More on homological supersymmetric quantum mechanics

NASA Astrophysics Data System (ADS)

Behtash, Alireza

2018-03-01

In this work, we first solve complex Morse flow equations for the simplest case of a bosonic harmonic oscillator to discuss localization in the context of Picard-Lefschetz theory. We briefly touch on the exact non-BPS solutions of the bosonized supersymmetric quantum mechanics on algebraic geometric grounds and report that their complex phases can be accessed through the cohomology of WKB 1-form of the underlying singular spectral curve subject to necessary cohomological corrections for nonzero genus. Motivated by Picard-Lefschetz theory, we write down a general formula for the index of N =4 quantum mechanics with background R -symmetry gauge fields. We conjecture that certain symmetries of the refined Witten index and singularities of the moduli space may be used to determine the correct intersection coefficients. A few examples, where this conjecture holds, are shown in both linear and closed quivers with rank-one quiver gauge groups. The R -anomaly removal along the "Morsified" relative homology cycles also called "Lefschetz thimbles" is shown to lead to the appearance of Stokes lines. We show that the Fayet-Iliopoulos parameters appear in the intersection coefficients for the relative homology of the quiver quantum mechanics resulting from dimensional reduction of 2 d N =(2 ,2 ) gauge theory on a circle and explicitly calculate integrals along the Lefschetz thimbles in N =4 C Pk -1 model. The Stokes jumping of coefficients and its relation to wall crossing phenomena is briefly discussed. We also find that the notion of "on-the-wall" index is related to the invariant Lefschetz thimbles under Stokes phenomena. An implication of the Lefschetz thimbles in constructing knots from quiver quantum mechanics is indicated.

A visual water vapor photonic crystal sensor with PVA/SiO2 opal structure

NASA Astrophysics Data System (ADS)

Yang, Haowei; Pan, Lei; Han, Yingping; Ma, Lihua; Li, Yao; Xu, Hongbo; Zhao, Jiupeng

2017-11-01

In study, we proposed a simple yet fast optical sensing motif based on thimbleful of polyvinyl alcohol (PVA) infiltrated photonic crystal (PC), which allows for high efficiency in vapor sensing through changes in their inter-layer space. Linear response to a broad dynamic range of vapor concentration was realized. Ultrafast response time (<1 s) and excellent recyclability were also demonstrated. Selective response to a vapor was exhibited, reflecting well the characteristic sorption properties of PVA, with which colorimetric reporting was readily achieved. These substantial improvements in performance are attributed to the efficacy of signal transduction and the enhanced signal transduction because of thimbleful PVA infiltrated space between adjacent SiO2 nanospheres.

Deep learning beyond Lefschetz thimbles

NASA Astrophysics Data System (ADS)

Alexandru, Andrei; Bedaque, Paulo F.; Lamm, Henry; Lawrence, Scott

2017-11-01

The generalized thimble method to treat field theories with sign problems requires repeatedly solving the computationally expensive holomorphic flow equations. We present a machine learning technique to bypass this problem. The central idea is to obtain a few field configurations via the flow equations to train a feed-forward neural network. The trained network defines a new manifold of integration which reduces the sign problem and can be rapidly sampled. We present results for the 1 +1 dimensional Thirring model with Wilson fermions on sizable lattices. In addition to the gain in speed, the parametrization of the integration manifold we use avoids the "trapping" of Monte Carlo chains which plagues large-flow calculations, a considerable shortcoming of the previous attempts.

The curious incident of multi-instantons and the necessity of Lefschetz thimbles

DOE PAGES

Behtash, Alireza; Poppitz, Erich; Sulejmanpasic, Tin; ...

2015-11-25

Here, we smore » how that compatibility of supersymmetry with exact semi-classics demands that in calculating multi-instanton amplitudes, the “separation” quasi-zeromode must be complexified and the integration cycles must be found by using complex gradient flow (or Picard-Lefschetz equations.) As a non-trivial application, we study N = 2 extended supersymmetric quantum mechanics. Even though in this case supersymmetry is unbroken, the instanton-anti-instanton amplitude (naively calculated) seems to contribute to the ground state energy. We show, however, that the instanton-anti-instanton event consists of two parts: a fermion-correlated and a scalar-correlated event. Although both of these contributions are naively of the same sign and the latter is superficially higher order in the perturbative coupling, we show that the two contributions exactly cancel when they are evaluated on Lefschetz thimbles due to their relative Hidden Topological Angles (HTAs). This gives strong evidence that the semi-classical expansion using Lefschetz thimbles is not only a meaningful prescription for higher order semi-classics, but a necessary one. This deduction seems to be universal and applicable to both supersymmetric and non-supersymmetric theories. In conclusion we speculate that similar conspiracies are responsible for the non-formation of certain molecular contributions in theories where instantons have more than two fermionic zeromodes and do not contribute to the superpotential.« less

NEUTRONIC REACTOR CORE INSTRUMENT

DOEpatents

Mims, L.S.

1961-08-22

A multi-purpose instrument for measuring neutron flux, coolant flow rate, and coolant temperature in a nuclear reactor is described. The device consists essentially of a hollow thimble containing a heat conducting element protruding from the inner wall, the element containing on its innermost end an amount of fissionsble materinl to function as a heat source when subjected to neutron flux irradiation. Thermocouple type temperature sensing means are placed on the heat conducting element adjacent the fissionable material and at a point spaced therefrom, and at a point on the thimble which is in contact with the coolant fluid. The temperature differentials measured between the thermocouples are determinative of the neutron flux, coolant flow, and temperature being measured. The device may be utilized as a probe or may be incorporated in a reactor core. (AE C)

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

Tanizaki, Yuya; Nishimura, Hiromichi; Verbaarschot, Jacobus J. M.

We propose new gradient flows that define Lefschetz thimbles and do not blow up in a finite flow time. Here, we study analytic properties of these gradient flows, and confirm them by numerical tests in simple examples.

Orbital Winch

NASA Technical Reports Server (NTRS)

Hoyt, Robert (Inventor); Slostad, Jeffrey T. (Inventor); Frank, Scott (Inventor); Barnes, Ian M. (Inventor)

2016-01-01

Orbital winch having: lower and upper frames; spool having upper and lower flanges with lower flange attached to lower frame; axial tether guide mounted to upper frame; secondary slewing ring coaxial with spool and rotatably mounted to upper frame, wherein secondary slewing ring's outer surface has gearing; upper tether guide mounted to inner surface of secondary slewing ring; linear translation means having upper end mounted to upper frame and lower end mounted on lower frame; primary slewing ring rotatably mounted within linear translation means allowing translation axially between flanges, wherein primary slewing ring's outer surface has gearing; lower tether guide mounted on primary slewing ring's inner surface; pinion rod having upper end mounted to upper frame and lower end mounted to lower frame, wherein pinion rod's teeth engage primary and secondary slewing rings' outer surface teeth; and tether passing through axial, upper, and lower tether guides and winding around spool.

Upper internals arrangement for a pressurized water reactor

DOEpatents

Singleton, Norman R; Altman, David A; Yu, Ching; Rex, James A; Forsyth, David R

2013-07-09

In a pressurized water reactor with all of the in-core instrumentation gaining access to the core through the reactor head, each fuel assembly in which the instrumentation is introduced is aligned with an upper internals instrumentation guide-way. In the elevations above the upper internals upper support assembly, the instrumentation is protected and aligned by upper mounted instrumentation columns that are part of the instrumentation guide-way and extend from the upper support assembly towards the reactor head in hue with a corresponding head penetration. The upper mounted instrumentation columns are supported laterally at one end by an upper guide tube and at the other end by the upper support plate.

Evaluating the functional outcomes of ultrasound-guided botulinum toxin type A injections using the Euro-musculus approach for upper limb spasticity treatment in post-stroke patients; an observational study.

PubMed

Buyukavci, Raikan; Akturk, Semra; Ersoy, Yüksel

2018-02-07

Ultrasound-guided botulinum toxin type A injection is an effective treatment for spasticity. Euro-musculus spasticity approach is a new method for administering injections to the correct point of the correct muscle. The clinical outcomes of this practical approach is not yet available in the literature. The purpose of this study was to evaluate the effects on spasticity and the functional outcomes of ultrasound guided botulinum toxin type A injections via the Euro-musculus spasticity approach to treat upper limb spasticity in post-stroke patients. An observational study. Inpatient post-stroke patients. Twenty five post-stroke patients with post-stroke upper limb spasticity were recruited. The ultrasound-guided botulinum toxin type A injections were administered into the spastic target muscles using the Euro-musculus spasticity approach, and all of the patients were enrolled in rehabilitation programmes after the injections. This research included the innervation zone and injection site figures and ultrasound images of each muscle in the upper limb. The degree of spasticity was assessed via the Modified Ashworth Scale and the upper limb motor function via the Fugl Meyer Upper Extremity Scale at the baseline and 4 and 12 weeks after the botulinum toxin type A injection. Significant decreases in the Modified Ashworth Scale scores of the upper limb flexor muscle tone measured 4 and 12 weeks after the botulinum toxin type A injection were found when compared to the baseline scores (p<0.025). When compared with the baseline Fugl Meyer Upper Extremity subgroup scores, the sitting position, wrist and total scores at 4 and 12 weeks were significantly improved (p<0.025). However, only the Fugl Meyer Upper Extremity hand scores were significantly improved 12 weeks after the injection (p<0.025). Ultrasound-guided botulinum toxin type A injection via the Euro- musculus spasticity approach is a practical and effective method for administering injections to the correct point of the correct muscle. Ultrasound-guided botulinum toxin type A injections combined with rehabilitation programmes decrease spasticity and improve the upper extremity motor functions in stroke patients. This new approach for ultrasound- guided botulinum toxin type A injection is very practical and effective method for upper extremity spasticity.

Alaska's Living Tundra. Alaska Wildlife Week, 25-29 April 1988. Unit 6: Primary Teacher's Guide; Upper Elementary Teacher's Guide; Junior/Senior High School Teacher's Guide; Supplement.

ERIC Educational Resources Information Center

Quinlan, Susan E.

Despite its cold and barren appearance, Alaska's tundra supports a surprising variety of insects, birds, and mammals. In this document, three teacher's guides (for primary, upper elementary, and junior and senior high schools) and a supplementary resource packet present a comprehensive unit of study on Alaska's living tundra. The five lessons in…

Pressurized-water reactor internals aging degradation study. Phase 1

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

Luk, K.H.

1993-09-01

This report documents the results of a Phase I study on the effects of aging degradations on pr internals. Primary stressers for internals an generated by the primary coolant flow in the they include unsteady hydrodynamic forces and pump-generated pressure pulsations. Other stressors are applied loads, manufacturing processes, impurities in the coolant and exposures to fast neutron fluxes. A survey of reported aging-related failure information indicates that fatigue, stress corrosion cracking (SCC) and mechanical wear are the three major aging-related degradation mechanisms for PWR internals. Significant reported failures include thermal shield flow-induced vibration problems, SCC in guide tube support pinsmore » and core support structure bolts, fatigue-induced core baffle water-jet impingement problems and excess wear in flux thimbles. Many of the reported problems have been resolved by accepted engineering practices. Uncertainties remain in the assessment of long-term neutron irradiation effects and environmental factors in high-cycle fatigue failures. Reactor internals are examined by visual inspections and the technique is access limited. Improved inspection methods, especially one with an early failure detection capability, can enhance the safety and efficiency of reactor operations.« less

Procalcitonin Testing to Guide Antibiotic Therapy in Acute Upper and Lower Respiratory Tract Infections.

PubMed

Schuetz, Philipp; Wirz, Yannick; Mueller, Beat

2018-03-06

Is the use of procalcitonin for guiding antibiotic decisions in patients with acute upper and lower respiratory tract infections associated with improved clinical outcomes compared with usual care? Among patients with varying types and severity of acute respiratory infection, using procalcitonin to guide decisions about antibiotics is associated with lower rates of antibiotic exposure, antibiotic-related adverse effects, and mortality.

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

M. J. Appel

This cleanup verification package documents completion of remedial action for the 118-F-3, Minor Construction Burial Ground waste site. This site was an open field covered with cobbles, with no vegetation growing on the surface. The site received irradiated reactor parts that were removed during conversion of the 105-F Reactor from the Liquid 3X to the Ball 3X Project safety systems and received mostly vertical safety rod thimbles and step plugs.

Heat Treatment of Tools in Light Industry

NASA Astrophysics Data System (ADS)

Petukhov, V. A.

2005-09-01

Heat treatment processes for some tools (knitting needles, travelers for thimbles of spinning and doubling frames, thread-forming spinnerets) used for the production of cloths, hosiery, and other articles) in the knitting and textile industries are considered. Problems of the choice of steel and the kind and parameters of heat treatment are discussed in connection with the special features of tool design and operating conditions.

Imagination Unlimited: A Guide for Creative Problem Solving, Upper Elementary Summer School.

ERIC Educational Resources Information Center

Cleveland Public Schools, OH. Div. of Major Work Classes.

The guide gives procedures for helping gifted upper elementary school students in Major Work classes utilize their imagination. Appropriate literary quotes introduce a discussion on creativity, which involves the imaginative recombination of known ideas into something new. Considered are obstacles that work against creativity such as mental…

NEUTRONIC REACTOR WITH ACCESSIBLE THIMBLE AND EMERGENCY COOLING FEATURES

DOEpatents

McCorkle, W.H.

1960-02-23

BS>A safety system for a water-moderated reactor is described. The invention comprises a reservoir system for spraying the fuel elements within a fuel assembly with coolant and keeping them in a continuous bath even if the coolant moderator is lost from the reactor vessel. A reservoir gravity feeds one or more nozzels positioned within each fuel assembly which continually forces water past the fuel elements.

Cultural Resources Survey of Five Mississippi River Revetment Items.

DTIC Science & Technology

1985-08-01

children’s shoes. 551.42 Lot No. Fourteen, Notions: pens, needles, thimbles, suspenders, handkerchiefs, trimmings, lace, gloves, tooth -brushes, fans, match...to produce a green opaque glaze. Usually, tin glazed, or tin enameled , earthenwares received hand painted decoration; this class of decoration is a...creamware gives a yellowish appearance, cobalt has the effect of whitening pearlware. Like creamware, pearlware was popular through the 163 a 7

Vapor-Phase Infrared Absorptivity Coefficient of HN1

DTIC Science & Technology

2013-08-01

the boil-off of a bulk liquid nitrogen tank, across an alumina Soxhlet thimble in a glass holder filled with the analyte. A vapor–liquid...with mass spectrometry (MS) yielded the results shown in Table 3. Table 3. Results from Analysis of HN1 Sample Used for Determination of...2 yields (3) Equation 3 can then be solved at each frequency using a least-squares approach. This was

Micrometer for Measuring Trepanned Grooves

NASA Technical Reports Server (NTRS)

Bird, S. K.

1983-01-01

Special micrometer measures diameter of circular groove on face of large part, while part is mounted in lathe chuck. Tool has curved frame so it can reach around obstruction on centerline of part. At one end of frame is blade/ micrometer spindle for reaching into groove to be measured; this type of spindle does not rotate when micrometer thimble is turned in taking measurement. Other end of frame has sliding foot with blade.

Status of ionization chambers calibration for radiation therapy in Brazil

NASA Astrophysics Data System (ADS)

Gonçalves, M.; Joana, G.; Leal, P.; Vasconcelos, R.; do Couto, N.; Teixeira, F. C.; Soares, A. D.; Santini, E. S.; Salata, C.

2018-03-01

CNEN makes a constant effort to keep updated with international standards and national needs to strengthen the radiological protection status of the country. The guidelines related to radiation treatment facilities have been revised in the last five years in order to take in consideration the most relevant aspects of the growing technology as well as to mitigate the accidents or incidents observed in practice. Hence, clinical dosimeters have gained special importance as significant items in Brazilian regulation. In the present work we discuss the importance of inspections from the point of view of equipment dosimetry and instruments quality control. The dosimeter sets based on thimble and well ionization chambers need periodic calibration, and this calibration becomes a fundamental task in order to guarantee the dose prescribed-delivered to patients. Thus Brazilian guidelines enforce the need of at least two sets of clinical dosimeters with thimble chambers calibrated and one set of electrometer with well ionization chamber for hdr equipment. We call attention to the fact that inspections are a very valuable tool in order to enforce the application of guidelines around the country both by enlightening the weaker aspects of facilities concerning radiological protection and by stating in loco that reasons which lead the regulatory body to enforce such guidelines items.

Upper-Secondary Agricultural Course. A Suggested Three-Year Teacher's Guide. InfoTVE 13.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Paris (France).

This teacher's guide provides syllabi for a 3-year program for upper secondary agricultural programs in rural agricultural schools. Part 1 contains an introduction, recommendations for early morning practical classes, and suggestions for scheduling of theoretical classes. Part 2 consists of the syllabi. Each syllabus offers a content outline. The…

Evaluation of Fuel Character Effects on J79 Engine Combustion System

DTIC Science & Technology

1979-06-01

A. Overall Engine Description The J79 engine is a lightweight, high-thrust, axial - flow turbojet engine with variable afterburner thrust. This engine...thimbles are arranged to provide flow patterns for flame stabilization in the primary zone and mixing and turbine inlet temperature profile control at...measured with stainard )S𔃾Z orifices- Fuel flow races uere measured with calibrated turbine flotaMcers corrected for the density aan viscosity of each

[Ultrasound-guided rectus sheath block for upper abdominal surgery].

PubMed

Osaka, Yoshimune; Kashiwagi, Masanori; Nagatsuka, Yukio; Oosaku, Masayoshi; Hirose, Chikako

2010-08-01

Upper abdominal surgery leads to severe postoperative pain. Insufficient postoperative analgesia accompanies a high incidence of complications. Therefore, postoperative analgesia is very important. The epidural analgesia has many advantages. However it has a high risk of epidural hematoma in anticoagulated patients. Rectus sheath block provided safer and more reliable analgesia in recent years, by the development of ultrasound tools. We experienced two cases of the rectus sheath block in upper abdominal surgery under ultrasound guidance. Ultrasound guided rectus sheath block can reduce the risk of peritoneal puncture, bleeding, and other complications. Rectus sheath block is very effective to reduce postoperative pain in upper abdominal surgery as an alternative method to epidural anesthesia in anticoagulated patients.

Monthly, 100 Area technical activities report, Physics, 10-25-45--May 1947

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

Jordan, W.E.; Wende, C.W.J.; Gaxt, P.F.

1945-11-29

Two events of broad significance occurred in the 100B Area during this report period. These are the discovery of pimpled slugs in high concentration tubes discharged on 10-30-45 and the discovery of leaking VSR thimbles on 11-15-45. Although more extensive reports of these occurrences will be made elsewhere, these events have aspects of significance to physics and basic data will be given in this report for record purposes.

Real-time Feynman path integral with Picard–Lefschetz theory and its applications to quantum tunneling

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

Tanizaki, Yuya, E-mail: yuya.tanizaki@riken.jp; Theoretical Research Division, Nishina Center, RIKEN, Wako 351-0198; Koike, Takayuki, E-mail: tkoike@ms.u-tokyo.ac.jp

Picard–Lefschetz theory is applied to path integrals of quantum mechanics, in order to compute real-time dynamics directly. After discussing basic properties of real-time path integrals on Lefschetz thimbles, we demonstrate its computational method in a concrete way by solving three simple examples of quantum mechanics. It is applied to quantum mechanics of a double-well potential, and quantum tunneling is discussed. We identify all of the complex saddle points of the classical action, and their properties are discussed in detail. However a big theoretical difficulty turns out to appear in rewriting the original path integral into a sum of path integralsmore » on Lefschetz thimbles. We discuss generality of that problem and mention its importance. Real-time tunneling processes are shown to be described by those complex saddle points, and thus semi-classical description of real-time quantum tunneling becomes possible on solid ground if we could solve that problem. - Highlights: • Real-time path integral is studied based on Picard–Lefschetz theory. • Lucid demonstration is given through simple examples of quantum mechanics. • This technique is applied to quantum mechanics of the double-well potential. • Difficulty for practical applications is revealed, and we discuss its generality. • Quantum tunneling is shown to be closely related to complex classical solutions.« less

Computer-aided design and computer-aided manufacturing cutting guides and customized titanium plates are useful in upper maxilla waferless repositioning.

PubMed

Mazzoni, Simona; Bianchi, Alberto; Schiariti, Giulio; Badiali, Giovanni; Marchetti, Claudio

2015-04-01

The purpose of the present study was to develop a computer-aided design (CAD) and computer-aided manufacturing (CAM) technique that enabled fabrication of surgical cutting guides and titanium fixation plates that would allow the upper maxilla to be repositioned correctly without a surgical splint in orthognathic patients. Ten patients were recruited. A complete CAD-CAM workflow for orthognathic surgery has 3 steps: 1) virtual planning of the surgical treatment, 2) CAD-CAM and 3-dimensional printing of customized surgical devices (surgical cutting guide and titanium fixation plates), and 3) computer-aided surgery. Upper maxilla repositioning was performed in a waferless manner using a CAD-CAM device: the surgical cutting guide was used during surgery to pilot the osteotomy line that had been planned preoperatively at the computer and the custom-made fixation titanium plates allowed desired repositioning of the maxilla. To evaluate the reproducibility of this CAD-CAM orthognathic surgical method, the virtually planned and actually achieved positions of the upper maxilla were compared. Overlap errors using a threshold value smaller than 2 mm were evaluated, and the frequency of such errors was used as a measurement of accuracy. By this definition, the accuracy was 100% in 7 patients (range in all patients, 62 to 100%; median, 92.7%). These results tend to confirm that the use of CAD-CAM cutting guides and customized titanium plates for upper maxilla repositioning represents a promising method for the accurate reproduction of preoperative virtual planning without the use of surgical splints. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Alaska Wildlife Week, Upper Elementary Teacher's Guide. Unit 4. We All Need Each Other--The Web of Life. April 20-26, l986.

ERIC Educational Resources Information Center

Quinlan, Susan E.

The ecological theme of "We all need each other--the web of life" serves as the focus of Alaska's fourth annual wildlife week and as the emphasis for the activities in this guide for upper elementary teachers. The packet of materials contains: (1) an introduction (explaining the theme); (2) table of contents (indicating each lesson's…

101 Things to Do for Your Bicentennial: A Program for the American Issues Forum. A Teaching Guide for the Cultural History and Geography of the Western Frontier and Upper Missouri Region.

ERIC Educational Resources Information Center

Milne, Bruce G.; Hoover, Herbert T.

The junior-high-level teaching guide incorporates historical, geographical, social, political, and cultural materials that cover the heritage of the society of the Western Frontier and Upper Missouri region: Minnesota, Iowa, North and South Dakota, Nebraska, Wyoming, Utah, Colorado, and Montana. The purpose is to acquaint students with culture of…

Human Resources in the Library System. Course 2, Study Guide. Final Report, Phase 2, Post-Master's Education for Middle and Upper-Level Personnel in Libraries and Information Centers.

ERIC Educational Resources Information Center

Goodman, Charles H.; Stone, Elizabeth W.

A study guide is presented for a course designed for the continuing education of professional librarians at the level of middle or upper management who find that they need understanding about human resources in the library system beyond that acquired on the job or in previous library education. The course has four units: (1) Management: A Systems…

Manual braille writer

DOEpatents

Hawk, L.S.; Turner, J.H.

1992-07-28

A manual-type braille writer is described that provides for both writing and reading in a normal left-to-right manner. In the preferred form, this braille writer has a clip board type base, and in the preferred embodiment a guide plate assembly can be moved to, and releasable fixed at, selected vertical locations along this base. The guide plate assembly is provided with a plurality of character cells uniformly spaced along rows across the guide plate assembly as well as in uniformly spaced rows. This guide plate assembly has a lower portion to be placed under a sheet of paper positioned on the clip board base and an upper portion to be positioned on top of the sheet. This upper portion is hinged with respect to the lower portion. Each character cell is typically made up of six appropriately spaced pins extending up from the lower portion that are aligned with a rosette-shaped cutout in the upper portion. A stylus member is provided that has a distal end to be fitted into the cutout of the character cell so that a recess in the end thereof presses the writing paper over the pin associated with that recess to produce a braille dot at that location. When desired, the upper portion can be lifted up so that the text already written can be read or to determine the place for initiating writing when writing has been interrupted. 10 figs.

Manual braille writer

DOEpatents

Hawk, Lawrence S.; Turner, Joe H.

1992-01-01

A manual-type braille writer that provides for both writing and reading in a normal left-to-right manner. In the preferred form, this braille writer has a clip board type base, and in the preferred embodiment a guide plate assembly can be moved to, and releasable fixed at, selected vertical locations along this base. The guide plate assembly is provided with a plurality of character cells uniformly spaced along rows across the guide plate assembly as well as in uniformly spaced rows. This guide plate assembly has a lower portion to be placed under a sheet of paper positioned on the clip board base and an upper portion to be positioned on top of the sheet. This upper portion is hinged with respect to the lower portion. Each character cell is typically made up of six appropriately spaced pins extending up from the lower portion that are aligned with a rosette-shaped cutout in the upper portion. A stylus member is provided that has a distal end to be fitted into the cutout of the character cell so that a recess in the end thereof presses the writing paper over the pin associated with that recess to produce a braille dot at that location. When desired, the upper portion can be lifted up so that the text already written can be read or to determine the place for initiating writing when writing has been interrupted.

Principles of Tendon Reconstruction Following Complex Trauma of the Upper Limb

PubMed Central

Chattopadhyay, Arhana; McGoldrick, Rory; Umansky, Elise; Chang, James

2015-01-01

Reconstruction of tendons following complex trauma to the upper limb presents unique clinical and research challenges. In this article, the authors review the principles guiding preoperative assessment, surgical reconstruction, and postoperative rehabilitation and management of the upper extremity. Tissue engineering approaches to address tissue shortages for tendon reconstruction are also discussed. PMID:25685101

Oxford Guide to British and American Culture for Learners of English.

ERIC Educational Resources Information Center

Crowther, Jonathan, Ed.; Kavanagh, Kathryn, Ed.

The guide to American and British culture, for upper secondary- and university-level students, is intended for use by learners of English as a second language. It is designed to explain specific aspects of British and American life and traditions not generally included in English language dictionaries. The guide has a dictionary format, with terms…

Social Studies, Book II: A Bilingual Multicultural Guide, English-Spanish.

ERIC Educational Resources Information Center

Cedillo, Gustavo F.

This is the second of two social science guides designed for the bilingual, multicultural, upper elementary classroom. The guide may be used independently or as a supplement to other social studies programs. Activities may be done in writing or orally, in English or Spanish, with the entire class, in small groups, or individually. Eight curriculum…

Feasibility of ultrasound-guided sacroiliac joint injection considering sonoanatomic landmarks at two different levels in cadavers and patients.

PubMed

Klauser, Andrea; De Zordo, Tobias; Feuchtner, Gudrun; Sögner, Peter; Schirmer, Michael; Gruber, Johann; Sepp, Norbert; Moriggl, Bernhard

2008-11-15

Sacroiliitis is often caused by rheumatic diseases, and besides other therapeutic options, treatment consists of intraarticular injection of corticosteroids. The purpose of this study was to assess the feasibility of ultrasound (US)-guided sacroiliac joint (SI joint) injection at 2 different puncture levels in cadavers and patients when defined sonoanatomic landmarks were considered. After defining sonoanatomic landmarks, US-guided needle insertion was performed in 10 human cadavers (20 SI joints) at 2 different puncture sites. Upper level was defined at the level of the posterior sacral foramen 1 and lower level at the level of the posterior sacral foramen 2. In 10 patients with unilateral sacroiliitis, injection at the most feasible level was attempted. Computed tomography confirmed correct intraarticular needle placement in cadavers by showing the tip of the needle in the joint and intraarticular diffusion of contrast media in 16 (80%) of 20 SI joints (upper level 7 [70%] of 10; lower level 9 [90%] of 10). In all 4 cases in which needle insertion failed, intraarticular SI joint injection at the other level was successful. In patients, 100% of US-guided injections were successful (8 lower level, 2 upper level), with a mean pain relief of 8.6 after 3 months. US guidance of needle insertion into SI joints was feasible at both levels when defined sonoanatomic landmarks were used. If SI joint alterations do not allow for direct visualization of the dorsal joint space of the lower level, which is easier to access, the upper level might offer an appropriate alternative.

Ultrasound-guided supraclavicular block: outcome of 510 consecutive cases.

PubMed

Perlas, Anahi; Lobo, Giovanni; Lo, Nick; Brull, Richard; Chan, Vincent W S; Karkhanis, Reena

2009-01-01

Supraclavicular brachial plexus block provides consistently effective anesthesia to the upper extremity. However, traditional nerve localization techniques may be associated with a high risk of pneumothorax. In the present study, we report block success and clinical outcome data from 510 consecutive patients who received an ultrasound-guided supraclavicular block for upper extremity surgery. After institutional review board approval, the outcome of 510 consecutive patients who received an ultrasound-guided supraclavicular block for upper extremity surgery was reviewed. Real-time ultrasound guidance was used with a high-frequency linear probe. The neurovascular structures were imaged on short axis, and the needle was inserted using an in-plane technique with either a medial-to-lateral or lateral-to-medial orientation. Five hundred ten ultrasound-guided supraclavicular blocks were performed (50 inpatients, 460 outpatients) by 47 different operators at different levels of training over a 24-month period. Successful surgical anesthesia was achieved in 94.6% of patients after a single attempt; 2.8% required local anesthetic supplementation of a single peripheral nerve territory; and 2.6% received an unplanned general anesthetic. No cases of clinically symptomatic pneumothorax developed. Complications included symptomatic hemidiaphragmatic paresis (1%), Horner syndrome (1%), unintended vascular punctures (0.4%), and transient sensory deficits (0.4%). Ultrasound-guided supraclavicular block is associated with a high rate of successful surgical anesthesia and a low rate of complications and thus may be a safe alternative for both inpatients and outpatients. Severe underlying respiratory disease and coagulopathy should remain a contraindication for this brachial plexus approach.

Unification of the complex Langevin method and the Lefschetzthimble method

NASA Astrophysics Data System (ADS)

Nishimura, Jun; Shimasaki, Shinji

2018-03-01

Recently there has been remarkable progress in solving the sign problem, which occurs in investigating statistical systems with a complex weight. The two promising methods, the complex Langevin method and the Lefschetz thimble method, share the idea of complexifying the dynamical variables, but their relationship has not been clear. Here we propose a unified formulation, in which the sign problem is taken care of by both the Langevin dynamics and the holomorphic gradient flow. We apply our formulation to a simple model in three different ways and show that one of them interpolates the two methods by changing the flow time.

Ionization chamber-based reference dosimetry of intensity modulated radiation beams.

PubMed

Bouchard, Hugo; Seuntjens, Jan

2004-09-01

The present paper addresses reference dose measurements using thimble ionization chambers for quality assurance in IMRT fields. In these radiation fields, detector fluence perturbation effects invalidate the application of open-field dosimetry protocol data for the derivation of absorbed dose to water from ionization chamber measurements. We define a correction factor C(Q)IMRT to correct the absorbed dose to water calibration coefficient N(D, w)Q for fluence perturbation effects in individual segments of an IMRT delivery and developed a calculation method to evaluate the factor. The method consists of precalculating, using accurate Monte Carlo techniques, ionization chamber, type-dependent cavity air dose, and in-phantom dose to water at the reference point for zero-width pencil beams as a function of position of the pencil beams impinging on the phantom surface. These precalculated kernels are convolved with the IMRT fluence distribution to arrive at the dose-to-water-dose-to-cavity air ratio [D(a)w (IMRT)] for IMRT fields and with a 10x10 cm2 open-field fluence to arrive at the same ratio D(a)w (Q) for the 10x10 cm2 reference field. The correction factor C(Q)IMRT is then calculated as the ratio of D(a)w (IMRT) and D(a)w (Q). The calculation method was experimentally validated and the magnitude of chamber correction factors in reference dose measurements in single static and dynamic IMRT fields was studied. The results show that, for thimble-type ionization chambers the correction factor in a single, realistic dynamic IMRT field can be of the order of 10% or more. We therefore propose that for accurate reference dosimetry of complete n-beam IMRT deliveries, ionization chamber fluence perturbation correction factors must explicitly be taken into account.

SXR measurement and W transport survey using GEM tomographic system on WEST

NASA Astrophysics Data System (ADS)

Mazon, D.; Jardin, A.; Malard, P.; Chernyshova, M.; Coston, C.; Malard, P.; O'Mullane, M.; Czarski, T.; Malinowski, K.; Faisse, F.; Ferlay, F.; Verger, J. M.; Bec, A.; Larroque, S.; Kasprowicz, G.; Wojenski, A.; Pozniak, K.

2017-11-01

Measuring Soft X-Ray (SXR) radiation (0.1-20 keV) of fusion plasmas is a standard way of accessing valuable information on particle transport. Since heavy impurities like tungsten (W) could degrade plasma core performances and cause radiative collapses, it is necessary to develop new diagnostics to be able to monitor the impurity distribution in harsh fusion environments like ITER. A gaseous detector with energy discrimination would be a very good candidate for this purpose. The design and implementation of a new SXR diagnostic developed for the WEST project, based on a triple Gas Electron Multiplier (GEM) detector is presented. This detector works in photon counting mode and presents energy discrimination capabilities. The SXR system is composed of two 1D cameras (vertical and horizontal views respectively), located in the same poloidal cross-section to allow for tomographic reconstruction. An array (20 cm × 2 cm) consists of up to 128 detectors in front of a beryllium pinhole (equipped with a 1 mm diameter diaphragm) inserted at about 50 cm depth inside a cooled thimble in order to retrieve a wide plasma view. Acquisition of low energy spectrum is insured by a helium buffer installed between the pinhole and the detector. Complementary cooling systems (water) are used to maintain a constant temperature (25oC) inside the thimble. Finally a real-time automatic extraction system has been developed to protect the diagnostic during baking phases or any overheating unwanted events. Preliminary simulations of plasma emissivity and W distribution have been performed for WEST using a recently developed synthetic diagnostic coupled to a tomographic algorithm based on the minimum Fisher information (MFI) inversion method. First GEM acquisitions are presented as well as estimation of transport effect in presence of ICRH on W density reconstruction capabilities of the GEM.

Guide to Understanding Moebius Syndrome

MedlinePlus

... due to upper body weakness • Strabismus (crossed eyes) • Dry eyes and irritability • Dental problems • High palate • Cleft palate • Hand and feet problems including club foot and missing or fused fingers (syndactyly) • Hearing problems • Poland’s syndrome (chest wall and upper limb anomalies) Although they ...

Upper limb function in persons with long term paraplegia and implications for independence: Part II.

PubMed

Pentland, W E; Twomey, L T

1994-04-01

Research has shown that wheelchair use in long term paraplegia is associated with upper limb pain and degeneration that interferes with the independent performance of activities of daily living. This paper proposes a model to explain the development of upper limb problems in persons with long term paraplegia, and one that will guide in the prevention and management of this type of long term complication.

Differentiating Study Guides

ERIC Educational Resources Information Center

Conderman, Greg; Hedin, Laura

2017-01-01

Study guides are a popular and frequently student-requested instructional support developed primarily by upper elementary, middle, and high school teachers to help students navigate through a course of study. With the increase of the number of learners with diverse needs in general education classrooms, teachers need to be mindful of various ways…

Computer Applications in Instruction: A Teacher's Guide to Selection and Use.

ERIC Educational Resources Information Center

Edwards, Judith B.; And Others

Intended for upper elementary and secondary teachers in all subject areas, this guide provides practical advice on determining the appropriate application of computer technology and on the selection of specific, subject-related computer-based instruction units. Under the heading of hardware and software, topics discussed include communicating with…

Teacher's Guide for Optics. Elementary Science Study.

ERIC Educational Resources Information Center

Lange, Robert V.; And Others

This teacher's guide suggests activities that provide opportunities for upper elementary students to explore, by direct experiment, many of the properties of light. Equipment is listed and construction of a light source is detailed. Instructions are given for setting up a classroom with electrical equipment. Activities are described in units…

TEACHER'S GUIDE FOR MICROGARDENING.

ERIC Educational Resources Information Center

CHANDLER, MARION N.

THIS TEACHING GUIDE IS DESIGNED FOR USE WITH AN ELEMENTARY SCIENCE STUDY UNIT "MICROGARDENING" IN WHICH SIMPLER AND LOWER FORMS OF PLANT LIFE ARE STUDIED THROUGH STUDENT ACTIVITIES INVOLVING MOLDS. THE MATERIALS HAVE BEEN CLASSROOM TESTED AND ARE SUGGESTED FOR MIDDLE AND UPPER ELEMENTARY GRADES. THE WORK HAS BEEN ORGANIZED IN FIVE AREAS…

Formation of Apprenticeships in the Swedish Education System: Different Stakeholder Perspectives

ERIC Educational Resources Information Center

Andersson, Ingela; Wärvik, Gun-Britt; Thång, Per-Olof

2015-01-01

The article explores the major features of the Swedish Government's new initiative--a school based Upper Secondary Apprenticeship model. The analyses are guided by activity theory. The analysed texts are part of the parliamentary reform-making process of the 2011 Upper Secondary School reform. The analyses unfold how the Government, the Swedish…

A plasma arc reactor for fullerene research

NASA Astrophysics Data System (ADS)

Anderson, T. T.; Dyer, P. L.; Dykes, J. W.; Klavins, P.; Anderson, P. E.; Liu, J. Z.; Shelton, R. N.

1994-12-01

A modified Krätschmer-Huffman reactor for the mass production of fullerenes is presented. Fullerene mass production is fundamental for the synthesis of higher and endohedral fullerenes. The reactor employs mechanisms for continuous graphite-rod feeding and in situ slag removal. Soot collects into a Soxhlet extraction thimble which serves as a fore-line vacuum pump filter, thereby easing fullerene separation from soot. Thermal gravimetric analysis (TGA) for yield determination is reported. This TGA method is faster and uses smaller samples than Soxhlet extraction methods which rely on aromatic solvents. Production of 10 g of soot per hour is readily achieved utilizing this reactor. Fullerene yields of 20% are attained routinely.

The occurrence of the Complexiopollis-Atlantopollis zone (Palynomorphs) in the Eagle Ford Group (Upper Cretaceous) of Texas

USGS Publications Warehouse

Christopher, Raymond A.

1982-01-01

The Lower and lower Upper Cretaceous palynological zones defined in the Atlantic Coastal Plain Province and which occur in the eastern Gulf Coastal Plain Province are characterized by a paucity of marine invertebrate fossils. As a result, correlation of these zones with European and provincial stages, as well as with other microfossil and megafossil zones is tenuous. However, an examination of a complete section of the Eagle Ford Group and adjacent strata in Texas reveals that: 1) the upper part of the Woodbine Formation and the Tarrant Formation of the overlying Eagle Ford Group represent a biostratigraphic interval that is absent in the Atlantic and eastern Gulf Coastal Plain Provinces; 2) the Complexiopollis-Atlantopollis Zone (zone IV of some authors) occurs within the Britton Formation (Eagle Ford Group), and is equivalent to the upper part of the Rotalipora cushmani-greenhornensis Subzone (planktic foraminifers) and possibly to the Sciponoceras gracile Zone (ammonites); 3) the Arcadia Park Formation (Eagle Ford Group) contains a mixed assemblage of palynomorphs that includes guides to both the Complexiopollis-Atlantopollis and the overlying Complexiopollis exigua-Santalacites minor Zones, suggesting that biostratigraphic equivalents of the Arcadia Park Formation are not represented in the Atlantic and eastern Gulf Coastal Plain Provinces; and 4) in the basal part of the Austin Chalk of Texas, only one guide palynomorph to the Complexiopollis-Atlantopollis Zone was recognized, but guides to the Complexiopollis exigua-Santalacites minor Zone are present. The Tuscaloosa Group of the eastern Gulf Coastal Plain appears to be biostratigraphically equivalent to the Complexiopollis-Atlantopollis Zone, and therefore correlative with the middle to upper part of the Britton Formation of the Eagle Ford Group.

Environmental Education Manual. Teacher's Guide to Environmental Education.

ERIC Educational Resources Information Center

Griffith, Stafford; Williams, Eugenie

This five-unit volume is intended for use principally as a guide to the teaching of environmental education in upper secondary schools in Barbados. Topic areas of units include: (1) the environment and environmental conservation; (2) erosion/conservation and land use/misuse; (3) destruction/protection of wildlife and the importance, destruction,…

Nutrition Education-Choose Well, Be Well: A Curriculum Guide for the Upper Elementary Grades.

ERIC Educational Resources Information Center

Merklein, Robert, Ed.; Smith, Theodore, Ed.

Part of the "Nutrition Education-Choose Well, Be Well" curriculum series, this guide was developed to help teachers, food service personnel, professionals, and parents provide nutrition education and make nutrition come alive in the classroom, home, or cafeteria. Organized by grade level (from fourth through sixth), activities described…

Supplement for Curriculum Guide for Science: Vietnamese-Speaking Students, Kindergarten-Upper Two. Field Test.

ERIC Educational Resources Information Center

Chicago Board of Education, IL.

This supplement to the Chicago public schools' science curriculum guide is for use with Vietnamese-speaking students and is designed to help students make the transition to science learning in English. English-Vietnamese vocabulary lists, independent learning activities (in Vietnamese), and teaching aids (cultural activities such as songs,…

Measuring Norfloxacin Binding to Trypsin Using a Fluorescence Quenching Assay in an Upper-Division, Integrated Laboratory Course

ERIC Educational Resources Information Center

Hicks, Katherine A.

2016-01-01

Fluorescence quenching assays are often used to measure dissociation constants that quantify the binding affinity between small molecules and proteins. In an upper-division undergraduate laboratory course, where students work on projects using a guided inquiry-based approach, a binding titration experiment at physiological pH is performed to…

Drill string enclosure

DOEpatents

Jorgensen, D.K.; Kuhns, D.J.; Wiersholm, O.; Miller, T.A.

1993-03-02

The drill string enclosure consists of six component parts, including; a top bracket, an upper acrylic cylinder, an acrylic drill casing guide, a lower acrylic cylinder, a bottom bracket, and three flexible ducts. The upper acrylic cylinder is optional based upon the drill string length. The drill string enclosure allows for an efficient drill and sight operation at a hazardous waste site.

Drill string enclosure

DOEpatents

Jorgensen, Douglas K.; Kuhns, Douglass J.; Wiersholm, Otto; Miller, Timothy A.

1993-01-01

The drill string enclosure consists of six component parts, including; a top bracket, an upper acrylic cylinder, an acrylic drill casing guide, a lower acrylic cylinder, a bottom bracket, and three flexible ducts. The upper acrylic cylinder is optional based upon the drill string length. The drill string enclosure allows for an efficient drill and sight operation at a hazardous waste site.

Famous Georgians and Their Homes: A Social Studies Unit for Upper Elementary Students.

ERIC Educational Resources Information Center

Deaver, Susan B.

This upper-elementary level social studies curriculum guide is designed to: (1) teach students to understand and appreciate the built (man made) environment; (2) instruct students about Georgia's history and heritage; and (3) introduce the basic concepts of historic preservation. The unit highlights 10 architectural styles of the homes of famous…

INSTRUCTIONAL TELEVISION FOR THE UPPER PRIMARY. A TEACHER GUIDE, SEMESTER II.

ERIC Educational Resources Information Center

DELIKAN, ALFRED; AND OTHERS

TELECAST PROGRAMS FOR THE UPPER PRIMARY GRADES WERE IN ART, MUSIC, PHYSICAL EDUCATION AND SCIENCE. A PREVIEW OF THE CONTENT OF EACH UNIT WAS GIVEN, TOGETHER WITH DETAILED INFORMATION FOR FOLLOWUP ACTIVITY. IN THE ART SERIES, IT WAS RECOMMENDED THAT PUPIL PARTICIPATION TAKE PLACE AS SOON AS POSSIBLE AFTER THE TELECAST. INDIVIDUAL CREATIVITY WAS…

Eco-Inquiry: A Guide to Ecological Learning Experiences for the Upper Elementary/Middle Grades.

ERIC Educational Resources Information Center

Hogan, Kathleen

Eco-Inquiry may be defined as a "whole science" curriculum that embeds hands-on science within thematic multi-dimensional learning experiences. Three modules for the upper elementary and middle grades focus on food webs, decomposition, and nutrient cycling. Each module lasts 4-7 weeks and may be used alone or in sequence. Student…

Ionization chamber correction factors for MR-linacs

NASA Astrophysics Data System (ADS)

Pojtinger, Stefan; Steffen Dohm, Oliver; Kapsch, Ralf-Peter; Thorwarth, Daniela

2018-06-01

Previously, readings of air-filled ionization chambers have been described as being influenced by magnetic fields. To use these chambers for dosimetry in magnetic resonance guided radiotherapy (MRgRT), this effect must be taken into account by introducing a correction factor k B. The purpose of this study is to systematically investigate k B for a typical reference setup for commercially available ionization chambers with different magnetic field strengths. The Monte Carlo simulation tool EGSnrc was used to simulate eight commercially available ionization chambers in magnetic fields whose magnetic flux density was in the range of 0–2.5 T. To validate the simulation, the influence of the magnetic field was experimentally determined for a PTW30013 Farmer-type chamber for magnetic flux densities between 0 and 1.425 T. Changes in the detector response of up to 8% depending on the magnetic flux density, on the chamber geometry and on the chamber orientation were obtained. In the experimental setup, a maximum deviation of less than 2% was observed when comparing measured values with simulated values. Dedicated values for two MR-linac systems (ViewRay MRIdian, ViewRay Inc, Cleveland, United States, 0.35 T/ 6 MV and Elekta Unity, Elekta AB, Stockholm, Sweden, 1.5 T/7 MV) were determined for future use in reference dosimetry. Simulated values for thimble-type chambers are in good agreement with experiments as well as with the results of previous publications. After further experimental validation, the results can be considered for definition of standard protocols for purposes of reference dosimetry in MRgRT.

Ionization chamber correction factors for MR-linacs.

PubMed

Pojtinger, Stefan; Dohm, Oliver Steffen; Kapsch, Ralf-Peter; Thorwarth, Daniela

2018-06-07

Previously, readings of air-filled ionization chambers have been described as being influenced by magnetic fields. To use these chambers for dosimetry in magnetic resonance guided radiotherapy (MRgRT), this effect must be taken into account by introducing a correction factor k B . The purpose of this study is to systematically investigate k B for a typical reference setup for commercially available ionization chambers with different magnetic field strengths. The Monte Carlo simulation tool EGSnrc was used to simulate eight commercially available ionization chambers in magnetic fields whose magnetic flux density was in the range of 0-2.5 T. To validate the simulation, the influence of the magnetic field was experimentally determined for a PTW30013 Farmer-type chamber for magnetic flux densities between 0 and 1.425 T. Changes in the detector response of up to 8% depending on the magnetic flux density, on the chamber geometry and on the chamber orientation were obtained. In the experimental setup, a maximum deviation of less than 2% was observed when comparing measured values with simulated values. Dedicated values for two MR-linac systems (ViewRay MRIdian, ViewRay Inc, Cleveland, United States, 0.35 T/ 6 MV and Elekta Unity, Elekta AB, Stockholm, Sweden, 1.5 T/7 MV) were determined for future use in reference dosimetry. Simulated values for thimble-type chambers are in good agreement with experiments as well as with the results of previous publications. After further experimental validation, the results can be considered for definition of standard protocols for purposes of reference dosimetry in MRgRT.

Rule based artificial intelligence expert system for determination of upper extremity impairment rating.

PubMed

Lim, I; Walkup, R K; Vannier, M W

1993-04-01

Quantitative evaluation of upper extremity impairment, a percentage rating most often determined using a rule based procedure, has been implemented on a personal computer using an artificial intelligence, rule-based expert system (AI system). In this study, the rules given in Chapter 3 of the AMA Guides to the Evaluation of Permanent Impairment (Third Edition) were used to develop such an AI system for the Apple Macintosh. The program applies the rules from the Guides in a consistent and systematic fashion. It is faster and less error-prone than the manual method, and the results have a higher degree of precision, since intermediate values are not truncated.

Moving Raman spectroscopy into real-time, online diagnosis and detection of precancer and cancer in vivo in the upper GI during clinical endoscopic examination

NASA Astrophysics Data System (ADS)

Huang, Zhiwei; Bergholt, Mads Sylvest; Zheng, Wei; Ho, Khek Yu; Yeoh, Khay Guan; Teh, Ming; So, Jimmy Bok Yan; Shabbir, Asim

2013-03-01

A rapid image-guided Raman endoscopy system integrated with on-line diagnostic scheme is developed for in vivo Raman tissue diagnosis (optical biopsy) in the upper GI during clinical gastrointestinal endoscopy under multimodal wide-field imaging guidance. The real-time Raman endoscopy technique was tested prospectively on new gastric patients (n=4) and could identify dysplasia in vivo with sensitivity of 81.5% (22/27) and specificity of 87.9% (29/33). This study realizes for the first time the novel image-guided Raman endoscopy as a screening tool for real-time, online diagnosis of gastric cancer and precancer in vivo at endoscopy.

Shuttleless toroid winder

DOEpatents

Lindenmeyer, Carl W.

1981-01-01

A lower support receives a toroid at a winding station with the axis of the toroid aligned with a slot in the support. An upper guide member applies an axial force to hold the toroid against the lower support. A pair of movable jaws carried by an indexing mechanism engage the outer surface of the toroid to apply a radial holding force. While the toroid is thus held, a wire is placed axially through the toroid, assisted by a funnel-shaped surface in the upper guide member, and is drawn tight about the toroid by a pair of cooperating draw rollers. When operated in the "full cycle" mode, the operator then actuates a switch which energizes a power drive to release the axial clamp and to drive the indexing mechanism and the jaws to rotate the toroid about its axis. At the same time, the wire is ejected from the draw rollers beneath the toroid so that the operator may grasp it to form another loop. When the toroid is fully indexed, the jaws release it, and the upper guide member is returned to clamp the toroid axially while the indexing mechanism is returned to its starting position. The apparatus may also be operated in a "momentary contact" mode in which the mechanism is driven only for the time a switch is actuated.

Marking guides for northern hardwoods under the selection system

Treesearch

Carl, Jr. Arbogast

1957-01-01

The preparation of these guides has been a joint undertaking of research and national forest administration. Reviews and suggestions of other members of the Station who are active in northern hardwood research were helpful, especially those from men working at the Upper Peninsula Research Center in Marquette, Mich., and the Northern Lakes Research Center in Wausau, Wis...

Rights and Responsibilities. User Guide for Grades K-6. My America: Building a Democracy Series.

ERIC Educational Resources Information Center

Fier, Harriet, Ed.; And Others

This user guide covers "Rights and Responsibilities," and offers suggestions for preparatory activities, lessons, and follow-up activities for primary, intermediate, and upper grade students. Goals for the series are to help children: (1) become familiar with the democratic process and active citizenship; (2) recognize what it means to be a…

Student Perceptions on Using Guided Reading Questions to Motivate Student Reading in the Flipped Classroom

ERIC Educational Resources Information Center

Brown, Charles A.; Danvers, Kreag; Doran, David T.

2016-01-01

Although upper-level accounting majors tend to be more motivated than introductory-level students, or non-accounting majors, it is still challenging to motivate such students to complete and understand assigned readings. The purpose of this study is to assess student perceptions on the implementation of guided reading questions to motivate and…

Neato Mosquito: An Elementary Curriculum Guide. 2nd Edition.

ERIC Educational Resources Information Center

Nasci, Roger S.; Herrington, James E.

This curriculum guide was designed with the purpose of developing public awareness of LaCrosse (LAC) encephalitis, which is a mosquito transmitted disease. LAC cases have been increasing in large numbers in the Upper Midwest and Great Lakes regions during recent years. This disease primarily affects children under the age of 15, and this guide…

Shade determination using camouflaged visual shade guides and an electronic spectrophotometer.

PubMed

Kvalheim, S F; Øilo, M

2014-03-01

The aim of the present study was to compare a camouflaged visual shade guide to a spectrophotometer designed for restorative dentistry. Two operators performed analyses of 66 subjects. One central upper incisor was measured four times by each operator; twice with a camouflaged visual shade guide and twice with a spectrophotometer Both methods had acceptable repeatability rates, but the electronic shade determination showed higher repeatability. In general, the electronically determined shades were darker than the visually determined shades. The use of a camouflaged visual shade guide seems to be an adequate method to reduce operator bias.

Teaching Astrophysics to Upper Level Undergraduates

NASA Astrophysics Data System (ADS)

Van Dorn Bradt, Hale

2010-03-01

A Socratic peer-instruction method for teaching upper level undergraduates is presented. Basically, the instructor sits with the students and guides their presentations of the material. My two textbooks* (on display) as well as many others are amenable to this type of teaching. *Astronomy Methods - A Physical Approach to Astronomical Observations (CUP 2004) *Astrophysics Processes-The Physics of Astronomical Phenomena (CUP 2008)

Analysis of Whiskey by Dispersive Liquid-Liquid Microextraction Coupled with Gas Chromatography/Mass Spectrometry: An Upper Division Analytical Chemistry Experiment Guided by Green Chemistry

ERIC Educational Resources Information Center

Owens, Janel E.; Zimmerman, Laura B.; Gardner, Michael A.; Lowe, Luis E.

2016-01-01

Analysis of whiskey samples prepared by a green microextraction technique, dispersive liquid-liquid microextraction (DLLME), before analysis by a qualitative gas chromatography-mass spectrometry (GC/MS) method, is described as a laboratory experiment for an upper division instrumental methods of analysis laboratory course. Here, aroma compounds in…

Adequacy of Material Resources Required for Effective Implementation of Upper Basic Education Business Studies Curriculum in Nigeria

ERIC Educational Resources Information Center

Okoli, B. E.; Okorie, Ogbonnaya

2015-01-01

This work is a descriptive survey of the adequacy of the material resources required for effective implementation of upper basic education business studies curriculum in Ebonyi State. Two research questions and two hypotheses guided the study. The entire population of two hundred and forty-one (241) business studies teachers were used for the…

Viscoelastic-coupling model for the earthquake cycle driven from below

USGS Publications Warehouse

Savage, J.C.

2000-01-01

In a linear system the earthquake cycle can be represented as the sum of a solution which reproduces the earthquake cycle itself (viscoelastic-coupling model) and a solution that provides the driving force. We consider two cases, one in which the earthquake cycle is driven by stresses transmitted along the schizosphere and a second in which the cycle is driven from below by stresses transmitted along the upper mantle (i.e., the schizosphere and upper mantle, respectively, act as stress guides in the lithosphere). In both cases the driving stress is attributed to steady motion of the stress guide, and the upper crust is assumed to be elastic. The surface deformation that accumulates during the interseismic interval depends solely upon the earthquake-cycle solution (viscoelastic-coupling model) not upon the driving source solution. Thus geodetic observations of interseismic deformation are insensitive to the source of the driving forces in a linear system. In particular, the suggestion of Bourne et al. [1998] that the deformation that accumulates across a transform fault system in the interseismic interval is a replica of the deformation that accumulates in the upper mantle during the same interval does not appear to be correct for linear systems.

Eddy current position indicating apparatus for measuring displacements of core components of a liquid metal nuclear reactor

DOEpatents

Day, Clifford K.; Stringer, James L.

1977-01-01

Apparatus for measuring displacements of core components of a liquid metal fast breeder reactor by means of an eddy current probe. The active portion of the probe is located within a dry thimble which is supported on a stationary portion of the reactor core support structure. Split rings of metal, having a resistivity significantly different than sodium, are fixedly mounted on the core component to be monitored. The split rings are slidably positioned around, concentric with the probe and symmetrically situated along the axis of the probe so that motion of the ring along the axis of the probe produces a proportional change in the probes electrical output.

Pushing Boundaries: My Personal and Scientific Journey

NASA Astrophysics Data System (ADS)

Sarachik, Myriam P.

2018-03-01

This autobiographical narrative offers a brief account of my journey and adventures in condensed matter physics (a.k.a. solid state physics) and some of the personal events that shaped my life and my career: my early years in Europe, my family's escape from the Nazis, growing up in Cuba, the difficult road into a field that was essentially closed to women, a personal disaster that knocked the wind out of my sails for more than a decade, and my return to a successful career in physics. In closing, I argue that, although we have made remarkable progress, we know but a thimble-full in our inexhaustible search for an understanding of the laws of nature.

Exploring the Moon: A Teacher's Guide with Activities for Earth and Space Sciences.

ERIC Educational Resources Information Center

National Aeronautics and Space Administration, Washington, DC.

These materials have been designed for use with the upper elementary through high school levels especially, but not exclusively, with the Lunar Sample Disk. This book contains: information on the Lunar Sample Disk, a curriculum content matrix, a teacher's guide, Moon ABCs fact sheet, rock ABCs fact sheet, Progress in Lunar Science chart, 17…

Liberty and Justice. User Guide for Grades K-6. My America: Building a Democracy Series.

ERIC Educational Resources Information Center

Fier, Harriet, Ed.; And Others

This user guide covers "Liberty and Justice," and offers suggestions for preparatory activities, lessons, and follow-up activities for primary, intermediate, and upper grade students. Goals for the series are to help children: (1) become familiar with the democratic process and active citizenship; (2) recognize what it means to be a citizen in a…

Stenting of the Upper Gastrointestinal Tract: Current Status

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

Katsanos, Konstantinos; Sabharwal, Tarun, E-mail: tarun.sabharwal@gstt.nhs.uk; Adam, Andreas

2010-08-15

Minimally invasive image-guided insertion of self-expanding metal stents in the upper gastrointestinal tract is the current treatment of choice for palliation of malignant esophageal or gastroduodenal outlet obstructions. A concise review is presented of contemporary stenting practice of the upper gastrointestinal tract, and the procedures in terms of appropriate patient evaluation, indications, and contraindications for treatment are analyzed, along with available stent designs, procedural steps, clinical outcomes, inadvertent complications, and future technology. Latest developments include biodegradable polymeric stents for benign disease and radioactive or drug-eluting stents for malignant obstructions.

Complexity, Heuristic, and Search Analysis for the Games of Crossings and Epaminondas

DTIC Science & Technology

2014-03-27

research in Artifical Intelligence (Section 2.1) and why games are studied (Section 2.2). Section 2.3 discusses how games are played and solved. An...5 2.1 Games in Artificial Intelligence . . . . . . . . . . . . . . . . . . . . . . . . 5 2.2 Game Study...Artificial Intelligence UCT Upper Confidence Bounds applied to Trees HUCT Heuristic Guided UCT LOA Lines of Action UCB Upper Confidence Bound RAVE Rapid

Breaking the Silence: Teaching the Next Generation about Mental Illness. For Upper Elementary Grades. Third Edition.

ERIC Educational Resources Information Center

Susin, Janet; Kaplan, Lorraine; Slater, Louise

This guide provides curriculum lessons for the upper elementary school student that put a human face on mental illness and confront myths passed on from one generation to the next. One in five children will be affected by mental illness at some point in their lives. The goal of these lessons is help students understand that severe mental illnesses…

Dose comparison between CTDI and the AAPM Report No. 111 methodology in adult, adolescent, and child head phantom

NASA Astrophysics Data System (ADS)

Li, Celina L.; Thakur, Yogesh; Ford, Nancy L.

2017-03-01

The standard computed tomography dose index (CTDI) metric tends to underestimate scatter radiation in cone beam computed tomography (CBCT) acquisition; therefore, the American Association of Physicists in Medicine (AAPM) Task Group 111 proposed a new dosimetry methodology to measure equilibrium dose at the center of a phantom (z = 0) using a 2-cm thimble ionization chamber. In this study, we implement the CTDI and the AAPM method with a thimble chamber on adult, adolescent, and child head phantoms using the Toshiba Aquilion One CBCT and compare the results to the CTDI measured with a 10-cm pencil chamber. Following the AAPM protocol, the normalized (100 mAs) equilibrium doses (Deq) computed using dose measurements taken in the central hole of the phantom (Deq,c), the peripheral hole of the phantom, (Deq,p), and by the CTDIw equation (Deq,w) are 20.13 +/- 0.19, 21.53 +/- 0.48, and 20.93 +/- 0.40 mGy for adult; 21.55 +/- 0.40, 21.14 +/- 0.43, and 21.08 +/- 0.45 mGy for adolescent; and 24.58 +/- 0.40, 24.92 +/- 0.85, and 24.77 +/- 0.72 mGy for child, respectively. The CTDIw, which measured 17.70, 19.86, and 22.43 mGy for adult, adolescent and child respectively, is about 10% lower than their corresponding Deq's. The extended AAPM method proposed by Deman et al., which estimates the dose profile along the rotational axis (z axis), has demonstrated consistency between theoretical and experimental results for all phantoms. With the introduction of the child and the adolescent head phantoms, we not only have emphasized the practical aspects including relative convenience of the CTDI method and accuracy of the AAPM method, but also proposed a method to approximate Deq for different sized patients.

Upper Extremity Proprioception After Stroke: Bridging the Gap Between Neuroscience and Rehabilitation.

PubMed

Findlater, Sonja E; Dukelow, Sean P

2017-01-01

Proprioception is an important aspect of function that is often impaired in the upper extremity following stroke. Unfortunately, neurorehabilitation has few evidence based treatment options for those with proprioceptive deficits. The authors consider potential reasons for this disparity. In doing so, typical assessments and proprioceptive intervention studies are discussed. Relevant evidence from the field of neuroscience is examined. Such evidence may be used to guide the development of targeted interventions for upper extremity proprioceptive deficits after stroke. As researchers become more aware of the impact of proprioceptive deficits on upper extremity motor performance after stroke, it is imperative to find successful rehabilitation interventions to target these deficits and ultimately improve daily function.

Exploring the Moon: A teacher's guide with activities for Earth and space sciences

NASA Technical Reports Server (NTRS)

Taylor, G. Jeffrey; Martel, Linda M. V.; Bays, Brooks G., Jr.

1994-01-01

This guide contains educational materials designed for use in upper elementary through high schools with the Lunar Sample Disk. A set of thirty-six 35-mm slides complements the activities in this guidebook. The book contains: (1) information on the Lunar Sample Disk; (2) a curriculum content matrix; (3) a teacher's guide; (4) moon ABC's fact sheet; (5) rock ABC's fact sheet; (6) progress in Lunar Science chart; (7) seventeen activities; (8) a resource section for each unit; (9) a glossary; and (10) a list of NASA educational resources.

CSMP Mathematics for the Upper Primary Grades Part II, Teacher's Guide [and] Worksheets. General Introduction. The World of Numbers. Final Experimental Version.

ERIC Educational Resources Information Center

Heidema, Clare; Schweitzer, Janis

This guide represents the final experimental version of a pilot project conducted in the United States between 1973 and 1976. The ideas and manner of presentation are based on the works of Georges and Frederique Papy. They are recognized as having introduced colored arrow drawings ("papygrams") and models of our numeration system (the…

CSMP Mathematics for the Upper Primary Grades Part I, Teacher's Guide [and] Worksheets. General Introduction. The World of Numbers. Final Experimental Version.

ERIC Educational Resources Information Center

Heidema, Clare; Schweitzer, Janis

This guide represents the final experimental version of a pilot project conducted in the United States between 1973 and 1976. The ideas and manner of presentation are based on the works of Georges and Frederique Papy. They are recognized as having introduced colored arrow drawings ("papygrams") and models of our numeration system (the…

Suggestions for Curriculum Development [And] Handbook Upper Elementary Grades, Part B, 4-6. Environmental Education Interdependence: A Concept Approach. Revised.

ERIC Educational Resources Information Center

King, David C.; Long, Cathryn J.

Two booklets comprise the grades 4-6 component of a series of guides for incorporating environmental education into the existing curriculum. Both the guide and handbook emphasize a multidisciplinary approach, use the concept of interdependence as an organizing theme, and offer suggestions for using the local community as a resource to study the…

A Teacher's Guide to the Energy 80 Student Booklet for the 1981-82 School Year.

ERIC Educational Resources Information Center

Lord, John, Ed.

This teaching guide was developed for use with Energy 80 program student booklets. Although the program was designed for junior high/middle school students in science/social studies classes, it is indicated that the materials are suitable for use at higher grades and, to a lesser extent, in upper elementary grades. The first 80 pages of the guide…

Doppler Endoscopic Probe Monitoring of Blood Flow Improves Risk Stratification and Outcomes of Patients With Severe Nonvariceal Upper Gastrointestinal Hemorrhage.

PubMed

Jensen, Dennis M; Kovacs, Thomas O G; Ohning, Gordon V; Ghassemi, Kevin; Machicado, Gustavo A; Dulai, Gareth S; Sedarat, Alireza; Jutabha, Rome; Gornbein, Jeffrey

2017-05-01

For 4 decades, stigmata of recent hemorrhage in patients with nonvariceal lesions have been used for risk stratification and endoscopic hemostasis. The arterial blood flow that underlies the stigmata rarely is monitored, but can be used to determine risk for rebleeding. We performed a randomized controlled trial to determine whether Doppler endoscopic probe monitoring of blood flow improves risk stratification and outcomes in patients with severe nonvariceal upper gastrointestinal hemorrhage. In a single-blind study performed at 2 referral centers we assigned 148 patients with severe nonvariceal upper gastrointestinal bleeding (125 with ulcers, 19 with Dieulafoy's lesions, and 4 with Mallory Weiss tears) to groups that underwent standard, visually guided endoscopic hemostasis (control, n = 76), or endoscopic hemostasis assisted by Doppler monitoring of blood flow under the stigmata (n = 72). The primary outcome was the rate of rebleeding after 30 days; secondary outcomes were complications, death, and need for transfusions, surgery, or angiography. There was a significant difference in the rates of lesion rebleeding within 30 days of endoscopic hemostasis in the control group (26.3%) vs the Doppler group (11.1%) (P = .0214). The odds ratio for rebleeding with Doppler monitoring was 0.35 (95% confidence interval, 0.143-0.8565) and the number needed to treat was 7. In a randomized controlled trial of patients with severe upper gastrointestinal hemorrhage from ulcers or other lesions, Doppler probe guided endoscopic hemostasis significantly reduced 30-day rates of rebleeding compared with standard, visually guided hemostasis. Guidelines for nonvariceal gastrointestinal bleeding should incorporate these results. ClinicalTrials.gov no: NCT00732212 (CLIN-013-07F). Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Ultrasound-guided rectus sheath and transversus abdominis plane blocks for perioperative analgesia in upper abdominal surgery: A randomized controlled study.

PubMed

Abdelsalam, Khaled; Mohamdin, O W

2016-01-01

Regional anesthetic techniques can be used to alleviate postoperative pain in patients undergoing major upper abdominal surgery. Our aim was to evaluate the efficacy of bilateral ultrasound (US)-guided rectus sheath (RS) and transversus abdominis plane (TAP) blocks for better perioperative analgesia. It is a prospective, observer-blinded, randomized clinical study. 40 eligible patients undergoing elective liver resection or Whipple procedure were included. All patients received a standardized anesthetic technique. Group 1 (n = 20) received preincisional US-guided bilateral RS and TAP blocks using 20 ml volume of bupivacaine 0.25% for each, and group 2 (n = 20) received local wound infiltration at end of surgery with 40 ml of bupivacaine 0.25%. A standardized postoperative analgesic regimen composed of intravenous paracetamol and a morphine patient-controlled analgesia (PCA). The use of intraoperative fentanyl and recovery room morphine boluses, PCA-administered morphine, pain scores as well as number of patients' experienced postoperative nausea and vomiting in the ward at 6 and 24 h were recorded. Group 1 patients received a significantly lower cumulative intraoperative fentanyl, significantly lesser boluses of morphine in postanesthesia care unit, as well, significantly lower cumulative 24 h postoperative morphine dosage than the group 2 patients. Pain visual analog scale scores were significantly lower at both 6 and 24 h postoperatively in TAP group when compared with the no-TAP group. There were no complications related to the TAP block procedures. No signs or symptoms of local anesthetic systemic toxicity were detected. The combination of bilateral US-guided RS and TAP blocks provides excellent perioperative analgesia for major upper abdominal surgery.

Implant image quality in dental radiographs recorded using a customized imaging guide or a standard film holder.

PubMed

Schropp, Lars; Stavropoulos, Andreas; Spin-Neto, Rubens; Wenzel, Ann

2012-01-01

To compare a customized imaging guide and a standard film holder for obtaining optimally projected intraoral radiographs of dental implants. Intraoral radiographs of four screw-type implants with different inclination placed in an upper or lower dental phantom model were recorded by 32 groups of examiners after a short instruction in the use of the RB-RB/LB-LB mnemonic rule. Half of the examiners recorded the images using a standard film holder and the other half used a customized imaging guide. Each radiograph was assessed under blinded conditions with regard to rendering of the implant threads and was assigned to one of four quality categories: (1) perfect, (2) not perfect, but clinically acceptable, (3) not acceptable, and (4) hopeless. For the upper jaw, the same number of exposures per implant were made to achieve an acceptable image (P=0.86) by the standard film holder method (median=2) and the imaging guide method (median=2). For the lower jaw, medians for the imaging guide method and the film holder method were 1 and 2, respectively (P=0.004). For the imaging guide method, the first exposure was rated as perfect/acceptable in 62% of the cases and for the film holder method in 41% of the cases (P=0.013). After ≤ 2 exposures, 78% (imaging guide method) and 69% (film holder method) of the implant images were perfect/acceptable (P=0.23). The implant inclination did not have a major influence on the outcomes. Perfect or acceptable images were achieved after two exposures with the same frequency either using a customized imaging guide method or a standard film holder method. However, the use of a customized imaging guide method was overall significantly superior to a standard film holder method in terms of obtaining perfect or acceptable images with only one exposure. © 2011 John Wiley & Sons A/S.

CSMP Mathematics for the Upper Primary Grades Part I, Teacher's Guide. The Languages of Strings and Arrows. Geometry and Measurement. Workbooks. Final Experimental Version.

ERIC Educational Resources Information Center

CEMREL, Inc., St. Ann, MO.

This guide represents the final experimental version of a pilot project conducted in the Unites States between 1973 and 1976. The ideas and manner of presentation are based on the works of Georges and Frederique Papy. They are recognized as having introduced colored arrow drawings ("papygrams") and models of our numeration system (the…

CSMP Mathematics for the Upper Primary Grades Part II, Teacher's Guide. The Languages of Strings and Arrows. Geometry and Measurement. Workbooks. Final Experimental Version.

ERIC Educational Resources Information Center

CEMREL, Inc., St. Ann, MO.

This guide represents the final experimental version of an extended pilot project which was conducted in the United States between 1973 and 1976. The manner of presentation and the pedagogical ideas and tools are based on the works of Georges and Frederique Papy. They are recognized as having introduced colored arrow drawings…

Science of Alcohol Curriculum for American Indians (SACAI): An Interdisciplinary Approach to the Study of the Science of Alcohol for Upper Elementary and Middle Level Students.

ERIC Educational Resources Information Center

American Indian Science and Engineering Society, Boulder, CO.

This curriculum provides American Indian youth with a framework for learning about the effects of alcohol on the body and the community. The curriculum stresses the development of scientific thinking skills and was designed for upper elementary and middle level students. The guide consists of four units: How Does Alcohol Circulate through the Body…

The consummatory origins of visually guided reaching in human infants: a dynamic integration of whole-body and upper-limb movements.

PubMed

Foroud, Afra; Whishaw, Ian Q

2012-06-01

Reaching-to-eat (skilled reaching) is a natural behaviour that involves reaching for, grasping and withdrawing a target to be placed into the mouth for eating. It is an action performed daily by adults and is among the first complex behaviours to develop in infants. During development, visually guided reaching becomes increasingly refined to the point that grasping of small objects with precision grips of the digits occurs at about one year of age. Integration of the hand, upper-limbs, and whole body are required for successful reaching, but the ontogeny of this integration has not been described. The present longitudinal study used Laban Movement Analysis, a behavioural descriptive method, to investigate the developmental progression of the use and integration of axial, proximal, and distal movements performed during visually guided reaching. Four infants (from 7 to 40 weeks age) were presented with graspable objects (toys or food items). The first prereaching stage was associated with activation of mouth, limb, and hand movements to a visually presented target. Next, reaching attempts consisted of first, the advancement of the head with an opening mouth and then with the head, trunk and opening mouth. Eventually, the axial movements gave way to the refined action of one upper-limb supported by axial adjustments. These findings are discussed in relation to the biological objective of reaching, the evolutionary origins of reaching, and the decomposition of reaching after neurological injury. Copyright © 2012 Elsevier B.V. All rights reserved.

Adventures in Law and History. Volume I: Native Americans, the Spanish Frontier, and the Gold Rush. A Law and Civic Education Curriculum for Upper Elementary Grades with Units on Rules and Laws, Property, and Authority.

ERIC Educational Resources Information Center

Croddy, Marshall; Degelman, Charles; Doggett, Keri; Hayes, Bill

This is volume one of a two-volume civics curriculum on law and effective citizenship for upper-elementary students. The lessons, set in American historical eras, engage students in cooperative-learning activities, role plays, simulations, readers theater, stories, and guided discussions, which introduce and reinforce law-related and civic…

Ultrasound-Guided Single-Injection Infraclavicular Block Versus Ultrasound-Guided Double-Injection Axillary Block: A Noninferiority Randomized Controlled Trial.

PubMed

Boivin, Ariane; Nadeau, Marie-Josée; Dion, Nicolas; Lévesque, Simon; Nicole, Pierre C; Turgeon, Alexis F

2016-01-01

Single-injection ultrasound-guided infraclavicular block is a simple, reliable, and effective technique. A simplified double-injection ultrasound-guided axillary block technique with a high success rate recently has been described. It has the advantage of being performed in a superficial and compressible location, with a potentially improved safety profile. However, its effectiveness in comparison with single-injection infraclavicular block has not been established. We hypothesized that the double-injection ultrasound-guided axillary block would show rates of complete sensory block at 30 minutes noninferior to the single-injection ultrasound-guided infraclavicular block. After approval by our research ethics committee and written informed consent, adults undergoing distal upper arm surgery were randomized to either group I, ultrasound-guided single-injection infraclavicular block, or group A, ultrasound-guided double-injection axillary block. In group I, 30 mL of 1.5% mepivacaine was injected posterior to the axillary artery. In group A, 25 mL of 1.5% mepivacaine was injected posteromedial to the axillary artery, after which 5 mL was injected around the musculocutaneous nerve. Primary outcome was the rate of complete sensory block at 30 minutes. Secondary outcomes were the onset of sensory and motor blocks, surgical success rates, performance times, and incidence of complications. All outcomes were assessed by a blinded investigator. The noninferiority of the double-injection ultrasound-guided axillary block was considered if the limits of the 90% confidence intervals (CIs) were within a 10% margin of the rate of complete sensory block of the infraclavicular block. At 30 minutes, the rate of complete sensory block was 79% in group A (90% CI, 71%-85%) compared with 91% in group I (90% CI, 85%-95%); the upper limit of CI of group A is thus included in the established noninferiority margin of 10%. The rate of complete sensory block was lower in group A (proportion difference of 12% [95% CI, 2-22]; P = 0.0091), as was surgical success rate (82% [95% CI, 74%-89%] vs 93% [95% CI, 86%-97%]; proportion difference of 11% [95% CI 1-20]; P = 0.0153). Sensory block onset also was slower in group A (log rank test P = 0.0020). Performance times were faster in group I (231 seconds [95% CI, 213-250]) than in group A (358 seconds [95% CI, 332-387]; P < 0.0001). No statistically significant difference was observed for vascular puncture, paresthesia during block performance, or procedure-related pain. No neurologic complication was noted at follow-up. We failed to demonstrate that the rate of complete sensory block of the double-injection axillary block is noninferior to the single-injection infraclavicular block. However, the rate of complete sensory block at 30 minutes is statistically significantly lower with the axillary block. The ultrasound-guided single-injection infraclavicular block thus seems to be the preferred technique over the axillary for upper arm anesthesia.

Current situation regarding central venous port implantation procedures and complications: a questionnaire-based survey of 11,693 implantations in Japan.

PubMed

Shiono, Masatoshi; Takahashi, Shin; Takahashi, Masanobu; Yamaguchi, Takuhiro; Ishioka, Chikashi

2016-12-01

We conducted a nationwide questionnaire-based survey to understand the current situation regarding central venous port implantation in order to identify the ideal procedure. Questionnaire sheets concerning the number of implantation procedures and the incidence of complications for all procedures completed in 2012 were sent to 397 nationwide designated cancer care hospitals in Japan in June 2013. Venipuncture sites were categorized as chest, neck, upper arm, forearm, and others. Methods were categorized as landmark, cut-down, ultrasound-mark, real-time ultrasound guided, venography, and other groups. We received 374 responses (11,693 procedures) from 153 centers (38.5 %). The overall complication rates were 7.4 % for the chest (598/8,097 cases); 6.8 % for the neck (157/2325); 5.2 % for the upper arm (54/1,033); 7.3 % for the forearm (9/124); and 6.1 % for the other groups (7/114). Compared to the chest group, only the upper arm group showed a significantly lower incidence of complications (P = 0.010), and multivariate logistic regression (odds ratio 0.69; 95 % confidence interval 0.51-0.91; P = 0.008) also showed similar findings. Real-time ultrasound-guided puncture was most commonly used in the upper arm group (83.8 %), followed by the neck (69.8 %), forearm (53.2 %), chest (41.8 %), and other groups (34.2 %). Upper arm venipuncture with ultrasound guidance seems the most promising technique to prevent complications of central venous port implantation.

Raza de Tesoros. Programa de Lectura y Ensenanza del Lenguaje, Unidad B. Guia para el Maestro (Race of Treasures. Reading and Language Learning Program, Unit B. Teacher's Guide).

ERIC Educational Resources Information Center

Dissemination and Assessment Center for Bilingual Education, Austin, TX.

This is the teacher's guide accompanying a reader and a workbook that are part of an ungraded language arts and reading program that can be used in classes from upper elementary through high school. The program is designed around reading selections which present aspects of history, culture, and present-day experiences of special relevance to the…

Diagnosis of gastrointestinal bleeding: A practical guide for clinicians

PubMed Central

Kim, Bong Sik Matthew; Li, Bob T; Engel, Alexander; Samra, Jaswinder S; Clarke, Stephen; Norton, Ian D; Li, Angela E

2014-01-01

Gastrointestinal bleeding is a common problem encountered in the emergency department and in the primary care setting. Acute or overt gastrointestinal bleeding is visible in the form of hematemesis, melena or hematochezia. Chronic or occult gastrointestinal bleeding is not apparent to the patient and usually presents as positive fecal occult blood or iron deficiency anemia. Obscure gastrointestinal bleeding is recurrent bleeding when the source remains unidentified after upper endoscopy and colonoscopic evaluation and is usually from the small intestine. Accurate clinical diagnosis is crucial and guides definitive investigations and interventions. This review summarizes the overall diagnostic approach to gastrointestinal bleeding and provides a practical guide for clinicians. PMID:25400991

Imaging-guided thoracoscopic resection of a ground-glass opacity lesion in a hybrid operating room equipped with a robotic C-arm CT system.

PubMed

Hsieh, Chen-Ping; Hsieh, Ming-Ju; Fang, Hsin-Yueh; Chao, Yin-Kai

2017-05-01

The intraoperative identification of small pulmonary nodules through video-assisted thoracoscopic surgery remains challenging. Although preoperative CT-guided nodule localization is commonly used to detect tumors during video-assisted thoracoscopic surgery (VATS), this approach carries inherent risks. We report the case of a patient with stage I lung cancer presenting as an area of ground-glass opacity (GGO) in the right upper pulmonary lobe. He successfully underwent a single-stage, CT-guided localization and removal of the pulmonary nodule within a hybrid operating room (OR) equipped with a robotic C-arm.

A New Approach to Ballistic Missile Defense for Countering Antiaccess/Area-Denial Threats from Precision-Guided Weapons

DTIC Science & Technology

2013-04-01

performance esti- mates. Four notional developments of the PAA surrogate were mod- eled , with burnout velocities of 5 km/second and 6 km/second (40...his weapon on the intended target. Interceptor Models The notional baseline surface-launch interceptor was modeled with 3.5 km/second burnout ...agility. The AWL upper-tier interceptor was modeled, based on employment from an F-35A.11 In general the upper-tier interceptor has a burnout

The Efficacy of Platelets Rich Plasma Injection in the Superior Joint Space of the Tempromandibular Joint Guided by Ultra Sound in Patients with Non-reducing Disk Displacement.

PubMed

Al-Delayme, Ra'ed M Ayoub; Alnuamy, Shefaa H; Hamid, Firas Taha; Azzamily, Tariq Jassim; Ismaeel, Salah AbdulMahdy; Sammir, R; Hadeel, M; Nabeel, Jafaar; Shwan, R; Alfalahi, Shahad Jamal; Yasin, Alaa

2017-03-01

The objective of this study was to determine average improvement during the rest and active mouth opening after ultrasound guided platelets rich plasma injection in the tempromandibular superior joint space for the patients complaining from non-reducing disk displacement. Thirty-four patients with non-reducing disk displacement underwent guided ultrasound injection of platelet rich plasma to the upper joint space. The extent of maximal mouth opening, chewing efficiency, sound intensity of the TMJ, and tenderness of the TMJ and the masticatory muscles at rest, motion and mastication were thoroughly assessed at the beginning of the study and scheduled for next follow-up at 1st, 3rd, and 6th months. Injection with platelets rich plasma was significantly more effective in improvements of the extent of maximal mouth opening, statistics result demonstrated a significant reduction in the VAS values of pain at rest, motion and mastication compared to the baseline VAS values. PRP injection to the upper temporomandibular joint space provided improvement in signs and symptoms of patient with non-reducing disk displacement of the temporomandibular joint.

Right Upper Quadrant Pain: Ultrasound First!

PubMed

Revzin, Margarita V; Scoutt, Leslie M; Garner, Joseph G; Moore, Christopher L

2017-10-01

Acute right upper quadrant (RUQ) pain is a common presenting symptom in emergency departments and outpatient medical practices, and is most commonly attributable to biliary and hepatic pathology. Ultrasound should be used as a first-line imaging modality for the diagnosis of gallstones and cholecystitis, as it allows the differentiation of medical and surgical causes of upper abdominal pathology, and in many circumstances is sufficient to guide patient management. Knowledge of strengths and limitations of ultrasound in the evaluation of RUQ is paramount in correct diagnosis. A spectrum of RUQ pathology for which a RUQ ultrasound examination should reasonably be considered as the initial imaging modality of choice will be reviewed. © 2017 by the American Institute of Ultrasound in Medicine.

MDCT-Guided Transthoracic Needle Aspiration Biopsy of the Lung Using the Transscapular Approach

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

Rossi, Umberto G., E-mail: urossi76@hotmail.com; Seitun, Sara; Ferro, Carlo

2011-02-15

The purpose of this study is to report our preliminary experience using MDCT-guided percutaneous transthoracic needle aspiration biopsy using the transscapular approach in the upper posterolateral lung nodules, an area that it is difficult or hazardous to reach with the conventional approach. Five patients underwent CT-guided percutaneous transthoracic needle aspiration biopsy of the lung via the transscapular approach. A coaxial needle technique was used in all patients. Biopsy was successful in all patients. No major complications were encountered. One patient developed a minimal pneumothorax next to the lesion immediately after biopsy, which resolved spontaneously. MDCT-guided percutaneous transthoracic needle aspiration biopsymore » of the lung via the transscapular approach is an effective and safe procedure that reduces the risk of pneumothorax in selected patients.« less

Congenital Differences of the Upper Extremity: Classification and Treatment Principles

PubMed Central

2011-01-01

For hand surgeons, the treatment of children with congenital differences of the upper extremity is challenging because of the diverse spectrum of conditions encountered, but the task is also rewarding because it provides surgeons with the opportunity to impact a child's growth and development. An ideal classification of congenital differences of the upper extremity would reflect the full spectrum of morphologic abnormalities and encompass etiology, a guide to treatment, and provide prognoses. In this report, I review current classification systems and discuss their contradictions and limitations. In addition, I present a modified classification system and provide treatment principles. As our understanding of the etiology of congenital differences of the upper extremity increases and as experience of treating difficult cases accumulates, even an ideal classification system and optimal treatment strategies will undoubtedly continue to evolve. PMID:21909463

Flow instabilities in non-uniformly heated helium jet arrays used for divertor PFCs

DOE PAGES

Youchison, Dennis L.

2015-07-30

In this study, due to a lack of prototypical experimental data, little is known about the off-normal behavior of recently proposed divertor jet cooling concepts. This article describes a computational fluid dynamics (CFD) study on two jet array designs to investigate their susceptibility to parallel flow instabilities induced by non-uniform heating and large increases in the helium outlet temperature. The study compared a single 25-jet helium-cooled modular divertor (HEMJ) thimble and a micro-jet array with 116 jets. Both have pure tungsten armor and a total mass flow rate of 10 g/s at a 600 °C inlet temperature. We investigated flowmore » perturbations caused by a 30 MW/m 2 off-normal heat flux applied over a 25 mm 2 area in addition to the nominal 5 MW/m 2 applied over a 75 mm 2 portion of the face. The micro-jet array exhibited lower temperatures and a more uniform surface temperature distribution than the HEMJ thimble. We also investigated the response of a manifolded nine-finger HEMJ assembly using the nominal heat flux and a 274 mm 2 heated area. For the 30 MW/m2 case, the micro-jet array absorbed 750 W in the helium with a maximum armor surface temperature of 1280 °C and a fluid/solid interface temperature of 801 °C. The HEMJ absorbed 750 W with a maximum armor surface temperature of 1411 °C and a fluid/solid interface temperature of 844 °C. For comparison, both the single HEMJ finger and the micro-jet array used 5-mm-thick tungsten armor. The ratio of maximum to average temperature and variations in the local heat transfer coefficient were lower for the micro-jet array compared to the HEMJ device. Although high heat flux testing is required to validate the results obtained in these simulations, the results provide important guidance in jet design and manifolding to increase heat removal while providing more even temperature distribution and minimizing non-uniformity in the gas flow and thermal stresses at the armor joint.« less

Improved Point Analysis Model (IPAM) (Users Guide)

DTIC Science & Technology

1991-02-01

Descriptions 7 Stratus fractus of bad weather* or Cumulus fractus of bad weather, or both ( pannus ), usually below Altostratus or Nimbostratus. 8...Cumulonimbus without anvil or fibrous upper part, Cumulus, Stratocumulus, Stratus or pannus . / Stratocumulus, Stratus, Cumulus and Cumulonimbus invisible owing

Appropriateness of advanced upper limb prosthesis prescription for a patient with cognitive impairment: a case report.

PubMed

Barredo, Jennifer; Acluche, Frantzy; Disla, Roxanne; Fantini, Christopher; Fishelis, Leah; Sasson, Nicole; Resnik, Linda

2017-08-01

To describe a participant with scapulo-thoracic amputation and cognitive impairment trained to use the DEKA Arm and discuss factors relevant to the determination that he was not an appropriate candidate for independent home use of the device. The participant underwent 40 h of in-laboratory training with the DEKA Arm Advanced Upper Limb Prosthesis. Pre-training neuropsychological measures of cognition were collected. Qualitative and quantitative data related to functional performance, quality of life and pain were collected after 10 h of training, and at the conclusion of training. Using a constant comparative approach, data were binned into major themes; elements within each theme were identified. Six themes were relevant to the determination that the participant was inappropriate for home use of the DEKA Arm: physical and mental health; learning, memory and cognition; adult role function; functional performance; user safety and judgement and capacity for independent device use. Issues contraindicating unsupervised device use included: uncontrolled health symptoms, poor knowledge application, safety concerns, absenteeism and performance degradation under stress. The findings have implications for training with and prescription of the DEKA Arm and other complex upper limb prostheses. Further research is needed to develop a model to guide prescription of technologically complex upper limb prostheses. Implications for Rehabilitation Advanced upper limb prostheses, like the DEKA Arm, promise greater functionality, but also may be cognitively demanding, raising questions of when, and if, prescription is appropriate for patients with cognitive impairment. At this time, no formal criteria exist to guide prescription of advanced upper limb prostheses. Each clinical team applies their own informal standards in decision-making. In this case report, we described six factors that were considered in determining whether or not a research participant, with scapulo-thoracic amputation and cognitive impairment was appropriate for home use of a complex upper limb prosthesis. The findings have implications for training with and prescription of the DEKA Arm, and highlights the need for further research to develop prescription guidelines for advanced assistive devices.

A stocking guide for eastern white pine

Treesearch

James S. Philbrook; James P. Barrett; William B. Leak

1973-01-01

A stocking chart for eastern white pine is presented and described. The chart shows basal areas and numbers of trees by mean stand diameter, representing the upper limit in stocking for practical management (A curve) and minimum stocking for full site utilization (B curve).

C-431 B -- Scope document

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

Hollister, H.L.

1951-06-01

This document describes the scope of the C-431-B Reactor Production Facility. In dealing with the broad phases of the project, it includes the Sections ``A`` (Scope Modifications) of the approved Design Criteria, modified to ensure correctness to date. Location of the facility has been set as shown on the site map in HDC-2101, designated site number one. Included in Project C-431-B are the 105-C Building, including within that building facilities previously located in the 1608 Building, a contaminated effluent crib adjacent to 105-C, and gas facilities using the 115-B Building interconnected with 105-C. Also included are an oil shed, amore » thimble storage cave, a badge house, and an exclusion fence. Building services and process lines will be considered part of the project to a location nominally five feet outside of 105-C.« less

Fort Peck Dam/Fort Peck Lake Master Plan with Integrated Programmatic Environmental Assessment, Missouri River, Montana: Update of Design Memorandum MFP-105D

DTIC Science & Technology

2008-08-01

wilderness areas, and a self-guided auto tour. BUREAU OF LAND MANAGEMENT The l49-mile Upper Missouri National Wild and Scenic River flows between Fort...and CMR. This segment is classified as scenic. The National Park Service (NPS) is the overseeing agency for the National Wild and Scenic Rivers...System. Under NPS oversight, the Bureau of Land Management (BLM) is the managing agency for the Upper Missouri National Wild and Scenic River. Within

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

Lee, Ching-Pang; Tham, Kok-Mun; Schroeder, Eric

An outer rim seal arrangement (10), including: an annular rim (70) centered about a longitudinal axis (30) of a rotor disc (31), extending fore and having a fore-end (72), an outward-facing surface (74), and an inward-facing surface (76); a lower angel wing (62) extending aft from a base of a turbine blade (22) and having an aft end (64) disposed radially inward of the rim inward-facing surface to define a lower angel wing seal gap (80); an upper angel wing (66) extending aft from the turbine blade base and having an aft end (68) disposed radially outward of the rimmore » outward-facing surface to define a upper angel wing seal gap (80, 82); and guide vanes (100) disposed on the rim inward-facing surface in the lower angel wing seal gap. Pumping fins (102) may be disposed on the upper angel wing seal aft end in the upper angel wing seal gap.« less

The Peroxide Pathway

NASA Technical Reports Server (NTRS)

McNeal, Curtis I., Jr.; Anderson, William

1999-01-01

NASA's current focus on technology roadmaps as a tool for guiding investment decisions leads naturally to a discussion of NASA's roadmap for peroxide propulsion system development. NASA's new Second Generation Space Transportation System roadmap calls for an integrated Reusable Upper-Stage (RUS) engine technology demonstration in the FY03/FY04 time period. Preceding this integrated demonstration are several years of component developments and subsystem technology demonstrations. NASA and the Air Force took the first steps at developing focused upper stage technologies with the initiation of the Upper Stage Flight Experiment with Orbital Sciences in December 1997. A review of this program's peroxide propulsion development is a useful first step in establishing the peroxide propulsion pathway that could lead to a RUS demonstration in 2004.

Diagnosis of Upper-Quadrant Lymphedema Secondary to Cancer: Clinical Practice Guideline From the Oncology Section of APTA

PubMed Central

Levenhagen, Kimberly; Davies, Claire; Perdomo, Marisa; Ryans, Kathryn

2017-01-01

Introduction: The Oncology Section of APTA developed a clinical practice guideline to aid the clinician in diagnosing secondary upper-quadrant cancer-related lymphedema. Methods: Following a systematic review of published studies and a structured appraisal process, recommendations were written to guide the physical therapist and other health care clinicians in their diagnostic process. Overall, clinical practice recommendations were formulated on the basis of the evidence for each diagnostic method and were assigned a grade based on the strength of the evidence for different patient presentations and clinical utility. Recommendations: In an effort to make these clinically applicable, recommendations were based on the characteristics as to the location and stage of a patient's upper-quadrant lymphedema. PMID:28748128

Investigation of the phase velocities of guided acoustic waves in soft porous layers.

PubMed

Boeckx, L; Leclaire, P; Khurana, P; Glorieux, C; Lauriks, W; Allard, J F

2005-02-01

A new experimental method for measuring the phase velocities of guided acoustic waves in soft poroelastic or poroviscoelastic plates is proposed. The method is based on the generation of standing waves in the material and on the spatial Fourier transform of the displacement profile of the upper surface. The plate is glued on a rigid substrate so that it has a free upper surface and a nonmoving lower surface. The displacement is measured with a laser Doppler vibrometer along a line corresponding to the direction of propagation of plane surface waves. A continuous sine with varying frequencies was chosen as excitation signal to maximize the precision of the measurements. The spatial Fourier transform provides the wave numbers, and the phase velocities are obtained from the relationship between wave number and frequency. The phase velocities of several guided modes could be measured in a highly porous foam saturated by air. The modes were also studied theoretically and, from the theoretical results, the experimental results, and a fitting procedure, it was possible to determine the frequency behavior of the complex shear modulus and of the complex Poisson ratio from 200 Hz to 1.4 kHz, in a frequency range higher than the traditional methods.

U.S. Air Force Engineering and Services Hardware Requirements

DOT National Transportation Integrated Search

1991-04-01

This document proposes a path to meet the communications-computer systems (CSC) requirements of Air Force Engineering and Services (E and S) in the mid-to-late 1990s. It reflects the philosophies that guide E and S upper- level management as it carri...

5. VIEW LOOKING DOWN ON TOP OF ELEVATOR CAR FROM ...

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

5. VIEW LOOKING DOWN ON TOP OF ELEVATOR CAR FROM THIRD FLOOR, SHOWING CROSSHEAD AND BROKEN ROPE SAFETY STOP MECHANISM INSIDE; GUIDES AT LOWER LEFT AND UPPER RIGHT; OPERATING ROPE AT LEFT - 72 Marlborough Street, Residential Hydraulic Elevator, Boston, Suffolk County, MA

Indians of Nevada: Volume 2.

ERIC Educational Resources Information Center

Dunn, Helen

Designed to provide Nevada's school population with information that will facilitate awareness and understanding of past and present Native Nevadan lifestyles and contributions, this generalized curriculum guide might constitute a social studies unit for upper elementary and/or junior high schools. Emphasis is on the cultural-historical influence…

Recreating the 1950’s Chesapeake Bay: Use of a Network Model to Guide the Application of a Eutrophication Model

DTIC Science & Technology

2009-08-01

14. Comparison of surface light extinction for base and 1950’ s RMB2 results in the upper, mid, and lower regions of the Chesapeake Bay...Lower Bay Light Extinction Surface 1950 Lower Bay Light Extinction Surface Figure 14. Comparison of surface light extinction for base and 1950’ s RMB2...ER D C/ EL T R -0 9 -9 System-Wide Water Resources Program Recreating the 1950’ s Chesapeake Bay: Use of a Network Model to Guide the

Recurrent clot anuria following laparoscopic pyeloplasty in a solitary functioning kidney: managing with double guide wire technique

PubMed Central

Kumar, Santosh; Singh, Shivanshu; Parmar, Kalpesh Mahesh; Garg, Nitin

2014-01-01

Clot anuria in a solitary functioning kidney is an emergency situation. Haematuria with clot anuria in an early postoperative period represents a challenge, as treatment options are limited. Manipulation of the anastomotic site may lead to anastomotic disruption and urinoma while use of thrombolytic therapy poses the danger of increasing haematuria. We report a case of anuria due to clot retention in the upper tract following laparoscopic dismembered pyeloplasty in a solitary functioning kidney, managed successfully with double guide wire technique. PMID:25540210

An Evaluation of the Design and Usability of a Novel Robotic Bilateral Arm Rehabilitation Device for Patients with Stroke.

PubMed

Pei, Yu-Cheng; Chen, Jean-Lon; Wong, Alice M K; Tseng, Kevin C

2017-01-01

Case series. IV (case series). Robot-assisted therapy for upper limb rehabilitation is an emerging research topic and its design process must integrate engineering, neurological pathophysiology, and clinical needs. This study developed/evaluated the usefulness of a novel rehabilitation device, the MirrorPath , designed for the upper limb rehabilitation of patients with hemiplegic stroke. The process follows Tseng's methodology for innovative product design and development, namely two stages, device development and usability assessment. During the development process, the design was guided by patients' rehabilitation needs as defined by patients and their therapists. The design applied synchronic movement of the bilateral upper limbs, an approach that is compatible with the bilateral movement therapy and proprioceptive neuromuscular facilitation theories. MirrorPath consists of a robotic device that guides upper limb movement linked to a control module containing software controlling the robotic movement. Five healthy subjects were recruited in the pretest, and 4 patients, 4 caregivers, and 4 therapists were recruited in the formal test for usability. All recruited subjects were allocated to the test group, completed the evaluation, and their data were all analyzed. The total system usability scale score obtained from the patients, caregivers, and therapists was 71.8 ± 11.9, indicating a high level of usability and product acceptance. Following a standard development process, we could yield a design that meets clinical needs. This low-cost device provides a feasible platform for carrying out robot-assisted bilateral movement therapy of patients with hemiplegic stroke. identifier NCT02698605.

Validity of the Dictionary of Occupational Titles for Assessing Upper Extremity Work Demands

PubMed Central

Opsteegh, Lonneke; Soer, Remko; Reinders-Messelink, Heleen A.; Reneman, Michiel F.; van der Sluis, Corry K.

2010-01-01

Objectives The Dictionary of Occupational Titles (DOT) is used in vocational rehabilitation to guide decisions about the ability of a person with activity limitations to perform activities at work. The DOT has categorized physical work demands in five categories. The validity of this categorization is unknown. Aim of this study was to investigate whether the DOT could be used validly to guide decisions for patients with injuries to the upper extremities. Four hypotheses were tested. Methods A database including 701 healthy workers was used. All subjects filled out the Dutch Musculoskeletal Questionnaire, from which an Upper Extremity Work Demands score (UEWD) was derived. First, relation between the DOT-categories and UEWD-score was analysed using Spearman correlations. Second, variance of the UEWD-score in occupational groups was tested by visually inspecting boxplots and assessing kurtosis of the distribution. Third, it was investigated whether occupations classified in one DOT-category, could significantly differ on UEWD-scores. Fourth, it was investigated whether occupations in different DOT-categories could have similar UEWD-scores using Mann Whitney U-tests (MWU). Results Relation between the DOT-categories and the UEWD-score was weak (rsp = 0.40; p<.01). Overlap between categories was found. Kurtosis exceeded ±1.0 in 3 occupational groups, indicating large variance. UEWD-scores were significantly different within one DOT-category (MWU = 1.500; p<.001). UEWD scores between DOT-categories were not significantly different (MWU = 203.000; p = .49). Conclusion All four hypotheses could not be rejected. The DOT appears to be invalid for assessing upper extremity work demands. PMID:21151934

Ultrasound-Guided Forearm Nerve Blocks: A Novel Application for Pain Control in Adult Patients with Digit Injuries

PubMed Central

Patricia Javedani, Parisa; Amini, Albert

2016-01-01

Phalanx fractures and interphalangeal joint dislocations commonly present to the emergency department. Although these orthopedic injuries are not complex, the four-point digital block used for anesthesia during the reduction can be painful. Additionally, cases requiring prolonged manipulation or consultation for adequate reduction may require repeat blockade. This case series reports four patients presenting after mechanical injuries resulting in phalanx fracture or interphalangeal joint dislocations. These patients received an ultrasound-guided peripheral nerve block of the forearm with successful subsequent reduction. To our knowledge, use of ultrasound-guided peripheral nerve blocks of the forearm for anesthesia in reduction of upper extremity digit injuries in adult patients in the emergency department setting has not been described before. PMID:27555971

Indians of Nevada: Volume 4.

ERIC Educational Resources Information Center

Dunn, Helen

As part of a continuing program designed to provide Nevada's school population with information that will facilitate greater awareness and understanding of both past and present Native Nevadan lifestyles and contributions, this generalized curriculum guide might constitute a social studies unit on early Indian culture for upper elementary and/or…

SIP Version 1.0 User's Guide for Pesticide Exposure of Birds and Mammals through Drinking Water

EPA Pesticide Factsheets

Model provides an upper bound estimate of exposure of birds and mammals to pesticides through drinking water alone. Intended for use in problem formulation to determine whether or not drinking water exposure alone is a potential pathway of concern.

A computed tomographic anatomical study of the upper sacrum. Application for a user guide of pelvic fixation with iliosacral screws in adult spinal deformity.

PubMed

Dubory, Arnaud; Bouloussa, Houssam; Riouallon, Guillaume; Wolff, Stéphane

2017-12-01

Widely used in traumatic pelvic ring fractures, the iliosacral (IS) screw technique for spino-pelvic fixation remains anecdotal in adult spinal deformity. The objective of this study was to assess anatomical variability of the adult upper sacrum and to provide a user guide of spino-pelvic fixation with IS screws in adult spinal deformity. Anatomical variability of the upper sacrum according to age, gender, height and weight was sought on 30 consecutive pelvic CT-scans. Thus, a user guide of spino-pelvic fixation with IS screws was modeled and assessed on ten CT-scans as described below. Two invariable landmarks usable during the surgical procedure were defined: point A (corresponding to the connector binding the IS screw to the spinal rod), equidistant from the first posterior sacral hole and the base of the S1 articular facet and 10 mm-embedded into the sacrum; point B (corresponding to the tip of the IS screw) located at the junction of the anterior third and middle third of the sacral endplate in the sagittal plane and at the middle of the endplate in the coronal plane. Point C corresponded to the intersection between the A-B direction and the external facet of the iliac wing. Three-dimensional reconstructions modeling the IS screw optimal direction according to the A-B-C straight line were assessed. Age had no effect on the anatomy of the upper sacrum. The distance between the base of the S1 superior articular facet and the top of the first posterior sacral hole was correlated with weight (r = 0.6; 95% CI [0.6-0.9]); p < 0.001). Sacral end-plate thickness increased for male patients (p < 0.001) and was strongly correlated with height (r = 0.6; 95% CI [0.29-0.75]); p < 0.001) and weight (r = 0.8; 95% CI [0.6-0.9]); p < 0.001). The thickness of the inferior part of the S1 vertebral body increased in male patients (p < 0.001). Other measured parameters slightly varied according to gender, height and weight. Simulating the described technique of pelvic fixation, no misplaced IS screw was found whatever the age, gender and morphologic parameters. This user guide of spinopelvic fixation with IS screws seems to be reliable and reproducible independently of age, gender and morphologic characteristics but needs clinical assessment. Level IV.

Method for automatically scramming a nuclear reactor

DOEpatents

Ougouag, Abderrafi M.; Schultz, Richard R.; Terry, William K.

2005-12-27

An automatically scramming nuclear reactor system. One embodiment comprises a core having a coolant inlet end and a coolant outlet end. A cooling system operatively associated with the core provides coolant to the coolant inlet end and removes heated coolant from the coolant outlet end, thus maintaining a pressure differential therebetween during a normal operating condition of the nuclear reactor system. A guide tube is positioned within the core with a first end of the guide tube in fluid communication with the coolant inlet end of the core, and a second end of the guide tube in fluid communication with the coolant outlet end of the core. A control element is positioned within the guide tube and is movable therein between upper and lower positions, and automatically falls under the action of gravity to the lower position when the pressure differential drops below a safe pressure differential.

Diagnosis of Upper Quadrant Lymphedema Secondary to Cancer: Clinical Practice Guideline From the Oncology Section of the American Physical Therapy Association

PubMed Central

Levenhagen, Kimberly; Davies, Claire; Perdomo, Marisa; Ryans, Kathryn

2017-01-01

Abstract The Oncology Section of the American Physical Therapy Association (APTA) developed a clinical practice guideline to aid the clinician in diagnosing secondary upper quadrant cancer-related lymphedema. Following a systematic review of published studies and a structured appraisal process, recommendations were written to guide the physical therapist and other health care clinicians in the diagnostic process. Overall clinical practice recommendations were formulated based on the evidence for each diagnostic method and were assigned a grade based on the strength of the evidence for different patient presentations and clinical utility. In an effort to maximize clinical applicability, recommendations were based on the characteristics as to the location and stage of a patient's upper quadrant lymphedema. PMID:28838217

Mental practice for upper limb rehabilitation after stroke: a systematic review and meta-analysis.

PubMed

Park, Si-Woon; Kim, Jae-Hyung; Yang, Yun-Jung

2018-06-14

Mental practice (MP) is usually provided in combination with other therapies, and new developments for neurofeedback to support MP have been made recently. The objectives of this study were to evaluate the effectiveness of MP and to investigate the intervention characteristics including neurofeedback that may affect treatment outcome. The Cochrane Central Register of Controlled Trials, PubMed, Embase, KoreaMed, Scopus, Web of Science, PEDro, and CIRRIE were searched from inception to March 2017 for randomized controlled trials to assess the effect of MP for upper limb rehabilitation after stroke. Fugl-Meyer Assessment (FMA) was used as the outcome measure for meta-analysis. Twenty-five trials met the inclusion criteria, and 15 trials were eligible for meta-analysis. Among the trials selected for meta-analysis, MP was added to conventional therapy in eight trials or to modified constraint-induced movement therapy in one trial. The other trials provided neurofeedback to support MP: MP-guided neuromuscular electrical stimulation (NMES) in four trials and MP-guided robot-assisted therapy (RAT) in two trials. MP added to conventional therapy resulted in significantly higher FMA gain than conventional therapy alone. MP-guided NMES showed superior result than conventional NMES as well. However, the FMA gain of MP-guided RAT was not significantly higher than RAT alone. We suggest that MP is an effective complementary therapy either given with neurofeedback or not. Neurofeedback applied to MP showed different results depending on the therapy provided. This study has limitations because of heterogeneity and inadequate quality of trials. Further research is requested.

Development of upper tract stones in patients with congenital neurogenic bladder.

PubMed

Stephany, Heidi A; Clayton, Douglass B; Tanaka, Stacy T; Thomas, John C; Pope, John C; Brock, John W; Adams, Mark C

2014-02-01

Patients with neurogenic bladder are at increased risk of developing upper tract stones. We hypothesized that patients with lower urinary tract stone disease are at greater risk of developing upper tract stones. We performed a 10-year retrospective case-control study of patients with neurogenic bladder to determine the association between bladder and upper tract stones. Independent risk factors for upper tract stones were assessed. Cases and controls were matched 1:1. Univariable analysis was performed by Fisher's exact test and the Mann-Whitney U test. Multivariable logistic regression was performed. 52 cases and controls were identified. Cases were significantly more likely to be non-ambulatory, have bowel-urinary tract interposition, thoracic level dysraphism, and history of bladder stones. On multivariable analysis, independent predictors of stone formation were male sex (OR 2.82; p = 0.02), dysraphism involving the thoracic spine (OR 3.37; p = 0.014) bowel-urinary tract interposition (OR 2.611; p = 0.038), and a history of bladder stones (OR 3.57; p = 0.015). Patients with neurogenic bladder are at increased risk for upper tract stones. The presence of bladder stones may herald the development of upper tract stones. The predictors of stone disease identified should guide prospective studies to better understand the natural history of upper tract stone development in this population. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Vocational Students Experiences with Assessment in Workplace Learning

ERIC Educational Resources Information Center

Sandal, Ann Karin; Smith, Kari; Wangensteen, Ragne

2014-01-01

Vocational education, as part of the Norwegian upper secondary education, includes both school-based learning and workplace learning. While school-based learning is characterized by formal structures and guided by aims in the curricula, workplace learning is often informal, incidental and directed by the daily work-tasks. Assessment in workplace…

UNIT, PETROLOGY.

ERIC Educational Resources Information Center

Louisiana Arts and Science Center, Baton Rouge.

THIS TEACHER'S GUIDE FOR A UNIT ON PETROLOGY IS SUITABLE FOR ADAPTATION AT EITHER THE UPPER ELEMENTARY OR THE JUNIOR HIGH SCHOOL LEVELS. THE UNIT BEGINS WITH A STORY THAT INTRODUCES VOLCANIC ACTION AND IGNEOUS ROCK FORMATION. SELECTED CONCEPTS ARE LISTED FOLLOWED BY SUGGESTED ACTIVITIES. A BIBLIOGRAPHY, FILM LIST, VOCABULARY LIST, AND QUESTION AND…

Street Crossing: Observational Research and Developing Health Communication Strategies

ERIC Educational Resources Information Center

Mackert, Michael; Lazard, Allison; Wyeth, Ben

2015-01-01

Students in communication, and particularly in advertising, are encouraged to value creativity. However, even in programs that value creativity, it can be difficult to encourage creativity in the process of research that guides communication efforts. The project described in this paper--"Street Crossing"--is used in upper-division and…

Consumer Education for Kindergarten through Grade 8.

ERIC Educational Resources Information Center

Illinois State Office of Education, Springfield. Div. of Program Planning and Development.

This guide is intended to assist school administrative personnel in the integration of consumer education into the curriculum at the elementary level and to assist teachers in planning and implementing consumer education concepts at the primary, intermediate, and upper elementary levels in language arts, mathematics, science, and social studies…

Field guide to summit area and upper east rift zone, Kilauea Volcano, Hawaii

NASA Technical Reports Server (NTRS)

1974-01-01

The field trip is divided into two sections: (1) Crater Rim Road; and (2) Chain of Craters Road. Most bibliographic references are omitted from the text, but a selected list of references to recent Hawaiian volcanic activity and to special studies is included.

Let's Repair the Broken Galileo Thermometer

ERIC Educational Resources Information Center

Kireš, Marián

2018-01-01

We have developed and verified laboratory work as guided inquiry for upper secondary level students, focusing on conceptual understanding of the physical principle that forms the basis of temperature measurement, and on improvement of selected skills. Conceptual pre-test questions initiate the students' interest and help identify input…

Birds of Prey.

ERIC Educational Resources Information Center

Irwin, Harriet

Introducing students to different hawks and owls found in Wisconsin and building a basis for appreciation of these birds in their own environment is the purpose of this teacher's guide. Primarily geared for upper elementary and junior high grades, the concepts presented could be used in conjunction with the study of ecology. A filmstrip is…

Science Experience Unit: Plant and Animal Adaptations.

ERIC Educational Resources Information Center

Ferguson-Florissant School District, Ferguson, MO.

GRADES OR AGES: No mention. Appears to be upper elementary. SUBJECT MATTER: Science units--plants and animals. ORGANIZATION AND PHYSICAL APPEARANCE: The guide is divided into 35 activities. It is mimeographed and staple-bound with a paper cover. OBJECTIVES AND ACTIVITIES: No objectives are mentioned. The activities suggested aim to recreate common…

Use of LEU in the aqueous homogeneous medical isotope production reactor

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

Ball, R.M.

1997-08-01

The Medical Isotope Production Reactor (MIPR) is an aqueous solution of uranyl nitrate in water, contained in an aluminum cylinder immersed in a large pool of water which can provide both shielding and a medium for heat exchange. The control rods are inserted at the top through re-entrant thimbles. Provision is made to remove radiolytic gases and recombine emitted hydrogen and oxygen. Small quantities of the solution can be continuously extracted and replaced after passing through selective ion exchange columns, which are used to extract the desired products (fission products), e.g. molybdenum-99. This reactor type is known for its largemore » negative temperature coefficient, the small amount of fuel required for criticality, and the ease of control. Calculation using TWODANT show that a 20% U-235 enriched system, water reflected can be critical with 73 liters of solution.« less

On the effective point of measurement in megavoltage photon beams.

PubMed

Kawrakow, Iwan

2006-06-01

This paper presents a numerical investigation of the effective point of measurement of thimble ionization chambers in megavoltage photon beams using Monte Carlo simulations with the EGSNRC system. It is shown that the effective point of measurement for relative photon beam dosimetry depends on every detail of the chamber design, including the cavity length, the mass density of the wall material, and the size of the central electrode, in addition to the cavity radius. Moreover, the effective point of measurement also depends on the beam quality and the field size. The paper therefore argues that the upstream shift of 0.6 times the cavity radius, recommended in current dosimetry protocols, is inadequate for accurate relative photon beam dosimetry, particularly in the build-up region. On the other hand, once the effective point of measurement is selected appropriately, measured depth-ionization curves can be equated to measured depth-dose curves for all depths within +/- 0.5%.

Application of solid/liquid extraction for the gravimetric determination of lipids in royal jelly.

PubMed

Antinelli, Jean-François; Davico, Renée; Rognone, Catherine; Faucon, Jean-Paul; Lizzani-Cuvelier, Louisette

2002-04-10

Gravimetric lipid determination is a major parameter for the characterization and the authentication of royal jelly quality. A solid/liquid extraction was compared to the reference method, which is based on liquid/liquid extraction. The amount of royal jelly and the time of the extraction were optimized in comparison to the reference method. Boiling/rinsing ratio and spread of royal jelly onto the extraction thimble were identified as critical parameters, resulting in good accuracy and precision for the alternative method. Comparison of reproducibility and repeatability of both methods associated with gas chromatographic analysis of the composition of the extracted lipids showed no differences between the two methods. As the intra-laboratory validation tests were comparable to the reference method, while offering rapidity and a decrease in amount of solvent used, it was concluded that the proposed method should be used with no modification of quality criteria and norms established for royal jelly characterization.

Enhanced magnetic Purcell effect in room-temperature masers

PubMed Central

Breeze, Jonathan; Tan, Ke-Jie; Richards, Benjamin; Sathian, Juna; Oxborrow, Mark; Alford, Neil McN

2015-01-01

Recently, the world’s first room-temperature maser was demonstrated. The maser consisted of a sapphire ring housing a crystal of pentacene-doped p-terphenyl, pumped by a pulsed rhodamine-dye laser. Stimulated emission of microwaves was aided by the high quality factor and small magnetic mode volume of the maser cavity yet the peak optical pumping power was 1.4 kW. Here we report dramatic miniaturization and 2 orders of magnitude reduction in optical pumping power for a room-temperature maser by coupling a strontium titanate resonator with the spin-polarized population inversion provided by triplet states in an optically excited pentacene-doped p-terphenyl crystal. We observe maser emission in a thimble-sized resonator using a xenon flash lamp as an optical pump source with peak optical power of 70 W. This is a significant step towards the goal of continuous maser operation. PMID:25698634

Reaching consensus on the physiotherapeutic management of patients following upper abdominal surgery: a pragmatic approach to interpret equivocal evidence.

PubMed

Hanekom, Susan D; Brooks, Dina; Denehy, Linda; Fagevik-Olsén, Monika; Hardcastle, Timothy C; Manie, Shamila; Louw, Quinette

2012-02-06

Postoperative pulmonary complications remain the most significant cause of morbidity following open upper abdominal surgery despite advances in perioperative care. However, due to the poor quality primary research uncertainty surrounding the value of prophylactic physiotherapy intervention in the management of patients following abdominal surgery persists. The Delphi process has been proposed as a pragmatic methodology to guide clinical practice when evidence is equivocal. The objective was to develop a clinical management algorithm for the post operative management of abdominal surgery patients. Eleven draft algorithm statements extracted from the extant literature by the primary research team were verified and rated by scientist clinicians (n=5) in an electronic three round Delphi process. Algorithm statements which reached a priori defined consensus-semi-interquartile range (SIQR)<0.5-were collated into the algorithm. The five panelists allocated to the abdominal surgery Delphi panel were from Australia, Canada, Sweden, and South Africa. The 11 draft algorithm statements were edited and 5 additional statements were formulated. The panel reached consensus on the rating of all statements. Four statements were rated essential. An expert Delphi panel interpreted the equivocal evidence for the physiotherapeutic management of patients following upper abdominal surgery. Through a process of consensus a clinical management algorithm was formulated. This algorithm can now be used by clinicians to guide clinical practice in this population.

The reliability of cone-beam computed tomography to assess bone density at dental implant recipient sites: a histomorphometric analysis by micro-CT.

PubMed

González-García, Raúl; Monje, Florencio

2013-08-01

The aim of this study was to objectively assess the reliability of the cone-beam computed tomography (CBCT) as a tool to pre-operatively determine radiographic bone density (RBD) by the density values provided by the system, analyzing its relationship with histomorphometric bone density expressed as bone volumetric fraction (BV/TV) assessed by micro-CT of bone biopsies at the site of insertion of dental implants in the maxillary bones. Thirty-nine bone biopsies of the maxillary bones at the sites of 39 dental implants from 31 edentulous healthy patients were analyzed. The NobelGuide™ software was used for implant planning, which also allowed fabrication of individual stereolithographic surgical guides. The analysis of CBCT images allowed pre-operative determination of mean density values of implant recipient sites along the major axis of the planned implants (axial RBD). Stereolithographic surgical guides were used to guide implant insertion and also to extract cylindrical bone biopsies from the core of the exact implant site. Further analysis of several osseous micro-structural variables including BV/TV was performed by micro-CT of the extracted bone biopsies. Mean axial RBD was 478 ± 212 (range: 144-953). A statistically significant difference (P = 0.02) was observed among density values of the cortical bone of the upper maxilla and mandible. A high positive Pearson's correlation coefficient (r = 0.858, P < 0.001) was observed between RBD and BV/TV, with the regression equations: (1) Axial RBD = -19.974 + 10.238·BV/TV; (2) BV/TV = 14.258 + 0.72·Axial RBD. RBD was also positively correlated with the trabecular thickness (Tb.Th) and trabecular number (Tb.N), but negatively correlated with trabecular separation (Tb.Sp), structural model index, and inverse connectivity (Tb.Pf). Density values upper than 450 were associated with BV/TV upper than 50%, mean Tb.Th upper than 0.2 mm, mean Tb.Sp lower than 0.3 mm, and mean Tb.N upper than 2. RBD assessed by CBCT has a strong positive correlation with BV/TV assessed by micro-CT at the site of dental implants in the maxillary bones. Pre-operative estimation of density values by CBCT is a reliable tool to objectively determine bone density. © 2012 John Wiley & Sons A/S.

Effectiveness of Stellate Ganglion Block Under Fuoroscopy or Ultrasound Guidance in Upper Extremity CRPS.

PubMed

Imani, Farnad; Hemati, Karim; Rahimzadeh, Poupak; Kazemi, Mohamad Reza; Hejazian, Kokab

2016-01-01

Stellate Ganglion Block (SGB) is an effective technique which may be used to manage upper extremities pain due to Chronic Regional Pain Syndrome (CRPS), in this study we tried to evaluate the effectiveness of this procedure under two different guidance for management of this syndrome. The purpose of this study was to evaluate the effectiveness of ultrsound guide SGB by comparing it with the furoscopy guided SGB in upper extermities CRPS patients in reducing pain & dysfuction of the affected link. Fourteen patients with sympathetic CRPS in upper extremities in a randomized method with block randomization divided in two equal groups (with ultrasound or fluoroscopic guidance). First group was blocked under fluoroscopic guidance and second group blocked under ultrasound guidance. After correct positioning of the needle, a mixture of 5 ml bupivacaine 0.25% and 1 mL of triamcinolone was injected. These data represent no meaningful statistical difference between the two groups in terms of the number of pain attacks before the blocks, a borderline correlation between two groups one week and one month after the block and a significant statistical correlation between two groups three month after the block. These data represent no meaningful statistical difference between the patients of any group in terms of the pain intensity (from one week to six months after block), p-value = 0.61. These data represent a meaningful statistical difference among patients of any group and between the two groups in terms of the pain intensity (before the block until six months after block), p-values were 0.001, 0.031 respectively. According the above mentioned data, in comparison with fluoroscopic guidance, stellate ganglion block under ultrasound guidance is a safe and effective method with lower complication and better improvement in patient's disability indexes.

Ultrasound-Guided Selective Versus Conventional Block of the Medial Brachial Cutaneous and the Intercostobrachial Nerves: A Randomized Clinical Trial.

PubMed

Magazzeni, Philippe; Jochum, Denis; Iohom, Gabriella; Mekler, Gérard; Albuisson, Eliane; Bouaziz, Hervé

2018-06-13

For superficial surgery of anteromedial and posteromedial surfaces of the upper arm, the medial brachial cutaneous nerve (MBCN) and the intercostobrachial nerve (ICBN) must be selectively blocked, in addition to an axillary brachial plexus block. We compared efficacy of ultrasound-guided (USG) versus conventional block of the MBCN and the ICBN. Eighty-four patients, undergoing upper limb surgery, were randomized to receive either USG (n = 42) or conventional (n = 42) block of the MBCN and the ICBN with 1% mepivacaine. Sensory block was evaluated using light-touch on the upper and lower half of the anteromedial and posteromedial surfaces of the upper arm at 5, 10, 15, 20 minutes after nerve blocks. The primary outcome was the proportion of patients who had no sensation in all 4 regions innervated by the MBCN and the ICBN at 20 minutes. Secondary outcomes were onset time of complete anesthesia, volume of local anesthetic, tourniquet tolerance, and quality of ultrasound images. In the USG group, 37 patients (88%) had no sensation at 20 minutes in any of the 4 areas tested versus 8 patients (19%) in the conventional group (P < 0.001). When complete anesthesia was obtained, it occurred within 10 minutes in more than 90% of patients, in both groups. Mean total volumes of local anesthetic used for blocking the MBCN and the ICBN were similar in the 2 groups. Ultrasound images were of good quality in only 20 (47.6%) of 42 patients. Forty-one patients (97.6%) who received USG block were comfortable with the tourniquet versus 16 patients (38.1%) in the conventional group (P < 0.001). Ultrasound guidance improved the efficacy of the MBCN and ICBN blocks. This study was registered at ClinicalTrials.gov, identifier NCT02940847.

Comparison between Steroid Injection and Stretching Exercise on the Scalene of Patients with Upper Extremity Paresthesia: Randomized Cross-Over Study.

PubMed

Kim, Yong Wook; Yoon, Seo Yeon; Park, Yongbum; Chang, Won Hyuk; Lee, Sang Chul

2016-03-01

To compare the therapeutic effects on upper extremity paresthesia of intra-muscular steroid injections into the scalene muscle with those of stretching exercise only. Twenty patients with upper extremity paresthesia who met the criteria were recruited to participate in this single-blind, crossover study. Fourteen of 20 patients were female. The average age was 45.0 ± 10.5 years and duration of symptom was 12.2 ± 8.7 months. Each participant completed one injection and daily exercise program for 2 weeks. After randomization, half of all patients received ultrasound-guided injection of scalene muscles before exercise, while the other was invested for the other patients. After two weeks, there was a significant decrease of the visual analog scale score of treatment effect compared with baseline in both groups (6.90 to 2.85 after injection and 5.65 to 4.05 after stretching exercise, p<0.01). However, injection resulted in greater improvements than stretching exercise (p<0.01). The number of patients with successful treatment, defined as >50% reduction in post-treatment visual analog scale, was 18 of 20 (90.0%) after injection, compared to 5 of 20 (25.0%) after stretching exercise. There were no cases of unintended brachial plexus block after injection. Ultrasound-guided steroid injection or stretching exercise of scalene muscles led to reduced upper extremity paresthesia in patients who present with localized tenderness in the scalene muscle without electrodiagnostic test abnormalities, although injection treatment resulted in more improvements. The results suggest that symptoms relief might result from injection into the muscle alone not related to blockade of the brachial plexus.

Comparison between Steroid Injection and Stretching Exercise on the Scalene of Patients with Upper Extremity Paresthesia: Randomized Cross-Over Study

PubMed Central

Kim, Yong Wook; Yoon, Seo Yeon; Park, Yongbum; Chang, Won Hyuk

2016-01-01

Purpose To compare the therapeutic effects on upper extremity paresthesia of intra-muscular steroid injections into the scalene muscle with those of stretching exercise only. Materials and Methods Twenty patients with upper extremity paresthesia who met the criteria were recruited to participate in this single-blind, crossover study. Fourteen of 20 patients were female. The average age was 45.0±10.5 years and duration of symptom was 12.2±8.7 months. Each participant completed one injection and daily exercise program for 2 weeks. After randomization, half of all patients received ultrasound-guided injection of scalene muscles before exercise, while the other was invested for the other patients. Results After two weeks, there was a significant decrease of the visual analog scale score of treatment effect compared with baseline in both groups (6.90 to 2.85 after injection and 5.65 to 4.05 after stretching exercise, p<0.01). However, injection resulted in greater improvements than stretching exercise (p<0.01). The number of patients with successful treatment, defined as >50% reduction in post-treatment visual analog scale, was 18 of 20 (90.0%) after injection, compared to 5 of 20 (25.0%) after stretching exercise. There were no cases of unintended brachial plexus block after injection. Conclusion Ultrasound-guided steroid injection or stretching exercise of scalene muscles led to reduced upper extremity paresthesia in patients who present with localized tenderness in the scalene muscle without electrodiagnostic test abnormalities, although injection treatment resulted in more improvements. The results suggest that symptoms relief might result from injection into the muscle alone not related to blockade of the brachial plexus. PMID:26847305

Trapping Mode Dipolar DC Collisional Activation in the RF-Only Ion Guide of a Linear Ion Trap/Time-of-Flight Instrument for Gaseous Bio-Ion Declustering

PubMed Central

Webb, Ian K.; Gao, Yang; Londry, Frank A.; McLuckey, Scott A.

2013-01-01

The application of dipolar DC (DDC) to the RF-only ion guide (Q0) of a hybrid quadrupole/time-of-flight (QqTOF) mass spectrometer for collision-induced declustering of large bio-ions is described. As a broadband technique, ion trap DDC collision activation (CA) is employed to decluster ions simultaneously over a relatively broad mass-to-charge range. Declustering DDC CA can yield significantly narrower peaks relative to those observed in the absence of declustering methods, depending upon the extent of non-covalent adduction associated with the ions, and can also be used in conjunction with other methods, such as nozzle-skimmer collisional activation. The key experimental variables in the DDC experiment are the dipolar DC voltage (VDDC), VRF, and the time over which VDDC is applied. The VDDC/VRF ratio is key to the extent to which ion temperatures are elevated and also influences the upper mass-to-charge limit for ion storage. The VDDC/VRF ratio affects ion temperatures and upper m/z limit in opposing directions. That is, as the ratio increases, ion temperature increases whereas the upper m/z storage limit decreases. However, for a given VDDC/VRF ratio, the upper m/z storage limit can be increased by increasing VRF, at the expense of the lower m/z limit for ion storage. The key value of the approach is that it affords a relatively precise degree of control over ion temperatures as well as the time over which they are elevated to the higher temperature. The utility of the method is illustrated by the application of ion trap DDC CA in Q0 to oligonucleotide, protein, and multimeric protein complex analyte ions. PMID:24078247

Effects of Subsonic Aircraft on Aerosols and Cloudiness in the Upper Troposphere and Lower Stratosphere

NASA Technical Reports Server (NTRS)

Detwiler, Andrew G.

1997-01-01

This work was accomplished primarily by Allison G. Wozniak, a graduate research assistant who has completed the Master of Science in Meteorology program at the South Dakota School of Mines and Technology. Ms. Wozniak was guided and assisted in her work by L. R. Johnson and the principal investigator. Invaluable guidance was supplied by Dr. James Holdeman, NASA Lewis, the manager of the Global Atmospheric Sampling Program (GASP). Dr. Gregory Nastrom, St. Cloud (Minnesota) State University, who has used the GASP data set to provide unique views of the distribution of ozone, clouds, and atmospheric waves and turbulence, in the upper troposphere/lower stratosphere region, was also extremely helpful. Finally, Dr. Terry Deshler, University of Wyoming, supplied observations from the university's upper atmospheric monitoring program for comparison to GASP data.

16 CFR 24.2 - Deception as to composition.

Code of Federal Regulations, 2013 CFR

2013-01-01

... example: 2 With regard to footwear, it is sufficient to disclose the presence of non-leather materials in... Guides, footwear is composed of three parts: the upper, the lining and sock, and the outersole. These... the inside of the footwear article; and (3) the outersole is the bottom part of the footwear article...

16 CFR 24.2 - Deception as to composition.

Code of Federal Regulations, 2012 CFR

2012-01-01

... example: 2 With regard to footwear, it is sufficient to disclose the presence of non-leather materials in... Guides, footwear is composed of three parts: the upper, the lining and sock, and the outersole. These... the inside of the footwear article; and (3) the outersole is the bottom part of the footwear article...

16 CFR 24.2 - Deception as to composition.

Code of Federal Regulations, 2011 CFR

2011-01-01

... example: 2 With regard to footwear, it is sufficient to disclose the presence of non-leather materials in... Guides, footwear is composed of three parts: the upper, the lining and sock, and the outersole. These... the inside of the footwear article; and (3) the outersole is the bottom part of the footwear article...

16 CFR 24.2 - Deception as to composition.

Code of Federal Regulations, 2014 CFR

2014-01-01

... example: 2 With regard to footwear, it is sufficient to disclose the presence of non-leather materials in... Guides, footwear is composed of three parts: the upper, the lining and sock, and the outersole. These... the inside of the footwear article; and (3) the outersole is the bottom part of the footwear article...

Island of the Sharks Activity Guide To Accompany the Large-Format Film.

ERIC Educational Resources Information Center

Gowell, Elizabeth Tayntor

This document targets upper elementary and middle school students and provides activities to understand what the ocean floor looks like, the interactions of ocean communities, and the true nature of sharks. The activities are developed at three levels: beginner, intermediate, and advanced. The twelve activities include: (1) "Ocean…

ILLUSTRATED HANDBOOK OF SOME COMMON MOLDS.

ERIC Educational Resources Information Center

CHANDLER, MARION N.

THIS DOCUMENT IS A PICTURE GUIDE FOR THE IDENTIFICATION OF TEN COMMON MOLDS. IT IS DESIGNED FOR USE WITH THE ELEMENTARY SCIENCE STUDY UNIT "MICROGARDENING" AND IS SUGGESTED FOR UPPER ELEMENTARY GRADES. INCLUDED FOR EACH MOLD ARE COLOR PHOTOGRAPHS AND PHOTOMICROGRAPHS OF THE INTACT MOLD MASS AND OF THE MOLD'S SPORE PRODUCING STRUCTURES.…

Using the Newspaper in Upper Elementary and Middle Grades.

ERIC Educational Resources Information Center

Morse, Julie C.

Newspapers are valuable educational resources because they contain material that is varied, up-to-date, and interesting to students. This document is a guide for elementary and middle school teachers who want to incorporate newspapers into daily classroom instruction. There are ten lessons for each of the five subject areas covered. Each lesson…

Using Notable Children's Literature and Questioning Techniques to Enhance Comprehension.

ERIC Educational Resources Information Center

Poole, Gary; Poole, Scott

Intended for language arts teachers of the upper elementary grades, this guide suggests vocabulary and discussion questions for teaching novels. The questions are on an inferential level of interpretation, rather than literal, and address such topics as style, technique, and plot development. Novels for which questions are provided are: (1)…

Marine Science Activities for Visually Impaired.

ERIC Educational Resources Information Center

Schatz, Dennis; And Others

These marine education materials are based on the approach that students learn best when given a multisensory experience. The activities are intended to develop such experiences for the visually impaired child. Activities are intended to supplement an upper-elementary science curriculum or be the basis of a unit on marine biology. The guide is…

Bringing in the Bard: Shakespearean Plays as Context for Instrumental Analysis Projects

ERIC Educational Resources Information Center

Kloepper, Kathryn D.

2015-01-01

Scenes from the works of William Shakespeare were incorporated into individual and group projects for an upper-level chemistry class, instrumental analysis. Students read excerpts from different plays and then viewed a corresponding video clip from a stage or movie production. Guided-research assignments were developed based on these scenes. These…

Development of a Semester-Long, Inquiry-Based Laboratory Course in Upper-Level Biochemistry and Molecular Biology

ERIC Educational Resources Information Center

Murthy, Pushpalatha P. N.; Thompson, Martin; Hungwe, Kedmon

2014-01-01

A semester-long laboratory course was designed and implemented to familiarize students with modern biochemistry and molecular biology techniques. The designed format involved active student participation, evaluation of data, and critical thinking, and guided students to become independent researchers. The first part of the course focused on…

Application of synthetic scenarios to address water resource concerns: A management-guided case study from the Upper Colorado River Basin

USGS Publications Warehouse

McAfee, Stephanie A.; Pederson, Gregory T.; Woodhouse, Connie A.; McCabe, Gregory

2017-01-01

Water managers are increasingly interested in better understanding and planning for projected resource impacts from climate change. In this management-guided study, we use a very large suite of synthetic climate scenarios in a statistical modeling framework to simultaneously evaluate how (1) average temperature and precipitation changes, (2) initial basin conditions, and (3) temporal characteristics of the input climate data influence water-year flow in the Upper Colorado River. The results here suggest that existing studies may underestimate the degree of uncertainty in future streamflow, particularly under moderate temperature and precipitation changes. However, we also find that the relative severity of future flow projections within a given climate scenario can be estimated with simple metrics that characterize the input climate data and basin conditions. These results suggest that simple testing, like the analyses presented in this paper, may be helpful in understanding differences between existing studies or in identifying specific conditions for physically based mechanistic modeling. Both options could reduce overall cost and improve the efficiency of conducting climate change impacts studies.

Clinical evaluation of stethoscope-guided inflation of tracheal tube cuffs.

PubMed

Kumar, R D C; Hirsch, N P

2011-11-01

Tracheal tube cuffs are commonly inflated to pressures exceeding the recommended upper limit of 30 cmH(2)O. We evaluated whether a stethoscope-guided method of cuff inflation results in pressures within the recommended range. Patients were randomly assigned to receive one of two methods of cuff inflation. In the standard 'just seal' group, air was introduced into the tracheal cuff until the audible leak at the mouth disappeared. In the stethoscope-guided group, air was introduced into the cuff until a change from harsh to soft breath sounds occurred, whilst listening with a stethoscope bell placed over the thyroid cartilage. Twenty-five patients were recruited to each group. The median (IQR [range]) cuff pressure in the 'just seal' group was 34 (28-40 [18-49]) cmH(2)O, and in the stethoscope-guided group was 20 (20-26 [16-28]) cmH(2)O, p < 0.0001. The stethoscope-guided method of tracheal tube cuff inflation is a novel, simple technique that reliably results in acceptable tracheal cuff pressures. © 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.

Sphincterotomy by triple lumen needle knife using guide wire in patients with Billroth II gastrectomy

PubMed Central

Park, Su Bum; Kim, Hyung Wook; Kang, Dae Hwan; Choi, Cheol Woong; Yoon, Ki Tae; Cho, Mong; Song, Byeong Jun

2013-01-01

AIM: To investigate the usefulness of a guide wire and triple lumen needle knife for removing stones in Billroth II (B-II) gastrectomy patients. METHODS: Endoscopic sphincterotomy in patients with B-II gastrectomy is challenging. We used a new guide wire technique involving sphincterotomy by triple lumen needle knife through a forward-viewing endoscopy. This technique was performed in nine patients between August 2010 and June 2012. Sphincterotomy as described above was performed. Adequate sphincterotomy, successful stone removal, and complications were investigated prospectively. RESULTS: Sphincterotomy by triple lumen needle knife using guide wire was successful in all nine patients. Sphincterotomy started towards the 4-5 o’clock direction and continued to the upper margin of the papillary roof. Complete stone removal in one session was achieved in all patients. There were no procedure related complications, such as bleeding, pancreatitis, or perforation. CONCLUSION: In patients with B-II gastrectomy, guide wire using sphincterotomy by triple lumen needle knife through a forward-viewing endoscopy seems to be an effective and safe procedure for the removal of common bile duct stones. PMID:24409069

Numerical study of heating the upper atmosphere by acoustic-gravity waves from a local source on the Earth's surface and influence of this heating on the wave propagation conditions

NASA Astrophysics Data System (ADS)

Karpov, I. V.; Kshevetskii, S. P.

2017-11-01

The propagation of acoustic-gravity waves (AGW) from a source on the Earth's surface to the upper atmosphere is investigated with methods of mathematical modeling. The applied non-linear model of wave propagation in the atmosphere is based on numerical integration of a complete set of two-dimensional hydrodynamic equations. The source on the Earth's surface generates waves with frequencies near to the Brunt-Vaisala frequency. The results of simulation have revealed that some region of heating the atmosphere by propagated upward and dissipated AGWs arises above the source at altitudes nearby of 200 km. The horizontal scale of this heated region is about 1000 km in the case of the source that radiates AGWs during approximately 1 h. The appearing of the heated region has changed the conditions of AGW propagation in the atmosphere. When the heated region in the upper atmosphere has been formed, further a waveguide regime of propagation of waves with the periods shorter the Brunt-Vaisala period is realized. The upper boundary of the wave-guide coincides with the arisen heated region in the upper atmosphere. The considered mechanism of formation of large-scale disturbances in the upper atmosphere may be useful for explanation of connections of processes in the upper and lower atmospheric layers.

Upper limb contributions to frontal plane balance control in rollator-assisted walking.

PubMed

Tung, James Y; Gage, William H; Poupart, Pascal; McIlroy, William E

2014-01-01

While assisting with balance is a primary reason for rollator use, few studies have examined how the upper limbs are used for balance. This study examines upper limb contributions to balance control during rollator-assisted walking. We hypothesized that there would be an increased upper limb contribution, measured by mean vertical loading (Fz) and variation in frontal plane center-of-pressure (COPhigh), when walking balance is challenged/impaired. Experiment 1 compared straight-line and beam-walking in young adults (n = 11). As hypothesized, Fz and COPhighincreased in beam-walking compared to baseline (mean Fz: 13.7 vs. 9.1% body weight (BW), p < 0.001, RMS COPhigh: 1.35 vs. 1.07 cm, p < 0.001). Experiment 2 compared older adults who regularly use rollators (RU, n = 10) to older adult controls (CTL, n = 10). The predicted higher upper limb contribution in the RU group was not supported. However, when individuals were grouped by balance impairment, those with the lowest Berg Balance scores (< 45) demonstrated greater speed-adjusted COPhigh than those with higher scores (p = 0.013). Furthermore, greater COPhigh and Fz were correlated to greater reduction in step width, supporting the role of upper limb contributions to frontal plane balance. This work will guide studies assessing reliance on rollators by providing a basis for measurement of upper limb balance contributions.

Efficient RNA pseudouridylation by eukaryotic H/ACA ribonucleoproteins requires high affinity binding and correct positioning of guide RNA

PubMed Central

Caton, Evan A; Kelly, Erin K; Kamalampeta, Rajashekhar

2018-01-01

Abstract H/ACA ribonucleoproteins (H/ACA RNPs) are responsible for introducing many pseudouridines into RNAs, but are also involved in other cellular functions. Utilizing a purified and reconstituted yeast H/ACA RNP system that is active in pseudouridine formation under physiological conditions, we describe here the quantitative characterization of H/ACA RNP formation and function. This analysis reveals a surprisingly tight interaction of H/ACA guide RNA with the Cbf5p–Nop10p–Gar1p trimeric protein complex whereas Nhp2p binds comparably weakly to H/ACA guide RNA. Substrate RNA is bound to H/ACA RNPs with nanomolar affinity which correlates with the GC content in the guide-substrate RNA base pairing. Both Nhp2p and the conserved Box ACA element in guide RNA are required for efficient pseudouridine formation, but not for guide RNA or substrate RNA binding. These results suggest that Nhp2p and the Box ACA motif indirectly facilitate loading of the substrate RNA in the catalytic site of Cbf5p by correctly positioning the upper and lower parts of the H/ACA guide RNA on the H/ACA proteins. In summary, this study provides detailed insight into the molecular mechanism of H/ACA RNPs. PMID:29177505

US-guided percutaneous cholecystostomy: features predicting culture-positive bile and clinical outcome.

PubMed

Sosna, Jacob; Kruskal, Jonathan B; Copel, Laurian; Goldberg, S Nahum; Kane, Robert A

2004-03-01

To assess sonographic and clinical features that might be used to predict infected bile and/or patient outcome from ultrasonography (US)-guided percutaneous cholecystostomy. Between February 1997 and August 2002 at one institution, 112 patients underwent US-guided percutaneous cholecystostomy (59 men, 53 women; average age, 69.3 years). All US images were scored on a defined semiquantitative scale according to preset parameters: (a) gallbladder distention, (b) sludge and/or stones, (c) wall appearance, (d) pericholecystic fluid, and (e) common bile duct size and/or choledocholithiasis. Separate and total scores were generated. Retrospective evaluation of (a) the bacteriologic growth of aspirated bile and its color and (b) clinical indices (fever, white blood cell count, bilirubin level, liver function test results) was conducted by reviewing medical records. For each patient, the clinical manifestation was classified into four groups: (a) localized right upper quadrant symptoms, (b) generalized abdominal symptoms, (c) unexplained sepsis, or (d) sepsis with other known infection. Logistic regression models, exact Wilcoxon-Mann-Whitney test, and the Kruskal-Wallis test were used. Forty-seven (44%) of 107 patients had infected bile. A logistic regression model showed that wall appearance, distention, bile color, and pericholecystic fluid were not individually significant predictors for culture-positive bile, leaving sludge and/or stones (P =.003, odds ratio = 1.647), common bile duct status (P =.02, odds ratio = 2.214), and total score (P =.007, odds ratio = 1.267). No US covariates or clinical indices predicted clinical outcome. Clinical manifestation was predictive of clinical outcome (P =.001) and aspirating culture-positive bile (P =.008); specifically, 30 (86%) of 35 patients with right upper quadrant symptoms had their condition improve, compared with one (7%) of 15 asymptomatic patients with other known causes of infection. US variables can be used to predict culture-positive bile but not patient outcome. Clinical manifestation is important because patients with right upper quadrant symptoms have the best clinical outcome. Copyright RSNA, 2004

A reliable technique for ultrasound-guided perineural injection in ulnar neuropathy at the elbow.

PubMed

Hamscha, Ulrike M; Tinhofer, Ines; Heber, Stefan; Grisold, Wolfgang; Weninger, Wolfgang J; Meng, Stefan

2017-08-01

Ulnar neuropathy at the elbow (UNE) is a common peripheral compression neuropathy and, in most cases, occurs at 2 sites, the retroepicondylar groove or the cubital tunnel. With regard to a potential therapeutic approach with perineural corticosteroid injection, the aim of this study was to evaluate the distribution of injection fluid applied at a standard site. We performed ultrasound-guided (US-guided) perineural injections to the ulnar nerve halfway between the olecranon and the medial epicondyle in 21 upper limbs from 11 non-embalmed cadavers. In anatomic dissection we investigated the spread of injected ink. Ink was successfully injected into the perineural sheath of the ulnar nerve in all 21 cases (cubital tunnel: 21 of 21; retroepicondylar groove: 19 of 21). US-guided injection between the olecranon and the medial epicondyle is a feasible and safe method to reach the most common sites of ulnar nerve entrapment. Muscle Nerve 56: 237-241, 2017. © 2016 Wiley Periodicals, Inc.

Multiband guided-mode resonance filter in bilayer asymmetric metallic gratings

NASA Astrophysics Data System (ADS)

Wang, Yanhui; Li, Xiangjun; Lang, Tingting; Jing, Xufeng; Hong, Zhi

2018-07-01

In this paper, a guided-mode resonances (GMRs) based multiband filter in bilayer asymmetric metallic gratings is presented. Four sharp dips are generated in the frequency range of 1.4-2.0 THz, which are induced by the split of two GMR modes (TE0 and TM0) due to the break of the structure's symmetry. This symmetry of the structure depends on the relative position between the upper layer and lower layer gratings. Therefore, by choosing proper lateral displacement, the split of TE0 or/and TM0 modes can be eliminated. Two-, three-, and four- GMRs based polarization insensitive or sensitive filters are demonstrated numerically.

Chronic musculoskeletal pain: ultrasound guided pain control.

PubMed

Chiou, Hong-Jen; Chou, Yi-Hong; Wang, Hsin-Kai; Lai, Yi-Chen

2014-09-01

The review demonstrates the unique advantages of ultrasonography in pain control. Several imaging modalities can be used to guide pain control, such as computed tomography, magnetic resonance imaging, and radiography. Ultrasonography has unique advantages over these other modalities in terms of its non-ionizing radiation, real-time imaging, portability, and cost-effectiveness. Ultrasonography with color Doppler and elastography can provide safer guidance to avoid blood vessels and the nerve trunk when using steroid or xylocaine infusions to encase the nerve trunk. This review focuses on the control of chronic pain in the upper limbs, lower limbs, and trunk. Copyright © 2014. Published by Elsevier B.V.

Objects of Maximum Electromagnetic Chirality

NASA Astrophysics Data System (ADS)

Fernandez-Corbaton, Ivan; Fruhnert, Martin; Rockstuhl, Carsten

2016-07-01

We introduce a definition of the electromagnetic chirality of an object and show that it has an upper bound. Reciprocal objects attain the upper bound if and only if they are transparent for all the fields of one polarization handedness (helicity). Additionally, electromagnetic duality symmetry, i.e., helicity preservation upon interaction, turns out to be a necessary condition for reciprocal objects to attain the upper bound. We use these results to provide requirements for the design of such extremal objects. The requirements can be formulated as constraints on the polarizability tensors for dipolar objects or on the material constitutive relations for continuous media. We also outline two applications for objects of maximum electromagnetic chirality: a twofold resonantly enhanced and background-free circular dichroism measurement setup, and angle-independent helicity filtering glasses. Finally, we use the theoretically obtained requirements to guide the design of a specific structure, which we then analyze numerically and discuss its performance with respect to maximal electromagnetic chirality.

Do-It-Yourself Guide to: A Solid Waste Seminar. Construction Plans and Use Guidelines.

ERIC Educational Resources Information Center

Quarry Hill Nature Center, Rochester, Minn.

Ten learning stations dealing with solid waste comprise the seminar described in this booklet. At each station, students observe a display and then answer questions listed on their data sheets. Although the seminar was intended for junior high school students, it has been used successfully with upper elementary and adult participants. Among the…

Unit: Plants, Inspection Pack, National Trial Print.

ERIC Educational Resources Information Center

Australian Science Education Project, Toorak, Victoria.

This is a National Trial Print of a unit on plants produced as a part of the Australian Science Education Project. The unit consists of an information booklet for students, a booklet for recording student data, and a teacher's guide. The material, designed for use with students in the upper elementary grades, takes from 15 to 20 forty-minute…

Guiding Readers and Writers, Grades 3-6: Teaching Comprehension, Genre, and Content Literacy.

ERIC Educational Resources Information Center

Fountas, Irene C.; Pinnell, Gay Su

Exploring all the essential components of a quality upper elementary literacy program, this book is a resource for fostering success that will enable students to enjoy a future filled with literacy journeys. Sections of the book address: special help for struggling readers and writers; a basic structure of the literacy program within a framework…

Department of Defense Space Technology Guide

DTIC Science & Technology

2001-01-01

Projected Applications, which summarizes a more detailed range of near -term experiments , demonstrations and developmental activities – Opportunities for...upon new, even smaller classes of spacecraft known generically as microsatellites. Near -term microsat experiments and technology demonstrations are...Additional projects with sensors hosted on both operational and experimental spacecraft to measure and characterize the upper atmosphere Experiment ACTD

FIX: A Strategic Approach to Writing and Revision for Students with Learning Disabilities

ERIC Educational Resources Information Center

Sherman, Cindy K.; De La Paz, Susan

2015-01-01

Teaching students in upper elementary school to revise their papers effectively requires a three-pronged approach. First, teachers provide instruction on a relevant genre or writing form (using the Common Core State Standards for English language arts or other relevant standards as a guide). Second, teachers help students to use four basic…

RAETRAD-F: VERSION 1.1 USER'S GUIDE FOR ANALYZING SITE-SPECIFIC MEASUREMENTS OF SOIL RADON POTENTIAL CATEGORY FOR FLORIDA HOUSES

EPA Science Inventory

The document describes RAETRAD-F (RAdon Emanation and TRAnsport into Dwellings--Florida), a computer code that provides a simple way to analyze site-specific soil measurements to estimate upper-limit indoor radon concentrations in a reference house on a site. The code uses data f...

How Do Structure and Charge Affect Metal-Complex Binding to DNA? An Upper-Division Integrated Laboratory Project Using Cyclic Voltammetry

ERIC Educational Resources Information Center

Kulczynska, Agnieszka; Johnson, Reed; Frost, Tony; Margerum, Lawrence D.

2011-01-01

An advanced undergraduate laboratory project is described that integrates inorganic, analytical, physical, and biochemical techniques to reveal differences in binding between cationic metal complexes and anionic DNA (herring testes). Students were guided to formulate testable hypotheses based on the title question and a list of different metal…

Active Learning of Biochemistry Made Easy (for the Teacher)

ERIC Educational Resources Information Center

Bobich, Joseph A.

2008-01-01

This active learning pedagogical technique aims to improve students' learning in a two-semester, upper-division biochemistry course sequence in which the vast majority of students enrolled will continue on to medical or graduate schools. Instead of lecturing, the Instructor moves to the side of the room, thereby becoming "the guide on the side".…

Sex Can Wait: An Abstinence-Based Sexuality Curriculum for Upper Elementary School.

ERIC Educational Resources Information Center

Young, Michael; Young, Tamera

This curriculum, directed primarily to students in grades five and six, is a 5-week sexuality education program designed to promote sexual abstinence as the best decision young people can make for themselves. The guide is divided into three general areas of emphasis: Knowing Myself, Reltating to Others, and Planning My Future. These sections are…

The Implications of Assessment for Learning in Physical Education and Health

ERIC Educational Resources Information Center

Tolgfors, Bjorn; Öhman, Marie

2016-01-01

This article deals with the implications of assessment for learning (AfL) in upper secondary physical education and health (PEH). Inspired by the research field that emanates from the concept of governmentality, the study is concerned with how AfL guides teachers' and students' actions in certain directions. Based on teachers' descriptions of how…

49 CFR 572.185 - Thorax (upper torso) assembly.

Code of Federal Regulations, 2010 CFR

2010-10-01

... impactor at contact with the thorax. The non-struck side arm is oriented vertically, pointing downward. The...); (iv) The impactor is guided, if needed, so that at contact with the thorax its longitudinal axis is... rib not less than 37 mm and not greater than 44 mm. (ii) The impactor force shall be computed as the...

49 CFR 572.185 - Thorax (upper torso) assembly.

Code of Federal Regulations, 2014 CFR

2014-10-01

... impactor at contact with the thorax. The non-struck side arm is oriented vertically, pointing downward. The...); (iv) The impactor is guided, if needed, so that at contact with the thorax its longitudinal axis is... rib not less than 37 mm and not greater than 44 mm. (ii) The impactor force shall be computed as the...

49 CFR 572.185 - Thorax (upper torso) assembly.

Code of Federal Regulations, 2013 CFR

2013-10-01

... impactor at contact with the thorax. The non-struck side arm is oriented vertically, pointing downward. The...); (iv) The impactor is guided, if needed, so that at contact with the thorax its longitudinal axis is... rib not less than 37 mm and not greater than 44 mm. (ii) The impactor force shall be computed as the...

49 CFR 572.185 - Thorax (upper torso) assembly.

Code of Federal Regulations, 2011 CFR

2011-10-01

... impactor at contact with the thorax. The non-struck side arm is oriented vertically, pointing downward. The...); (iv) The impactor is guided, if needed, so that at contact with the thorax its longitudinal axis is... rib not less than 37 mm and not greater than 44 mm. (ii) The impactor force shall be computed as the...

49 CFR 572.185 - Thorax (upper torso) assembly.

Code of Federal Regulations, 2012 CFR

2012-10-01

... impactor at contact with the thorax. The non-struck side arm is oriented vertically, pointing downward. The...); (iv) The impactor is guided, if needed, so that at contact with the thorax its longitudinal axis is... rib not less than 37 mm and not greater than 44 mm. (ii) The impactor force shall be computed as the...

Consuming in the 80's and Beyond.

ERIC Educational Resources Information Center

Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

This guide is designed to give advanced or upper-level consumer and homemaking education students a chance to take a futuristic look at the roles they will have as consumers in the next years. Divided into 12 units, the first three cover the consumer, the family, and consumer responsibilities. The next eight units are on the goods and services…

Teaching the Bill of Rights. A Guide for Upper Elementary and Middle School Teachers.

ERIC Educational Resources Information Center

Lindquist, Tarry L.; And Others

To celebrate the Bicentennial of the United States Constitution, this curriculum illustrates the concepts of the Constitution and Bill of Rights through events and issues of the Pacific Northwest. The eight units of the curriculum include constitutional visions, the trial of Hershel C. Lyon: an environmental dilemma, comparison of rights around…

Project-Based Learning in Undergraduate Environmental Chemistry Laboratory: Using EPA Methods to Guide Student Method Development for Pesticide Quantitation

ERIC Educational Resources Information Center

Davis, Eric J.; Pauls, Steve; Dick, Jonathan

2017-01-01

Presented is a project-based learning (PBL) laboratory approach for an upper-division environmental chemistry or quantitative analysis course. In this work, a combined laboratory class of 11 environmental chemistry students developed a method based on published EPA methods for the extraction of dichlorodiphenyltrichloroethane (DDT) and its…

Guiding Music Students during Workshop-Based On-the-Job Learning

ERIC Educational Resources Information Center

Virkkula, Esa; Kunwar, Jagat Bahadur

2017-01-01

This article explains the realisation and impact of tutoring on learning through a new kind of on-the-job learning method in workshops led by professional musicians. The research is a qualitative case study involving 62 upper secondary Finnish vocational music students who participated in 11 workshops. The research data consist of (a) workshop…

Rhythmic arm movements are less affected than discrete ones after a stroke.

PubMed

Leconte, Patricia; Orban de Xivry, Jean-Jacques; Stoquart, Gaëtan; Lejeune, Thierry; Ronsse, Renaud

2016-06-01

Recent reports indicate that rhythmic and discrete upper-limb movements are two different motor primitives which recruit, at least partially, distinct neural circuitries. In particular, rhythmic movements recruit a smaller cortical network than discrete movements. The goal of this paper is to compare the levels of disability in performing rhythmic and discrete movements after a stroke. More precisely, we tested the hypothesis that rhythmic movements should be less affected than discrete ones, because they recruit neural circuitries that are less likely to be damaged by the stroke. Eleven stroke patients and eleven age-matched control subjects performed discrete and rhythmic movements using an end-effector robot (REAplan). The rhythmic movement condition was performed with and without visual targets to further decrease cortical recruitment. Movement kinematics was analyzed through specific metrics, capturing the degree of smoothness and harmonicity. We reported three main observations: (1) the movement smoothness of the paretic arm was more severely degraded for discrete movements than rhythmic movements; (2) most of the patients performed rhythmic movements with a lower harmonicity than controls; and (3) visually guided rhythmic movements were more altered than non-visually guided rhythmic movements. These results suggest a hierarchy in the levels of impairment: Discrete movements are more affected than rhythmic ones, which are more affected if they are visually guided. These results are a new illustration that discrete and rhythmic movements are two fundamental primitives in upper-limb movements. Moreover, this hierarchy of impairment opens new post-stroke rehabilitation perspectives.

Using a Research-based Approach to Transform Upper-division Courses in Classical and Quantum Mechanics and E&M

NASA Astrophysics Data System (ADS)

Pollock, Steven

2013-04-01

At most universities, including the University of Colorado, upper-division physics courses are taught using a traditional lecture approach that does not make use of many of the instructional techniques that have been found to improve student learning at the introductory level. We are transforming several upper-division courses using principles of active engagement and learning theory, guided by the results of observations, interviews, and analysis of student work at CU and elsewhere. In this talk I outline these transformations, including the development of faculty consensus learning goals, clicker questions, tutorials, modified homeworks, and more. We present evidence of the effectiveness of these transformations relative to traditional courses, based on student grades, interviews, and through research-based assessments of student conceptual mastery and student attitudes. Our results suggest that many of the tools that have been effective in introductory courses are effective for our majors, and that further research is warranted in the upper-division environment. (See www.colorado.edu/sei/departments/physics.htm for materials)

Nerve monitoring-guided selective hypoglossal nerve stimulation in obstructive sleep apnea patients.

PubMed

Heiser, Clemens; Hofauer, Benedikt; Lozier, Luke; Woodson, B Tucker; Stark, Thomas

2016-12-01

Selective stimulation of the upper airway is a new therapy for obstructive sleep apnea. The aim of the study was to determine if a selective nerve integrity monitoring (NIM) system could aid in precise placement of the cuff electrode in selective upper-airway stimulation. Single-center, prospective clinical trial. Twenty patients who received a selective upper-airway stimulation system (Inspire Medical Systems, Maple Grove, MN) were implanted by using a NIM system. The tongue motions were recorded during surgery and 2 months postoperatively from the transoral view and by transnasal endoscopy. All patients exhibited consistent protrusion at tongue front and tongue base. The nerve monitoring system helped to place the cuff electrode around the protrusion and stiffening branches, while excluding the retractor branches of the hypoglossal nerve. This report demonstrated a novel use of a NIM system to identify the functional separation between inclusion and exclusion branches of the hypoglossal nerve for implantation of a selective upper-airway stimulation system. 4. Laryngoscope, 126:2852-2858, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

On the Piezoelectric Detection of Guided Ultrasonic Waves

PubMed Central

2017-01-01

In order to quantify the wave motion of guided ultrasonic waves, the characteristics of piezoelectric detectors, or ultrasonic transducers and acoustic emission sensors, have been evaluated systematically. Such guided waves are widely used in structural health monitoring and nondestructive evaluation, but methods of calibrating piezoelectric detectors have been inadequate. This study relied on laser interferometry for the base displacement measurement of bar waves, from which eight different guided wave test set-ups are developed with known wave motion using piezoelectric transmitters. Both plates and bars of 12.7 and 6.4 mm thickness were used as wave propagation media. The upper frequency limit was 2 MHz. Output of guided wave detectors were obtained on the test set-ups and their receiving sensitivities were characterized and averaged. While each sensitivity spectrum was noisy for a detector, the averaged spectrum showed a good convergence to a unique receiving sensitivity. Twelve detectors were evaluated and their sensitivity spectra determined in absolute units. Generally, these showed rapidly dropping sensitivity with increasing frequency due to waveform cancellation on their sensing areas. This effect contributed to vastly different sensitivities to guided wave and to normally incident wave for each one of the 12 detectors tested. Various other effects are discussed and recommendations on methods of implementing the approach developed are provided. PMID:29156579

Crustal structure in the Elko-Carlin Region, Nevada, during Eocene gold mineralization: Ruby-East Humboldt metamorphic core complex as a guide to the deep crust

USGS Publications Warehouse

Howard, K.A.

2003-01-01

The deep crustal rocks exposed in the Ruby-East Humboldt metamorphic core complex, northeastern Nevada, provide a guide for reconstructing Eocene crustal structure ~50 km to the west near the Carlin trend of gold deposits. The deep crustal rocks, in the footwall of a west-dipping normal-sense shear system, may have underlain the Pinon and Adobe Ranges about 50 km to the west before Tertiary extension, close to or under part of the Carlin trend. Eocene lakes formed on the hanging wall of the fault system during an early phase of extension and may have been linked to a fluid reservoir for hydrothermal circulation. The magnitude and timing of Paleogene extension remain indistinct, but dikes and tilt axes in the upper crust indicate that spreading was east-west to northwest-southeast, perpendicular to a Paleozoic and Mesozoic orogen that the spreading overprinted. High geothermal gradients associated with Eocene or older crustal thinning may have contributed to hydrothermal circulation in the upper crust. Late Eocene eruptions, upper crustal dike intrusion, and gold mineralization approximately coincided temporally with deep intrusion of Eocene sills of granite and quartz diorite and shallower intrusion of the Harrison Pass pluton into the core-complex rocks. Stacked Mesozoic nappes of metamorphosed Paleozoic and Precambrian rocks in the core complex lay at least 13 to 20 km deep in Eocene time, on the basis of geobarometry studies. In the northern part of the complex, the presently exposed rocks had been even deeper in the late Mesozoic, to >30 km depths, before losing part of their cover by Eocene time. Nappes in the core plunge northward beneath the originally thicker Mesozoic tectonic cover in the north part of the core complex. Mesozoic nappes and tectonic wedging likely occupied the thickened midlevel crustal section between the deep crustal core-complex intrusions and nappes and the overlying upper crust. These structures, as well as the subsequent large-displacement Cenozoic extensional faulting and flow in the deep crust, would be expected to blur the expression of any regional structural roots that could correlate with mineral belts. Structural mismatch of the mineralized upper crust and the tectonically complex middle crust suggests that the Carlin trend relates not to subjacent deeply penetrating rooted structures but to favorable upper crustal host rocks aligned within a relatively coherent regional block of upper crust.

Multi-Ethnic Contributions to American History. A Supplementary Booklet, Grades 4-12.

ERIC Educational Resources Information Center

Caddo Parish School Board, Shreveport, LA.

This booklet is designed as a teacher guide for supplementary use in the regular social studies program. It lists names and contributions of Americans from all ethnic groups to the development of the United States. Seven units usable at three levels (upper elementary, junior high, and high school) have been developed, with the material arranged in…

Alaska Wildlife Week--Upper Elementary Teachers' Guide. Unit 7. Together, We Can Help Wildlife. April 23-29, 1989.

ERIC Educational Resources Information Center

Sigman, Marilyn, Ed.

Wildlife is often described as one of Alaska's most important and valuable resources. Helping wildlife can take many forms. In this educational packet, a variety of activities are included to help intermediate students understand which human activities help wildlife and which harm wildlife. In addition, suggestions on planning hands-on projects to…

Transforming a Fourth Year Modern Optics Course Using a Deliberate Practice Framework

ERIC Educational Resources Information Center

Jones, David J.; Madison, Kirk W.; Wieman, Carl E.

2015-01-01

We present a study of active learning pedagogies in an upper-division physics course. This work was guided by the principle of deliberate practice for the development of expertise, and this principle was used in the design of the materials and the orchestration of the classroom activities of the students. We present our process for efficiently…

Upper tract urothelial carcinoma topical issue 2016: treatment of metastatic cancer.

PubMed

Pham, M N; Apolo, A B; De Santis, M; Galsky, M D; Leibovich, B C; Pisters, L L; Siefker-Radtke, A O; Sonpavde, G; Steinberg, G D; Sternberg, C N; Tagawa, S T; Weizer, A Z; Woods, M E; Milowsky, M I

2017-03-01

To review the management of metastatic upper tract urothelial carcinoma (UTUC) including recent advances in targeted and immune therapies as an update to the 2014 joint international consultation on UTUC, co-sponsored by the Société Internationale d'Urologie and International Consultation on Urological Diseases. A PubMed database search was performed between January 2013 and May 2016 related to the treatment of metastatic UTUC, and 54 studies were selected for inclusion. The management of patients with metastatic UTUC is primarily an extrapolation from evidence guiding the management of metastatic urothelial carcinoma of the bladder. The first-line therapy for metastatic UTUC is platinum-based combination chemotherapy. Standard second-line therapies are limited and ineffective. Patients with UTUC who progress following platinum-based chemotherapy are encouraged to participate in clinical trials. Recent advances in genomic profiling present exciting opportunities to guide the use of targeted therapy. Immunotherapy with checkpoint inhibitors has demonstrated extremely promising results. Retrospective studies provide support for post-chemotherapy surgery in appropriately selected patients. The management of metastatic UTUC requires a multi-disciplinary approach. New insights from genomic profiling using targeted therapies, novel immunotherapies, and surgery represent promising avenues for further therapeutic exploration.

The accuracy of image-guided navigation for maxillary positioning in bimaxillary surgery.

PubMed

Sun, Yi; Luebbers, Heinz-Theo; Agbaje, Jimoh Olubanwo; Lambrichts, Ivo; Politis, Constantinus

2014-05-01

The aim of our study was to evaluate the accuracy of image-guided maxillary positioning in sagittal, vertical, and mediolateral direction. Between May 2011 and July 2012, 17 patients (11 males, 6 females) underwent bimaxillary surgery with the use of intraoperative surgical navigation. During Le Fort I osteotomy, the Kolibri navigation system was used to measure movement of the maxilla at the edge of the upper central upper incisor in sagittal (buccal surface), vertical (incisor edge), and mediolateral (dental midline) direction. Six weeks after surgery, a postoperative CBCT scan was taken and registered to the preoperative cone-beam computed tomography scan to identify the actual surgical movement of the maxilla. Student 2-tailed paired t test was used to evaluate differences between the measured result from navigation system and actual surgical movement of the maxilla, which were 0.44 ± 0.35 mm (P = 0.82) in the sagittal, 0.50 ± 0.35 mm (P = 0.85) in the vertical, and 0.56 ± 0.36 mm (P = 0.81) in the mediolateral direction. Our finding demonstrates that intraoperative computer navigation is a promising tool for measuring the surgical change of the maxilla in bimaxillary surgery.

Dosimetric properties of high energy current (HEC) detector in keV x-ray beams.

PubMed

Zygmanski, Piotr; Shrestha, Suman; Elshahat, Bassem; Karellas, Andrew; Sajo, Erno

2015-04-07

We introduce a new x-ray radiation detector. The detector employs high-energy current (HEC) formed by secondary electrons consisting predominantly of photoelectrons and Auger electrons, to directly convert x-ray energy to detector signal without externally applied power and without amplification. The HEC detector is a multilayer structure composed of thin conducting layers separated by dielectric layers with an overall thickness of less than a millimeter. It can be cut to any size and shape, formed into curvilinear surfaces, and thus can be designed for a variety of QA applications. We present basic dosimetric properties of the detector as function of x-ray energy, depth in the medium, area and aspect ratio of the detector, as well as other parameters. The prototype detectors show similar dosimetric properties to those of a thimble ionization chamber, which operates at high voltage. The initial results obtained for kilovoltage x-rays merit further research and development towards specific medical applications.

Forest farming of shiitake mushrooms: an integrated evaluation of management practices.

PubMed

Bruhn, J N; Mihail, J D; Pickens, J B

2009-12-01

Two outdoor shiitake (Lentinula edodes) cultivation experiments, established in Missouri USA in 1999 and 2000, produced mushrooms in 2000-2005. We examined shiitake production in response to substrate species, inoculum form, inoculum strain, and inoculation timing, using total mushroom weight per log as the primary response variable with log characteristics as covariates. The significantly greater mushroom weight produced by sugar maple logs compared with white or northern red oak was attributable to the higher proportion of undiscolored wood volume in the maple logs, rather than to bark thickness or log diameter. The "wide temperature range" shiitake strain produced significantly greater yield compared with the "warm" or "cold" weather strains. Both the wide-range and warm-weather strains were stimulated to fruit by significant rain events, while the cold-weather strain was responsive to temperature. Inoculation with sawdust spawn gave significantly greater yield than colonized wooden dowels or pre-packaged "thimble" plug inoculum. The second and third full years following inoculation were the most productive.

Dosimetric audit in brachytherapy

PubMed Central

Bradley, D A; Nisbet, A

2014-01-01

Dosimetric audit is required for the improvement of patient safety in radiotherapy and to aid optimization of treatment. The reassurance that treatment is being delivered in line with accepted standards, that delivered doses are as prescribed and that quality improvement is enabled is as essential for brachytherapy as it is for the more commonly audited external beam radiotherapy. Dose measurement in brachytherapy is challenging owing to steep dose gradients and small scales, especially in the context of an audit. Several different approaches have been taken for audit measurement to date: thimble and well-type ionization chambers, thermoluminescent detectors, optically stimulated luminescence detectors, radiochromic film and alanine. In this work, we review all of the dosimetric brachytherapy audits that have been conducted in recent years, look at current audits in progress and propose required directions for brachytherapy dosimetric audit in the future. The concern over accurate source strength measurement may be essentially resolved with modern equipment and calibration methods, but brachytherapy is a rapidly developing field and dosimetric audit must keep pace. PMID:24807068

Atmospheric deposition, retention, and stream export of dioxins and PCBs in a pristine boreal catchment.

PubMed

Bergknut, Magnus; Laudon, Hjalmar; Jansson, Stina; Larsson, Anna; Gocht, Tilman; Wiberg, Karin

2011-06-01

The mass-balance between diffuse atmospheric deposition of organic pollutants, amount of pollutants retained by the terrestrial environment, and levels of pollutants released to surface stream waters was studied in a pristine northern boreal catchment. This was done by comparing the input of atmospheric deposition of polychlorinated dibenzo-p-dioxins and furans (PCDD/Fs) and PCBs with the amounts exported to surface waters. Two types of deposition samplers were used, equipped with a glass fibre thimble and an Amberlite sampler respectively. The measured fluxes showed clear seasonality, with most of the input and export occurring during winter and spring flood, respectively. The mass balance calculations indicates that the boreal landscape is an effective sink for PCDD/Fs and PCBs, as 96.0-99.9 % of received bulk deposition was retained, suggesting that organic pollutants will continue to impact stream water in the region for an extended period of time. Copyright © 2011 Elsevier Ltd. All rights reserved.

Comparison of Ultrasound with Peripheral Nerve Stimulator-guided Technique for Supraclavicular Block in Upper Limb Surgeries: A Randomized Controlled Trial.

PubMed

Alfred, Vinu Mervick; Srinivasan, Gnanasekaran; Zachariah, Mamie

2018-01-01

The supraclavicular approach is considered to be the easiest and most effective approach to block the brachial plexus for upper limb surgeries. The classical approach using the anatomical landmark technique was associated with higher failure rates and complications. Ultrasonography (USG) guidance and peripheral nerve stimulator (PNS) have improved the success rates and safety margin. The aim of the present study is to compare USG with PNS in supraclavicular brachial plexus block for upper limb surgeries with respect to the onset of motor and sensory blockade, total duration of blockade, procedure time, and complications. Prospective, randomized controlled study. Sixty patients aged above 18 years scheduled for elective upper limb surgery were randomly allocated into two groups. Group A patients received supraclavicular brachial plexus block under ultrasound guidance and in Group B patients, PNS was used. In both groups, local anesthetic mixture consisting of 15 ml of 0.5% bupivacaine and 10 ml of 2% lignocaine with 1:200,000 adrenaline were used. Independent t -test used to compare mean between groups; Chi-square test for categorical variables. The procedure time was shorter with USG (11.57 ± 2.75 min) compared to PNS (21.73 ± 4.84). The onset time of sensory block (12.83 ± 3.64 min vs. 16 ± 3.57 min) and onset of motor block (23 ± 4.27 min vs. 27 ± 3.85 min) were significantly shorter in Group A compared to Group B ( P < 0.05). The duration of sensory block was significantly prolonged in Group A (8.00 ± 0.891 h) compared to Group B (7.25 ± 1.418 h). None of the patients in either groups developed any complications. The ultrasound-guided supraclavicular brachial plexus block can be done quicker, with a faster onset of sensory and motor block compared to nerve stimulator technique.

The Influence of Altering Push Force Effectiveness on Upper Extremity Demand during Wheelchair Propulsion

PubMed Central

Rankin, Jeffery W.; Kwarciak, Andrew M.; Richter, W. Mark; Neptune, Richard R.

2010-01-01

Manual wheelchair propulsion has been linked to a high incidence of overuse injury and pain in the upper extremity, which may be caused by the high load requirements and low mechanical efficiency of the task. Previous studies have suggested that poor mechanical efficiency may be due to a low effective handrim force (i.e. applied force that is not directed tangential to the handrim). As a result, studies attempting to reduce upper extremity demand have used various measures of force effectiveness (e.g. fraction effective force, FEF) as a guide for modifying propulsion technique, developing rehabilitation programs and configuring wheelchairs. However, the relationship between FEF and upper extremity demand is not well understood. The purpose of this study was to use forward dynamics simulations of wheelchair propulsion to determine the influence of FEF on upper extremity demand by quantifying individual muscle stress, work and handrim force contributions at different values of FEF. Simulations maximizing and minimizing FEF resulted in higher average muscle stresses (23% and 112%) and total muscle work (28% and 71%) compared to a nominal FEF simulation. The maximal FEF simulation also shifted muscle use from muscles crossing the elbow to those at the shoulder (e.g. rotator cuff muscles), placing greater demand on shoulder muscles during propulsion. The optimal FEF value appears to represent a balance between increasing push force effectiveness to increase mechanical efficiency and minimizing upper extremity demand. Thus, care should be taken in using force effectiveness as a metric to reduce upper extremity demand. PMID:20674921

Comparing Effective Doses During Image-Guided Core Needle Biopsies with Computed Tomography Versus C-Arm Cone Beam CT Using Adult and Pediatric Phantoms.

PubMed

Ben-Shlomo, A; Cohen, D; Bruckheimer, E; Bachar, G N; Konstantinovsky, R; Birk, E; Atar, E

2016-05-01

To compare the effective doses of needle biopsies based on dose measurements and simulations using adult and pediatric phantoms, between cone beam c-arm CT (CBCT) and CT. Effective doses were calculated and compared based on measurements and Monte Carlo simulations of CT- and CBCT-guided biopsy procedures of the lungs, liver, and kidney using pediatric and adult phantoms. The effective doses for pediatric and adult phantoms, using our standard protocols for upper, middle and lower lungs, liver, and kidney biopsies, were significantly lower under CBCT guidance than CT. The average effective dose for a 5-year old for these five biopsies was 0.36 ± 0.05 mSv with the standard CBCT exposure protocols and 2.13 ± 0.26 mSv with CT. The adult average effective dose for the five biopsies was 1.63 ± 0.22 mSv with the standard CBCT protocols and 8.22 ± 1.02 mSv using CT. The CT effective dose was higher than CBCT protocols for child and adult phantoms by 803 and 590% for upper lung, 639 and 525% for mid-lung, and 461 and 251% for lower lung, respectively. Similarly, the effective dose was higher by 691 and 762% for liver and 513 and 608% for kidney biopsies. Based on measurements and simulations with pediatric and adult phantoms, radiation effective doses during image-guided needle biopsies of the lung, liver, and kidney are significantly lower with CBCT than with CT.

Ecology: Learning To Love Our Planet. A Self-Directed Learning Experience. Grades K-8.

ERIC Educational Resources Information Center

Enz, Judith; Diffenderfer, Susan

This self-directed study unit for grades K-3 and 4-8 was developed expressly to transport the student from the position of passive recipient to active participant in his/her own pursuit of knowledge. Within the guide are two complete units: one created for the lower elementary student and one for the upper elementary/middle school student. Units…

Esophageal lichen planus: An unusual cause of dysphagia in the elderly.

PubMed

Carbonari, Augusto Pinke Cruz; Imada, Regina Rie; Nakamura, Romeu; Araki, Osvaldo; Cristina, Kelly; Balancin, Marcelo Luiz; Ibrahim, Roberto El

2018-03-01

An 82-year-old man sought our service with dysphagia and was referred for upper endoscopy with biopsies, which evidenced multiple ulcers of the esophagus and oropharinx. Histopathology confirmed the unusual diagnosis of esophageal lichen planus. The correct clinical suspicion of this disease can facilitate the diagnosis and guide specific treatment, which can drastically change the natural course of the disease.

Hokule'a: A Field Trip. A Guide for Upper-Elementary Teachers.

ERIC Educational Resources Information Center

Larson, R. Bruce

This document is a packet designed to be used in conjunction with a visit to the Hokule'a, a famous voyaging canoe that is usually docked at the Hawaii Maritime Center in Honolulu Harbor. The material focuses on the canoe itself and on the skills needed to sail it. The packet includes background information on the Hokule'a, basic terms,…

Upper Secondary and First-Year University Students' Explanations of Animal Behaviour: To What Extent Are Tinbergen's Four Questions about Causation, Ontogeny, Function and Evolution, Represented?

ERIC Educational Resources Information Center

Pinxten, Rianne; Desclée, Mathieu; Eens, Marcel

2016-01-01

In 1963, the Nobel Prize-winning ethologist Niko Tinbergen proposed a framework for the scientific study of animal behaviour by outlining four questions that should be answered to have a complete understanding: causation, ontogeny, function and evolution. At present, Tinbergen's framework is still considered the best way to guide animal…

Percutaneous CT-Guided Biopsy of C3 Vertebral Body: Modified Approach for an Old Procedure

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

Pua, Uei, E-mail: druei@yahoo.com; Chan, Stephen Yung-Wei

2013-06-15

Percutaneous biopsy of upper cervical vertebrae is challenging due to the various critical structures in the location and often requires difficult trajectory such as transoral or paramaxillary approaches. The purpose of this manuscript is to illustrate the utility of head rotation in creating a potential space for direct percutaneous access to C3 vertebral body for safe biopsy.

The Dynamics of Finite-Dimensional Systems Under Nonconservative Position Forces

NASA Astrophysics Data System (ADS)

Lobas, L. G.

2001-01-01

General theorems on the stability of stationary states of mechanical systems subjected to nonconservative position forces are presented. Specific mechanical problems on gyroscopic systems, a double-link pendulum with a follower force and elastically fixed upper tip, multilink pneumowheel vehicles, a monorail car, and rail-guided vehicles are analyzed. Methods for investigation of divergent bifurcations and catastrophes of stationary states are described

Fluorescence imaging in the upper gastrointestinal tract for the detection of dysplasic changes

NASA Astrophysics Data System (ADS)

Sukowski, Uwe; Ebert, Bernd; Ortner, Marianne; Mueller, Karsten; Voderholzer, W.; Weber-Eibel, J.; Dietel, M.; Lochs, Herbert; Rinneberg, Herbert H.

2001-10-01

During endoscopy of the esophagus fluorescence images were recorded at a delay of 20 ns after pulsed laser excitation simultaneously with conventional reflected white light images. To label malignant cells (dysplasia, tumor) 5-aminolaevulinic acid was applied prior to fluorescence guided bi-opsy. In this way pre-malignant and malignant lesions were detected not seen previously during routine endoscopy.

Two Energy Gulfs, Grades 6-7. Interdisciplinary Student/Teacher Materials in Energy, the Environment, and the Economy.

ERIC Educational Resources Information Center

Lendsey, Jacqueline L.; And Others

This text, which focuses on coastal oil production, the countries and the people involved, is designed for use in upper elementary science, social studies, or math courses concerned with energy-related topics. The first half of the text is the Teacher's Guide. It presents an overview of the main ideas for each lesson, strategies for…

40 CFR 600.307-95 - Fuel economy label format requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... pump logo. (iv) The phrase “Compare this [vehicle/truck] to others in the FREE FUEL ECONOMY GUIDE... (example “METHANOL “(M85))”)”. The title shall be positioned above the fuel pump logo and shall be in upper... automobiles, the title “NATURAL GAS*”. The title shall be positioned above the fuel pump logo and shall be in...

Navy Physical Conditioning Guide

DTIC Science & Technology

1989-03-30

walked, jogged in place, or performed calisthenic exercises like jumping jacks for 2-3 minutes; it is time to stretch. The static stretching exercises...manufacturer should be followed. 8 CROSS-COUNTRY SKIING The cardiovascular benefits of cross-country skiing have been well documented. Energy expenditure ...may also be used to strengthen the upper and lower body By increasing the resistance and repetition rates on this device, the energ, expenditure can be

Plant guide: Rocky Mountain penstemon (Penstemon strictus) [Revised 2014].

Treesearch

Daniel G. Ogle; J. Scott Peterson; Loren. St. John

2013-01-01

Rocky Mountain penstemon, a member of the Figwort family (Schrophulariaceae) is a semi-evergreen, native, perennial forb with fibrous roots and is 35-70 cm tall. Plants are mostly glabrous and the leaves are entire. Basal and lower leaves are 5-15 cm long, 5-16 mm wide, narrowly oblanceolate, rounded at the tip and tapering to the base. The upper leaves are 4-10 cm...

Solar Terrestrial programs: A five year plan

NASA Technical Reports Server (NTRS)

Stern, D. P.

1978-01-01

Major projects to be initiated in the 1980-1985 period, designed to study the Sun, the heliosphere, Earth's magnetosphere, and the upper atmosphere involve the use of spacelab as well as free flying spacecraft. Current and recent investigations in these areas are reviewed and the guiding principles followed in planning future missions are examined. The implementation strategy, the planning process, and supporting research and technology are discussed.

Influence of arm position on catheter placement during real-time ultrasound-guided right infraclavicular proximal axillary venous catheterization.

PubMed

Ahn, J H; Kim, I S; Shin, K M; Kang, S S; Hong, S J; Park, J H; Kim, H J; Lee, S H; Kim, D Y; Jung, J H

2016-03-01

Real-time ultrasound-guided infraclavicular proximal axillary venous catheterization is used in many clinical situations and provides the advantages of catheter stabilization, a reduced risk of catheter-related infection, and comfort for the patient without limitation of movement. However, unintended catheter tip dislocation and accidental arterial puncture occur occasionally. This study was designed to investigate the influence of arm position on catheter placement and complications. Patients were randomized to either the neutral group (n=240) or the abduction group (n=241). In the neutral group, patients were positioned with the head and shoulders placed in an anatomically neutral position and the arms kept by the side during catheterization. In the abduction group, the right upper arm was abducted at 90° from the trunk during catheterization. After real-time ultrasound-guided catheterization was carried out in the right infraclavicular proximal axillary vein, misplacement of the catheter and all complications were evaluated with ultrasound and chest radiography. The success rate of complete catheterization before evaluating the placement of the catheter was high in both groups (97.1 vs 98.8%, P=not significant). The incidence of accidental arterial puncture was not different (1.7 vs 0%, P=not significant). The incidence of misplacement of the catheter was higher in the neutral group than in the abduction group (3.9 vs 0.4%, P=0.01). There were no complications, such as haemothorax, pneumothorax, or injury to the brachial plexus and phrenic nerve, in either group. Upper arm abduction may minimize the risk of misplacement of the catheter during real-time ultrasound-guided infraclavicular proximal axillary venous catheterization. The trial was registered with the Clinical Trial Registry of Korea: https://cris.nih.go.kr/cris/index.jsp. Identifier: KCT0001417. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Computed Tomography-Guided Methylene Blue Labeling Prior to Thoracoscopic Resection of Small Deeply Placed Pulmonary Nodules. Do We Really Need Palpation?

PubMed

Findik, Gokturk; Demiröz, S Mustafa; Apaydın, Selma Mine Kara; Ertürk, Hakan; Biri, Suzan; Incekara, Funda; Aydogdu, Koray; Kaya, Sadi

2017-08-01

Background  Video-assisted thoracic surgery (VATS) is widely used for thoracic surgery operations, and day by day it becomes routine for the excision of undetermined pulmonary nodules. However, it is sometimes hard to reach millimetric nodules through a VATS incision. Therefore, some additional techniques were developed to reach such nodules little in size and which are settled on a challenging localization. In the literature, coils, hook wires, methylene blue, lipidol, and barium staining, and also ultrasound guidance were described for this aim. Herein we discuss our experience with CT-guided methylene blue labeling of small, deeply located pulmonary nodules just before VATS excision. Method  From April 2013 to October 2016, 11 patients with millimetric pulmonary nodules (average 8, 7 mm) were evaluated in our clinic. For all these patients who had strong predisposing factors for malignancy, an 18F-FDG PET-CT scan was also performed. The patients whose nodules were decided to be excised were consulted the radiology clinic. The favorable patients were taken to CT room 2 hours prior to the operation, and CT-guided methylene blue staining were performed under sterile conditions. Results  Mean nodule size of 11 patients was 8.7 mm (6, 2-12). Mean distance from the visceral pleural surface was 12.7 mm (4-29.3). Four of the nodules were located on the left (2 upper lobes, 2 lower lobes), and seven of them were on the right (four lower lobes, two upper lobes, one middle lobe). The maximum standardized uptake values (SUV max) on 18F-FDG PET/CT scan ranged between 0 and 2, 79. Conclusion  CT-guided methylene blue staining of millimetric deeply located pulmonary nodules is a safe and feasible technique that helps surgeon find these undetermined nodules by VATS technique without any need of digital palpation. Georg Thieme Verlag KG Stuttgart · New York.

Quantum State Tomography via Linear Regression Estimation

PubMed Central

Qi, Bo; Hou, Zhibo; Li, Li; Dong, Daoyi; Xiang, Guoyong; Guo, Guangcan

2013-01-01

A simple yet efficient state reconstruction algorithm of linear regression estimation (LRE) is presented for quantum state tomography. In this method, quantum state reconstruction is converted into a parameter estimation problem of a linear regression model and the least-squares method is employed to estimate the unknown parameters. An asymptotic mean squared error (MSE) upper bound for all possible states to be estimated is given analytically, which depends explicitly upon the involved measurement bases. This analytical MSE upper bound can guide one to choose optimal measurement sets. The computational complexity of LRE is O(d4) where d is the dimension of the quantum state. Numerical examples show that LRE is much faster than maximum-likelihood estimation for quantum state tomography. PMID:24336519

Repair boundary for parent tube indications within the upper joint zone of hybrid expansion joint (HEJ) sleeved tubes

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

Cullen, W.K.; Keating, R.F.

1997-02-01

In the Spring and Fall of 1994, and the Spring of 1995, crack-like indications were found in the upper hybrid expansion joint (HEJ) region of Steam Generator (S/G) tubes which had been sleeved using Westinghouse HEJ sleeves. As a result of these findings, analytic and test evaluations were performed to assess the effect of the degradation on the structural, and leakage, integrity of the sleeve/tube joint relative to the requirements of the United States Nuclear Regulatory Commission`s (NRC) draft Regulatory Guide (RG) 1.121. The results of these evaluations demonstrated that tubes with implied or known crack-like circumferential parent tube indicationsmore » (PTIs) located 1.1 inches or farther below the bottom of the hardroll upper transition, have sufficient, and significant, integrity relative to the requirements of RG 1.121. Thus, the purpose of this report is to provide background information related to the justification of the modified tube repair boundary.« less

Colorado Upper-Division Electrostatics diagnostic: A conceptual assessment for the junior level

NASA Astrophysics Data System (ADS)

Chasteen, Stephanie V.; Pepper, Rachel E.; Caballero, Marcos D.; Pollock, Steven J.; Perkins, Katherine K.

2012-12-01

As part of an effort to systematically improve our junior-level E&M I course, we have developed a tool to assess student conceptual learning of electrostatics at the upper division. Together with a group of physics faculty, we established a list of learning goals for the course that, with results from student observations and interviews, served as a guide in creating the Colorado Upper-Division Electrostatics (CUE) assessment. The result is a 17-question open-ended post-test diagnostic (with an optional 7-question pretest) and an accompanying grading rubric. We present measures of the validation and reliability of the instrument and grading rubric, plus results from 535 students in both standard and interactive-engagement courses across seven institutions as a baseline for the instrument. Overall, we find that the CUE is a valid and reliable measure, and the data herein are intended to be of use to researchers and faculty interested in using the CUE to measure student learning.

Resolution of Postural Orthostatic Tachycardia Syndrome After CT-Guided, Percutaneous T2 Ethanol Ablation for Hyperhidrosis.

PubMed

Brock, Malcolm; Chung, Tae Hwan; Gaddam, Sathvika Reddy; Kathait, Anjaneya Singh; Ober, Cecily; Georgiades, Christos

2016-12-01

Postural orthostatic tachycardia syndrome is characterized by orthostatic intolerance. Orthostasis (or other mild physical stress) triggers a cascade of inappropriate tachycardia, lightheadedness, palpitations, and often fainting. The underlying defect is sympathetic dysregulation of the heart, which receives its sympathetic tone from the cervical and upper thoracic sympathetic ganglia. Primary hyperhidrosis is also thought to be the result of sympathetic dysregulation. We present the case of a patient treated with CT-guided, percutaneous T2 EtOH sympatholysis for craniofacial hyperhidrosis. The patient also suffered from postural orthostatic tachycardia syndrome for many years and was unresponsive to treatment. Immediately after sympatholysis, the patient experienced resolution of both craniofacial hyperhidrosis and postural orthostatic tachycardia syndrome.

Resolution of Postural Orthostatic Tachycardia Syndrome After CT-Guided, Percutaneous T2 Ethanol Ablation for Hyperhidrosis

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

Brock, Malcolm, E-mail: mabrock@jhmni.edu; Chung, Tae Hwan, E-mail: Tchang7@jhmi.edu; Gaddam, Sathvika Reddy, E-mail: drsathvikareddy@yahoo.com

Postural orthostatic tachycardia syndrome is characterized by orthostatic intolerance. Orthostasis (or other mild physical stress) triggers a cascade of inappropriate tachycardia, lightheadedness, palpitations, and often fainting. The underlying defect is sympathetic dysregulation of the heart, which receives its sympathetic tone from the cervical and upper thoracic sympathetic ganglia. Primary hyperhidrosis is also thought to be the result of sympathetic dysregulation. We present the case of a patient treated with CT-guided, percutaneous T2 EtOH sympatholysis for craniofacial hyperhidrosis. The patient also suffered from postural orthostatic tachycardia syndrome for many years and was unresponsive to treatment. Immediately after sympatholysis, the patient experiencedmore » resolution of both craniofacial hyperhidrosis and postural orthostatic tachycardia syndrome.« less

The upper limits of pain and suffering in animal research.

PubMed

Beauchamp, Tom L; Morton, David B

2015-10-01

The control of risk and harm in human research often calls for the establishment of upper limits of risk of pain, suffering, and distress that investigators must not exceed. Such upper limits are uncommon in animal research, in which limits of acceptability are usually left to the discretion of individual investigators, institutions, national inspectors, or ethics review committees. We here assess the merits of the European Directive 2010/63/EU on the Protection of Animals Used for Scientific Purposes and its accompanying instruments, such as guides and examples. These documents present a body of legislation governing animal research in the European Union. We argue that the directive supplies a promising approach, but one in need of revision. We interpret the directive's general conception of upper limits and show its promise for the establishment of high-quality policies. We provide a moral rationale for such policies, address the problem of justified exceptions to established upper limits, and show when causing harm is and is not wrongful. We conclude that if the standards we propose for improving the directive are not realized in the review of research protocols, loose and prejudicial risk-benefit assessments may continue to be deemed sufficient to justify morally questionable research. However, a revised EU directive and accompanying instruments could have a substantial influence on the ethics of animal research worldwide, especially in the development of morally sound legal frameworks.

Bleeding after expandable nitinol stent placement in patients with esophageal and upper gastrointestinal obstruction: incidence, management, and predictors.

PubMed

Oh, Se Jin; Song, Ho-Young; Nam, Deok Ho; Ko, Heung Kyu; Park, Jung-Hoon; Na, Han Kyu; Lee, Jong Jin; Kang, Min Kyoung

2014-11-01

Placement of self-expandable nitinol stents is useful for the treatment of esophageal and upper gastrointestinal (GI) obstruction. However, complications such as stent migration, tumor overgrowth, and bleeding occur. Although stent migration and tumor overgrowth are well documented in previous studies, the occurrence of bleeding has not been fully evaluated. To evaluate the incidence, management strategies, and predictors of bleeding after placement of self-expandable nitinol stents in patients with esophageal and upper GI obstruction. We retrospectively reviewed the medical records and results of computed tomography and endoscopy of 1485 consecutive patients with esophageal and upper GI obstructions who underwent fluoroscopically guided stent placement. Bleeding occurred in 25 of 1485 (1.7%) patients 0 to 348 days after stent placement. Early stent-related bleeding occurred in 10 patients (40%) and angiographic embolization was used for 5/10. Late bleeding occurred in 15 patients (60%) and endoscopic hemostasis was used for 7/15. Twenty-two of 25 (88%) patients with bleeding had received prior radiotherapy and/or chemotherapy. Bleeding is a rare complication after placement of expandable nitinol stents in patients with esophageal and upper GI obstruction, but patients with early bleeding may require embolization for control. Care must be exercised on placing stents in patients who have received prior radiotherapy or chemotherapy. © The Foundation Acta Radiologica 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

KSC-2009-1458

NASA Image and Video Library

2009-01-13

VANDENBERG AIR FORCE BASE, Calif. -- In Bldg. 1610 at Vandenberg Air Force Base in California, workers guide an upper segment of the transportation canister toward the NOAA-N Prime spacecraft. NOAA-N Prime is the latest polar-orbiting operational environmental weather satellite developed by NASA for the National Oceanic and Atmospheric Administration. The satellite is scheduled to launch Feb. 4 aboard a Delta II rocket from Vandenberg Air Force Base. Photo credit: NASA/ Daniel Liberotti, VAFB

Evaluation of Cross River State Access of Matching Grants for the Implementation of UBE Policies between 2010 and 2014

ERIC Educational Resources Information Center

Enu, Donald Bette; Opoh, Fredrick Awhen; Esu, A. E. O.

2016-01-01

This study focused on the evaluation of access of matching grants for the implementation of UBE policies in upper basic in Cross River State, Nigeria. To achieve the purpose of this study, a research question was posed to guide the study. Data were generated from SUBEB office and downloaded from UBE web site (www.ubec.com). The result was…

Italy: A Study of the Educational System of Italy and a Guide to the Academic Placement of Students from Italy in Educational Institutions of the United States.

ERIC Educational Resources Information Center

Capobianco, Joseph P.

The educational system of Italy is described, and placement recommendations concerning students who want to study in the United States are presented. After a description of preschool, elementary, and middle school education, the different types of upper-secondary education system are considered (i.e., the lyceums, teacher training, and technical…

Statistical evaluation of the metallurgical test data in the ORR-PSF-PVS irradiation experiment. [PWR; BWR

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

Stallmann, F.W.

1984-08-01

A statistical analysis of Charpy test results of the two-year Pressure Vessel Simulation metallurgical irradiation experiment was performed. Determination of transition temperature and upper shelf energy derived from computer fits compare well with eyeball fits. Uncertainties for all results can be obtained with computer fits. The results were compared with predictions in Regulatory Guide 1.99 and other irradiation damage models.

Endoscopic Ultrasound of the Upper Gastrointestinal Tract and Mediastinum: Diagnosis and Therapy

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

Prasad, Priyajit; Wittmann, Johannes; Pereira, Stephen P.

2006-12-15

Endoscopic ultrasound (EUS) has developed significantly over the last two decades and has had a considerable impact on the imaging and staging of mass lesions within or in close proximity to the gastrointestinal (GI) tract. In conjunction with conventional imaging such as helical computed tomography and magnetic resonance imaging, the indications for EUS include (1) differentiating between benign and malignant lesions of the mediastinum and upper GI tract, (2) staging malignant tumors of the lung, esophagus, stomach, and pancreas prior to surgery or oncological treatment, (3) excluding common bile duct stones before laparoscopic cholecystectomy, thereby avoiding the need for endoscopicmore » retrograde cholangiopancreatography (ERCP) in some patients, and (4) assessing suspected lesions that are either equivocal or not seen on conventional imaging. In recent years, EUS has charted a course similar to that taken by ERCP, evolving from a purely diagnostic modality to one that is interventional and therapeutic. These indications include (5) obtaining a tissue diagnosis by EUS-guided fine-needle aspiration or trucut-type needle biopsy and (6) providing therapy such as coeliac plexus neurolysis and pancreatic pseudocyst drainage-in many cases, more accurately and safely than conventional techniques. Emerging investigational techniques include EUS-guided enteric anastomosis formation and fine-needle injection therapy for malignant disease.« less

KENNEDY SPACE CENTER, FLA. - Workers at Hangar A&E, Cape Canaveral Air Force Station, help guide the upper canister toward the Space Infrared Telescope Facility (SIRTF) at left. After encapsulation is complete, the spacecraft will be transported to Launch Complex 17-B for mating with its launch vehicle, the Delta II rocket. SIRTF consists of three cryogenically cooled science instruments and an 0.85-meter telescope, and is one of NASA's largest infrared telescopes to be launched. SIRTF will obtain images and spectra by detecting the infrared energy, or heat, radiated by objects in space. Most of this infrared radiation is blocked by the Earth's atmosphere and cannot be observed from the ground.

NASA Image and Video Library

2003-08-07

KENNEDY SPACE CENTER, FLA. - Workers at Hangar A&E, Cape Canaveral Air Force Station, help guide the upper canister toward the Space Infrared Telescope Facility (SIRTF) at left. After encapsulation is complete, the spacecraft will be transported to Launch Complex 17-B for mating with its launch vehicle, the Delta II rocket. SIRTF consists of three cryogenically cooled science instruments and an 0.85-meter telescope, and is one of NASA's largest infrared telescopes to be launched. SIRTF will obtain images and spectra by detecting the infrared energy, or heat, radiated by objects in space. Most of this infrared radiation is blocked by the Earth's atmosphere and cannot be observed from the ground.

The Prevalence of Congenital Hand and Upper Extremity Anomalies Based Upon the New York Congenital Malformations Registry.

PubMed

Goldfarb, Charles A; Shaw, Neil; Steffen, Jennifer A; Wall, Lindley B

2017-03-01

There have been few publications regarding the prevalence of congenital upper extremity anomalies and no recent reports from the United States. The purpose of this investigation was to examine the prevalence of congenital upper extremity anomalies in the total birth population of New York State over a 19-year period utilizing the New York Congenital Malformations Registry (NYCMR) database. The NYCMR includes children with at least 1 birth anomaly diagnosed by 2 years of age and listed by diagnosis code. We scrutinized these codes for specific upper extremity anomalies, including polydactyly, syndactyly, reduction defects, clubhand malformations, and syndromes with upper limb anomalies. We included children born between 1992 and 2010. There were a total of 4,883,072 live births in New York State during the study period. The overall prevalence of congenital upper extremity anomalies was 27.2 cases per 10,000 live births. Polydactyly was most common with 12,418 cases and a prevalence rate of 23.4 per 10,000 live births. The next most common anomalies included syndactyly with 627 cases affecting the hands (1498 total) and reduction defects (1111 cases). Specific syndromes were quite rare and were noted in a total of 215 live births. The prevalence of anomalies was higher in New York City compared with New York State populations at 33.0 and 21.9 per 10,000 live births, respectively. The NYCMR data demonstrate that congenital upper extremity anomalies are more common than previously reported. This is in large part due to the high prevalence of polydactyly. Although registries are imperfect, such data are helpful in monitoring prevalence rates over time, identifying potential causes or associations, and guiding health care planning and future research. Level I-diagnostic.

Predicting Recovery Potential for Individual Stroke Patients Increases Rehabilitation Efficiency.

PubMed

Stinear, Cathy M; Byblow, Winston D; Ackerley, Suzanne J; Barber, P Alan; Smith, Marie-Claire

2017-04-01

Several clinical measures and biomarkers are associated with motor recovery after stroke, but none are used to guide rehabilitation for individual patients. The objective of this study was to evaluate the implementation of upper limb predictions in stroke rehabilitation, by combining clinical measures and biomarkers using the Predict Recovery Potential (PREP) algorithm. Predictions were provided for patients in the implementation group (n=110) and withheld from the comparison group (n=82). Predictions guided rehabilitation therapy focus for patients in the implementation group. The effects of predictive information on clinical practice (length of stay, therapist confidence, therapy content, and dose) were evaluated. Clinical outcomes (upper limb function, impairment and use, independence, and quality of life) were measured 3 and 6 months poststroke. The primary clinical practice outcome was inpatient length of stay. The primary clinical outcome was Action Research Arm Test score 3 months poststroke. Length of stay was 1 week shorter for the implementation group (11 days; 95% confidence interval, 9-13 days) than the comparison group (17 days; 95% confidence interval, 14-21 days; P =0.001), controlling for upper limb impairment, age, sex, and comorbidities. Therapists were more confident ( P =0.004) and modified therapy content according to predictions for the implementation group ( P <0.05). The algorithm correctly predicted the primary clinical outcome for 80% of patients in both groups. There were no adverse effects of algorithm implementation on patient outcomes at 3 or 6 months poststroke. PREP algorithm predictions modify therapy content and increase rehabilitation efficiency after stroke without compromising clinical outcome. URL: http://anzctr.org.au. Unique identifier: ACTRN12611000755932. © 2017 American Heart Association, Inc.

Tube structural integrity evaluation of Palo Verde Unit 1 steam generators for axial upper-bundle cracking

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

Woodman, B.W.; Begley, J.A.; Brown, S.D.

1995-12-01

The analysis of the issue of upper bundle axial ODSCC as it apples to steam generator tube structural integrity in Unit 1 at the Palo Verde Nuclear generating Station is presented in this study. Based on past inspection results for Units 2 and 3 at Palo Verde, the detection of secondary side stress corrosion cracks in the upper bundle region of Unit 1 may occur at some future date. The following discussion provides a description and analysis of the probability of axial ODSCC in Unit 1 leading to the exceedance of Regulatory Guide 1.121 structural limits. The probabilities of structuralmore » limit exceedance are estimated as function of run time using a conservative approach. The chosen approach models the historical development of cracks, crack growth, detection of cracks and subsequent removal from service and the initiation and growth of new cracks during a given cycle of operation. Past performance of all Palo Verde Units as well as the historical performance of other steam generators was considered in the development of cracking statistics for application to Unit 1. Data in the literature and Unit 2 pulled tube examination results were used to construct probability of detection curves for the detection of axial IGSCC/IGA using an MRPC (multi-frequency rotating panake coil) eddy current probe. Crack growth rates were estimated from Unit 2 eddy current inspection data combined with pulled tube examination results and data in the literature. A Monte-Carlo probabilistic model is developed to provide an overall assessment of the risk of Regulatory Guide exceedance during plant operation.« less

Tissue adaptation to physical stress: a proposed "Physical Stress Theory" to guide physical therapist practice, education, and research.

PubMed

Mueller, Michael J; Maluf, Katrina S

2002-04-01

The purpose of this perspective is to present a general theory--the Physical Stress Theory (PST). The basic premise of the PST is that changes in the relative level of physical stress cause a predictable adaptive response in all biological tissue. Specific thresholds define the upper and lower stress levels for each characteristic tissue response. Qualitatively, the 5 tissue responses to physical stress are decreased stress tolerance (eg, atrophy), maintenance, increased stress tolerance (eg, hypertrophy), injury, and death. Fundamental principles of tissue adaptation to physical stress are described that, in the authors' opinion, can be used to help guide physical therapy practice, education, and research. The description of fundamental principles is followed by a review of selected literature describing adaptation to physical stress for each of the 4 main organ systems described in the Guide to Physical Therapist Practice (ie, cardiovascular/pulmonary, integumentary, musculoskeletal, neuromuscular). Limitations and implications of the PST for practice, research, and education are presented.

Food impaction after expandable metal stent placement: experience in 1,360 patients with esophageal and upper gastrointestinal tract obstruction.

PubMed

Song, Min; Song, Ho-Young; Kim, Jin Hyoung; Park, Jung-Hoon; Jung, Hwoon-Yong; Kim, Jong-Hoon; Kim, Sung-Bae

2011-09-01

To retrospectively evaluate the incidence, predictive factors, and interventional management of food impaction after expandable metallic stent placement in patients with obstruction of the esophagus or upper gastrointestinal tract caused by benign or malignant disease. Between March 1993 and March 2010, 1,360 patients (1,029 men, 331 women; age range, 21-89 y; mean age, 61 y) underwent fluoroscopically guided stent placement for dysphagia caused by esophageal or gastrointestinal tract strictures. Five types of covered expandable metal stents were used, including four types of esophageal stents (types A-D) and one type of gastroduodenal stent (type E), with types A, B, C, D, and E stents used in 180, 60, 90, 432, and 598 patients, respectively. Multivariate analysis was performed to evaluate factors predictive of food impaction. Food impaction occurred in 41 of 1,360 patients (3.0%). The food impaction rates for types A, B, C, D, and E stents were 0.6%, 1.7%, 1.1%, 3.2%, and 4.0%, respectively. Multivariate analysis showed that stent length was an independent predictor of food impaction (odds ratio, 0.839; P = .012). Of the 41 patients with food impaction, 23 underwent endoscopic management, 12 underwent fluoroscopically guided management, and six did not require management because impacted food spontaneously passed through the stent. The overall food impaction rate was 3.0%, with multiple logistic regression analysis showing that shorter stent length was the only significant predictor of food impaction. Food impaction can be managed by endoscopic or fluoroscopically guided removal or placement of a second stent. Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.

Guided Z mode propagation observed in the OEDIPUS A tethered rocket experiment

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

James, H.G.

1991-10-01

The tethered sounding rocket payload OEDIPUS A conducted bistatic propagation experiments on plasma waves in the auroral ionosphere. Synchronized sweeps of the frequency range 0-5 MHz by the 2-W transmitter high-frequency exciter (HEX) on the upper end of the tether and its associated receiver for exciter (REX) on the lower end have produced signatures of quasi-electrostatic waves guided along field-aligned depletions of ambient density. The propagation is in the slow Z mode, between the plasma frequency f{sub p} and the upper hybrid resonance frequency f{sub uhr} when f{sub p} is greater than the cyclotron frequency. The mode identification is basedmore » on payload measurements of f{sub p}. These waves have signal delays of about 1 ms. The delays are much greater than expected for free-space propagation over the transmitter-receiver separation distance which varies up to 960 m during the flight. The transmitted pulses typically appear inside a frequency bandwidth of about 100 kHz just above the plasma frequency, but occasionally occupy most of the available bandwidth, {approx equal}300 kHz, between f{sub p} and f{sub uhr}. The observed delays and the stretching by a factor of 3 of the transmitted 300-{mu}s pulses are accounted for with two-dimensional ray tracing using a complete electromagnetic solution of the hot plasma dispersion relation. Delayed Z mode pulses appear in about 20% of the ionograms. Given the weakness of the HEX transmitter and the abundance of examples obtained during the flight, guiding of natural Z mode emissions in the auroral ionosphere may be efficient and widespread.« less

Comparing Effective Doses During Image-Guided Core Needle Biopsies with Computed Tomography Versus C-Arm Cone Beam CT Using Adult and Pediatric Phantoms

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

Ben-Shlomo, A.; Cohen, D.; Bruckheimer, E.

PurposeTo compare the effective doses of needle biopsies based on dose measurements and simulations using adult and pediatric phantoms, between cone beam c-arm CT (CBCT) and CT.MethodEffective doses were calculated and compared based on measurements and Monte Carlo simulations of CT- and CBCT-guided biopsy procedures of the lungs, liver, and kidney using pediatric and adult phantoms.ResultsThe effective doses for pediatric and adult phantoms, using our standard protocols for upper, middle and lower lungs, liver, and kidney biopsies, were significantly lower under CBCT guidance than CT. The average effective dose for a 5-year old for these five biopsies was 0.36 ± 0.05 mSv withmore » the standard CBCT exposure protocols and 2.13 ± 0.26 mSv with CT. The adult average effective dose for the five biopsies was 1.63 ± 0.22 mSv with the standard CBCT protocols and 8.22 ± 1.02 mSv using CT. The CT effective dose was higher than CBCT protocols for child and adult phantoms by 803 and 590 % for upper lung, 639 and 525 % for mid-lung, and 461 and 251 % for lower lung, respectively. Similarly, the effective dose was higher by 691 and 762 % for liver and 513 and 608 % for kidney biopsies.ConclusionsBased on measurements and simulations with pediatric and adult phantoms, radiation effective doses during image-guided needle biopsies of the lung, liver, and kidney are significantly lower with CBCT than with CT.« less

Electromagnetic-guided placement of nasoduodenal feeding tubes versus endoscopic placement: a randomized, multicenter trial.

PubMed

Kappelle, Wouter F W; Walter, Daisy; Stadhouders, Paul H; Jebbink, Hendrik J A; Vleggaar, Frank P; van der Schaar, Peter J; Kappelle, Jan Willem; van der Tweel, Ingeborg; Van den Broek, Medard F M; Wessels, Frank J; Siersema, Peter D; Monkelbaan, Jan F

2018-01-01

Electromagnetic-guided placement (EMP) of a nasoduodenal feeding tube by trained nurses is an attractive alternative to EGD-guided placement (EGDP). We aimed to compare EMP and EGDP in outpatients, ward patients, and critically ill patients with normal upper GI anatomy. In 3 centers with no prior experience in EMP, patients were randomized to placement of a single-lumen nasoduodenal feeding tube either with EGDP or EMP. The primary endpoint was post-pyloric position of the tube on abdominal radiography. Patients were followed for 10 days to assess patency and adverse events. The analyses were performed according to the intention-to-treat principle. In total, 160 patients were randomized to EGDP (N = 76) or EMP (N = 84). Three patients withdrew informed consent, and no abdominal radiography was performed in 2 patients. Thus, 155 patients (59 intensive care unit, 38%) were included in the analyses. Rates of post-pyloric tube position between EGDP and EMP were comparable (79% vs 82%, odds ratio 1.16; 90% confidence interval, 0.58-2.38; P = .72). Adverse events were observed in 4 patients after EMP (hypoxia, GI blood loss, atrial fibrillation, abdominal pain) and in 4 after EGDP (epistaxis N = 2, GI blood loss, hypoxia). Costs of tube placements were lower for EMP compared with EGDP: $519.09 versus $622.49, respectively (P = .04). Success rates and safety of EMP and EGDP in patients with normal upper GI anatomy were comparable. Lower costs and potential logistic advantages may drive centers to adopt EMP as their new standard of care. (Clinical trial registration number: NTR4286.). Copyright © 2018 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

In vivo assessment of the gastric mucosal tolerance dose after single fraction, small volume irradiation of liver malignancies by computed tomography-guided, high-dose-rate brachytherapy

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

Streitparth, Florian; Pech, Maciej; Boehmig, Michael

2006-08-01

Purpose: The aim of this study was to assess the tolerance dose of gastric mucosa for single-fraction computed tomography (CT)-guided, high-dose-rate (HDR) brachytherapy of liver malignancies. Methods and Materials: A total of 33 patients treated by CT-guided HDR brachytherapy of liver malignancies in segments II and/or III were included. Dose planning was performed upon a three-dimensional CT data set acquired after percutaneous applicator positioning. All patients received gastric protection post-treatment. For further analysis, the contours of the gastric wall were defined in every CT slice using Brachyvision Software. Dose-volume histograms were calculated for each treatment and correlated with clinical datamore » derived from questionnaires assessing Common Toxicity Criteria (CTC). All patients presenting symptoms of upper GI toxicity were examined endoscopically. Results: Summarizing all patients the minimum dose applied to 1 ml of the gastric wall (D{sub 1ml}) ranged from 6.3 to 34.2 Gy; median, 14.3 Gy. Toxicity was present in 18 patients (55%). We found nausea in 16 (69%), emesis in 9 (27%), cramping in 13 (39%), weight loss in 12 (36%), gastritis in 4 (12%), and ulceration in 5 patients (15%). We found a threshold dose D{sub 1ml} of 11 Gy for general gastric toxicity and 15.5 Gy for gastric ulceration verified by an univariate analysis (p = 0.01). Conclusions: For a single fraction, small volume irradiation we found in the upper abdomen a threshold dose D{sub 1ml} of 15.5 Gy for the clinical endpoint ulceration of the gastric mucosa. This in vivo assessment is in accordance with previously published tolerance data.« less

Upper gastrointestinal barium evaluation of duodenal pathology: A pictorial review

PubMed Central

Gupta, Pankaj; Debi, Uma; Sinha, Saroj Kant; Prasad, Kaushal Kishor

2014-01-01

Like other parts of the gastrointestinal tract (GIT), duodenum is subject to a variety of lesions both congenital and acquired. However, unlike other parts of the GIT viz. esophagus, rest of the small intestine and large intestine, barium evaluation of duodenal lesions is technically more challenging and hence not frequently reported. With significant advances in computed tomography technology, a thorough evaluation including intraluminal, mural and extramural is feasible in a single non-invasive examination. Notwithstanding, barium evaluation still remains the initial and sometimes the only imaging study in several parts of the world. Hence, a thorough acquaintance with the morphology of various duodenal lesions on upper gastrointestinal barium examination is essential in guiding further evaluation. We reviewed our experience with various common and uncommon barium findings in duodenal abnormalities. PMID:25170399

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

Ward, Morris A.; Parker, Elissa A.

The Environmental Law Institute, the grantee, in the final quarter of operation under Department of Energy Grant DE-FG02-02ER63414, successfully completed the following tasks associated with the grant: (1) published ''Reporting on Climate Change: Understanding the Science'', the third edition of this resource intended primarily to help print and broadcast journalists report more effectively on scientific aspects of global climate change; (2) distributed the reporters guide directly to roughly 500 journalists and journalism educators participating in the annual meeting of the Society of Environmental Journalists in New Orleans, La.; (3) distributed the reporters guide to an additional 1,500 journalists and journalismmore » educators by mail; (4) provided journalism educators bulk copies, upon specific request, for their use in upper-level science journalism and environmental journalism classes; (5) conducted outreach to science editors and environmental reporters on availability and use of the reporter's guide; (6) completed financial reporting associated with the reporter's guide grant. ELI has provided requested bulk numbers of copies of ''Reporting on Climate Change: Understanding the Science'' to the DOE Project Officer, David C. Bader, Ph.D., and to Jeffrey Amthor, Ph.D., in the Office of Science. ELI currently has a remaining inventory of roughly 500 copies from the original printing of more than 3,000 copies of the guide. These copies are used for responding to continuing requests from journalists and educators for the guide. ELI is currently exploring opportunities for reprinting additional copies to help meet the continuing demand from the educational and journalism communities.« less

Groundwater quality, age, and susceptibility and vulnerability to nitrate contamination with linkages to land use and groundwater flow, Upper Black Squirrel Creek Basin, Colorado, 2013

USGS Publications Warehouse

Wellman, Tristan P.; Rupert, Michael G.

2016-03-03

The results of this investigation offer the foundational information needed for developing best management practices to mitigate nitrate contamination, basic concepts on water quality to aid public education, and information to guide regulatory measures if policy makers determine this is warranted. Science-based decision making will require continued monitoring and analysis of water quality in the future.

Gastric schwannoma presenting as a casual ultrasonographic findings.

PubMed

Álvarez Higueras, Francisco Javier; Pereñíguez López, Ana; Estrella Díez, Esther; Muñoz Tornero, María; Egea Valenzuela, Juan; Bas Bernal, Águeda; Garre Sánchez, Carmen; Vargas Acosta, Ángel; Sánchez Velasco, Eduardo; Carballo Álvarez, Luis Fernando

2016-12-01

We present the case of a patient under study due to ascites in which a mass located on the gastric wall was observed during ultrasonography. Further studies (upper endoscopy and computed tomography) confirmed this finding. After an ultrasound-guided percutaneous biopsy, diagnosis of gastric schwannoma was made as intense S-100 expression was found. Surgery was rejected due to the bad clinical situation of the patient and because the mass was an asymptomatic benign tumor.

Geology and geologic history of the Moscow-Pullman basin, Idaho and Washington, from late Grande Ronde to late Saddle Mountains time

USGS Publications Warehouse

Bush, John H; Garwood, Dean L; Dunlap, Pamela

2016-01-01

The Moscow-Pullman basin, located on the eastern margin of the Columbia River flood basalt province, consists of a subsurface mosaic of interlayered Miocene sediments and lava flows of the Imnaha, Grande Ronde, Wanapum, and Saddle Mountains Basalts of the Columbia River Basalt Group. This sequence is ~1800 ft (550 m) thick in the east around Moscow, Idaho, and exceeds 2300 ft (700 m) in the west at Pullman, Washington. Most flows entered from the west into a topographic low, partially surrounded by steep mountainous terrain. These flows caused a rapid rise in base level and deposition of immature sediments. This field guide focuses on the upper Grande Ronde Basalt, Wanapum Basalt, and sediments of the Latah Formation.Late Grande Ronde flows terminated midway into the basin to begin the formation of a topographic high that now separates a thick sediment wedge of the Vantage Member to the east of the high from a thin layer to the west. Disrupted by lava flows, streams were pushed from a west-flowing direction to a north-northwest orientation and drained the basin through a gap between steptoes toward Palouse, Washington. Emplacement of the Roza flow of the Wanapum Basalt against the western side of the topographic high was instrumental in this process, plugging west-flowing drainages and increasing deposition of Vantage sediments east of the high. The overlying basalt of Lolo covered both the Roza flow and Vantage sediments, blocking all drainages, and was in turn covered by sediments interlayered with local Saddle Mountains Basalt flows. Reestablishment of west-flowing drainages has been slow.The uppermost Grande Ronde, the Vantage, and the Wanapum contain what is known as the upper aquifer. The water supply is controlled, in part, by thickness, composition, and distribution of the Vantage sediments. A buried channel of the Vantage likely connects the upper aquifer to Palouse, Washington, outside the basin. This field guide locates outcrops; relates them to stratigraphic well data; outlines paleogeographic basin evolution from late Grande Ronde to the present time; and notes structures, basin margin differences, and features that influence upper aquifer water supply.

Hydro-ball in-core instrumentation system and method of operation

DOEpatents

Tower, Stephen N.; Veronesi, Luciano; Braun, Howard E.

1990-01-01

A hydro-ball in-core instrumentation system employs detector strings each comprising a wire having radiation sensitive balls affixed diametrically at spaced positions therealong and opposite tip ends of which are transportable by fluid drag through interior passageways. In the passageways primary coolant is caused to flow selectively in first and second opposite directions for transporting the detector strings from stored positions in an exterior chamber to inserted positions within the instrumentation thimbles of the fuel rod assemblies of a pressure vessel, and for return. The coolant pressure within the detector passageways is the same as that within the vessel; face contact, disconnectable joints between sections of the interior passageways within the vessel facilitate assembly and disassembly of the vessel for refueling and routine maintenance operations. The detector strings may pass through a very short bend radius thereby minimizing space requirements for the connections of the instrumentation system to the vessel and concomitantly the vessel containment structure. Improved radiation mapping and a significant reduction in potential exposure of personnel to radiation are provided. Both top head and bottom head penetration embodiments are disclosed.

Immunological and Toxinological Responses to Jellyfish Stings

PubMed Central

Tibballs, James; Yanagihara, Angel A.; Turner, Helen C.; Winkel, Ken

2013-01-01

Just over a century ago, animal responses to injections of jellyfish extracts unveiled the phenomenon of anaphylaxis. Yet, until very recently, understanding of jellyfish sting toxicity has remained limited. Upon contact, jellyfish stinging cells discharge complex venoms, through thousands of barbed tubules, into the skin resulting in painful and, potentially, lethal envenomations. This review examines the immunological and toxinological responses to stings by prominent species of jellyfish including Physalia sp. (Portuguese Man-o-War, Blue-bottle), Cubozoan jellyfish including Chironex fleckeri, several Carybdeids including Carybdea arborifera and Alatina moseri, Linuche unguiculta (Thimble jellyfish), a jellyfish responsible for Irukandji syndrome (Carukia barnesi) and Pelagia noctiluca. Jellyfish venoms are composed of potent proteinaceous porins (cellular membrane pore-forming toxins), neurotoxic peptides, bioactive lipids and other small molecules whilst the tubules contain ancient collagens and chitins. We postulate that immunologically, both tubular structural and functional biopolymers as well as venom components can initiate innate, adaptive, as well as immediate and delayed hypersensitivity reactions that may be amenable to topical anti-inflammatory-immunomodifier therapy. The current challenge for immunotoxinologists is to deconstruct the actions of venom components to target therapeutic modalities for sting treatment. PMID:21824077

The San Juan Canyon, southeastern Utah: A geographic and hydrographic reconnaissance

USGS Publications Warehouse

Miser, Hugh D.

1924-01-01

This report, which describes the San Juan Canyon, San Juan River and the tributary streams and the geography and to some extent the geology of the region, presents information obtained by me during the descent of the river with the Trimble party in 1921. The exploration of the canyon, which was financed jointly by the United States Geological Survey and the Southern California Edison Co., had as its primary object the mapping and study of the San Juan in connection with proposed power and storage projects along this and Colorado rivers.1 The exploration party was headed by K. W. Thimble, topographic engineer of the United States Geological Survey. Other members of the party were Robert N. Allen, Los Angeles, Calif., recorder; H. E. Blake, jr., Monticello, Utah, and Hugh Hyde, Salt Lake City, Utah, rodmen; Bert Loper, Green River, Utah, boatman; Heber Christensen, Moab, Utah, cook; and H. D. Miser, geologist. Wesley Oliver, of Mexican Hat, Utah, served as packer for the party and brought mail and provisions by pack train twice a month to specified accessible places west of Goodridge.

Postprocedural problems in an overdenture population: a longitudinal study.

PubMed

Ettinger, Ronald L; Qian, Fang

2004-05-01

This study reports on endodontic and other post-procedural problems experienced by overdenture patients from 1973 to 1996. There were 395 subjects enrolled in the study; 273 fulfilled the recall criteria. At recall, all subjects were examined by a single examiner, and appropriate maintenance care was performed. The 273 subjects had 666 abutments and 626 endodontically treated teeth; of these, 51 subjects had postprocedural problems in 81 teeth. Thus, 87.1% of the endodontically treated teeth had no postprocedural problems, and 12.9% had postprocedural problems. Of the subpopulation with postprocedural problems, the most common problem was endodontically treated teeth developing periradicular lesions (37.0%) because of recurrent caries causing loss of the restoration sealing the root canal. Twenty of the 30 teeth were successfully retreated. The next most common problem was vertical root fractures (30.9%), followed by vital teeth developing periradicular lesions (19.8%). Most of the failures could have been prevented by better oral hygiene. Vertical root fractures were statistically associated with abutments in the maxilla and opposed by natural teeth; protection of these abutments with thimble crowns could prevent fractures.

[A case of lung cancer producing granulocyte colony-stimulating factor with a significantly high uptake in the bones observed by a FDG-PET scan].

PubMed

Hidaka, Dai; Koshizuka, Hiroaki; Hiyama, Junichiro; Nakatsubo, Seita; Ikeda, Koutarou; Hayashi, Akihiro; Fujii, Akiko; Sawamoto, Ryouko; Misumi, Yukihiro; Miyagawa, Yousuke

2009-03-01

A 57-year-old man complaining of right shoulder pain was admitted. Chest enhanced CT scanning showed a mass shadow in the right upper lobe with chest wall invasion. The laboratory data on admission showed marked leukocytosis. A CT-guided lung biopsy was performed, and a histological examination of the biopsy specimen showed a spindle cell type pleomorphic carcinoma. Immunohistochemistry staining using an anti-granulocyte colony-stimulating factor (G-CSF) monoclonal antibody demonstrated many tumor cells containing G-CSF as well as an increased level of serum G-CSF. The diagnosis was determined to be lung cancer producing G-CSF. FDG-PET scanning showed a significantly high uptake in the right upper field and the bones throughout the body. After chemoradiation therapy, the patient underwent a right upper lobectomy with a chest wall resection. Since then, the leukocytosis and the high level of serum G-CSF normalized and the high uptake in the bones disappeared in the FDG-PET scan.

Transport and Use of a Centaur Second Stage in Space

NASA Technical Reports Server (NTRS)

Strong, James M.; Morgowicz, Bernard; Drucker, Eric; Tompkins, Paul D.; Kennedy, Brian; Barber, Robert D,; Luzod, Louie T.; Kennedy, Brian Michael; Luzod, Louie T.

2010-01-01

As nations continue to explore space, the desire to reduce costs will continue to grow. As a method of cost reduction, transporting and/or use of launch system components as integral components of missions may become more commonplace in the future. There have been numerous scenarios written for using launch vehicle components (primarily space shuttle used external tanks) as part of flight missions or future habitats. Future studies for possible uses of launch vehicle upper stages might include asteroid diverter using gravity orbital perturbation, orbiting station component, raw material at an outpost, and kinetic impactor. The LCROSS (Lunar CRater Observation and Sensing Satellite) mission was conceived as a low-cost means of determining whether water exists at the polar regions of the moon. Manifested as a secondary payload with the LRO (Lunar Reconnaissance Orbiter) spacecraft aboard an Atlas V launch vehicle, LCROSS guided its spent Centaur Earth Departure Upper Stage (EDUS) into the lunar crater Cabeu's, as a kinetic impactor. This paper describes some of the challenges that the LCROSS project encountered in planning, designing, launching with and carrying the Centaur upper stage to the moon.

Social inclusion and career development--transition from upper secondary school to work or post-secondary education among hard of hearing students.

PubMed

Danermark, B; Antonson, S; Lundström, I

2001-01-01

The aim of this study was to investigate the decision process and to analyse the mechanisms involved in the transition from upper secondary education to post-secondary education or the labour market. Sixteen students with sensorioneural hearing loss were selected. Among these eight of the students continued to university and eight did not. Twenty-five per cent of the students were women and the average age was 28 years. The investigation was conducted about 5 years after graduation from the upper secondary school. Both quantitative and qualitative methods were used. The results showed that none of the students came from a family where any or both of the parents had a university or comparable education. The differences in choice between the two groups cannot be explained in terms of social inheritance. Our study indicates that given normal intellectual capacity the level of the hearing loss seems to have no predictive value regarding future educational performance and academic career. The conclusion is that it is of great importance that a hearing impaired pupil with normal intellectual capacity is encouraged and guided to choose an upper secondary educational programme which is orientated towards post-secondary education (instead of a narrow vocational programme). Additional to their hearing impairment and related educational problems, hard of hearing students have much more difficulty than normal hearing peers in coping with changes in intentions and goals regarding their educational career during their upper secondary education.

Cost-effectiveness of focused ultrasound, radiosurgery, and DBS for essential tremor.

PubMed

Ravikumar, Vinod K; Parker, Jonathon J; Hornbeck, Traci S; Santini, Veronica E; Pauly, Kim Butts; Wintermark, Max; Ghanouni, Pejman; Stein, Sherman C; Halpern, Casey H

2017-08-01

Essential tremor remains a very common yet medically refractory condition. A recent phase 3 study demonstrated that magnetic resonance-guided focused ultrasound thalamotomy significantly improved upper limb tremor. The objectives of this study were to assess this novel therapy's cost-effectiveness compared with existing procedural options. Literature searches of magnetic resonance-guided focused ultrasound thalamotomy, DBS, and stereotactic radiosurgery for essential tremor were performed. Pre- and postoperative tremor-related disability scores were collected from 32 studies involving 83 magnetic resonance-guided focused ultrasound thalamotomies, 615 DBSs, and 260 stereotactic radiosurgery cases. Utility, defined as quality of life and derived from percent change in functional disability, was calculated; Medicare reimbursement was employed as a proxy for societal cost. Medicare reimbursement rates are not established for magnetic resonance-guided focused ultrasound thalamotomy for essential tremor; therefore, reimbursements were estimated to be approximately equivalent to stereotactic radiosurgery to assess a cost threshold. A decision analysis model was constructed to examine the most cost-effective option for essential tremor, implementing meta-analytic techniques. Magnetic resonance-guided focused ultrasound thalamotomy resulted in significantly higher utility scores compared with DBS (P < 0.001) or stereotactic radiosurgery (P < 0.001). Projected costs of magnetic resonance-guided focused ultrasound thalamotomy were significantly less than DBS (P < 0.001), but not significantly different from radiosurgery. Magnetic resonance-guided focused ultrasound thalamotomy is cost-effective for tremor compared with DBS and stereotactic radiosurgery and more effective than both. Even if longer follow-up finds changes in effectiveness or costs, focused ultrasound thalamotomy will likely remain competitive with both alternatives. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

Real-time ultrasound-guided PCNL using a novel SonixGPS needle tracking system.

PubMed

Li, Xiang; Long, Qingzhi; Chen, Xingfa; He, Dalin; Dalin, He; He, Hui

2014-08-01

SonixGPS is a successful ultrasound guidance position system. It helps to improve accuracy in performing complex puncture operations. This study firstly used SonixGPS to perform kidney calyx access in PCNL to investigate its effectiveness and safety. This was a prospectively randomized controlled study performed from September 2011 to October 2012. A total of 97 patients were prospectively randomized into two groups using random number generated from SAS software. 47 Patients were enrolled in conventional ultrasound-guided (US-guided) group and 50 patients were classified into SonixGPS-guided group. Nine patients were lost during follow-up. Hence, a total of 88 patients were qualified and analyzed. Preoperative examinations included urine analysis, urine culture, kidney function, coagulation profile and routine analysis of blood. Ultrasonography was used to evaluate the degree of hydronephrosis. The intraoperative findings, including blood loss, operating time, time to successful puncture, the number of attempts for successful puncture and hospital stay were recorded. The stone clearance rate and complications were analyzed. The present study showed no significant difference between the two groups in terms of demographic data, preoperative markers, stone clearance rate and the stone composition. However, the time to successful puncture, the number of trials for successful puncture, operating time and hospital length of stay were significantly decreased in the SonixGPS-guided group. Furthermore, the hemoglobin decrease was also obviously lower in the SonixGPS group than that in conventional US-guided group. SonixGPS needle tacking system guided PCNL is safe and effective in treating upper urinary tract stones. This novel technology makes puncturing more accuracy and can significantly decrease the incidence of relative hemorrhage and accelerate recovery.

KSC-2009-1768

NASA Image and Video Library

2009-02-21

CAPE CANAVERAL, Fla. – In the Assembly and Refurbishment Facility, or ARF, at NASA's Kennedy Space Center, workers help guide the frustum as a cable lifts it from the transporter. The last manufactured section of the Ares I-X test rocket, the frustum will be moved from the transporter to supports on the floor. Resembling a giant funnel, the frustum's function is to transition the primary flight loads from the rocket's upper stage to the first stage. The frustum is located between the forward skirt extension and the upper stage of the Ares I-X. The frustum will be integrated with the forward skirt and forward skirt extension, which already are in the ARF. That will complete the forward assembly. The assembly then will be moved to the Vehicle Assembly Building for stacking operations, which are scheduled to begin in April. Photo credit: NASA/Kim Shiflett

Information Centers in the United States Navy: Future Support for a Computer Literature Society

DTIC Science & Technology

1989-03-01

not need the adverse publicity of not delivering what it advertised. (Carr, 1987) Part of the marketing strategy should be to inform users and upper...meet their EUC needs. (Alavi, Nelson, and Weiss, 1987-88) In the marketing strategy , EUC is developed at a predetermined rate along chosen paths that...functional, and application knowledge. The authors emphasize that in the marketing strategy , the central drive for guiding EUC activities must remain

Magnetic guide-wire navigation in pulmonary and systemic arterial catheterization: initial experience in pigs.

PubMed

Grosse-Wortmann, Lars; Grabitz, Ralf; Seghaye, Marie-Christine

2007-04-01

Cardiovascular catheterization can be challenging whenever a stenosis or an abnormal vascular course interferes with probing the target vessel. This study addresses the feasibility of navigating a guide wire with a magnetic tip by an external magnetic field through pulmonary and systemic arteries in an experimental porcine model. We investigated six piglets using magnetic guide-wire navigation. Two pulmonary arteriograms were taken from different angles in order to reconstruct the three-dimensional vessel anatomy. A computer interface then calculated three-dimensional coordinates for the vessel in space. Using these coordinates, two external magnets were positioned to create magnetic vectors along the expected vessel course. Magnetically enabled guide wires were then navigated into the vessels using the magnetic field to orient the guide-wire tips. Aortic and renal branches were addressed in a similar fashion. Difficulty in reaching the target vessel was reflected by the number of attempts that were necessary. After 10 failed attempts, the maneuver was recorded to have failed. Thirty-five of 37 (94.6%) arteries with branches at acute angles were reached successfully using magnetic navigation. In two pigs, the left upper lobe artery could not be probed. Peripheral arteries of small diameter were easier to reach than large central arteries, requiring less attempts. Magnetic guide-wire navigation is feasible in the arteries of the lungs, the head and neck, and the kidneys. It is particularly useful in entering small arterial branches at acute angles and may facilitate interventional therapy in a variety of vascular diseases in children and adults.

Arrangement for controlled engagement of the tools of a mining machine with a mine face

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

Blumenthal, G.; Bollmann, A.

1981-07-28

An arrangement for controlled engagement of the tools of a coal planer, with a mine face comprises a scraper conveyor, provided on its front face directed toward the mine face with a guide rail guiding the coal planer for reciprocation along the mine face and a mechanism for tilting the conveyor and the coal planer about a substantially horizontal axis. The tilting mechanism is connected to the rear face of the conveyor and extends in its entirety rearwardly of the rear face of the latter. The tilting mechanism comprises a guide linkage pivotally connected at its front end to themore » rear face of the scraper conveyor while its rear end portion forms a housing for a fluid operated cylinder and piston unit, the piston rod of which is connected to a connecting rod guided by the guide linkage for movement in longitudinal direction and having an upwardly extending front section pivotally connected at its upper free end to the rear face of the scraper conveyor. The fluid operated cylinder-and-piston unit is thus considerably spaced from the scraper conveyor and the material transported thereby and especially coal dust raised during transport of the mined coal by the conveyor, whereby maintenance of the tilting unit is reduced. The guide linkage, the connecting rod and the tilting unit are all in close vicinity to the sole of the mine gallery to leave a considerable free space between the arrangement and the roof of the mine gallery.« less

A technical report on ultrasound-guided scapulocostal syndrome injection.

PubMed

McCarthy, C; Harmon, D

2016-08-01

We describe a case report and technique for using an ultrasound scanner and a linear transducer to guide serratus posterior superior (SPS) muscle injection. A 43-year-old female presented with chronic pain centered under the right upper portion of her scapula impacting her activities of daily living. For the ultrasound-guided SPS muscle injection, the patient was placed in the prone position. The transducer was oriented in a transverse orientation at the level of the C6-T1 vertebrae. Here the SPS muscle attaches to the lower portion of the ligament nuchae and the intervening interspinous ligaments. The muscle fibers run inferiorly and laterally to attach to the 2nd-5th ribs which were identified along with the lateral portion of the serratus posterior superior muscle which is covered by the scapula. Real-time imaging was used to direct a spinal needle into the trigger points of the SPS muscle, where solution was injected under direct vision. The patient's pain symptoms improved significantly. Serratus posterior superior injection can confirm a diagnosis of scapulocostal syndrome and be therapeutically beneficial.

Radiologic Analysis and Clinical Study of the Upper One-third Joint Technique for Fluoroscopically Guided Sacroiliac Joint Injection.

PubMed

Park, Junghyun; Park, Hue Jung; Moon, Dong Eon; Sa, Gye Jeol; Kim, Young Hoon

2015-01-01

Sacroiliac intraarticular injection by the traditional technique can be challenging to perform when the joint is covered with osteophytes or is extremely narrow. To examine whether there is enough space for the needle to be advanced from the L5-S1 interspinous space to the upper one-third sacroiliac joint (SIJ) by magnetic resonance image (MRI) analysis as an alternative to fluoroscopically guided SIJ injection with the lower one-third joint technique, and to determine the feasibility of this novel technique in clinical practice. MRI analysis and observational study. An interventional pain management practice at a university hospital. We analyzed 200 axial T2-weighted MRIs between the L5 and S1 vertebrae of 100 consecutive patients. The following measurements were obtained on both sides: 1) the thickness of fat in the midline; 2) the distance between the midline (Point C) and the junction (Point A) of the skin and the imaginary line that connects the SIJ and the most medial cortex of the ilium; 3) the distance between the midline (Point C) and the junction (Point B) of the skin and the imaginary line that connects the SIJ and the L5 spinous process; 4) the distance between the SIJ and midline (Point C) on the skin, or between the SIJ and the midpoint (Point C') of the line from Point A to Point B; and 5) the angle between the sagittal line and the imaginary line that connects the SIJ and the midline on the skin. The upper one-third joint technique was performed to establish the feasibility of the alternative technique in 20 patients who had unsuccessful sacroiliac intraarticular injections using the lower one-third joint technique. The mean distances from the midline to Point A and to Point B were 21.9 ± 13.7 mm and 27.8 ± 13.6 mm, respectively. The mean distance between the SIJ and Point C (or Point C') was 81.0 ± 13.3 mm. The angle between the sagittal line and the imaginary line that connects the SIJ and the midline on the skin was 42.8 ± 5.1°. The success rate of sacroiliac intraarticular injections with the upper one-third joint technique was 90% (18/20). This was an observational study and lacked a control group. Sacroiliac intraarticular injections with the upper one-third joint technique are advisable when it is hard to perform them with the lower one-third joint technique.

Design and test of a Microsoft Kinect-based system for delivering adaptive visual feedback to stroke patients during training of upper limb movement.

PubMed

Simonsen, Daniel; Popovic, Mirjana B; Spaich, Erika G; Andersen, Ole Kæseler

2017-11-01

The present paper describes the design and test of a low-cost Microsoft Kinect-based system for delivering adaptive visual feedback to stroke patients during the execution of an upper limb exercise. Eleven sub-acute stroke patients with varying degrees of upper limb function were recruited. Each subject participated in a control session (repeated twice) and a feedback session (repeated twice). In each session, the subjects were presented with a rectangular pattern displayed on a vertical mounted monitor embedded in the table in front of the patient. The subjects were asked to move a marker inside the rectangular pattern by using their most affected hand. During the feedback session, the thickness of the rectangular pattern was changed according to the performance of the subject, and the color of the marker changed according to its position, thereby guiding the subject's movements. In the control session, the thickness of the rectangular pattern and the color of the marker did not change. The results showed that the movement similarity and smoothness was higher in the feedback session than in the control session while the duration of the movement was longer. The present study showed that adaptive visual feedback delivered by use of the Kinect sensor can increase the similarity and smoothness of upper limb movement in stroke patients.

Constructing a patient-specific computer model of the upper airway in sleep apnea patients.

PubMed

Dhaliwal, Sandeep S; Hesabgar, Seyyed M; Haddad, Seyyed M H; Ladak, Hanif; Samani, Abbas; Rotenberg, Brian W

2018-01-01

The use of computer simulation to develop a high-fidelity model has been proposed as a novel and cost-effective alternative to help guide therapeutic intervention in sleep apnea surgery. We describe a computer model based on patient-specific anatomy of obstructive sleep apnea (OSA) subjects wherein the percentage and sites of upper airway collapse are compared to findings on drug-induced sleep endoscopy (DISE). Basic science computer model generation. Three-dimensional finite element techniques were undertaken for model development in a pilot study of four OSA patients. Magnetic resonance imaging was used to capture patient anatomy and software employed to outline critical anatomical structures. A finite-element mesh was applied to the volume enclosed by each structure. Linear and hyperelastic soft-tissue properties for various subsites (tonsils, uvula, soft palate, and tongue base) were derived using an inverse finite-element technique from surgical specimens. Each model underwent computer simulation to determine the degree of displacement on various structures within the upper airway, and these findings were compared to DISE exams performed on the four study patients. Computer simulation predictions for percentage of airway collapse and site of maximal collapse show agreement with observed results seen on endoscopic visualization. Modeling the upper airway in OSA patients is feasible and holds promise in aiding patient-specific surgical treatment. NA. Laryngoscope, 128:277-282, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Types of Renal Calculi and Management Regimen for Chinese Minimally Invasive Percutaneous Nephrolithotomy.

PubMed

Gu, Si-Ping; Zeng, Guo-Hua; You, Zhi-Yuan; Lu, Yi-Jin; Huang, Yun-Teng; Wang, Qing-Mao; He, Zhao-Hui

2015-12-01

Strict selection of patients for minimally invasive percutaneous nephrolithotomy could effectively improve the success rate of surgery. This study aimed to understand the required skills and the efficacy of mini-PCNL in the treatment of five types of upper ureteral calculi. Data collected after X-ray analysis and B mode ultrasound from 633 patients with upper ureteral and renal pelvis calculi who underwent B ultrasound-guided lithotomy was reviewed, including the following: type I, upper ureteral or renal pelvis calculi with moderate hydronephrosis (154 cases); type II, upper ureteral or renal pelvis calculi with severe hydronephrosis (157 cases); type III, upper ureteral or renal pelvis calculi without hydronephrosis (61 cases); type IV, renal pelvis calculi, one or two renal calyx calculi (206 cases); and type V, renal staghorn calculi (55 cases). Operations on 611 cases were successful. The treatment method for five patients was converted to open surgery. Twelve cases were treated by indwelling double-J tube retro-catheterization and extracorporeal shock wave lithotripsy. Five patients gave up the treatment. The rate of calculus clearance was 82.3 %, and the rate of residual calculus was 17.6 %. Selective renal artery embolization was performed in nine cases. Hydropneumothorax occurred in nine cases. No intestinal fistula occurred, and no patient had to undergo nephrectomy. The difficulty and the curative effect of the operation were different because the types of calculi varied. Selection of the procedure based on the different types of calculi could effectively improve the success rate of the procedure, reduce complications, and shorten the learning curve.

Reconfiguration of the upper extremity relative to the pushrim affects load distribution during wheelchair propulsion.

PubMed

Munaretto, Joseph M; McNitt-Gray, Jill L; Flashner, Henryk; Requejo, Philip S

2013-08-01

Repetitive loading during manual wheelchair propulsion (WCP) is associated with overuse injury to the upper extremity (UE). The aim of this study was to determine how RF redirection and load distribution are affected by changes upper extremity kinematic modifications associated with modifications in seat positions during a WCP task. The aim of this study was to determine how RF redirection and load distribution are affected by upper extremity kinematic changes associated with seat position adjustment during a WCP task. Dynamic simulations using an experiment-based multi-link inverse dynamics model were used to generate solutions for redistributing UE mechanical load in different seating positions without decrements in WCP task performance. Experimental RF and kinematic data were collected for one subject propelling at a self-selected speed and used as input into the model. Shoulder/axle distance, wrist angular position, and RF direction were systematically modified to simulate how the mechanical demand imposed on the upper extremity (elbow and shoulder net joint moments (NJMs) and net joint forces) may vary. Load distribution depended on UE orientation relative to the wheel. At peak force, lower shoulder/axle distances and more anterior wrist positions on the pushrim allowed for more extended elbow positions and reduced total NJM load. Simulation results incorporating subject-specific data may provide mechanically based information to guide clinical interventions that aim to maintain WCP performance and redistribute load by modifying RF direction, seat configuration and hand/rim interaction. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.

Sports and performing arts medicine. 2. Shoulder and elbow overuse injuries in sports.

PubMed

Akuthota, Venu; Chou, Larry H; Drake, David F; Nadler, Scott F; Toledo, Santiago D

2004-03-01

This self-directed learning module discusses classic topics and highlights new advances in this area. This article discusses upper-limb sports injuries as part of a section of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article uses case vignettes as a vehicle to elaborate on shoulder and elbow pain in the athlete. To discuss shoulder and elbow overuse injuries in sports.

Selected French Speaking Sub-Saharan African Countries: Burundi, Cameroon (Eastern), Chad, Congo (Brazzaville), Dahomey, Gabon, Ivory Coast, Mali, Mauritania, Niger, Rwanda, Senegal, Togo, Upper Volta, Zaire. A Guide to the Academic Placement of Students from These Countries in Academic Institutions of the United States.

ERIC Educational Resources Information Center

Trudeau, Edouard J. C.

The educational systems of 15 Sub-Saharan African countries are described, and guidelines concerning the academic placement of students who wish to study in U.S. institutions are provided. Tables indicate the grades covered by primary education and secondary education (academic and technical). Burundi, Rwanda, and Zaire have followed the Belgian…

KSC-07pd1610

NASA Image and Video Library

2007-06-21

KENNEDY SPACE CENTER, FLA. -- At Astrotech, workers help guide the Dawn spacecraft toward the upper stage booster below. The two elements will be mated for launch. Dawn's goal is to characterize the conditions and processes of the solar system's earliest epoch by investigating in detail the largest protoplanets that have remained intact since their formations: asteroid Vesta and the dwarf planet Ceres. They reside in the extensive zone between Mars and Jupiter together with many other smaller bodies, called the asteroid belt. Photo credit: NASA/George Shelton

Random vibration (stress screening) of printed wiring assemblies

NASA Technical Reports Server (NTRS)

Bastien, Gilbert J.

1988-01-01

The results of a random vibration test screening (RVSS) study of the determination of the upper and lower vibration limits on printed wiring assemblies (PWA) are summarized. The study results are intended to serve as a guide for engineers and designers who make decisions on PWA features that need to withstand the stresses of dynamic testing and screening. The maximum allowable PWA deflection, G levels, and PSD levels are compared to the expected or actual levels to determine if deleterious effects will occur.

SPARTAN high resolution solar studies

NASA Technical Reports Server (NTRS)

Bruner, Marilyn E.

1993-01-01

This report summarizes the work performed on Contract NAS5-29739, a sub-orbital research program directed toward the study of the geometry of and physical conditions in matter found in the upper layers of the solar atmosphere. The report describes a new sounding rocket payload developed under the contract, presents a guide to the contents of semiannual reports submitted during the contract, discusses the results of the first flight of the payload and the progress on scientific analysis. A bibliography of papers and publications is included.

Design and control of six degree-of-freedom active vibration isolation table.

PubMed

Hong, Jinpyo; Park, Kyihwan

2010-03-01

A six-axis active vibration isolation system (AVIS) is designed by using the direct driven guide and ball contact mechanisms in order to have no cross-coupling between actuators. The point contact configuration gives an advantage of having an easy assembly of eight voice coil actuators to an upper and a base plate. A voice coil actuator is used since it can provide a large displacement and sufficient bandwidth required for vibration control. The AVIS is controlled considering the effect of flexible vibration mode in the upper plate and velocity sensor dynamics. A loop shaping technique and phase margin condition are applied to design a vibration controller. The performances of the AVIS are investigated in the frequency domain and finally validated by comparing with the passive isolation system. The scanning profiles of the specimen are compared together by using the atomic force microscope. The robustness of the AVIS is verified by showing the impulse response.

Updates of operative techniques for upper airway stimulation.

PubMed

Heiser, Clemens; Thaler, Erica; Boon, Maurits; Soose, Ryan J; Woodson, B Tucker

2016-09-01

Selective upper airway stimulation has been established as an additional treatment for obstructive sleep apnea (OSA). Essential for the treatment is the precise placement of the cuff electrode for select branches of the hypoglossal nerve, which innervate the protrusors and stiffeners of the tongue. A direct approach to the distal hypoglossal nerve has been established to achieve this goal. For surgeons, detailed knowledge of this anatomy is vital. Another decisive step is the placement of the sensing lead between the intercostal muscles. Also, the complexity of follow-up care postoperatively should be kept in mind. The aim of this article is to provide the latest knowledge on the neuroanatomy of the hypoglossal nerve and to give surgeons a step-by-step guide on the current operative technique. Laryngoscope, 126:S12-S16, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Design and control of six degree-of-freedom active vibration isolation table

NASA Astrophysics Data System (ADS)

Hong, Jinpyo; Park, Kyihwan

2010-03-01

A six-axis active vibration isolation system (AVIS) is designed by using the direct driven guide and ball contact mechanisms in order to have no cross-coupling between actuators. The point contact configuration gives an advantage of having an easy assembly of eight voice coil actuators to an upper and a base plate. A voice coil actuator is used since it can provide a large displacement and sufficient bandwidth required for vibration control. The AVIS is controlled considering the effect of flexible vibration mode in the upper plate and velocity sensor dynamics. A loop shaping technique and phase margin condition are applied to design a vibration controller. The performances of the AVIS are investigated in the frequency domain and finally validated by comparing with the passive isolation system. The scanning profiles of the specimen are compared together by using the atomic force microscope. The robustness of the AVIS is verified by showing the impulse response.

A comparison of the dose of anesthetic agents and the effective interval from the block procedure to skin incision for ultrasound-guided supraclavicular brachial plexus block in upper extremity surgery.

PubMed

Nakayama, Masanori; Sakuma, Yu; Imamura, Hitoshi; Yano, Koichiro; Kodama, Takao; Ikari, Katsunori

2017-12-01

The aim of this study was to review and evaluate the selection and dose of anesthetic agents and the interval from the block procedure to skin incision for supraclavicular brachial plexus block in upper extremity surgery. We reviewed our cases that underwent upper extremity surgery using only ultrasound-guided supraclavicular brachial plexus block in our hospital between 2011 and 2016. Adverse events during surgery were evaluated. Receiver operating characteristic (ROC) curves were constructed to investigate the relationship between the time from the end of the block procedure to skin incision and the use of local anesthesia on the surgical site. There were 255 patients who were divided into three groups according to the anesthetic agents used: group 1, 1% lidocaine (L) 10 ml + 0.75% ropivacaine (R) 20 ml (n = 62); group 2, L 20 ml + R 10 ml (n = 93); and group 3, L 10 ml + R 15 ml (n = 100). The rate of use of local anesthesia on the surgical site was significantly higher in group 3 than in the other two groups. There were no significant differences in the other evaluated items among the three groups. ROC curve analysis indicated that ≥24 min from the end of the block procedure to skin incision might reduce the use of local anesthesia. The total volume of anesthetic agents had an important influence on the rate of the addition of local anesthesia for surgical pain; however, the combined dose of agents did not influence the evaluation items. For effective analgesia, ≥24 min should elapse from the end of the block procedure to skin incision. Copyright © 2017. Published by Elsevier B.V.

General relativity in upper secondary school: Design and evaluation of an online learning environment using the model of educational reconstruction

NASA Astrophysics Data System (ADS)

Kersting, Magdalena; Henriksen, Ellen Karoline; Bøe, Maria Vetleseter; Angell, Carl

2018-06-01

Because of its abstract nature, Albert Einstein's theory of general relativity is rarely present in school physics curricula. Although the educational community has started to investigate ways of bringing general relativity to classrooms, field-tested educational material is rare. Employing the model of educational reconstruction, we present a collaborative online learning environment that was introduced to final year students (18-19 years old) in six Norwegian upper secondary physics classrooms. Design-based research methods guided the development of the learning resources, which were based on a sociocultural view of learning and a historical-philosophical approach to teaching general relativity. To characterize students' learning from and interaction with the learning environment we analyzed focus group interviews and students' oral and written responses to assigned problems and discussion tasks. Our findings show how design choices on different levels can support or hinder understanding of general relativity, leading to the formulation of design principles that help to foster qualitative understanding and encourage collaborative learning. The results indicate that upper secondary students can obtain a qualitative understanding of general relativity when provided with appropriately designed learning resources and sufficient scaffolding of learning through interaction with teacher and peers.

Cognitive-Motor Interference on Upper Extremity Motor Performance in a Robot-Assisted Planar Reaching Task Among Patients With Stroke.

PubMed

Shin, Joon-Ho; Park, Gyulee; Cho, Duk Youn

2017-04-01

To explore motor performance on 2 different cognitive tasks during robotic rehabilitation in which motor performance was longitudinally assessed. Prospective study. Rehabilitation hospital. Patients (N=22) with chronic stroke and upper extremity impairment. A total of 640 repetitions of robot-assisted planar reaching, 5 times a week for 4 weeks. Longitudinal robotic evaluations regarding motor performance included smoothness, mean velocity, path error, and reach error by the type of cognitive task. Dual-task effects (DTEs) of motor performance were computed to analyze the effect of the cognitive task on dual-task interference. Cognitive task type influenced smoothness (P=.006), the DTEs of smoothness (P=.002), and the DTEs of reach error (P=.052). Robotic rehabilitation improved smoothness (P=.007) and reach error (P=.078), while stroke severity affected smoothness (P=.01), reach error (P<.001), and path error (P=.01). Robotic rehabilitation or severity did not affect the DTEs of motor performance. The results provide evidence for the effect of cognitive-motor interference on upper extremity performance among participants with stroke using a robotic-guided rehabilitation system. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Validation of the Medisana MTP Plus upper arm blood pressure monitor, for self-measurement, according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Erdem, Emre; Aydogdu, Türkan; Akpolat, Tekin

2011-02-01

Standard validation protocols are objective guides for healthcare providers, physicians, and patients. The purpose of this study was to test validation of the Medisana MTP Plus upper arm blood pressure (BP) measuring monitor for self-measurement according to the European Society of Hypertension International Protocol (ESH-IP2) in adults. The Medisana MTP Plus monitor is an automated and oscillometric upper arm device for home BP monitoring. Nine consecutive measurements were made according to the ESH-IP2. Overseen by an independent supervisor, measurements were recorded by two observers blinded from both each other's readings and from the device readings. The Medisana MTP Plus device fulfills the validation criteria of the ESH-IP2 for the general population. The mean (standard deviation) of the difference between the observers and the device measurements was 0.6 mmHg (5.1 mmHg) for systolic and 2.7 mmHg (3.4 mmHg) for diastolic pressures, respectively. As the Medisana MTP Plus device has achieved the required standards, it is recommended for home BP monitoring in an adult population.

Transforming a fourth year modern optics course using a deliberate practice framework

NASA Astrophysics Data System (ADS)

Jones, David J.; Madison, Kirk W.; Wieman, Carl E.

2015-12-01

[This paper is part of the Focused Collection on Upper Division Physics Courses.] We present a study of active learning pedagogies in an upper-division physics course. This work was guided by the principle of deliberate practice for the development of expertise, and this principle was used in the design of the materials and the orchestration of the classroom activities of the students. We present our process for efficiently converting a traditional lecture course based on instructor notes into activities for such a course with active learning methods. Ninety percent of the same material was covered and scores on common exam problems showed a 15% improvement with an effect size greater than 1 after the transformation. We observe that the improvement and the associated effect size is sustained after handing off the materials to a second instructor. Because the improvement on exam questions was independent of specific problem topics and because the material tested was so mathematically advanced and broad (including linear algebra, Fourier transforms, partial differential equations, and vector calculus), we expect the transformation process could be applied to most upper-division physics courses having a similar mathematical base.

Topical airway anesthesia for awake fiberoptic intubation: Comparison between airway nerve blocks and nebulized lignocaine by ultrasonic nebulizer

PubMed Central

Gupta, Babita; Kohli, Santvana; Farooque, Kamran; Jalwal, Gopal; Gupta, Deepak; Sinha, Sumit; Chandralekha

2014-01-01

Overview: Awake fiberoptic bronchoscope (FOB) guided intubation is the gold standard of airway management in patients with cervical spine injury. It is essential to sufficiently anesthetize the upper airway before the performance of awake FOB guided intubation in order to ensure patient comfort and cooperation. This randomized controlled study was performed to compare two methods of airway anesthesia, namely ultrasonic nebulization of local anesthetic and performance of airway blocks. Materials and Methods: A total of 50 adult patients with cervical spine injury were randomly allocated into two groups. Group L received airway anesthesia through ultrasonic nebulization of 10 ml of 4% lignocaine and Group NB received airway blocks (bilateral superior laryngeal and transtracheal recurrent laryngeal) each with 2 ml of 2% lignocaine and viscous lignocaine gargles. FOB guided orotracheal intubation was then performed. Hemodynamic variables at baseline and during the procedure, patient recall, vocal cord visibility, ease of intubation, coughing/gagging episodes, and signs of lignocaine toxicity were noted. Results: The observations did not reveal any significant differences in demographics or hemodynamic parameters at any time during the study. However, the time taken for intubation was significantly lower in Group NB as compared with the Group L. Group L had an increased number of coughing/gagging episodes as compared with Group NB. Vocal cord visibility and ease of intubation were better in patients who received airway blocks and hence the amount of supplemental lignocaine used was less in this group. Overall patient comfort was better in Group NB with fewer incidences of unpleasant recalls as compared with Group L. Conclusion: Upper airway blocks provide better quality of anesthesia than lignocaine nebulization as assessed by patient recall of procedure, coughing/gagging episodes, ease of intubation, vocal cord visibility, and time taken to intubate. PMID:25538514

CAN HANDLING FIXTURES

DOEpatents

Kelman, Ler.R.; Yaggee, F.L.

1958-08-01

A sleeveless cauning apparatus is described for bonding and canning uranium fuel elements under the surface of a liquid bonding alloy. The can is supported on a pedestal by vertical pegs, and an adjustable collar is placed around the upper, open end of the can, which preferably is flared to assure accurate centering in the fixture and to guide the uranium slug into the can. The fixture with a can in place is then immersed in a liquid aluminum-silicon alloy and the can becomes filled with the liquid alloy. The slug is inserted by a slug guide located vertically above the can opening. The slug settles by gravity into the can, after which a cap is emplaced. A quenching tool lifts the capped can out of the bath by means of a slot provided for it in the pedestal. This apparatus provides a simple means of canning the slug without danger of injury to the uranium metal or the aluminum can.

Stents in Renal Artery Bifurcation Stenosis: A Case Report

PubMed Central

Leonardou, Polytimi; Pappas, Paris

2011-01-01

A 39-year-old patient presented with poorly controlled hypertension, and she was referred to renal angiogram and potential renal angioplasty. Renal angiogram showed a bifurcation lesion of the right renal artery. A guide wire was used to cross the upper branch, while the lower branch was protected by another same-type guide wire through the same introducer. Two thin monorail balloons were used to dilate the two branches; however, despite balloon dilatation, the stenosis of the vessels persisted. The “kissing balloon” technique was then attempted by simultaneously inflating both branches using the same balloons, but more than a 70% residual stenosis persisted in each branch. Two stents were finally placed in a “kissing” way through the main renal artery. The imaging and clinical results were good, without any procedure-related complications. Three years clinical followup was also good, without any reason for further interventional approach. PMID:21789043

The SUPERCOMET 2 Project: Teacher Seminar and Teacher Guide

NASA Astrophysics Data System (ADS)

Engstrom, V.; Ireson, G.; Latal, H.; Mathelitsch, L.; Michelini, M.; Peeters, W.; Rath, G.

2008-05-01

The Leonardo da Vinci pilot projects SUPERCOMET (2001-2004) and SUPERCOMET 2 (2004-2007) developed and tested teacher training materials for active, minds-on learning of electromagnetism and superconductivity at the level of upper secondary school. New multimedia materials for the pupils supported the teacher materials, including a teacher seminar in 4 half-day modules detailing the scientific contents, teaching methods, using ICT in physics teaching and learning, online collaboration and further resources for exploring the selected topics. The aim of these projects were to improve the quality of physics teaching on a European level, involving a combined total of 45 partners in 16 countries, and conducting trials at 67 schools with approx. 230 teachers, 280 trainee teachers and 2200 pupils. New follow-up projects develop hands-on materials for carrying out the activities described in the teacher guide and seminars and additional teacher materials involving modelling, simulations and data logging.

Optical analysis of AlGaInP laser diodes with real refractive index guided self-aligned structure

NASA Astrophysics Data System (ADS)

Xu, Yun; Zhu, Xiaopeng; Ye, Xiaojun; Kang, Xiangning; Cao, Qing; Guo, Liang; Chen, Lianghui

2004-05-01

Optical modes of AlGaInP laser diodes with real refractive index guided self-aligned (RISA) structure were analyzed theoretically on the basis of two-dimension semivectorial finite-difference methods (SV-FDMs) and the computed simulation results were presented. The eigenvalue and eigenfunction of this two-dimension waveguide were obtained and the dependence of the confinement factor and beam divergence angles in the direction of parallel and perpendicular to the pn junction on the structure parameters such as the number of quantum wells, the Al composition of the cladding layers, the ridge width, the waveguide thickness and the residual thickness of the upper P-cladding layer were investigated. The results can provide optimized structure parameters and help us design and fabricate high performance AlGaInP laser diodes with a low beam aspect ratio required for optical storage applications.

Tapered fiber coupling of single photons emitted by a deterministically positioned single nitrogen vacancy center

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

Liebermeister, Lars, E-mail: lars.liebermeister@physik.uni-muenchen.de; Petersen, Fabian; Münchow, Asmus v.

2014-01-20

A diamond nano-crystal hosting a single nitrogen vacancy (NV) center is optically selected with a confocal scanning microscope and positioned deterministically onto the subwavelength-diameter waist of a tapered optical fiber (TOF) with the help of an atomic force microscope. Based on this nano-manipulation technique, we experimentally demonstrate the evanescent coupling of single fluorescence photons emitted by a single NV-center to the guided mode of the TOF. By comparing photon count rates of the fiber-guided and the free-space modes and with the help of numerical finite-difference time domain simulations, we determine a lower and upper bound for the coupling efficiency ofmore » (9.5 ± 0.6)% and (10.4 ± 0.7)%, respectively. Our results are a promising starting point for future integration of single photon sources into photonic quantum networks and applications in quantum information science.« less

Field trip guide to selected studies of the Southwest Mineral and Environmental Investigations Project in southeastern Arizona

USGS Publications Warehouse

Houser, B.B.; Gettings, M.E.; Bultman, M.W.; Gray, Floyd; Caruthers, K.R.; Hirschberg, D.M.

1999-01-01

The Southwest Mineral and Environmental Investigations Project is designed to address issues raised by rapid urban development in the basins of the southwestern U.S. These issues require objective geoscientific data that can be used by land managers and stakeholders to develop informed land and water use strategies. The project integrates new and existing geologic, geophysical, and geochemical data, and imagery to provide three-dimensional visualizations of the basins of southeastern Arizona. Emphasis is on developing better knowledge of the aquifer systems of both the basins and the ranges, on acquiring background and baseline information, and on determining the distribution of metals related to mineralization and the fate of these metals in surface and subsurface environments. The products of the project will be used in resolving issues of water quality and quantity, in understanding environmental impacts such as riparian ecosystem maintenace, and in evaluating mineral resources beneath and within the basins. The field trip highlights three topics and areas (figs. 1 and 2): (1) geology and geophysics of the upper San Pedro and upper Santa Cruz basins (M.E. Gettings, M. W. Bultman, and B.B. Houser), (2) geology, geophysics, and mineral resource potential of the San Rafael basin (M.W. Bultman), and (3) hydrology and aqueous geochemistry of the Red Mountain and Sonoita Creek drainage system (Floyd Gray). The trip guide, which begins and ends in Tucson, Arizona, also includes commentary on the cultural and mining history of the area.

The management of lower gastrointestinal bleeding.

PubMed

Marion, Y; Lebreton, G; Le Pennec, V; Hourna, E; Viennot, S; Alves, A

2014-06-01

Lower gastrointestinal (LGI) bleeding is generally less severe than upper gastrointestinal (UGI) bleeding with spontaneous cessation of bleeding in 80% of cases and a mortality of 2-4%. However, unlike UGI bleeding, there is no consensual agreement about management. Once the patient has been stabilized, the main objective and greatest difficulty is to identify the location of bleeding in order to provide specific appropriate treatment. While upper endoscopy and colonoscopy remain the essential first-line examinations, the development and availability of angiography have made this an important imaging modality for cases of active bleeding; they allow diagnostic localization of bleeding and guide subsequent therapy, whether therapeutic embolization, interventional colonoscopy or, if other techniques fail or are unavailable, surgery directed at the precise site of bleeding. Furthermore, newly developed endoscopic techniques, particularly video capsule enteroscopy, now allow minimally invasive exploration of the small intestine; if this is positive, it will guide subsequent assisted enteroscopy or surgery. Other small bowel imaging techniques include enteroclysis by CT or magnetic resonance imaging. At the present time, exploratory surgery is no longer a first-line approach. In view of the lesser gravity of LGI bleeding, it is most reasonable to simply stabilize the patient initially for subsequent transfer to a specialized center, if minimally invasive techniques are not available at the local hospital. In all cases, the complexity and diversity of LGI bleeding require a multidisciplinary collaboration involving the gastroenterologist, radiologist, intensivist and surgeon to optimize diagnosis and treatment of the patient. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Quantification of the Upper Extremity Motor Functions of Stroke Patients Using a Smart Nine-Hole Peg Tester

PubMed Central

Marik, Anikó Rita; Fazekas, Gábor

2018-01-01

This paper introduces a smart nine-hole peg tester (s-9HPT), which comprises a standard nine-hole peg test pegboard, but with light-emitting diodes (LEDs) next to each hole. The s-9HPT still supports the traditional nine-hole peg test operating mode, in which the order of the peg placement and removal can be freely chosen. Considering this, the s-9HPT was used in lab research to analyze the traditional procedure and possible new procedures. As this analysis required subjects with similar levels of dexterity, measurement data from 16 healthy subjects (seven females, nine males, 25–80 years old) were used. We consequently found that illuminating the LEDs in various patterns facilitated guided tests of diverse complexity levels. Next, to demonstrate the clinical application of the s-9HPT, the improvement in the hand dexterity of 12 hospitalized stroke patients (45–80 years old, six females and six males) was monitored during their rehabilitation. Here, we used traditional and guided tests validated by healthy subjects. Consequently, improvements were found to be patient specific. At the beginning of rehabilitation, traditional tests suitably indicate improvements, while guided tests are beneficial following improvements in motor functions. Further, the guided tests motivated certain patients, meaning the rehabilitation was more effective for these individuals. PMID:29850001

A novel method for intraoral access to the superior head of the human lateral pterygoid muscle.

PubMed

Oliveira, Aleli Tôrres; Camilo, Anderson Aparecido; Bahia, Paulo Roberto Valle; Carvalho, Antonio Carlos Pires; DosSantos, Marcos Fabio; da Silva, Jorge Vicente Lopes; Monteiro, André Antonio

2014-01-01

The uncoordinated activity of the superior and inferior parts of the lateral pterygoid muscle (LPM) has been suggested to be one of the causes of temporomandibular joint (TMJ) disc displacement. A therapy for this muscle disorder is the injection of botulinum toxin (BTX), of the LPM. However, there is a potential risk of side effects with the injection guide methods currently available. In addition, they do not permit appropriate differentiation between the two bellies of the muscle. Herein, a novel method is presented to provide intraoral access to the superior head of the human LPM with maximal control and minimal hazards. Computational tomography along with digital imaging software programs and rapid prototyping techniques were used to create a rapid prototyped guide to orient BTX injections in the superior LPM. The method proved to be feasible and reliable. Furthermore, when tested in one volunteer it allowed precise access to the upper head of LPM, without producing side effects. The prototyped guide presented in this paper is a novel tool that provides intraoral access to the superior head of the LPM. Further studies will be necessary to test the efficacy and validate this method in a larger cohort of subjects.

Malignant perivascular epithelioid cell neoplasm of the mediastinum and the lung: one case report.

PubMed

Liang, Wenjie; Xu, Shunliang; Chen, Feng

2015-06-01

A perivascular epithelioid cell neoplasm (PEComa) in the chest is rare, let alone in the mediastinum and lung. A 63-year-old man was admitted to our hospital with chest pain for more than 2 months and was found to have an opacity in his mediastinum and lung for 3 weeks. Enhanced chest computed tomography (CT) revealed a mass in both the left upper lobe and central anterior mediastinum. To identify the disease, a CT-guided percutaneous transthoracic needle biopsy of the upper left lung lesions was performed. The pathology result was consistent with epithelioid angiomyolipoma/PEComa. After a standard preparation for surgery, the neoplasms in the mediastinum and left lung were resected. The operative findings revealed extensive mediastinal tumor invasion in parts adjacent to the pericardium, including the mediastinal pleura, left pulmonary artery and vein, and phrenic nerve. The left lung tumor had invaded the lung membranes. The final pathologic diagnosis was malignant epithelioid angioleiomyoma in the left upper lung and mediastinum. Later, the mediastinal tumor recurred. The radiography of this case resembles left upper lobe lung cancer with mediastinal lymph node metastasis. Because this tumor lacks fat, the enhanced CT indicated that it was malignant but failed to identify it as a perivascular epithelioid cell neoplasm.This case reminds clinicians that, although most PEComa are benign, some can be malignant. As the radiology indicated, chest PEComas lack fat, which makes their preoperative diagnosis difficult. Therefore, needle biopsy is valuable for a definitive diagnosis.

Malignant Perivascular Epithelioid Cell Neoplasm of the Mediastinum and the Lung

PubMed Central

Liang, Wenjie; Xu, Shunliang; Chen, Feng

2015-01-01

Abstract A perivascular epithelioid cell neoplasm (PEComa) in the chest is rare, let alone in the mediastinum and lung. A 63-year-old man was admitted to our hospital with chest pain for more than 2 months and was found to have an opacity in his mediastinum and lung for 3 weeks. Enhanced chest computed tomography (CT) revealed a mass in both the left upper lobe and central anterior mediastinum. To identify the disease, a CT-guided percutaneous transthoracic needle biopsy of the upper left lung lesions was performed. The pathology result was consistent with epithelioid angiomyolipoma/PEComa. After a standard preparation for surgery, the neoplasms in the mediastinum and left lung were resected. The operative findings revealed extensive mediastinal tumor invasion in parts adjacent to the pericardium, including the mediastinal pleura, left pulmonary artery and vein, and phrenic nerve. The left lung tumor had invaded the lung membranes. The final pathologic diagnosis was malignant epithelioid angioleiomyoma in the left upper lung and mediastinum. Later, the mediastinal tumor recurred. The radiography of this case resembles left upper lobe lung cancer with mediastinal lymph node metastasis. Because this tumor lacks fat, the enhanced CT indicated that it was malignant but failed to identify it as a perivascular epithelioid cell neoplasm. This case reminds clinicians that, although most PEComa are benign, some can be malignant. As the radiology indicated, chest PEComas lack fat, which makes their preoperative diagnosis difficult. Therefore, needle biopsy is valuable for a definitive diagnosis. PMID:26039123

[Koame wemakaa pandza kome watapetaaka kaawa (Baniwa, a story of plants and cures): the pathways to a script].

PubMed

Penido, Stella Oswaldo Cruz

2007-12-01

Traditional curing practices lie at the heart of the culture of the Baniwa, an indigenous people from the upper Negro river in the state of Amazonas. The Baniwa's mythical knowledge guides their understanding of health and sickness and directs the curing action of those who understand plants and of their pajés and benzedores. The documentary explores the permanence of these practices within today's context of interethnic contact. To what extent and in what realms is this knowledge recognized today?

Passive PE Sampling in Support of In Situ Remediation of Contaminated Sediments - Passive Sampler PRC Calculation Software User’s Guide

DTIC Science & Technology

2014-07-01

different value and pressing Enter. The PRC- Calc session can be saved for future use with these new values using the Save Session button in the upper...describe (a) how the PRC Correction Calculator (PRC- Calc ) uses the model of Fernandez et al. (2009), (b) how well its performance compares against...experimental data, (c) how the user may prepare their computer with software to use the PRC calculator, and then (d) how to use PRC- Calc to process PRC

National Program for Inspection of Non-Federal Dams. Crescent Lake Dam (CT 00277), Connecticut River Basin, Enfield, Connecticut. Phase I Inspection Report.

DTIC Science & Technology

1978-11-01

hydraulic analyses. In accordance with the established Guide- lines , the Spillway Test Flood is based on the estimated "Probable Maximum Flood" for the...the south by Shaker Road. A branch line of the Penn Central Railroad pas- ses to the right of the dam and reservoir. - 0 The dam was originally...passage of water through the - upper foot of stone. ,,,’. i. Regulating Outlets There is a 375 foot long raceway outlet on the east shore- -" line

Proceedings of the Annual Meeting of the Eastern Snow Conference (47th) Held in Bangor, Maine on 7-8 June 1990

DTIC Science & Technology

1990-06-01

western U.S. Ten additional windows contain basin boundary data sets to map snow cover for the Upper Midwest , the Great Lakes, New England, and... Midwest and in the East. The User’s Guide gives the data format. 4.3.2 Satellite Areal Extent of Snow Cover by Basin/Zone (MCI/AFOS-ASCII) Alphanumeric...acres) of lake shore land in the snowbelt and this perennial vine is susceptible to winter cold damage. County extension agents indicated that winter

Guide to thoracic imaging.

PubMed

Skinner, Sarah

2015-08-01

Thoracic imaging is commonly ordered in general practice. Guidelines exist for ordering thoracic imaging but few are specific for general practice. This article summarises current indications for imaging the thorax with chest X-ray and computed tomography. A simple frame-work for interpretation of the chest X-ray, suitable for trainees and practitioners providing primary care imaging in rural and remote locations, is presented. Interpretation of thoracic imaging is best done using a systematic approach. Radiological investigation is not warranted in un-complicated upper respiratory tract infections or asthma, minor trauma or acute-on-chronic chest pain.

Utility of blind forceps biopsy of the main carina and upper-lobe carina in patients with non-small cell lung cancer.

PubMed

Gunen, H; Kizkin, O; Tahaoglu, C; Aktas, O

2001-02-01

Preoperative detection of non-small cell lung cancer (NSCLC) metastasis to the main carina and upper-lobe carina can alter the operative approach, preclude further staging procedures, and save many patients from thoracotomy. This study assessed whether bronchoscopic forceps biopsy of the normal-appearing main carina and upper-lobe carina (blind biopsy) ipsilateral to the primary NSCLC lesion improved the accuracy of cancer staging and helped guide the management of these patients. A prospective study of 52 patients was carried out at the SSK Süreyyapasa Center for Chest Disease and Cardiothoracic Surgery. Over a 6-month period, we bronchoscopically evaluated 52 consecutive NSCLC patients who were radiologically classified as operable. At least five blind forceps biopsy specimens were obtained from the main carina and/or upper-lobe carina during each patient's initial fiberoptic bronchoscopic examination. Biopsy specimens were collected from the main carina and upper-lobe carina in 51 and 17 patients, respectively. Initially, all patients were staged and evaluated for operability in standard fashion, without histologic assessment of the blind biopsy specimens. We then restaged the disease and reassessed the patients' operability in light of the biopsy findings. Metastasis was histologically diagnosed in seven patients (13.7%) who underwent main carina biopsy and in four patients (23.5%) who underwent upper-lobe carina biopsy. Cancer-positive blind biopsy results changed the status of 25% (6 of 24) of patients from operable to inoperable, and changed the surgical approach in 11.1% (2 of 18) of patients who ultimately did undergo surgery. We found no statistical relationship between metastasis to either carina and tumor type, stage of disease, visibility of the tumor on fiberoptic bronchoscopy, primary tumor location, T status, or N status (p > 0.05). A blind forceps biopsy of the main carina and upper-lobe carina ipsilateral to the lesion site should be done routinely at initial bronchoscopic examination of all radiologically operable patients with suspected lung cancer. This type of screening can save a significant number of NSCLC patients from inappropriate or unnecessary thoracotomy and further staging procedures with their associated morbidity and risk.

Individualized 3D printing navigation template for pedicle screw fixation in upper cervical spine

PubMed Central

Guo, Fei; Dai, Jianhao; Zhang, Junxiang; Ma, Yichuan; Zhu, Guanghui; Shen, Junjie; Niu, Guoqi

2017-01-01

Purpose Pedicle screw fixation in the upper cervical spine is a difficult and high-risk procedure. The screw is difficult to place rapidly and accurately, and can lead to serious injury of spinal cord or vertebral artery. The aim of this study was to design an individualized 3D printing navigation template for pedicle screw fixation in the upper cervical spine. Methods Using CT thin slices data, we employed computer software to design the navigation template for pedicle screw fixation in the upper cervical spine (atlas and axis). The upper cervical spine models and navigation templates were produced by 3D printer with equal proportion, two sets for each case. In one set (Test group), pedicle screws fixation were guided by the navigation template; in the second set (Control group), the screws were fixed under fluoroscopy. According to the degree of pedicle cortex perforation and whether the screw needed to be refitted, the fixation effects were divided into 3 types: Type I, screw is fully located within the vertebral pedicle; Type II, degree of pedicle cortex perforation is <1 mm, but with good internal fixation stability and no need to renovate; Type III, degree of pedicle cortex perforation is >1 mm or with the poor internal fixation stability and in need of renovation. Type I and Type II were acceptable placements; Type III placements were unacceptable. Results A total of 19 upper cervical spine and 19 navigation templates were printed, and 37 pedicle screws were fixed in each group. Type I screw-placements in the test group totaled 32; Type II totaled 3; and Type III totaled 2; with an acceptable rate of 94.60%. Type I screw placements in the control group totaled 23; Type II totaled 3; and Type III totaled 11, with an acceptable rate of 70.27%. The acceptability rate in test group was higher than the rate in control group. The operation time and fluoroscopic frequency for each screw were decreased, compared with control group. Conclusion The individualized 3D printing navigation template for pedicle screw fixation is easy and safe, with a high success rate in the upper cervical spine surgery. PMID:28152039

Individualized 3D printing navigation template for pedicle screw fixation in upper cervical spine.

PubMed

Guo, Fei; Dai, Jianhao; Zhang, Junxiang; Ma, Yichuan; Zhu, Guanghui; Shen, Junjie; Niu, Guoqi

2017-01-01

Pedicle screw fixation in the upper cervical spine is a difficult and high-risk procedure. The screw is difficult to place rapidly and accurately, and can lead to serious injury of spinal cord or vertebral artery. The aim of this study was to design an individualized 3D printing navigation template for pedicle screw fixation in the upper cervical spine. Using CT thin slices data, we employed computer software to design the navigation template for pedicle screw fixation in the upper cervical spine (atlas and axis). The upper cervical spine models and navigation templates were produced by 3D printer with equal proportion, two sets for each case. In one set (Test group), pedicle screws fixation were guided by the navigation template; in the second set (Control group), the screws were fixed under fluoroscopy. According to the degree of pedicle cortex perforation and whether the screw needed to be refitted, the fixation effects were divided into 3 types: Type I, screw is fully located within the vertebral pedicle; Type II, degree of pedicle cortex perforation is <1 mm, but with good internal fixation stability and no need to renovate; Type III, degree of pedicle cortex perforation is >1 mm or with the poor internal fixation stability and in need of renovation. Type I and Type II were acceptable placements; Type III placements were unacceptable. A total of 19 upper cervical spine and 19 navigation templates were printed, and 37 pedicle screws were fixed in each group. Type I screw-placements in the test group totaled 32; Type II totaled 3; and Type III totaled 2; with an acceptable rate of 94.60%. Type I screw placements in the control group totaled 23; Type II totaled 3; and Type III totaled 11, with an acceptable rate of 70.27%. The acceptability rate in test group was higher than the rate in control group. The operation time and fluoroscopic frequency for each screw were decreased, compared with control group. The individualized 3D printing navigation template for pedicle screw fixation is easy and safe, with a high success rate in the upper cervical spine surgery.

Palliative management of malignant upper urinary tract obstruction

PubMed Central

Sountoulides, P; Mykoniatis, I; Dimasis, N

2014-01-01

Malignancies of the genitourinary tract are diagnosed with increased frequency compared to the past. Currently prostate and bladder cancer account for the majority of urological malignancies. While for prostate cancer recent developments in the management of local and metastatic disease are likely to lead the majority of patients to either cure from the disease or to longer survival time, for bladder cancer advanced disease will unfortunately lead to death within months. However, the common clinical scenario in both prostate and bladder cancer includes, in high incidence, upper urinary tract obstruction in the advanced stages of these malignancies. This coupled with the fact that average life expectancy in the western world is increasing, will result in a significant patient population with either advanced, non-curable disease or with problems related to the received therapeutic surgical or medical interventions. There is no doubt that in both circumstances the room and role of palliation therapy is increasing. The care of patients with advanced urologic malignancies requires a multi-disciplinary effort from physicians of many specialties under the guiding role of the treating urologist. This review focuses on currently available palliative therapeutic options for upper urinary tract obstruction in the setting of patients with advanced malignancies of the urinary tract, as recently significant advancements have been witnessed in this field. PMID:26052193

Palliative management of malignant upper urinary tract obstruction.

PubMed

Sountoulides, P; Mykoniatis, I; Dimasis, N

2014-01-01

Malignancies of the genitourinary tract are diagnosed with increased frequency compared to the past. Currently prostate and bladder cancer account for the majority of urological malignancies. While for prostate cancer recent developments in the management of local and metastatic disease are likely to lead the majority of patients to either cure from the disease or to longer survival time, for bladder cancer advanced disease will unfortunately lead to death within months. However, the common clinical scenario in both prostate and bladder cancer includes, in high incidence, upper urinary tract obstruction in the advanced stages of these malignancies. This coupled with the fact that average life expectancy in the western world is increasing, will result in a significant patient population with either advanced, non-curable disease or with problems related to the received therapeutic surgical or medical interventions. There is no doubt that in both circumstances the room and role of palliation therapy is increasing. The care of patients with advanced urologic malignancies requires a multi-disciplinary effort from physicians of many specialties under the guiding role of the treating urologist. This review focuses on currently available palliative therapeutic options for upper urinary tract obstruction in the setting of patients with advanced malignancies of the urinary tract, as recently significant advancements have been witnessed in this field.

A strategy for computer-assisted mental practice in stroke rehabilitation.

PubMed

Gaggioli, Andrea; Meneghini, Andrea; Morganti, Francesca; Alcaniz, Mariano; Riva, Giuseppe

2006-12-01

To investigate the technical and clinical viability of using computer-facilitated mental practice in the rehabilitation of upper-limb hemiparesis following stroke. A single-case study. Academic-affiliated rehabilitation center. A 46-year-old man with stable motor deficit of the upper right limb following subcortical ischemic stroke. Three computer-enhanced mental practice sessions per week at the rehabilitation center, in addition to usual physical therapy. A custom-made virtual reality system equipped with arm-tracking sensors was used to guide mental practice. The system was designed to superimpose over the (unseen) paretic arm a virtual reconstruction of the movement registered from the nonparetic arm. The laboratory intervention was followed by a 1-month home-rehabilitation program, making use of a portable display device. Pretreatment and posttreatment clinical assessment measures were the upper-extremity scale of the Fugl-Meyer Assessment of Sensorimotor Impairment and the Action Research Arm Test. Performance of the affected arm was evaluated using the healthy arm as the control condition. The patient's paretic limb improved after the first phase of intervention, with modest increases after home rehabilitation, as indicated by functional assessment scores and sensors data. Results suggest that technology-supported mental training is a feasible and potentially effective approach for improving motor skills after stroke.

Diffusion Influenced Adsorption Kinetics.

PubMed

Miura, Toshiaki; Seki, Kazuhiko

2015-08-27

When the kinetics of adsorption is influenced by the diffusive flow of solutes, the solute concentration at the surface is influenced by the surface coverage of solutes, which is given by the Langmuir-Hinshelwood adsorption equation. The diffusion equation with the boundary condition given by the Langmuir-Hinshelwood adsorption equation leads to the nonlinear integro-differential equation for the surface coverage. In this paper, we solved the nonlinear integro-differential equation using the Grünwald-Letnikov formula developed to solve fractional kinetics. Guided by the numerical results, analytical expressions for the upper and lower bounds of the exact numerical results were obtained. The upper and lower bounds were close to the exact numerical results in the diffusion- and reaction-controlled limits, respectively. We examined the validity of the two simple analytical expressions obtained in the diffusion-controlled limit. The results were generalized to include the effect of dispersive diffusion. We also investigated the effect of molecular rearrangement of anisotropic molecules on surface coverage.

Development of the Korean Academy of Medical Sciences Guideline for Rating the Impairment in the Brain Injured and Brain Diseased Persons with Motor Dysfunction

PubMed Central

Baik, Jong Sam; Jang, Seong Ho; Park, Dong Sik

2009-01-01

To develop an objective and scientific method to evaluate the brain injured and brain diseased persons with motor dysfunction, American Medical Association's Guides to the Evaluation of Permanent Impairment was used as an exemplar. After the motor dysfunction due to brain injury or brain disease was confirmed, active range of motion and muscle strength of affected extremities were measured. Also, the total function of extremities was evaluated through the assessment of activities of daily living, fine coordination of hand, balance and gait. Then, the total score of manual muscle test and functional assessment of impaired upper and lower extremity were added, respectively. Spasticity of upper and lower extremity was used as minus factors. Patients with movement disorder such as Parkinson's disease were assessed based on the degree of dysfunction in response to medication. We develop a new rating system based on the concept of total score. PMID:19503680

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

PubMed

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

2016-01-01

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

Screw Placement Accuracy and Outcomes Following O-Arm-Navigated Atlantoaxial Fusion: A Feasibility Study.

PubMed

Smith, Jacob D; Jack, Megan M; Harn, Nicholas R; Bertsch, Judson R; Arnold, Paul M

2016-06-01

Study Design Case series of seven patients. Objective C2 stabilization can be challenging due to the complex anatomy of the upper cervical vertebrae. We describe seven cases of C1-C2 fusion using intraoperative navigation to aid in the screw placement at the atlantoaxial (C1-C2) junction. Methods Between 2011 and 2014, seven patients underwent posterior atlantoaxial fusion using intraoperative frameless stereotactic O-arm Surgical Imaging and StealthStation Surgical Navigation System (Medtronic, Inc., Minneapolis, Minnesota, United States). Outcome measures included screw accuracy, neurologic status, radiation dosing, and surgical complications. Results Four patients had fusion at C1-C2 only, and in the remaining three, fixation extended down to C3 due to anatomical considerations for screw placement recognized on intraoperative imaging. Out of 30 screws placed, all demonstrated minimal divergence from desired placement in either C1 lateral mass, C2 pedicle, or C3 lateral mass. No neurovascular compromise was seen following the use of intraoperative guided screw placement. The average radiation dosing due to intraoperative imaging was 39.0 mGy. All patients were followed for a minimum of 12 months. All patients went on to solid fusion. Conclusion C1-C2 fusion using computed tomography-guided navigation is a safe and effective way to treat atlantoaxial instability. Intraoperative neuronavigation allows for high accuracy of screw placement, limits complications by sparing injury to the critical structures in the upper cervical spine, and can help surgeons make intraoperative decisions regarding complex pathology.

Deep Inspiration Breath Hold—Based Radiation Therapy: A Clinical Review

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

Boda-Heggemann, Judit, E-mail: judit.boda-heggemann@umm.de; Knopf, Antje-Christin; Simeonova-Chergou, Anna

Several recent developments in linear accelerator–based radiation therapy (RT) such as fast multileaf collimators, accelerated intensity modulation paradigms like volumeric modulated arc therapy and flattening filter-free (FFF) high-dose-rate therapy have dramatically shortened the duration of treatment fractions. Deliverable photon dose distributions have approached physical complexity limits as a consequence of precise dose calculation algorithms and online 3-dimensional image guided patient positioning (image guided RT). Simultaneously, beam quality and treatment speed have continuously been improved in particle beam therapy, especially for scanned particle beams. Applying complex treatment plans with steep dose gradients requires strategies to mitigate and compensate for motion effectsmore » in general, particularly breathing motion. Intrafractional breathing-related motion results in uncertainties in dose delivery and thus in target coverage. As a consequence, generous margins have been used, which, in turn, increases exposure to organs at risk. Particle therapy, particularly with scanned beams, poses additional problems such as interplay effects and range uncertainties. Among advanced strategies to compensate breathing motion such as beam gating and tracking, deep inspiration breath hold (DIBH) gating is particularly advantageous in several respects, not only for hypofractionated, high single-dose stereotactic body RT of lung, liver, and upper abdominal lesions but also for normofractionated treatment of thoracic tumors such as lung cancer, mediastinal lymphomas, and breast cancer. This review provides an in-depth discussion of the rationale and technical implementation of DIBH gating for hypofractionated and normofractionated RT of intrathoracic and upper abdominal tumors in photon and proton RT.« less

A contemporary review of management and prognostic factors of upper tract urothelial carcinoma.

PubMed

Leow, Jeffrey J; Orsola, Anna; Chang, Steven L; Bellmunt, Joaquim

2015-04-01

Upper tract urothelial carcinoma (UTUC) accounts for <5% of all urothelial cancers. Although the main treatment is radical nephroureterectomy (NU), oncologic outcomes are not comparable to lower tract urothelial cancers. Identifying prognostic factors can help guide management and potentially improve outcomes. This article systematically reviews current literature on prognostic factors and management options for UTUC. A comprehensive literature search was performed to identify all studies examining prognostic factors and management options for UTUC. The search included the Medline, Embase, Cochrane Central Register of Controlled Trials databases, and abstracts from the American Society of Clinical Oncology meetings up to November 2014. An updated systematic review was performed. Preoperative prognostic factors for UTUC patients include age, race, performance status, obesity, smoking status, elevated fibrinogen levels, hydronephrosis, tumor size, multi-focality, location, clinical grade and previous/synchronous bladder cancer. Postoperative variables include tumor stage/grade, multifocality, nodal involvement, lympho-vascular invasion, initial ureteral location, necrosis, sessile architecture, variant histologies and presence of tissue ALDH1 and SOX2. Curative treatment of choice is NU, with lymphadenectomy conferring survival benefits. Minimally invasive surgery has equivalent oncologic and better peri-operative outcomes compared to open surgery. Conservative therapy includes adjuvant BCG and intravesical mitomycin C. Two randomized trials investigating postoperative instillation of mitomycin C suggest bladder recurrence benefits. Adjuvant chemo-radiotherapy may be useful for patients with advanced T3/4 and/or N+ disease. Gold-standard treatment for UTUC remains NU, increasingly performed using minimally invasive surgery. Nomograms including pre- and post-operative variables can aid prognostication and guide further therapy. Copyright © 2015 Elsevier Ltd. All rights reserved.

Rates of Upper Facet Joint Violation in Minimally Invasive Percutaneous and Open Instrumentation: A Comparative Cohort Study of Different Insertion Techniques.

PubMed

Archavlis, Eleftherios; Amr, Nimer; Kantelhardt, Sven Rainer; Giese, Alf

2018-01-01

 Minimally invasive pedicle screw placement may have a higher incidence of violation of the superior cephalad unfused facet joint.  We investigated the incidence and risk factors of upper facet joint violation in percutaneous robot-assisted instrumentation versus percutaneous fluoroscopy-guided and open transpedicular instrumentation.  A retrospective study including all consecutive patients who underwent lumbar instrumentation, fusion, and decompression for spondylolisthetic stenosis and degenerative disk disease was conducted between January 2012 and January 2016. All operations were performed by the same surgeon; the patients were divided into three groups according to the method of instrumentation. Group 1 involved the robot-assisted instrumentation in 58 patients, group 2 consisted of 64 patients treated with a percutaneous transpedicular instrumentation using fluoroscopic guidance, and 72 patients in group 3 received an open midline approach for pedicle screw insertion.  Superior segment facet joint violation occurred in 2 patients in the robot-assisted group 1 (7%), in 22 of the percutaneous fluoroscopy-guided group 2 (34%), and in 6 cases of the open group (8%). The incidence of facet joint violation was present in 5% (3) of the screws in group 1, 22% (28) of the screws in group 2, and 3% (4) of the screws in group 3.  Meticulous surgical planning of the appropriate entry site (Weinstein's method), trajectory planning, and proper robot-assisted instrumentation of pedicle screws reduced the risk of superior segment facet joint violation. Georg Thieme Verlag KG Stuttgart · New York.

Tai chi for upper limb rehabilitation in stroke patients: the patient's perspective.

PubMed

Desrochers, Pascal; Kairy, Dahlia; Pan, Shujuan; Corriveau, Hélène; Tousignant, Michel

2017-06-01

This study aimed at exploring the perceived benefits and drawbacks of practicing tai chi, an alternative therapy that can be implemented in the community, as part of upper-limb rehabilitation following stroke. Semistructured interviews were carried out with participants with chronic stroke (>6 months). The participants took part in 16 tai chi sessions over 8 weeks. Interviews were conducted in person using an interview guide based on the theory of planned behavior (TPB), and a thematic analysis was conducted. Eight interviews were carried out with participants at various stages of motor recovery. Participants perceived a number of physical, functional, and psychological benefits. They found tai chi to be a global exercise, including both physical and mental aspects, and suggested that it can be included as part of rehabilitation for stroke patients. Many participants expressed a desire to continue practicing tai chi after completion of the study because it exceeded their expectations, among other reasons. This study can serve to guide future tai chi interventions and research on tai chi for rehabilitation in terms of the characteristics of the intervention and the various areas to assess in order to measure the overall benefits. IMPLICATIONS FOR REHABILITATION Tai chi was perceived as a good way of integrating various skills learned during rehabilitation. Despite having different functional abilities, all the participants noted various physical, functional, and psychological benefits from participating in the tai chi sessions. Tai chi seems to be a form of exercise that stroke patients would perform more long-term since all the participants in this study expressed the desire to continue practicing tai chi.

Slab anisotropy from subduction zone guided waves in Taiwan

NASA Astrophysics Data System (ADS)

Chen, K. H.; Tseng, Y. L.; Hu, J. C.

2014-12-01

Frozen-in anisotropic structure in the oceanic lithosphere and faulting/hydration in the upper layer of the slab are expected to play an important role in anisotropic signature of the subducted slab. Over the past several decades, despite the advances in characterizing anisotropy using shear wave splitting method and its developments, the character of slab anisotropy remains poorly understood. In this study we investigate the slab anisotropy using subduction zone guided waves characterized by long path length in the slab. In the southernmost Ryukyu subduction zone, seismic waves from events deeper than 100 km offshore northern Taiwan reveal wave guide behavior: (1) a low-frequency (< 1 Hz) first arrival recognized on vertical and radial components but not transverse component (2) large, sustained high-frequency (3-10 Hz) signal in P and S wave trains. The depth dependent high-frequency content (3-10Hz) confirms the association with a waveguide effect in the subducting slab rather than localized site amplification effects. Using the selected subduction zone guided wave events, we further analyzed the shear wave splitting for intermediate-depth earthquakes in different frequency bands, to provide the statistically meaningful shear wave splitting parameters. We determine shear wave splitting parameters from the 34 PSP guided events that are deeper than 100 km with ray path traveling along the subducted slab. From shear wave splitting analysis, the slab and crust effects reveal consistent polarization pattern of fast directions of EN-WS and delay time of 0.13 - 0.27 sec. This implies that slab anisotropy is stronger than the crust effect (<0.1 s) but weaker than the mantle wedge and sub-slab mantle effect (0.3-1.3 s) in Taiwan.

Is There a Role for Empiric Gastroduodenal Artery Embolization in the Management of Patients with Active Upper GI Hemorrhage?

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

Dixon, Shaheen, E-mail: shaheen7noorani@gmail.com; Chan, Victoria, E-mail: dr.victoriac@gmail.com; Shrivastava, Vivek, E-mail: vivshriv@yahoo.com

2013-08-01

PurposeTo assess the relative efficacy of empiric gastroduodenal artery (GDA) embolization in reducing recurrent hemorrhage compared to image-guided targeted embolization.MethodsData were retrospectively collected for consecutive patients who had catheter angiography for major upper gastrointestinal hemorrhage from May 2008 to November 2010 (n = 40). The total number of cases were divided into two main groups according to angiographic findings: those that demonstrated a site of hemorrhage on catheter angiography (group 1, n = 13), and those where the site of hemorrhage was not identified on catheter angiography (group 2, n = 27). Group 2 was then further divided into patientsmore » who received empiric embolization (group 2a, n = 20) and those who had no embolization performed after angiography (group 2b, n = 7).ResultsThe technical and clinical success rates for embolization in groups 1 and 2a were, respectively, 100 vs. 95 %, and 85 vs. 80 %. There was no statistical significance in the recurrent hemorrhage rate, reintervention rate, or 30 day mortality between targeted and empiric embolization groups. There were no complications attributed to embolization within this study cohort.ConclusionCases of duodenal-related major upper gastrointestinal hemorrhage where no embolization is performed have poor outcome. Empiric embolization of the GDA in patients with major upper gastrointestinal hemorrhage refractory to endoscopic treatment appears to be a safe and effective treatment, with low reintervention rates and good clinical outcome comparable to patients where the site of hemorrhage is localized and embolized with computed tomographic angiography or catheter angiography and embolized.« less

Risk assessment of sleeping disorder breathing based on upper airway centerline evaluation

NASA Astrophysics Data System (ADS)

Alsufyani, Noura; Shen, Rui; Cheng, Irene; Major, Paul

2013-02-01

One of the most important breathing disorders in childhood is obstructive sleep apnea syndrome which affects 2-3% of children, and the reported failure rate of surgical treatment was as high as 54%. A possible reason in respiratory complications is having reduced dimensions of the upper airway which are further compressed when muscle tone is decreased during sleep. In this study, we use Cone-beam computed tomography (CBCT) to assess the location or cause of the airway obstruction. To date, all studies analyzing the upper airway in subjects with Sleeping Disorder Breathing were based on linear, area, or volumetric measurements, which are global computations and can easily ignore local significance. Skeletonization was initially introduced as a 3D modeling technique by which representative medial points of a model are extracted to generate centerlines for evaluations. Although centerlines have been commonly used in guiding surgical procedures, our novelty lies in comparing its geometric properties before and after surgeries. We apply 3D data refinement, registration and projection steps to quantify and localize the geometric deviation in target airway regions. Through cross validation with corresponding subjects' therapy data, we expect to quantify the tolerance threshold beyond which reduced dimensions of the upper airway are not clinically significant. The ultimate goal is to utilize this threshold to identify patients at risk of complications. Outcome from this research will also help establish a predictive model for training and to estimate treatment success based on airway measurements prior to intervention. Preliminary results demonstrate the feasibility of our approach.

Upper limb prosthesis use and abandonment: a survey of the last 25 years.

PubMed

Biddiss, Elaine A; Chau, Tom T

2007-09-01

This review presents an analytical and comparative survey of upper limb prosthesis acceptance and abandonment as documented over the past 25 years, detailing areas of consumer dissatisfaction and ongoing technological advancements. English-language articles were identified in a search of Ovid, PubMed, and ISI Web of Science (1980 until February 2006) for key words upper limb and prosthesis. Articles focused on upper limb prostheses and addressing: (i) Factors associated with abandonment; (ii) Rejection rates; (iii) Functional analyses and patterns of wear; and (iv) Consumer satisfaction, were extracted with the exclusion of those detailing tools for outcome measurement, case studies, and medical procedures. Approximately 200 articles were included in the review process with 40 providing rates of prosthesis rejection. Quantitative measures of population characteristics, study methodology, and prostheses in use were extracted from each article. Mean rejection rates of 45% and 35% were observed in the literature for body-powered and electric prostheses respectively in pediatric populations. Significantly lower rates of rejection for both body-powered (26%) and electric (23%) devices were observed in adult populations while the average incidence of non-wear was similar for pediatric (16%) and adult (20%) populations. Documented rates of rejection exhibit a wide range of variance, possibly due to the heterogeneous samples involved and methodological differences between studies. Future research should comprise of controlled, multifactor studies adopting standardized outcome measures in order to promote comprehensive understanding of the factors affecting prosthesis use and abandonment. An enhanced understanding of these factors is needed to optimize prescription practices, guide design efforts, and satiate demand for evidence-based measures of intervention.

Evaluation of the Leap Motion Controller during the performance of visually-guided upper limb movements.

PubMed

Niechwiej-Szwedo, Ewa; Gonzalez, David; Nouredanesh, Mina; Tung, James

2018-01-01

Kinematic analysis of upper limb reaching provides insight into the central nervous system control of movements. Until recently, kinematic examination of motor control has been limited to studies conducted in traditional research laboratories because motion capture equipment used for data collection is not easily portable and expensive. A recently developed markerless system, the Leap Motion Controller (LMC), is a portable and inexpensive tracking device that allows recording of 3D hand and finger position. The main goal of this study was to assess the concurrent reliability and validity of the LMC as compared to the Optotrak, a criterion-standard motion capture system, for measures of temporal accuracy and peak velocity during the performance of upper limb, visually-guided movements. In experiment 1, 14 participants executed aiming movements to visual targets presented on a computer monitor. Bland-Altman analysis was conducted to assess the validity and limits of agreement for measures of temporal accuracy (movement time, duration of deceleration interval), peak velocity, and spatial accuracy (endpoint accuracy). In addition, a one-sample t-test was used to test the hypothesis that the error difference between measures obtained from Optotrak and LMC is zero. In experiment 2, 15 participants performed a Fitts' type aiming task in order to assess whether the LMC is capable of assessing a well-known speed-accuracy trade-off relationship. Experiment 3 assessed the temporal coordination pattern during the performance of a sequence consisting of a reaching, grasping, and placement task in 15 participants. Results from the t-test showed that the error difference in temporal measures was significantly different from zero. Based on the results from the 3 experiments, the average temporal error in movement time was 40±44 ms, and the error in peak velocity was 0.024±0.103 m/s. The limits of agreement between the LMC and Optotrak for spatial accuracy measures ranged between 2-5 cm. Although the LMC system is a low-cost, highly portable system, which could facilitate collection of kinematic data outside of the traditional laboratory settings, the temporal and spatial errors may limit the use of the device in some settings.

Evaluation of the Leap Motion Controller during the performance of visually-guided upper limb movements

PubMed Central

Gonzalez, David; Nouredanesh, Mina; Tung, James

2018-01-01

Kinematic analysis of upper limb reaching provides insight into the central nervous system control of movements. Until recently, kinematic examination of motor control has been limited to studies conducted in traditional research laboratories because motion capture equipment used for data collection is not easily portable and expensive. A recently developed markerless system, the Leap Motion Controller (LMC), is a portable and inexpensive tracking device that allows recording of 3D hand and finger position. The main goal of this study was to assess the concurrent reliability and validity of the LMC as compared to the Optotrak, a criterion-standard motion capture system, for measures of temporal accuracy and peak velocity during the performance of upper limb, visually-guided movements. In experiment 1, 14 participants executed aiming movements to visual targets presented on a computer monitor. Bland-Altman analysis was conducted to assess the validity and limits of agreement for measures of temporal accuracy (movement time, duration of deceleration interval), peak velocity, and spatial accuracy (endpoint accuracy). In addition, a one-sample t-test was used to test the hypothesis that the error difference between measures obtained from Optotrak and LMC is zero. In experiment 2, 15 participants performed a Fitts’ type aiming task in order to assess whether the LMC is capable of assessing a well-known speed-accuracy trade-off relationship. Experiment 3 assessed the temporal coordination pattern during the performance of a sequence consisting of a reaching, grasping, and placement task in 15 participants. Results from the t-test showed that the error difference in temporal measures was significantly different from zero. Based on the results from the 3 experiments, the average temporal error in movement time was 40±44 ms, and the error in peak velocity was 0.024±0.103 m/s. The limits of agreement between the LMC and Optotrak for spatial accuracy measures ranged between 2–5 cm. Although the LMC system is a low-cost, highly portable system, which could facilitate collection of kinematic data outside of the traditional laboratory settings, the temporal and spatial errors may limit the use of the device in some settings. PMID:29529064

Dielectric image line groove antennas for millimeterwaves

NASA Astrophysics Data System (ADS)

Solbach, K.; Wolff, I.

Grooves in the ground plane of dielectric image lines are proposed as a new radiating structure. A figure is included showing the proposed groove structure as a discontinuity in a dielectric image line. A wave incident on the dielectric image line is partly reflected by the discontinuity, partly transmitted across the groove, and partly radiated into space above the line. In a travelling-wave antenna, a number of grooves are arranged below a dielectric guide, with spacings around one guide wavelength to produce a beam in the upper half space. A prescribed aperture distribution can be effected by tapering the series radiation resistance of the grooves. This can be done by adjusting the depths of the grooves with a constant width or by varying the widths of the grooves with a constant depth. Attention is also given to circular grooves. Here, the widths of the holes are chosen so that they can be considered as waveguides operating far below the cut-off frequency of the fundamental circular waveguide mode.

3D Navigation-guided Resection of Giant Ventral Cervical Intradural Schwannoma With 360-Degree Stabilization.

PubMed

Hussain, Ibrahim; Navarro-Ramirez, Rodrigo; Lang, Gernot; Härtl, Roger

2018-06-01

Giant schwannomas are defined as intradural extramedullary tumors that span >2 vertebral body lengths. Although uncommon, these lesions can cause significant mass effect on the spinal cord and subsequent neurologic compromise. Gross total resection is the goal of operative intervention, however, is extremely challenging in cases where the tumor occupies a ventral, midline position within the lower cervical thecal sac. Using a representative case presentation, we describe an adult male with insidious progression of upper extremity radicular pain and paresthesias, found to have a ventral, solid/cystic C5-C7 giant schwannoma. We demonstrate the step-by-step surgical technique for an anterior approach 2-level cervical corpectomy, microsurgical resection of an intradural giant schwannoma, watertight dural closure, and lastly 360-degrees instrumented stabilization of the cervicothoracic spine. In addition we incorporate the utilization of a portable intraoperative computed tomography for stereotactic localization and 3-dimensional navigation-guided screw implantation. Finally, we discuss various preoperative, perioperative, and postoperative considerations that can have profound impact on successful outcomes.

Ultra-broadband and wide-angle perfect absorber based on composite metal-semiconductor grating

NASA Astrophysics Data System (ADS)

Li, Xu; Wang, Zongpeng; Hou, Yumin

2018-01-01

In this letter, we present an ultra-broadband and wide-angle perfect absorber based on composite Ge-Ni grating. Near perfect absorption above 90% is achieved in a wide frequency range from 150 nm to 4200 nm, which covers almost the full spectrum of solar radiation. The absorption keeps robust in a wide range of incident angle from 0º to 60º. The upper triangle Ge grating works as an antireflection coating. The lower Ni grating works as a reflector and an effective energy trapper. The guided modes inside Ge grating are excited due to reflection of the lower Ni grating surface. In longer wavelength band, gap surface plasmons (GSPs) in the Ni grating are excited and couple with the guided modes inside the Ge grating. The coupled modes extend the perfect absorption band to the near-infrared region (150 nm-4200 nm). This design has potential application in photovoltaic devices and thermal emitters.

Are Evidence Standards Different for Genomic- vs. Clinical-Based Precision Medicine? A Quantitative Analysis of Individualized Warfarin Therapy.

PubMed

Dhanda, D S; Guzauskas, G F; Carlson, J J; Basu, A; Veenstra, D L

2017-11-01

Evidence requirements for implementation of precision medicine (PM), whether informed by genomic or clinical data, are not well defined. Evidence requirements are driven by uncertainty and its attendant consequences; these aspects can be quantified by a novel technique in health economics: value of information analysis (VOI). We utilized VOI analysis to compare the evidence levels over time for warfarin dosing based on pharmacogenomic vs. amiodarone-warfarin drug-drug interaction information. The primary outcome was the expected value of perfect information (EVPI), which is an estimate of the upper limit of the societal value of conducting future research. Over the past decade, the EVPI for the pharmacogenomic strategy decreased from $1,550 to $140 vs. $1,220 to $280 per patient for the drug-interaction strategy. Evidence levels thus appear to be higher for pharmacogenomic-guided vs. drug-interaction-guided warfarin dosing. Clinical guidelines and reimbursement policies for warfarin PM could be informed by these findings. © 2017 American Society for Clinical Pharmacology and Therapeutics.

Evaluating and redesigning teaching learning sequences at the introductory physics level

NASA Astrophysics Data System (ADS)

Guisasola, Jenaro; Zuza, Kristina; Ametller, Jaume; Gutierrez-Berraondo, José

2017-12-01

In this paper we put forward a proposal for the design and evaluation of teaching and learning sequences in upper secondary school and university. We will connect our proposal with relevant contributions on the design of teaching sequences, ground it on the design-based research methodology, and discuss how teaching and learning sequences designed according to our proposal relate to learning progressions. An iterative methodology for evaluating and redesigning the teaching and learning sequence (TLS) is presented. The proposed assessment strategy focuses on three aspects: (a) evaluation of the activities of the TLS, (b) evaluation of learning achieved by students in relation to the intended objectives, and (c) a document for gathering the difficulties found when implementing the TLS to serve as a guide to teachers. Discussion of this guide with external teachers provides feedback used for the TLS redesign. The context of our implementation and evaluation is an innovative calculus-based physics course for first-year engineering and science degree students at the University of the Basque Country.

Intrathecal Spread of Injectate Following an Ultrasound-Guided Selective C5 Nerve Root Injection in a Human Cadaver Model.

PubMed

Falyar, Christian R; Abercrombie, Caroline; Becker, Robert; Biddle, Chuck

2016-04-01

Ultrasound-guided selective C5 nerve root blocks have been described in several case reports as a safe and effective means to anesthetize the distal clavicle while maintaining innervation of the upper extremity and preserving diaphragmatic function. In this study, cadavers were injected with 5 mL of 0.5% methylene blue dye under ultrasound guidance to investigate possible proximal and distal spread of injectate along the brachial plexus, if any. Following the injections, the specimens were dissected and examined to determine the distribution of dye and the structures affected. One injection revealed dye extended proximally into the epidural space, which penetrated the dura mater and was present on the spinal cord and brainstem. Dye was noted distally to the divisions in 3 injections. The anterior scalene muscle and phrenic nerve were stained in all 4 injections. It appears unlikely that local anesthetic spread is limited to the nerve root following an ultrasound-guided selective C5 nerve root injection. Under certain conditions, intrathecal spread also appears possible, which has major patient safety implications. Additional safety measures, such as injection pressure monitoring, should be incorporated into this block, or approaches that are more distal should be considered for the acute pain management of distal clavicle fractures.

A Novel Method for Intraoral Access to the Superior Head of the Human Lateral Pterygoid Muscle

PubMed Central

Oliveira, Aleli Tôrres; Camilo, Anderson Aparecido; Bahia, Paulo Roberto Valle; Carvalho, Antonio Carlos Pires; DosSantos, Marcos Fabio; da Silva, Jorge Vicente Lopes; Monteiro, André Antonio

2014-01-01

Background. The uncoordinated activity of the superior and inferior parts of the lateral pterygoid muscle (LPM) has been suggested to be one of the causes of temporomandibular joint (TMJ) disc displacement. A therapy for this muscle disorder is the injection of botulinum toxin (BTX), of the LPM. However, there is a potential risk of side effects with the injection guide methods currently available. In addition, they do not permit appropriate differentiation between the two bellies of the muscle. Herein, a novel method is presented to provide intraoral access to the superior head of the human LPM with maximal control and minimal hazards. Methods. Computational tomography along with digital imaging software programs and rapid prototyping techniques were used to create a rapid prototyped guide to orient BTX injections in the superior LPM. Results. The method proved to be feasible and reliable. Furthermore, when tested in one volunteer it allowed precise access to the upper head of LPM, without producing side effects. Conclusions. The prototyped guide presented in this paper is a novel tool that provides intraoral access to the superior head of the LPM. Further studies will be necessary to test the efficacy and validate this method in a larger cohort of subjects. PMID:24963484

Seismic Evidence of A Widely Distributed West Napa Fault Zone, Hendry Winery, Napa, California

NASA Astrophysics Data System (ADS)

Goldman, M.; Catchings, R.; Chan, J. H.; Criley, C.

2015-12-01

Following the 24 August 2014 Mw 6.0 South Napa earthquake, surface rupture was mapped along the West Napa Fault Zone (WNFZ) for a distance of ~ 14 km and locally within zones up to ~ 2 km wide. Near the northern end of the surface rupture, however, several strands coalesced to form a narrow, ~100-m-wide zone of surface rupture. To determine the location, width, and shallow (upper few hundred meters) geometry of the fault zone, we acquired an active-source seismic survey across the northern surface rupture in February 2015. We acquired both P- and S-wave data, from which we developed reflection images and tomographic images of Vp, Vs, Vp/Vs, and Poisson's ratio of the upper 100 m. We also used small explosive charges within surface ruptures located ~600 m north of our seismic array to record fault-zone guided waves. Our data indicate that at the latitude of the Hendry Winery, the WNFZ is characterized by at least five fault traces that are spaced 60 to 200 m apart. Zones of low-Vs, low-Vp/Vs, and disrupted reflectors highlight the fault traces on the tomography and reflection images. On peak-ground-velocity (PGV) plots, the most pronounced high-amplitude guided-wave seismic energy coincides precisely with the mapped surface ruptures, and the guided waves also show discrete high PGV zones associated with unmapped fault traces east of the surface ruptures. Although the surface ruptures of the WNFZ were observed only over a 100-m-wide zone at the Hendry Winery, our data indicate that the fault zone is at least 400 m wide, which is probably a minimum width given the 400-m length of our seismic profile. Slip on the WNFZ is generally considered to be low relative to most other Bay Area faults, but we suggest that the West Napa Fault is a zone of widely distributed shear, and to fully account for the total slip on the WNFZ, slip on all traces of this wide fault zone must be considered.

Aerial field guide

NASA Technical Reports Server (NTRS)

Nummedal, D.

1978-01-01

There are two overflights planned for the field conference; one for the Cheney-Palouse tract of the eastern channeled scabland, the other covering the coulees and basins of the western region. The approximate flight lines are indicated on the accompanying LANDSAT images. The first flight will follow the eastern margin of this large scabland tract, passing a series of loess remnants, gravel bars and excavated rock basins. The western scablands overflight will provide a review of the structurally controlled complex pattern of large-scale erosion and deposition characteristic of the region between the upper Grand Coulee (Banks Lake) and the Pasco Basin.

KSC-06pd1886

NASA Image and Video Library

2006-08-18

KENNEDY SPACE CENTER, FLA. - At Astrotech Space Operations in Titusville, Fla., workers help guide the upper portion of the transportation canister onto the lower portion. The canister encases the STEREO spacecraft for its move to Launch Pad 17-B at Cape Canaveral Air Force Station. STEREO stands for Solar Terrestrial Relations Observatory and comprises two spacecraft. The STEREO mission is the first to take measurements of the sun and solar wind in 3-dimension. This new view will improve our understanding of space weather and its impact on the Earth. STEREO is expected to lift off Aug. 31. Photo credit: NASA/Kim Shiflett

Reduced order feedback control equations for linear time and frequency domain analysis

NASA Technical Reports Server (NTRS)

Frisch, H. P.

1981-01-01

An algorithm was developed which can be used to obtain the equations. In a more general context, the algorithm computes a real nonsingular similarity transformation matrix which reduces a real nonsymmetric matrix to block diagonal form, each block of which is a real quasi upper triangular matrix. The algorithm works with both defective and derogatory matrices and when and if it fails, the resultant output can be used as a guide for the reformulation of the mathematical equations that lead up to the ill conditioned matrix which could not be block diagonalized.

Path optimization method for the sign problem

NASA Astrophysics Data System (ADS)

Ohnishi, Akira; Mori, Yuto; Kashiwa, Kouji

2018-03-01

We propose a path optimization method (POM) to evade the sign problem in the Monte-Carlo calculations for complex actions. Among many approaches to the sign problem, the Lefschetz-thimble path-integral method and the complex Langevin method are promising and extensively discussed. In these methods, real field variables are complexified and the integration manifold is determined by the flow equations or stochastically sampled. When we have singular points of the action or multiple critical points near the original integral surface, however, we have a risk to encounter the residual and global sign problems or the singular drift term problem. One of the ways to avoid the singular points is to optimize the integration path which is designed not to hit the singular points of the Boltzmann weight. By specifying the one-dimensional integration-path as z = t +if(t)(f ɛ R) and by optimizing f(t) to enhance the average phase factor, we demonstrate that we can avoid the sign problem in a one-variable toy model for which the complex Langevin method is found to fail. In this proceedings, we propose POM and discuss how we can avoid the sign problem in a toy model. We also discuss the possibility to utilize the neural network to optimize the path.

High spatial resolution dosimetric response maps for radiotherapy ionization chambers measured using kilovoltage synchrotron radiation

NASA Astrophysics Data System (ADS)

Butler, D. J.; Stevenson, A. W.; Wright, T. E.; Harty, P. D.; Lehmann, J.; Livingstone, J.; Crosbie, J. C.

2015-11-01

Small circular beams of synchrotron radiation (0.1 mm and 0.4 mm in diameter) were used to irradiate ionization chambers of the types commonly used in radiotherapy. By scanning the chamber through the beam and measuring the ionization current, a spatial map of the dosimetric response of the chamber was recorded. The technique is able to distinguish contributions to the large-field ionization current from the chamber walls, central electrode and chamber stem. Scans were recorded for the NE 2571 Farmer chamber, the PTW 30013, IBA FC65-G Farmer-type chambers, the NE 2611A and IBA CC13 thimble chambers, the PTW 31006 and 31014 pinpoint chambers, the PTW Roos and Advanced Markus plane-parallel chambers, and the PTW 23342 thin-window soft x-ray chamber. In all cases, large contributions to the response arise from areas where the incident beam grazes the cavity surfaces. Quantitative as well as qualitative information about the relative chamber response was extracted from the maps, including the relative contribution of the central electrode. Line scans using monochromatic beams show the effect of the photon energy on the chamber response. For Farmer-type chambers, a simple Monte Carlo model was in good agreement with the measured response.

Investigation of the piezoelectric thimble tactile device operating modes.

PubMed

Bansevicius, Ramutis; Dragasius, Egidijus; Grigas, Vytautas; Jurenas, Vytautas; Mazeika, Darius; Zvironas, Arunas

2014-01-01

A multifunctional device to transfer graphical or text information for blind or visually impaired is presented. The prototype using tactile perception has been designed where information displayed on the screen of electronic device (mobile phone, PC) is transferred by oscillating needle, touching the fingertip. Having the aim to define optimal parameters of the fingertip excitation by needle, the computational analysis of different excitation modes has been carried out. A 3D solid computational finite element model of the skin segment, comprising four main fingertip skin layers (stratum corneum, epidermis, dermis and hypodermis) was built by using ANSYS Workbench FEA software. Harmonic analysis of its stress-strain state under excitation with different frequency (up to 10000 Hz) and harmonic force (0.01 N), acting outer stratum corneum layer in normal direction at one, two or three points has been performed. The influence of the mode of dynamic loading of skin was evaluated (in terms of the tactile signal level) on the basis of the normal and shear elastic strain in dermis, where mechanoreceptors are placed. It is shown that the tactile perception of information, delivered by three vibrating pins, may be influenced by configuration of excitation points (their number and phase of loading) and the frequency of excitation.

Assessing the Effects of Radiation Damage on Ni-base Alloys for the Prometheus Space Reactor System

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

T. Angeliu

2006-01-19

Ni-base alloys were considered for the Prometheus space reactor pressure vessel with operational parameters of {approx}900 K for 15 years and fluences up to 160 x 10{sup 20} n/cm{sup 2} (E > 0.1 MeV). This paper reviews the effects of irradiation on the behavior of Ni-base alloys and shows that radiation-induced swelling and creep are minor considerations compared to significant embrittlement with neutron ,exposure. While the mechanism responsible for radiation-induced embrittlement is not fully understood, it is likely a combination of helium embrittlement and solute segregation that can be highly dependent on the alloy composition and exposure conditions. Transmutation calculationsmore » show that detrimental helium levels would be expected at the end of life for the inner safety rod vessel (thimble) and possibly the outer pressure vessel, primarily from high energy (E > 1 MeV) n,{alpha} reactions with {sup 58}Ni. Helium from {sup 10}B is significant only for the outer vessel due to the proximity of the outer vessel to the Be0 control elements. Recommendations for further assessments of the material behavior and methods to minimize the effects of radiation damage through alloy design are provided.« less

Dosimetric characteristics of a new unshielded silicon diode and its application in clinical photon and electron beams.

PubMed

Griessbach, Irmgard; Lapp, Markus; Bohsung, Jörg; Gademann, Günther; Harder, Dietrich

2005-12-01

Shielded p-silicon diodes, frequently applied in general photon-beam dosimetry, show certain imperfections when applied in the small photon fields occurring in stereotactic or intensity modulated radiotherapy (IMRT), in electron beams and in the buildup region of photon beam dose distributions. Using as a study object the shielded p-silicon diode PTW 60008, well known for its reliable performance in general photon dosimetry, we have identified these imperfections as effects of electron scattering at the metallic parts of the shielding. In order to overcome these difficulties a new, unshielded diode PTW 60012 has been designed and manufactured by PTW Freiburg. By comparison with reference detectors, such as thimble and plane-parallel ionization chambers and a diamond detector, we could show the absence of these imperfections. An excellent performance of the new unshielded diode for the special dosimetric tasks in small photon fields, electron beams and build-up regions of photon beams has been observed. The new diode also has an improved angular response. However, due to its over-response to low-energy scattered photons, its recommended range of use does not include output factor measurements in large photon fields, although this effect can be compensated by a thin auxiliary lead shield.

[Combination of periodontal, orthodontic and endodontic therapy in upper anterior teeth with hopeless prognosis and long-time follow-up: a case report].

PubMed

Li, Y; Xu, L; Zhou, Y H; Ouyang, X Y; Cao, T

2017-08-18

It is complicated to decide the treatment plan of hopeless anterior teeth in esthetic zone due to severe periodontitis, periodontal-endodontic combined lesion or teeth trauma. The optional treatment plan for this kind of teeth includes retention after periodontal treatment, extraction and implant treatment, extraction and prosthodontic treatment and so on. To make an appropriate treatment plan, patients' periodontal conditions, periodontal biotype, local anatomy, esthetic demand, economic condition and social psychological status should be comprehensively considered. A combine of periodontal, endodontic and orthodontic therapy may achieve a good treatment effect in hopeless anterior teeth with severe periodontal destruction, tooth extrusion and occlusal trauma. In this case, a 20-year-old female who presented with symptoms of bleeding on brushing and upper incisors loosening for 1 month came to the Department of Periodontology, Peking University School and Hospital of Stomatology. The clinical examinations revealed that the patient's right upper incisor had signs of mobility (III°), intrusion of 1-2 mm, and probing depth (PD) of 9-10 mm. The periapical radiograph showed that the alveolar bone of right upper incisor absorbed horizontally to the apex. And the patients showed Angle II° malocclusion with II° overbite in anterior teeth and maxillary protrusion. A diagnosis of aggressive periodontitis and Angle II° malocclusion was made. The treatment of this patient lasts for 5 years which include periodontal initial therapy, orthodontic therapy, guided tissue regeneration (GTR) of right upper incisor and supportive periodontal therapy and the clinical result is fine. A hopeless upper incisor was successfully retained and the longtime clinical condition was stable. The strategy of retention of hopeless upper anterior teeth, the relationship of periodontal treatment and orthodontic treatment, and the indications of periodontal and orthodontic combined therapy were also discussed on the basis of this case. Generally, the positive factors in retention of hopeless teeth includes young age, absence of systemic conditions, strong motivation for maintaining the tooth, single root anatomy, integrated dentition, good response to cause-related therapy, intrabony alveolar bone defect, thick periodontal biotype, and regular supportive periodontal therapy. And in the progress of orthodontic therapy, regular supportive periodontal therapy and good plaque control is extremely important.

COMPLETE - a school-based intervention project to increase completion of upper secondary school in Norway: study protocol for a cluster randomized controlled trial.

PubMed

Larsen, T; Urke, H B; Holsen, I; Anvik, C H; Olsen, T; Waldahl, R H; Antonsen, K M; Johnson, R; Tobro, M; Brastad, B; Hansen, T B

2018-03-09

Drop out from upper secondary school represents a risk for the future health and wellbeing of young people. Strengthening of psychosocial aspects of the learning environment may be an effective strategy to promote completion of upper secondary school. This paper is a study protocol of a school based cluster randomized controlled trial (RCT) evaluating two school-based interventions, namely the Dream School Program (DSP) and the Mental Health Support Team (MHST). The interventions aim to improve psychosocial learning environments and subsequently school achievements and decrease drop-out and absence. The COMPLETE RCT is aimed at youth in upper secondary school, grade 1 (age 15-16 years), and examines the effect of the combination of the DSP and the MHST; and the DSP only, compared with a comparison group on the following primary outcomes: student completion, presence, average grade, and self-reported mental health. Seventeen upper secondary schools from four counties in Norway were randomized to one of the three arms: 1) DSP and MHST; 2) DSP; and 3) comparison (offered DSP intervention in 2018/2019). The study will evaluate the interventions based on information from two cohorts of students (cohort 1 (C1) and cohort 2 (C2)). For C1, data was collected at baseline (August 2016), and at first follow-up seven months later. Second follow-up will be collected 19 months after baseline. For C2, data was collected at baseline (August 2017), and first and second follow-up will be collected similarly to that of C2 seven and 19 months respectively after baseline. Process evaluations based on focus groups, interviews and observation will be conducted twice (first completed spring 2017). The COMPLETE trial is a large study that can provide useful knowledge about what interventions might effectively improve completion of upper secondary school. Its thorough process evaluation will provide critical information about barriers and points of improvement for optimizing intervention implementation. Findings can guide school development in the perspective of improving psychosocial learning environments and subsequent completion of upper secondary schooling. The trial was retrospectively registered in the ClinicalTrials.gov register on December 22.2017: NCT03382080 .

Cortical motor activity and reorganization following upper-limb amputation and subsequent targeted reinnervation.

PubMed

Chen, Albert; Yao, Jun; Kuiken, Todd; Dewald, Julius P A

2013-01-01

Previous studies have postulated that the amount of brain reorganization following peripheral injuries may be correlated with negative symptoms or consequences. However, it is unknown whether restoring effective limb function may then be associated with further changes in the expression of this reorganization. Recently, targeted reinnervation (TR), a surgical technique that restores a direct neural connection from amputated sensorimotor nerves to new peripheral targets such as muscle, has been successfully applied to upper-limb amputees. It has been shown to be effective in restoring both peripheral motor and sensory functions via the reinnervated nerves as soon as a few months after the surgery. However, it was unclear whether TR could also restore normal cortical motor representations for control of the missing limb. To answer this question, we used high-density electroencephalography (EEG) to localize cortical activity related to cued motor tasks generated by the intact and missing limb. Using a case study of 3 upper-limb amputees, 2 of whom went through pre and post-TR experiments, we present unique quantitative evidence for the re-mapping of motor representations for the missing limb closer to their original locations following TR. This provides evidence that an effective restoration of peripheral function from TR can be linked to the return of more normal cortical expression for the missing limb. Therefore, cortical mapping may be used as a potential guide for monitoring rehabilitation following peripheral injuries.

Alternative method for predicting optimal insertion depth of the laryngeal tube in children.

PubMed

Kim, J T; Jeon, S Y; Kim, C S; Kim, S D; Kim, H S

2007-11-01

Little information is available about the accuracy of the teeth mark on the laryngeal tube (LT) as a guide to correct placement in children. The aim of this crossover study was to evaluate three methods for optimal insertion depth of the size (#) 2 tube in children weighing 12-25 kg. In 24 children, the LT #2 was consecutively inserted by three different methods: (A) until the thick teeth mark on the tube was aligned with the upper incisors, (B) until resistance was felt, and (C) by inserting to a depth, previously measured, of the curved distance between the cricoid cartilage and the upper incisor. In each case, the depth of insertion, the degree of effective ventilation, the presence of leakage, and the fibreoptic view were assessed. Insertion based on the teeth mark led to a shorter insertion depth and a greater incidence of inadequate ventilation compared with the other two methods. There was no difference in the adequacy of ventilation between methods B and C. The vocal cords were more easily identified with methods B (62.5%) and C (75%) than with method A (12.5%). Insertion of the LT #2 aligned with the teeth mark can result in a shallow insertion depth and inadequate ventilation. The measured distance from the cricoid cartilage to the upper incisor offers alternative guidance for correct LT insertion.

The late Cenomanian oyster Lopha staufferi (Bergquist, 1944) - the oldest ribbed oyster in the Upper Cretaceous of the Western Interior of the United States

NASA Astrophysics Data System (ADS)

Hook, Stephen C.; Cobban, William A.

2016-12-01

Lopha staufferi (Bergquist, 1944) is a medium-sized, ribbed, Late Cretaceous oyster with a slightly curved axis and a zigzag commissure; it appears suddenly and conspicuously in upper Cenomanian rocks in the Western Interior Basin of the United States. At maturity, the ribs on both valves thicken into steep flanks that allow the oyster to increase interior volume without increasing its exterior footprint on the seafloor. Lopha staufferi is the first (earliest) ribbed oyster in the Late Cretaceous of the Western Interior, but has no ancestor in the basin. It disappears from the rock record as suddenly as it appeared, leaving no direct descendent in the basin. In the southern part of the basin where it is well constrained, L. staufferi is restricted stratigraphically to the upper Cenomanian Metoicoceras mosbyense Zone (= Dunveganoceras conditum Zone in the north). Lopha staufferi has an unusual paleogeographic distribution, occurring in only two, widely scattered areas in the basin. It has been found at several localities near the western shoreline of the Late Cretaceous Seaway in west-central New Mexico and adjacent Arizona, and in localities 1,900 km (1,200 mi) to the northeast near the eastern shoreline in northeastern Minnesota, but nowhere in between. In west-central New Mexico and adjacent Arizona, L. staufferi is a guide fossil to the Twowells Tongue of the Dakota Sandstone.

Contrasting upper-mantle shear wave anisotropy across the transpressive Queen Charlotte margin

NASA Astrophysics Data System (ADS)

Cao, Lingmin; Kao, Honn; Wang, Kelin

2017-10-01

In order to investigate upper mantle and crustal anisotropy along the transpressive Queen Charlotte margin between the Pacific (PA) and North America (NA) plates, we conducted shear wave splitting analyses using 17 seismic stations in and around the island of Haida Gwaii, Canada. Despite the limited station coverage at present, our reconnaissance study does reveal a systematic pattern of mantle anisotropy in this region. Fast directions derived from teleseismic SKS-phase splitting are mostly margin-parallel (NNW-SSE) near the plate boundary but transition to predominantly E-W-trending farther away. We propose that the former is associated with the absolute motion of PA, and the latter reflects a transition from this direction to that of the absolute motion of NA. The broad width of the zone of transition from the PA to NA direction is probably caused by the very obliquely subducting PA slab that travels primarily in the margin-parallel direction. Anisotropy of Haida Gwaii based on local earthquakes features a fast direction that cannot be explained with regional stresses and is probably associated with local structural fabric within the overriding crust. Our preliminary shear wave splitting measurements and working hypotheses based on them will serve to guide more refined future studies to unravel details of the geometry and kinematics of the subducted PA slab, as well as the viscous coupling between the slab and upper mantle in other transpressive margins.

[Guide for the use of jet-ventilation during ENT and oral surgery].

PubMed

Bourgain, J-L; Chollet, M; Fischler, M; Gueret, G; Mayne, A

2010-10-01

The aim of this synthesis was to give recommendations on the use of jet-ventilation during ENT surgical and endoscopy procedures. Literature was collected from PUBMED and analysed by the members of French association of anaesthesiologists in ENT surgery, all skilled in this field. Presentation of these recommendations was given during the general assembly held in Reims, the 15th May 2009. Jet-ventilation is especially indicated during upper airway endoscopy and laryngeal invasive endoscopic surgery. Furthermore, transtracheal jet ventilation is included on most of difficult oxygenation and difficult intubation algorithm. The main risk of jet-ventilation is pulmonary barotrauma when expiration of injected gas is impeded by an upper airway obstruction. Failure and complications of tracheal puncture are rare when performed by experimented operators. Clinical use of jet ventilation requires a dedicated device. Practice of jet ventilation without intubation may be dangerous when applied without control of driving pressure and end expiratory tracheal pressure. Every anaesthetist should be familiar with transtracheal ventilation since they may face a "cannot ventilate cannot intubate" situation. Upper airway endoscopy and laryngeal surgery are the ideal field for training jet ventilation, even more so as this technique offers perfect operative conditions. To apply this project, jet ventilation should be used more frequently in routine practice. To maintain skill, regular use of these techniques is required. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Appearance of burning abdominal pain during cesarean section under spinal anesthesia in a patient with complex regional pain syndrome: a case report.

PubMed

Kato, Jitsu; Gokan, Dai; Hirose, Noriya; Iida, Ryoji; Suzuki, Takahiro; Ogawa, Setsuro

2013-02-01

The mechanism of complex regional pain syndrome (CRPS) was reported as being related to both the central and peripheral nervous systems. Recurrence of CRPS was, reportedly, induced by hand surgery in a patient with upper limb CRPS. However, there is no documentation of mechanical allodynia and burning abdominal pain induced by Cesarean section under spinal anesthesia in patients with upper limb CRPS. We report the case of a patient who suffered from burning abdominal pain during Cesarean section under spinal anesthesia 13 years after the occurrence of venipuncture-induced CRPS of the upper arm. The patient's pain characteristics were similar to the pain characteristics of her right arm during her previous CRPS episode 13 years earlier. In addition, mechanical allodynia around the incision area was confirmed after surgery. We provided ultrasound-guided rectus sheath block using 20 mL of 0.4% ropivacaine under ultrasound guidance twice, which resulted in the disappearance of the spontaneous pain and allodynia. The pain relief was probably related to blockade of the peripheral input by this block, which in turn would have improved her central sensitization. Our report shows that attention should be paid to the appearance of neuropathic pain of the abdomen during Cesarean section under spinal anesthesia in patients with a history of CRPS. Wiley Periodicals, Inc.

Diagnostic and therapeutic direct peroral cholangioscopy using an intraductal anchoring balloon

PubMed Central

Parsi, Mansour A; Stevens, Tyler; Vargo, John J

2012-01-01

AIM: To report our experience using a recently introduced anchoring balloon for diagnostic and therapeutic direct peroral cholangioscopy (DPOC). METHODS: Consecutive patients referred for diagnostic or therapeutic peroral cholangioscopy were evaluated in a prospective cohort study. The patients underwent DPOC using an intraductal anchoring balloon, which was recently introduced to allow consistent access to the biliary tree with an ultraslim upper endoscope. The device was later voluntarily withdrawn from the market by the manufacturer. RESULTS: Fourteen patients underwent DPOC using the anchoring balloon. Biliary access with an ultraslim upper endoscope was accomplished in all 14 patients. In 12 (86%) patients, ductal access required sphincteroplasty with a 10-mm dilating balloon. Intraductal placement of the ultraslim upper endoscope allowed satisfactory visualization of the biliary mucosa to the level of the confluence of the right and left hepatic ducts in 13 of 14 patients (93%). Therapeutic interventions by DPOC were successfully completed in all five attempted cases (intraductal biopsy in one and DPOC guided laser lithotripsy in four). Adverse events occurred in a patient on immunosuppressive therapy who developed an intrahepatic biloma at the site of the anchoring balloon. This required hospitalization and antibiotics. Repeat endoscopic retrograde cholangiopancreatography 8 wk after the index procedure showed resolution of the biloma. CONCLUSION: Use of this anchoring balloon allowed consistent access to the biliary tree for performance of diagnostic and therapeutic DPOC distal to the biliary bifurcation. PMID:22912549

Diagnostic and therapeutic direct peroral cholangioscopy using an intraductal anchoring balloon.

PubMed

Parsi, Mansour A; Stevens, Tyler; Vargo, John J

2012-08-14

To report our experience using a recently introduced anchoring balloon for diagnostic and therapeutic direct peroral cholangioscopy (DPOC). Consecutive patients referred for diagnostic or therapeutic peroral cholangioscopy were evaluated in a prospective cohort study. The patients underwent DPOC using an intraductal anchoring balloon, which was recently introduced to allow consistent access to the biliary tree with an ultraslim upper endoscope. The device was later voluntarily withdrawn from the market by the manufacturer. Fourteen patients underwent DPOC using the anchoring balloon. Biliary access with an ultraslim upper endoscope was accomplished in all 14 patients. In 12 (86%) patients, ductal access required sphincteroplasty with a 10-mm dilating balloon. Intraductal placement of the ultraslim upper endoscope allowed satisfactory visualization of the biliary mucosa to the level of the confluence of the right and left hepatic ducts in 13 of 14 patients (93%). Therapeutic interventions by DPOC were successfully completed in all five attempted cases (intraductal biopsy in one and DPOC guided laser lithotripsy in four). Adverse events occurred in a patient on immunosuppressive therapy who developed an intrahepatic biloma at the site of the anchoring balloon. This required hospitalization and antibiotics. Repeat endoscopic retrograde cholangiopancreatography 8 wk after the index procedure showed resolution of the biloma. Use of this anchoring balloon allowed consistent access to the biliary tree for performance of diagnostic and therapeutic DPOC distal to the biliary bifurcation.

Laser Guidestar Satellite for Ground-based Adaptive Optics Imaging of Geosynchronous Satellites and Astronomical Targets

NASA Astrophysics Data System (ADS)

Marlow, W. A.; Cahoy, K.; Males, J.; Carlton, A.; Yoon, H.

2015-12-01

Real-time observation and monitoring of geostationary (GEO) satellites with ground-based imaging systems would be an attractive alternative to fielding high cost, long lead, space-based imagers, but ground-based observations are inherently limited by atmospheric turbulence. Adaptive optics (AO) systems are used to help ground telescopes achieve diffraction-limited seeing. AO systems have historically relied on the use of bright natural guide stars or laser guide stars projected on a layer of the upper atmosphere by ground laser systems. There are several challenges with this approach such as the sidereal motion of GEO objects relative to natural guide stars and limitations of ground-based laser guide stars; they cannot be used to correct tip-tilt, they are not point sources, and have finite angular sizes when detected at the receiver. There is a difference between the wavefront error measured using the guide star compared with the target due to cone effect, which also makes it difficult to use a distributed aperture system with a larger baseline to improve resolution. Inspired by previous concepts proposed by A.H. Greenaway, we present using a space-based laser guide starprojected from a satellite orbiting the Earth. We show that a nanosatellite-based guide star system meets the needs for imaging GEO objects using a low power laser even from 36,000 km altitude. Satellite guide star (SGS) systemswould be well above atmospheric turbulence and could provide a small angular size reference source. CubeSatsoffer inexpensive, frequent access to space at a fraction of the cost of traditional systems, and are now being deployed to geostationary orbits and on interplanetary trajectories. The fundamental CubeSat bus unit of 10 cm cubed can be combined in multiple units and offers a common form factor allowing for easy integration as secondary payloads on traditional launches and rapid testing of new technologies on-orbit. We describe a 6U CubeSat SGS measuring 10 cm x 20 cm x 30 cm with laser power on the order of milliwatts, and a commercial off the shelf based attitude determination and control system, among others. Different from standard 1U and 3U buses, the 6U form factor allows for a propulsion system for navigating around multiple targets in the GEO belt.

Ultrasound-guided corticosteroid injection therapy for juvenile idiopathic arthritis: 12-year care experience.

PubMed

Young, Cody M; Shiels, William E; Coley, Brian D; Hogan, Mark J; Murakami, James W; Jones, Karla; Higgins, Gloria C; Rennebohm, Robert M

2012-12-01

Intra-articular corticosteroid injections are a safe and effective treatment for patients with juvenile idiopathic arthritis. The potential scope of care in ultrasound-guided corticosteroid therapy in children and a joint-based corticosteroid dose protocol designed to optimize interdisciplinary care are not found in the current literature. The purpose of this study was to report the spectrum of care, technique and safety of ultrasound-guided corticosteroid injection therapy in patients with juvenile idiopathic arthritis and to propose an age-weight-joint-based corticosteroid dose protocol. A retrospective analysis was performed of 198 patients (ages 21 months to 28 years) referred for treatment of juvenile idiopathic arthritis with corticosteroid therapy. Symptomatic joints and tendon sheaths were treated as prescribed by the referring rheumatologist. An age-weight-joint-based dose protocol was developed and utilized for corticosteroid dose prescription. A total of 1,444 corticosteroid injections (1,340 joints, 104 tendon sheaths) were performed under US guidance. Injection sites included small, medium and large appendicular skeletal joints (upper extremity 497, lower extremity 837) and six temporomandibular joints. For patients with recurrent symptoms, 414 repeat injections were performed, with an average time interval of 17.7 months (range, 0.5-101.5 months) between injections. Complications occurred in 2.6% of injections and included subcutaneous tissue atrophy, skin hypopigmentation, erythema and pruritis. US-guided corticosteroid injection therapy provides dynamic, precise and safe treatment of a broad spectrum of joints and tendon sheaths throughout the entire pediatric musculoskeletal system. An age-weight-joint-based corticosteroid dose protocol is effective and integral to interdisciplinary care of patients with juvenile idiopathic arthritis.

Spiral Orbit Tribometer

NASA Technical Reports Server (NTRS)

Pepper, Stephen V.; Jones, William R., Jr.; Kingsbury, Edward; Jansen, Mark J.

2007-01-01

The spiral orbit tribometer (SOT) bridges the gap between full-scale life testing and typically unrealistic accelerated life testing of ball-bearing lubricants in conjunction with bearing ball and race materials. The SOT operates under realistic conditions and quickly produces results, thereby providing information that can guide the selection of lubricant, ball, and race materials early in a design process. The SOT is based upon a simplified, retainerless thrust bearing comprising one ball between flat races (see figure). The SOT measures lubricant consumption and degradation rates and friction coefficients in boundary lubricated rolling and pivoting contacts. The ball is pressed between the lower and upper races with a controlled force and the lower plate is rotated. The combination of load and rotation causes the ball to move in a nearly circular orbit that is, more precisely, an opening spiral. The spiral s pitch is directly related to the friction coefficient. At the end of the orbit, the ball contacts the guide plate, restoring the orbit to its original radius. The orbit is repeatable throughout the entire test. A force transducer, mounted in-line with the guide plate, measures the force between the ball and the guide plate, which directly relates to the friction coefficient. The SOT, shown in the figure, can operate in under ultra-high vacuum (10(exp -9) Torr) or in a variety of gases at atmospheric pressure. The load force can be adjusted between 45 and 450 N. By varying the load force and ball diameter, mean Hertzian stresses between 0.5 and 5.0 GPa can be obtained. The ball s orbital speed range is between 1 and 100 rpm.

Contribution to the development of a food guide in Benin: linear programming for the optimization of local diets.

PubMed

Levesque, Sarah; Delisle, Hélène; Agueh, Victoire

2015-03-01

Food guides are important tools for nutrition education. While developing a food guide in Benin, the objective was to determine the daily number of servings per food group and the portion sizes of common foods to be recommended. Linear programming (LP) was used to determine, for each predefined food group, the optimal number and size of servings of commonly consumed foods. Two types of constraints were introduced into the LP models: (i) WHO/FAO Recommended Nutrient Intakes and dietary guidelines for the prevention of chronic diseases; and (ii) dietary patterns based on local food consumption data recently collected in southern Benin in 541 adults. Dietary intakes of the upper tertile of participants for diet quality based on prevention and micronutrient adequacy scores were used in the LP algorithms. Southern area of the Republic of Benin. Local key-players in nutrition (n 30) from the government, academic institutions, international organizations and civil society were partners in the development of the food guide directed at the population. The number of servings per food group and the portion size for eight age-sex groups were determined. For four limiting micronutrients (Fe, Ca, folate and Zn), local diets could be optimized to meet only 70 % of the Recommended Nutrient Intakes, not 100 %. It was possible to determine the daily number of servings and the portion sizes of common foods that can be recommended in Benin with the help of LP to optimize local diets, although Recommended Nutrient Intakes were not fully met for a few critical micronutrients.

Guided Endodontic Access in Maxillary Molars Using Cone-beam Computed Tomography and Computer-aided Design/Computer-aided Manufacturing System: A Case Report.

PubMed

Lara-Mendes, Sônia T de O; Barbosa, Camila de Freitas M; Santa-Rosa, Caroline C; Machado, Vinícius C

2018-05-01

The aim of this study was to describe a guided endodontic technique that facilitates access to root canals of molars presenting with pulp calcifications. A 61-year-old woman presented to our service with pain in the upper left molar region. The second and third left molars showed signs of apical periodontitis confirmed by the cone-beam computed tomographic (CBCT) scans brought to us by the patient at the initial appointment. Conventional endodontic treatment was discontinued given the difficulty in locating the root canals. Intraoral scanning and the CBCT scans were used to plan the access to the calcified canals by means of implant planning software. Guides were fabricated through rapid prototyping and allowed for the correct orientation of a cylindrical drill used to provide access through the calcifications. Second to that, the root canals were prepared with reciprocating endodontic instruments and rested for 2 weeks with intracanal medication. Subsequently, canals were packed with gutta-percha cones using the hydraulic compression technique. Permanent restorations of the access cavities were performed. By comparing the tomographic images, the authors observed a drastic reduction of the periapical lesions as well as the absence of pain symptoms after 3 months. This condition was maintained at the 1-year follow-up. The guided endodontic technique in maxillary molars was shown to be a fast, safe, and predictable therapy and can be regarded as an excellent option for the location of calcified root canals, avoiding failures in complex cases. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Computed tomography-guided tissue engineering of upper airway cartilage.

PubMed

Brown, Bryan N; Siebenlist, Nicholas J; Cheetham, Jonathan; Ducharme, Norm G; Rawlinson, Jeremy J; Bonassar, Lawrence J

2014-06-01

Normal laryngeal function has a large impact on quality of life, and dysfunction can be life threatening. In general, airway obstructions arise from a reduction in neuromuscular function or a decrease in mechanical stiffness of the structures of the upper airway. These reductions decrease the ability of the airway to resist inspiratory or expiratory pressures, causing laryngeal collapse. We propose to restore airway patency through methods that replace damaged tissue and improve the stiffness of airway structures. A number of recent studies have utilized image-guided approaches to create cell-seeded constructs that reproduce the shape and size of the tissue of interest with high geometric fidelity. The objective of the present study was to establish a tissue engineering approach to the creation of viable constructs that approximate the shape and size of equine airway structures, in particular the epiglottis. Computed tomography images were used to create three-dimensional computer models of the cartilaginous structures of the larynx. Anatomically shaped injection molds were created from the three-dimensional models and were seeded with bovine auricular chondrocytes that were suspended within alginate before static culture. Constructs were then cultured for approximately 4 weeks post-seeding and evaluated for biochemical content, biomechanical properties, and histologic architecture. Results showed that the three-dimensional molded constructs had the approximate size and shape of the equine epiglottis and that it is possible to seed such constructs while maintaining 75%+ cell viability. Extracellular matrix content was observed to increase with time in culture and was accompanied by an increase in the mechanical stiffness of the construct. If successful, such an approach may represent a significant improvement on the currently available treatments for damaged airway cartilage and may provide clinical options for replacement of damaged tissue during treatment of obstructive airway disease.

Evaluation of the effects of the Arm Light Exoskeleton on movement execution and muscle activities: a pilot study on healthy subjects.

PubMed

Pirondini, Elvira; Coscia, Martina; Marcheschi, Simone; Roas, Gianluca; Salsedo, Fabio; Frisoli, Antonio; Bergamasco, Massimo; Micera, Silvestro

2016-01-23

Exoskeletons for lower and upper extremities have been introduced in neurorehabilitation because they can guide the patient's limb following its anatomy, covering many degrees of freedom and most of its natural workspace, and allowing the control of the articular joints. The aims of this study were to evaluate the possible use of a novel exoskeleton, the Arm Light Exoskeleton (ALEx), for robot-aided neurorehabilitation and to investigate the effects of some rehabilitative strategies adopted in robot-assisted training. We studied movement execution and muscle activities of 16 upper limb muscles in six healthy subjects, focusing on end-effector and joint kinematics, muscle synergies, and spinal maps. The subjects performed three dimensional point-to-point reaching movements, without and with the exoskeleton in different assistive modalities and control strategies. The results showed that ALEx supported the upper limb in all modalities and control strategies: it reduced the muscular activity of the shoulder's abductors and it increased the activity of the elbow flexors. The different assistive modalities favored kinematics and muscle coordination similar to natural movements, but the muscle activity during the movements assisted by the exoskeleton was reduced with respect to the movements actively performed by the subjects. Moreover, natural trajectories recorded from the movements actively performed by the subjects seemed to promote an activity of muscles and spinal circuitries more similar to the natural one. The preliminary analysis on healthy subjects supported the use of ALEx for post-stroke upper limb robotic assisted rehabilitation, and it provided clues on the effects of different rehabilitative strategies on movement and muscle coordination.

Inserting pedicle screws in the upper thoracic spine without the use of fluoroscopy or image guidance. Is it safe?

PubMed

Schizas, Constantin; Theumann, Nicolas; Kosmopoulos, Victor

2007-05-01

Several studies have looked at accuracy of thoracic pedicle screw placement using fluoroscopy, image guidance, and anatomical landmarks. To our knowledge the upper thoracic spine (T1-T6) has not been specifically studied in the context of screw insertion and placement accuracy without the use of either image guidance or fluoroscopy. Our objective was to study the accuracy of upper thoracic screw placement without the use of fluoroscopy or image guidance, and report on implant related complications. A single surgeon inserted 60 screws in 13 consecutive non-scoliotic spine patients. These were the first 60 screws placed in the high thoracic spine in our institution. The most common diagnosis in our patient population was trauma. All screws were inserted using a modified Roy-Camille technique. Post-operative axial computed tomography (CT) images were obtained for each patient and analyzed by an independent senior radiologist for placement accuracy. Implant related complications were prospectively noted. No pedicle screw misplacement was found in 61.5% of the patients. In the remaining 38.5% of patients some misplacements were noted. Fifty-three screws out of the total 60 implanted were placed correctly within all the pedicle margins. The overall pedicle screw placement accuracy was 88.3% using our modified Roy-Camille technique. Five medial and two lateral violations were noted in the seven misplaced screws. One of the seven misplaced screws was considered to be questionable in terms of pedicle perforation. No implant related complications were noted. We found that inserting pedicle screws in the upper thoracic spine based solely on anatomical landmarks was safe with an accuracy comparable to that of published studies using image-guided navigation at the thoracic level.

Comparison of Right and Left Upper Limb Arterial Variants in Patients Undergoing Bilateral Transradial Procedures.

PubMed

Burzotta, Francesco; Brancati, Marta Francesca; Porto, Italo; Saffioti, Silvia; Aurigemma, Cristina; Niccoli, Giampaolo; Leone, Antonio Maria; Coluccia, Valentina; Crea, Filippo; Trani, Carlo

2015-12-01

Transradial approach (TRA), when compared with transfemoral, improves the safety of percutaneous coronary procedures. Arterial axis variants are known to hinder the performance of transradial approach percutaneous coronary procedures. Data on the occurrence of arterial axis variants in the right and left arm arterial axes of individual patients are lacking. From a single-center prospective registry, we selected all patients in whom bilateral upper limb arterial anatomy was assessed based on the performance of left and right radial catheterization obtained during the same or during repeat coronary diagnostic or interventional procedure(s). The occurrence of upper right and left limb arterial axis variants was classified according to the previously described operative ABC classification. A total of 610 patients were identified. An ABC upper limb arterial axis variant was detected in 156 (25.6%) patients. Variants were right-sided only in 65 (11.0%), left-sided only in 40 (6.6%), and bilateral in 46 (7.5%) patients. Thus, arterial axis variants were significantly more common in the right side (P=0.02). Bilateral arterial variants were significantly associated with age, female sex, and valvulopathy. Both A (radial/brachial) and B (axillary/subclavian/innominate) variants exhibited concordance across the 2 sides (odds ratio, 7.2; 95% confidence interval, 4.1-12.7 and 8.0; 95% confidence interval, 2.1-30.9, respectively). The occurrence of an anatomic variant potentially hindering transradial approach coronary diagnostic or interventional procedures is bilateral in <8% of cases and is more common in the right arm. Such information may guide, during the clinical practice, the access selection in the case of repeat procedures or need for additional accesses. © 2015 American Heart Association, Inc.

A Comparative Analysis of Speed Profile Models for Ankle Pointing Movements: Evidence that Lower and Upper Extremity Discrete Movements are Controlled by a Single Invariant Strategy

PubMed Central

Michmizos, Konstantinos P.; Vaisman, Lev; Krebs, Hermano Igo

2014-01-01

Little is known about whether our knowledge of how the central nervous system controls the upper extremities (UE), can generalize, and to what extent to the lower limbs. Our continuous efforts to design the ideal adaptive robotic therapy for the lower limbs of stroke patients and children with cerebral palsy highlighted the importance of analyzing and modeling the kinematics of the lower limbs, in general, and those of the ankle joints, in particular. We recruited 15 young healthy adults that performed in total 1,386 visually evoked, visually guided, and target-directed discrete pointing movements with their ankle in dorsal–plantar and inversion–eversion directions. Using a non-linear, least-squares error-minimization procedure, we estimated the parameters for 19 models, which were initially designed to capture the dynamics of upper limb movements of various complexity. We validated our models based on their ability to reconstruct the experimental data. Our results suggest a remarkable similarity between the top-performing models that described the speed profiles of ankle pointing movements and the ones previously found for the UE both during arm reaching and wrist pointing movements. Among the top performers were the support-bounded lognormal and the beta models that have a neurophysiological basis and have been successfully used in upper extremity studies with normal subjects and patients. Our findings suggest that the same model can be applied to different “human” hardware, perhaps revealing a key invariant in human motor control. These findings have a great potential to enhance our rehabilitation efforts in any population with lower extremity deficits by, for example, assessing the level of motor impairment and improvement as well as informing the design of control algorithms for therapeutic ankle robots. PMID:25505881

Conceptual model of sediment processes in the upper Yuba River watershed, Sierra Nevada, CA

USGS Publications Warehouse

Curtis, J.A.; Flint, L.E.; Alpers, Charles N.; Yarnell, S.M.

2005-01-01

This study examines the development of a conceptual model of sediment processes in the upper Yuba River watershed; and we hypothesize how components of the conceptual model may be spatially distributed using a geographical information system (GIS). The conceptual model illustrates key processes controlling sediment dynamics in the upper Yuba River watershed and was tested and revised using field measurements, aerial photography, and low elevation videography. Field reconnaissance included mass wasting and channel storage inventories, assessment of annual channel change in upland tributaries, and evaluation of the relative importance of sediment sources and transport processes. Hillslope erosion rates throughout the study area are relatively low when compared to more rapidly eroding landscapes such as the Pacific Northwest and notable hillslope sediment sources include highly erodible andesitic mudflows, serpentinized ultramafics, and unvegetated hydraulic mine pits. Mass wasting dominates surface erosion on the hillslopes; however, erosion of stored channel sediment is the primary contributor to annual sediment yield. We used GIS to spatially distribute the components of the conceptual model and created hillslope erosion potential and channel storage models. The GIS models exemplify the conceptual model in that landscapes with low potential evapotranspiration, sparse vegetation, steep slopes, erodible geology and soils, and high road densities display the greatest hillslope erosion potential and channel storage increases with increasing stream order. In-channel storage in upland tributaries impacted by hydraulic mining is an exception. Reworking of stored hydraulic mining sediment in low-order tributaries continues to elevate upper Yuba River sediment yields. Finally, we propose that spatially distributing the components of a conceptual model in a GIS framework provides a guide for developing more detailed sediment budgets or numerical models making it an inexpensive way to develop a roadmap for understanding sediment dynamics at a watershed scale.

Heavy Tail Behavior of Rainfall Extremes across Germany

NASA Astrophysics Data System (ADS)

Castellarin, A.; Kreibich, H.; Vorogushyn, S.; Merz, B.

2017-12-01

Distributions are termed heavy-tailed if extreme values are more likely than would be predicted by probability distributions that have exponential asymptotic behavior. Heavy-tail behavior often leads to surprise, because historical observations can be a poor guide for the future. Heavy-tail behavior seems to be widespread for hydro-meteorological extremes, such as extreme rainfall and flood events. To date there have been only vague hints to explain under which conditions these extremes show heavy-tail behavior. We use an observational data set consisting of 11 climate variables at 1440 stations across Germany. This homogenized, gap-free data set covers 110 years (1901-2010) at daily resolution. We estimate the upper tail behavior, including its uncertainty interval, of daily precipitation extremes for the 1,440 stations at the annual and seasonal time scales. Different tail indicators are tested, including the shape parameter of the Generalized Extreme Value distribution, the upper tail ratio and the obesity index. In a further step, we explore to which extent the tail behavior can be explained by geographical and climate factors. A large number of characteristics is derived, such as station elevation, degree of continentality, aridity, measures for quantifying the variability of humidity and wind velocity, or event-triggering large-scale atmospheric situation. The link between the upper tail behavior and these characteristics is investigated via data mining methods capable of detecting non-linear relationships in large data sets. This exceptionally rich observational data set, in terms of number of stations, length of time series and number of explaining variables, allows insights into the upper tail behavior which is rarely possible given the typical observational data sets available.

Identifying Emergency Department Patients at Low Risk for a Variceal Source of Upper Gastrointestinal Hemorrhage.

PubMed

Klein, Lauren R; Money, Joel; Maharaj, Kaveesh; Robinson, Aaron; Lai, Tarissa; Driver, Brian E

2017-11-01

Assessing the likelihood of a variceal versus nonvariceal source of upper gastrointestinal bleeding (UGIB) guides therapy, but can be difficult to determine on clinical grounds. The objective of this study was to determine if there are easily ascertainable clinical and laboratory findings that can identify a patient as low risk for a variceal source of hemorrhage. This was a retrospective cohort study of adult ED patients with UGIB between January 2008 and December 2014 who had upper endoscopy performed during hospitalization. Clinical and laboratory data were abstracted from the medical record. The source of the UGIB was defined as variceal or nonvariceal based on endoscopic reports. Binary recursive partitioning was utilized to create a clinical decision rule. The rule was internally validated and test characteristics were calculated with 1,000 bootstrap replications. A total of 719 patients were identified; mean age was 55 years and 61% were male. There were 71 (10%) patients with a variceal UGIB identified on endoscopy. Binary recursive partitioning yielded a two-step decision rule (platelet count > 200 × 10 9 /L and an international normalized ratio [INR] < 1.3), which identified patients who were low risk for a variceal source of hemorrhage. For the bootstrapped samples, the rule performed with 97% sensitivity (95% confidence interval [CI] = 91%-100%) and 49% specificity (95% CI = 44%-53%). Although this derivation study must be externally validated before widespread use, patients presenting to the ED with an acute UGIB with platelet count of >200 × 10 9 /L and an INR of <1.3 may be at very low risk for a variceal source of their upper gastrointestinal hemorrhage. © 2017 by the Society for Academic Emergency Medicine.

Pinedale glacial history of the upper Arkansas River valley: New moraine chronologies, modeling results, and geologic mapping

USGS Publications Warehouse

Schweinsberg, Avriel D.; Briner, Jason P.; Shroba, Ralph R.; Licciardi, Joseph M.; Leonard, Eric M.; Brugger, Keith A.; Russell, Charles M.

2016-01-01

This field-trip guide outlines the glacial history of the upper Arkansas River valley, Colorado, and builds on a previous GSA field trip to the area in 2010. The following will be presented: (1) new cosmogenic 10Be exposure ages of moraine boulders from the Pinedale and Bull Lake glaciations (Marine Isotope Stages 2 and 6, respectively) located adjacent to the Twin Lakes Reservoir, (2) numerical modeling of glaciers during the Pinedale glaciation in major tributaries draining into the upper Arkansas River, (3) discharge estimates for glacial-lake outburst floods in the upper Arkansas River valley, and (4) 10Be ages on flood boulders deposited downvalley from the moraine sequences. This research was stimulated by a new geologic map of the Granite 7.5′ quadrangle, in which the mapping of surficial deposits was revised based in part on the interpretation of newly acquired LiDAR data and field investigations. The new 10Be ages of the Pinedale terminal moraine at Twin Lakes average 21.8 ± 0.7 ka (n = 14), which adds to nearby Pinedale terminal moraine ages of 23.6 ± 1.4 ka (n = 5), 20.5 ± 0.2 ka (n = 3), and 16.6 ± 1.0 ka (n = 7), and downvalley outburst flood terraces that date to 20.9 ± 0.9 ka (n = 4) and 19.0 ± 0.6 ka (n = 4). This growing chronology leads to improved understanding of the controls and timing of glaciation in the western United States, the modeling of glacial-lake outburst flooding, and the reconstruction of paleotemperature through glacier modeling.

An upper limit on Pluto's ionosphere from radio occultation measurements with New Horizons

NASA Astrophysics Data System (ADS)

Hinson, D. P.; Linscott, I. R.; Strobel, D. F.; Tyler, G. L.; Bird, M. K.; Pätzold, M.; Summers, M. E.; Stern, S. A.; Ennico, K.; Gladstone, G. R.; Olkin, C. B.; Weaver, H. A.; Woods, W. W.; Young, L. A.; New Horizons Science Team

2018-06-01

On 14 July 2015 New Horizons performed a radio occultation (RO) that sounded Pluto's neutral atmosphere and ionosphere. The solar zenith angle was 90.2° (sunset) at entry and 89.8° (sunrise) at exit. We examined the data for evidence of an ionosphere, using the same method of analysis as in a previous investigation of the neutral atmosphere (Hinson et al., 2017). No ionosphere was detected. The measurements are more accurate at occultation exit, where the 1-sigma sensitivity in integrated electron content (IEC) is 2.3 × 1011 cm-2. The corresponding upper bound on the peak electron density at the terminator is about 1000 cm-3. We constructed a model for the ionosphere and used it to guide the analysis and interpretation of the RO data. Owing to the large abundance of CH4 at ionospheric heights, the dominant ions are molecular and the electron densities are relatively small. The model predicts a peak IEC of 1.8 × 1011 cm-2 for an occultation at the terminator, slightly smaller than the threshold of detection by New Horizons.

Surveying Mercury Levels in Hair, Blood and Urine of under 7-Year Old Children from a Coastal City in China

PubMed Central

Chen, Guixia; Chen, Xiaoxin; Yan, Chonghuai; Wu, Xingdong; Zeng, Guozhang

2014-01-01

Aim: The average mercury load in children under 7-years old was determined in a populated but not overly industrial coastal area in China. Methods: 395 blood samples, 1072 urine samples, and 581 hair samples were collected from 1076 children, aged 0 to 6 years, from eight representative communities of Xiamen, China. Mercury levels in the samples were surveyed. Results: The 95% upper limits of mercury in blood, urine, and hair for the children were 2.30, 1.50 and 2100.00 μg/kg, respectively. Levels tended to increase with age. Correlation analyses showed that mercury levels in blood and urine correlated with those in hair (n = 132), r = 0.49, p < 0.0001 and r = 0.20, p = 0.0008; however, blood mercury levels did not correlate with urine levels (n = 284), r = 0.07, p = 0.35. Conclusions: Surveying the average mercury load in children 0 to 6 years, and the 95% upper limit value of mercury in their blood, urine, and hair should help guide risk assessment and health management for children. PMID:25419876

Analysis of occupational stress in a high fashion clothing factory with upper limb biomechanical overload.

PubMed

Forcella, Laura; Bonfiglioli, Roberta; Cutilli, Piero; Siciliano, Eugenio; Di Donato, Angela; Di Nicola, Marta; Antonucci, Andrea; Di Giampaolo, Luca; Boscolo, Paolo; Violante, Francesco Saverio

2012-07-01

To study job stress and upper limb biomechanical overload due to repetitive and forceful manual activities in a factory producing high fashion clothing. A total of 518 workers (433 women and 85 men) were investigated to determine anxiety, occupational stress (using the Italian version of the Karasek Job Content Questionnaire) and perception of symptoms (using the Italian version of the Somatization scale of Symptom Checklist SCL-90). Biomechanical overload was analyzed using the OCRA Check list. Biomechanical assessment did not reveal high-risk jobs, except for cutting. Although the perception of anxiety and job insecurity was within the normal range, all the workers showed a high level of job strain (correlated with the perception of symptoms) due to very low decision latitude. Occupational stress resulted partially in line with biomechanical risk factors; however, the perception of low decision latitude seems to play a major role in determining job strain. Interactions between physical and psychological factors cannot be demonstrated. Anyway, simultaneous long-term monitoring of occupational stress features and biomechanical overload could guide workplace interventions aimed at reducing the risk of adverse health effects.

The Effect of Laminar Flow on Rotor Hover Performance

NASA Technical Reports Server (NTRS)

Overmeyer, Austin D.; Martin, Preston B.

2017-01-01

The topic of laminar flow effects on hover performance is introduced with respect to some historical efforts where laminar flow was either measured or attempted. An analysis method is outlined using combined blade element, momentum method coupled to an airfoil analysis method, which includes the full e(sup N) transition model. The analysis results compared well with the measured hover performance including the measured location of transition on both the upper and lower blade surfaces. The analysis method is then used to understand the upper limits of hover efficiency as a function of disk loading. The impact of laminar flow is higher at low disk loading, but significant improvement in terms of power loading appears possible even up to high disk loading approaching 20 ps f. A optimum planform design equation is derived for cases of zero profile drag and finite drag levels. These results are intended to be a guide for design studies and as a benchmark to compare higher fidelity analysis results. The details of the analysis method are given to enable other researchers to use the same approach for comparison to other approaches.

The proximal-to-distal sequence in upper-limb motions on multiple levels and time scales.

PubMed

Serrien, Ben; Baeyens, Jean-Pierre

2017-10-01

The proximal-to-distal sequence is a phenomenon that can be observed in a large variety of motions of the upper limbs in both humans and other mammals. The mechanisms behind this sequence are not completely understood and motor control theories able to explain this phenomenon are currently incomplete. The aim of this narrative review is to take a theoretical constraints-led approach to the proximal-to-distal sequence and provide a broad multidisciplinary overview of relevant literature. This sequence exists at multiple levels (brain, spine, muscles, kinetics and kinematics) and on multiple time scales (motion, motor learning and development, growth and possibly even evolution). We hypothesize that the proximodistal spatiotemporal direction on each time scale and level provides part of the organismic constraints that guide the dynamics at the other levels and time scales. The constraint-led approach in this review may serve as a first onset towards integration of evidence and a framework for further experimentation to reveal the dynamics of the proximal-to-distal sequence. Copyright © 2017 Elsevier B.V. All rights reserved.

Multiple splenic abscesses in a rather healthy woman: a case report.

PubMed

Saber, Aly

2009-07-23

Abscess of the spleen is a rather clinical rarity with reported mortality rate up to 47%. The timely and widespread use of imaging methods facilitates early diagnosis and guides treatment, thus improving the prognosis. Most of patients were with recognized risk factors including conditions that compromise the immune system, trauma and intravenous drug abuse in addicts. The surgical treatment by splenectomy is usually the first choice of treatment. A healthy 45-year-old woman presented to the outpatient clinic with fever, 39 degrees C together with persistent upper-left-quadrant abdominal pain. Her past medical history was free from any chronic debilitating diseases or other predisposing factors. Imaging included chest and abdominal X-ray, followed by a CT scan of the upper abdomen. Splenic abscess is an unusual and potentially life-threatening disease with a diagnostic challenge due to the nonspecific clinical picture and diagnosis confirmed based mostly on imaging studies. Multiple splenic abscesses are very rarely encountered in surgical practice with a reported high mortality rate in neglected and untreated cases. Splenectomy is a safe procedure for patients with splenic abscess.

Attentional sensitivity and asymmetries of vertical saccade generation in monkey

NASA Technical Reports Server (NTRS)

Zhou, Wu; King, W. M.; Shelhamer, M. J. (Principal Investigator)

2002-01-01

The first goal of this study was to systematically document asymmetries in vertical saccade generation. We found that visually guided upward saccades have not only shorter latencies, but higher peak velocities, shorter durations and smaller errors. The second goal was to identify possible mechanisms underlying the asymmetry in vertical saccade latencies. Based on a recent model of saccade generation, three stages of saccade generation were investigated using specific behavioral paradigms: attention shift to a visual target (CUED paradigm), initiation of saccade generation (GAP paradigm) and release of the motor command to execute the saccade (DELAY paradigm). Our results suggest that initiation of a saccade (or "ocular disengagement") and its motor release contribute little to the asymmetry in vertical saccade latency. However, analysis of saccades made in the CUED paradigm indicated that it took less time to shift attention to a target in the upper visual field than to a target in the lower visual field. These data suggest that higher attentional sensitivity to targets in the upper visual field may contribute to shorter latencies of upward saccades.

A review of the progression and future implications of brain-computer interface therapies for restoration of distal upper extremity motor function after stroke

PubMed Central

Remsik, Alexander; Young, Brittany; Vermilyea, Rebecca; Kiekoefer, Laura; Abrams, Jessica; Elmore, Samantha Evander; Schultz, Paige; Nair, Veena; Edwards, Dorothy; Williams, Justin; Prabhakaran, Vivek

2016-01-01

Stroke is a leading cause of acquired disability resulting in distal upper extremity functional motor impairment. Stroke mortality rates continue to decline with advances in healthcare and medical technology. This has led to an increased demand for advanced, personalized rehabilitation. Survivors often experience some level of spontaneous recovery shortly after their stroke event; yet reach a functional plateau after which there is exiguous motor recovery. Nevertheless, studies have demonstrated the potential for recovery beyond this plateau. Non-traditional neurorehabilitation techniques, such as those incorporating the brain-computer interface (BCI), are being investigated for rehabilitation. BCIs may offer a gateway to the brain’s plasticity and revolutionize how humans interact with the world. Non-invasive BCIs work by closing the proprioceptive feedback loop with real-time, multi-sensory feedback allowing for volitional modulation of brain signals to assist hand function. BCI technology potentially promotes neuroplasticity and Hebbian-based motor recovery by rewarding cortical activity associated with sensory-motor rhythms through use with a variety of self-guided and assistive modalities. PMID:27112213

National Dam Safety Program. Palmer Falls Dam, Upper Hudson River Basin, Saratoga and Warren Counties, New York. Phase I Inspection Report,

DTIC Science & Technology

1980-08-23

MA = -a a (A ILa 0. on 4 04 - 0 4.. 4i 44 4i . 4 4. PN w 4 - at AISA 4, 4. 4 ac I r V tvso l, -Vcp4pnfyw to &A0: 1. 0.V. 494 4...for Nuclear Power Plants, Regulating Guide 1.59, Revision 2, August1977 3. Linsley and Franzini: Water Resources Engineering, Second Edition , McGraw...Hill (1972) 4. W. Viessman, Jr., J. Knapp, G. Lewis, 1977, 2nd Edition , Introduction to Hydrology 5. Ven Te Chow: Handbook of Applied Hydrology, McGraw

Evidence-based management of neonatal vomiting in the emergency department.

PubMed

Ratnayake, Kristin; Kim, Tommy Y

2014-11-01

Vomiting accounts for up to 36% of neonatal visits to the emergency department. The causes of vomiting can range from benign to life-threatening. Evidence to guide the diagnosis and management of neonatal vomiting in the emergency department is limited. History and physical examination are extremely important in these cases, especially in identifying red flags such as bilious or projectile emesis. A thorough review is presented, discussing various imaging modalities, including plain abdominal radiography, upper gastrointestinal studies, ultrasonography, and contrast enema. A systematic approach in the emergency department, as outlined in this review, is required to identify the serious causes of vomiting in the neonate.

Social and economic causes of deforestation in the Peruvian Amazon basin: Natives and colonists. Working paper

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

Garland, E.B.

1991-03-01

The people in the Peruvian Amazon directly engaged in agriculture are the leading cause of deforestation; and can be divided into two groups, colonists and indigenous groups. The factors affecting the rate at which each group causes deforestation differ. The paper explores these differences in Peru's Upper Huallaga Valley (the principal coca producing region in the world), focusing on the interrelationships between land availability, land tenure laws, and market forces on one hand, and agricultural intensification and deforestation on the other. The study concludes that the technological decisions of the two groups are guided by diverse sets of socioeconomic factors.

Ultrafast laser control of backward superfluorescence towards standoff sensing

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

Ariunbold, Gombojav O.; National University of Mongolia, Ulaanbaatar 210646; Baylor University, Waco, Texas 76798

2014-01-13

We study infrared backward cooperative emission in a rubidium vapor induced by ultrafast two-photon optical excitations. The laser coherent control of the backward emission is demonstrated by using a pair of 100 fs pulses with a variable time delay. The temporal variation (quantum beat) of the backward beam intensity due to interference of atomic transitions in the rubidium atomic level system 5S-5P-5D is produced and controlled. Based on the obtained experimental results, we discuss possible applications of the developed approach for creation of an effective “guide star” in the sodium atomic layer in the upper atmosphere (mesosphere)

Squamous cell carcinoma lung: Presented with bilateral lower limb deep venous thrombosis with gangrene formation

PubMed Central

Saha, Kaushik; Sengupta, Amitabha; Patra, Anupam; Jash, Debraj

2013-01-01

Bilateral venous thrombosis due to underlying malignancy is a rare entity. It is worthy to search for malignancy in patients of bilateral venous gangrene. Our patient presented with severe bilateral leg pain as a result of venous gangrene. There was associated left sided massive pleural effusion with scalp nodule. Fine needle aspiration cytology of scalp nodule revealed metastatic squamous cell carcinoma and fiber optic bronchoscopy guided biopsy from growth at left upper lobe bronchus confirmed the case as squamous cell carcinoma lung. It was rare for squamous cell carcinoma lung to present as bilateral venous gangrene with anticardiolipin antibody negative. PMID:24455526

KSC-07pd1908

NASA Image and Video Library

2007-07-17

KENNEDY SPACE CENTER, Fla. -- In the Payload Hazardous Servicing Facility, workers guide the Phoenix Mars Lander spacecraft onto the upper stage booster. The spacecraft and booster will be mated for launch. Targeted for launch from Cape Canaveral Air Force Station on Aug. 3, Phoenix will land in icy soils near the north polar permanent ice cap of Mars and explore the history of the water in these soils and any associated rocks, while monitoring polar climate. Landing on Mars is planned in May 2008 on arctic ground where a mission currently in orbit, Mars Odyssey, has detected high concentrations of ice just beneath the top layer of soil. NASA/Dimitri Gerondidakis

Esthetics of Flapless Single-Tooth Implants in the Anterior Maxilla Using Guided Surgery: Association of Three-Dimensional Accuracy and Pink Esthetic Score.

PubMed

Fürhauser, Rudolf; Mailath-Pokorny, Georg; Haas, Robert; Busenlechner, Dieter; Watzek, Georg; Pommer, Bernhard

2015-10-01

Flapless implant placement using surgical templates may guarantee predictable and esthetic results provided that preplanned implant positions are transfered precisely into surgical reality. The study aims to investigate the effect of three-dimensional accuracy in guided implant surgery on the esthetic outcome of single-tooth implants in the anterior maxilla. Single-tooth implants for delayed replacement of upper incisors were inserted in 27 patients using stereolithographic templates. Superimposition of postoperative cone beam computed tomography (CBCT) scans allowed assessment of positional inaccuracy at the implant shoulder and apex, as well as angular deviation. Objective evaluation of implant esthetics was performed after a mean follow-up of 2.3 years using the Pink Esthetic Score (PES). Mean deviation between planned and actual implant position was 0.84 mm at the implant shoulder and significantly correlated to average PES of 12 (p = .031). Inaccuracy toward the buccal side was most frequent (70%). Deviations  ≥  0.8  mm resulted in significantly worse implant esthetics (median PES: 9.5, interquartile range [IQR]: 8-11) compared with more accurate implant positions (median PES: 13, IQR: 12-13, p = .039). Positional inaccuracy is low in guided implant surgery, but may however significantly compromise implant esthetics in the anterior maxilla. © 2014 Wiley Periodicals, Inc.

Pain related to robotic cholecystectomy with lower abdominal ports: effect of the bilateral ultrasound-guided split injection technique of rectus sheath block in female patients

PubMed Central

Kim, Jin Soo; Choi, Jong Bum; Lee, Sook Young; Kim, Wook Hwan; Baek, Nam Hyun; Kim, Jayoun; Park, Chu Kyung; Lee, Yeon Ju; Park, Sung Yong

2016-01-01

Abstract Background: Robotic cholecystectomy (RC) using port sites in the lower abdominal area (T12-L1) rather than the upper abdomen has recently been introduced as an alternative procedure for laparoscopic cholecystectomy. Therefore, we investigated the time course of different components of pain and the analgesic effect of the bilateral ultrasound-guided split injection technique for rectus sheath block (sRSB) after RC in female patients. Methods: We randomly assigned 40 patients to undergo ultrasound-guided sRSB (RSB group, n = 20) or to not undergo any block (control group, n = 20). Pain was subdivided into 3 components: superficial wound pain, deep abdominal pain, and referred shoulder pain, which were evaluated with a numeric rating scale (from 0 to 10) at baseline (time of awakening) and at 1, 6, 9, and 24 hours postoperatively. Consumption of fentanyl and general satisfaction were also evaluated 1 hour (before discharge from the postanesthesia care unit) and 24 hours postoperatively (end of study). Results: Superficial wound pain was predominant only at awakening, and after postoperative 1 hour in the control group. Bilateral ultrasound-guided sRSB significantly decreased superficial pain after RC (P < 0.01) and resulted in a better satisfaction score (P < 0.05) 1 hour after RC in the RSB group compared with the control group. The cumulative postoperative consumption of fentanyl at 6, 9, and 24 hours was not significantly different between groups. Conclusions: After RC with lower abdominal ports, superficial wound pain predominates over deep intra-abdominal pain and shoulder pain only at the time of awakening. Afterwards, superficial and deep pain decreased to insignificant levels in 6 hours. Bilateral ultrasound-guided sRSB was effective only during the first hour. This limited benefit should be balanced against the time and risks entailed in performing RSB. PMID:27495072

Pain related to robotic cholecystectomy with lower abdominal ports: effect of the bilateral ultrasound-guided split injection technique of rectus sheath block in female patients: A prospective randomised trial.

PubMed

Kim, Jin Soo; Choi, Jong Bum; Lee, Sook Young; Kim, Wook Hwan; Baek, Nam Hyun; Kim, Jayoun; Park, Chu Kyung; Lee, Yeon Ju; Park, Sung Yong

2016-08-01

Robotic cholecystectomy (RC) using port sites in the lower abdominal area (T12-L1) rather than the upper abdomen has recently been introduced as an alternative procedure for laparoscopic cholecystectomy. Therefore, we investigated the time course of different components of pain and the analgesic effect of the bilateral ultrasound-guided split injection technique for rectus sheath block (sRSB) after RC in female patients. We randomly assigned 40 patients to undergo ultrasound-guided sRSB (RSB group, n = 20) or to not undergo any block (control group, n = 20). Pain was subdivided into 3 components: superficial wound pain, deep abdominal pain, and referred shoulder pain, which were evaluated with a numeric rating scale (from 0 to 10) at baseline (time of awakening) and at 1, 6, 9, and 24 hours postoperatively. Consumption of fentanyl and general satisfaction were also evaluated 1 hour (before discharge from the postanesthesia care unit) and 24 hours postoperatively (end of study). Superficial wound pain was predominant only at awakening, and after postoperative 1 hour in the control group. Bilateral ultrasound-guided sRSB significantly decreased superficial pain after RC (P < 0.01) and resulted in a better satisfaction score (P < 0.05) 1 hour after RC in the RSB group compared with the control group. The cumulative postoperative consumption of fentanyl at 6, 9, and 24 hours was not significantly different between groups. After RC with lower abdominal ports, superficial wound pain predominates over deep intra-abdominal pain and shoulder pain only at the time of awakening. Afterwards, superficial and deep pain decreased to insignificant levels in 6 hours. Bilateral ultrasound-guided sRSB was effective only during the first hour. This limited benefit should be balanced against the time and risks entailed in performing RSB.

Quality of MR thermometry during palliative MR-guided high-intensity focused ultrasound (MR-HIFU) treatment of bone metastases.

PubMed

Lam, Mie K; Huisman, Merel; Nijenhuis, Robbert J; van den Bosch, Maurice Aaj; Viergever, Max A; Moonen, Chrit Tw; Bartels, Lambertus W

2015-01-01

Magnetic resonance (MR)-guided high-intensity focused ultrasound has emerged as a clinical option for palliative treatment of painful bone metastases, with MR thermometry (MRT) used for treatment monitoring. In this study, the general image quality of the MRT was assessed in terms of signal-to-noise ratio (SNR) and apparent temperature variation. Also, MRT artifacts were scored for their occurrence and hampering of the treatment monitoring. Analyses were performed on 224 MRT datasets retrieved from 13 treatments. The SNR was measured per voxel over time in magnitude images, in the target lesion and surrounding muscle, and was averaged per treatment. The standard deviation over time of the measured temperature per voxel in MRT images, in the muscle outside the heated region, was defined as the apparent temperature variation and was averaged per treatment. The scored MRT artifacts originated from the following sources: respiratory and non-respiratory time-varying field inhomogeneities, arterial ghosting, and patient motion by muscle contraction and by gross body movement. Distinction was made between lesion type, location, and procedural sedation and analgesic (PSA). The average SNR was highest in and around osteolytic lesions (21 in lesions, 27 in surrounding muscle, n = 4) and lowest in the upper body (9 in lesions, 16 in surrounding muscle, n = 4). The average apparent temperature variation was lowest in osteolytic lesions (1.2°C, n = 4) and the highest in the upper body (1.7°C, n = 4). Respiratory time-varying field inhomogeneity MRT artifacts occurred in 85% of the datasets and hampered treatment monitoring in 81%. Non-respiratory time-varying field inhomogeneities and arterial ghosting MRT artifacts were most frequent (94% and 95%) but occurred only locally. Patient motion artifacts were highly variable and occurred less in treatments of osteolytic lesions and using propofol and esketamine as PSA. In this study, the general image quality of MRT was observed to be higher in osteolytic lesions and lower in the upper body. Respiratory time-varying field inhomogeneity was the most prominent MRT artifact. Patient motion occurrence varied between treatments and seemed to be related to lesion type and type of PSA. Clinicians should be aware of these observed characteristics when interpreting MRT images.

On the Electrons Dynamics during Rapid Island Coalescence in Asymmetric Magnetic Reconnection: Case With and With No Guide Field

NASA Astrophysics Data System (ADS)

Cazzola, E.; Innocenti, M. E.; Markidis, S.; Goldman, M. V.; Newman, D. L.; Lapenta, G.

2015-12-01

We present a set of fully kinetic 2.5D simulations of electron dynamics during rapid magnetic islands coalescence in asymmetric conditions. Simulations are performed using the massively parallel fully kinetic implicit moment method code iPIC3D (Markidis et al. 2010). The domain is a double periodic box with two current sheets initially representing two different reconnection conditions with the same asymmetric ratio. In the upper sheet the conventional hyperbolic continuous functions for magnetic field and density are initialised across the layer (e.g. Pritchett 2008). In the lower layer the same asymmetric conditions are used the presence of an extremely steep gradient describing a pure tangential discontinuity.Cases with and without guide field are compared. While the upper layer shows the typical reconnection evolution of an asymmetric configuration, the lower layer very soon develops not-uniformly distributed multiple reconnection points which rapidly evolve in a series of magnetic islands. Quick islands coalescence follows. Even though the electrons dynamics during island merging has been studied in both symmetric and asymmetric conditions (e.g. Pritchett 2007, 2008b, Drake et al. 2006, Oka et al. 2010, Huang et al. 2014), these simulations show new interesting features such as the presence of three distinct regions, here named X, M and D, with very different properties. Regions X and M manifest typical signatures of ongoing reconnection, distinguishable thanks to the direct comparison with the outcomes of the upper layer. In particular, M-type regions are different because reconnection occurs between two merging islands in a vertical fashion with respect to the direction of the current sheets initially set. In contrast, regions D present a quite diverse features, not showing the typical signatures of a occurring reconnection. The present work is supported by the NASA MMS Grant NNX08AO84G. Additional support for the KULeuven team is provided by the European Commission DEEP-ER project, by the Onderzoekfonds KU Leuven (Research Fund KU Leuven) and by the Interuniversity Attraction Poles Programme of the Belgian Science Policy Office (IAP P7/08 CHARM). The simulations were conducted on the computational resources provided by the PRACE Tier-0 2013091928 (SuperMUC supercomputer).

Outcomes of Ultrasound-Guided Thrombin Injection of Nongroin Arterial Pseudoaneurysms.

PubMed

Valesano, Johnathan C; Schmitz, John J; Kurup, A Nicholas; Schmit, Grant D; Moynagh, Michael R; Atwell, Thomas D; Lewis, Bradley D; Lee, Robert A; Callstrom, Matthew R

2017-08-01

To evaluate success and complication rates of percutaneous ultrasound-guided thrombin injection of nongroin pseudoaneurysms (PSAs). Retrospective review of a prospectively maintained institutional database yielded 39 cases of arterial PSAs occurring at nongroin sites that were treated with percutaneous ultrasound-guided thrombin injection between 2000 and 2016 (average patient age 69.2 y ± 14.0). Of PSAs, 74.4% (29/39) arose in the upper extremities, and 92.3% (36/39) were iatrogenic. The brachial artery was the most commonly affected vessel (51.3% [20/39]), and arterial access was the most common cause (56.4% [22/39]). Average overall PSA size was 2.4 cm (range, 0.5-7.2 cm); average amount of thrombin injected was 320 IU (range, 50-2,000 IU). Technical success was defined as absence of flow within the PSA immediately after thrombin injection. Treatment success was defined as sustained thrombosis on follow-up imaging obtained at 1-3 days after treatment. Technical and treatment success rates of thrombin injections were 100% (39/39) and 84.8% (28/33), respectively. Longer term follow-up imaging (average 71 d; range, 12-201 d) was available for 7 of the treatment successes with 100% (7/7) showing sustained thrombosis. Comparing treatment successes and failures, there was no significant difference in average PSA size (2.3 cm vs 2.0 cm, P = .51) or average amount of thrombin injected (360 IU vs 180 IU, P = .14). There were no complications. Ultrasound-guided thrombin injection is a safe, efficacious treatment option for PSAs arising in nongroin locations. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

Visual cortex activation in kinesthetic guidance of reaching.

PubMed

Darling, W G; Seitz, R J; Peltier, S; Tellmann, L; Butler, A J

2007-06-01

The purpose of this research was to determine the cortical circuit involved in encoding and controlling kinesthetically guided reaching movements. We used (15)O-butanol positron emission tomography in ten blindfolded able-bodied volunteers in a factorial experiment in which arm (left/right) used to encode target location and to reach back to the remembered location and hemispace of target location (left/right side of midsagittal plane) varied systematically. During encoding of a target the experimenter guided the hand to touch the index fingertip to an external target and then returned the hand to the start location. After a short delay the subject voluntarily moved the same hand back to the remembered target location. SPM99 analysis of the PET data contrasting left versus right hand reaching showed increased (P < 0.05, corrected) neural activity in the sensorimotor cortex, premotor cortex and posterior parietal lobule (PPL) contralateral to the moving hand. Additional neural activation was observed in prefrontal cortex and visual association areas of occipital and parietal lobes contralateral and ipsilateral to the reaching hand. There was no statistically significant effect of target location in left versus right hemispace nor was there an interaction of hand and hemispace effects. Structural equation modeling showed that parietal lobe visual association areas contributed to kinesthetic processing by both hands but occipital lobe visual areas contributed only during dominant hand kinesthetic processing. This visual processing may also involve visualization of kinesthetically guided target location and use of the same network employed to guide reaches to visual targets when reaching to kinesthetic targets. The present work clearly demonstrates a network for kinesthetic processing that includes higher visual processing areas in the PPL for both upper limbs and processing in occipital lobe visual areas for the dominant limb.

[Comparative analysis of some factors in tooth color matching].

PubMed

Török, Judit; Mauks, Levente; Márton, Sándor; Hegedűs, Csaba

2014-09-01

Recently (nowadays) to achieve a natural looking restoration is an ever increasing demand from the patients and also from the doctor side. To select the right color of the restoration matching the remaining natural teeth is always a challenging task. A clinical study was performed at the University of Debrecen Faculty of Dentristry with the help of dental students using two different shade guides. The study tested the influence of gender and knowledge of color science on shade matching. 78 students were asked to find the right matching color of the same upper canine to two different shade guides (Vitapan Classic and Vita 3D-Master) under standard condition. After informing the student about the basic principles of color the matching procedure was repeated. Results were analyzed statistically. In our study we found that gender does not influence the color choice. Matching accuracy is not increased by better knowledge of colors. We can conclude that significantly less students matched the proper color with Vitapan Classic shade guide after information of the property of colors without training the shade selection. Within the limitation of the study design it was concluded that not more students selected the proper color even after giving them information about colors, instructions about shade selections. For the same one canine several color were selected by the participants (6 types with Vitapan Classic and 19 types with Vita 3D-Master) which conformed that visual determination is not a reliably consistent way of the tooth shade selection. The Vita Company 1990s developed 3D-Master shade guide is not widely used, although we found the repeatability is more than 70%.

Indoor and outdoor elemental mercury: a comparison of three different cases.

PubMed

Loupa, G; Polyzou, C; Zarogianni, A M; Ouzounis, K; Rapsomanikis, S

2017-02-01

Gaseous elemental mercury (GEM) concentrations were determined in three different indoor environments: an office in a building with no indoor sources of mercury (Bldg. I), an office affected by indoor mercury emissions from an adjacent laboratory (Bldg. II), and finally, an office where an outdoor mercury spill occurred accidentally (Bldg. III). The maximum recorded indoor GEM concentrations, with the largest variation in time, were observed in Bldg. II, with a continuous indoor mercury source (lower to upper quartile 15 to 62 ng m -3 ). The lowest values were recorded in Bldg. I (lower to upper quartile 3 to 5 ng m -3 ), where indoor GEM levels were affected mainly by the exhaust of vehicles in the parking lot of the building. The monitoring of GEM indoors (lower to upper quartile 15 to 42 ng m -3 ), and outdoors (in several heights) of the Bldg. III, revealed that the cleaning up procedure that followed the spill was not adequate. Auxiliary measurements in the first two cases were the indoor microclimatic conditions, as well as the indoor CO 2 concentrations, and in the third case the outdoor meteorological data. The exhaust of vehicles, the chemical reagents, and an outdoor mercury spill were found to mainly affect the observed indoor GEM levels. People in Bldg. II and people walking through the area, where Hg 0 was spilled, were found to be exposed to concentrations above some guide values.

Clinical reasoning in neurology: use of the repertory grid technique to investigate the reasoning of an experienced occupational therapist.

PubMed

Kuipers, Kathy; Grice, James W

2009-08-01

The aim of this paper is to describe the use of a structured interview methodology, the repertory grid technique, for investigating the clinical reasoning of an experienced occupational therapist in the domain of upper limb hypertonia as a result of brain injury. Repertory grid interviews were completed before and after exposure to a protocol designed to guide clinical reasoning and decision-making in relation to upper limb neurological rehabilitation. Data were subjected to both qualitative and quantitative analyses. Qualitative analysis focussed on clinical reasoning content. Common themes across the pre- and post-exposure interviews were the use of theoretical frameworks and practice models, the significance of clinical expertise, and discrimination of 'broad' and 'specific' aspects, as well as differentiation between 'therapist and client-related' aspects of the clinical situation. Quantitative analysis indicated that for both pre- and post-exposure repertory grids, clinical reasoning was structured in terms of two main concepts. In the pre-exposure grid, these were related to the therapist's role, and to the 'scope' of practice tasks (either broad or specific). In the post-exposure grid the two main concepts were upper limb performance, and client-centred aspects of the therapy process. The repertory grid technique is proposed as an effective tool for exploring occupational therapy clinical reasoning, based on its capacity for accessing personal frames of reference, and elucidating both the meaning and the structure supporting clinical reasoning.

Technique to Obtain a Predictable Aesthetic Result through Appropriate Placement of the Prosthesis/Soft Tissue Junction in the Edentulous Patient with a Gingival Smile.

PubMed

Demurashvili, Georgy; Davarpanah, Keyvan; Szmukler-Moncler, Serge; Davarpanah, Mithridade; Raux, Didier; Capelle-Ouadah, Nedjoua; Rajzbaum, Philippe

2015-10-01

Treating the edentulous patient with a gingival smile requires securing the prosthesis/soft tissue junction (PSTJ) under the upper lip. To present a simple method that helps achieve a predictable aesthetic result when alveoplasty of the anterior maxilla is needed to place implants apical to the presurgical position of the alveolar ridge. The maximum smile line of the patient is recorded and carved on a thin silicone bite impression as a soft tissue landmark. During the three-dimensional radiographic examination, the patient wears the silicone guide loaded with radiopaque markers. The NobelClinician® software is then used to bring the hard and soft tissue landmarks together in a single reading. Using the software, a line is drawn 5 mm apical to the smile line; it dictates the position of the crestal ridge to be reached following the alveoplasty. Subsequently, the simulated implant position and the simulated residual bone height following alveoplasty can be simultaneously evaluated on each transverse section. An alveoplasty of the anterior maxilla was performed as simulated on the software, and implants were placed accordingly. The PSTJ was always under the upper lip, even during maximum smile events. The aesthetic result was, therefore, fully satisfactory. This simple method permits the placement of the PSTJ under the upper lip with a predictable outcome; it ensures a reliable aesthetic result for the edentulous patient with a gingival smile. © 2013 Wiley Periodicals, Inc.

Endosonographic examination of thyroid gland among patients with nonthyroid cancers.

PubMed

Alkhatib, Amer A; Mahayni, Abdulah A; Chawki, Ghaleb R; Yoder, Leon; Elkhatib, Fateh A; Al-Haddad, Mohammad

2016-01-01

There is limited endosonographic literature regarding thyroid gland pathology, which is frequently visualized during upper endoscopic ultrasound (EUS). Our objective was to assess the prevalence of benign and malignant thyroid lesions encountered during routine upper EUS within a cancer center setting. The data were prospectively collected and retrospectively analyzed. All upper EUS procedures performed between October 2012 and July 2014 were reviewed at a large referral cancer center. Data collected included patient demographics, preexisting thyroid conditions, thyroid gland dimensions, the presence or absence of thyroid lesions, and EUS morphology of lesions if present, and interventions performed to characterize thyroid lesions and pathology results when applicable. Two hundred and forty-five EUS procedures were reviewed. Of these, 100 cases reported a detailed endosonographic examination of the thyroid gland. Most of the thyroid glands were endosonographically visualized when the tip of the scope was at 18 cm from the incisors. Twelve cases showed thyroid lesions, out of which three previously undiagnosed thyroid cancers were visualized during EUS (two primary papillary thyroid cancers and one anaplastic thyroid cancer). Transesophageal EUS-guided fine needle aspiration of thyroid lesions was feasible when the lesion was in the inferior portion of the thyroid gland, and the tip of the scope was at 18 cm or more from the incisors. Routine EUS examination may detect unexpected thyroid lesions including malignant ones. We encourage endosonographers to screen the visualized portions of the thyroid gland during routine withdrawal of the echoendoscope.

Exploration for uranium deposits in the Atkinson Mesa area, Montrose County, Colorado

USGS Publications Warehouse

Brew, Daniel Allen

1954-01-01

The U.S. Geological Survey explored the Atkinson Mesa area for uranium- and vanadium-bearing deposits from July 2, 1951, to June 18, 1953, with 397 diamond-drill holes that totaled 261,251 feet. Sedimentary rocks of Mesozoic age are exposed in the Atkinson Mesa area. They are: the Brushy Basin member of the Upper Jurassic Morrison formation, the Lower Cretaceous Burro Canyon formation, and the Upper and Lower Cretaceous Dakota sandstone. All of the large uranium-vanadium deposits discovered by Geological Survey drilling are in a series of sandstone lenses in the upper part of the Salt Wash member of the Jurassic Morrison formation. The deposits are mainly tabular and blanket-like, but some elongate pod-shaped masses, locally called "rolls" may be present. The mineralized material consists of sandstone impregnated with a uranium mineral which is probably coffinite, spme carnotite, and vanadium minerals, thought to be mainly corvusite and montroseite. In addition,, some mudstone and carbonaceous material is similarly impregnated. Near masses of mineralized material the sandstone is light gray or light brown, is generally over 40 feet thick, and usually contains some carbonaceous material and abundant disseminated pyrite or limonite stain. Similarly, the mudstone in contact with the ore-bearing sandstone near bodies of mineralized rock is commonly blue gray, as compared to its dominant red color away from ore deposits. Presence and degree of these features are useful guides in exploring for new deposits.

Reconstructive operations for the upper limb after brachial plexus palsy.

PubMed

Rühmann, Oliver; Schmolke, Stephan; Bohnsack, Michael; Carls, Jörg; Flamme, Christian; Wirth, Carl Joachim

2004-07-01

Limited function due to paralysis following brachial plexus lesions can be improved by secondary operations of the bony and soft tissue. Between April 1994 and December 2000, 109 patients suffering from arm-plexus lesions underwent a total of 144 reconstructive operations guided by our concept of integrated therapy. The average age at the time of surgery was 32 years (range: 15-59). The following operations were performed: shoulder arthrodesis (23), trapezius transfer (74), rotation osteotomy of humerus (9), triceps to biceps transposition (9), transposition of forearm flexors or extensors (8), latissimus transfer (7), pectoralis transfer (1), teres major transfer (1), transposition of flexor carpi ulnaris to the tendons of extensor digitorum (10), and wrist arthrodesis (2). Prospectively, in all patients, the grade of muscle power of the affected upper extremity was evaluated prior to surgery. The follow-up period for all 144 operations was, on average, 22 months (range: 6-74). By means of operative measures, almost all patients obtained an improvement of shoulder function (100%) and stability (>90%), elbow flexion (85%), and hand, finger, and thumb (100%). When muscles malfunction after brachial plexus lesions, one should take into account the individual neuromuscular defect, passive joint function, and bony deformities; different procedures such as muscle transpositions, arthrodeses, and corrective osteotomies can then be performed to improve function of the upper extremity. Each form of operative treatment presents patients with certain benefits and all are integrated into a total treatment plan for the affected extremity.

[Investigation of reference intervals of blood gas and acid-base analysis assays in China].

PubMed

Zhang, Lu; Wang, Wei; Wang, Zhiguo

2015-10-01

To investigate and analyze the upper and lower limits and their sources of reference intervals in blood gas and acid-base analysis assays. The data of reference intervals were collected, which come from the first run of 2014 External Quality Assessment (EQA) program in blood gas and acid-base analysis assays performed by National Center for Clinical Laboratories (NCCL). All the abnormal values and errors were eliminated. Data statistics was performed by SPSS 13.0 and Excel 2007 referring to upper and lower limits of reference intervals and sources of 7 blood gas and acid-base analysis assays, i.e. pH value, partial pressure of carbon dioxide (PCO2), partial pressure of oxygen (PO2), Na+, K+, Ca2+ and Cl-. Values were further grouped based on instrument system and the difference between each group were analyzed. There were 225 laboratories submitting the information on the reference intervals they had been using. The three main sources of reference intervals were National Guide to Clinical Laboratory Procedures [37.07% (400/1 079)], instructions of instrument manufactures [31.23% (337/1 079)] and instructions of reagent manufactures [23.26% (251/1 079)]. Approximately 35.1% (79/225) of the laboratories had validated the reference intervals they used. The difference of upper and lower limits in most assays among 7 laboratories was moderate, both minimum and maximum (i.e. the upper limits of pH value was 7.00-7.45, the lower limits of Na+ was 130.00-156.00 mmol/L), and mean and median (i.e. the upper limits of K+ was 5.04 mmol/L and 5.10 mmol/L, the upper limits of PCO2 was 45.65 mmHg and 45.00 mmHg, 1 mmHg = 0.133 kPa), as well as the difference in P2.5 and P97.5 between each instrument system group. It was shown by Kruskal-Wallis method that the P values of upper and lower limits of all the parameters were lower than 0.001, expecting the lower limits of Na+ with P value 0.029. It was shown by Mann-Whitney that the statistic differences were found among instrument system groups and between most of two instrument system groups in all assays. The difference of reference intervals of blood gas and acid-base analysis assays used in China laboratories is moderate, which is better than other specialties in clinical laboratories.

The Second American Society of Regional Anesthesia and Pain Medicine Evidence-Based Medicine Assessment of Ultrasound-Guided Regional Anesthesia: Executive Summary.

PubMed

Neal, Joseph M; Brull, Richard; Horn, Jean-Louis; Liu, Spencer S; McCartney, Colin J L; Perlas, Anahi; Salinas, Francis V; Tsui, Ban Chi-Ho

2016-01-01

In 2009 and again in 2012, the American Society of Regional Anesthesia and Pain Medicine assembled an expert panel to assess the evidence basis for ultrasound guidance as a nerve localization tool for regional anesthesia. The 2012 panel reviewed evidence from the first advisory but focused primarily on new information that had emerged since 2009. A new section was added regarding the accuracy and reliability of ultrasound for determining needle-to-nerve proximity. Jadad scores are used to rank study quality. Grades of recommendations consistent with their level of evidence are provided. The panel offers recommendations based on synthesis and analysis of literature related to (1) the technical capabilities of ultrasound equipment and its operators, (2) comparison of ultrasound to other methods of nerve localization with regard to block characteristics, (3) comparison of block techniques where ultrasound is the sole nerve localization modality, and (4) major complications. Assessment of evidence strength and recommendations are made for upper- and lower-extremity, truncal, neuraxial, and pediatric blocks. Scientific evidence from the past 5 years has clarified and strengthened our understanding of ultrasound-guided regional anesthesia as a nerve localization tool. High-level evidence supports ultrasound guidance contributing to superior characteristics with selected blocks, although absolute differences with the comparator technique are often relatively small (especially for upper-extremity blocks). The clinical meaningfulness of these differences is likely of variable importance to individual practitioners. The use of ultrasound significantly reduces the risk of local anesthetic systemic toxicity as well as the incidence and intensity of hemidiaphragmatic paresis, but has no significant effect on the incidence of postoperative neurologic symptoms. WHAT'S NEW IN THIS UPDATE?: This evidence-based assessment of ultrasound-guided regional anesthesia reviews findings from our 2010 publication and focuses on new meta-analyses, randomized controlled trials, and large case series published since 2009. New to this exercise is an in-depth analysis of the accuracy and reliability of ultrasound guidance for identifying needle-to-nerve relationships. This version no longer addresses ultrasound for interventional pain medicine procedures, because the growth of that field demands separate consideration. Since our 2010 publication, new information has either supported or strengthened our original conclusions. There is no evidence that ultrasound is inferior to alternative nerve localization methods.

The calibration of a Scanditronix-Wellhöfer thimble chamber for photon dosimetry using the IAEA TRS 277 code of practice.

PubMed

Fourie, O L

2004-03-01

This note investigates the calibration of a Scanditronix-Wellhöfer type FC65-G ionisation chamber to be used in clinical photon dosimetry. The current Adaptation by the Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) of the IAEA TRS 277 dosimetry protocol makes no provision for this type of chamber. The absorbed dose to air calibration coefficient ND was therefore calculated from the air kerma calibration coefficient NK using the formalism of the IAEA TRS 277 protocol and it is shown that the value of the correction factor kmkatt for the FC65-G chamber is identical to that of the NE 2571 chamber. ND was also determined experimentally from a cross calibration against an NE 2571 dosimetry. It was found that there is a good correspondence between the calculated and measured values. To establish to what extent the ACPSEM Adaptation can be used for the FC65-G chamber, values for the ratio of stopping powers in water and air (Sw,air)Q and the perturbation correction factor pQ were calculated using the TRS 277 protocol. From these results it is shown that over the range of beam qualities TPR20,10 = 0.59 to TPR20,10 = 0.78 the Adaptation can be used for the FC65-G chamber.

Preliminary validation of computational model for neutron flux prediction of Thai Research Reactor (TRR-1/M1)

NASA Astrophysics Data System (ADS)

Sabaibang, S.; Lekchaum, S.; Tipayakul, C.

2015-05-01

This study is a part of an on-going work to develop a computational model of Thai Research Reactor (TRR-1/M1) which is capable of accurately predicting the neutron flux level and spectrum. The computational model was created by MCNPX program and the CT (Central Thimble) in-core irradiation facility was selected as the location for validation. The comparison was performed with the typical flux measurement method routinely practiced at TRR-1/M1, that is, the foil activation technique. In this technique, gold foil is irradiated for a certain period of time and the activity of the irradiated target is measured to derive the thermal neutron flux. Additionally, the flux measurement with SPND (self-powered neutron detector) was also performed for comparison. The thermal neutron flux from the MCNPX simulation was found to be 1.79×1013 neutron/cm2s while that from the foil activation measurement was 4.68×1013 neutron/cm2s. On the other hand, the thermal neutron flux from the measurement using SPND was 2.47×1013 neutron/cm2s. An assessment of the differences among the three methods was done. The difference of the MCNPX with the foil activation technique was found to be 67.8% and the difference of the MCNPX with the SPND was found to be 27.8%.

Validity of peptic ulcer disease and upper gastrointestinal bleeding diagnoses in administrative databases: a systematic review protocol.

PubMed

Montedori, Alessandro; Abraha, Iosief; Chiatti, Carlos; Cozzolino, Francesco; Orso, Massimiliano; Luchetta, Maria Laura; Rimland, Joseph M; Ambrosio, Giuseppe

2016-09-15

Administrative healthcare databases are useful to investigate the epidemiology, health outcomes, quality indicators and healthcare utilisation concerning peptic ulcers and gastrointestinal bleeding, but the databases need to be validated in order to be a reliable source for research. The aim of this protocol is to perform the first systematic review of studies reporting the validation of International Classification of Diseases, 9th Revision and 10th version (ICD-9 and ICD-10) codes for peptic ulcer and upper gastrointestinal bleeding diagnoses. MEDLINE, EMBASE, Web of Science and the Cochrane Library databases will be searched, using appropriate search strategies. We will include validation studies that used administrative data to identify peptic ulcer disease and upper gastrointestinal bleeding diagnoses or studies that evaluated the validity of peptic ulcer and upper gastrointestinal bleeding codes in administrative data. The following inclusion criteria will be used: (a) the presence of a reference standard case definition for the diseases of interest; (b) the presence of at least one test measure (eg, sensitivity, etc) and (c) the use of an administrative database as a source of data. Pairs of reviewers will independently abstract data using standardised forms and will evaluate quality using the checklist of the Standards for Reporting of Diagnostic Accuracy (STARD) criteria. This systematic review protocol has been produced in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P) 2015 statement. Ethics approval is not required given that this is a protocol for a systematic review. We will submit results of this study to a peer-reviewed journal for publication. The results will serve as a guide for researchers validating administrative healthcare databases to determine appropriate case definitions for peptic ulcer disease and upper gastrointestinal bleeding, as well as to perform outcome research using administrative healthcare databases of these conditions. CRD42015029216. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

USGS EDMAP Program-Training the Next Generation of Geologic Mappers

USGS Publications Warehouse

,

2010-01-01

EDMAP is an interactive and meaningful program for university students to gain experience and knowledge in geologic mapping while contributing to national efforts to map the geology of the United States. It is a matching-funds grant program with universities and is one of the three components of the congressionally mandated U.S. Geological Survey (USGS) National Cooperative Geologic Mapping Program. Geology professors whose specialty is geologic mapping request EDMAP funding to support upper-level undergraduate and graduate students at their colleges or universities in a 1-year mentor-guided geologic mapping project that focuses on a specific geographic area. Every Federal dollar that is awarded is matched with university funds.

Preoperative fiducial coil placement facilitates robot-assisted laparoscopic excision of retroperitoneal small solitary metastasis of kidney cancer.

PubMed

Agrawal, Vineet; Sharma, Ashwani; Wu, Guan

2014-11-01

Image-guided fiducial markers are being used in surgery, especially in spine and breast surgery, and radiotherapy, allowing localization of tumor sites precisely. We report a case of fiducial coil use in a man undergoing a robot-assisted laparoscopic resection of a metastatic nodule under the ipsilateral diaphragm after robot-assisted partial nephrectomy performed 2 years ago for a left upper pole renal tumor. The fiducial coil facilitated the localization of the lesion, which would otherwise have been challenging because of its small size and location. In addition, the fiducial coil was helpful to avoid cutting into the lesion directly. Copyright © 2014 Elsevier Inc. All rights reserved.

Conceptual assessment tool for advanced undergraduate electrodynamics

NASA Astrophysics Data System (ADS)

Baily, Charles; Ryan, Qing X.; Astolfi, Cecilia; Pollock, Steven J.

2017-12-01

As part of ongoing investigations into student learning in advanced undergraduate courses, we have developed a conceptual assessment tool for upper-division electrodynamics (E&M II): the Colorado UppeR-division ElectrodyNamics Test (CURrENT). This is a free response, postinstruction diagnostic with 6 multipart questions, an optional 3-question preinstruction test, and accompanying grading rubrics. The instrument's development was guided by faculty-consensus learning goals and research into common student difficulties. It can be used to gauge the effectiveness of transformed pedagogy, and to gain insights into student thinking in the covered topic areas. We present baseline data representing 500 students across 9 institutions, along with validity, reliability, and discrimination measures of the instrument and scoring rubric.

The non-storm time corrugated upper thermosphere: What is beyond MSIS?

NASA Astrophysics Data System (ADS)

Liu, Huixin; Thayer, Jeff; Zhang, Yongliang; Lee, Woo Kyoung

2017-06-01

Observations in the recent decade have revealed many thermospheric density corrugations/perturbations under nonstorm conditions (Kp < 2). They are generally not captured by empirical models like Mass Spectrometer Incoherent Scatter (MSIS) but are operationally important for long-term orbital evolution of Low Earth Orbiting satellites and theoretically for coupling processes in the atmosphere-ionosphere system. We review these density corrugations by classifying them into three types which are driven respectively by the lower atmosphere, ionosphere, and solar wind/magnetosphere. Model capabilities in capturing these features are discussed. A summary table of these corrugations is included to provide a quick guide on their magnitudes, occurring latitude, local time, and season.

3D force/torque characterization of emergency cricothyroidotomy procedure using an instrumented scalpel.

PubMed

Ryason, Adam; Sankaranarayanan, Ganesh; Butler, Kathryn L; DeMoya, Marc; De, Suvranu

2016-08-01

Emergency Cricothyroidotomy (CCT) is a surgical procedure performed to secure a patient's airway. This high-stakes, but seldom-performed procedure is an ideal candidate for a virtual reality simulator to enhance physician training. For the first time, this study characterizes the force/torque characteristics of the cricothyroidotomy procedure, to guide development of a virtual reality CCT simulator for use in medical training. We analyze the upper force and torque thresholds experienced at the human-scalpel interface. We then group individual surgical cuts based on style of cut and cut medium and perform a regression analysis to create two models that allow us to predict the style of cut performed and the cut medium.

Terminology modeling for an enterprise laboratory orders catalog.

PubMed

Zhou, Li; Goldberg, Howard; Pabbathi, Deepika; Wright, Adam; Goldman, Debora S; Van Putten, Cheryl; Barley, Amanda; Rocha, Roberto A

2009-11-14

Laboratory test orders are used in a variety of clinical information systems at Partners HealthCare. At present, each site at Partners manages its own set of laboratory orders with locally defined codes. Our current plan is to implement an enterprise catalog, where laboratory test orders are mapped to reference terminologies and codes from different sites are mapped to each other. This paper describes the terminology modeling effort that preceded the implementation of the enterprise laboratory orders catalog. In particular, we present our experience in adapting HL7's "Common Terminology Services 2 - Upper Level Class Model" as a terminology metamodel for guiding the development of fully specified laboratory orders and related services.

Fluorescent Endoscopy of Tumors in Upper Part of Gastrointestinal Tract

NASA Astrophysics Data System (ADS)

Borisova, E.; Vladimirov, B.; Angelov, I.; Avramov, L.

2007-04-01

In the recent study delta-aminolevulinic acid/Protoporphyrin IX (5-ALA/PpIX) is used as fluorescent marker for dysplasia and tumor detection in esophagus and stomach. The 5-ALA is administered per os six hours before measurements at dose 20mg/kg weight. High-power light-emitting diode at 405 nm is used as an excitation source. Special opto-mechanical device is built for LED to use the light guide of standard video-endoscopic system (Olimpus Corp.). Through endoscopic instrumental channel a fiber is applied to return information about fluorescence to microspectrometer (USB4000, OceanOptics Inc.). Very good correlation between fluorescence signals and histology examination of the lesions investigated is achieved.

Terminology Modeling for an Enterprise Laboratory Orders Catalog

PubMed Central

Zhou, Li; Goldberg, Howard; Pabbathi, Deepika; Wright, Adam; Goldman, Debora S.; Van Putten, Cheryl; Barley, Amanda; Rocha, Roberto A.

2009-01-01

Laboratory test orders are used in a variety of clinical information systems at Partners HealthCare. At present, each site at Partners manages its own set of laboratory orders with locally defined codes. Our current plan is to implement an enterprise catalog, where laboratory test orders are mapped to reference terminologies and codes from different sites are mapped to each other. This paper describes the terminology modeling effort that preceded the implementation of the enterprise laboratory orders catalog. In particular, we present our experience in adapting HL7’s “Common Terminology Services 2 – Upper Level Class Model” as a terminology metamodel for guiding the development of fully specified laboratory orders and related services. PMID:20351950

KSC-07pd1906

NASA Image and Video Library

2007-07-17

KENNEDY SPACE CENTER, Fla. -- In the Payload Hazardous Servicing Facility, workers help guide the suspended Phoenix Mars Lander spacecraft toward the upper stage booster in the center. The spacecraft and booster will be mated for launch. Targeted for launch from Cape Canaveral Air Force Station on Aug. 3, Phoenix will land in icy soils near the north polar permanent ice cap of Mars and explore the history of the water in these soils and any associated rocks, while monitoring polar climate. Landing on Mars is planned in May 2008 on arctic ground where a mission currently in orbit, Mars Odyssey, has detected high concentrations of ice just beneath the top layer of soil. NASA/Dimitri Gerondidakis

Flight Operations for the LCROSS Lunar Impactor Mission

NASA Technical Reports Server (NTRS)

Tompkins, Paul D.; Hunt, Rusty; D'Ortenzio, Matt D.; Strong, James; Galal, Ken; Bresina, John L.; Foreman, Darin; Barber, Robert; Shirley, Mark; Munger, James;

How to use PRICE treatment for soft tissue injuries.

PubMed

Norton, Cormac

2016-08-24

Rationale and key points This article assists nurses to use the acronym PRICE (protection, rest, ice, compression and elevation) to guide the treatment of patients with uncomplicated soft tissue injuries to their upper or lower limbs. » Treatment of soft tissue injuries to limbs is important to reduce complications following injury, alleviate pain and ensure normal limb function is restored promptly. » Nurses should have an understanding of the rationale and evidence base supporting PRICE treatment of soft tissue injuries. » Providing accurate information to patients and carers about the management of soft tissue injuries and anticipated recovery time is an important aspect of treatment. » Further research is required to develop best practice in the treatment of soft tissue injuries. Reflective activity 'How to' articles can help you update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. How this article might change your practice when managing patients with soft tissue injuries to upper or lower limbs. 2. Positive elements of your current practice and those that could be enhanced. Subscribers can upload their reflective accounts at: rcni.com/portfolio.

Development of conceptual ecological models linking management of the Missouri River to pallid sturgeon population dynamics

USGS Publications Warehouse

Jacobson, Robert B.; Parsley, Michael J.; Annis, Mandy L.; Colvin, Michael E.; Welker, Timothy L.; James, Daniel A.

2015-01-01

This report documents the process of developing and refining conceptual ecological models (CEMs) for linking river management to pallid sturgeon (Scaphirhynchus albus) population dynamics in the Missouri River. The refined CEMs are being used in the Missouri River Pallid Sturgeon Effects Analysis to organize, document, and formalize an understanding of pallid sturgeon population responses to past and future management alternatives. The general form of the CEMs, represented by a population-level model and component life-stage models, was determined in workshops held in the summer of 2013. Subsequently, the Missouri River Pallid Sturgeon Effects Analysis team designed a general hierarchical structure for the component models, refined the graphical structure, and reconciled variation among the components and between models developed for the upper river (Upper Missouri & Yellowstone Rivers) and the lower river (Missouri River downstream from Gavins Point Dam). Importance scores attributed to the relations between primary biotic characteristics and survival were used to define a candidate set of working dominant hypotheses about pallid sturgeon population dynamics. These CEMs are intended to guide research and adaptive-management actions to benefit pallid sturgeon populations in the Missouri River.

[Shoulder disability questionnaires: a systematic review].

PubMed

Fayad, F; Mace, Y; Lefevre-Colau, M M

2005-07-01

To identify all available shoulder disability questionnaires designed to measure physical functioning and to examine those with satisfactory clinimetric quality. We used the Medline database and the "Guide des outils de mesure de l'évaluation en médecine physique et de réadaptation" textbook to search for questionnaires. Analysis took into account the development methodology, clinimetric quality of the instruments and frequency of their utilization. We classified the instruments according to the International Classification of Functioning, Disability and Health. Thirty-eight instruments have been developed to measure disease-, shoulder- or upper extremity-specific outcome. Four scales assess upper-extremity disability and 3 others shoulder disability. We found 6 scales evaluating disability and shoulder pain, 7 scales measuring the quality of life in patients with various conditions of the shoulder, 14 scales combining objective and subjective measures, 2 pain scales and 2 unclassified scales. Older instruments developed before the advent of modern measurement development methodology usually combine objective and subjective measures. Recent instruments were designed with appropriate methodology. Most are self-administered questionnaires. Numerous shoulder outcome measure instruments are available. There is no "gold standard" for assessing shoulder function outcome in the general population.

Study of long term effect of Solar UV and X-ray radiation on the VLF signals

NASA Astrophysics Data System (ADS)

Ray, Suman; Chakrabarti, Sandip Kumar; Sanki, Dipak

2016-07-01

Very Low Frequency (VLF) is one of the bands of Radio waves having frequencies lying between 3-30 KHz, with wavelengths 100-10 Km. It propagates through the Earth-ionosphere wave-guide which is formed by lower part of the ionosphere and upper part of Earth's surface. Ionosphere is the ionized component of upper atmosphere. In the present work, we have studied the long term effect of the high energy solar UV and X-ray radiation on the VLF signals. We have analyzed the VLF signal transmitted at 24 KHz from NAA (Cutler, Maine) and received at Moore Observatory in Brownsboro, Kentucky. Also we have collected X-ray and UV data to study the long term effect of UV and X-ray radiation on the VLF signal. We have analyzed the VLF signal for 2007 to 2015. We calculate the average diurnal peak amplitude of the VLF signal for each day and compare it with the UV and X-ray solar radiation. We found that the correlation coefficient of diurnal peak VLF signal amplitude with both solar X-ray and UV radiation is 0.7 indicating a strong correlation between these two phenomena.

Influence of Preadjusted Bracket Shape and Positioning Reference on Angulation of Upper Central Incisor.

PubMed

Topolski, Francielle; de O Accorsi, Mauricio A; Trevisi, Hugo J; Cuoghi, Osmar A; Moresca, Ricardo

2016-10-01

To verify the influence of different bracket shapes and placement references according to Andrews and MBT systems on the expression of angulation in upper central incisors (UCI). Bracket positioning and mesiodistal dental movement simulations were performed and the angulations produced in the dental crown were evaluated, based on computed tomography scan images of 30 UCI and AutoCAD software analysis. Rectangular (Andrews) and rhomboid (MBT) brackets were placed according to the references recommended by Andrews and MBT systems - long axis of the clinical crown (LACC) and incisal edge (IE) respectively. Data showed that the use of LACC as reference for bracket positioning produced 5° and 4° UCI angulations in Andrews and MBT brackets respectively. The use of IE produced a 1.2° mean angulation in UCI for both brackets. When the LACC was used as reference for bracket positioning, the UCI crown angulation corresponded to the angulation built into the brackets, regardless of shape, while the use of IE resulted in natural crown angulation, regardless of bracket shape. This research contributes to guide the orthodontist in relation to the different treatment techniques based on the use of preadjusted brackets.

Squamous cell carcinoma variants of the upper aerodigestive tract: a comprehensive review with a focus on genetic alterations.

PubMed

Shah, Akeesha A; Jeffus, Susanne K; Stelow, Edward B

2014-06-01

Squamous cell carcinoma of the upper aerodigestive tract is a heterogenous entity. Although conventional squamous cell carcinomas are easily recognized, the morphologic variants of squamous cell carcinoma can present a diagnostic challenge. Familiarity with these variants is necessary because many are associated with unique risk factors and are characterized by specific molecular alterations (eg, nuclear protein in testis midline carcinomas). Perhaps the most important distinction is in identifying viral-related from nonviral-related carcinomas. The accurate diagnosis of these variants is necessary for prognostic and therapeutic reasons. To provide a clinicopathologic overview and summary of the molecular alterations of the common squamous cell carcinoma variants, including verrucous, spindle cell, acantholytic, adenosquamous, basaloid, and papillary squamous cell carcinoma, as well as nuclear protein in testis midline carcinoma, and to discuss the distinguishing features of human papillomavirus- and Epstein-Barr virus-related squamous cell carcinomas. Published peer-reviewed literature. Familiarity with squamous cell carcinoma variants is essential for proper diagnosis and to guide appropriate clinical management. Further insight into the molecular alterations underlying those variants may lead to alterations in existing treatment approaches and to evolution of novel treatment modalities.

General classification handbook for floodplain vegetation in large river systems

USGS Publications Warehouse

Dieck, Jennifer J.; Ruhser, Janis; Hoy, Erin E.; Robinson, Larry R.

2015-01-01

This handbook describes the General Wetland Vegetation Classification System developed as part of the U.S. Army Corps of Engineers’ Upper Mississippi River Restoration (UMRR) Program, Long Term Resource Monitoring (LTRM) element. The UMRR is a cooperative effort between the U.S. Army Corps of Engineers, U.S. Geological Survey, U.S. Fish and Wildlife Service, and the states of Illinois, Iowa, Minnesota, Missouri, and Wisconsin. The classification system consists of 31 general map classes and has been used to create systemic vegetation data layers throughout the diverse Upper Mississippi River System (UMRS), which includes the commercially navigable reaches of the Mississippi River from Minneapolis, Minnesota, in the north to Cairo, Illinois, in the south, the Illinois River, and navigable portions of the Kaskaskia, Black, St. Croix, and Minnesota Rivers. In addition, this handbook describes the evolution of the General Wetland Vegetation Classification System, discusses the process of creating a vegetation data layer, and describes each of the 31 map classes in detail. The handbook also acts as a pictorial guide to each of the map classes as they may appear in the field, as well as on color-infrared imagery. This version is an update to the original handbook published in 2004.

Stratigraphy of Citronelle Oil Field, AL: Perspectives from Enhanced Oil Recovery and Potential CO2 Sequestration

NASA Astrophysics Data System (ADS)

Hills, D. J.; Pashin, J. C.; Kopaska-Merkel, D. C.; Esposito, R. A.

2008-12-01

The Citronelle Dome is a giant salt-cored anticline in the eastern Mississippi Interior Salt Basin of south Alabama. The dome forms an elliptical structural closure containing multiple opportunities for enhanced oil recovery (EOR) and large-capacity saline reservoir CO2 sequestration. The Citronelle Oil Field, which is on the crest of the dome, has produced more than 168 MMbbl of 42° gravity oil from marginal marine sandstone in the Lower Cretaceous Donovan Sand. Recently, EOR field tests have begun in the northeastern part of the oil field. Citronelle Unit B-19-10 #2 well (Alabama State Oil and Gas Board Permit No. 3232) will serve as the CO2 injector for the first field test. CO2 will be injected into the Upper Donovan 14-1 and 16-2 sandstone units. All well logs in the 4-square-mile area surrounding the test site have been digitized and used to construct a network of nineteen stratigraphic cross sections correlating Sands 12 through 20A in the Upper Donovan. Detailed study of Citronelle cores has shown that depositional environments in the Donovan Sand differed significantly from the earlier model that has guided past development of the Citronelle Field. The cross sections demonstrate the extreme facies heterogeneity of the Upper Donovan, and this heterogeneity is well expressed within the five-spot well pattern where the field test will be conducted. Many other features bearing on the performance of the CO2 injection test have been discovered. Of particular interest is the 16-2 sand, which is interpreted as a composite of two tiers of channel fills. Pay strata are typically developed in the lower tier, and this is where CO2 will be injected. The upper tier is highly heterogeneous and is interpreted to contain sandstone fills of variable reservoir quality, as well as mudstone plugs.

Simulation of streamflow and the effects of brush management on water yields in the upper Guadalupe River watershed, south-central Texas, 1995-2010

USGS Publications Warehouse

Bumgarner, Johnathan R.; Thompson, Florence E.

2012-01-01

The U.S. Geological Survey, in cooperation with the Texas State Soil and Water Conservation Board and the Upper Guadalupe River Authority, developed and calibrated a Soil and Water Assessment Tool watershed model of the upper Guadalupe River watershed in south-central Texas to simulate streamflow and the effects of brush management on water yields in the watershed and to Canyon Lake for 1995-2010. Model simulations were done to quantify the possible change in water yield of individual subbasins in the upper Guadalupe River watershed as a result of the replacement of ashe juniper (Juniperus ashei) with grasslands. The simulation results will serve as a tool for resource managers to guide their brush-management efforts. Model hydrology was calibrated with streamflow data collected at the U.S. Geological Survey streamflow-gaging station 08167500 Guadalupe River near Spring Branch, Tex., for 1995-2010. Simulated monthly streamflow showed very good agreement with measured monthly streamflow: a percent bias of -5, a coefficient of determination of 0.91, and a Nash-Sutcliffe coefficient of model efficiency of 0.85. Modified land-cover input datasets were generated for the model in order to simulate the replacement of ashe juniper with grasslands in 23 brush-management subbasins in the watershed. Each of the 23 simulations showed an increase in simulated water yields in the targeted subbasins and to Canyon Lake. The simulated increases in average annual water yields in the subbasins ranged from 6,370 to 119,000 gallons per acre of ashe juniper replaced with grasslands with an average of 38,900 gallons. The simulated increases in average annual water yields to Canyon Lake from upstream subbasins ranged from 6,640 to 72,700 gallons per acre of ashe juniper replaced with grasslands with an average of 34,700 gallons.

Patterns of nodal metastases on 18F-FDG PET/CT in patients with esophageal squamous cell carcinoma are useful to guide treatment planning of radiotherapy.

PubMed

Liu, Chia-Ju; Cheng, Jason Chia-Hsien; Lee, Jang-Ming; Cheng, Mei-Fang; Tzen, Kai-Yuan; Yen, Ruoh-Fang

2015-05-01

The aim of the study was to examine the patterns of lymph node metastases from esophageal squamous cell carcinoma (ESCC) and compare the laterality of lymphatic metastasis in cervical, supraclavicular, and paratracheal areas using F-FDG PET/CT. The data of 75 patients who underwent F-FDG PET/CT for staging of ESCC between January 2011 and March 2012 were reviewed. Fourteen groups of lymph nodes from the neck to abdomen were defined. Lateralization of the upper thoracic lymph nodes was defined in reference to the midline of the trachea. Frequencies of positive lymph nodes were used to determine the pattern of lymphatic spread and compare the lateralization of metastases in the cervical and upper thoracic regions. The right paratracheal region was the most frequent site of metastasis among all patients. Left paratracheal and paragastric nodes were more frequent in upper and lower third ESCC, respectively. Upward and downward lymphatic spread was equal in mid third ESCC. In all patients, there was a trend toward more frequent lymph node metastasis on the right side than the left side for the supraclavicular and paratracheal regions. Further stratified analysis with tumor location found that right paratracheal node metastasis was significantly associated with mid third ESCC (P = 0.03). Remote nodal metastasis was found in 10.5% of patients with upper third ESCC and 13% of patients with lower third ESCC, respectively. Remote nodal metastasis was associated with higher SUV of the primary tumor (P = 0.02) and worse survival (P = 0.03). Receiver operating characteristic analysis showed a cutoff SUV of 14.8 for predicting remote lymph node metastases. PET/CT provides important information before radiotherapy planning. Mid and lower third ESCC tends to metastasize to the right paratracheal/supraclavicular lymph nodes. Remote nodal metastases on PET/CT correlated with higher primary tumor SUV and worse survival.

SHOULDER RANGE OF MOTION, PITCH COUNT, AND INJURIES AMONG INTERSCHOLASTIC FEMALE SOFTBALL PITCHERS: A DESCRIPTIVE STUDY

PubMed Central

Michener, Lori A.; Ellenbecker, Todd S.; Rauh, Mitchell J.

2012-01-01

Background/Purpose: Injury rates for softball players are similar to baseball players yet information regarding risk factors, pitching, and physical characteristics for high school windmill softball pitchers is limited. This information is needed to guide prevention, training, and rehabilitation efforts. The purpose of this study was to report descriptive data regarding the physical characteristics and pitching volume experienced by high school softball pitchers during one academic season. A secondary aim was to track and describe upper extremity injuries suffered by high school softball pitchers throughout the course of the 2009 season. Methods: Twelve uninjured female softball pitchers (13‐18y) from 5 Greenville, South Carolina high schools participated. Prior to the 2009 season, the pitchers' shoulder internal, external, total arc of rotation and horizontal adduction PROM was measured. During the 10‐week season, aggregate pitch counts (pitch volume) and occurrence of upper extremity injury were tracked for each pitcher. Results: Mean preseason internal, external, and total arc of rotation PROM was observed to be similar between the pitchers' dominant and non‐dominant shoulders. The PROM measures of horizontal abduction (HA) appear to demonstrate a side‐to‐side difference with less HA on the dominant arm of the pitchers who were examined. Subjects threw in an average of 10.1 games (±4.9) during the season. Six pitchers threw in 60% or more of the team's games and 3 of 12 pitchers pitched less than 25% of games. Pitchers averaged 61.8 pitches per game (±31.5) and 745.8 (±506.4) per season. Pitch count data did not appear to be different between injured and non‐injured pitchers. Conclusions: Knowledge of pitch volume can be used to prepare windmill softball pitchers for the seasonal stresses, guide establishment of goals when recovering from injury, or assist in training for an upcoming season. Further research is needed to examine larger samples of pitchers over multiple seasons and years. Level of Evidence: III PMID:23091788

The Ultrasound-Guided Retroclavicular Block: A Prospective Feasibility Study.

PubMed

Charbonneau, Jasmin; Fréchette, Yannick; Sansoucy, Yanick; Echave, Pablo

2015-01-01

The aim of this feasibility study was to determine the success rate (sensory and surgical) of the novel retroclavicular block and to thoroughly describe the technique. In addition, needle tip and shaft visibility, needling time, procedural discomfort, motor block success rate, patient satisfaction at 48-hour follow-up, and complications were also recorded. Fifty patients scheduled for distal upper limb surgery received an in-plane, single-shot, ultrasound-guided retroclavicular block with 40 mL of mepivacaine 1.5% with epinephrine 2.5 μg/mL. Block success was defined as a sensory score of 10/10 for the 5 nerves supplying the distal upper limb at 30 minutes. Surgical success, needle visibility, needling time, axillary artery depth, motor block rate, patient discomfort with technique, satisfaction at 48 hours, and complications were also recorded. All blocks were video-recorded and timed for further independent assessment. A chest x-ray was obtained before discharge. Forty-five patients had a total sensory score of 10/10 at 30 minutes (90% success rate). Surgical success rate was 96%. Mean needling time was 3.77 minutes (25th-75th percentiles, 2.90-6.53 minutes) with a mean axillary artery depth of 3.1 ± 0.7 cm. Procedure-related discomfort (mean visual analog scale, 1.9 ± 1.2) was low. Mean 48-hour patient satisfaction rate (9.2 ± 1.1), mean needle tip (Likert scale, 3.0 ± 0.9), and shaft visibility (3.9 ± 0.9) were high. One vascular puncture and two transient paresthesias were recorded. No pneumothorax was revealed by chest x-ray. In this study, the novel retroclavicular block offered a quick, safe, and reliable alternative for distal arm block. Further studies, comparing this approach with the classic infraclavicular block, are required to validate its efficacy, safety, and reliability.

Molecular Testing in Multiple Synchronous Lung Adenocarcinomas: Case Report and Literature Review.

PubMed

Rafael, Oana C; Lazzaro, Richard; Hasanovic, Adnan

2016-02-01

Discovery of driver mutations in pulmonary adenocarcinoma has revolutionized the field of thoracic oncology with major impact on therapy and diagnosis. Testing for EGFR, ALK, and KRAS mutations has become part of everyday practice. We report a case with multiple synchronous primary pulmonary adenocarcinomas in a 72-year-old female with previous history of smoking. The patient presented with cough and bilateral lung ground glass opacities. A positron emission tomography/computed tomography scan showed no activity in mediastinal lymph nodes. She underwent a left upper lobe biopsy and a right upper lobe wedge resection. Pathology revealed 4 morphologically distinct adenocarcinoma foci, suggestive of synchronous primary lung tumors. Molecular testing demonstrated no mutation in the left tumor. Three different driver mutations were present in the right lung tumors: KRAS codon 12 G12D and G12V and EGFR exon 21 L858R mutation, confirming the initial histologic impression. Subsequently, left upper lobe lobectomy showed 3 additional foci of adenocarcinoma with different morphologies, suggestive of synchronous primaries as well. No additional molecular testing was performed. Synchronous pulmonary adenocarcinomas are not uncommon; however, 4 or more synchronous tumors are rare. Distinguishing multiple primary tumors from intrapulmonary metastases is a common problem in thoracic oncology with major implications for staging, prognosis, and treatment. Lung adenocarcinoma subclassification based on predominant and coexisting histologic patterns can greatly facilitate differentiation between intrapulmonary metastases and multiple synchronous tumors. Use of molecular profiling is recommended since it further increases confidence in the diagnostic workup of multiple pulmonary adenocarcinomas and helps guiding therapy. © The Author(s) 2015.

Emergence of oropharyngeal, laryngeal and swallowing activity in the developing fetal upper aerodigestive tract: an ultrasound evaluation.

PubMed

Miller, Jeri L; Sonies, Barbara C; Macedonia, Christian

2003-02-01

The developing fetal upper aerodigestive system provides the structural support for respiratory and ingestive functions necessary to sustain life at birth. This study investigated prenatal development of upper aerodigestive anatomy and the association of emerging functions as predictors of postnatal feeding skills. Biometric measures of oral, lingual, pharyngeal and laryngeal structures were obtained in fetuses 15-38 weeks gestational age using a four-plane sonographic technique. Accompanying ingestive behaviors were tallied across development. The data from 62 healthy controls were compared to seven cases at risk for postnatal feeding and swallowing dysfunction (Type II Arnold Chiari Malformation, trisomy 18, polyhydramnios, intrauterine growth restriction, Brachmann-de Lange Syndrome). Significant (p<0.001) linear regressions occurred in pharyngeal and lingual growth across gestation while ingestive behavior such as suckling emerged in a sequence of basic to complex movement patterns. Jaw and lip movements progressed from simple mouth opening to repetitive open-close movements important for postnatal suckling. Lingual movements increased in complexity from simple forward thrusting and cupping to anterior-posterior motions necessary for successful suckling at term. Laryngeal movements varied from shallow flutter-like movements along the lumen to more complex and complete adduction-abduction patterns. Fetal swallowing primarily occurred in the presence of concomitant oral-facial stimulatory activity. Significant variations (p<0.01) in the form and function of the ingestive system occurred in comparisons of gestational age-matched controls to at-risk cases. We postulate that prenatal developmental indices of emerging aerodigestive skills may guide postnatal decisions for feeding readiness and, ultimately, advance the care of the premature, medically fragile neonate.

A Clinically Relevant Method of Analyzing Continuous Change in Robotic Upper Extremity Chronic Stroke Rehabilitation.

PubMed

Massie, Crystal L; Du, Yue; Conroy, Susan S; Krebs, H Igo; Wittenberg, George F; Bever, Christopher T; Whitall, Jill

2016-09-01

Robots designed for rehabilitation of the upper extremity after stroke facilitate high rates of repetition during practice of movements and record precise kinematic data, providing a method to investigate motor recovery profiles over time. To determine how motor recovery profiles during robotic interventions provide insight into improving clinical gains. A convenience sample (n = 22), from a larger randomized control trial, was taken of chronic stroke participants completing 12 sessions of arm therapy. One group received 60 minutes of robotic therapy (Robot only) and the other group received 45 minutes on the robot plus 15 minutes of translation-to-task practice (Robot + TTT). Movement time was assessed using the robot without powered assistance. Analyses (ANOVA, random coefficient modeling [RCM] with 2-term exponential function) were completed to investigate changes across the intervention, between sessions, and within a session. Significant improvement (P < .05) in movement time across the intervention (pre vs post) was similar between the groups but there were group differences for changes between and within sessions (P < .05). The 2-term exponential function revealed a fast and slow component of learning that described performance across consecutive blocks. The RCM identified individuals who were above or below the marginal model. The expanded analyses indicated that changes across time can occur in different ways but achieve similar goals and may be influenced by individual factors such as initial movement time. These findings will guide decisions regarding treatment planning based on rates of motor relearning during upper extremity stroke robotic interventions. © The Author(s) 2015.

Framework for understanding the patterns of student difficulties in quantum mechanics

NASA Astrophysics Data System (ADS)

Marshman, Emily; Singh, Chandralekha

2015-12-01

[This paper is part of the Focused Collection on Upper Division Physics Courses.] Compared with introductory physics, relatively little is known about the development of expertise in advanced physics courses, especially in the case of quantum mechanics. Here, we describe a framework for understanding the patterns of student reasoning difficulties and how students develop expertise in quantum mechanics. The framework posits that the challenges many students face in developing expertise in quantum mechanics are analogous to the challenges introductory students face in developing expertise in introductory classical mechanics. This framework incorporates both the effects of diversity in upper-level students' prior preparation, goals, and motivation in general (i.e., the facts that even in upper-level courses, students may be inadequately prepared, have unclear goals, and have insufficient motivation to excel) as well as the "paradigm shift" from classical mechanics to quantum mechanics. The framework is based on empirical investigations demonstrating that the patterns of reasoning, problem-solving, and self-monitoring difficulties in quantum mechanics bear a striking resemblance to those found in introductory classical mechanics. Examples from research in quantum mechanics and introductory classical mechanics are discussed to illustrate how the patterns of difficulties are analogous as students learn to unpack the respective principles and grasp the formalism in each knowledge domain during the development of expertise. Embracing such a framework and contemplating the parallels between the difficulties in these two knowledge domains can enable researchers to leverage the extensive literature for introductory physics education research to guide the design of teaching and learning tools for helping students develop expertise in quantum mechanics.

Carcinosarcoma of the upper urinary tract with an aggressive angiosarcoma component.

PubMed

Cuadra-Urteaga, José Luis; Font, Albert; Tapia, Gustavo; Areal, Juan; Taron, Miquel

2016-01-01

Carcinosarcomas (CS) are biphasic tumors with malignant epithelial and mesenchymal elements. The sarcomatoid elements of CS can include chondrosarcoma, malignant fibrous histiocytoma, osteosarcoma, leiomyosarcoma, fibrosarcoma, or liposarcoma. CS of the upper urinary tract are extremely rare but are associated with a poor prognosis. We report a case of a 44-year-old man with a localized right renal pelvis mass treated with a right nephroureterectomy. The pathological examination showed a high-grade urothelial carcinoma of the renal pelvis, stage III (pT3aNxM0). A few days later, he developed lower back pain, hematuria, cough with hemoptoic sputum and progressive dyspnea. Radiological explorations showed multiple bilateral lung nodules and a retroperitoneal mass. A CT-guided biopsy of the retroperitoneal mass revealed a high-grade angiosarcoma. A review of the nephrectomy specimen showed a microscopic focus of angiosarcoma in the urothelial carcinoma. Therefore, the initial diagnosis was changed to CS of the renal pelvis with an angiosarcoma component. The patient developed progressive respiratory failure and died 8 weeks after surgery. An autopsy revealed a large retroperitoneal mass with metastatic nodules to the abdominal wall, diaphragm, small intestine, liver, spleen, and lung. All lesions were angiosarcoma, with no evidence of urothelial carcinoma. This is the first case reported of a patient with CS of the upper urinary tract with an angiosarcoma component with a very aggressive course that caused the immediate appearance of multiple angiosarcoma metastases. We also describe the clinical and molecular characteristics of CS, which will help to contribute to a better understanding of this type of tumor.

Carcinosarcoma of the upper urinary tract with an aggressive angiosarcoma component

PubMed Central

Cuadra-Urteaga, José Luis; Font, Albert; Tapia, Gustavo; Areal, Juan; Taron, Miquel

2016-01-01

ABSTRACT Carcinosarcomas (CS) are biphasic tumors with malignant epithelial and mesenchymal elements. The sarcomatoid elements of CS can include chondrosarcoma, malignant fibrous histiocytoma, osteosarcoma, leiomyosarcoma, fibrosarcoma, or liposarcoma. CS of the upper urinary tract are extremely rare but are associated with a poor prognosis. We report a case of a 44-year-old man with a localized right renal pelvis mass treated with a right nephroureterectomy. The pathological examination showed a high-grade urothelial carcinoma of the renal pelvis, stage III (pT3aNxM0). A few days later, he developed lower back pain, hematuria, cough with hemoptoic sputum and progressive dyspnea. Radiological explorations showed multiple bilateral lung nodules and a retroperitoneal mass. A CT-guided biopsy of the retroperitoneal mass revealed a high-grade angiosarcoma. A review of the nephrectomy specimen showed a microscopic focus of angiosarcoma in the urothelial carcinoma. Therefore, the initial diagnosis was changed to CS of the renal pelvis with an angiosarcoma component. The patient developed progressive respiratory failure and died 8 weeks after surgery. An autopsy revealed a large retroperitoneal mass with metastatic nodules to the abdominal wall, diaphragm, small intestine, liver, spleen, and lung. All lesions were angiosarcoma, with no evidence of urothelial carcinoma. This is the first case reported of a patient with CS of the upper urinary tract with an angiosarcoma component with a very aggressive course that caused the immediate appearance of multiple angiosarcoma metastases. We also describe the clinical and molecular characteristics of CS, which will help to contribute to a better understanding of this type of tumor. PMID:26891233

Muscle focal vibration in healthy subjects: evaluation of the effects on upper limb motor performance measured using a robotic device.

PubMed

Aprile, Irene; Di Sipio, Enrica; Germanotta, Marco; Simbolotti, Chiara; Padua, Luca

2016-04-01

Muscle vibration is a technique that applies a low-amplitude/high-frequency vibratory stimulus to a specific muscle using a mechanical device. The aim of this study was to evaluate, using robot-based outcomes, the effects of focal muscle vibration, at different frequencies, on the motor performance of the upper limb in healthy subjects. Forty-eight volunteer healthy subjects (age: 31 ± 8 years) were enrolled. Subjects were assigned to three different groups: the first group, in which subjects underwent muscle vibration treatment with a frequency of 100 Hz; the second group of subjects underwent the same treatment protocol, but using a frequency of vibration of 200 Hz; finally, the control group did not undergo any treatment. The robot-based evaluation session consisted of visually guided reaching task, performed in the sagittal plane. Our results showed that the vibration treatment improved upper limb motor performance of healthy subjects from the baseline (T0) to 10 days after the end of the treatment (T2), but only the group treated with a frequency of 200 Hz reached statistical significance. Specifically, in this group we found an increase of the number of repetitions (T0: 51.4 ± 22.7; T2: 66.3 ± 11.8), and the smoothness of the movement, as showed by a decrease of the Normalized Jerk (T0: 10.5 ± 2.8; T2: 7.7 ± 0.5). The results of our study support the use of focal muscle vibration protocols in healthy subjects, to improve motor performance.

Office-based Electromyography-guided Botulinum Toxin Injection to the Cricopharyngeus Muscle: Optimal Patient Selection and Technique.

PubMed

Kim, Min-Su; Kim, Go-Woon; Rho, Young-Soo; Kwon, Kee-Hwan; Chung, Eun-Jae

2017-05-01

This retrospective study was carried out to investigate the effectiveness and safety of office-based electromyography-guided injection of botulinum toxin in the cricopharyngeus muscle of patients who did not show upper esophageal sphincter passage in a swallowing study in spite of maximal swallowing rehabilitation. Thirty-six patients who showed no or limited ability to oral feed after maximum swallowing rehabilitation were enrolled. Video fluoroscopic swallowing study, flexible endoscopic evaluation of swallowing, disability rating scale, penetration aspiration score, and National Institutes of Health swallowing safety scale were used in the evaluation of dysphagia. Success was defined as nondependence on gastrostomy for patients who previously were dependent on gastrostomy and improvement in disability rating scale score after botulinum toxin injections. The total success rate was 63.9%. The complication rate was very low, with only 1 patient showing temporary unilateral vocal fold paralysis. Botulinum toxin injection was more effective in patients with cranial nerve IX or X palsy than in those without it ( P = .006). This procedure can be a simple, safe, and effective tool in patients with cricopharyngeal dysfunction after swallowing rehabilitation, especially for cranial nerve IX or X palsy.

Model-Based Reasoning in Upper-division Lab Courses

NASA Astrophysics Data System (ADS)

Lewandowski, Heather

2015-05-01

Modeling, which includes developing, testing, and refining models, is a central activity in physics. Well-known examples from AMO physics include everything from the Bohr model of the hydrogen atom to the Bose-Hubbard model of interacting bosons in a lattice. Modeling, while typically considered a theoretical activity, is most fully represented in the laboratory where measurements of real phenomena intersect with theoretical models, leading to refinement of models and experimental apparatus. However, experimental physicists use models in complex ways and the process is often not made explicit in physics laboratory courses. We have developed a framework to describe the modeling process in physics laboratory activities. The framework attempts to abstract and simplify the complex modeling process undertaken by expert experimentalists. The framework can be applied to understand typical processes such the modeling of the measurement tools, modeling ``black boxes,'' and signal processing. We demonstrate that the framework captures several important features of model-based reasoning in a way that can reveal common student difficulties in the lab and guide the development of curricula that emphasize modeling in the laboratory. We also use the framework to examine troubleshooting in the lab and guide students to effective methods and strategies.

Preoperative determination of appropriate cutting line for proximal gastrectomy to avoid postoperative jejunal ulcer.

PubMed

Takahashi, Naoto; Kashimura, Hirotaka; Nimura, Hiroshi; Watanabe, Atsushi; Yano, Kentaro; Aoki, Hiroaki; Koyama, Tomoki; Sasaki, Toshiyuki; Shida, Atsuo; Mitsumori, Norio; Aoki, Teruaki; Kashiwagi, Hideyuki; Yanaga, Katsuhiko

2012-01-01

Although proximal gastrectomy has become a procedure of choice for patients' early cancer in the upper third of stomach, no clinical guide for optimal gastric resection in order to avoid postoperative jejunal ulcer is available. The aim of this study was to investigate whether determining the distribution of parietal and chief cells of the stomach using Congo red test is clinically relevant. The F-line was defined as a boundary line between fundic and intermediate area of the stomach according to the pathological findings in 29 patients who underwent total gastrectomy for early gastric cancer, whereas the f-line was regarded as a boundary line between intermediate and pyloric area. In the additional 6 patients undergoing vagus-preserving proximal gastrectomy with jejunal pouch interposition, endoscopic Congo red test was preoperatively performed to determine the F-f-line. The distances from the pyloric ring to f-line on the lesser and greater curvatures were variable. Long-term outcomes of proximal gastrectomy guided by preoperative endoscopic Congo red test were favorable. It is suggested that preoperative endoscopic Congo red test is useful to determine the appropriate cutting line in order to avoid postoperative jejunal ulcer after proximal gastrectomy.

Management of Dupuytren contracture with ultrasound-guided lidocaine injection and needle aponeurotomy coupled with osteopathic manipulative treatment.

PubMed

Sampson, Steven; Meng, Michael; Schulte, Adam; Trainor, Drew; Montenegro, Roberto; Aufiero, Danielle

2011-02-01

Dupuytren contracture is a debilitating disease that characteristically presents as a firm nodularity on the palmar surface of the hand with coalescing cords of soft tissue on the webs and digits. With few nonsurgical modalities providing clinical benefits, open surgical procedures are the standard of care for patients with this condition. However, recent studies have associated surgical intervention with many complications, necessitating further exploration of nonsurgical treatment options. We describe the case of a 64-year-old woman who presented with decreased extension of the fourth and fifth digits on the upper extremities bilaterally; previous conservative treatment regimens had been unsuccessful. After a diagnostic ultrasound, the patient was diagnosed as having Dupuytren contracture and underwent 5 treatments consisting of ultrasound-guided dry-needle aponeurotomy, lidocaine injections, and osteopathic manipulative treatment. During the fifth treatment session, the patient experienced dramatic relief of her symptoms after a palpable release during the manual manipulation portion of her therapeutic regimen. At 2-week follow-up, the patient was symptom-free. Based on this desirable outcome, the authors suggest future research be directed at minimally invasive therapeutic options in the management of Dupuytren contracture.

Sigmoid irrigation tube for the management of chronic evacuation disorders.

PubMed

Gauderer, Michael W L; Decou, James M; Boyle, John T

2002-03-01

Antegrade colonic irrigation, in which the right colon is accessed via appendicostomy or cecostomy, now is an important adjunct in the management of children with chronic evacuation disorders. However, in most children, the major area of dysfunction is the left rather than the right colon. The authors developed a simple, percutaneous endoscopic, laparoscopically controlled sigmoid irrigation tube placement and evaluated the results in 4 children. A rigid sigmoidoscope is advanced into the upper sigmoid and the loop brought in contact with the abdominal wall under laparoscopic control. A small skin incision is made and a needle pushed across the abdominal and sigmoid walls into the lumen of the sigmoidoscope. A guide wire is advanced through the needle into the scope and retrieved. After the scope is removed, a PEG-type catheter is attached to the guide wire and pulled back, securing the sigmoid loop to the abdominal wall. The tube is subsequently converted to a skin-level device by simply adding an external port valve. All 4 patients achieved prompt evacuation in the sitting position. Sigmoid tube for antegrade irrigation is an appealing alternative to conventional cecal access. The procedure is simple and may offer physiologic advantages. Copyright 2002 by W.B. Saunders Company.

RNA-Seq analyses reveal the order of tRNA processing events and the maturation of C/D box and CRISPR RNAs in the hyperthermophile Methanopyrus kandleri

PubMed Central

Su, Andreas A. H.; Tripp, Vanessa; Randau, Lennart

2013-01-01

The methanogenic archaeon Methanopyrus kandleri grows near the upper temperature limit for life. Genome analyses revealed strategies to adapt to these harsh conditions and elucidated a unique transfer RNA (tRNA) C-to-U editing mechanism at base 8 for 30 different tRNA species. Here, RNA-Seq deep sequencing methodology was combined with computational analyses to characterize the small RNome of this hyperthermophilic organism and to obtain insights into the RNA metabolism at extreme temperatures. A large number of 132 small RNAs were identified that guide RNA modifications, which are expected to stabilize structured RNA molecules. The C/D box guide RNAs were shown to exist as circular RNA molecules. In addition, clustered regularly interspaced short palindromic repeats RNA processing and potential regulatory RNAs were identified. Finally, the identification of tRNA precursors before and after the unique C8-to-U8 editing activity enabled the determination of the order of tRNA processing events with termini truncation preceding intron removal. This order of tRNA maturation follows the compartmentalized tRNA processing order found in Eukaryotes and suggests its conservation during evolution. PMID:23620296

Effect of warming bupivacaine 0.5% on ultrasound-guided axillary plexus block. Randomized prospective double-blind study.

PubMed

Trabelsi, W; Ben Gabsia, A; Lebbi, A; Sammoud, W; Labbène, I; Kchelfi, S; Ferjani, M

2017-02-01

To evaluate the effect of warming bupivacaine 0.5% on ultrasound-guided axillary brachial plexus block. Prospective, randomized, double-blind. Eighty patients undergoing elective or emergency surgery beyond the distal third of the upper limb were divided into two groups of 40 patients: the warm group received 15mL bupivacaine 0.5% heated to 37°C; the cold group received 15mL 0.5% bupivacaine stored for at least 24hours in the lower compartment of a refrigerator at 13-15°C. Onset and duration of sensory and motor blocks were evaluated every 5minutes for 40minutes. Postoperative pain was evaluated at 1, 3, 6, 12 and 24hours. Effective analgesia time was recorded as the interval between anesthetic injection and the first analgesia requirement (VAS>30mm). Time to onset of sensory and motor block was significantly shorter in the warm group, and mean duration of sensory and motor block and of postoperative analgesia significantly longer. Warming bupivacaine 0.5% to 37°C accelerated onset of sensory and motor block and extended action duration. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Robot-Aided Neurorehabilitation: A Pediatric Robot for Ankle Rehabilitation

PubMed Central

Michmizos, Konstantinos P.; Rossi, Stefano; Castelli, Enrico; Cappa, Paolo; Krebs, Hermano Igo

2015-01-01

This paper presents the pediAnklebot, an impedance-controlled low-friction, backdriveable robotic device developed at the Massachusetts Institute of Technology that trains the ankle of neurologically impaired children of ages 6-10 years old. The design attempts to overcome the known limitations of the lower extremity robotics and the unknown difficulties of what constitutes an appropriate therapeutic interaction with children. The robot's pilot clinical evaluation is on-going and it incorporates our recent findings on the ankle sensorimotor control in neurologically intact subjects, namely the speed-accuracy tradeoff, the deviation from an ideally smooth ankle trajectory, and the reaction time. We used these concepts to develop the kinematic and kinetic performance metrics that guided the ankle therapy in a similar fashion that we have done for our upper extremity devices. Here we report on the use of the device in at least 9 training sessions for 3 neurologically impaired children. Results demonstrated a statistically significant improvement in the performance metrics assessing explicit and implicit motor learning. Based on these initial results, we are confident that the device will become an effective tool that harnesses plasticity to guide habilitation during childhood. PMID:25769168

Detection of malignant lesions in vivo in the upper gastrointestinal tract using image-guided Raman endoscopy

NASA Astrophysics Data System (ADS)

Bergholt, Mads Sylvest; Zheng, Wei; Lin, Kan; Ho, Khek Yu; Yeoh, Khay Guan; Teh, Ming; So, Jimmy Bok Yan; Huang, Zhiwei

2012-01-01

Raman spectroscopy is a vibrational analytic technique sensitive to the changes in biomolecular composition and conformations occurring in tissue. With our most recent development of near-infrared (NIR) Raman endoscopy integrated with diagnostic algorithms, in vivo real-time Raman diagnostics has been realized under multimodal wide-field imaging (i.e., white- light reflectance (WLR), narrow-band imaging (NBI), autofluorescence imaging (AFI)) modalities. A selection of 177 patients who previously underwent Raman endoscopy (n=2510 spectra) was used to render two robust models based on partial least squares - discriminant analysis (PLS-DA) for esophageal and gastric cancer diagnosis. The Raman endoscopy technique was validated prospectively on 4 new gastric and esophageal patients for in vivo tissue diagnosis. The Raman endoscopic technique could identify esophageal cancer in vivo with a sensitivity of 88.9% (8/9) and specificity of 100.0% (11/11) and gastric cancers with a sensitivity of 77.8% (14/18) and specificity of 100.0% (13/13). This study realizes for the first time the image-guided Raman endoscopy for real-time in vivo diagnosis of malignancies in the esophagus and gastric at the biomolecular level.

Image Guidance to Aid Pedicle Screw Fixation of a Lumbar Fracture-Dislocation Injury in a Toddler.

PubMed

Houten, John K; Nahkla, Jonathan; Ghandi, Shashank

2017-09-01

Pedicle screw fixation of the lumbar spine in children age <2 years is particularly challenging, as successful cannulation of the small pedicle dimensions requires a high level of precision and there are no implants specifically designed for the infant spine. Image-guided navigation is commonly used in adult spinal surgery and may be particularly helpful for the placement of spinal screws in areas where the bony anatomy is small and/or anatomically complex, as in the upper cervical area. A 19-month-old female presented with a fracture-dislocation injury of L1-2. Intraoperative imaging using the O-arm multidimensional imaging system was networked to a workstation, and neuronavigation was used to place pedicle instrumentation with 3.5-mm-diameter polyaxial screws designed for posterior cervical fixation. At a 48-month follow-up, the patient was neurologically intact, demonstrated normal physical development, and was engaging in normal physical activity for her age. Radiographs obtained approximately 4 years postsurgery showed no evidence of loss for fixation. Image-guided placement of pedicle screws may be a useful aid in achieving accurate and safe fixation in the small dimensions of the infant spine. Copyright © 2017 Elsevier Inc. All rights reserved.

Population status and habitat associations of the King Rail in the midwestern United States

USGS Publications Warehouse

Bolenbaugh, Jason R.; Cooper, Tom; Brady, Ryan S.; Willard, Karen L.; Krementz, David G.

2012-01-01

The migratory population of the King Rail (Rallus elegans) has declined dramatically during the past 50 years, emphasizing the need to document the distribution and status of this species to help guide conservation efforts. In an effort to guide King Rail breeding habitat protection and restoration, a landscape suitability index (LSI) model was developed for the Upper Mississippi River and Great Lakes Region Joint Venture (JV). To validate this model, 264 sites were surveyed across the JV region in 2008 and 2009 using the National Marshbird Monitoring protocol. Two other similarly collected data sets from Wisconsin (250 sites) and Ohio (259 sites) as well as data from the Cornell Laboratory of Ornithology's eBird database were added to our data set. Sampling effort was not uniform across the study area. King Rails were detected at 29 sites with the greatest concentration in southeastern Wisconsin and northeastern Illinois. Too few detections were made to validate the LSI model. King Rail detection sites tended to have microtopographic heterogeneity, more emergent herbaceous wetland vegetation and less woody vegetation. The migrant population of the King Rail is rare and warrants additional conservation efforts to achieve stated conservation population targets.

The construction, fouling and enzymatic cleaning of a textile dye surface.

PubMed

Onaizi, Sagheer A; He, Lizhong; Middelberg, Anton P J

2010-11-01

The enzymatic cleaning of a rubisco protein stain bound onto Surface Plasmon Resonance (SPR) biosensor chips having a dye-bound upper layer is investigated. This novel method allowed, for the first time, a detailed kinetic study of rubisco cleanability (defined as fraction of adsorbed protein removed from a surface) from dyed surfaces (mimicking fabrics) at different enzyme concentrations. Analysis of kinetic data using an established mathematical model able to decouple enzyme transfer and reaction processes [Onaizi, He, Middelberg, Chem. Eng. Sci. 64 (2008) 3868] revealed a striking effect of dyeing on enzymatic cleaning performance. Specifically, the absolute rate constants for enzyme transfer to and from a dye-bound rubisco stain were significantly higher than reported previously for un-dyed surfaces. These increased transfer rates resulted in higher surface cleanability. Higher enzyme mobility (i.e., higher enzyme adsorption and desorption rates) at the liquid-dye interface was observed, consistent with previous suggestions that enzyme surface mobility is likely correlated with overall enzyme cleaning performance. Our results show that reaction engineering models of enzymatic action at surfaces may provide insight able to guide the design of better stain-resistant surfaces, and may also guide efforts to improve cleaning formulations. Copyright 2010 Elsevier Inc. All rights reserved.

In the Way of Peacemaker Guide Curve between Water Supply and Flood Control for Short Term Reservoir Operation

NASA Astrophysics Data System (ADS)

Uysal, G.; Sensoy, A.; Yavuz, O.; Sorman, A. A.; Gezgin, T.

2012-04-01

Effective management of a controlled reservoir system where it involves multiple and sometimes conflicting objectives is a complex problem especially in real time operations. Yuvacık Dam Reservoir, located in the Marmara region of Turkey, is built to supply annual demand of 142 hm3 water for Kocaeli city requires such a complex management strategy since it has relatively small (51 hm3) effective capacity. On the other hand, the drainage basin is fed by both rainfall and snowmelt since the elevation ranges between 80 - 1548 m. Excessive water must be stored behind the radial gates between February and May in terms of sustainability especially for summer and autumn periods. Moreover, the downstream channel physical conditions constraint the spillway releases up to 100 m3/s although the spillway is large enough to handle major floods. Thus, this situation makes short term release decisions the challenging task. Long term water supply curves, based on historical inflows and annual water demand, are in conflict with flood regulation (control) levels, based on flood attenuation and routing curves, for this reservoir. A guide curve, that is generated using both water supply and flood control of downstream channel, generally corresponds to upper elevation of conservation pool for simulation of a reservoir. However, sometimes current operation necessitates exceeding this target elevation. Since guide curves can be developed as a function of external variables, the water potential of a basin can be an indicator to explain current conditions and decide on the further strategies. Besides, releases with respect to guide curve are managed and restricted by user-defined rules. Although the managers operate the reservoir due to several variable conditions and predictions, still the simulation model using variable guide curve is an urgent need to test alternatives quickly. To that end, using HEC-ResSim, the several variable guide curves are defined to meet the requirements by taking inflow, elevation, precipitation and snow water equivalent into consideration to propose alternative simulations as a decision support system. After that, the releases are subjected to user-defined rules. Thus, previous year reservoir simulations are compared with observed reservoir levels and releases. Hypothetical flood scenarios are tested in case of different storm event timing and sizing. Numerical weather prediction data of Mesoscale Model 5 (MM5) can be used for temperature and precipitation forecasts that will form the inputs for a hydrological model. The estimated flows can be used for real time short term decisions for reservoir simulation based on variable guide curve and user defined rules.

An integrated model-driven method for in-treatment upper airway motion tracking using cine MRI in head and neck radiation therapy

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

Li, Hua, E-mail: huli@radonc.wustl.edu; Chen, Hsin

Purpose: For the first time, MRI-guided radiation therapy systems can acquire cine images to dynamically monitor in-treatment internal organ motion. However, the complex head and neck (H&N) structures and low-contrast/resolution of on-board cine MRI images make automatic motion tracking a very challenging task. In this study, the authors proposed an integrated model-driven method to automatically track the in-treatment motion of the H&N upper airway, a complex and highly deformable region wherein internal motion often occurs in an either voluntary or involuntary manner, from cine MRI images for the analysis of H&N motion patterns. Methods: Considering the complex H&N structures andmore » ensuring automatic and robust upper airway motion tracking, the authors firstly built a set of linked statistical shapes (including face, face-jaw, and face-jaw-palate) using principal component analysis from clinically approved contours delineated on a set of training data. The linked statistical shapes integrate explicit landmarks and implicit shape representation. Then, a hierarchical model-fitting algorithm was developed to align the linked shapes on the first image frame of a to-be-tracked cine sequence and to localize the upper airway region. Finally, a multifeature level set contour propagation scheme was performed to identify the upper airway shape change, frame-by-frame, on the entire image sequence. The multifeature fitting energy, including the information of intensity variations, edge saliency, curve geometry, and temporal shape continuity, was minimized to capture the details of moving airway boundaries. Sagittal cine MR image sequences acquired from three H&N cancer patients were utilized to demonstrate the performance of the proposed motion tracking method. Results: The tracking accuracy was validated by comparing the results to the average of two manual delineations in 50 randomly selected cine image frames from each patient. The resulting average dice similarity coefficient (93.28%  ±  1.46%) and margin error (0.49  ±  0.12 mm) showed good agreement between the automatic and manual results. The comparison with three other deformable model-based segmentation methods illustrated the superior shape tracking performance of the proposed method. Large interpatient variations of swallowing frequency, swallowing duration, and upper airway cross-sectional area were observed from the testing cine image sequences. Conclusions: The proposed motion tracking method can provide accurate upper airway motion tracking results, and enable automatic and quantitative identification and analysis of in-treatment H&N upper airway motion. By integrating explicit and implicit linked-shape representations within a hierarchical model-fitting process, the proposed tracking method can process complex H&N structures and low-contrast/resolution cine MRI images. Future research will focus on the improvement of method reliability, patient motion pattern analysis for providing more information on patient-specific prediction of structure displacements, and motion effects on dosimetry for better H&N motion management in radiation therapy.« less

An integrated model-driven method for in-treatment upper airway motion tracking using cine MRI in head and neck radiation therapy.

PubMed

Li, Hua; Chen, Hsin-Chen; Dolly, Steven; Li, Harold; Fischer-Valuck, Benjamin; Victoria, James; Dempsey, James; Ruan, Su; Anastasio, Mark; Mazur, Thomas; Gach, Michael; Kashani, Rojano; Green, Olga; Rodriguez, Vivian; Gay, Hiram; Thorstad, Wade; Mutic, Sasa

2016-08-01

For the first time, MRI-guided radiation therapy systems can acquire cine images to dynamically monitor in-treatment internal organ motion. However, the complex head and neck (H&N) structures and low-contrast/resolution of on-board cine MRI images make automatic motion tracking a very challenging task. In this study, the authors proposed an integrated model-driven method to automatically track the in-treatment motion of the H&N upper airway, a complex and highly deformable region wherein internal motion often occurs in an either voluntary or involuntary manner, from cine MRI images for the analysis of H&N motion patterns. Considering the complex H&N structures and ensuring automatic and robust upper airway motion tracking, the authors firstly built a set of linked statistical shapes (including face, face-jaw, and face-jaw-palate) using principal component analysis from clinically approved contours delineated on a set of training data. The linked statistical shapes integrate explicit landmarks and implicit shape representation. Then, a hierarchical model-fitting algorithm was developed to align the linked shapes on the first image frame of a to-be-tracked cine sequence and to localize the upper airway region. Finally, a multifeature level set contour propagation scheme was performed to identify the upper airway shape change, frame-by-frame, on the entire image sequence. The multifeature fitting energy, including the information of intensity variations, edge saliency, curve geometry, and temporal shape continuity, was minimized to capture the details of moving airway boundaries. Sagittal cine MR image sequences acquired from three H&N cancer patients were utilized to demonstrate the performance of the proposed motion tracking method. The tracking accuracy was validated by comparing the results to the average of two manual delineations in 50 randomly selected cine image frames from each patient. The resulting average dice similarity coefficient (93.28%  ±  1.46%) and margin error (0.49  ±  0.12 mm) showed good agreement between the automatic and manual results. The comparison with three other deformable model-based segmentation methods illustrated the superior shape tracking performance of the proposed method. Large interpatient variations of swallowing frequency, swallowing duration, and upper airway cross-sectional area were observed from the testing cine image sequences. The proposed motion tracking method can provide accurate upper airway motion tracking results, and enable automatic and quantitative identification and analysis of in-treatment H&N upper airway motion. By integrating explicit and implicit linked-shape representations within a hierarchical model-fitting process, the proposed tracking method can process complex H&N structures and low-contrast/resolution cine MRI images. Future research will focus on the improvement of method reliability, patient motion pattern analysis for providing more information on patient-specific prediction of structure displacements, and motion effects on dosimetry for better H&N motion management in radiation therapy.

The effect of guide-field and boundary conditions on the features and signatures of collisionless magnetic reconnection in a stressed X-point collapse

NASA Astrophysics Data System (ADS)

Graf von der Pahlen, J.; Tsiklauri, D.

2015-12-01

Magnetic X-point collapse is investigated using a 2.5D fully relativistic particle-in-cell simulation, with varying strengths of guide-field as well as open and closed boundary conditions. In the zero guide-field case we discover a new signature of Hall-reconnection in the out-of-plane magnetic field, namely an octupolar pattern, as opposed to the well-studied quadrupolar out-of-plane field of reconnection. The emergence of the octupolar components was found to be caused by ion currents and is a general feature of X-point collapse. In a comparative study of tearing-mode reconnection, signatures of octupolar components are found only in the out-flow region. It is argued that space-craft observations of magnetic fields at reconnection sites may be used accordingly to identify the type of reconnection [1][2]. Further, initial oscillatory reconnection is observed, prior to reconnection onset, generating electro-magnetic waves at the upper-hybrid frequency, matching solar flare progenitor emission. When applying a guide-field, in both open and closed boundary conditions, thinner dissipation regions are obtained and the onset of reconnection is increasingly delayed. Investigations with open boundary conditions show that, for guide-fields close to the strength of the in-plane field, shear flows emerge, leading to the formation of electron flow vortices and magnetic islands [3]. Asymmetries in the components of the generalised Ohm's law across the dissipation region are observed. Extended in 3D geometry, it is shown that locations of magnetic islands and vortices are not constant along the height of the current-sheet. Vortices formed on opposite sites of the current-sheet travel in opposite directions along it, leading to a criss-cross vortex pattern. Possible instabilities resulting from this specific structure formation are to be investigated [4].[1] J. Graf von der Pahlen and D. Tsiklauri, Phys. Plasmas 21, 060705 (2014), [2] J. Graf von der Pahlen and D. Tsiklauri, Phys. Plasmas 22, 032905 (2015) [3] J. Graf von der Pahlen and D. Tsiklauri, Phys. Plasmas 21, 012901 (2014), [4] http://astro.qmul.ac.uk/~tsiklauri/jgvdpdt4.pdf

Radiation brain dose to vascular surgeons during fluoroscopically guided interventions is not effectively reduced by wearing lead equivalent surgical caps.

PubMed

Kirkwood, Melissa L; Arbique, Gary M; Guild, Jeffrey B; Zeng, Katie; Xi, Yin; Rectenwald, John; Anderson, Jon A; Timaran, Carlos

2018-03-12

Radiation to the interventionalist's brain during fluoroscopically guided interventions (FGIs) may increase the incidence of cerebral neoplasms. Lead equivalent surgical caps claim to reduce radiation brain doses by 50% to 95%. We sought to determine the efficacy of the RADPAD (Worldwide Innovations & Technologies, Lenexa, Kan) No Brainer surgical cap (0.06 mm lead equivalent at 90 kVp) in reducing radiation dose to the surgeon's and trainee's head during FGIs and to a phantom to determine relative brain dose reductions. Optically stimulated, luminescent nanoDot detectors (Landauer, Glenwood, Ill) inside and outside of the cap at the left temporal position were used to measure cap attenuation during FGIs. To check relative brain doses, nanoDot detectors were placed in 15 positions within an anthropomorphic head phantom (ATOM model 701; CIRS, Norfolk, Va). The phantom was positioned to represent a primary operator performing femoral access. Fluorography was performed on a plastic scatter phantom at 80 kVp for an exposure of 5 Gy reference air kerma with or without the hat. For each brain location, the percentage dose reduction with the hat was calculated. Means and standard errors were calculated using a pooled linear mixed model with repeated measurements. Anatomically similar locations were combined into five groups: upper brain, upper skull, midbrain, eyes, and left temporal position. This was a prospective, single-center study that included 29 endovascular aortic aneurysm procedures. The average procedure reference air kerma was 2.6 Gy. The hat attenuation at the temporal position for the attending physician and fellow was 60% ± 20% and 33% ± 36%, respectively. The equivalent phantom measurements demonstrated an attenuation of 71% ± 2.0% (P < .0001). In the interior phantom locations, attenuation was statistically significant for the skull (6% ± 1.4%) and upper brain (7.2% ± 1.0%; P < .0001) but not for the middle brain (1.4% ± 1.0%; P = .15) or the eyes (-1.5% ± 1.4%; P = .28). The No Brainer surgical cap attenuates direct X rays at the superficial temporal location; however, the majority of radiation to an interventionalist's brain originates from scatter radiation from angles not shadowed by the cap as demonstrated by the trivial percentage brain dose reductions measured in the phantom. Radiation protective caps have minimal clinical relevance. Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

The calculation of the viscosity from the autocorrelation function using molecular and atomic stress tensors

NASA Astrophysics Data System (ADS)

Cui, S. T.

The stress-stress correlation function and the viscosity of a united-atom model of liquid decane are studied by equilibrium molecular dynamics simulation using two different formalisms for the stress tensor: the atomic and the molecular formalisms. The atomic and molecular correlation functions show dramatic difference in short-time behaviour. The integrals of the two correlation functions, however, become identical after a short transient period whichis significantly shorter than the rotational relaxation time of the molecule. Both reach the same plateau value in a time period corresponding to this relaxation time. These results provide a convenient guide for the choice of the upper integral time limit in calculating the viscosity by the Green-Kubo formula.

Integrating Research of the Sun-Earth System

DOE PAGES

Jordanova, Vania K.; Borovsky, Joseph E.; Jordanov, Valentin T.

2017-05-02

Understanding the complex interactions between the magnetic fields of the Sun and Earth remains an important challenge to space physics research. Processes that occur near the Sun at tens of thousands of kilometers from the Earth can generate geomagnetic storms that affect the entire magnetosphere, down to the upper atmosphere. These storms also threaten the ever more sophisticated technologies that we place into the space environment to sustain us, for example, GPS, the satellites we rely on to monitor our weather, and relays that guide our radio transmissions. Increasingly, we need to develop space weather models that can provide timelymore » and accurate predictions so that we can safeguard our society and the infrastructure we depend on.« less

KSC-07pd2066

NASA Image and Video Library

2007-07-22

KENNEDY SPACE CENTER, FLA. — At the Astrotech payload processing facility, workers guide the movement of the upper canister being lifted from the Dawn spacecraft, seen encased in a protective cover. Dawn was returned from Launch Pad 17-B at Cape Canaveral Air Force Station to Astrotech to await a new launch date. The launch opportunity extends from Sept. 7 to Oct. 15. Dawn is the ninth mission in NASA's Discovery Program. The spacecraft will be the first to orbit two planetary bodies, asteroid Vesta and dwarf planet Ceres, during a single mission. Vesta and Ceres lie in the asteroid belt between Mars and Jupiter. It is also NASA’s first purely scientific mission powered by three solar electric ion propulsion engines. NASA/Charisse Nahser

Ribbon growing method and apparatus

NASA Technical Reports Server (NTRS)

Morrison, Andrew D. (Inventor)

1989-01-01

A method and apparatus are described which facilitate the growing of silicon ribbon. A container for molten silicon has a pair of passages in its bottom through which filaments extend to a level above the molten silicon, so as the filaments are pulled up they drag up molten silicon to form a ribbon. A pair of guides surround the filaments along most of the height of the molten silicon, so that the filament contacts only the upper portion of the melt. This permits a filament to be used which tends to contaminate the melt if it is in long term contact with the melt. This arrangement also enables a higher melt to be used without danger that the molten silicon will run out of any bottom hole.

A practical guide for performing arthrography under fluoroscopic or ultrasound guidance.

PubMed

Lungu, Eugen; Moser, Thomas P

2015-12-01

We propose a practical approach for performing arthrography with fluoroscopic or ultrasound guidance. Different approaches to the principal joints of the upper limb (shoulder, elbow, wrist and fingers), lower limb (hip, knee, ankle and foot) as well as the facet joints of the spine are discussed and illustrated with numerous drawings. Whenever possible, we emphasise the concept of targeting articular recesses, which offers many advantages over traditional techniques aiming at the joint space. • Arthrography remains a foremost technique in musculoskeletal radiology • Most joints can be successfully accessed by targeting the articular recess • Targeting the recess offers several advantages over traditional approaches • Ultrasound-guidance is now favoured over fluoroscopy and targeting the recess is equally applicable.

Surgical Management of the Constricted or Obliterated Vagina.

PubMed

Gebhart, John B; Schmitt, Jennifer J

2016-08-01

Management of the constricted or obliterated vagina demands an understanding and recognition of the potential etiologies leading to this presentation. A thorough and comprehensive medical and surgical review is required to arrive at an accurate diagnosis, which then will guide medical or surgical intervention. It is paramount to recognize when underlying medical conditions are contributing to these conditions and to begin medical therapy; failure to do so will often yield suboptimal results. When these conditions arise after surgical interventions, compensatory surgical techniques that correct upper and lower vaginal strictures or obliteration include incision through the stricture, vaginal advancement, Z-plasty, skin grafts, perineal flaps, and abdominal flaps and grafts. Postoperative surveillance and dilation are critical to optimize long-term success.

Integrating Research of the Sun-Earth System

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

Jordanova, Vania K.; Borovsky, Joseph E.; Jordanov, Valentin T.

Understanding the complex interactions between the magnetic fields of the Sun and Earth remains an important challenge to space physics research. Processes that occur near the Sun at tens of thousands of kilometers from the Earth can generate geomagnetic storms that affect the entire magnetosphere, down to the upper atmosphere. These storms also threaten the ever more sophisticated technologies that we place into the space environment to sustain us, for example, GPS, the satellites we rely on to monitor our weather, and relays that guide our radio transmissions. Increasingly, we need to develop space weather models that can provide timelymore » and accurate predictions so that we can safeguard our society and the infrastructure we depend on.« less

Intestinal antispasmodic effects of Helichrysum italicum (Roth) Don ssp. italicum and chemical identification of the active ingredients.

PubMed

Rigano, Daniela; Formisano, Carmen; Senatore, Felice; Piacente, Sonia; Pagano, Ester; Capasso, Raffaele; Borrelli, Francesca; Izzo, Angelo A

2013-12-12

In the Mediterranean Area, the flowers of Helichrysum italicum ssp. italicum are a traditional remedy for the treatment of intestinal complaints and are used as herbal tea for curing digestive, stomachic and intestinal diseases. In order to find scientific evidence for the traditional utilization of this plant, the effect of an ethanolic extract of Helichrysum italicum was investigated by using in vivo and in vitro experimental models. Then, through bioassay-guided fractionation procedures, active component(s) were identified. Contractility in vitro was evaluated by stimulating the isolated ileum, in an organ bath, with acetylcholine and barium chloride; motility in vivo was evaluated by measuring upper gastrointestinal transit, both in control mice and in mice with experimental intestinal inflammation induced by croton oil. Chromatographic separation techniques such as HPLC and silica gel columns have yielded the active principles of Helichrysum italicum. We found that the ethanolic extract of Helichrysum italicum ssp. italicum flowers elicited antispasmodic actions in the isolated mouse ileum and inhibited transit preferentially in the inflamed gut. A bioassay guided fractionation of the extract yielded the known compounds 12-acetoxytremetone (1) and 2,3-dihydro-2-[1-(hydroxymethyl)ethenyl]-5-benzofuranyl]-ethanone (2). Present study supported the traditional use of Helichrysum italicum ssp. italicum flowers for intestinal complaints and through bioassay-guided fractionation procedures from the crude extract we showed that 12-acetoxytremetone (1) and 2,3-dihydro-2-[1-(hydroxymethyl)ethenyl]-5-benzofuranyl]-ethanone (2) acted in a synergistic way to produce an intestinal antispasmodic effect. © 2013 Elsevier Ireland Ltd. All rights reserved.

Is procalcitonin-guided antimicrobial use cost-effective in adult patients with suspected bacterial infection and sepsis?

PubMed

Harrison, Michelle; Collins, Curtis D

2015-03-01

Procalcitonin has emerged as a promising biomarker of bacterial infection. Published literature demonstrates that use of procalcitonin testing and an associated treatment pathway reduces duration of antibiotic therapy without impacting mortality. The objective of this study was to determine the financial impact of utilizing a procalcitonin-guided treatment algorithm in hospitalized patients with sepsis. Cost-minimization and cost-utility analysis. Hypothetical cohort of adult ICU patients with suspected bacterial infection and sepsis. Utilizing published clinical and economic data, a decision analytic model was developed from the U.S. hospital perspective. Effectiveness and utility measures were defined using cost-per-clinical episode and cost per quality-adjusted life years (QALYs). Upper and lower sensitivity ranges were determined for all inputs. Univariate and probabilistic sensitivity analyses assessed the robustness of our model and variables. Incremental cost-effectiveness ratios (ICERs) were calculated and compared to predetermined willingness-to-pay thresholds. Base-case results predicted the use of a procalcitonin-guided treatment algorithm dominated standard care with improved quality (0.0002 QALYs) and decreased overall treatment costs ($65). The model was sensitive to a number of key variables that had the potential to impact results, including algorithm adherence (<42.3%), number and cost of procalcitonin tests ordered (≥9 and >$46), days of antimicrobial reduction (<1.6 d), incidence of nephrotoxicity and rate of nephrotoxicity reduction. The combination of procalcitonin testing with an evidence-based treatment algorithm may improve patients' quality of life while decreasing costs in ICU patients with suspected bacterial infection and sepsis; however, results were highly dependent on a number of variables and assumptions.

Field guide to Cretaceous-tertiary boundary sections in northeastern Mexico

NASA Technical Reports Server (NTRS)

Keller, Gerta; Stinnesbeck, Wolfgang; Adatte, Thierry; Macleod, Norman; Lowe, Donald R.

1994-01-01

This guide was prepared for the field trip to the KT elastic sequence of northeastern Mexico, 5-8 February 1994, in conjunction with the Conference on New Developments Regarding the KT Event and Other Catastrophes in Earth History, held in Houston, Texas. The four-day excursion offers an invaluable opportunity to visit three key outcrops: Arroyo El Mimbral, La Lajilla, and El Pinon. These and other outcrops of this sequence have recently been interpreted as tsunami deposits produced by the meteorite impact event that produced the 200 to 300-km Chicxulub basin in Yucatan, and distributed ejecta around the world approximately 65 m.y. ago that today is recorded as a thin clay layer found at the K/T boundary. The impact tsunami interpretation for these rocks has not gone unchallenged, and others examining the outcrops arrive at quite different conclusions: not tsunami deposits but turbidites; not KT at all but 'upper Cretaceous.' Indeed, it is in hopes of resolving this debate through field discussion, outcrop evaluation, and sampling that led the organizers of the conference to sanction this field trip. This field guide provides participants with background information on the KT clastic sequence outcrops and is divided into two sections. The first section provides regional and logistical context for the outcrops and a description of the clastic sequence. The second section presents three representative interpretations of the outcrops by their advocates. There is clearly no way that these models can be reconciled and so two, if not all three, must be fundamentally wrong. Readers of this guide should keep in mind that many basic outcrop observations that these models are based upon remain unresolved. While great measures were taken to ensure that the information in the description section was as objective as possible, many observations are rooted in interpretations and the emphasis placed on certain observations depends to some degree upon the perspective of the author.

[Dysplastic cysts of the liver: our experience].

PubMed

Nardello, O; Muggianu, M; Cabras, V; Farina, G P; Cagetti, M

2004-08-01

Systematic surveys with advanced non-invasive imaging techniques have revealed that hepatic cysts are quite common in the general population. Therefore, we retrospectively examined our case series and compared it with the literature. Between January 1990 and December 2000, 228 patients with non-parasitic liver cysts were referred to the outpatients section of the Department of Surgery of the University of Cagliari and 23 were submitted to treatment: 14 patients (60.8%) for solitary cyst and 9 (39.2%) for multiple simple cysts of the liver. One patient (4.5%) had right upper quadrant pain. Eleven (47.8%) patients were asymptomatic: 7 (63.7%) required treatment for other pathologies, 3 (27.3%) for a progressive enlargement of the cyst and 1 (9%) for a suspected hydatid disease. Mean diameter of the treated cysts measured by preoperative CT or US was 8.8 cm (range 7-14). Percutaneous aspiration-injection reaspiration (PAIR) was performed in 5 patients (21.7%), US-guided in 2 cases (40%) and CT-guided in 3 (60%). Twenty patients (86.9%) underwent cysts unroofing, 18 (78.2%) with open surgical fenestration and the latest 2 cases with a laparoscopic approach. Two patients had PAIR as second treatment for recurrence: CT-guided in one and US-guided in the other case. Four (25%) out of 16 patients treated exclusively for cystic liver disease, had fever in 3 cases and nausea and vomiting in 1 case; 8 patients (50%) had an intraperitoneal drainage for a mean of 6-7 days (range 4-11) and of 116 cc of serum-hematic liquid. In our opinion the choice of an adequate treatment must be based on an accurate evaluation of the clinical aspects of the patients and on the characteristics of cystic lesions such as number, size and location. These data let us to choose a surgical treatment rather than a strict US follow-up and to get the best outcome in terms of absence of recurrence, and less biological and economic costs.

Guided bone regeneration and implant placement in association with a coronally positioned palatal sliding flap: a 17-year follow-up case report.

PubMed

Maiorana, Carlo; Poli, Pier Paolo; Beretta, Mario

2018-05-21

The aim of the present case report was to show the 17-year hard and soft tissues stability of guided bone regeneration procedure associated with dental implants insertion. A 52-year-old male patient presented with a partial edentulism in the upper right maxilla. A graft consisting of deproteinized bovine bone mineral and autogenous bone stabilized by a non-resorbable expanded polytetrafluoroethylene membrane was used to reconstruct the missing bone applying the biological principles of guided bone regeneration. Dental implants were inserted simultaneously in a prosthetically driven position. Soft tissues were managed with a coronally positioned palatal sliding flap technique to obtain a primary intention healing. The healing proceeded uneventfully, and after 8 months the re-entry procedure was carried out. The defect was three-dimensionally filled by newly formed bone in an ongoing maturation phase. The regenerated bone appeared strictly integrated within the surrounding hard tissue and well vascularized. Temporary crowns were left in situ for 6 months, and definitive metal-ceramic definitive prosthesis were finally cemented and delivered to the patient. No complications occurred during the follow-up period. Clinical follow-up recalls were planned yearly, while radiological exams consisting of orthopantomographs and intra-oral radiographs were performed at 1 year, 8 years, 12 years, and 17 years after the implants insertion. The latest follow-up visit performed after 17 years from the bone augmentation procedure showed clinically stable gingival levels. No radiographic signs of peri-implantitis were observed. Mesial and distal marginal bone levels remained almost unchanged within the physiological threshold. This case report highlighted the effectiveness of the guided bone regeneration technique over a long-term follow-up. Interestingly, the use of a palatal sliding flap repositioned coronally provided sufficient amount of buccal keratinized mucosa. This may had improved the clinical stability of soft tissues preventing at the same time the likelihood of developing peri-implant disease.

USING THE SELECTIVE FUNCTIONAL MOVEMENT ASSESSMENT AND REGIONAL INTERDEPENDENCE THEORY TO GUIDE TREATMENT OF AN ATHLETE WITH BACK PAIN: A CASE REPORT.

PubMed

Goshtigian, Gabriella R; Swanson, Brian T

2016-08-01

Despite the multidirectional quality of human movement, common measurement procedures used in physical therapy examination are often uni-planar and lack the ability to assess functional complexities involved in daily activities. Currently, there is no widely accepted, validated standard to assess movement quality. The Selective Functional Movement Assessment (SFMA) is one possible system to objectively assess complex functional movements. The purpose of this case report is to illustrate the application of the SFMA as a guide to the examination, evaluation, and management of a patient with non-specific low back pain (LBP). An adolescent male athlete with LBP was evaluated using the SFMA. It was determined that the patient had mobility limitations remote to the site of pain (thoracic spine and hips) which therapists hypothesized were leading to compensatory hypermobility at the lumbar spine. Guided by the SFMA, initial interventions focused on local (lumbar) symptom management, progressing to remote mobility deficits, and then addressing the local stability deficit. All movement patterns became functional/non-painful except the right upper extremity medial rotation-extension pattern. At discharge, the patient demonstrated increased soft tissue extensibility of hip musculature and joint mobility of the thoracic spine along with normalization of lumbopelvic motor control. Improvements in pain exceeded minimal clinically important differences, from 2-7/10 on a verbal analog scale at initial exam to 0-2/10 at discharge. Developing and progressing a plan of care for an otherwise healthy and active adolescent with non-specific LBP can be challenging. Human movement is a collaborative effort of muscle groups that are interdependent; the use of a movement-based assessment model can help identify weak links affecting overall function. The SFMA helped guide therapists to dysfunctional movements not seen with more conventional examination procedures. Level 4.

Paleoenvironmental analysis of a middle Wisconsinan biota site, southwestern Virginia, U.S.A.

NASA Astrophysics Data System (ADS)

Whittecar, G. Richard; Wynn, Thomas C.; Bartlett, Charles S.

2007-07-01

The Ratcliff Site in southwestern Virginia lies in a small second-order stream valley filled with approximately 3.5 m of organic-rich deposits that contain bones of mammoth, mastodon, deer (or antelope), logs, and plant macrofossils. Radiocarbon analyses indicate the age of the organic-rich sediment ranges from > 44,000 to 29,100 14C yr BP, a time period with no fossil remains reported in this region of the Appalachians. Analyses of field observations, textural data, organic carbon content, and plant macrofossils indicate that the organic-rich sediments contain interbedded standing-water and debris-flow deposits. Up to 6 m of oxidized debris-flow sediments bury the organic-rich sediments. The presence of Rubus parviflorus (Thimble Berry) throughout the deposit indicates the site had a boreal environment from > 44,000 to 29,100 14C yr BP. Plant macrofossil evidence indicates the uplands had stands of spruce/jack-pine forests while the valley contained ponds and associated wetlands. Three debris flows occurred at the site between approximately 38,000 and 29,000 14C yr BP, suggesting a recurrence interval for major storms of approximately 3000 yr, even though the apparent stability of the boreal environment implies a climate not conducive to catastrophic rainstorms. This conflicting combination of features suggests that during the middle Wisconsinan this area experienced generally cool climates, dominated by polar air masses, but was punctuated by relatively brief warm periods marked by incursions of tropical air masses.

Nuclear reactor with internal thimble-type delayed neutron detection system

DOEpatents

Gross, Kenny C.; Poloncsik, John; Lambert, John D. B.

1990-01-01

This invention teaches improved apparatus for the method of detecting a breach in cladded fuel used in a nuclear reactor. The detector apparatus is located in the primary heat exchanger which conveys part of the reactor coolant past at least three separate delayed-neutron detectors mounted in this heat exchanger. The detectors are spaced apart such that the coolant flow time from the core to each detector is different, and these differences are known. The delayed-neutron activity at the detectors is a function of the delay time after the reaction in the fuel until the coolant carrying the delayed-neutron emitter passes the respective detector. This time delay is broken down into separate components including an isotopic holdup time required for the emitter to move through the fuel from the reaction to the coolant at the breach, and two transit times required for the emitter now in the coolant to flow from the breach to the detector loop and then via the loop to the detector. At least two of these time components are determined during calibrated operation of the reactor. Thereafter during normal reactor operation, repeated comparisons are made by the method of regression approximation of the third time component for the best-fit line correlating measured delayed-neutron activity against activity that is approximated according to specific equations. The equations use these time-delay components and known parameter values of the fuel and of the part and emitting daughter isotopes.

Activation of human peroxisome-activated receptor-gamma ...

EPA Pesticide Factsheets

Obesity in children has become an epidemic and recent research suggests a possible contribution from exposure to environmental chemicals. Several chemicals, such as phthalates, brominated flame retardants, and perfluorinated chemicals, are common in house dust on floors where children play and are suspected obesogens. Obesogens can act via a mechanism that involves activation of peroxisome proliferator-activated receptor-gamma (PPARy). A previous study found that dust collected from children’s homes binds to PPARy. Here, we investigated the ability of house dust to activate PPARy in a transiently transfected cell assay. Dust samples were collected in 2012 from carpeted and hardwood floors in children’s homes using thimbles fitted into a vacuum cleaner hose (“TEO” samples), or from homes in an adult cohort NIEHS study. Dust was extracted with 50:50 hexane:acetone, sonicated, centrifuged, and the organic layer collected. This was repeated 2X. The extracts were filtered to remove particulates, dried with purified nitrogen, and reconstituted in DMS0 at 200 ug/ul. COS-1 cells were transfected for 24 hrs with a human PPARy vector containing a luciferase reporter, and exposed for 24 hrs to negative controls water or DMSO (0.1%), positive controls Troglitazone (3 uM in water) or Rosiglitazone (100 nM in DMSO), or dust extracts serially diluted in DMEM at 50, 100, and 200 ug/ml in 0.1% DMSO. Cells were lysed and luciferase activity was measured. Data were log-tra

Centrin-like filaments in the cytopharyngeal apparatus of the ciliates Nassula and Furgasonia: evidence for a relationship with microtubular structures.

PubMed

Vigues, B; Blanchard, M P; Bouchard, P

1999-01-01

The cytopharyngeal apparatus in the Nassulinid ciliates Nassula and Furgasonia is a highly specialized microtubular/filamentous organelle designed for ingestion of organisms such as filamentous bacteria. From studies on living cells, it was previously shown that this organelle, also called "feeding basket," guides the filamentous bacteria and manipulates them to some extent during the early steps of ingestion. This results in a complex sequence of movements where the basket is successively dilated and constricted in its upper part. Whereas some of these movements (dilation) seem to be intrinsic to the microtubular components of the basket, others (constriction) are believed to be mediated by contractile filamentous structures [Tucker, 1968: J. Cell Sci. 3:493-514]. In this study, we have used antibodies raised against ciliate centrins to demonstrate these proteins by Western blot and immunocytochemical methods in Nassula and Furgasonia. In both ciliates, a 20-kDa centrin immunoanalog was localized in the upper (contractile) part of the cytopharyngeal apparatus. Immunoelectron microscopy revealed that cytopharyngeal centrin is engaged in filamentous material, forming a sphincter-like structure possibly involved in the movements of contraction. Interestingly, physical links were noted between filaments labeled for centrin and cytopharyngeal microtubules. The mechanistic implications of these findings are discussed.

Improving students' understanding of quantum mechanics

NASA Astrophysics Data System (ADS)

Zhu, Guangtian

2011-12-01

Learning physics is challenging at all levels. Students' difficulties in the introductory level physics courses have been widely studied and many instructional strategies have been developed to help students learn introductory physics. However, research shows that there is a large diversity in students' preparation and skills in the upper-level physics courses and it is necessary to provide scaffolding support to help students learn advanced physics. This thesis explores issues related to students' common difficulties in learning upper-level undergraduate quantum mechanics and how these difficulties can be reduced by research-based learning tutorials and peer instruction tools. We investigated students' difficulties in learning quantum mechanics by administering written tests and surveys to many classes and conducting individual interviews with a subset of students. Based on these investigations, we developed Quantum Interactive Learning Tutorials (QuILTs) and peer instruction tools to help students build a hierarchical knowledge structure of quantum mechanics through a guided approach. Preliminary assessments indicate that students' understanding of quantum mechanics is improved after using the research-based learning tools in the junior-senior level quantum mechanics courses. We also designed a standardized conceptual survey that can help instructors better probe students' understanding of quantum mechanics concepts in one spatial dimension. The validity and reliability of this quantum mechanics survey is discussed.

Cluster detection methods applied to the Upper Cape Cod cancer data.

PubMed

Ozonoff, Al; Webster, Thomas; Vieira, Veronica; Weinberg, Janice; Ozonoff, David; Aschengrau, Ann

2005-09-15

A variety of statistical methods have been suggested to assess the degree and/or the location of spatial clustering of disease cases. However, there is relatively little in the literature devoted to comparison and critique of different methods. Most of the available comparative studies rely on simulated data rather than real data sets. We have chosen three methods currently used for examining spatial disease patterns: the M-statistic of Bonetti and Pagano; the Generalized Additive Model (GAM) method as applied by Webster; and Kulldorff's spatial scan statistic. We apply these statistics to analyze breast cancer data from the Upper Cape Cancer Incidence Study using three different latency assumptions. The three different latency assumptions produced three different spatial patterns of cases and controls. For 20 year latency, all three methods generally concur. However, for 15 year latency and no latency assumptions, the methods produce different results when testing for global clustering. The comparative analyses of real data sets by different statistical methods provides insight into directions for further research. We suggest a research program designed around examining real data sets to guide focused investigation of relevant features using simulated data, for the purpose of understanding how to interpret statistical methods applied to epidemiological data with a spatial component.

A standard set of upper extremity tasks for evaluating rehabilitation interventions for individuals with complete arm paralysis

PubMed Central

Cornwell, Andrew S.; Liao, James Y.; Bryden, Anne M.; Kirsch, Robert F.

2013-01-01

We have developed a set of upper extremity functional tasks to guide the design and test the performance of rehabilitation technologies that restore arm motion in people with high tetraplegia. Our goal was to develop a short set of tasks that would be representative of a much larger set of activities of daily living while also being feasible for a unilateral user of an implanted Functional Electrical Stimulation (FES) system. To compile this list of tasks, we reviewed existing clinical outcome measures related to arm and hand function, and were further informed by surveys of patient desires. We ultimately selected a set of five tasks that captured the most common components of movement seen in these tasks, making them highly relevant for assessing FES-restored unilateral arm function in individuals with high cervical spinal cord injury (SCI). The tasks are intended to be used when setting design specifications and for evaluation and standardization of rehabilitation technologies under development. While not unique, this set of tasks will provide a common basis for comparing different interventions (e.g., FES, powered orthoses, robotic assistants) and testing different user command interfaces (e.g., sip-and-puff, head joysticks, brain-computer interfaces). PMID:22773199

Optimal volume of injectate for fluoroscopy-guided cervical interlaminar epidural injection in patients with neck and upper extremity pain

PubMed Central

Park, Jun Young; Kim, Doo Hwan; Lee, Kunhee; Choi, Seong-Soo; Leem, Jeong-Gil

2016-01-01

Abstract There is no study of optimal volume of contrast medium to use in cervical interlaminar epidural injections (CIEIs) for appropriate spread to target lesions. To determine optimal volume of contrast medium to use in CIEIs. We analyzed the records of 80 patients who had undergone CIEIs. Patients were divided into 3 groups according to the amount of contrast: 3, 4.5, and 6 mL. The spread of medium to the target level was analyzed. Numerical rating scale data were also analyzed. The dye had spread to a point above the target level in 15 (78.9%), 22 (84.6%), and 32 (91.4%) patients in groups 1 to 3, respectively. The dye reached both sides in 14 (73.7%), 18 (69.2%), and 23 (65.7%) patients, and reached the ventral epidural space in 15 (78.9%), 22 (84.6%), and 30 (85.7%) patients, respectively. There were no significant differences of contrast spread among the groups. There were no significant differences in the numerical rating scale scores among the groups during the 3 months. When performing CIEIs, 3 mL medication is sufficient volume for the treatment of neck and upper-extremity pain induced by lower cervical degenerative disease. PMID:27787378

Optimal volume of injectate for fluoroscopy-guided cervical interlaminar epidural injection in patients with neck and upper extremity pain.

PubMed

Park, Jun Young; Kim, Doo Hwan; Lee, Kunhee; Choi, Seong-Soo; Leem, Jeong-Gil

2016-10-01

There is no study of optimal volume of contrast medium to use in cervical interlaminar epidural injections (CIEIs) for appropriate spread to target lesions. To determine optimal volume of contrast medium to use in CIEIs. We analyzed the records of 80 patients who had undergone CIEIs. Patients were divided into 3 groups according to the amount of contrast: 3, 4.5, and 6 mL. The spread of medium to the target level was analyzed. Numerical rating scale data were also analyzed. The dye had spread to a point above the target level in 15 (78.9%), 22 (84.6%), and 32 (91.4%) patients in groups 1 to 3, respectively. The dye reached both sides in 14 (73.7%), 18 (69.2%), and 23 (65.7%) patients, and reached the ventral epidural space in 15 (78.9%), 22 (84.6%), and 30 (85.7%) patients, respectively. There were no significant differences of contrast spread among the groups. There were no significant differences in the numerical rating scale scores among the groups during the 3 months. When performing CIEIs, 3 mL medication is sufficient volume for the treatment of neck and upper-extremity pain induced by lower cervical degenerative disease.

Avian magnetoreception: elaborate iron mineral containing dendrites in the upper beak seem to be a common feature of birds.

PubMed

Falkenberg, Gerald; Fleissner, Gerta; Schuchardt, Kirsten; Kuehbacher, Markus; Thalau, Peter; Mouritsen, Henrik; Heyers, Dominik; Wellenreuther, Gerd; Fleissner, Guenther

2010-02-16

The magnetic field sensors enabling birds to extract orientational information from the Earth's magnetic field have remained enigmatic. Our previously published results from homing pigeons have made us suggest that the iron containing sensory dendrites in the inner dermal lining of the upper beak are a candidate structure for such an avian magnetometer system. Here we show that similar structures occur in two species of migratory birds (garden warbler, Sylvia borin and European robin, Erithacus rubecula) and a non-migratory bird, the domestic chicken (Gallus gallus). In all these bird species, histological data have revealed dendrites of similar shape and size, all containing iron minerals within distinct subcellular compartments of nervous terminals of the median branch of the Nervus ophthalmicus. We also used microscopic X-ray absorption spectroscopy analyses to identify the involved iron minerals to be almost completely Fe III-oxides. Magnetite (Fe II/III) may also occur in these structures, but not as a major Fe constituent. Our data suggest that this complex dendritic system in the beak is a common feature of birds, and that it may form an essential sensory basis for the evolution of at least certain types of magnetic field guided behavior.

Direct peroral cholangioscopy using an ultraslim upper endoscope for biliary lesions.

PubMed

Omuta, Shigefumi; Maetani, Iruru; Ukita, Takeo; Nambu, Tomoko; Gon, Katsushige; Shigoka, Hiroaki; Saigusa, Yoshinori; Saito, Michihiro

2014-02-01

The development of direct peroral cholangioscopy (DPOC) using an ultraslim endoscope simplifies biliary cannulation. The conventional techniques are cumbersome to perform and require advanced skills. The recent introduction of the guidewires and balloons has improved the therapeutic outcomes. Here we describe an effective and easier method for performing DPOC using an ultraslim upper endoscope. Indications for DPOC were the presence of stones on follow-up of patients who had previously undergone complete sphincteroplasty, including endoscopic sphincterotomy or endoscopic papillary large balloon dilatation. Fifteen patients underwent DPOC. An ultraslim endoscope was inserted perorally and was advanced into the major papilla. The ampulla of Vater was visualized by retroflexing the endoscope in the distal second portion of the duodenum, and then DPOC was performed using a wire-guided cannulation technique with an anchored intraductal balloon catheter. One patient failed in the treatment due to looping of the endoscope in the fornix of the stomach. Fourteen (93.3%) were successfully treated with our modified DPOC technique. Only one patient (6.7%) experienced an adverse event (pancreatitis) who responded well to conservative management. Residual stones of the common bile duct were completely removed in 3 patients. The modified method of DPOC is simple, safe and easy to access the bile duct.

Utility of the iPhone 4 Gyroscope Application in the Measurement of Wrist Motion.

PubMed

Lendner, Nuphar; Wells, Erik; Lavi, Idit; Kwok, Yan Yan; Ho, Pak-Cheong; Wollstein, Ronit

2017-09-01

Measurement of wrist range of motion (ROM) is important to all aspects of treatment and rehabilitation of upper extremity conditions. Recently, gyroscopes have been used to measure ROM and may be more precise than manual evaluations. The purpose of this study was to evaluate the use of the iPhone gyroscope application and compare it with use of a goniometer, specifically evaluating its accuracy and ease of use. A cross-sectional study evaluated adult Caucasian participants, with no evidence of wrist pathology. Wrist ROM measurements in 306 wrists using the 2 methods were compared. Demographic information was collected including age, sex, and occupation. Analysis included mixed models and Bland-Altman plots. Wrist motion was similar between the 2 methods. Technical difficulties were encountered with gyroscope use. Age was an independent predictor of ROM. Correct measurement of ROM is critical to guide, compare, and evaluate treatment and rehabilitation of the upper extremity. Inaccurate measurements could mislead the surgeon and harm patient adherence with therapy or surgeon instruction. An application used by the patient could improve adherence but needs to be reliable and easy to use. Evaluation is necessary before utilization of such an application. This study supports revision of the application on the iPhone to improve ease of use.

Upper gastrointestinal bleeding risk scores: Who, when and why?

PubMed Central

Monteiro, Sara; Gonçalves, Tiago Cúrdia; Magalhães, Joana; Cotter, José

2016-01-01

Upper gastrointestinal bleeding (UGIB) remains a significant cause of hospital admission. In order to stratify patients according to the risk of the complications, such as rebleeding or death, and to predict the need of clinical intervention, several risk scores have been proposed and their use consistently recommended by international guidelines. The use of risk scoring systems in early assessment of patients suffering from UGIB may be useful to distinguish high-risks patients, who may need clinical intervention and hospitalization, from low risk patients with a lower chance of developing complications, in which management as outpatients can be considered. Although several scores have been published and validated for predicting different outcomes, the most frequently cited ones are the Rockall score and the Glasgow Blatchford score (GBS). While Rockall score, which incorporates clinical and endoscopic variables, has been validated to predict mortality, the GBS, which is based on clinical and laboratorial parameters, has been studied to predict the need of clinical intervention. Despite the advantages previously reported, their use in clinical decisions is still limited. This review describes the different risk scores used in the UGIB setting, highlights the most important research, explains why and when their use may be helpful, reflects on the problems that remain unresolved and guides future research with practical impact. PMID:26909231

Magnetic Shocks and Substructures Excited by Torsional Alfvén Wave Interactions in Merging Expanding Flux Tubes

NASA Astrophysics Data System (ADS)

Snow, B.; Fedun, V.; Gent, F. A.; Verth, G.; Erdélyi, R.

2018-04-01

Vortex motions are frequently observed on the solar photosphere. These motions may play a key role in the transport of energy and momentum from the lower atmosphere into the upper solar atmosphere, contributing to coronal heating. The lower solar atmosphere also consists of complex networks of flux tubes that expand and merge throughout the chromosphere and upper atmosphere. We perform numerical simulations to investigate the behavior of vortex-driven waves propagating in a pair of such flux tubes in a non-force-free equilibrium with a realistically modeled solar atmosphere. The two flux tubes are independently perturbed at their footpoints by counter-rotating vortex motions. When the flux tubes merge, the vortex motions interact both linearly and nonlinearly. The linear interactions generate many small-scale transient magnetic substructures due to the magnetic stress imposed by the vortex motions. Thus, an initially monolithic tube is separated into a complex multithreaded tube due to the photospheric vortex motions. The wave interactions also drive a superposition that increases in amplitude until it exceeds the local Mach number and produces shocks that propagate upward with speeds of approximately 50 km s‑1. The shocks act as conduits transporting momentum and energy upward, and heating the local plasma by more than an order of magnitude, with a peak temperature of approximately 60,000 K. Therefore, we present a new mechanism for the generation of magnetic waveguides from the lower solar atmosphere to the solar corona. This wave guide appears as the result of interacting perturbations in neighboring flux tubes. Thus, the interactions of photospheric vortex motions is a potentially significant mechanism for energy transfer from the lower to upper solar atmosphere.

Upper Tract Urothelial Carcinomas Accompanied by Previous or Synchronous Nonmuscle-Invasive Bladder Cancer and Preoperative Hydronephrosis Might Have Worse Oncologic Outcomes After Radical Nephroureterectomy.

PubMed

Liang, Chengcai; Chi, Runmin; Huang, Liqun; Wang, Jinliang; Liu, Hailong; Xu, Ding; Qian, Subo; Qian, Xiaoqiang; Qi, Jun

2016-10-01

The purpose of the study was to identify predictors of clinicopathologic features and oncologic outcomes in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy (RNU). The medical records of 172 patients treated with RNU from January 2001 to September 2014 were retrospectively reviewed. Logistic regression and survival analysis methodology were respectively used to evaluate predictors of clinicopathologic features and oncologic outcomes. Of the enrolled 172 patients, 80 (46.5%) had renal pelvic tumors, 67 (39%) had ureteral tumors, and the remaining 25 (14.5%) patients had multifocal tumors. Compared with patients with renal pelvic tumors, those with ureteral and multifocal tumors were more likely to have previous or synchronous nonmuscle-invasive bladder cancer (NMIBC) and severe hydronephrosis (P = .001 and P < .001, respectively). Logistic regression analysis showed that previous or synchronous NMIBC was significantly associated with worse renal function and high grade (P = .034 and P = .014, respectively), and severe hydronephrosis independently predicted worse renal function and positive lymph node or lymphovascular invasion status (P = .001 and P = .007, respectively). Moreover, severe hydronephrosis was an independent risk factor for overall survival and cancer-specific survival in multivariate analysis (P = .025 and P = .045, respectively). Multifocality and previous or synchronous NMIBC were significantly associated with bladder-recurrence-free survival (P = .023 and P = .001, respectively). Upper tract urothelial carcinoma accompanied by previous or synchronous NMIBC and preoperative severe hydronephrosis could have worse oncologic outcomes after RNU. These common accompanied diagnoses could be valuable for guiding preoperative planning and postoperative adjuvant therapy. Copyright © 2016 Elsevier Inc. All rights reserved.

Effect of a multi-layer infection control barrier on the micro-hardness of a composite resin

PubMed Central

HWANG, In-Nam; HONG, Sung-Ok; LEE, Bin-Na; HWANG, Yun-Chan; OH, Won-Mann; CHANG, Hoon-Sang

2012-01-01

Objective The aim of this study was to evaluate the effect of multiple layers of an infection control barrier on the micro-hardness of a composite resin. Material and Methods One, two, four, and eight layers of an infection control barrier were used to cover the light guides of a high-power light emitting diode (LED) light curing unit (LCU) and a low-power halogen LCU. The composite specimens were photopolymerized with the LCUs and the barriers, and the micro-hardness of the upper and lower surfaces was measured (n=10). The hardness ratio was calculated by dividing the bottom surface hardness of the experimental groups by the irradiated surface hardness of the control groups. The data was analyzed by two-way ANOVA and Tukey's HSD test. Results The micro-hardness of the composite specimens photopolymerized with the LED LCU decreased significantly in the four- and eight-layer groups of the upper surface and in the two-, four-, and eight-layer groups of the lower surface. The hardness ratio of the composite specimens was <80% in the eight-layer group. The micro-hardness of the composite specimens photopolymerized with the halogen LCU decreased significantly in the eight-layer group of the upper surface and in the two-, four-, and eight-layer groups of the lower surface. However, the hardness ratios of all the composite specimens photopolymerized with barriers were <80%. Conclusions The two-layer infection control barrier could be used on high-power LCUs without decreasing the surface hardness of the composite resin. However, when using an infection control barrier on the low-power LCUs, attention should be paid so as not to sacrifice the polymerization efficiency. PMID:23138746

Evaluation Results of an Ontology-based Design Model of Virtual Environments for Upper Limb Motor Rehabilitation of Stroke Patients.

PubMed

Ramírez-Fernández, Cristina; Morán, Alberto L; García-Canseco, Eloísa; Gómez-Montalvo, Jorge R

2017-03-23

1) To enhance the content of an ontology for designing virtual environments (VEs) for upper limb motor rehabilitation of stroke patients according to the suggestions and comments of rehabilitation specialists and software developers, 2) to characterize the perceived importance level of the ontology, 3) to determine the perceived usefulness of the ontology, and 4) to identify the safety characteristics of the ontology for VEs design according to the rehabilitation specialists. Using two semi-structured Web questionnaires, we asked six rehabilitation specialists and six software developers to provide us with their perception regarding the level of importance and the usability of the ontology. From their responses we have identified themes related to perceived and required safety characteristics of the ontology. Significant differences in the importance level were obtained for the Stroke Disability, VE Configuration, Outcome Measures, and Safety Calibration classes, which were perceived as highly important by rehabilitation specialists. Regarding usability, the ontology was perceived by both groups with high usefulness, ease of use, learnability and intention of use. Concerning the thematic analysis of recommendations, eight topics for safety characteristics of the ontology were identified: adjustment of therapy strategies; selection and delimitation of movements; selection and proper calibration of the interaction device; proper selection of measuring instruments; gradual modification of the difficulty of the exercise; adaptability and variability of therapy exercises; feedback according to the capabilities of the patient; and real-time support for exercise training. The rehabilitation specialists and software developers confirmed the importance of the information contained in the ontology regarding motor rehabilitation of the upper limb. Their recommendations highlight the safety features and the advantages of the ontology as a guide for the effective design of VEs.

Student learning of upper-level thermal and statistical physics: The derivation and use of the Boltzmann factor

NASA Astrophysics Data System (ADS)

Thompson, John

2015-04-01

As the Physical Review Focused Collection demonstrates, recent frontiers in physics education research include systematic investigations at the upper division. As part of a collaborative project, we have examined student understanding of several topics in upper-division thermal and statistical physics. A fruitful context for research is the Boltzmann factor in statistical mechanics: the standard derivation involves several physically justified mathematical steps as well as the invocation of a Taylor series expansion. We have investigated student understanding of the physical significance of the Boltzmann factor as well as its utility in various circumstances, and identified various lines of student reasoning related to the use of the Boltzmann factor. Results from written data as well as teaching interviews suggest that many students do not use the Boltzmann factor when answering questions related to probability in applicable physical situations, even after lecture instruction. We designed an inquiry-based tutorial activity to guide students through a derivation of the Boltzmann factor and to encourage deep connections between the physical quantities involved and the mathematics. Observations of students working through the tutorial suggest that many students at this level can recognize and interpret Taylor series expansions, but they often lack fluency in creating and using Taylor series appropriately, despite previous exposure in both calculus and physics courses. Our findings also suggest that tutorial participation not only increases the prevalence of relevant invocation of the Boltzmann factor, but also helps students gain an appreciation of the physical implications and meaning of the mathematical formalism behind the formula. Supported in part by NSF Grants DUE-0817282, DUE-0837214, and DUE-1323426.

Predictors of a variceal source among patients presenting with upper gastrointestinal bleeding.

PubMed

Alharbi, Ahmad; Almadi, Majid; Barkun, Alan; Martel, Myriam

2012-04-01

Patients with upper gastrointestinal bleeding (UGIB) require an early, tailored approach best guided by knowledge of the bleeding lesion, especially a variceal versus a nonvariceal source. To identify, by investigating a large national registry, variables that would be predictive of a variceal origin of UGIB using clinical parameters before endoscopic evaluation. A retrospective study was conducted in 21 Canadian hospitals during the period from January 2004 until the end of May 2005. Consecutive charts for hospitalized patients with a primary or secondary discharge diagnosis of UGIB were reviewed. Data regarding demographics, including historical, physical examination, initial laboratory investigations, endoscopic and pharmacological therapies administered, as well as clinical outcomes, were collected. Multivariable logistic regression modelling was performed to identify clinical predictors of a variceal source of bleeding. The patient population included 2020 patients (mean [± SD] age 66.3±16.4 years; 38.4% female). Overall, 215 (10.6%) were found to be bleeding from upper gastrointestinal varices. Among 26 patient characteristics, variables predicting a variceal source of bleeding included history of liver disease (OR 6.36 [95% CI 3.59 to 11.3]), excessive alcohol use (OR 2.28 [95% CI 1.37 to 3.77]), hematemesis (OR 2.65 [95% CI 1.61 to 4.36]), hematochezia (OR 3.02 [95% CI 1.46 to 6.22]) and stigmata of chronic liver disease (OR 2.49 [95% CI 1.46 to 4.25]). Patients treated with antithrombotic therapy were more likely to experience other causes of hemorrhage (OR 0.44 [95% CI 0.35 to 0.78]). Presenting historical and physical examination data, and initial laboratory tests carry significant predictive ability in discriminating variceal versus nonvariceal sources of bleeding.

Does internal climate variability overwhelm climate change signals in streamflow? The upper Po and Rhone basin case studies.

PubMed

Fatichi, S; Rimkus, S; Burlando, P; Bordoy, R

2014-09-15

Projections of climate change effects in streamflow are increasingly required to plan water management strategies. These projections are however largely uncertain due to the spread among climate model realizations, internal climate variability, and difficulties in transferring climate model results at the spatial and temporal scales required by catchment hydrology. A combination of a stochastic downscaling methodology and distributed hydrological modeling was used in the ACQWA project to provide projections of future streamflow (up to year 2050) for the upper Po and Rhone basins, respectively located in northern Italy and south-western Switzerland. Results suggest that internal (stochastic) climate variability is a fundamental source of uncertainty, typically comparable or larger than the projected climate change signal. Therefore, climate change effects in streamflow mean, frequency, and seasonality can be masked by natural climatic fluctuations in large parts of the analyzed regions. An exception to the overwhelming role of stochastic variability is represented by high elevation catchments fed by glaciers where streamflow is expected to be considerably reduced due to glacier retreat, with consequences appreciable in the main downstream rivers in August and September. Simulations also identify regions (west upper Rhone and Toce, Ticino river basins) where a strong precipitation increase in the February to April period projects streamflow beyond the range of natural climate variability during the melting season. This study emphasizes the importance of including internal climate variability in climate change analyses, especially when compared to the limited uncertainty that would be accounted for by few deterministic projections. The presented results could be useful in guiding more specific impact studies, although design or management decisions should be better based on reliability and vulnerability criteria as suggested by recent literature. Copyright © 2013 Elsevier B.V. All rights reserved.

Ultrathin endoscope-assisted self-expandable metallic stent placement following initial unsuccessful attempt in malignant upper gastrointestinal obstruction.

PubMed

Park, Se Woo; Lee, Hyuk; Park, Jun Chul; Shin, Sung Kwan; Lee, Sang Kil; Lee, Yong Chan

2014-03-01

Conventional endoscopy for self-expandable metallic stent (SEMS) placement may be technically limited in long and tortuous strictures. Therefore, we analyzed the feasibility, safety and usefulness of ultrathin endoscopy (UTE)-guided SEMS placement. This study involved 24 patients with upper gastrointestinal obstruction and unsuccessful initial attempts to place SEMS using conventional endoscopy. After completely passing a UTE across the stricture, the UTE was withdrawn, leaving a guidewire placed via the working channel. Through-the-scope SEMS placement was done using a conventional endoscope inserted along the guidewire. The primary endpoints were assessed by technical/clinical success and stent patency duration. Stents were successfully placed at target locations in all but one case with a long tortuous stricture, with 95.8% (23/24) technical success. One week after stent placement, mean gastricoutlet obstruction score improved significantly from baseline (1.74 ± 0.62 and 0.33 ± 0.48, respectively; P < 0.001). Stent migration, restenosis, and fracture occurred in four (17.4%), six (26.1%), and one (4.3%) of 23 stents, respectively. Median stent patency duration was 79 days. Mean stent patency was significantly longer in patients who received palliative chemotherapy than in those who did not (122.9 ± 11.0 and 38.3 ± 4.6, respectively; P < 0.001). UTE guidance SEMS delivery can be a feasible and safe rescue treatment method for malignant upper gastrointestinal obstruction in cases of failed attempts to place SEMS using conventional endoscopy. Our result warrants a further study to define the efficacy of this method in difficult SEMS placement cases. © 2013 The Authors. Digestive Endoscopy © 2013 Japan Gastroenterological Endoscopy Society.

Testing for the J-2X Upper Stage Engine

NASA Technical Reports Server (NTRS)

Buzzell, James C.

2010-01-01

NASA selected the J-2X Upper Stage Engine in 2006 to power the upper stages of the Ares I crew launch vehicle and the Ares V cargo launch vehicle. Based on the proven Saturn J-2 engine, this new engine will provide 294,000 pounds of thrust and a specific impulse of 448 seconds, making it the most efficient gas generator cycle engine in history. The engine's guiding philosophy emerged from the Exploration Systems Architecture Study (ESAS) in 2005. Goals established then called for vehicles and components based, where feasible, on proven hardware from the Space Shuttle, commercial, and other programs, to perform the mission and provide an order of magnitude greater safety. Since that time, the team has made unprecedented progress. Ahead of the other elements of the Constellation Program architecture, the team has progressed through System Requirements Review (SRR), System Design Review (SDR), Preliminary Design Review (PDR), and Critical Design Review (CDR). As of February 2010, more than 100,000 development engine parts have been ordered and more than 18,000 delivered. Approximately 1,300 of more than 1,600 engine drawings were released for manufacturing. A major factor in the J-2X development approach to this point is testing operations of heritage J-2 engine hardware and new J-2X components to understand heritage performance, validate computer modeling of development components, mitigate risk early in development, and inform design trades. This testing has been performed both by NASA and its J-2X prime contractor, Pratt & Whitney Rocketdyne (PWR). This body of work increases the likelihood of success as the team prepares for testing the J-2X powerpack and first development engine in calendar 2011. This paper will provide highlights of J-2X testing operations, engine test facilities, development hardware, and plans.

Determination of a sagittal plane axis of rotation for a dynamic office chair.

PubMed

Bauer, C M; Rast, F M; Böck, C; Kuster, R P; Baumgartner, D

2018-10-01

This study investigated the location of the axis of rotation in sagittal plane movement of the spine in a free sitting condition to adjust the kinematics of a mobile seat for a dynamic chair. Dynamic office chairs are designed to avoid continuous isometric muscle activity, and to facilitate increased mobility of the back during sitting. However, these chairs incorporate increased upper body movement which could distract office workers from the performance of their tasks. A chair with an axis of rotation above the seat would facilitate a stable upper back during movements of the lower back. The selection of a natural kinematic pattern is of high importance in order to match the properties of the spine. Twenty-one participants performed four cycles of flexion and extension of the spine during an upper arm hang on parallel bars. The location of the axis of rotation relative to the seat was estimated using infrared cameras and reflective skin markers. The median axis of rotation across all participants was located 36 cm above the seat for the complete movement and 39 cm for both the flexion and extension phases, each with an interquartile range of 20 cm. There was no significant effect of the movement direction on the location of the axis of rotation and only a weak, non-significant correlation between body height and the location of the axis of rotation. Individual movement patterns explained the majority of the variance. The axis of rotation for a spinal flexion/extension movement is located above the seat. The recommended radius for a guide rail of a mobile seat is between 36 cm and 39 cm. Copyright © 2018 Elsevier Ltd. All rights reserved.

Investigating Undergraduates’ Perceptions of Science in Courses Taught Using the CREATE Strategy †

PubMed Central

Hoskins, Sally G.; Gottesman, Alan J.

2018-01-01

Many science educators agree that 21st century students need to develop mature scientific thinking skills. Unsurprisingly, students’ and experts’ perceptions about the nature of scientific knowledge differ. Moreover, students’ naïve and entrenched epistemologies can preclude their development toward “thinking like scientists.” Novel teaching approaches that guide students toward more mature perceptions may be needed to support their development of scientific thinking skills. To address such issues, physics educators developed the Colorado Learning Attitudes About Science Survey (CLASS), subsequently adapted for chemistry and biology. These surveys are “designed to compare novice and expert perceptions about the content and structure of a specific discipline; the source of knowledge about that discipline, including connection of the discipline to the real world; and problem-solving approaches” (Semsar et al., CBE Life Sci. Educ. 10:268–278; p 269). We used CLASS-Bio to track students’ perceptions of science in separate first-year and upper-level CREATE (Consider, Read, Elucidate hypotheses, Analyze and interpret the data, Think of the next Experiment) electives, hypothesizing that perceptions would become significantly more expert-like across a semester. Both first-year and upper-level cohorts made significant expert-like shifts. Students also made significant critical thinking gains in CREATE courses. Our findings of more mature, expert-like perceptions of science post-course contrast with those of previous studies, where students’ thinking became significantly less expert-like across a term of introductory instruction and changed little in upper-level biology electives. Augmenting traditional biology curricula with CREATE courses could be an economical way to help undergraduates develop more mature views of science. PMID:29904553

A low upper mass limit for the central black hole in the late-type galaxy NGC 4414

NASA Astrophysics Data System (ADS)

Thater, S.; Krajnović, D.; Bourne, M. A.; Cappellari, M.; de Zeeuw, T.; Emsellem, E.; Magorrian, J.; McDermid, R. M.; Sarzi, M.; van de Ven, G.

2017-01-01

We present our mass estimate of the central black hole in the isolated spiral galaxy NGC 4414. Using natural guide star adaptive optics assisted observations with the Gemini Near-Infrared Integral Field Spectrometer (NIFS) and the natural seeing Gemini Multi-Object Spectrographs-North (GMOS), we derived two-dimensional stellar kinematic maps of NGC 4414 covering the central 1.5 arcsec and 10 arcsec, respectively, at a NIFS spatial resolution of 0.13 arcsec. The kinematic maps reveal a regular rotation pattern and a central velocity dispersion dip down to around 105 km s-1. We constructed dynamical models using two different methods: Jeans anisotropic dynamical modeling and axisymmetric Schwarzschild modeling. Both modeling methods give consistent results, but we cannot constrain the lower mass limit and only measure an upper limit for the black hole mass of MBH = 1.56 × 106M⊙ (at 3σ level) which is at least 1σ below the recent MBH-σe relations. Further tests with dark matter, mass-to-light ratio variation and different light models confirm that our results are not dominated by uncertainties. The derived upper limit mass is not only below the MBH-σe relation, but is also five times lower than the lower limit black hole mass anticipated from the resolution limit of the sphere of influence. This proves that via high quality integral field data we are now able to push black hole measurements down to at least five times less than the resolution limit. The reduced data cubes (FITS files) are only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/597/A18

What drives the Tibetan crust to the South East Asia? Role of upper mantle density discontinuities as inferred from the continental geoid anomalies

NASA Astrophysics Data System (ADS)

Rajesh, S.

2012-04-01

The Himalaya-Tibet orogen formed as a result of the northward convergence of India into the Asia over the past 55 Ma had caused the north south crustal shortening and Cenozoic upliftment of the Tibetan plateau, which significantly affected the tectonic and climatic framework of the Asia. Geodetic measurements have also shown eastward crustal extrusion of Tibet, especially along major east-southeast strike slip faults at a slip rate of 15-20 mm a-1 and around 40 mm a-1. Such continental scale deformations have been modeled as block rotation by fault boundary stresses developed due to the India-Eurasia collision. However, the Thin Sheet model explained the crustal deformation mechanism by considering varying gravitational potential energy arise out of varying crustal thickness of the viscous lithosphere. The Channel Flow model, which also suggests extrusion is a boundary fault guided flow along the shallow crustal brittle-ductile regime. Although many models have proposed, but no consensus in these models to explain the dynamics of measured surface geodetic deformation of the Tibetan plateau. But what remains conspicuous is the origin of driving forces that cause the observed Tibetan crustal flow towards the South East Asia. Is the crustal flow originated only because of the differential stresses that developed in the shallow crustal brittle-ductile regime? Or should the stress transfer to the shallow crustal layers as a result of gravitational potential energy gradient driven upper mantle flow also to be accounted. In this work, I examine the role of latter in the light of depth distribution of continental geoid anomalies beneath the Himalaya-Tibet across major upper mantle density discontinuities. These discontinuity surfaces in the upper mantle are susceptible to hold the plastic deformation that may occur as a result of the density gradient driven flow. The distribution of geoid anomalies across these density discontinuities at 220, 410 and 660 km depth in the upper mantle beneath the Himalaya-Tibet has been studied by analyzing the geoid undulation data obtained from various satellite geodetic missions along with the recent and old (EGM2008 and EGM2006) Earth Gravity models. Results show that the net geoid anomaly varies from -65 m to -20 m, which signify a density stratified upper mantle beneath the Himalaya-Tibet and the same has been confirmed from the results of regional seismic tomography studies. The density anomaly distribution beneath Tibet from 163 km depth to its upper mantle thickness of 1063 km show a strong NW-SE elliptically oriented positive geoid anomalies of magnitude around 40 meter. Asymmetric density anomaly gradient have been observed along the Himalayan arc from west to east as well as across the arc from north to south. This caused differential gravitational potential gradient and hence an elliptical flow structure of the Tibetan continental mantle along the resultant NW-SE direction, which is in concurrence with the observed present day direction of the Tibetan crustal flow. Thus the geoid anomalies distributed at various depth ranges show how the gradient in the upper mantle gravitational potential energy, especially across the deformed discontinuity surface, is significant in determining the transfer of deviatoric stresses and providing traction to the flow of crustal layers of the Tibetan Plateau. This suggests the viscous flow model could be a preferable choice, which could better accommodate the dynamics of the upper mantle, in explaining the crustal extrusion processes of the Tibetan Plateau.

The Republic of Chile: an upper middle-income country at the crossroads of economic development and aging.

PubMed

Gitlin, Laura N; Fuentes, Patricio

2012-06-01

Chile is a developing country with a rapidly expanding economy and concomitant social and cultural changes. It is expected to become a developed country within 10 years. Chile is also characterized as being in an advanced demographic transition. Unique challenges are posed by the intersection of rapid economic development and an aging population, making Chile an intriguing case study for examining the impact of these societal-level trends on the aging experience. This paper highlights essential characteristics of this country for understanding its emerging aging society. It reveals that there is a fundamental lack of adequate and depthful epidemiologic and country-specific research from which to fully understand the aging experience and guide new policies in support of health and well-being.

The Republic of Chile: An Upper Middle-Income Country at the Crossroads of Economic Development and Aging

PubMed Central

Gitlin, Laura N.; Fuentes, Patricio

2012-01-01

Chile is a developing country with a rapidly expanding economy and concomitant social and cultural changes. It is expected to become a developed country within 10 years. Chile is also characterized as being in an advanced demographic transition. Unique challenges are posed by the intersection of rapid economic development and an aging population, making Chile an intriguing case study for examining the impact of these societal-level trends on the aging experience. This paper highlights essential characteristics of this country for understanding its emerging aging society. It reveals that there is a fundamental lack of adequate and depthful epidemiologic and country-specific research from which to fully understand the aging experience and guide new policies in support of health and well-being. PMID:22534464

From the Ionosphere to the Classroom: Exploring the Earth's Upper Atmosphere with CINDI

NASA Astrophysics Data System (ADS)

Urquhart, M. L.; Hairston, M. R.

2004-12-01

CINDI (Coupled Ion Neutral Dynamic Investigation) is a NASA funded instrument scheduled for an early 2005 launch by the Air Force on board the C/NOFS (Communications/Navigations Outage Forecast System) satellite. In preparation for this launch, our education and public outreach program is well under way, and focuses on making the difficult-to-visualize science of the ionosphere understandable to students in middle school and above. Our formal education strategy is to create engaging and usable materials that meet teachers' needs and integrate well into existing curriculum in today's era of high stakes testing. We will present our middle school educator guide, a preview of our new CINDI comic book, highlights from our 2004 educator workshops, and future plans to bring the ionosphere into classrooms around the country.

Nuclear fuel alloys or mixtures and method of making thereof

DOEpatents

Mariani, Robert Dominick; Porter, Douglas Lloyd

2016-04-05

Nuclear fuel alloys or mixtures and methods of making nuclear fuel mixtures are provided. Pseudo-binary actinide-M fuel mixtures form alloys and exhibit: body-centered cubic solid phases at low temperatures; high solidus temperatures; and/or minimal or no reaction or inter-diffusion with steel and other cladding materials. Methods described herein through metallurgical and thermodynamics advancements guide the selection of amounts of fuel mixture components by use of phase diagrams. Weight percentages for components of a metallic additive to an actinide fuel are selected in a solid phase region of an isothermal phase diagram taken at a temperature below an upper temperature limit for the resulting fuel mixture in reactor use. Fuel mixtures include uranium-molybdenum-tungsten, uranium-molybdenum-tantalum, molybdenum-titanium-zirconium, and uranium-molybdenum-titanium systems.

Instrument characterization for the detection of long-term changes in stratospheric ozone - An analysis of the SBUV/2 radiometer

NASA Technical Reports Server (NTRS)

Frederick, J. E.; Heath, D. F.; Cebula, R. P.

1986-01-01

The scientific objective of unambiguously detecting subtle global trends in upper stratospheric ozone requires that one maintains a thorough understanding of the satellite-based remote sensors intended for this task. The instrument now in use for long term ozone monitoring is the SBUV/2 being flown on NOAA operational satellites. A critical activity in the data interpretation involves separating small changes in measurement sensitivity from true atmospheric variability. By defining the specific issues that must be addressed and presenting results derived early in the mission of the first SBUV/2 flight model, this work serves as a guide to the instrument investigations that are essential in the attempt to detect long-term changes in the ozone layer.

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

Seger, Tona

This guidebook is a resource to help field personnel (nonbotanists) identify plants on the Savannah River Site (SRS) premises. Although not a complete flora guide, this publication contains information about 123 plant species found on the SRS. Plants are listed by their common names and arranged by the color of the flower. The SRS supports a diverse array of plant communities. Land use history, the establishment of the SRS, and current land management practices have shaped the flora presently found on the SRS. Located south of Aiken, SC, SRS spans 198,344 acres with land covering Aiken, Allendale, and Barnwell Counties.more » Situated on the Upper Coastal Plain and Sandhills physiographic provinces, the SRS has more than 50 distinct soil types. The topography is rolling to flat with elevation ranges from 50 to 400 feet above sea level.« less