaluated, along with the determination of serum concentrations of the complement proteins C3, C4, C3d, the soluble terminal complement complex (sTCC) sC5b-9, as well as C-reactive protein (CRP) and albumin. Measurements of CRP and albumin levels elucidated a marked inflammatory response following the operation. The CH50, AH50 and C3 and C4 levels were significantly lower 6 h after the surgery compared with the preoperative levels, but elevated above the preoperative levels during the following 3 days. The complement activation product C3d levels increased continually during the whole observation period, from 13.5 AU/ml (range: 8-19 AU/ml) preoperative to 20 AU/ml (range: 12-34 AU/ml) on the third post-operative day. Furthermore, we observed an increase in the sC5b-9 levels between the preoperative and the third post-operative day. These results demonstrate a significant activation of the complement system following cemented THR. Further studies are needed to elucidate the time frame and the pathogenic role of this observed complement activation.

  15. Effect of calorie restriction on energy expenditure in overweight and obese adult women.

    PubMed

    Jiménez Jaime, Teresa; Leiva Balich, Laura; Barrera Acevedo, Gladys; de la Maza Cave, María Pía; Hirsch Birn, Sandra; Henríquez Parada, Sandra; Rodríguez Silva, Juan; Bunout Barnett, Daniel

    2015-06-01

    El gasto energetico (GE) puede disminuir en sujetos sometidos a dietas hipocaloricas, en una magnitud que excede la reduccion explicada por los cambios en la composicion corporal; dificultando la mantencion del peso perdido. Objetivo: verificar si el Gasto Energetico en Reposo (GER) y Total (GET) experimentan una disminucion mayor a lo atribuible a cambios en la composicion corporal y dependen de la adherencia al tratamiento dietario. Metodología: veintidos mujeres (23-44 anos) con Indice de Masa Corporal (IMC) entre 25 y 32 kg/m2 fueron sometidas a tres meses de restriccion calorica (20 kcal/kg de peso inicial) y motivadas a aumentar su actividad fisica. Al inicio y al final se evaluo: peso, masa grasa (MG) y masa libre de grasa (MLG) con DEXA, GER (calorimetria indirecta), Gasto Energetico por Actividad Fisica (GEAF) y GET (actigrafia). Las participantes que perdieron ≥ 5% del peso inicial fueron consideradas como adherentes a la dieta. Resultados: el grupo adherente tuvo una disminucion significativa del GER absoluto [-164 } 168 kcal/dia (10,6%) y -4,3 } 4,6 kcal/kg MLG (10,5%)]. Esta disminucion fue significativamente mayor que la observada en el grupo no adherente [-6,2 } 1.42 kcal/dia (0.16%) y -0,5 } 3,4/kg FFM (0.96%)]. La MLG no cambio en ninguno de los dos grupos. Existio asociacion significativa entre MLG y GER (r = 0,56; p < 0,05) solo al inicio en el grupo total. Conclusiones: las mujeres adherentes a la restriccion calorica mostraron una reduccion en el GER tanto absoluto como ajustado por la MLG, lo cual, junto con la perdida de correlacion entre el GER y la MLG al final de la intervencion, sugieren adaptacion metabolica.

  16. Image-guided total marrow and total lymphatic irradiation using helical tomotherapy

    SciTech Connect

    Schultheiss, Timothy E. . E-mail: Schultheiss@coh.org; Wong, Jeffrey; Liu, An; Olivera, Gustavo; Somlo, George

    2007-03-15

    Purpose: To develop a treatment technique to spare normal tissue and allow dose escalation in total body irradiation (TBI). We have developed intensity-modulated radiotherapy techniques for the total marrow irradiation (TMI), total lymphatic irradiation, or total bone marrow plus lymphatic irradiation using helical tomotherapy. Methods and Materials: For TBI, we typically use 12 Gy in 10 fractions delivered at an extended source-to-surface distance (SSD). Using helical tomotherapy, it is possible to deliver equally effective doses to the bone marrow and lymphatics while sparing normal organs to a significant degree. In the TMI patients, whole body skeletal bone, including the ribs and sternum, comprise the treatment target. In the total lymphatic irradiation, the target is expanded to include the spleen and major lymph node areas. Sanctuary sites for disease (brain and testes) are included when clinically indicated. Spared organs include the lungs, esophagus, parotid glands, eyes, oral cavity, liver, kidneys, stomach, small and large intestine, bladder, and ovaries. Results: With TBI, all normal organs received the TBI dose; with TMI, total lymphatic irradiation, and total bone marrow plus lymphatic irradiation, the visceral organs are spared. For the first 6 patients treated with TMI, the median dose to organs at risk averaged 51% lower than would be achieved with TBI. By putting greater weight on the avoidance of specific organs, greater sparing was possible. Conclusion: Sparing of normal tissues and dose escalation is possible using helical tomotherapy. Late effects such as radiation pneumonitis, veno-occlusive disease, cataracts, neurocognitive effects, and the development of second tumors should be diminished in severity and frequency according to the dose reduction realized for the organs at risk.

  17. Coronal Dynamics at Recent Total Solar Eclipses

    NASA Astrophysics Data System (ADS)

    Pasachoff, J. M.; Lu, M.; Davis, A. B.; Demianski, M.; Rusin, V.; Saniga, M.; Seaton, D. B.; Lucas, R.; Babcock, B. A.; Dantowitz, R.; Gaintatzis, P.; Seeger, C. H.; Malamut, C.; Steele, A.

    2014-12-01

    Our composite images of the solar corona based on extensive imaging at the total solar eclipses of 2010 (Easter Island), 2012 (Australia), and 2013 (Gabon) reveal several coronal mass ejections and other changes in coronal streamers and in polar plumes. Our resultant spatial resolution is finer than that available in imaging from spacecraft, including that from SOHO/LASCO or STEREO. We trace the eruptions back to their footpoints on the sun using imaging from SDO and SWAP, and follow them upwards through the corona, measuring velocities. The high-resolution computer compositing by Miloslav Druckmüller and Hana Druckmüllerová (2010 and 2013) and Pavlos Gaintatzis (2012) allows comparison of our images with those taken at intervals of minutes or hours along the totality path. Williams College's 2013 eclipse expedition was supported in part by grant 9327-13 from National Geographic Society/Committee for Research and Exploration. Our work on the 2012 eclipse is supported in part by grant AGS-1047726 from Solar Terrestrial Research/NSF AGS. V.R. and M.S. were partially supported by the VEGA grant agency project 2/0098/10 and 2/0003/13 (Slovak Academy of Sciences) and Grant 0139-12 from NG/CRE, and Hana Druckmüllerová by grant 205/09/1469 of the Czech Science Foundation. M.L. was supported by Sigma Xi. C.M. was a Keck Northeast Astronomy Consortium Summer Fellow, supported at Williams College by REU/NSF grant AST-1005024. Partial support was provided by U.S. Department of Defense's ASSURE program. J.M.P. thanks Caltech's Planetary Sciences Department for hospitality. Support for D.B.S. and SWAP came from PRODEX grant C90345 managed by ESA in collaboration with the Belgian Federal Science Policy Office (BELSPO) in support of the PROBA2/SWAP mission, and from the EC's Seventh Framework Programme (FP7/2007-2013) under grant 218816 (SOTERIA project, www.soteria-space.eu). SWAP is a project of the Centre Spatial de Liège and the Royal Observatory of Belgium funded by

  18. Total intravenous anesthesia for major burn surgery

    PubMed Central

    Cancio, Leopoldo C; Cuenca, Phillip B; Walker, Stephen C; Shepherd, John M

    2013-01-01

    Total intravenous anesthesia (TIVA) is frequently used for major operations requiring general anesthesia in critically ill burn patients. We reviewed our experience with this approach. Methods: During a 22-month period, 547 major burn surgeries were performed in this center’s operating room and were staffed by full-time burn anesthesiologists. The records of all 123 TIVA cases were reviewed; 112 records were complete and were included. For comparison, 75 cases were selected at random from a total of 414 non-TIVA general anesthetics. Some patients had more than one operation during the study: as appropriate for the analysis in question, each operation or each patient was entered as an individual case. For inter-patient analysis, exposure to 1 or more TIVAs was used to categorize a patient as member of the TIVA group. Results: Excision and grafting comprised 78.2% of the operations. 14 TIVA regimens were used, employing combinations of 4 i.v. drugs: ketamine (K, 91 cases); i.v. methadone (M, 62); fentanyl (F, 58); and propofol (P, 21). The most common regimens were KM (34 cases); KF (26); KMF (16); and K alone (8). Doses used often exceeded those used in non-burn patients. TIVA was preferred for those patients who were more critically ill prior to surgery, with a higher ASA score (3.87 vs. 3.11). Consistent with this, inhalation injury (26.7 vs. 1.6%), burn size (TBSA, 36.3 vs. 15.8%), and full-thickness burn size (FULL, 19.8 vs. 6.5%) were higher in TIVA than in non-TIVA patients. Despite this, intraoperative pressor use was as common in TIVA as in non-TIVA cases (23.9 vs. 22.7%). Conclusions: TIVA was used in patients whose inhalation injury rate and TBSA were greater than those of non-TIVA patients. TIVA cases were not associated with increased hemodynamic instability. TIVA is a viable approach to general anesthesia in critically ill burn patients. PMID:23638329

  19. Efficient oil palm total RNA extraction with a total RNA extraction kit.

    PubMed

    Habib, S H; Saud, H M; Kausar, H

    2014-01-01

    Oil palm tissues are rich in polyphenols, polysaccharides and secondary metabolites; these can co-precipitate with RNA, causing problems for downstream applications. We compared two different methods (one conventional and a kit-based method - Easy-Blue(TM) Total RNA Extraction Kit) to isolate total RNA from leaves, roots and shoot apical meristems of tissue culture derived truncated leaf syndrome somaclonal oil palm seedlings. The quality and quantity of total RNA were compared through spectrophotometry and formaldehyde gel electrophoresis. The specificity and applicability of the protocols were evaluated for downstream applications, including cDNA synthesis and RT-PCR analysis. We found that the conventional method gave higher yields of RNA but took longer, and it was contaminated with genomic DNA. This method required extra genomic DNA removal steps that further reduced the RNA yield. The kit-based method, on the other hand, produced good yields as well as well as good quality RNA, within a very short period of time from a small amount of starting material. Moreover, the RNA from the kit-based method was more suitable for synthesizing cDNA and RT-PCR amplification than the conventional method. Therefore, we conclude that the Easy-BlueTM Total RNA Extraction Kit method is suitable and superior for isolation of total RNA from oil palm leaf, root and shoot apical meristem. PMID:24781991

  20. Preliminary total dose measurements on LDEF.

    PubMed

    Reitz, G

    1992-01-01

    After spending nearly six years in Earth orbit twenty stacks consisting of radiation detectors and biological objects are now back on Earth. These stacks (Experiment A0015 Free Flyer Biostack) are part of the fifty seven science and technology experiments of the Long Duration Exposure Facility (LDEF) of NASA. The major objectives of the Free Flyer Biostack experiments are to investigate the biological effectiveness of single heavy ions of the cosmic radiation in various biological systems and to provide information about the spectral composition of the radiation field and the total dose received in the LDEF orbit. The Biostacks are mounted in two different locations of the LDEF. Up to three layers of Lithium fluoride thermoluminescence dosimeters (TLD) of different isotopic composition were located at different depths of some Biostacks. The preliminary analysis of the TLD yields maximum absorbed dose rates of 2.24 mGy day-1 behind 0.7 g cm-2 shielding and 1.17 mGy day-1 behind 12 g cm-2 shielding. A thermal neutron fluence of 1.7 n cm-2 s-1 is determined from the differences in absorbed dose for different isotopic mixtures of Lithium. The results of this experiment on LDEF are especially valuable and of high importance since LDEF stayed for about six years in the prospected orbit of the Space Station Freedom. There is no knowledge about the effectiveness of the space radiation in long-term spaceflights and the dosimetric data in this orbit are scarce.

  1. [Total and methyl mercury contents in arthropods].

    PubMed

    Zheng, Dong-Mei; Wang, Qi-Chao; Zhang, Zhong-Sheng; Zheng, Na; Zhang, Xiu-Wu

    2007-11-01

    We researched mercury contents in plants and arthropods collected from the river banks in mercury polluted areas. The results show that total mercury (T-Hg) and methyl mercury (Me-Hg) in Locusta migratoria manilensis and Acrida chinensis are 0.032 - 0.402 mg x kg(-1), 0.023 - 0.362 mg x kg(-1) and 0.003 - 0.031 mg x kg(-1), 0.004 - 0.015 mg x kg(-1) while the proportion of Me-Hg to T-Hg are 3.5% - 49.7% and 2.0% - 44.4%. T-Hg in arthropods is higher than that a magnitude in non-polluted areas. As primary consumers, mercury contents in Locusta migratoria manilensis and Acrida chinensis are lower than plants they eat. That is not consistent with the non-polluted areas. Paratenodera sinensis is the second consumer and there is an obvious mercury accumulation in it. For Locusta migratoria manilensis, T-Hg decreased with the body length while for Acrida chinensis that increased following a decreasing. But Me-Hg in both increased with body length. Mercury contents in tissues of arthropods are significantly different. The order is abdomen > thorax > head. Mercury and methyl mercury contents in arthropods would lead wild birds, fowls and amphibians in the ecologic risk condition.

  2. Patient Satisfaction after Total Knee Arthroplasty

    PubMed Central

    Choi, Young-Joon

    2016-01-01

    Total knee arthroplasty (TKA) is one of the most successful and effective surgical options to reduce pain and restore function for patients with severe osteoarthritis. The purpose of this article was to review and summarize the recent literatures regarding patient satisfaction after TKA and to analyze the various factors associated with patient dissatisfaction after TKA. Patient satisfaction is one of the many patient-reported outcome measures (PROMs). Patient satisfaction can be evaluated from two categories, determinants of satisfaction and components of satisfaction. The former have been described as all of the patient-related factors including age, gender, personality, patient expectations, medical and psychiatric comorbidity, patient's diagnosis leading to TKA and severity of arthropathy. The latter are all of the processes and technical aspects of TKA, ranging from the anesthetic and surgical factors, type of implants and postoperative rehabilitations. The surgeon- and patient-reported outcomes have been shown to be disparate occasionally. Among various factors that contribute to patient satisfaction, some factors can be managed by the surgeon, which should be improved through continuous research. Furthermore, extensive discussion and explanation before surgery will reduce patient dissatisfaction after TKA. PMID:26955608

  3. SynCardia: the total artificial heart

    PubMed Central

    Anyanwu, Anelechi; Zucchetta, Fabio; Gerosa, Gino

    2014-01-01

    The SynCardia total artificial heart (TAH) currently provides the most definitive option for patients with biventricular failure who are not candidates for isolated left ventricular (LV) assist device placement. The techniques for implantation are adaptable to almost all patients with advanced heart failure, including those with severe biventricular cardiomyopathy, complex congenital heart disease, failed LV assist devices, failed transplantations, and acquired structural heart defects that have failed or are not amenable to conventional surgical treatment. Over the years, the implantation technique has evolved in order to minimize the surgical invasiveness of the procedure, in anticipation of additional future surgery. Meticulous hemostasis with double layer sutures, use of Gore-Tex sheets around the TAH and the pericardial cavity, and use of tissue expanders to avoid contraction of pericardial cavity around the device are discussed in detail in the following report. Additionally, we will provide our experience with implantation of TAH in various challenging scenarios, such as patients with a small chest cavity, congenital heart defects, and simultaneous use of extracorporeal membrane oxygenation (ECMO). PMID:25512904

  4. Flexible remediation design lowers total cost

    SciTech Connect

    Struttman, T.; Towarnicky, J.

    1995-08-01

    Most groundwater remediation systems are built to operate for many years. Predicting time to cleanup is difficult due to unforeseeable problems and changes in underground conditions. As a result, many treatment systems tend to be over-designed, with multiple built-in safety factors and excessive capital costs. Total time in operation also is unnecessarily long because upfront assumptions often fail to match future realities. A Superfund site remediation in Arizona illustrates how a flexible, ongoing design approach can significantly reduce life cycle costs. The site is a municipal airport where degreasing activities from the 1940s through the 1970s left trichloroethylene (TCE) in the soil and in two aquifers beneath the site. The soil is being remediated in five areas, representing approximately 10 acres. The upper aquifer plume covers approximately 400 acres, and the two lower aquifer plumes cover 10 and 30 acres. The cleanup involves extraction of groundwater in a pump-and-treat system of 16 extraction wells, followed by treatment with an air stripper for the upper aquifer and liquid-phase high-pressure carbon on the lower aquifer. The treated/clean water is reinjected to augment hydraulic control.

  5. [Total transgastric highly selective vagotomy (author's transl)].

    PubMed

    Petropoulos, P C

    1981-01-01

    By replacing the transection and excision of the hiatal cardioesophageal branches of the vagus nerve including the nerve branches accompanying those arteries entering the proximal gastric fundus and the gastric branches of the nerves of Laterjet by a seromuscular incision along the lesser curvature from the incisura to the cardia continuing in an arch below the oesophagogastric junction downwards along the greater curvature to a level between the estimated entrance of the short gastric and left gastroepiploic vessels, a total transgastric highly selective vagotomy is achieved. The danger of free exposure of the mucosa is prevented by interposing a free omental graft sutured into the gap in the gastric musculature. The graft protects against complications due to regeneration of the divided vagal branches. This operation is much less extensive, less invasive and significantly more simple than HSV. Completeness of vagotomy is less invasive and significantly more simple than HSV. Completeness of vagotomy is controlled intra-operatively both a gastric pH meter and by measuring the oxygen tension of the gastric mucosa. Twelve to twenty months after applying TTrHSV the mortality was nil in only a restricted number of patients with duodenal ulcers and the morbidity was insignificant. Previous ulcer symptoms disappeared. Dumping syndrome, recurrence of ulceration and other significant complications were not observed. Data of basal and stimulated acid secretion during the 12 to 20 month period after the operation are given.

  6. Acetabular Reconstruction in Total Hip Arthroplasty.

    PubMed

    Shon, Won Yong; Santhanam, Siva Swaminathan; Choi, Jung Woo

    2016-03-01

    The difficulties encountered in dealing with the bone deficient acetabulum are amongst the greatest challenges in hip surgery. Acetabular reconstruction in revision total hip arthroplasty can successfully be achieved with hemispherical components featuring a porous or roughened ingrowth surface and options for placement of multiple screws for minor acetabular defect. Acetabular component selection is mostly based on the amount of bone loss present. In the presence of combined cavitary and segmental defects without superior acetabular coverage, reconstructions with a structural acetabular allograft protected by a cage or a custom-made triflange cage have been one of preferred surgical options. The use of a cage or ring over structural allograft bone for massive uncontained defects in acetabular revision can restore host bone stock and facilitate subsequent rerevision surgery to a certain extent. But high complication rates have been reported including aseptic loosening, infection, dislocation and metal failure. On the other hand, recent literature is reporting satisfactory outcomes with the use of modular augments combined with a hemispherical shell for major acetabular defect. Highly porous metals have been introduced for clinical use in arthroplasty surgery over the last decade. Their higher porosity and surface friction are ideal for acetabular revision, optimizing biological fixation. The use of trabecular metal cups in acetabular revision has yielded excellent clinical results. This article summarizes author's experience regarding revision acetabular reconstruction options following failed hip surgery including arthroplasty. PMID:27536638

  7. The femoral sulcus in total knee arthroplasty.

    PubMed

    Lingaraj, Krishna; Bartlett, John

    2009-05-01

    The position of the femoral sulcus relative to the midline of the distal femoral resection in total knee arthroplasty (TKA) was studied to determine if centralized placement of the femoral component on the distal femur was justified in terms of aligning the prosthetic sulcus with the native femoral sulcus. The location of the femoral sulcus was studied in 112 consecutive patients undergoing TKA. The mean sulcus position was 0.7 mm lateral to the midline of the distal femoral resection (SD 1.4, 95% CI, 0.5-1.0 mm). However, the variation in sulcus positions ranged from 4 mm medial to 4 mm lateral to the midline. The mean sulcus position in valgus knees was 1.0 mm lateral to the midline (SD 1.8), and that in varus knees was 0.7 mm lateral to the midline (SD 1.2) (P = 0.501). It appears prudent to centre the femoral component on the native sulcus rather than the midline of the distal femoral resection, so as to ensure accurate alignment of the prosthetic sulcus with the native sulcus and to encourage normal patella tracking.

  8. Totally vegetarian diets and infant nutrition.

    PubMed

    Shinwell, E D; Gorodischer, R

    1982-10-01

    Observations on the deleterious effects of a totally vegetarian diet in infancy are reported and the difficulties encountered in the prevention of nutritional deficiencies in a vegan religious community are discussed. Twenty-five infants of this community who were seen at the hospital showed evidence of protein-calorie malnutrition, iron- and vitamin B12-deficient anemia, rickets, zinc deficiency, and multiple recurrent infections. Evidence of growth retardation was also found in 47 infants seen at the local mother-child health (well-baby) clinic. Samples of breast milk showed low levels of carbohydrate (1.6 to 3.5 gm/100 ml), protein (0.8 to 1.4 gm/100 ml), and fat (2.4 to 4.1 gm/100 ml). The main constituent of the infants' diet after the age of 3 months (a "soya milk" prepared at the community's central kitchen) was extremely dilute with a very low calorific value (13.7 kcal/100 ml). Persistent attempts to find dietary modifications that would satisfy both the vegan philosophy and also the recommended dietary allowances failed. This problem represents a scientific and medicosocial challenge to pediatricians and nutritionists.

  9. The Cruciate Ligaments in Total Knee Arthroplasty.

    PubMed

    Parcells, Bertrand W; Tria, Alfred J

    2016-01-01

    The early knee replacements were hinge designs that ignored the ligaments of the knee and resurfaced the joint, allowing freedom of motion in a single plane. Advances in implant fixation paved the way for modern designs, including the posterior-stabilized (PS) total knee arthroplasty (TKA) that sacrifices both cruciate ligaments while substituting for the posterior cruciate ligament (PCL), and the cruciate-retaining (CR) TKA designs that sacrifice the anterior cruciate ligament but retain the PCL. The early bicruciate retaining (BCR) TKA designs suffered from loosening and early failures. Townley and Cartier designed BCR knees that had better clinical results but the surgical techniques were challenging.Kinematic studies suggest that normal motion relies on preservation of both cruciate ligaments. Unicompartmental knee arthroplasty retains all knee ligaments and closely matches normal motion, while PS and CR TKA deviate further from normal. The 15% to 20% dissatisfaction rate with current TKA has renewed interest in the BCR design. Replication of normal knee kinematics and proprioception may address some of the dissatisfaction.

  10. Current concepts in total femoral replacement

    PubMed Central

    Ramanathan, Deepak; Siqueira, Marcelo BP; Klika, Alison K; Higuera, Carlos A; Barsoum, Wael K; Joyce, Michael J

    2015-01-01

    Total femoral replacement (TFR) is a salvage arthroplasty procedure used as an alternative to lower limb amputation. Since its initial description in the mid-20th century, this procedure has been used in a variety of oncologic and non-oncologic indications. The most compelling advantage of TFR is the achievement of immediate fixation which permits early mobilization. It is anticipated that TFR will be increasingly performed as the rate of revision arthroplasty rises worldwide. The existing literature is mainly composed of a rather heterogeneous mix of retrospective case series and a wide assortment of case reports. Numerous TFR prostheses are currently available and the surgeon must understand the unique implications of each implant design. Long-term functional outcomes are dependent on adherence to proper technique and an appropriate physical therapy program for postoperative rehabilitation. Revision TFR is mainly performed for periprosthetic infection and the severe femoral bone loss associated with aseptic revisions. Depending on the likelihood of attaining infection clearance, it may sometimes be advisable to proceed directly to hip disarticulation without attempting salvage of the TFR. Other reported complications of TFR include hip joint instability, limb length discrepancy, device failure, component loosening, patellar maltracking and delayed wound healing. Further research is needed to better characterize the long-term functional outcomes and complications associated with this complex procedure. PMID:26716087

  11. Process optimized minimally invasive total hip replacement

    PubMed Central

    Gebel, Philipp; Oszwald, Markus; Ishaque, Bernd; Ahmed, Gaffar; Blessing, Recha; Thorey, Fritz; Ottersbach, Andreas

    2012-01-01

    The purpose of this study was to analyse a new concept of using the the minimally invasive direct anterior approach (DAA) in total hip replacement (THR) in combination with the leg positioner (Rotex- Table) and a modified retractor system (Condor). We evaluated retrospectively the first 100 primary THR operated with the new concept between 2009 and 2010, regarding operation data, radiological and clinical outcome (HOOS). All surgeries were perfomed in a standardized operation technique including navigation. The average age of the patients was 68 years (37 to 92 years), with a mean BMI of 26.5 (17 to 43). The mean time of surgery was 80 min. (55 to 130 min). The blood loss showed an average of 511.5 mL (200 to 1000 mL). No intra-operative complications occurred. The postoperative complication rate was 6%. The HOOS increased from 43 points pre-operatively to 90 (max 100 points) 3 months after surgery. The radiological analysis showed an average cup inclination of 43° and a leg length discrepancy in a range of +/− 5 mm in 99%. The presented technique led to excellent clinic results, showed low complication rates and allowed correct implant positions although manpower was saved. PMID:22577504

  12. Crossing Total Occlusions: Navigating Towards Recanalization.

    PubMed

    Sakes, Aimée; Regar, Evelyn; Dankelman, Jenny; Breedveld, Paul

    2016-06-01

    Chronic total occlusions (CTOs) represent the "last frontier" of percutaneous interventions. The main technical challenges lies in crossing the guidewire into the distal true lumen, which is primarily due to three problems: device buckling during initial puncture, inadequate visualization, and the inability to actively navigate through the CTO. To improve the success rate and to identify future research pathways, this study systematically reviews the state-of-the-art of all existing and invented devices for crossing occlusions. The literature search was executed in the databases of Scopus and Espacenet using medical and instrument-related keyword combinations. The search yielded over 840 patents and 69 articles. After scanning for relevancy, 45 patents and 16 articles were included. The identified crossing devices were subdivided based on the determinant for the crossing path through the occlusion, which is either the device (straight and angled crossing), the environment (least resistance, tissue selective, centerline, and subintimal crossing) or the user (directly steered and sensor enhanced crossing). It was found that each crossing path is characterized by specific advantages and disadvantages. For a future crossing device, a combination of crossing paths is suggested were the interventionist is able to exert high forces on the CTO (as seen in the device approach) and actively steer through the CTO (user: directly steered crossing) aided by intravascular imaging (user: sensor enhanced crossing) or an intrinsically safe device following the centerline or path of least resistance (environment: centerline crossing or least resistance crossing) to reach the distal true lumen.

  13. Muscular strength after total hip arthroplasty

    PubMed Central

    Winther, Siri B; Husby, Vigdis S; Foss, Olav A; Wik, Tina S; Svenningsen, Svein; Engdal, Monika; Haugan, Kristin; Husby, Otto S

    2016-01-01

    Background and purpose Minimizing the decrease in muscular strength after total hip arthroplasty (THA) might allow patients to recover faster. We evaluated muscular strength in patients who were operated on using 3 surgical approaches. Patients and methods In a prospective cohort study, 60 patients scheduled for primary THA were allocated to the direct lateral, posterior, or anterior approach. Leg press and abduction strength were evaluated 2 weeks or less preoperatively, 2 and 8 days postoperatively, and at 6-week and 3-month follow-up. Results Differences in maximal strength change were greatest after 2 and 8 days. The posterior and anterior approaches produced less decrease in muscular strength than the direct lateral approach. 6 weeks postoperatively, the posterior approach produced greater increase in muscular strength than the direct lateral approach, and resulted in a greater increase in abduction strength than the anterior approach. At 3-month follow-up, no statistically significant differences between the groups were found. The operated legs were 18% weaker in leg press and 15% weaker in abduction than the unoperated legs, and the results were similar between groups. Interpretation The posterior and anterior approaches appeared to have the least negative effect on abduction and leg press muscular strength in the first postoperative week; the posterior approach had the least negative effect, even up to 6 weeks postoperatively. THA patients have reduced muscle strength in the operated leg (compared to the unoperated leg) 3 months after surgery. PMID:26141371

  14. Hiatal Hernia as a Total Gastrectomy Complication

    PubMed Central

    Santos, Bruna do Nascimento; de Oliveira, Marcos Belotto; Peixoto, Renata D'Alpino

    2016-01-01

    Introduction According to the Brazilian National Institute of Cancer, gastric cancer is the third leading cause of death among men and the fifth among women in Brazil. Surgical resection is the only potentially curative treatment. The most serious complications associated with surgery are fistulas and dehiscence of the jejunal-esophageal anastomosis. Hiatal hernia refers to herniation of elements of the abdominal cavity through the esophageal hiatus of the diaphragm, though this occurrence is rarely reported as a complication in gastrectomy. Case Report A 76-year-old man was diagnosed with intestinal-type gastric adenocarcinoma. He underwent a total laparoscopic-assisted gastrectomy and D2 lymphadenectomy on May 19, 2015. The pathology revealed a pT4pN3 gastric adenocarcinoma. The patient became clinically stable and was discharged 10 days after surgery. He was subsequently started on adjuvant FOLFOX chemotherapy; however, 9 days after the second cycle, he was brought to the emergency room with nausea and severe epigastric pain. A CT scan revealed a hiatal hernia with signs of strangulation. The patient underwent emergent repair of the hernia and suffered no postoperative complications. He was discharged from the hospital 9 days after surgery. Conclusion Hiatal hernia is not well documented, and its occurrence in the context of gastrectomy is an infrequent complication. PMID:27293395

  15. Extensor tendon ruptures after total knee arthroplasty.

    PubMed

    Bonnin, M; Lustig, S; Huten, D

    2016-02-01

    Extensor tendon rupture is a rare but serious complication after total knee arthroplasty (TKA) that impairs active knee extension, thereby severely affecting knee function. Surgery is usually required. Surgical options range from simple suturing to allograft reconstruction of the entire extensor mechanism and include intermediate methods such as reconstruction using neighbouring tendons or muscles, synthetic ligament implantation, and partial allograft repair. Simple suturing carries a high failure rate and should therefore be routinely combined with tissue augmentation using a neighbouring tendon or a synthetic ligament. After allograft reconstruction, outcomes are variable and long-term complications common. Salvage procedures for managing the most severe cases after allograft failure involve reconstruction using gastrocnemius or vastus flaps. Regardless of the technique used, suturing must be performed under tension, with the knee fully extended, and rehabilitation must be conducted with great caution. Weaknesses of available case-series studies include small sample sizes, heterogeneity, and inadequate follow-up duration. All treatment options are associated with substantial failure rates. The patient should be informed of this fact and plans made for a salvage option. Here, the main techniques and their outcomes are discussed, and a therapeutic strategy is suggested.

  16. Nineteen-Step Total Synthesis of (+)-Phorbol

    PubMed Central

    Kawamura, Shuhei; Chu, Hang; Felding, Jakob; Baran, Phil S.

    2016-01-01

    Phorbol, the flagship member of the tigliane diterpene family, has been known for over 80 years and has attracted attention from scores of chemists and biologists due to its intriguing chemical structure and the medicinal potential of phorbol esters.1 Access to useful quantities of phorbol and related analogs has relied upon isolation from natural sources and semisynthesis. Despite relentless efforts spanning 40 years, chemical synthesis has been unable to compete with these strategies due to its sheer complexity and unusual oxidation pattern. In fact, purely synthetic enantiopure phorbol has remained elusive and efforts on the synthetic biology side have not led to even the simplest members of this terpene family. Recently the chemical syntheses of eudesmanes,2 germacrenes,3 taxanes,4,5 and ingenanes6-8 have all benefited from a strategy inspired by the logic of two-phase terpene biosynthesis where powerful C–C bond constructions and C–H bond oxidations go hand in hand. In this manuscript, we show how a two-phase terpene synthesis strategy can be enlisted to achieve the first enantiospecific total synthesis of (+)-phorbol in only 19 steps from the abundant monoterpene (+)-3-carene. The purpose of this route is not to displace isolation/semisynthesis as a means to generate the natural product per se, but rather to enable access to analogs containing unique oxidation patterns that are otherwise inaccessible. PMID:27007853

  17. Mortality after total hip replacement surgery

    PubMed Central

    Berstock, J. R.; Beswick, A. D.; Lenguerrand, E.; Whitehouse, M. R.; Blom, A. W.

    2014-01-01

    Total hip replacement causes a short-term increase in the risk of mortality. It is important to quantify this and to identify modifiable risk factors so that the risk of post-operative mortality can be minimised. We performed a systematic review and critical evaluation of the current literature on the topic. We identified 32 studies published over the last 10 years which provide either 30-day or 90-day mortality data. We estimate the pooled incidence of mortality during the first 30 and 90 days following hip replacement to be 0.30% (95% CI 0.22 to 0.38) and 0.65% (95% CI 0.50 to 0.81), respectively. We found strong evidence of a temporal trend towards reducing mortality rates despite increasingly co-morbid patients. The risk factors for early mortality most commonly identified are increasing age, male gender and co-morbid conditions, particularly cardiovascular disease. Cardiovascular complications appear to have overtaken fatal pulmonary emboli as the leading cause of death after hip replacement. Cite this article: Bone Joint Res 2014;3:175–82. PMID:24894596

  18. Total parenteral nutrition in diabetic rats

    SciTech Connect

    Norcross, E.D.; Stein, T.P.

    1986-03-01

    Parenteral Nutrition with hypertonic glucose is frequently given to diabetic patients. Large amounts of insulin can be required. The purpose of this investigation was to develop a totally parenterally nourished diabetic rat model. 200 g Female Sprague Dawley rats were made diabetic by i.v. injection of streptozotocin (50 mg/kg). Rats were then allowed to recover for at least 1 week before undergoing surgical insertion of a central venous catheter for parenteral feeding. TPN was begun 3 days after surgery. Prior to this they were allowed unlimited access to food and water. Control (non-streptozotocin treated) rats were run at the same time. Protein turnover was investigated by using /sup 15/N glycine. Preliminary results: diabetic rats given mostly fat as a calorie source survived well in the absence of exogenous insulin whereas those that were given glucose only as their non-protein calorie source showed poor survival even with exogenous insulin. N balance and protein turnover in the lipid treated diabetic rats were comparable to the non-diabetic control rats.

  19. Chronic Knee Dislocation After Total Knee Arthroplasty.

    PubMed

    Ross, John P; Brown, Nicholas M; Levine, Brett R

    2015-12-01

    Knee dislocation after total knee arthroplasty (TKA), although rare, is a dangerous injury that can lead to neurovascular compromise and permanent disability. Chronic dislocation after TKA is even less common and is defined as dislocation that is present for 4 weeks or more. There are few reports of its management. Chronic dislocation may be complicated further by concomitant extensor mechanism disruption, ligamentous instability, and/or capsular contracture. This article describes 3 cases of chronically dislocated TKAs and the challenges encountered in treating this difficult problem. A higher level of constraint was required to maintain knee stability, and an extensor mechanism allograft was needed in 2 of the 3 reported patients. The preferred technique at the authors' institution is a complete allograft composite, tensioned in full extension. In the setting of a chronically dislocated TKA, the authors now recommend revision surgery with an enhanced measure of constraint (constrained condylar device or hinged knee prosthesis), reconstruction of the extensor mechanism when necessary, and restoration of the joint while compensating for concomitant bony defects. Even when surgeons follow these principles, it is important to inform the patient that long-term outcomes will likely be inferior to those of revision surgery for other causes.

  20. Total least squares for anomalous change detection

    SciTech Connect

    Theiler, James P; Matsekh, Anna M

    2010-01-01

    A family of difference-based anomalous change detection algorithms is derived from a total least squares (TLSQ) framework. This provides an alternative to the well-known chronochrome algorithm, which is derived from ordinary least squares. In both cases, the most anomalous changes are identified with the pixels that exhibit the largest residuals with respect to the regression of the two images against each other. The family of TLSQ-based anomalous change detectors is shown to be equivalent to the subspace RX formulation for straight anomaly detection, but applied to the stacked space. However, this family is not invariant to linear coordinate transforms. On the other hand, whitened TLSQ is coordinate invariant, and furthermore it is shown to be equivalent to the optimized covariance equalization algorithm. What whitened TLSQ offers, in addition to connecting with a common language the derivations of two of the most popular anomalous change detection algorithms - chronochrome and covariance equalization - is a generalization of these algorithms with the potential for better performance.

  1. Total Solar Eclipse to Introduce Scientific Research

    NASA Astrophysics Data System (ADS)

    Choudhary, D. P.

    2015-12-01

    We are designing an experiment to record time lapse slit-less flash spectra of solar chromosphere and corona before, during and after the Total Solar Eclipse (TSE). As the moon gradually covers different heights of chromosphere and corona, the time lapse spectra would provide high hight-resolution information about the line formation starting at very close proximity to the solar limb. The flash spectrum will be recored with a slit-less spectrograph consisting of a transmission grating of 300 lines/mm, blazed at 5000 Å, and an 135 mm f/3.5 telephoto lens. Based on earlier such instruments, the system's efficiency is expected to be about 60% at 5303 Å (Fe XIV emission line) and 20% at 6374 Å (Fe X emission line) (Voulgaris, 2010). We shall place the grating before the telephoto lens on a wedge shaped. The full range of the visible spectrum, from 3900 Å to 6700 Å will be projected on the CCD sensor of the digital camera. The resolution of the spectrograph is expected to be 0.5 Å/pixel at 5215 Å. The diameter of the Sun would corresponded to 275 pixels or 6.87''/pixel. By turning the grating, the direction of the ruling shall be set parallel to the direction of the last visible elongated crescent of the Sun; which will play the role of the "slit" in the slitless spectrograph. The spectrograph will be mounted on a solar tracker to observe the sun during TSE.

  2. Total scalp irradiation using helical tomotherapy

    SciTech Connect

    Orton, Nigel . E-mail: nporton@facstaff.wisc.edu; Jaradat, Hazim; Welsh, James; Tome, Wolfgang

    2005-09-30

    Homogeneous irradiation of the scalp poses technical and dosimetric challenges due to the extensive, superficial, curved treatment volume. Conventional treatments on a linear accelerator use multiple matched electron fields or a combination of electron and photon fields. Problems with these techniques include dose heterogeneity in the target due to varying source-to-skin distance (SSD) and angle of beam incidence, significant dose to the brain, and the potential for overdose or underdose at match lines between the fields. Linac-based intensity-modulated radiation therapy (IMRT) plans have similar problems. This work presents treatment plans for total scalp irradiation on a helical tomotherapy machine. Helical tomotherapy is well-suited for scalp irradiation because it has the ability to deliver beamlets that are tangential to the scalp at all points. Helical tomotherapy also avoids problems associated with field matching and use of more than one modality. Tomotherapy treatment plans were generated and are compared to plans for treatment of the same patient on a linac. The resulting tomotherapy plans show more homogeneous target dose and improved critical structure dose when compared to state-of-the-art linac techniques. Target equivalent uniform dose (EUD) for the best tomotherapy plan was slightly higher than for the linac plan, while the volume of brain tissue receiving over 30 Gy was reduced by two thirds. Furthermore, the tomotherapy plan can be more reliably delivered than linac treatments, because the patient is aligned prior to each treatment based on megavoltage computed tomography (MVCT)

  3. Human pancreatic cell autotransplantation following total pancreatectomy.

    PubMed Central

    Traverso, L W; Abou-Zamzam, A M; Longmire, W P

    1981-01-01

    During total pancreaticoduodenectomy for chronic pancreatitis, four patients received an intraportal pancreatic mixed-cell autograft prepared by collagenase digestion. The technique of this autotransplantation procedure was successfully developed using a normal canine pancreas, but has proved difficult to apply in the human chronic pancreatitis model. Our four patients became insulin-dependent, with proof of intrahepatic insulin production in only one patient. Three factors have contributed to the lack of graft success: 1) the preoperative endocrine status, 2) systemic hypotension and portal hypertension secondary to graft infusion, and 3) difficulty applying the successful technique in a normal dog pancreas to an extensively scarred human pancreas. The preoperative insulin response during a glucose tolerance test was blunted or delayed in the three patients tested. An immediate decrease in blood pressure and rise in portal pressure occurred in every patient and prevented infusion of the entire graft (30-50%) in three patients. Unfortunately, the patient with the most compromised insulin status was the only patient able to receive the entire graft. Our experience would indicate that further refinements in technique are necessary to prevent the vascular reaction and allow infusion of the entire graft. Furthermore, normal islet cell function is necessary before a successful graft can be expected. PMID:6781424

  4. Total parenteral nutrition in pancreatic disease.

    PubMed

    Grant, J P; James, S; Grabowski, V; Trexler, K M

    1984-11-01

    Total parenteral nutrition (TPN) was given to 121 patients admitted with severe pancreatitis (73), chronic pancreatitis (23), or pancreatic malignancy (25) over 104 months. No adverse effects on the pancreas were detected from the TPN, including the provision of intravenous (IV) fat. Nutritional status was maintained or improved in all groups, including patients undergoing surgical procedures and those experiencing marked stress. No significant impact on the clinical course of pancreatitis was observed, although the death rate in acute pancreatitis (15.2%) and complicated pancreatitis (18.5%) compares favorably with other published series where early surgical intervention was undertaken. There was an increased risk of catheter-related sepsis in patients with complicated pancreatitis (14.8%) and with chronic pancreatitis (17.4%). No increase septic risk was seen in patients with acute pancreatitis or pancreatic malignancy. Eighty-two per cent of patients with acute pancreatitis required an average of 87 units of insulin per day while 78% of patients with chronic pancreatitis required an average of 54 units per day. In summary, TPN proved to be safe, effective, and well-tolerated in those patients with disorders of the pancreas.

  5. Effect of total laryngectomy on esophageal motility

    SciTech Connect

    Hanks, J.B.; Fisher, S.R.; Meyers, W.C.; Christian, K.C.; Postlethwait, R.W.; Jones, R.S.

    1981-01-01

    Total laryngectomy for cancer can result in dysphagia and altered esophageal motility. Manometric changes in the upper esophageal sphincter (UES), and in proximal and distal esophageal function have been reported. However, most studies have failed to take into account radiation therapy and appropriate controls. We selected ten male patients (54.3 +/- 1.9 yr) for longitudinal manometric evaluation prior to laryngectomy then at two weeks and again six months later. No patient received preoperative radiation therapy, had a previous history of esophageal surgery, or developed a postoperative wound infection or fistula. Seven of ten patients had positive nodes and received 6,000-6,600 rads postoperative radiation therapy. Preoperatively 4 of 10 patients complained of dysphagia which did not significantly change following surgery and radiation. Two of three patients who did not complain of dysphagia preoperatively and received radiation postoperatively developed dysphagia. No patient without dysphagia preoperatively who received no radiation therapy developed symptoms. Our studies show that laryngectomy causes alterations in the UES resting and peak pressures but not in the proximal or distal esophagus, or the lower esophageal sphincter. These data also imply radiation therapy may be associated with progressive alterations in motility and symptomatology. Further study regarding the effects of radiation on esophageal motility and function are urged.

  6. AIRS total precipitable water over high latitudes

    NASA Astrophysics Data System (ADS)

    Ye, H.; Fetzer, E. J.; Bromwich, D. H.; Fishbein, E.; Olsen, E. T.; Granger, S.; Lee, S.; Lambrigtsen, B.; Chen, L.

    2006-12-01

    Given the importance of atmospheric conditions over the Arctic and Antarctica to the global climate system, hydrological cycles, and cryopspheric dynamics, and the poor coverage of traditional data over these region, AIRS data will play a significant role in filling the information gaps. In this study, we examine the quality of AIRS total atmospheric precipitable water (PWV) and explore its potential applications over the Antarctica and Arctic. For Antarctica, both Level II matching files and Level III gridded products of AIRS are compared with radiosonde records at Dome C and ECMWF's analysis products during December 10, 2003 to January 26, 2004. Results will testify to the quality of AIRS moisture data over glacial surfaces. For the Arctic region, AIRS level III data are used to compare with AMSR-E data and ECMWF analysis product during September of 2004. Results will reveal the quality of AIRS data over high-latitude water, sea ice, and land surfaces. The potential of AIRS data to improve model simulation will be discussed.

  7. Total quality management in blood transfusion.

    PubMed

    Smit-Sibinga, C T

    2000-01-01

    Quality management is an ongoing development resulting in consistency products and services and ever increasing customer satisfaction. The ultimum is Total Quality Management. Quality systems and quality management in transfusion medicine have gained considerable attention since the outbreak of the AIDS epidemic. Where product orientation has long been applied through quality control, Good Manufacturing Practice (GMP) principles were introduced, shifting the developments in the direction of process orientation. Globally, and particularly in the more industrialised world people and system orientation has come along with the introduction of the ISO9001 concept. Harmonisation and a degree of uniformity are needed to implement a universally applicable Quality System and related Quality Management. Where the American Association of Blood Banks (AABB) is the professional organisation with the most extensive experience in quality systems in blood transfusion, the European Union and the Council of Europe now are in the process to design a quality system and management applicable to a larger variety of countries, based on a hybrid of current GMP and ISO9001 principles. The International Federation of Red Cross and Red Crescent Societies has developed a more universally to implement Quality Manual, with a pilot project in Honduras. It is recommendable to harmonise the various designs and bring the approaches under one common denominator. PMID:10938970

  8. APPARATUS FOR MEASURING TOTAL NEUTRON CROSS SECTIONS

    DOEpatents

    Cranberg, L.

    1959-10-13

    An apparatus is described for measuring high-resolution total neutron cross sections at high counting rate in the range above 50-kev neutron energy. The pulsed-beam time-of-flight technique is used to identify the neutrons of interest which are produced in the target of an electrostatic accelerator. Energy modulation of the accelerator . makes it possible to make observations at 100 energy points simultaneously. 761O An apparatus is described for monitoring the proton resonance of a liquid which is particulariy useful in the continuous purity analysis of heavy water. A hollow shell with parallel sides defines a meander chamber positioned within a uniform magnetic fieid. The liquid passes through an inlet at the outer edge of the chamber and through a spiral channel to the central region of the chamber where an outlet tube extends into the chamber perpendicular to the magnetic field. The radiofrequency energy for the monitor is coupled to a coil positioned coaxially with the outlet tube at its entrance point within the chamber. The improvement lies in the compact mechanical arrangement of the monitor unit whereby the liquid under analysis is subjected to the same magnetic field in the storage and sensing areas, and the entire unit is shielded from external electrostatic influences.

  9. [The fibrinolytic system and total parenteral nutrition].

    PubMed

    Fernández Ruiz, M; Lasierra Cirujeda, J

    1993-12-01

    A study is presented which was carried out in twenty-five patients operated on in a surgical service, and who received total parenteral nutrition. Samples were taken to check modifications to the fibrinolytic system occurring after administration of hyperosmotic solutions, principally lipidic emulsions, from a contemporary standpoint. We performed three extractions: on day one, day five and following the withdrawal of the fat emulsion, with study of modifications to antithrombin III, alpha 2 antiplasmin, plasminogen, C protein, plasminogen tissular activator (t-PA), plasminogen tissular activator inhibitor (PAI 1), fibrinogen, and fibrinogen/fibrin degradation products. The laboratory techniques used are shown, along with the results obtained: increased for alpha 2 antiplasmin and antigenic t-PA with significant values (p < 0.05) on the day of withdrawal in comparison with pre-PN values, plus increased values for plasminogen, fibrinogen/fibrin degradation products and t-PA activity. In conclusion, it is suggested that antithrombin III deficiency, along with reduction in C protein levels and increased fibrinogen and PAI 1 concentration predispose patients with t-PA release defects to thrombo-embolic complication.

  10. Patellar malalignment treatment in total knee arthroplasty

    PubMed Central

    Gasparini, Giorgio; Familiari, Filippo; Ranuccio, Francesco

    2013-01-01

    Summary The patella, with or without resurfacing, plays a fundamental role in the success of a total knee arthroplasty (TKA). Patellofemoral joint complications are due to problems related to the patient, to the surgical technique, or to the design of the components. Patellar tracking is influenced by several factors: a severe preoperative valgus, the presence of pre-existing patellofemoral dysplasia, the design of the femoral component, the surgical approach, the Q angle, the mechanical alignment of the limb, the tightness of the lateral retinaculum, the positioning of the patellar component in the proximal-distal and medial-lateral directions, the patella height, the patella (native or resurfaced) thickness, the size of the femoral and the tibial components, and the alignment and rotation of the components. Several factors are crucial to prevent patellar maltracking in TKA: the use of an anatomical femoral component, a meticulous surgical technique, careful dynamic intraoperative assessment of patellar tracking, and, if necessary, the achievement of an adequate lateral release. PMID:25606506

  11. [Clinical evaluation tools of total hip arthroplasties].

    PubMed

    Hamadouche, M

    2006-10-01

    Total hip arthroplasty is one of the most efficient hip surgery procedures enabling improved function in the vast majority of operated patients. The major long-term complication is aseptic loosening due to an inflammatory response to particle wear debris coming from the bearings. Polyethylene is the key culprit. Currently two solutions are proposed: eliminating polyethylene from the prosthetic articulation or reducing material wear. This leads to the need for reliable tools for evaluating short-term results, predictive of long-term outcome. When the innovation concerns reduction of polyethylene wear, short-term wear should be measured with software methods or radiostereometry. If the innovation concerns improvement of polyethyleneless implants, then short-term migration should be measured with EBRA or radiostereometry. In addition, the long-term retrospective evaluation of large series of patients remains of major interest provided that it is performed with survival analysis. These different methods are detailed in this study, indicating the pros and cons for each solution. PMID:17088755

  12. Process optimized minimally invasive total hip replacement.

    PubMed

    Gebel, Philipp; Oszwald, Markus; Ishaque, Bernd; Ahmed, Gaffar; Blessing, Recha; Thorey, Fritz; Ottersbach, Andreas

    2012-01-01

    The purpose of this study was to analyse a new concept of using the the minimally invasive direct anterior approach (DAA) in total hip replacement (THR) in combination with the leg positioner (Rotex- Table) and a modified retractor system (Condor). We evaluated retrospectively the first 100 primary THR operated with the new concept between 2009 and 2010, regarding operation data, radiological and clinical outcome (HOOS). All surgeries were perfomed in a standardized operation technique including navigation. The average age of the patients was 68 years (37 to 92 years), with a mean BMI of 26.5 (17 to 43). The mean time of surgery was 80 min. (55 to 130 min). The blood loss showed an average of 511.5 mL (200 to 1000 mL). No intra-operative complications occurred. The postoperative complication rate was 6%. The HOOS increased from 43 points pre-operatively to 90 (max 100 points) 3 months after surgery. The radiological analysis showed an average cup inclination of 43° and a leg length discrepancy in a range of +/- 5 mm in 99%. The presented technique led to excellent clinic results, showed low complication rates and allowed correct implant positions although manpower was saved. PMID:22577504

  13. Total ankle replacement for posttraumatic arthritis

    PubMed Central

    Weme, Rebecca A Nieuwe; van Solinge, Guido; N Doornberg, Job; Sierevelt, Inger; Haverkamp, Daniël; Doets, H Cornelis

    2015-01-01

    Background and purpose Most studies on total ankle replacement (TAR) have used a case mix of patients. We evaluated the outcome of TAR performed for end-stage arthritis either because of fracture or ligamentous injury. Patients and methods We prospectively followed 88 consecutive patients (50 postfracture ankles and 40 ankles with instability arthritis (2 bilateral)) who underwent TAR between 2001 and 2009. Mean follow-up for both groups was 5 years. Results Preoperative varus deformity of 10° or more was present in 23 ankles in the instability group. At 6 years, survival with revision or salvage fusion as an endpoint was 87% (95% CI: 74–99) in the postfracture group and 79% (95% CI: 63–94) in the instability group. Progressive periprosthetic osteolysis was seen in 23 ankles, and required salvage fusion in 6. The number of reoperations was similar in both groups. Clinical outcome, as assessed with 2 ankle scores and 2 questionnaires, showed good results and was similar at the latest follow-up. Interpretation The outcome was similar in the postfracture and instability groups and also similar to that reported in series including a case mix of patients. In contrast to earlier reports, preoperative frontal plane deformity in this series was not identified as a risk factor for failure. PMID:25772269

  14. TOTAL ANKLE REPLACEMENT: WHY, WHEN AND HOW?

    PubMed Central

    Bonasia, Davide Edoardo; Dettoni, Federico; Femino, John E; Phisitkul, Phinit; Germano, Margherita; Amendola, Annunziato

    2010-01-01

    Total ankle replacement (TAR) was first attempted in the 1970s, but poor results led to its being considered inferior to ankle fusion until the late 1980s and early 1990s. By that time, newer designs which more closely replicated the natural anatomy of the ankle, showed improved clinical outcomes.1 Currently, even though controversy still exists about the effectiveness of TAR compared to ankle fusion, TAR has shown promising mid-term results and should no longer be considered an experimental procedure. Factors related to improved TAR outcomes include: 1) better patient selection, 2) more precise knowledge and replication of ankle biomechanics, 3) the introduction of less-constrained designs with reduced bone resection and no need for cementation, and 4) greater awareness of soft-tissue balance and component alignment. When TAR is performed, a thorough knowledge of ankle anatomy, pathologic anatomy and biomechanics is needed along with a careful pre-operative plan. These are fundamental in obtaining durable and predictable outcomes. The aim of this paper is to outline these aspects through a literature review. PMID:21045984

  15. Totally vegetarian diets and infant nutrition.

    PubMed

    Shinwell, E D; Gorodischer, R

    1982-10-01

    Observations on the deleterious effects of a totally vegetarian diet in infancy are reported and the difficulties encountered in the prevention of nutritional deficiencies in a vegan religious community are discussed. Twenty-five infants of this community who were seen at the hospital showed evidence of protein-calorie malnutrition, iron- and vitamin B12-deficient anemia, rickets, zinc deficiency, and multiple recurrent infections. Evidence of growth retardation was also found in 47 infants seen at the local mother-child health (well-baby) clinic. Samples of breast milk showed low levels of carbohydrate (1.6 to 3.5 gm/100 ml), protein (0.8 to 1.4 gm/100 ml), and fat (2.4 to 4.1 gm/100 ml). The main constituent of the infants' diet after the age of 3 months (a "soya milk" prepared at the community's central kitchen) was extremely dilute with a very low calorific value (13.7 kcal/100 ml). Persistent attempts to find dietary modifications that would satisfy both the vegan philosophy and also the recommended dietary allowances failed. This problem represents a scientific and medicosocial challenge to pediatricians and nutritionists. PMID:6812012

  16. Dextromethorphan and pain after total abdominal hysterectomy.

    PubMed

    McConaghy, P M; McSorley, P; McCaughey, W; Campbell, W I

    1998-11-01

    Dextromethorphan is an N-methyl-D-aspartate (NMDA) receptor antagonist which has been shown to inhibit the development of cutaneous secondary hyperalgesia after tissue trauma. We studied 60 ASA I-II patients undergoing total abdominal hysterectomy in a randomized, double-blind, placebo-controlled study. Patients received either dextromethorphan 27 mg capsules, two doses before operation and three doses in the first 24 h after operation, or placebo. Visual analogue pain scores (VAS) at 24 and 48 h were assessed at rest, on coughing and on sitting up, and were not significantly different between groups. Morphine consumption from a patient-controlled analgesia (PCA) device was also not significantly different between groups. Evidence of secondary hyperalgesia was assessed with von Frey hairs 10 cm above the Pfannenstiel incision. Both groups of patients exhibited evidence of secondary hyperalgesia after 24 and 48 h but there were no significant differences between groups. There was also no difference between groups in VAS scores at 1 month.

  17. The Road to Total Earthquake Safety

    NASA Astrophysics Data System (ADS)

    Frohlich, Cliff

    Cinna Lomnitz is possibly the most distinguished earthquake seismologist in all of Central and South America. Among many other credentials, Lomnitz has personally experienced the shaking and devastation that accompanied no fewer than five major earthquakes—Chile, 1939; Kern County, California, 1952; Chile, 1960; Caracas,Venezuela, 1967; and Mexico City, 1985. Thus he clearly has much to teach someone like myself, who has never even actually felt a real earthquake.What is this slim book? The Road to Total Earthquake Safety summarizes Lomnitz's May 1999 presentation at the Seventh Mallet-Milne Lecture, sponsored by the Society for Earthquake and Civil Engineering Dynamics. His arguments are motivated by the damage that occurred in three earthquakes—Mexico City, 1985; Loma Prieta, California, 1989; and Kobe, Japan, 1995. All three quakes occurred in regions where earthquakes are common. Yet in all three some of the worst damage occurred in structures located a significant distance from the epicenter and engineered specifically to resist earthquakes. Some of the damage also indicated that the structures failed because they had experienced considerable rotational or twisting motion. Clearly, Lomnitz argues, there must be fundamental flaws in the usually accepted models explaining how earthquakes generate strong motions, and how we should design resistant structures.

  18. New Total Ozone Algorithm for Application to the Total Ozone Mapping Spectrometer

    NASA Technical Reports Server (NTRS)

    Wellemeyer, C.; Bhartia, P. K.; Taylor, S. L.; Qin, W.; Flynn, L.; Seftor, C.

    2003-01-01

    The Total Ozone Mapping Spectrometer (TOMS) series comprises four instruments providing a total of 25 years of daily global stratospheric ozone data over the sunlit portion of the Earth. A new retrieval algorithm has been developed for TOMS, designated Version 8. The algorithm is based on differential absorption across a pair of wavelength channels chosen close together to minimize the impact of wavelength dependent forward modeling errors. Version 8 enhancements include correction for the presence of tropospheric aerosols and sun glint from water surfaces, a better treatment of variability due to tropospheric ozone and temperature dependence, and an improved forward model, particularly in regions of persistent snow and ice. Among other things, the Version 8 enhancements have reduced latitudinal dependence seen previously in TOMS - Dobson comparisons, predominantly in the Southern Hemisphere's summer, when the tropospheric ozone, temperature, and snow/ice corrections are additive. The basic components of the algorithm and its impact on derived total ozone will be discussed.

  19. Durability of highly cross-linked polyethylene in total hip and total knee arthroplasty.

    PubMed

    Dion, Neil T; Bragdon, Charles; Muratoglu, Orhun; Freiberg, Andrew A

    2015-07-01

    This article reviews the history of the development of highly cross-linked polyethylene and provides an in-depth review of the clinical results regarding the durability of highly cross-linked polyethylene (HXLPE) used in total hip arthroplasty (THA) and total knee arthroplasty (TKA). The use of polyethylene as a bearing surface has contributed to the success of THA and TKA; however, polyethylene wear and osteolysis can lead to failure. Ongoing clinical and retrieval studies are required to analyze outcomes at longer-term follow-up.

  20. Apparatus and method for quantitatively evaluating total fissile and total fertile nuclide content in samples

    DOEpatents

    Caldwell, John T.; Kunz, Walter E.; Cates, Michael R.; Franks, Larry A.

    1985-01-01

    Simultaneous photon and neutron interrogation of samples for the quantitative determination of total fissile nuclide and total fertile nuclide material present is made possible by the use of an electron accelerator. Prompt and delayed neutrons produced from resulting induced fissions are counted using a single detection system and allow the resolution of the contributions from each interrogating flux leading in turn to the quantitative determination sought. Detection limits for .sup.239 Pu are estimated to be about 3 mg using prompt fission neutrons and about 6 mg using delayed neutrons.

  1. Durability of highly cross-linked polyethylene in total hip and total knee arthroplasty.

    PubMed

    Dion, Neil T; Bragdon, Charles; Muratoglu, Orhun; Freiberg, Andrew A

    2015-07-01

    This article reviews the history of the development of highly cross-linked polyethylene and provides an in-depth review of the clinical results regarding the durability of highly cross-linked polyethylene (HXLPE) used in total hip arthroplasty (THA) and total knee arthroplasty (TKA). The use of polyethylene as a bearing surface has contributed to the success of THA and TKA; however, polyethylene wear and osteolysis can lead to failure. Ongoing clinical and retrieval studies are required to analyze outcomes at longer-term follow-up. PMID:26043046

  2. Glucagon deficiency and hyperaminoacidemia after total pancreatectomy.

    PubMed Central

    Boden, G; Master, R W; Rezvani, I; Palmer, J P; Lobe, T E; Owen, O E

    1980-01-01

    The first goal of this study was to investigate whether totally pancreatectomized patients are glucagon deficient and if so, to what degree. Immunoreactive glucagon (IRG) concentrations in peripheral plasma of nine pancreatectomized patients were not significantly different from those of 10 normal controls as measured by two antisera (30-K and RCS-5) both detecting the COOH-terminal portion of the molecule and one (RCS-5) postulated to be specific for pancreatic glucagon. Plasma from six of nine pancreatectomized patients were fractionated over Sephadex G-50 and IRG was measured with both antisera in the column eluates. Using 30-K, 80.8 +/- 9% of the IRG eluted within the void volume. This material was rechromatographed on Sephadex G-200 and found to have an apparent mol wt of approximately 200,000. Only 18.3 +/- 9% eluted in the IRG3500 region. IRG3500 was significantly reduced in pancreatectomized patients as compared to normal controls (49 +/- 9 vs. 18 +/- 9 pg/ml, P less than 0.05). Using RCS-5, all IRG (corresponding to 20 +/- 6 pg/ml of plasma) eluted in the IRG3500 region. The second goal of this study was to investigate the effects of chronic glucagon deficiency on plasma amino acids. In the nine pancreatectomized patients studied, postabsorptive plasma concentrations of serine, alanine, arginine, glycine, threonine, citrulline, alpha-aminobutyrate, and tryosine were significantly elevated compared to values obtained from 20 normal controls. Physiological glucagon increments produced in two pancreatectomized patients by infusion of glucagon (6.25 and 8.0 microgram/h, respectively) resulted in normalization of the hyperaminoacidemia within 22 h. We conclude (a) that pancreatectomized patients are partially glucagon deficient because of diminished basal as well as diminished stimulated glucagon secretion; (b) that fasting concentrations of certain glucogenic amino acids are elevated in pancreatectomized patients probably as result of reduce; hepatic

  3. Patient injuries in primary total hip replacement.

    PubMed

    Helkamaa, Teemu; Hirvensalo, Eero; Huhtala, Heini; Remes, Ville

    2016-06-01

    Background and purpose - Although the results of primary total hip replacements (THRs) are generally excellent, sometimes serious complications arise. Some of these severe complications are considered to be patient injuries. We analyzed primary THR-related patient injuries in a nationwide setting. Patients and methods - We evaluated all the primary THR-related patient injury claims in Finland between 2008 and 2010. We used the original medical records and 2 nationwide registries, the Care Register for Social Welfare and Health Care and the Patient Injury Claim Register. Results - We identified 563 claims, 44% of which were compensated (n = 250). Of these 250 compensated claims, 79% were considered to be avoidable (treatment injuries) and 21% were severe unexpected infections (with a preoperative infection risk of less than 2%). The most common type of technical error was cup malposition (31%). High-volume hospitals (with an annual primary THR volume ≥ 400) had a lower patient injury rate. In lower-volume hospitals (with an annual primary THR volume of < 400), the relative risks (RRs) of patient injury for any reason, due to technical errors, or because of cup malposition were 2-fold (95% CI: 1.6-3.1), 4-fold (95% CI: 2.3-6.2), and 9-fold (95% CI: 3-28), respectively, compared to high-volume hospitals. Interpretation - Our study provides the first comprehensive nationwide data on THR-related patient injury types. Hospital volume was associated with the quality and quantity of errors detected. An annual hospital volume of ≥ 400 primary THRs was established as a protective factor against patient injuries. PMID:26808350

  4. Hypocupremia in patients receiving total parenteral nutrition.

    PubMed

    Bozzetti, F; Inglese, M G; Terno, G; Pupa, A; Sequeira, C; Migliavacca, S

    1983-01-01

    Although hypocupremia is a well-known consequence of long-term total parenteral nutrition (TPN), its incidence as well as the duration of TPN necessary to induce it are still unsettled. The purpose of this study is to review the changes in serum copper level in 25 patients receiving TPN for a period longer than 2 wk (mean duration 6 wk) at the Istituto Nazionale Tumori of Milan and to evaluate the possible relationship of cupremia with the basic disease. Main indications for TPN included enterocutaneous fistulas (11 patients), cancer cachexia (10 patients), radiation enteropathy (two patients), and severe postoperative stricture following esophagogastric resection (two patients). Mean value of serum copper at the beginning of the study was 143 micrograms/100 ml (normal value 65-165 micrograms/100 ml), and the regression analysis showed a mean fall of 5.64 micrograms/100 ml/wk. Hypocupremia occurred in four patients (three with intestinal fistulas and one with radiation obstructive enteritis) at 5th, 6th, 9th, and 6th wk of TPN, respectively. No patient with cancer cachexia developed hypocupremia. No patient with hypocupremia had clinical evidence of a copper deficiency syndrome. We conclude that 1) hypocupremia does not occur within the first month of TPN; 2) its incidence is about 16% in patients intravenously fed for period longer than 2 wk; 3) it is more frequent in patients with enterocutaneous fistulas, whereas it never occurs in patients with cancer cachexia, and 4) it is not necessarily associated to a clinicometabolic syndrome of copper deficiency. Finally, the "nutritional" meaning of serum copper should be questioned in cancer patients since it could represent a "tumor marker."

  5. Totally implantable artificial organ: cardiac prosthesis.

    PubMed

    Nosé, Y

    1986-04-01

    This article reviews the current status of completely implantable cardiac prostheses, with an emphasis on those systems presently under development at The Cleveland Clinic Foundation (CCF). Such devices have been one of the final goals of artificial heart research since 1957, when Dr. Kolff initiated these studies in Cleveland. Although earlier plans aimed at using radioisotopes as the energy source, more recently, due to public opinion and sociopolitical influences, the shift has been towards exclusive use of electrically activated energy converters. These systems can be roughly broken down into two groups according to the powertrain configuration. In the first group, electric heating coils maintain liquid salts in thermal batteries at temperatures close to 500 degrees C. This thermal energy is then converted (through a Stirling cycle) to mechanical motion of the pusher plate (PP) which in turn acts on the blood. Two such systems (emphasized in this article) are under development here at CCF in joint efforts with Nimbus Corporation and the University of Washington, respectively. In the second group of ventricular assist systems, electric energy is converted directly to PP motion through rotating cams, solenoids, or electrohydraulic transmission systems. At least four American contractors are working at the preclinical stage on this group of devices. One in particular, the CCF-Nimbus system, consisting of a biolized surface blood pump, an electrohydraulic energy converter, and a compliance chamber to handle the variable volume behind the PP, is described in depth in this discussion. In terms of future prospects, it is forecasted that by 1988, the completely implantable VAS will be used clinically, and that by 1994, a specially designed total artificial heart (nontethered patient) would be ready for human use. PMID:3718273

  6. Future Bearing Surfaces in Total Hip Arthroplasty

    PubMed Central

    2014-01-01

    One of the most important issues in the modern total hip arthroplasty (THA) is the bearing surface. Extensive research on bearing surfaces is being conducted to seek an ideal bearing surface for THA. The ideal bearing surface for THA should have superior wear characteristics and should be durable, bio-inert, cost-effective, and easy to implant. However, bearing surfaces that are currently being implemented do not completely fulfill these requirements, especially for young individuals for whom implant longevity is paramount. Even though various new bearing surfaces have been investigated, research is still ongoing, and only short-term results have been reported from clinical trials. Future bearing surfaces can be developed in the following ways: (1) change in design, (2) further improvement of polyethylene, (3) surface modification of the metal, (4) improvement in the ceramic, and (5) use of alternative, new materials. One way to reduce wear and impingement in THA is to make changes in its design by using a large femoral head, a monobloc metal shell with preassembled ceramic liner, dual mobility cups, a combination of different bearing surfaces, etc. Polyethylene has improved over time with the development of highly crosslinked polyethylene. Further improvements can be made by reinforcing it with vitamin E or multiwalled carbon nanotubes and by performing a surface modification with a biomembrane. Surface modifications with titanium nitride or titanium niobium nitride are implemented to try to improve the metal bearings. The advance to the fourth generation ceramics has shown relatively promising results, even in young patients. Nevertheless, further improvement is required to reduce fragility and squeaking. Alternative materials like diamond coatings on surfaces, carbon based composite materials, oxidized zirconium, silicon nitride, and sapphire are being sought. However, long-term studies are necessary to confirm the efficacy of these surfaces after enhancements

  7. Aperture modulated, translating bed total body irradiation

    SciTech Connect

    Hussain, Amjad; Villarreal-Barajas, Jose Eduardo; Dunscombe, Peter; Brown, Derek W.

    2011-02-15

    Purpose: Total body irradiation (TBI) techniques aim to deliver a uniform radiation dose to a patient with an irregular body contour and a heterogeneous density distribution to within {+-}10% of the prescribed dose. In the current article, the authors present a novel, aperture modulated, translating bed TBI (AMTBI) technique that produces a high degree of dose uniformity throughout the entire patient. Methods: The radiation beam is dynamically shaped in two dimensions using a multileaf collimator (MLC). The irregular surface compensation algorithm in the Eclipse treatment planning system is used for fluence optimization, which is performed based on penetration depth and internal inhomogeneities. Two optimal fluence maps (AP and PA) are generated and beam apertures are created to deliver these optimal fluences. During treatment, the patient/phantom is translated on a motorized bed close to the floor (source to bed distance: 204.5 cm) under a stationary radiation beam with 0 deg. gantry angle. The bed motion and dynamic beam apertures are synchronized. Results: The AMTBI technique produces a more homogeneous dose distribution than fixed open beam translating bed TBI. In phantom studies, the dose deviation along the midline is reduced from 10% to less than 5% of the prescribed dose in the longitudinal direction. Dose to the lung is reduced by more than 15% compared to the unshielded fixed open beam technique. At the lateral body edges, the dose received from the open beam technique was 20% higher than that prescribed at umbilicus midplane. With AMTBI the dose deviation in this same region is reduced to less than 3% of the prescribed dose. Validation of the technique was performed using thermoluminescent dosimeters in a Rando phantom. Agreement between calculation and measurement was better than 3% in all cases. Conclusions: A novel, translating bed, aperture modulated TBI technique that employs dynamically shaped MLC defined beams is shown to improve dose uniformity

  8. Total lymphoid irradiation for multiple sclerosis

    SciTech Connect

    Devereux, C.K.; Vidaver, R.; Hafstein, M.P.; Zito, G.; Troiano, R.; Dowling, P.C.; Cook, S.D.

    1988-01-01

    Although chemical immunosuppression has been shown to benefit patients with chronic progressive multiple sclerosis (MS), it appears that chemotherapy has an appreciable oncogenic potential in patients with multiple sclerosis. Accordingly, we developed a modified total lymphoid irradiation (TLI) regimen designed to reduce toxicity and applied it to a randomized double blind trial of TLI or sham irradiation in MS. Standard TLI regimens were modified to reduce dose to 1,980 rad, lowering the superior mantle margin to midway between the thyroid cartilage and angle of the mandible (to avert xerostomia) and the lower margin of the mantle field to the inferior margin of L1 (to reduce gastrointestinal toxicity by dividing abdominal radiation between mantle and inverted Y), limiting spinal cord dose to 1,000 rad by custom-made spine blocks in the mantle and upper 2 cm of inverted Y fields, and also protecting the left kidney even if part of the spleen were shielded. Clinical efficacy was documented by the less frequent functional scale deterioration of 20 TLI treated patients with chronic progressive MS compared to to 20 sham-irradiated progressive MS patients after 12 months (16% versus 55%, p less than 0.03), 18 months (28% versus 63%, p less than 0.03), and 24 months (44% versus 74%, N.S.). Therapeutic benefit during 3 years follow-up was related to the reduction in lymphocyte count 3 months post-irradiation (p less than 0.02). Toxicity was generally mild and transient, with no instance of xerostomia, pericarditis, herpes zoster, or need to terminate treatment in TLI patients. However, menopause was induced in 2 patients and staphylococcal pneumonia in one.

  9. Patient injuries in primary total hip replacement

    PubMed Central

    Helkamaa, Teemu; Hirvensalo, Eero; Huhtala, Heini; Remes, Ville

    2016-01-01

    Background and purpose Although the results of primary total hip replacements (THRs) are generally excellent, sometimes serious complications arise. Some of these severe complications are considered to be patient injuries. We analyzed primary THR-related patient injuries in a nationwide setting. Patients and methods We evaluated all the primary THR-related patient injury claims in Finland between 2008 and 2010. We used the original medical records and 2 nationwide registries, the Care Register for Social Welfare and Health Care and the Patient Injury Claim Register. Results We identified 563 claims, 44% of which were compensated (n = 250). Of these 250 compensated claims, 79% were considered to be avoidable (treatment injuries) and 21% were severe unexpected infections (with a preoperative infection risk of less than 2%). The most common type of technical error was cup malposition (31%). High-volume hospitals (with an annual primary THR volume ≥ 400) had a lower patient injury rate. In lower-volume hospitals (with an annual primary THR volume of < 400), the relative risks (RRs) of patient injury for any reason, due to technical errors, or because of cup malposition were 2-fold (95% CI: 1.6–3.1), 4-fold (95% CI: 2.3–6.2), and 9-fold (95% CI: 3–28), respectively, compared to high-volume hospitals. Interpretation Our study provides the first comprehensive nationwide data on THR-related patient injury types. Hospital volume was associated with the quality and quantity of errors detected. An annual hospital volume of ≥ 400 primary THRs was established as a protective factor against patient injuries. PMID:26808350

  10. Future bearing surfaces in total hip arthroplasty.

    PubMed

    Chang, Jun-Dong

    2014-03-01

    One of the most important issues in the modern total hip arthroplasty (THA) is the bearing surface. Extensive research on bearing surfaces is being conducted to seek an ideal bearing surface for THA. The ideal bearing surface for THA should have superior wear characteristics and should be durable, bio-inert, cost-effective, and easy to implant. However, bearing surfaces that are currently being implemented do not completely fulfill these requirements, especially for young individuals for whom implant longevity is paramount. Even though various new bearing surfaces have been investigated, research is still ongoing, and only short-term results have been reported from clinical trials. Future bearing surfaces can be developed in the following ways: (1) change in design, (2) further improvement of polyethylene, (3) surface modification of the metal, (4) improvement in the ceramic, and (5) use of alternative, new materials. One way to reduce wear and impingement in THA is to make changes in its design by using a large femoral head, a monobloc metal shell with preassembled ceramic liner, dual mobility cups, a combination of different bearing surfaces, etc. Polyethylene has improved over time with the development of highly crosslinked polyethylene. Further improvements can be made by reinforcing it with vitamin E or multiwalled carbon nanotubes and by performing a surface modification with a biomembrane. Surface modifications with titanium nitride or titanium niobium nitride are implemented to try to improve the metal bearings. The advance to the fourth generation ceramics has shown relatively promising results, even in young patients. Nevertheless, further improvement is required to reduce fragility and squeaking. Alternative materials like diamond coatings on surfaces, carbon based composite materials, oxidized zirconium, silicon nitride, and sapphire are being sought. However, long-term studies are necessary to confirm the efficacy of these surfaces after enhancements

  11. Pain Characteristics after Total Laparoscopic Hysterectomy

    PubMed Central

    Choi, Jong Bum; Kang, Kyeongjin; Song, Mi Kyung; Seok, Suhyun; Kim, Yoon Hee; Kim, Ji Eun

    2016-01-01

    Background. Total laparoscopic hysterectomy (TLH) causes various types of postoperative pain, and the pain pattern has not been evaluated in detail to date. This prospective observational study investigated the types of postoperative pain, intensity in the course of time, and pain characteristics during the first postoperative 72 hr after TLH. Methods. Sixty four female patients undergoing TLH were enrolled, which finally 50 patients were included for the data analyses. The locations of pain included overall pain, abdominal visceral and incisional pains, shoulder pain, and perineal pain. Assessments were made at rest and in motion, and pain level was scored with the use of the 100 mm visual analog scale. The pain was assessed at baseline, and at postoperative 30 min, 1 hr, 3 hr, 6 hr, 24 hr, 48 hr, and 72 hr. Results. Overall, visceral, and incisional pains were most intense on the day of operation and then decreased following surgery. In contrast, shoulder pain gradually increased, peaking at postoperative 24 hr. Shoulder pain developed in 90% of all patients (44/50). It was not more aggravated in motion than at rest, in comparison with other pains, and right shoulder pain was more severe than left shoulder pain (p=0.006). In addition, the preoperative exercise habit of patients increased the threshold of shoulder pain. Most patients (46/50) had perineal pain, which was more severe than abdominal pain in approximately 30% of patients (17/50). Conclusion. Pain after TLH showed considerably different duration, severity, and characteristics, compared with other laparoscopic procedures. Shoulder pain was most intense at postoperative 24 hr, and the intensity was associated with the prior exercise habit of patients and the high level of analgesic request. PMID:27499688

  12. Periprosthetic Bone Remodelling in Total Knee Arthroplasty

    PubMed Central

    GEORGEANU, Vlad; ATASIEI, Tudor; GRUIONU, Lucian

    2014-01-01

    Introduction: The clinical studies have shown that the displacement of the prosthesis components, especially of the tibial one is higher during the first year, after which it reaches an equilibrum position compatible with a good long term functioning. This displacement takes place due to bone remodelling close to the implant secondary to different loading concentrations over different areas of bone. Material and Method: Our study implies a simulation on a computational model using the finite element analysis. The simulation started taking into account arbitrary points because of non-linear conditions of bone-prosthesis interface and it was iterative.. A hundred consecutive situations corresponding to intermediate bone remodelling phases have been calculated according to given loadings. Bone remodelling was appreciated as a function of time and bone density for each constitutive element of the computational model created by finite element method. For each constitutive element a medium value of stress during the walking cycle was applied. Results: Analyse of proximal epiphysis-prosthesis complex slices showed that bone density increase is maintained all over the stem in the immediately post-operative period. At 10 months, the moment considered to be the end of bone remodelling, areas with increased bone density are fewer and smaller. Meanwhile, their distribution with a concentration toward the internal compartment in the distal metaphysis is preserved. Conclusions: After the total knee arthroplasty the tibial bone suffered a process of remodelling adapted to the new stress conditions. This bone remodelling can influence, sometimes negatively, especially in the cases with tibial component varus malposition, the fixation, respectively the survival of the prosthesis. This process has been demonstrated both by clinical trials and by simulation, using the finite elements method of periprosthetic bone remodelling. PMID:25553127

  13. Salvage arthrodesis for failed total ankle arthroplasty

    PubMed Central

    Zürcher, Arthur W

    2010-01-01

    Background and purpose Total ankle arthroplasty (TAA) has gained popularity in recent years. If it fails, however, salvage arthrodesis must be reliable as a rescue procedure. We therefore investigated the clinical, radiographic, and subjective outcome after salvage arthrodesis in a consecutive group of patients, and concentrated on the influence of the method of fixation on union rate and on salvage in inflammatory joint disease. Patients and methods Between 1994 and 2005, salvage arthrodesis was performed on 18 ankles (18 patients). Diagnosis was inflammatory joint disease (IJD) in 15 cases and osteoarthritis (OA) in 3. Tibio-talar fusion was performed in 7 ankles, and tibio-talocalcaneal fusion in 11. Serial radiographs were studied for time to union. Clinical outcome at latest follow-up was measured by the AOFAS score, the foot function index (FFI) and by VAS scores for pain, function, and satisfaction. Results Blade plates were used in 7 ankles (4 IJD, 3 OA); all united. Nonunion developed in 7 of the 11 rheumatic ankles stabilized by other methods. 11 patients (8 fused ankles, 3 nonunions) were available for clinical evaluation. Their mean AOFAS score was 62 and mean overall FFI was 70. VAS score for pain was 20, for function 64, and for satisfaction 74. The scores were similar in united and non-united ankles. Interpretation Blade plate fixation is successful in salvage arthrodesis for failed TAA. A high nonunion rate was found after salvage ankle arthrodesis in IJD with other methods of fixation. Clinical results were fair to good. PMID:20175648

  14. 10-year survival of total ankle arthroplasties

    PubMed Central

    2011-01-01

    Background and purpose There is an ongoing need to review large series of total ankle replacements (TARs) for monitoring of changes in practice and their outcome. 4 national registries, including the Swedish Ankle Register, have previously reported their 5-year results. We now present an extended series with a longer follow-up, and with a 10-year survival analysis. Patients and methods Records of uncemented 3-component TARs were retrospectively reviewed, determining risk factors such as age, sex, and diagnosis. Prosthetic survival rates were calculated with exchange or removal of components as endpoint—excluding incidental exchange of the polyethylene meniscus. Results Of the 780 prostheses implanted since 1993, 168 (22%) had been revised by June 15, 2010. The overall survival rate fell from 0.81 (95% CI: 0.79–0.83) at 5 years to 0.69 (95% CI: 0.67–0.71) at 10 years. The survival rate was higher, although not statistically significantly so, during the latter part of the period investigated. Excluding the STAR prosthesis, the survival rate for all the remaining designs was 0.78 at 10 years. Women below the age of 60 with osteoarthritis were at a higher risk of revision, but age did not influence the outcome in men or women with rheumatoid arthritis. Revisions due to technical mistakes at the index surgery and instability were undertaken earlier than revisions for other reasons. Interpretation The results have slowly improved during the 18-year period investigated. However, we do not believe that the survival rates of ankle replacements in the near future will approach those of hip and knee replacements—even though improved instrumentation and design of the prostheses, together with better patient selection, will presumably give better results. PMID:22066551

  15. "Total Physical Response": Un apprentissage non conventionnel ("Total Physical Response": An Unconventional Way to Learn).

    ERIC Educational Resources Information Center

    Lafayette, R. C.

    1991-01-01

    A discussion of the Total Physical Response method of second language instruction places the concept within the context of other unconventional language learning methods, reviews the rationale behind the approach, and outlines the classroom procedures used. A sampling of useful commands for classroom use is included. (19 references) (MSE)

  16. VDAC and the bacterial porin PorB of Neisseria gonorrhoeae share mitochondrial import pathways.

    PubMed

    Müller, Anne; Rassow, Joachim; Grimm, Jan; Machuy, Nikolaus; Meyer, Thomas F; Rudel, Thomas

    2002-04-15

    The human pathogen Neisseria gonorrhoeae induces host cell apoptosis during infection by delivering the outer membrane protein PorB to the host cell's mitochondria. PorB is a pore-forming beta-barrel protein sharing several features with the mitochondrial voltage-dependent anion channel (VDAC), which is involved in the regulation of apoptosis. Here we show that PorB of pathogenic Neisseria species produced by host cells is efficiently targeted to mitochondria. Imported PorB resides in the mitochondrial outer membrane and forms multimers with similar sizes as in the outer bacterial membrane. The mitochondria completely lose their membrane potential, a characteristic previously observed in cells infected with gonococci or treated with purified PorB. Closely related bacterial porins of non-pathogenic Neisseria mucosa or Escherichia coli remain in the cytosol. Import of PorB into mitochondria in vivo is independent of a linear signal sequence. Insertion of PorB into the mitochondrial outer membrane in vitro depends on the activity of Tom5, Tom20 and Tom40, but is independent of Tom70. Our data show that human VDAC and bacterial PorB are imported into mitochondria by a similar mechanism. PMID:11953311

  17. Evaluation of total phosphorus and total nitrogen methods in pulp mill effluents.

    PubMed

    Cook, D L; Frum, N L

    2004-01-01

    Under the Clean Water Action Plan, the US Environmental Protection Agency is requiring states to establish numeric criteria for phosphorus and nitrogen. In preparation for the development of nutrient criteria NCASI undertook a research project to conduct a comparative study of methods for the determination of total phosphorus and total nitrogen in pulp and paper mill matrices. This paper presents results of a single laboratory method evaluation and comparative study of digestion techniques and analytical methods for the determination of total phosphorus (TP) and total nitrogen (TN) in pulp and paper mill secondary treated effluents. Analytical methods included EPA Methods 365.2 and 365.4 for TP. TN and total kjeldahl nitrogen (TKN) methods included EPA Methods 351.2, 351.4, and 353.2. Examinations of sample preservation and storage stability were conducted. Substitution of mercuric sulfate with copper sulfate during block digestion resulted in higher blank levels and method detection limits. TP measurements using EPA Method 365.4 (autoanalyzer) were found to be accurate with a positive bias as determined using matrix spike experiments. Sample digestion by acidic persulfate oxidation or mercuric sulfate block digestion in conjunction with EPA Method 365.4 yielded low blank levels (averages of 0.01 and 0.02 mg/L, respectively), precision of 2.1 and 2.4% relative standard deviations, respectively, and accuracy expressed as an average recovery (%R) of 117% for both. EPA Method 351.2 (autoanalyzer) was more precise than EPA Method 351.4 (ammonia probe). Accuracy (%R) for EPA Method 351.2 ranged from 81 to 95%, depending on the digestion technique applied, and was 55% when EPA Method 351.4 was utilized. Investigation of a method utilizing basic to acidic persulfate oxidation for the simultaneous determination of TN and TP using only two analytical techniques was found to be effective at concentrations above 1 mg/L in pulp mill effluents.

  18. Quantification of total element concentrations in soils using total X-ray fluorescence spectroscopy (TXRF).

    PubMed

    Towett, Erick K; Shepherd, Keith D; Cadisch, Georg

    2013-10-01

    Total X-ray fluorescence spectroscopy (TXRF) determines concentrations of major and trace elements in multiple media. We developed and tested a method for the use of TXRF for direct quantification of total element concentrations in soils using an S2 PICOFOX™ spectrometer (Bruker AXS Microanalysis GmbH, Germany). We selected 15 contrasting soil samples from across sub-Saharan Africa for element analysis to calibrate the instrument against concentrations determined using the inductively coupled plasma-mass spectroscopy (ICP-MS) standard method. A consistent underestimation of element concentrations using TXRF compared to ICP-MS reference analysis occurred, indicating that spectrometer recalibration was required. Single-element recalibration improved the TXRF spectrometer's sensitivity curve. Subsequent analysis revealed that TXRF determined total element concentrations of Al, K, Ti, V, Cr, Mn, Fe, Ni, Cu, Zn, and Ga accurately (model efficacy/slope close to 1:1 line, and R(2)>0.80) over a wide range of soil samples. Other elements that could be estimated with an acceptable precision (R(2)>0.60) compared with ICP-MS although generally somewhat under- or overestimated were P, Ca, As, Rb, Sr, Y, Pr, Ta and Pb. Even after recalibration, compared to ICP-MS the TXRF spectrometer produced underestimations for elements Na, Mg, Ba, Ce, Hf, La, Nd, W and Sm and overestimations for elements Bi, Tl and Zr. We validated the degree of accuracy of the TXRF analytical method after recalibration using an independent set of 20 soil samples. We also tested the accuracy of the analysis using 2 multi-element standards as well as the method repeatability on replicate samples. The resulting total element concentration repeatability for all elements analyzed were within 10% coefficient of variability after the instrument recalibration except for Cd and Tl. Our findings demonstrate that TXRF could be used as a rapid screening tool for total element concentrations in soils assuming that

  19. The satellite total solar irradiance database

    NASA Astrophysics Data System (ADS)

    Willson, R. C.

    2009-12-01

    A precise knowledge of the total solar irradiance (TSI) over time is essential to understanding the physics of solar luminosity variation and its impact on the Earth in the form of climate change. A National Research Council study found that sustained trends as small as 0.25% per century were the most likely forcing for ‘little ice age’ climate minima during the 12th - 19th centuries. Recent phenomenological analyses of TSI observations and proxies indicate that TSI variation is an important climate change forcing on many timescales including the industrial era. The profound sociological and economic implications of understanding the relative climate change contributions of natural and anthropogenic forcings makes it essential that the satellite TSI database be precisely sustained into the foreseeable future. There are currently three satellite TSI monitoring experiments in operation: SOHO/VIRGO, ACRIMSAT/ACRIM3 and SORCE/TIM, in order of deployment (1996, 2000 and 2003, resp.). Results reported on their ‘native scales show the same basic variations in TSI over time, yet some smaller variations detected by ACRIM3 are less well defined or absent in the results of VIRGO and TIM. There is also a scale difference issue: TIM results are 0.35% lower than those of ACRIM3 and VIRGO, outside the ± 0.1% uncertainty bounds predicted for ACRIM3 and VIRGO, and well outside TIM’s ± 0.01% uncertainty design goal. TIM’s failure to achieve 0.01% uncertainty in flight demonstrates that the TSI monitoring paradigm shift of relying on measurement accuracy rather than a redundant/overlap strategy to provide long term traceability cannot be realized with current ‘ambient temperature’ technology. The only viable monitoring approach for the foreseeable future continues to be the redundant/overlap strategy that has provided the 31 year satellite TSI database to date with useful traceability. Intercomparisons of flight experiments at their levels of mutual precision can

  20. Isolated Total Rupture of Extraocular Muscles

    PubMed Central

    Chen, Jingchang; Kang, Ying; Deng, Daming; Shen, Tao; Yan, Jianhua

    2015-01-01

    Abstract Total rupture of extraocular muscles is an infrequent clinical finding. Here we conducted this retrospective study to evaluate their causes of injury, clinical features, imaging, surgical management, and final outcomes in cases of isolated extraocular muscle rupture at a tertiary center in China. Thirty-six patients were identified (24 men and 12 women). Mean age was 34 years (range 2–60). The right eye was involved in 21 patients and the left 1 in 15. A sharp object or metal hook was the cause of this lesion in 16 patients, sinus surgery in 14 patients, traffic accident in 3 patients, orbital surgery in 2 patients, and conjunctive tumor surgery in 1 patient. The most commonly involved muscles were medial (18 patients) and inferior rectus muscles (13 patients). The function of the ruptured muscles revealed a scale of −3 to −4 defect of ocular motility and the amount of deviation in primary position varied from 10 to 140 PD (prism diopter). Computerized tomography (CT) confirmed the presence of ruptured muscles. An end-to-end muscle anastomosis was performed and 3 to 5 mm of muscle was resected in 23 patients. When the posterior border of the injured muscle could not be identified (13 patients), a partial tendon transposition was performed, together with recession of the antagonist in most patients, whereas a recession of the antagonist muscle plus a resection of the involved muscle with or without nasal periosteal fixation was performed in the remaining patients. After an average of 16.42 months of follow-up an excellent result was achieved in 23 patients and results of 13 patients were considered as a failure. In most patients, the posterior border of the ruptured muscle can be identified and an early surgery can be performed to restore function. Alternatively, a partial tendon transposition should be performed. When muscular rupture is suspected, an early orbital CT is required to confirm this possibility, which can then verify the necessity for

  1. Computer-Navigated Total Knee Arthroplasty Utilization.

    PubMed

    Bala, Abiram; Penrose, Colin Thomas; Seyler, Thorsten Markus; Mather, Richard Chad; Wellman, Samuel Secord; Bolognesi, Michael Paul

    2016-07-01

    Computer-navigated total knee arthroplasty (CN-TKA) has been used to improve component alignment, though the evidence is currently mixed on whether there are clinically significant differences in long-term outcomes. Given the established increased costs and operative time, we hypothesized that the utilization rate of CN-TKA would be decreasing relative to standard TKA in the Medicare population given the current health care economic environment. We queried 1,914,514 primary TKAs performed in the entire Medicare database from 2005 to 2012. Current Procedural Terminology (CPT) and International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes were used to identify and separate CN-TKAs. Utilization of TKA was compared by year, gender, and region. Average change in cases per year and compound annual growth rate (CAGR) were used to evaluate trends in utilization of the procedure. We identified 30,773 CN-TKAs performed over this time period. There was an increase in utilization of CN-TKA per year from 984 to 5,352 (average = 572/year, R (2) = 0.85, CAGR = 23.58%) from 2005 to 2012. In contrast, there was a slight decrease in overall TKA utilization from 264,345 to 230,654 (average = 4297/year, R (2) = 0.74, CAGR = - 1.69%). When comparing proportion of CN-TKA to all TKAs, there was an increase from 0.37 to 2.32% (average 0.26%/year, R (2) = 0.88, CAGR = 25.70%). CN-TKA growth in males and females was comparable at 24.42 and 23.11%, respectively. The South region had the highest growth rate at 28.76%, whereas the Midwest had the lowest growth rate at 15.51%. The Midwest was the only region that peaked (2008) with a slow decline in utilization until 2012. Despite increased costs with unclear clinical benefit, CN-TKA is increasing in utilization among Medicare patients. Reasons could include patient preference, advertising, proper of coding the procedure, and increased publicly available information about

  2. Solar total irradiance in cycle 23

    NASA Astrophysics Data System (ADS)

    Krivova, N. A.; Solanki, S. K.; Schmutz, W.

    2011-05-01

    Context. The most recent minimum of solar activity was deeper and longer than the previous two minima as indicated by different proxies of solar activity. This is also true for the total solar irradiance (TSI) according to the PMOD composite. Aims: The apparently unusual behaviour of the TSI has been interpreted as evidence against solar surface magnetism as the main driver of the secular change in the TSI. We test claims that the evolution of the solar surface magnetic field does not reproduce the observed TSI in cycle 23. Methods: We use sensitive, 60-min averaged MDI magnetograms and quasi-simultaneous continuum images as an input to our SATIRE-S model and calculate the TSI variation over cycle 23, sampled roughly every two weeks. The computed TSI is then compared with the PMOD composite of TSI measurements and with the data from two individual instruments, SORCE/TIM and UARS/ACRIM II, that monitored the TSI during the declining phase of cycle 23 and over the previous minimum in 1996, respectively. Results: Excellent agreement is found between the trends shown by the model and almost all sets of measurements. The only exception is the early, i.e. 1996 to 1998, PMOD data. Whereas the agreement between the model and the PMOD composite over the period 1999-2009 is almost perfect, the modelled TSI shows a steeper increase between 1996 and 1999 than implied by the PMOD composite. On the other hand, the steeper trend in the model agrees remarkably well with the ACRIM II data. A closer look at the VIRGO data, which are the basis of the PMOD composite after 1996, reveals that only one of the two VIRGO instruments, the PMO6V, shows the shallower trend present in the composite, whereas the DIARAD measurements indicate a steeper trend. Conclusions: Based on these results, we conclude that (1) the sensitivity changes of the PMO6V radiometers within VIRGO during the first two years have very likely not been correctly evaluated; and that (2) the TSI variations over cycle 23

  3. Total probabilities of ensemble runoff forecasts

    NASA Astrophysics Data System (ADS)

    Olav Skøien, Jon; Bogner, Konrad; Salamon, Peter; Smith, Paul; Pappenberger, Florian

    2016-04-01

    Ensemble forecasting has for a long time been used as a method in meteorological modelling to indicate the uncertainty of the forecasts. However, as the ensembles often exhibit both bias and dispersion errors, it is necessary to calibrate and post-process them. Two of the most common methods for this are Bayesian Model Averaging (Raftery et al., 2005) and Ensemble Model Output Statistics (EMOS) (Gneiting et al., 2005). There are also methods for regionalizing these methods (Berrocal et al., 2007) and for incorporating the correlation between lead times (Hemri et al., 2013). Engeland and Steinsland Engeland and Steinsland (2014) developed a framework which can estimate post-processing parameters which are different in space and time, but still can give a spatially and temporally consistent output. However, their method is computationally complex for our larger number of stations, and cannot directly be regionalized in the way we would like, so we suggest a different path below. The target of our work is to create a mean forecast with uncertainty bounds for a large number of locations in the framework of the European Flood Awareness System (EFAS - http://www.efas.eu) We are therefore more interested in improving the forecast skill for high-flows rather than the forecast skill of lower runoff levels. EFAS uses a combination of ensemble forecasts and deterministic forecasts from different forecasters to force a distributed hydrologic model and to compute runoff ensembles for each river pixel within the model domain. Instead of showing the mean and the variability of each forecast ensemble individually, we will now post-process all model outputs to find a total probability, the post-processed mean and uncertainty of all ensembles. The post-processing parameters are first calibrated for each calibration location, but assuring that they have some spatial correlation, by adding a spatial penalty in the calibration process. This can in some cases have a slight negative

  4. P450 (Cytochrome) Oxidoreductase Gene (POR) Common Variant (POR*28) Significantly Alters CYP2C9 Activity in Swedish, But Not in Korean Healthy Subjects.

    PubMed

    Hatta, Fazleen H M; Aklillu, Eleni

    2015-12-01

    CYP2C9 enzyme contributes to the metabolism of several pharmaceuticals and xenobiotics and yet displays large person-to-person and interethnic variation. Understanding the mechanisms of CYP2C9 variation is thus of immense importance for personalized medicine and rational therapeutics. A genetic variant of P450 (cytochrome) oxidoreductase (POR), a CYP450 redox partner, is reported to influence CYP2C9 metabolic activity in vitro. We investigated the impact of a common variant, POR*28, on CYP2C9 metabolic activity in humans. 148 healthy Swedish and 146 healthy Korean volunteers were genotyped for known CYP2C9 defective variant alleles (CYP2C9*2, *3). The CYP2C9 phenotype was determined using a single oral dose of 50 mg losartan. Excluding oral contraceptive (OC) users and carriers of 2C9*2 and *3 alleles, 117 Korean and 65 Swedish were genotyped for POR*5, *13 and *28 using Taqman assays. The urinary losartan to its metabolite E-3174 metabolic ratio (MR) was used as an index of CYP2C9 metabolic activity. The allele frequency of the POR*28 variant allele in Swedes and Koreans was 29% and 44%, respectively. POR*5 and *13 were absent in both study populations. Considering the CYP2C9*1/*1 genotypes only, the CYP2C9 metabolic activity was 1.40-fold higher in carriers of POR*28 allele than non-carriers among Swedes (p = 0.02). By contrast, no influence of the POR*28 on CYP2C9 activity was found in Koreans (p = 0.68). The multivariate analysis showed that ethnicity, POR genotype, and smoking were strong predictors of CYP2C9 MR (p < 0.05). This is the first report to implicate the importance of POR*28 genetic variation for CYP2C9 metabolic activity in humans. These findings contribute to current efforts for global personalized medicine and using medicines by taking into account pharmacogenetic and phenotypic variations. PMID:26669712

  5. Total Phenolic, Total Flavonoids, Antioxidant and Antimicrobial Activities of Scrophularia Striata Boiss Extracts

    PubMed Central

    Mahboubi, Mohaddese; Kazempour, Nastaran; Boland Nazar, Ali Reza

    2013-01-01

    Background Scrophularia striata (Scrophulariaceae family) is an herbaceous plant that is traditionally used for treatment of microbial infections. Objectives Antimicrobial and antioxidant activity of different extracts (methanolic, ethanolic, aqueous and ethyl acetate) from S. striata aerial parts was evaluated. Materials and Methods The antimicrobial activity of different extracts from S. striata was evaluated against a large number of bacteria and fungi by micro broth dilution. Total phenolic and flavonoid contents were measured and their antioxidant activities evaluated by DPPH assay and beta carotene linoleic acid test. Results Antimicrobial screening exhibited the positive relation between the total phenolic content and its antimicrobial activity but their antioxidant activity had a negative relation. Conclusions Further studies are recommended against clinical isolate of sensitive bacteria and deep investigation on flavonoid and phenolic compounds of S. striata and detecting the antioxidant portion in aqueous extract. PMID:24624181

  6. Determining total phenolic content and total antioxidant capacity of loquat cultivars grown in Hatay

    PubMed Central

    Polat, A. Aytekin; Çalişkan, Oğuzhan; Serçe, Sedat; Saraçoğlu, Onur; Kaya, Cemal; Özgen, Mustafa

    2010-01-01

    Several fruit characteristics of five loquat (Eriobotrya japonica (Thunb.) Lindl.) cultivars/selections grown in Dörtyol, Hatay, Turkey were investigated in 2008. The cultivars/selections included ‘Baduna 5’, Güzelyurt 1, ‘Hafif Çukurgöbek’, ‘Ottaviani,’ and Type 1. The characteristics evaluated included fruit weight, width, length, seed number and weight, flesh/seed ratio, total soluble solids (TSS), pH, acidity, total phenolic (TP) content, and total antioxidant capacity (TAC), determined by the ferric reducing antioxidant power (FRAP) assay. The analyses were conducted by three replicates, with 30 fruits in each replicate. The results indicated that there were significant differences among the cultivars, for all the traits tested. For example, ‘Hafif Çukurgöbek’ and ‘Ottaviani’ had smaller fruits than others, although ‘Hafif Çukurgöbek’ had heavier seeds. The flesh/seed ratio was the highest in Type 1, while ‘Hafif Çukurgöbek’ had the highest pH and high soluble solids. ‘Baduna 5’ and ‘Hafif Çukurgöbek’ had the highest acidity. The TP ranged from 129 (‘Baduna 5’) to 578 (‘Hafif Çukurgöbek’) mg gallic acid equivalent (GAE)/kg fresh fruit (fw). ‘Hafif Çukurgöbek’ also had the highest FRAP mean (12.1 mmol Trolox Equivalent (TE)/kg fw). The results suggest that loquat cultivars have a variable range of TP content and a relatively high total antioxidant capacity, which is crucial for human health. PMID:20548929

  7. Diabetic Neuropathy: What is a Total Contact Cast?

    MedlinePlus

    ... Web version Diabetic Neuropathy | What is a Total Contact Cast? What is a total contact cast? A total contact cast is a cast used to treat ulcers ( ... foot--that's why it is called a total contact cast. The cast helps to protect the skin ...

  8. 38 CFR 8.18 - Total disability-speech.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Total disability-speech... SERVICE LIFE INSURANCE Premium Waivers and Total Disability § 8.18 Total disability—speech. The organic loss of speech shall be deemed to be total disability under National Service Life...

  9. 38 CFR 8.18 - Total disability-speech.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Total disability-speech... SERVICE LIFE INSURANCE Premium Waivers and Total Disability § 8.18 Total disability—speech. The organic loss of speech shall be deemed to be total disability under National Service Life...

  10. 38 CFR 8.18 - Total disability-speech.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Total disability-speech... SERVICE LIFE INSURANCE Premium Waivers and Total Disability § 8.18 Total disability—speech. The organic loss of speech shall be deemed to be total disability under National Service Life...

  11. 38 CFR 8.18 - Total disability-speech.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Total disability-speech... SERVICE LIFE INSURANCE Premium Waivers and Total Disability § 8.18 Total disability—speech. The organic loss of speech shall be deemed to be total disability under National Service Life...

  12. 38 CFR 8.18 - Total disability-speech.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Total disability-speech... SERVICE LIFE INSURANCE Premium Waivers and Total Disability § 8.18 Total disability—speech. The organic loss of speech shall be deemed to be total disability under National Service Life...

  13. 21 CFR 862.1635 - Total protein test system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Total protein test system. 862.1635 Section 862....1635 Total protein test system. (a) Identification. A total protein test system is a device intended to measure total protein(s) in serum or plasma. Measurements obtained by this device are used in...

  14. 21 CFR 862.1635 - Total protein test system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Total protein test system. 862.1635 Section 862....1635 Total protein test system. (a) Identification. A total protein test system is a device intended to measure total protein(s) in serum or plasma. Measurements obtained by this device are used in...

  15. 21 CFR 862.1635 - Total protein test system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Total protein test system. 862.1635 Section 862....1635 Total protein test system. (a) Identification. A total protein test system is a device intended to measure total protein(s) in serum or plasma. Measurements obtained by this device are used in...

  16. 21 CFR 862.1635 - Total protein test system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Total protein test system. 862.1635 Section 862....1635 Total protein test system. (a) Identification. A total protein test system is a device intended to measure total protein(s) in serum or plasma. Measurements obtained by this device are used in...

  17. 21 CFR 862.1635 - Total protein test system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Total protein test system. 862.1635 Section 862....1635 Total protein test system. (a) Identification. A total protein test system is a device intended to measure total protein(s) in serum or plasma. Measurements obtained by this device are used in...

  18. Total oxidant status, total antioxidant capacity and ischemia modified albumin levels in children with celiac disease.

    PubMed

    Sayar, Ersin; Özdem, Sebahat; Uzun, Gülbahar; İşlek, Ali; Yılmaz, Aygen; Artan, Reha

    2015-01-01

    In our study, we aimed to investigate ischemia modified albumin (IMA) as an oxidative stress marker, as well as other oxidant and antioxidant markers that have not been evaluated in children with celiac disease. A total of 37 pediatric patients who were diagnosed with celiac disease (CD) and 29 healthy children were enrolled in this prospective study. We evaluated the IMA, total oxidant status, total antioxidant capacity, sulfhydryl, and advanced oxidation protein products in all of the subjects. We also compared the levels at the time of the diagnosis, and following a gluten-free diet (GFD) in the children with CD. While the IMA and the other oxidant marker levels were significantly higher in the patient group compared to the control group, the antioxidant marker levels were found to be significantly lower in the patient group, compared to the control group. We also determined that the tissue transglutaminase IgA showed a highly positive correlation, and that the IMA showed a moderately positive correlation with the Marsh-Oberhuber histopathological stage. Additionally, the IMA and other oxidant marker levels were significantly lower, while the antioxidant marker levels were significantly higher after the GFD, compared to the pre-diet period. We detected that oxidative stress played a role in the pathogenesis of CD, and that this could be evaluated using oxidative stress markers, which would regress after the GFD. We also detected that IMA is a marker that shows a correlation with the histopathological stage, and may be used in the diagnosis. PMID:27411418

  19. Physical rehabilitation after total joint arthroplasty in companion animals.

    PubMed

    Marcellin-Little, Denis J; Doyle, Nancy D; Pyke, Joanna Freeman

    2015-01-01

    Patients who have total joint arthroplasty have varying needs related to rehabilitation. In the short term, rehabilitation should be used in all dogs to identify high-risk patients and to minimize the likelihood of postoperative complications. Many patients undergoing total hip replacement recover uneventfully without needing long-term physiotherapy. All patients undergoing total knee replacement and total elbow replacement need rehabilitation to restore limb use and maximize their functional recovery. This article presents rehabilitation considerations for companion animals undergoing total hip replacement, total knee replacement, and total elbow replacement; postoperative complications and how to mitigate risks; and anticipated patient outcomes.

  20. THE TOTAL LUMINOUS EFFICIENCY OF LUMINOUS BACTERIA.

    PubMed

    Harvey, E N

    1925-09-18

    emits 14 lumen-seconds per mg. O(2) absorbed. Since the maximum lumens per watt are 640, representing 100 per cent efficiency, the total luminous efficiency if .00156. As some of the oxygen is used in respiratory oxidation which may have nothing to do with luminescence, the luminescence efficiency must be higher than 1 lumen per watt. Experiments with KCN show that this substance may reduce the oxygen consumption to 1/20 of its former value while reducing the luminescence intensity only (1/4). A partial separation of respiratory from luminescence oxidations is therefore effected by KCN, and our efficiency becomes 5 lumens per watt, or .0078. This is an over-all efficiency, based on the energy value of the "fuel" of the bacteria, regarded as a power plant for producing light. It compares very favorably with the 1.6 lumens per watt of a tungsten vacuum lamp or the 3.9 lumens per watt of a tungsten nitrogen lamp, if we correct the usual values for these illuminants, based on watts at the lamp terminals, for a 20 per cent efficiency of the power plant converting the energy of coal fuel into electric current. The specific luminous emission of the bacteria is 3.14 x 10(-6) lumens per cm(2). One bacterium absorbs 215,000 molecules of oxygen per second and emits 1,280 quanta of light at lambda(max) = 510micromicro. If we suppose that a molecule of oxygen uniting with luminous material gives rise to the emission of 1 quantum of light energy, only 1/168 of the oxygen absorbed is used in luminescence. On this basis the efficiency becomes 168 lumens per watt or 26.2 per cent. PMID:19872192

  1. Evaluation of total oxidative status and total antioxidant capacity in patients with endemic fluorosis.

    PubMed

    Varol, Ercan; Icli, Atilla; Aksoy, Fatih; Bas, Hasan Aydin; Sutcu, Recep; Ersoy, Ismail Hakki; Varol, Simge; Ozaydin, Mehmet

    2013-03-01

    The objective of the present study was to determine the plasma total oxidative status (TOS) and total antioxidant capacity (TAC) in patients with endemic fluorosis. A total of 79 (35 males and 44 females; mean age 44.0 ± 11.9 years) patients with endemic fluorosis and 55 (23 males and 32 females; mean age 48.3 ± 8.5 years) age-, sex- and body mass index-matched healthy controls were included in this study. The urine fluoride levels and plasma TOS and TAC levels were measured. The urine fluoride levels of fluorosis patients were significantly higher than control subjects as expected (1.91 ± 0.15 vs. 0.49 ± 0.13 mg/L, respectively; p < 0.001). TOS was significantly higher in fluorosis group than in control group (17.55 ± 3.82 vs. 15.06 ± 4.31 μmol H(2)O(2) Eq/L, respectively; p = 0.001). TAC was significantly lower in fluorosis group than in control group (1.60 ± 0.36 vs. 1.82 ± 0.51 mmol Trolox Eq/L, respectively; p = 0.004). Oxidative stress index (OSI) was significantly higher in fluorosis group than in control group (11.5 ± 3.8 vs. 8.8 ± 3.7, respectively; p < 0.001). Correlation analysis in all the groups indicated that TAC was negatively correlated with urine fluoride (r = -0.25, p = 0.003), TOS was positively correlated with urine fluoride (r = 0.34, p < 0.001) and OSI was positively correlated with urine fluoride (r = 0.36, p < 0.001). The results of our study demonstrate that oxidative stress plays an important role in the pathogenesis of the endemic fluorosis.

  2. Total management of short gut secondary to midgut volvulus without prolonged total parenteral alimentation.

    PubMed

    Tepas, J J; MacLean, W C; Kolbach, S; Shermeta, D W

    1978-12-01

    Absorption studies in rats have shown that intestinal adaptation after catastrophic injury can be stimulated by early enteral feeding. Using this concept, we have devised a technique of early initiation and advancement of oral feedings that begins with Cho-Free and Polycose and gradually adds sucrose and MCT in increasing proportions. The increasing complexity and caloric density of this diet provide sufficient nutrition to allow weaning from total parenteral alimentation within 2--3 wk. Our preliminary experience in babies with midgut volvulus, necrotizing enterocolitis, and gastroschisis has been successful and uncomplicated. These patients have demonstrated consistent weight gain and have been spared the complications associated with prolonged parenteral alimentation.

  3. Total transmission and total reflection by zero index metamaterials with defects.

    PubMed

    Nguyen, Viet Cuong; Chen, Lang; Halterman, Klaus

    2010-12-01

    We theoretically investigate microwave transmission through a zero-index metamaterial loaded with dielectric defects. The metamaterial is impedance matched to free space, with the permittivity and permeability tending towards zero over a given frequency range. By simply varying the radii and permittivities of the defects, total transmission or reflection of the impinging electromagnetic wave can be achieved. The proposed defect structure can offer advances in shielding or cloaking technologies without restricting the object's viewpoint. Active control of the observed exotic transmission and reflection signatures can occur by incorporating tunable refractive index materials such as liquid crystals and BaSrTiO3.

  4. Outcomes of Surgery for Total Anomalous Pulmonary Venous Return without Total Circulatory Arrest

    PubMed Central

    Lee, Youngok; Cho, Joon Yong; Kwon, O Young; Jang, Woo Sung

    2016-01-01

    Background Recent developments in surgical techniques and hospital care have led to improved outcomes following total anomalous pulmonary venous return (TAPVR) repair. However, the surgical repair of TAPVR remains associated with a high risk of mortality and need for reoperation. We conducted this retrospective study to evaluate mid-term outcomes following in situ TAPVR repair without total circulatory arrest (TCA), and to identify the risk factors associated with surgical outcomes. Methods We retrospectively reviewed 29 cases of surgical intervention for TAPVR conducted between April 2000 and July 2015. All patients were newborns or infants who underwent in situ TAPVR repair without TCA. Results Four anatomic subtypes of TAPVR were included in this study: supracardiac (20 cases, 69.0%), cardiac (4 cases, 13.8%), infracardiac (4 cases, 13.8%), and mixed (1 case, 3.4%). The median follow-up period for all patients was 42.9 months. Two (6.9%) early mortalities occurred, as well as 2 (6.9%) cases of postoperative pulmonary venous obstruction (PVO). Preoperative ventilator care (p=0.027) and preoperative PVO (p=0.002) were found to be independent risk factors for mortality. Conclusion In situ repair of TAPVR without TCA was associated with encouraging mid-term outcomes. Preoperative ventilator care and preoperative PVO were found to be independent risk factors for mortality associated with TAPVR repair. PMID:27733992

  5. Total Phenolics, Total Anthocyanins, Antioxidant and Pro-oxidant Activity of Some Red Fruits Teas.

    PubMed

    Moldovan, Bianca; Hosu, Anamaria; David, Luminita; Cimpoiu, Claudia

    2016-01-01

    Fruits represent one of the main dietary sources of bioactive compounds. Due to their remarkable health benefits, many functional foods of fruit origin, including fruit teas, are present on the market and there is an increased interest regarding the investigation of their nutritional parameters and quality. The aims of our study were: 1) to determine the total phenolic content (TPC), total anthocyanins content (TAC), antioxidant activity (AA), the scavenging capacity (IC50), the pro-oxidant activity (Pro-ox) and Pro-Antidex of 12 commercially available red fruit teas, 2) to classify the analysed teas and 3) to evaluate the similarities between samples. The TPC was between 12.5 and 29.3 mg gallic acid equivalents (GAE)/g tea, the TAC varied between 2.6 and 5.6 mg cyanidin-3-glucoside (Cy-3-glu)/g tea and AA was in the range of 10.9-19.1 mg ascorbic acid equivalents (AAE)/g tea. The Pro-ox activity varied between 3.9 and 10.0 mg/mL tea extract and Pro-Antidex was between 3.3 and 7.3.

  6. Total Phenolics, Total Anthocyanins, Antioxidant and Pro-oxidant Activity of Some Red Fruits Teas.

    PubMed

    Moldovan, Bianca; Hosu, Anamaria; David, Luminita; Cimpoiu, Claudia

    2016-01-01

    Fruits represent one of the main dietary sources of bioactive compounds. Due to their remarkable health benefits, many functional foods of fruit origin, including fruit teas, are present on the market and there is an increased interest regarding the investigation of their nutritional parameters and quality. The aims of our study were: 1) to determine the total phenolic content (TPC), total anthocyanins content (TAC), antioxidant activity (AA), the scavenging capacity (IC50), the pro-oxidant activity (Pro-ox) and Pro-Antidex of 12 commercially available red fruit teas, 2) to classify the analysed teas and 3) to evaluate the similarities between samples. The TPC was between 12.5 and 29.3 mg gallic acid equivalents (GAE)/g tea, the TAC varied between 2.6 and 5.6 mg cyanidin-3-glucoside (Cy-3-glu)/g tea and AA was in the range of 10.9-19.1 mg ascorbic acid equivalents (AAE)/g tea. The Pro-ox activity varied between 3.9 and 10.0 mg/mL tea extract and Pro-Antidex was between 3.3 and 7.3. PMID:27333542

  7. Rapid recovery protocol for peri-operative care of total hip and total knee arthroplasty patients.

    PubMed

    Berend, Keith R; Lombardi, Adolph V; Mallory, Thomas H

    2004-01-01

    Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are among the most successful procedures performed in terms of quality-of-life years gained. The long-term goals of arthroplasty, to relieve pain, increase function, provide stability, and obtain durability, are accomplished in the vast majority of cases. The short-term goals, however, have become the target of aggressive peri-operative programs that aim to speed recovery, reduce morbidity and complications, and create a program of efficiency while maintaining the highest level of patient care. The concept of rapid recovery is built upon the burgeoning interest in less-invasive and small-incision surgeries for (THA and TKA). However, the incision size does not appear to be the most critical aspect of the program. This article outlines the specific elements of the rapid-recovery program for lower-extremity arthroplasty patients, including pre-operative patient education, peri-operative nutrition, vitamin and herbal medication supplementation, preemptive analgesia, and post-operative rehabilitation. A holistic peri-operative, rapid-recovery program has lead to a significantly decreased hospital length of stay and significantly lower hospital readmission rates in patients who undergo primary THAs and TKAs. Combining these results with minimally invasive techniques and instrumentation should make recovery even faster.

  8. Educational Needs of Patients Undergoing Total Joint Arthroplasty

    PubMed Central

    MacKay, Crystal; Saryeddine, Tina; Davis, Aileen M.; Flannery, John F.; Jaglal, Susan B.; Levy, Charissa; Mahomed, Nizar

    2010-01-01

    ABSTRACT Purpose: To identify the educational needs of adults who undergo total hip and total knee replacement surgery. Methods: A qualitative research design using a semi-standardized interviewing method was employed. A purposive sampling technique was used to recruit participants, who were eligible if they were scheduled to undergo total hip or total knee replacement or had undergone total hip or total knee replacement in the previous 3 to 6 months. A comparative contrast method of analysis was used. Results: Of 22 potential participants who were approached, 15 participated. Five were booked for upcoming total hip or total knee replacement and 10 had undergone at least one total hip or total knee replacement in the previous 3 to 6 months. Several themes related to specific educational needs and factors affecting educational needs, including access, preoperative phase, surgery and medical recovery, rehabilitation process and functional recovery, fears, and expectations counterbalanced with responsibility, emerged from the interviews. Conclusions: Educational needs of adults who undergo total hip and knee replacement surgery encompass a broad range of topics, confirming the importance of offering an all-inclusive information package regarding total hip and total knee replacement. PMID:21629598

  9. Joint Line Reconstruction in Navigated Total Knee Arthroplasty Revision

    ClinicalTrials.gov

    2012-05-16

    Revision Total Knee Arthroplasty Because of; Loosening; Instability; Impingement; or Other Reasons Accepted as Indications for TKA Exchange.; The Focus is to Determine the Precision of Joint Line Restoration in Navigated vs. Conventional Revision Total Knee Arthroplasty

  10. Rainfall Totals from the Tropical Cyclones Passing Over Philippines

    NASA Video Gallery

    Rainfall totals from the TRMM satellite of all tropical cyclones that passed through the Philippines from January through November 11, 2013. Red indicated areas where rainfall totals were greater t...

  11. Total Protein and Albumin/Globulin Ratio Test

    MedlinePlus

    ... limited. Home Visit Global Sites Search Help? Total Protein and Albumin/Globulin (A/G) Ratio Share this ... Globulin Ratio; A/G Ratio Formal name: Total Protein; Albumin to Globulin Ratio Related tests: Albumin ; Liver ...

  12. GPM Shows Large Rainfall Totals from Typhoon Dujuan

    NASA Video Gallery

    GPM showed that Taiwan's heaviest rainfall totals of over 275 mm (10.8 inches) were located along the coast south of where Typhoon Dujuan made landfall. The highest rainfall totals were found over ...

  13. IMERG Shows Rainfall Totals Over the Philippines from Melor

    NASA Video Gallery

    The highest rainfall totals during this five day period were still found along the typhoon's path in the central Philippines where rainfall totals were now measured by IMERG at over 899 mm (35.4 in...

  14. Genome Sequences of Pseudomonas oryzihabitans Phage POR1 and Pseudomonas aeruginosa Phage PAE1

    PubMed Central

    Dyson, Zoe A.; Seviour, Robert J.; Tucci, Joseph

    2016-01-01

    We report the genome sequences of two double-stranded DNA siphoviruses, POR1 infective for Pseudomonas oryzihabitans and PAE1 infective for Pseudomonas aeruginosa. The phage POR1 genome showed no nucleotide sequence homology to any other DNA phage sequence in the GenBank database, while phage PAE1 displayed synteny to P. aeruginosa phages M6, MP1412, and YuA. PMID:27313312

  15. Genome Sequences of Pseudomonas oryzihabitans Phage POR1 and Pseudomonas aeruginosa Phage PAE1.

    PubMed

    Dyson, Zoe A; Seviour, Robert J; Tucci, Joseph; Petrovski, Steve

    2016-06-16

    We report the genome sequences of two double-stranded DNA siphoviruses, POR1 infective for Pseudomonas oryzihabitans and PAE1 infective for Pseudomonas aeruginosa The phage POR1 genome showed no nucleotide sequence homology to any other DNA phage sequence in the GenBank database, while phage PAE1 displayed synteny to P. aeruginosa phages M6, MP1412, and YuA.

  16. Genome Sequences of Pseudomonas oryzihabitans Phage POR1 and Pseudomonas aeruginosa Phage PAE1.

    PubMed

    Dyson, Zoe A; Seviour, Robert J; Tucci, Joseph; Petrovski, Steve

    2016-01-01

    We report the genome sequences of two double-stranded DNA siphoviruses, POR1 infective for Pseudomonas oryzihabitans and PAE1 infective for Pseudomonas aeruginosa The phage POR1 genome showed no nucleotide sequence homology to any other DNA phage sequence in the GenBank database, while phage PAE1 displayed synteny to P. aeruginosa phages M6, MP1412, and YuA. PMID:27313312

  17. [What are the recommendations for sport activity following total hip or total knee arthroplasty?].

    PubMed

    Tsur, Azmon; Volpin, Gershon

    2013-11-01

    Total hip and knee arthroplasty are surgical procedures usually performed in older adults aged 65-70 years and more, who suffer from arthritic joint degeneration, in order to relieve pain and improve functioning. In the past decade there have been more and more documentations of younger people, 50-60 years old and even less, who expect to participate in physical activity following these procedures. The trend today is to recommend activities which exert mild pressure on the implants such as swimming, cycling, golf, bowling, walking and cycling. It is not recommended to participate in sports activities that place greater pressure on the implants such as soccer, football, volleyball, handball, basketball, hockey and jogging. Such high-stress activities may cause early loosening of implants, as described in the article by Keren et al. in this issue: "Sport activity after hip and knee arthroplasty". PMID:24416821

  18. [What are the recommendations for sport activity following total hip or total knee arthroplasty?].

    PubMed

    Tsur, Azmon; Volpin, Gershon

    2013-11-01

    Total hip and knee arthroplasty are surgical procedures usually performed in older adults aged 65-70 years and more, who suffer from arthritic joint degeneration, in order to relieve pain and improve functioning. In the past decade there have been more and more documentations of younger people, 50-60 years old and even less, who expect to participate in physical activity following these procedures. The trend today is to recommend activities which exert mild pressure on the implants such as swimming, cycling, golf, bowling, walking and cycling. It is not recommended to participate in sports activities that place greater pressure on the implants such as soccer, football, volleyball, handball, basketball, hockey and jogging. Such high-stress activities may cause early loosening of implants, as described in the article by Keren et al. in this issue: "Sport activity after hip and knee arthroplasty".

  19. Concentration and flux of total and dissolved phosphorus, total nitrogen, chloride, and total suspended solids for monitored tributaries of Lake Champlain, 1990-2012

    USGS Publications Warehouse

    Medalie, Laura

    2014-01-01

    Annual and daily concentrations and fluxes of total and dissolved phosphorus, total nitrogen, chloride, and total suspended solids were estimated for 18 monitored tributaries to Lake Champlain by using the Weighted Regressions on Time, Discharge, and Seasons regression model. Estimates were made for 21 or 23 years, depending on data availability, for the purpose of providing timely and accessible summary reports as stipulated in the 2010 update to the Lake Champlain “Opportunities for Action” management plan. Estimates of concentration and flux were provided for each tributary based on (1) observed daily discharges and (2) a flow-normalizing procedure, which removed the random fluctuations of climate-related variability. The flux bias statistic, an indicator of the ability of the Weighted Regressions on Time, Discharge, and Season regression models to provide accurate representations of flux, showed acceptable bias (less than ±10 percent) for 68 out of 72 models for total and dissolved phosphorus, total nitrogen, and chloride. Six out of 18 models for total suspended solids had moderate bias (between 10 and 30 percent), an expected result given the frequently nonlinear relation between total suspended solids and discharge. One model for total suspended solids with a very high bias was influenced by a single extreme value; however, removal of that value, although reducing the bias substantially, had little effect on annual fluxes.

  20. Climatological variations of total alkalinity and total dissolved inorganic carbon in the Mediterranean Sea surface waters

    NASA Astrophysics Data System (ADS)

    Gemayel, E.; Hassoun, A. E. R.; Benallal, M. A.; Goyet, C.; Rivaro, P.; Abboud-Abi Saab, M.; Krasakopoulou, E.; Touratier, F.; Ziveri, P.

    2015-12-01

    A compilation of data from several cruises between 1998 and 2013 was used to derive polynomial fits that estimate total alkalinity (AT) and total dissolved inorganic carbon (CT) from measurements of salinity and temperature in the Mediterranean Sea surface waters. The optimal equations were chosen based on the 10-fold cross-validation results and revealed that second- and third-order polynomials fit the AT and CT data respectively. The AT surface fit yielded a root mean square error (RMSE) of ± 10.6 μmol kg-1, and salinity and temperature contribute to 96 % of the variability. Furthermore, we present the first annual mean CT parameterization for the Mediterranean Sea surface waters with a RMSE of ± 14.3 μmol kg-1. Excluding the marginal seas of the Adriatic and the Aegean, these equations can be used to estimate AT and CT in case of the lack of measurements. The identified empirical equations were applied on the 0.25° climatologies of temperature and salinity, available from the World Ocean Atlas 2013. The 7-year averages (2005-2012) showed that AT and CT have similar patterns with an increasing eastward gradient. The variability is influenced by the inflow of cold Atlantic waters through the Strait of Gibraltar and by the oligotrophic and thermohaline gradient that characterize the Mediterranean Sea. The summer-winter seasonality was also mapped and showed different patterns for AT and CT. During the winter, the AT and CT concentrations were higher in the western than in the eastern basin. The opposite was observed in the summer where the eastern basin was marked by higher AT and CT concentrations than in winter. The strong evaporation that takes place in this season along with the ultra-oligotrophy of the eastern basin determines the increase of both AT and CT concentrations.

  1. Qualifying CT for wrist arthroplasty: extending techniques for total hip arthroplasty to total wrist arthroplasty

    NASA Astrophysics Data System (ADS)

    Alcala, Yvonne; Olivecrona, Henrik; Olivecrona, Lotta; Noz, Marilyn E.; Maguire, Gerald Q., Jr.; Zeleznik, Michael P.; Sollerman, Christer

    2005-04-01

    The purpose of this study was to extend previous work to detect migration of total wrist arthroplasty non-invasively, and with greater accuracy. Two human cadaverous arms, each with a cemented total wrist implant, were used in this study. In one of the arms, 1 mm tantalum balls were implanted, six in the carpal bones and five in the radius. Five CT scans of each arm were acquired, changing the position of the arm each time to mimic different positions patients might take on repeated examinations. Registration of CT volume data sets was performed using an extensively validated, 3D semi-automatic volume fusion tool in which co-homologous point pairs (landmarks) are chosen on each volume to be registered. Three sets of ten cases each were obtained by placing landmarks on 1) bone only (using only arm one), 2) tantalum implants only, and 3) bone and tantalum implants (both using only arm two). The accuracy of the match was assessed visually in 2D and 3D, and numerically by calculating the distance difference between the actual position of the transformed landmarks and their ideal position (i.e., the reference landmark positions). All cases were matched visually within one width of cortical bone and numerically within one half CT voxel (0.32 mm, p = 0.05). This method matched only the bone/arm and not the prosthetic component per se, thus making it possible to detect prosthetic movement and wear. This method was clinically used for one patient with pain. Loosening of the carpal prosthetic component was accurately detected and this was confirmed at surgery.

  2. Absence of association between total heterotrophic and total coliform bacteria from a public water supply.

    PubMed Central

    Edberg, S; Smith, D B

    1989-01-01

    Heterotrophic plate counts (HPC) and total coliforms (TC) are two major microbial indicators that are used to monitor the potability of water. Although the presence of heterotrophs has been hypothesized to predict the presence of TC, there have been few documented reports. Intensive sampling of raw, treated effluent and distribution water from a public water supply serving 400,000 people provided an opportunity to study the relationship between these two indicator groups of bacteria. A total of 26,158 samples were analyzed, including 12,970 from 1986 and 13,188 from 1985. There were 13,429 samples from the distribution system, 5,524 from treatment effluents, and 7,205 from raw water. The associations between HPC and TC were made on both a hits-and-misses and numerical comparison (CFU per milliliter) basis. The periodicity of the two indicators was also analyzed to determine whether the presence of one group could predict the presence of the other. Atypical bacteria were also related to the presence of these two indicator bacteria. Venn diagrams and nonparametric statistics revealed the following correlation coefficients for HPC and TC for 1985 and 1986 combined: raw water r = 0.45, treated effluent r = 0.06, and distribution system r = 0.10. Atypical bacteria showed a similar relationship with HPC. There was no predictive periodicity for HPC and TC within +/- 10 days of isolation of each other. Therefore, in a 2-year survey of a public water supply, the presence of HPC had a low correlation coefficient with TC, as determined by hits-and-misses and numerical comparisons. The enumeration of one group was found to be independent of the other. PMID:2719479

  3. An investigation of exploitation versus exploration in GBEA optimization of PORS 15 and 16 Problems

    SciTech Connect

    Koch, Kaelynn

    2012-01-01

    It was hypothesized that the variations in time to solution are driven by the competing mechanisms of exploration and exploitation.This thesis explores this hypothesis by examining two contrasting problems that embody the hypothesized tradeoff between exploration and exploitation. Plus one recall store (PORS) is an optimization problem based on the idea of a simple calculator with four buttons: plus, one, store, and recall. Integer addition and store are classified as operations, and one and memory recall are classified as terminals. The goal is to arrange a fixed number of keystrokes in a way that maximizes the numerical result. PORS 15 (15 keystrokes) represents the subset of difficult PORS problems and PORS 16 (16 keystrokes) represents the subset of PORS problems that are easiest to optimize. The goal of this work is to examine the tradeoff between exploitation and exploration in graph based evolutionary algorithm (GBEA) optimization. To do this, computational experiments are used to examine how solutions evolve in PORS 15 and 16 problems when solved using GBEAs. The experiment is comprised of three components; the graphs and the population, the evolutionary algorithm rule set, and the example problems. The complete, hypercube, and cycle graphs were used for this experiment. A fixed population size was used.

  4. Crystallographic analysis of Neisseria meningitidis PorB extracellular loops potentially implicated in TLR2 recognition.

    PubMed

    Kattner, Christof; Toussi, Deana N; Zaucha, Jan; Wetzler, Lee M; Rüppel, Nadine; Zachariae, Ulrich; Massari, Paola; Tanabe, Mikio

    2014-03-01

    Among all Neisseriae species, Neisseria meningitidis and Neisseria gonorrhoeae are the only human pathogens, causative agents of bacterial meningitis and gonorrhoea, respectively. PorB, a pan-Neisseriae trimeric porin that mediates diffusive transport of essential molecules across the bacterial outer membrane, is also known to activate host innate immunity via Toll-like receptor 2 (TLR2)-mediated signaling. The molecular mechanism of PorB binding to TLR2 is not known, but it has been hypothesized that electrostatic interactions contribute to ligand/receptor binding. Strain-specific sequence variability in the surface-exposed loops of PorB which are potentially implicated in TLR2 binding, may explain the difference in TLR2-mediated cell activation in vitro by PorB homologs from the commensal Neisseriae lactamica and the pathogen N. meningitidis. Here, we report a comparative structural analysis of PorB from N. meningitidis serogroup B strain 8765 (63% sequence homology with PorB from N. meningitidis serogroup W135) and a mutant in which amino acid substitutions in the extracellular loop 7 lead to significantly reduced TLR2-dependent activity in vitro. We observe that this mutation both alters the loop conformation and causes dramatic changes of electrostatic surface charge, both of which may affect TLR2 recognition and signaling. PMID:24361688

  5. Structural basis for solute transport, nucleotide regulation, and immunological recognition of Neisseria meningitidis PorB

    SciTech Connect

    Tanabe, Mikio; Nimigean, Crina M.; Iverson, T.M.

    2010-06-25

    PorB is the second most prevalent outer membrane protein in Neisseria meningitidis. PorB is required for neisserial pathogenesis and can elicit a Toll-like receptor mediated host immune response. Here, the x-ray crystal structure of PorB has been determined to 2.3 {angstrom} resolution. Structural analysis and cocrystallization studies identify three putative solute translocation pathways through the channel pore: One pathway transports anions nonselectively, one transports cations nonselectively, and one facilitates the specific uptake of sugars. During infection, PorB likely binds host mitochondrial ATP, and cocrystallization with the ATP analog AMP-PNP suggests that binding of nucleotides regulates these translocation pathways both by partial occlusion of the pore and by restricting the motion of a putative voltage gating loop. PorB is located on the surface of N. meningitidis and can be recognized by receptors of the host innate immune system. Features of PorB suggest that Toll-like receptor mediated recognition outer membrane proteins may be initiated with a nonspecific electrostatic attraction.

  6. 40 CFR 503.44 - Operational standard-total hydrocarbons.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... hydrocarbons. 503.44 Section 503.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... standard—total hydrocarbons. (a) The total hydrocarbons concentration in the exit gas from a sewage sludge incinerator shall be corrected for zero percent moisture by multiplying the measured total...

  7. 40 CFR 503.44 - Operational standard-total hydrocarbons.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... hydrocarbons. 503.44 Section 503.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... standard—total hydrocarbons. (a) The total hydrocarbons concentration in the exit gas from a sewage sludge incinerator shall be corrected for zero percent moisture by multiplying the measured total...

  8. 40 CFR 503.44 - Operational standard-total hydrocarbons.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... hydrocarbons. 503.44 Section 503.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... standard—total hydrocarbons. (a) The total hydrocarbons concentration in the exit gas from a sewage sludge incinerator shall be corrected for zero percent moisture by multiplying the measured total...

  9. 40 CFR 503.44 - Operational standard-total hydrocarbons.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... hydrocarbons. 503.44 Section 503.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... standard—total hydrocarbons. (a) The total hydrocarbons concentration in the exit gas from a sewage sludge incinerator shall be corrected for zero percent moisture by multiplying the measured total...

  10. 40 CFR 503.44 - Operational standard-total hydrocarbons.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... hydrocarbons. 503.44 Section 503.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... standard—total hydrocarbons. (a) The total hydrocarbons concentration in the exit gas from a sewage sludge incinerator shall be corrected for zero percent moisture by multiplying the measured total...

  11. 29 CFR 4022.6 - Annuity payable for total disability.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Annuity payable for total disability. 4022.6 Section 4022.6... § 4022.6 Annuity payable for total disability. (a) Except as provided in paragraph (b) of this section... terms of a plan on account of the total and permanent disability of a participant which is expected...

  12. 20 CFR 10.400 - What is total disability?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true What is total disability? 10.400 Section 10... AMENDED Compensation and Related Benefits Compensation for Disability and Impairment § 10.400 What is total disability? (a) Permanent total disability is presumed to result from the loss of use of...

  13. 29 CFR 4022.6 - Annuity payable for total disability.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Annuity payable for total disability. 4022.6 Section 4022.6... § 4022.6 Annuity payable for total disability. (a) Except as otherwise provided in this section, an... on account of the total and permanent disability of a participant which is expected to last for...

  14. 29 CFR 4022.6 - Annuity payable for total disability.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Annuity payable for total disability. 4022.6 Section 4022.6... § 4022.6 Annuity payable for total disability. (a) Except as provided in paragraph (b) of this section... terms of a plan on account of the total and permanent disability of a participant which is expected...

  15. 29 CFR 4022.6 - Annuity payable for total disability.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Annuity payable for total disability. 4022.6 Section 4022.6... § 4022.6 Annuity payable for total disability. (a) Except as otherwise provided in this section, an... on account of the total and permanent disability of a participant which is expected to last for...

  16. 29 CFR 4022.6 - Annuity payable for total disability.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Annuity payable for total disability. 4022.6 Section 4022.6... § 4022.6 Annuity payable for total disability. (a) Except as otherwise provided in this section, an... on account of the total and permanent disability of a participant which is expected to last for...

  17. 7 CFR 760.635 - Total farm revenue.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Total farm revenue. 760.635 Section 760.635... AGRICULTURE SPECIAL PROGRAMS INDEMNITY PAYMENT PROGRAMS Supplemental Revenue Assistance Payments Program § 760.635 Total farm revenue. (a) For the purpose of SURE payment calculation, total farm revenue will...

  18. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Total temporomandibular joint prosthesis. 872.3940... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3940 Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is intended to...

  19. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Total temporomandibular joint prosthesis. 872.3940... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3940 Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is intended to...

  20. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Total temporomandibular joint prosthesis. 872.3940... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3940 Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is intended to...

  1. 38 CFR 3.343 - Continuance of total disability ratings.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... disability ratings. 3.343 Section 3.343 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... Evaluations; Service Connection § 3.343 Continuance of total disability ratings. (a) General. Total disability... latter, reduction from total disability ratings will not be considered pending reexamination after...

  2. 20 CFR 10.400 - What is total disability?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false What is total disability? 10.400 Section 10... AMENDED Compensation and Related Benefits Compensation for Disability and Impairment § 10.400 What is total disability? (a) Permanent total disability is presumed to result from the loss of use of...

  3. 20 CFR 10.400 - What is total disability?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false What is total disability? 10.400 Section 10... AMENDED Compensation and Related Benefits Compensation for Disability and Impairment § 10.400 What is total disability? (a) Permanent total disability is presumed to result from the loss of use of...

  4. 20 CFR 10.400 - What is total disability?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false What is total disability? 10.400 Section 10... AMENDED Compensation and Related Benefits Compensation for Disability and Impairment § 10.400 What is total disability? (a) Permanent total disability is presumed to result from the loss of use of...

  5. 20 CFR 10.400 - What is total disability?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true What is total disability? 10.400 Section 10... AMENDED Compensation and Related Benefits Compensation for Disability and Impairment § 10.400 What is total disability? (a) Permanent total disability is presumed to result from the loss of use of...

  6. 10 CFR 603.520 - Reasonableness of total project funding.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Reasonableness of total project funding. 603.520 Section 603.520 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre-Award Business Evaluation Total Funding § 603.520 Reasonableness of total project funding....

  7. 48 CFR 31.201-1 - Composition of total cost.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Composition of total cost. 31.201-1 Section 31.201-1 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... Organizations 31.201-1 Composition of total cost. (a) The total cost, including standard costs properly...

  8. 48 CFR 31.201-1 - Composition of total cost.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false Composition of total cost. 31.201-1 Section 31.201-1 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... Organizations 31.201-1 Composition of total cost. (a) The total cost, including standard costs properly...

  9. 48 CFR 31.201-1 - Composition of total cost.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Composition of total cost. 31.201-1 Section 31.201-1 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... Organizations 31.201-1 Composition of total cost. (a) The total cost, including standard costs properly...

  10. 48 CFR 31.201-1 - Composition of total cost.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Composition of total cost. 31.201-1 Section 31.201-1 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... Organizations 31.201-1 Composition of total cost. (a) The total cost, including standard costs properly...

  11. 48 CFR 31.201-1 - Composition of total cost.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false Composition of total cost. 31.201-1 Section 31.201-1 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... Organizations 31.201-1 Composition of total cost. (a) The total cost, including standard costs properly...

  12. Total Lightning as an Indicator of Mesocyclone Behavior

    NASA Technical Reports Server (NTRS)

    Stough, Sarah M.; Carey, Lawrence D.; Schultz, Christopher J.

    2014-01-01

    Apparent relationship between total lightning (in-cloud and cloud to ground) and severe weather suggests its operational utility. Goal of fusion of total lightning with proven tools (i.e., radar lightning algorithms. Preliminary work here investigates circulation from Weather Suveilance Radar- 1988 Doppler (WSR-88D) coupled with total lightning data from Lightning Mapping Arrays.

  13. 26 CFR 1.801-5 - Total reserves.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... TAXES Life Insurance Companies § 1.801-5 Total reserves. (a) Total reserves defined. For purposes of section 801(a) and § 1.801-3, the term “total reserves” is defined in section 801(c) as the sum of: (1) Life insurance reserves (as defined in section 801(b) and § 1.801-4), (2) Unearned premiums (as...

  14. 26 CFR 1.801-5 - Total reserves.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... TAXES (CONTINUED) Life Insurance Companies § 1.801-5 Total reserves. (a) Total reserves defined. For purposes of section 801(a) and § 1.801-3, the term “total reserves” is defined in section 801(c) as the sum of: (1) Life insurance reserves (as defined in section 801(b) and § 1.801-4), (2) Unearned...

  15. 26 CFR 1.801-5 - Total reserves.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... TAXES (CONTINUED) Life Insurance Companies § 1.801-5 Total reserves. (a) Total reserves defined. For purposes of section 801(a) and § 1.801-3, the term “total reserves” is defined in section 801(c) as the sum of: (1) Life insurance reserves (as defined in section 801(b) and § 1.801-4), (2) Unearned...

  16. 26 CFR 1.801-5 - Total reserves.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... TAXES (CONTINUED) Life Insurance Companies § 1.801-5 Total reserves. (a) Total reserves defined. For purposes of section 801(a) and § 1.801-3, the term “total reserves” is defined in section 801(c) as the sum of: (1) Life insurance reserves (as defined in section 801(b) and § 1.801-4), (2) Unearned...

  17. Predictions for the total solar eclipse of 1991

    NASA Technical Reports Server (NTRS)

    Espenak, Fred

    1989-01-01

    A total eclipse of the sun will be widely visible from the Western Hemisphere on July 11, 1991. Detailed predictions for this event are presented which include tables of geographic coordinates for the northern limit, southern limit and center line of the path of totality, local circumstances on the center line and for 95 cities within the partial and total eclipse paths, maps depicting the path of totality, the sky during totality and the lunar limb profile. The author discusses the general characteristics of the eclipse including local circumstances from various points along the central path, the Saros series history and effects caused by the lunar limb profile.

  18. Total or near total pancreatectomy and islet autotransplantation for treatment of chronic pancreatitis.

    PubMed Central

    Najarian, J S; Sutherland, D E; Baumgartner, D; Burke, B; Rynasiewicz, J J; Matas, A J; Goetz, F C

    1980-01-01

    Total or near total pancreatectomy is the surest way to relieve the pain of chronic pancreatitis but is rarely applied because the metabolic consequences are so severe. For most patients drainage procedures are applicable, but pancreatectomy may be the only alternative for small duct disease or where procedures to improve duct drainage have failed. Preservation of endocrine function is a major problem in patients who require pancreatectomy. Experiments in pancreatectomized dogs have shown that intrasplenic or intraportal transplantation of unpurified pancreatic islet tissue dispersed by collagenase digestion can prevent diabetes. We have applied this technique to ten patients with chronic pancreatitis, small ducts, and intractable pain. The entire pancreas of > 95% of the pancrease was excised, minced, dispersed by collagenase digestion and infused into the portal vein < 2 1/2 hours after removal. Mean (+/- SD) rise in portal pressure was 17 +/- 8 cm of water. Liver function tests were altered minimally. All patients were relieved of pain. One patient died of a complication not related to the islet autotransplant; viable islets were identified in the liver at autopsy. Of the remaining nine patients, three have been insulin independent for 1, 9, and 38 months. One patient was insulin indpendent for 15 months and now takes 12 units of insulin daily. Three have nonketosis prone diabetes (tested by insulin withdrawal) and take 15--30 units of insulin per day. C-peptide studies in these patients show that functioning islets are present. Two patients are diabetic and require 35 and 60 units of insulin per day. In eight of nine patients tested serum insulin concentrations fell to undetectable levels during the interval between pancreatectomy and islet transplantation. Serum insulin levels during the first few hours after islet transplantation predicted success. In the insulin independent or in the patients with mild diabetes, insulin levels were persistently greater than

  19. Robotic-Assisted Total Laparoscopic Hysterectomy Versus Conventional Total Laparoscopic Hysterectomy

    PubMed Central

    Gill, Diana; Locher, Stephen R.

    2009-01-01

    Objectives: To compare patient characteristics, operative variables, and outcomes of 24 patients who underwent robotic-assisted total laparoscopic hysterectomy (TLH) with 44 patients who underwent conventional TLH. We retrospectively reviewed the charts of 44 patients with TLH and 24 patients with robotic TLH. Results: Robotic TLH was associated with a shorter hospital stay (1.0 vs 1.4 days, P=0.011) and a significant decrease in narcotic use (1.2 vs 5.0 units, P=0.002). EBL and drop in hemoglobin were not significantly different. The operative time was significantly longer in patients undergoing robotic TLH (142.2 vs 122.1 minutes, P=0.027). However, only need for laparoscopic morcellation, BMI, and uterine weight, not robotic use, were independently associated with increased operative times. Conclusions: Robotic hysterectomy can be performed safely with comparable operative times to those of conventional laparoscopic hysterectomy. Postoperative measures were improved over measures for conventional laparoscopy. PMID:19793478

  20. Por Secretion System-Dependent Secretion and Glycosylation of Porphyromonas gingivalis Hemin-Binding Protein 35

    PubMed Central

    Shoji, Mikio; Sato, Keiko; Yukitake, Hideharu; Kondo, Yoshio; Narita, Yuka; Kadowaki, Tomoko; Naito, Mariko; Nakayama, Koji

    2011-01-01

    The anaerobic Gram-negative bacterium Porphyromonas gingivalis is a major pathogen in severe forms of periodontal disease and refractory periapical perodontitis. We have recently found that P. gingivalis has a novel secretion system named the Por secretion system (PorSS), which is responsible for secretion of major extracellular proteinases, Arg-gingipains (Rgps) and Lys-gingipain. These proteinases contain conserved C-terminal domains (CTDs) in their C-termini. Hemin-binding protein 35 (HBP35), which is one of the outer membrane proteins of P. gingivalis and contributes to its haem utilization, also contains a CTD, suggesting that HBP35 is translocated to the cell surface via the PorSS. In this study, immunoblot analysis of P. gingivalis mutants deficient in the PorSS or in the biosynthesis of anionic polysaccharide-lipopolysaccharide (A-LPS) revealed that HBP35 is translocated to the cell surface via the PorSS and is glycosylated with A-LPS. From deletion analysis with a GFP-CTD[HBP35] green fluorescent protein fusion, the C-terminal 22 amino acid residues of CTD[HBP35] were found to be required for cell surface translocation and glycosylation. The GFP-CTD fusion study also revealed that the CTDs of CPG70, peptidylarginine deiminase, P27 and RgpB play roles in PorSS-dependent translocation and glycosylation. However, CTD-region peptides were not found in samples of glycosylated HBP35 protein by peptide map fingerprinting analysis, and antibodies against CTD-regions peptides did not react with glycosylated HBP35 protein. These results suggest both that the CTD region functions as a recognition signal for the PorSS and that glycosylation of CTD proteins occurs after removal of the CTD region. Rabbits were used for making antisera against bacterial proteins in this study. PMID:21731719

  1. Molecular characterisation of Porcine rubulavirus (PorPV) isolates from different outbreaks in Mexico.

    PubMed

    Cuevas-Romero, S; Rivera-Benítez, J F; Blomström, A-L; Ramliden, M; Hernández-Baumgarten, E; Hernández-Jáuregui, P; Ramírez-Mendoza, H; Berg, M

    2016-02-01

    Since the report of the initial outbreak of Porcine rubulavirus (PorPV) infection in pigs, only one full-length genome from 1984 (PorPV-LPMV/1984) has been characterised. To investigate the overall genetic variation, full-length gene nucleotide sequences of current PorPV isolates were obtained from different clinical cases of infected swine. Genome organisation and sequence analysis of the encoded proteins (NP, P, F, M, HN and L) revealed high sequence conservation of the NP protein and the expression of the P and V proteins in all PorPV isolates. The V protein of one isolate displayed a mutation that has been implicated to antagonise the antiviral immune responses of the host. The M protein indicated a variation in a short region that could affect the electrostatic charge and the interaction with the membrane. One PorPV isolate recovered from the lungs showed a mutation at the cleavage site (HRKKR) of the F protein that could represent an important factor to determine the tissue tropism and pathogenicity of this virus. The HN protein showed high sequence identity through the years (up to 2013). Additionally, a number of sequence motifs of very high amino acid conservation among the PorPV isolates important for polymerase activity of the L protein have been identified. In summary, genetic comparisons and phylogenetic analyses indicated that three different genetic variants of PorPV are currently spreading within the swine population, and a new generation of circulating virus with different characteristics has begun to emerge.

  2. Totally implantable total artificial heart and ventricular assist device with multipurpose miniature electromechanical energy system.

    PubMed

    Takatani, S; Orime, Y; Tasai, K; Ohara, Y; Naito, K; Mizuguchi, K; Makinouchi, K; Damm, G; Glueck, J; Ling, J

    1994-01-01

    A multipurpose miniature electromechanical energy system has been developed to yield a compact, efficient, durable, and biocompatible total artificial heart (TAH) and ventricular assist device (VAD). Associated controller-driver electronics were recently miniaturized and converted into hybrid circuits. The hybrid controller consists of a microprocessor and controller, motor driver, Hall sensor, and commutation circuit hybrids. The sizing study demonstrated that all these components can be incorporated in the pumping unit of the TAH and VAD, particularly in the centerpiece of the TAH and the motor housing of the VAD. Both TAH and VAD pumping units will start when their power line is connected to either the internal power pack or the external battery unit. As a redundant driving and diagnostic port, an emergency port was newly added and will be placed in subcutaneous location. In case of system failure, the skin will be cut down, and an external motor drive or a pneumatic driver will be connected to this port to run the TAH. This will minimize the circulatory arrest time. Overall efficiency of the TAH without the transcutaneous energy transmission system was 14-18% to deliver pump outputs of 4-9 L/min against the right and left afterload pressures of 25 and 100 mm Hg. The internal power requirement ranged from 6 to 13 W. The rechargeable batteries such as NiCd or NiMH with 1 AH capacity can run the TAH for 30-45 min. The external power requirement, when TETS efficiency of 75% was assumed, ranged from 8 to 18 W. The accelerated endurance test in the 42 degrees C saline bath demonstrated stable performance over 4 months. Long-term endurance and chronic animal studies will continue toward a system with 5 years durability by the year 2000.

  3. A New Total Body Potassium Method to Estimate Total Body Skeletal Muscle Mass in Children12

    PubMed Central

    Wang, ZiMian; Heshka, Stanley; Pietrobelli, Angelo; Chen, Zhao; Silva, Analiza M.; Sardinha, Luis B.; Wang, Jack; Gallager, Dympna; Heymsfield, Steven B.

    2009-01-01

    A whole body skeletal muscle [(SM); kg] mass estimation model, based on total body potassium [(TBK); mmol] measured by whole body 40K counting (WBC) was developed (SM = 0.0082·TBK) and validated in adults in a previous study. It is unknown whether the adult TBK SM prediction model is applicable for pediatric use. The aim of this study was to derive and validate a pediatric TBK SM prediction equation. SM measured by MRI was used as the criterion and TBK was measured by WBC. The protocol was completed in 116 healthy children, 66 males and 50 females, 11.7 ± 3.5 y (mean ± SD, range = 5–17 y). A strong linear correlation was observed between TBK and SM (r = 0.984; P < 0.001). The SM:TBK ratio was 0.0071 ± 0.0008 kg/mmol in the children studied, much lower than the corresponding value of 0.0082 kg/mmol in adults. An empirical SM prediction equation was developed using TBK alone: SM = 0.0085·TBK − 2.83, r2 = 0.97, SEE = 1.39 kg. Bland-Altman analysis did not disclose a significant bias in the prediction of SM. When biological factors entered along with TBK in the general linear model, another prediction equation was developed: SM = 5.52 + 0.001·TBK (mmol) + 0.081·weight (kg) − 0.049·height (cm) + 0.00004·TBK · height + race (−0.60 for Caucasian, 0.49 for African-American, and 0 for Hispanic). Because the adult TBK SM prediction model is not applicable for pediatric use, this study provides new empirical TBK SM prediction equations that should prove useful for studies on nutrition, growth, and development in children. PMID:17634275

  4. Popliteal Artery Pseudoaneurysm Following Primary Total Knee Arthroplasty

    PubMed Central

    Shin, Young-Soo; Hwang, Yeok-Gu; Savale, Abhijit Prakash

    2014-01-01

    An early diagnosis of popliteal artery pseudoaneurysm-a sequela of popliteal artery trauma-is difficult owing to its late presentation following total knee arthroplasty. The incidence of a popliteal artery pseudoaneurysm with a hematoma presenting only a peripheral nerve injury after total knee arthroplasty is also uncommon in the absence of common diagnostic features such as a pulsatile swelling with an audible bruit on auscultation. In the present report, we describe popliteal artery pseudoaneurysm following total knee arthroplasty. PMID:24944978

  5. Internet Relaying of Total Solar Eclipse on 11 August,1999

    NASA Astrophysics Data System (ADS)

    Nagai, T.; Takahashi, N.; Okyudo, M.; Suginaka, M.; Matsumoto, N.; Team Of Live! Eclipse

    The total solar eclipse was relayed live through the Internet from Siberia, Russia, on 9 March 1997. Subsequently, the total solar eclipse was relayed from Venezuela and Guadeloupe in the Caribbean Sea in 26 February 1998, the annular solar eclipse from Malaysia on 21 August 1998, and the annular solar eclipse from Australia on 16 February 1999. The Internet was used to relay the total solar eclipse to be seen in Europe, Rumania, Turkey, and Iran. We succeeded in transmitting images from Turkey.

  6. Education and Understanding of Astronomy through Total Solar Eclipses

    NASA Astrophysics Data System (ADS)

    Hiei, E.; Takahashi, N.; Iizuka, Y.

    2003-05-01

    A total solar eclipse has a great impact on ppeople, and hence there are very old historic records in China, Mesopotamia, etc. The impact still does not change in present times, and inspires wonder in us. The spectacular and magnificent event at a total solar eclipse appeals to our scientific thinking and sensitive feelings. Every one thinks about what nature is. A total solar eclipse is therefore a good and effective opportunity for education and understanding of astronomy.

  7. 21 CFR 862.1700 - Total thyroxine test system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862... intended to measure total (free and protein bound) thyroxine (thyroid hormone) in serum and...

  8. Predictions for the total solar eclipse of 1988

    NASA Technical Reports Server (NTRS)

    Espenak, Fred

    1987-01-01

    A total eclipse of the sun will be widely visible from the East Indies on March 18, 1988. Detailed predictions for this event are presented which include tables of geographic coordinates for the northern limit, center line and southern limit of the path of totality, local circumstances for 40 cities within the total and partial eclipse paths, the lunar-limb profile, and maps depicting the path of totality. The author discusses the general characteristics of the eclipse, local circumstances from various points along the central path and the Saros-series history.

  9. Arthroscopic Management of Complications Following Total Ankle Replacement.

    PubMed

    Lui, Tun Hing; Roukis, Thomas S

    2015-10-01

    There is great potential of managing the complications of total ankle replacement arthroscopically and endoscopically, and these procedures can be summarized into 3 groups. Group 1 includes procedures of the ankle joint proper with close proximity to the articular components of the total ankle replacement. Group 2 includes procedures of the tibia and talus with close proximity to the nonarticular parts of the total ankle replacement. Group 3 includes procedures that are away from the total ankle replacement. However, these remain master arthroscopist procedures and should be performed by foot and ankle surgeons who perform them with regularity.

  10. Bilateral anatomic total shoulder arthroplasty versus reverse shoulder arthroplasty.

    PubMed

    Latif, Vaqar; Denard, Patrick J; Young, Allan A; Liotard, Jean-Pierre; Walch, Gllies

    2012-04-01

    The results of anatomic total shoulder arthroplasty and reverse shoulder arthroplasty have previously been reported separately. Although the indications differ, scenarios exist in which a patient may have a total shoulder arthroplasty on 1 shoulder and a reverse shoulder arthroplasty on the contralateral shoulder.Between 1992 and 2009, twelve patients underwent bilateral sequential primary shoulder arthroplasty with a total shoulder arthroplasty on 1 side and reverse shoulder arthroplasty on the contralateral side. Constant score, American Shoulder and Elbow Surgeons (ASES) score, subjective shoulder value, and patient satisfaction were obtained a minimum 1 year postoperatively. Mean postoperative Constant score was 77 after total shoulder arthroplasty and 73 after reverse shoulder arthroplasty (P<.2488). Mean postoperative active forward flexion was similar after total shoulder arthroplasty compared with reverse shoulder arthroplasty (P=.8910). Greater external rotation at the side (43° vs 12°; P<.0001) and internal rotation (T8 vs L1; P<.0001) were observed after total shoulder arthroplasty. Mean ASES score was 89.6 after total shoulder arthroplasty compared with 82.4 after reverse shoulder arthroplasty (P=.0125). Patient satisfaction was 92% for both prostheses, and mean subjective shoulder value was similar (85.4% vs 82.5%; P=.6333).Bilateral shoulder arthroplasty performed with a total shoulder arthroplasty and reverse shoulder arthroplasty on opposite shoulders can provide good functional outcome and high patient satisfaction. Although range of motion is better following total shoulder arthroplasty, no difference was observed in final Constant score or subjective patient assessment. PMID:22495846

  11. Gait Analysis of Conventional Total Knee Arthroplasty and Bicruciate Stabilized Total Knee Arthroplasty Using a Triaxial Accelerometer.

    PubMed

    Tomite, Takenori; Saito, Hidetomo; Aizawa, Toshiaki; Kijima, Hiroaki; Miyakoshi, Naohisa; Shimada, Yoichi

    2016-01-01

    One component of conventional total knee arthroplasty is removal of the anterior cruciate ligament, and the knee after total knee arthroplasty has been said to be a knee with anterior cruciate ligament dysfunction. Bicruciate stabilized total knee arthroplasty is believed to reproduce anterior cruciate ligament function in the implant and provide anterior stability. Conventional total knee arthroplasty was performed on the right knee and bicruciate stabilized total knee arthroplasty was performed on the left knee in the same patient, and a triaxial accelerometer was fitted to both knees after surgery. Gait analysis was then performed and is reported here. The subject was a 78-year-old woman who underwent conventional total knee arthroplasty on her right knee and bicruciate stabilized total knee arthroplasty on her left knee. On the femoral side with bicruciate stabilized total knee arthroplasty, compared to conventional total knee arthroplasty, there was little acceleration in the x-axis direction (anteroposterior direction) in the early swing phase. Bicruciate stabilized total knee arthroplasty may be able to replace anterior cruciate ligament function due to the structure of the implant and proper anteroposterior positioning. PMID:27648328

  12. Gait Analysis of Conventional Total Knee Arthroplasty and Bicruciate Stabilized Total Knee Arthroplasty Using a Triaxial Accelerometer

    PubMed Central

    Saito, Hidetomo; Aizawa, Toshiaki; Miyakoshi, Naohisa; Shimada, Yoichi

    2016-01-01

    One component of conventional total knee arthroplasty is removal of the anterior cruciate ligament, and the knee after total knee arthroplasty has been said to be a knee with anterior cruciate ligament dysfunction. Bicruciate stabilized total knee arthroplasty is believed to reproduce anterior cruciate ligament function in the implant and provide anterior stability. Conventional total knee arthroplasty was performed on the right knee and bicruciate stabilized total knee arthroplasty was performed on the left knee in the same patient, and a triaxial accelerometer was fitted to both knees after surgery. Gait analysis was then performed and is reported here. The subject was a 78-year-old woman who underwent conventional total knee arthroplasty on her right knee and bicruciate stabilized total knee arthroplasty on her left knee. On the femoral side with bicruciate stabilized total knee arthroplasty, compared to conventional total knee arthroplasty, there was little acceleration in the x-axis direction (anteroposterior direction) in the early swing phase. Bicruciate stabilized total knee arthroplasty may be able to replace anterior cruciate ligament function due to the structure of the implant and proper anteroposterior positioning. PMID:27648328

  13. Gait Analysis of Conventional Total Knee Arthroplasty and Bicruciate Stabilized Total Knee Arthroplasty Using a Triaxial Accelerometer

    PubMed Central

    Saito, Hidetomo; Aizawa, Toshiaki; Miyakoshi, Naohisa; Shimada, Yoichi

    2016-01-01

    One component of conventional total knee arthroplasty is removal of the anterior cruciate ligament, and the knee after total knee arthroplasty has been said to be a knee with anterior cruciate ligament dysfunction. Bicruciate stabilized total knee arthroplasty is believed to reproduce anterior cruciate ligament function in the implant and provide anterior stability. Conventional total knee arthroplasty was performed on the right knee and bicruciate stabilized total knee arthroplasty was performed on the left knee in the same patient, and a triaxial accelerometer was fitted to both knees after surgery. Gait analysis was then performed and is reported here. The subject was a 78-year-old woman who underwent conventional total knee arthroplasty on her right knee and bicruciate stabilized total knee arthroplasty on her left knee. On the femoral side with bicruciate stabilized total knee arthroplasty, compared to conventional total knee arthroplasty, there was little acceleration in the x-axis direction (anteroposterior direction) in the early swing phase. Bicruciate stabilized total knee arthroplasty may be able to replace anterior cruciate ligament function due to the structure of the implant and proper anteroposterior positioning.

  14. A Total Lightning Climatology for the Tennessee Valley Region

    NASA Technical Reports Server (NTRS)

    McCaul, E. W.; Goodman, S. J.; Buechler, D. E.; Blakeslee, R.; Christian, H.; Boccippio, D.; Koshak, W.; Bailey, J.; Hallm, J.; Bateman, M.

    2003-01-01

    Total flash counts derived from the North Alabama Lightning Mapping Array are being processed for 2002 to form a climatology of total lightning for the Tennessee Valley region. The data from this active and interesting period will be compared to data fiom the National Lightning Detection Network, space-based lightning sensors, and weather radars.

  15. Application of Total Quality Management System in Thai Primary Schools

    ERIC Educational Resources Information Center

    Prueangphitchayathon, Setthiya; Tesaputa, Kowat; Somprach, Kanokorn

    2015-01-01

    The present study seeks to develop a total quality management (TQM) system that can be applied to primary schools. The approach focuses on customer orientation, total involvement of all constituencies and continuous improvement. TQM principles were studied and synthesized according to case studies of the best practices in 3 primary schools (small,…

  16. 20 CFR 404.1903 - Negotiating totalization agreements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Section 404.1903 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Totalization Agreements General Provisions § 404.1903 Negotiating totalization... entire country. However, agreements may only be negotiated with foreign countries that have a...

  17. 21 CFR 862.1700 - Total thyroxine test system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Total thyroxine test system. 862.1700 Section 862.1700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... intended to measure total (free and protein bound) thyroxine (thyroid hormone) in serum and...

  18. 20 CFR 606.2 - Total credits allowable.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Total credits allowable. 606.2 Section 606.2 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR TAX CREDITS UNDER THE... credits allowable. The total credits allowed to an employer subject to the tax imposed by section 3301...

  19. 20 CFR 606.2 - Total credits allowable.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 3 2012-04-01 2012-04-01 false Total credits allowable. 606.2 Section 606.2 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR TAX CREDITS UNDER THE... credits allowable. The total credits allowed to an employer subject to the tax imposed by section 3301...

  20. 20 CFR 606.2 - Total credits allowable.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 3 2013-04-01 2013-04-01 false Total credits allowable. 606.2 Section 606.2 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR TAX CREDITS UNDER THE... credits allowable. The total credits allowed to an employer subject to the tax imposed by section 3301...