History of mercury use and environmental contamination at the Oak Ridge Y-12 Plant.

PubMed

Brooks, Scott C; Southworth, George R

2011-01-01

Between 1950 and 1963 approximately 11 million kilograms of mercury (Hg) were used at the Oak Ridge Y-12 National Security Complex (Y-12 NSC) for lithium isotope separation processes. About 3% of the Hg was lost to the air, soil and rock under facilities, and East Fork Poplar Creek (EFPC) which originates in the plant site. Smaller amounts of Hg were used at other Oak Ridge facilities with similar results. Although the primary Hg discharges from Y-12 NSC stopped in 1963, small amounts of Hg continue to be released into the creek from point sources and diffuse contaminated soil and groundwater sources within Y-12 NSC. Mercury concentration in EFPC has decreased 85% from ∼2000 ng/L in the 1980s. In general, methylmercury concentrations in water and in fish have not declined in response to improvements in water quality and exhibit trends of increasing concentration in some cases. Published by Elsevier Ltd.

HISTOPATHOLOGIC BIOMARKERS IN FERAL FRESHWATER FISH POPULATIONS EXPOSED TO DIFFERENT TYPES OF CONTAMINANT STRESS. (R825433)

EPA Science Inventory

Histopathologic alterations of gill, liver, and spleen were studied in feral fish from three freshwater ecosystems that experience different types of contaminant stress. East Fork Poplar Creek (EFPC), a third-order stream in East Tennessee, receives point source discharges of ...

Mn-oxidizing Bacteria in Oak Ridge, TN and the Potential for Mercury Remediation

NASA Astrophysics Data System (ADS)

Wright, K. L.; McNeal, K. S.; Han, F. X.

2012-12-01

East Fork Poplar Creek (EFPC) in Oak Ridge, TN was highly contaminated with elemental mercury in the 1950 and 1960. The area is still experiencing the effects of mercury contamination, and researchers are searching for ways to remediate the EFPC. One possible mechanism for bioremediation is the use of biogenic Mn oxides to remove heavy metals from water systems. Six native Pseudomonas bacteria species were isolated from the EFPC in order to examine biogenic Mn oxides production and bioremediation of Oak Ridge slurries. To investigate the biochemical interactions of Pseudomonas and the native microbial communities with Hg, Mn, Fe, S, six different slurry treatment groups were compared using inductively coupled plasma-atomic emission spectrometry (ICP-AES) and cold vapor atomic absorption spectrometry (CVAAS). Oak Ridge slurries were autoclaved to inhibit microbial growth (group 1), autoclaved and amended with HgS (group 2), autoclaved and amended with Pseudomonas isolates and additional HgS (group 3), untreated slurry (group 4), normal slurry amended with HgS (group 5), and normal slurry amended with Pseudomonas isolates and additional HgS (group 6). The comparison of the autoclaved groups with the counterpart untreated and normal Oak Ridge slurries highlighted important microbial interactions. Also, the Pseudomonas isolates were grown separately in a MnSO4 media, and the individual bacteria were monitored for Mn-oxidization using ICP-AES and transmission electron microscopy (TEM). In the slurry sediments, the Pseudomonas isolates did produce Mn oxides which bound to mercury, and mercury bound to organic matter significantly decreased. However, after a significant decrease of dissolved mercury in the water, dissolved mercury was cycled back into the water system on day 10 of the study. Additionally, two individual native Oak Ridge Pseudomonas isolates demonstrated Mn-oxidization. Biogenic Mn oxides have the potential to decrease mercury cycling, however there is need for more in depth and long-term studies to confirm their sustained use as Hg bioremediators.

Intraday Water Quality Patterns in East Fork Poplar Creek with an Emphasis on Mercury and Monomethylmercury

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

Brooks, Scott C.; Lowe, Kenneth Alan

We conducted a diel sampling campaign at three locations along the Hg contaminated East Fork Poplar Creek (EFPC) in Oak Ridge, Tennessee to (i) quantify diel patterns of particulate and dissolved mercury (Hg) and monomethylmercury (MMHg) (HgD, HgP, MMHgD, and MMHgP, respectively) and associated water quality parameters along a longitudinal gradient of EFPC during the summer season, (ii) determine if diel patterns in Hg and/or MMHg are related to the daily photocycle or any other short term cycle, such as wastewater treatment plant discharge, (iii) determine if diel variability in turbidity and dissolved organic matter (DOM) composition correspond to particulatemore » HgP or MMHgP and dissolved organic carbon (DOC) or dissolved HgD or MMHgD. Samples were collected every two hours for a 30 hour period. The farthest upstream site was located at the boundary of Y-12 and the City of Oak Ridge (EFK 23.4) while two additional sites were located 7.2 kilometers (Wiltshire Drive, EFK 16.2) and 18 kilometers (Horizon Center, EFK 5.4) downstream of EFK 23.4).HgP and MMHgP concentrations increased overnight at EFK 16.2 and EFK 5.4 coincident with increases in turbidity and total suspended solids (TSS). These overnight increases were likely due to diel changes in the activity of macrobiota (re)suspending contaminated sediments in the creek. Both HgD and MMHgD were higher during the day at EFK 23.4 and EFK 5.4. The underlying causes for the patterns in HgD and MMHgD are less clear but correspond with similar patterns in DOC concentration and DOM composition. Photochemical reactions may also play a role in these HgD, MMHgD, DOC, and DOM patterns. Both Hg and MMHg loading increased with downstream distance. The greatest increase in loading occurred in the reach from EFK 23.4 to EFK 16.2 which encompasses areas where the Historic Release Deposits (HRD) have been identified. These results suggest that diffuse legacy sources of Hg, outside of Y-12, contribute Hg load to EFPC whereas MMHg is generated from instream processes.Intraday patterns in Hg and MMHg concentration and speciation have implications with respect to biotic exposure. Greater biotic activity and feeding during times of higher concentration would correspond to greater exposure than estimated from daily or longer term averages. Both Hg and MMHg responded rapidly to processes governing their concentration. This latter point is encouraging from the perspective of site remediation as it suggests that MMHg concentrations and flux in EFPC would respond rapidly to appropriate remedial actions.« less

Mercury Remediation Technology Development for Lower East Fork Poplar Creek - FY 2016 Progress Report

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

Dickson, Johnbull O.; Smith, John G.; Mehlhorn, Tonia L.

2017-07-01

Mercury remediation is a high priority for the US Department of Energy (DOE) Oak Ridge Office of Environmental Management (OREM), especially at and near the Y-12 National Security Complex (Y-12) where historical mercury use has resulted in contaminated buildings, soils, and downstream surface waters. To address mercury contamination of East Fork Poplar Creek (EFPC), the DOE has adopted a phased, adaptive management approach to remediation, which includes mercury treatment actions at Y-12 in the short-term and research and technology development (TD) to evaluate longer-term solutions in the downstream environment (US Department of Energy 2014).

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

Olsen, Todd Andrew; Brandt, Craig C.; Brooks, Scott C.

Mercury (Hg) methylation and methylmercury (MMHg) demethylation activity of periphyton biofilms from East Fork Poplar Creek, Tennessee, USA (EFPC) were measured during 2014-2015 using stable Hg isotopic rate assays. 201Hg II and MM 202Hg were added to intact periphyton samples and the formation of MM 201Hg and loss of MM 202Hg were monitored over time and used to calculate first-order rate constants for methylation and demethylation, respectively. The influence of location, temperature/season, light exposure and biofilm structure on methylation and demethylation were examined. Between-site differences in net methylation for samples collected from an upstream versus downstream location were driven bymore » differences in the demethylation rate constant (k d). In contrast, the within-site seasonal difference in net methylation was driven by changes in the methylation rate constant (k m). Samples incubated in the dark had lower net methylation due to km values that were 60% less than those incubated in the light. Disrupting the biofilm structure decreased km by 50% and resulted in net demethylating conditions. Overall, the measured rates resulted in a net excess of MMHg generated which could account for 27-85% of the MMHg flux in EFPC and suggests intact, actively photosynthesizing periphyton biofilms harbor zones of MMHg production.« less

Periphyton Biofilms Influence Net Methylmercury Production in an Industrially Contaminated System.

PubMed

Olsen, Todd A; Brandt, Craig C; Brooks, Scott C

2016-10-18

Mercury (Hg) methylation and methylmercury (MMHg) demethylation activity of periphyton biofilms from the industrially contaminated East Fork Poplar Creek, Tennessee (EFPC) were measured during 2014-2016 using stable Hg isotopic rate assays. 201 Hg II and MM 202 Hg were added to intact periphyton samples in ambient streamwater and the formation of MM 201 Hg and loss of MM 202 Hg were monitored over time and used to calculate first-order rate potentials for methylation and demethylation. The influences of location, temperature/season, light exposure and biofilm structure on methylation and demethylation potentials were examined. Between-site differences in net methylation for samples collected from an upstream versus downstream location were driven by differences in the demethylation rate potential (k d ). In contrast, the within-site temperature-dependent difference in net methylation was driven by changes in the methylation rate potential (k m ). Samples incubated in the dark had lower net methylation due to lower k m values than those incubated in the light. Disrupting the biofilm structure decreased k m and resulted in lower net methylation. Overall, the measured rates resulted in a net excess of MMHg generated which could account for 3.71-7.88 mg d -1 MMHg flux in EFPC and suggests intact, actively photosynthesizing periphyton biofilms harbor zones of MMHg production.

Periphyton biofilms influence net methylmercury production in an industrially contaminated system

DOE PAGES

Olsen, Todd Andrew; Brandt, Craig C.; Brooks, Scott C.

2016-09-12

Mercury (Hg) methylation and methylmercury (MMHg) demethylation activity of periphyton biofilms from East Fork Poplar Creek, Tennessee, USA (EFPC) were measured during 2014-2015 using stable Hg isotopic rate assays. 201Hg II and MM 202Hg were added to intact periphyton samples and the formation of MM 201Hg and loss of MM 202Hg were monitored over time and used to calculate first-order rate constants for methylation and demethylation, respectively. The influence of location, temperature/season, light exposure and biofilm structure on methylation and demethylation were examined. Between-site differences in net methylation for samples collected from an upstream versus downstream location were driven bymore » differences in the demethylation rate constant (k d). In contrast, the within-site seasonal difference in net methylation was driven by changes in the methylation rate constant (k m). Samples incubated in the dark had lower net methylation due to km values that were 60% less than those incubated in the light. Disrupting the biofilm structure decreased km by 50% and resulted in net demethylating conditions. Overall, the measured rates resulted in a net excess of MMHg generated which could account for 27-85% of the MMHg flux in EFPC and suggests intact, actively photosynthesizing periphyton biofilms harbor zones of MMHg production.« less

Mercury Remediation Technology Development for Lower East Fork Poplar Creek - FY 2015 Progress Report

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

Peterson, Mark J.; Brooks, Scott C.; Mathews, Teresa J.

2016-04-01

Mercury remediation is a high priority for the US Department of Energy (DOE) Oak Ridge Office of Environmental Management (OREM) because of large historical losses of mercury within buildings and to soils and surface waters at the Y-12 National Security Complex (Y-12). Because of the extent of mercury losses and the complexities of mercury transport and fate in the downstream environment, the success of conventional options for mercury remediation in lower East Fork Poplar Creek (EFPC) is uncertain. A phased, adaptive management approach to remediation of surface water includes mercury treatment actions at Y-12 in the short-term and research andmore » technology development (TD) to evaluate longer-term solutions in the downstream environment (US Department of Energy 2014b).« less

Long-term benthic macroinvertebrate community monitoring to assess pollution abatement effectiveness.

PubMed

Smith, John G; Brandt, Craig C; Christensen, Sigurd W

2011-06-01

The benthic macroinvertebrate community of East Fork Poplar Creek (EFPC) in East Tennessee was monitored for 18 years to evaluate the effectiveness of a water pollution control program implemented at a major United States (U.S.) Department of Energy facility. Several actions were implemented to reduce and control releases of pollutants into the headwaters of the stream. Four of the most significant actions were implemented during different time periods, which allowed assessment of each action. Macroinvertebrate samples were collected annually in April from three locations in EFPC (EFK24, EFK23, and EFK14) and two nearby reference streams from 1986 through 2003. Significant improvements occurred in the macroinvertebrate community at the headwater sites (EFK24 and EFK23) after implementation of each action, while changes detected 9 km further downstream (EFK14) could not be clearly attributed to any of the actions. Because the stream was impacted at its origin, invertebrate recolonization was primarily limited to aerial immigration, thus, recovery has been slow. As recovery progressed, abundances of small pollution-tolerant taxa (e.g., Orthocladiinae chironomids) decreased and longer lived taxa colonized (e.g., hydropsychid caddisflies, riffle beetles, Baetis). While assessments lasting three to four years may be long enough to detect a response to new pollution controls at highly impacted locations, more time may be needed to understand the full effects. Studies on the effectiveness of pollution controls can be improved if impacted and reference sites are selected to maximize spatial and temporal trending, and if a multidisciplinary approach is used to broadly assess environmental responses (e.g., water quality trends, invertebrate and fish community assessments, toxicity testing, etc.).

Long-Term Benthic Macroinvertebrate Community Monitoring to Assess Pollution Abatement Effectiveness

NASA Astrophysics Data System (ADS)

Smith, John G.; Brandt, Craig C.; Christensen, Sigurd W.

2011-06-01

The benthic macroinvertebrate community of East Fork Poplar Creek (EFPC) in East Tennessee was monitored for 18 years to evaluate the effectiveness of a water pollution control program implemented at a major United States (U.S.) Department of Energy facility. Several actions were implemented to reduce and control releases of pollutants into the headwaters of the stream. Four of the most significant actions were implemented during different time periods, which allowed assessment of each action. Macroinvertebrate samples were collected annually in April from three locations in EFPC (EFK24, EFK23, and EFK14) and two nearby reference streams from 1986 through 2003. Significant improvements occurred in the macroinvertebrate community at the headwater sites (EFK24 and EFK23) after implementation of each action, while changes detected 9 km further downstream (EFK14) could not be clearly attributed to any of the actions. Because the stream was impacted at its origin, invertebrate recolonization was primarily limited to aerial immigration, thus, recovery has been slow. As recovery progressed, abundances of small pollution-tolerant taxa (e.g., Orthocladiinae chironomids) decreased and longer lived taxa colonized (e.g., hydropsychid caddisflies, riffle beetles, Baetis). While assessments lasting three to four years may be long enough to detect a response to new pollution controls at highly impacted locations, more time may be needed to understand the full effects. Studies on the effectiveness of pollution controls can be improved if impacted and reference sites are selected to maximize spatial and temporal trending, and if a multidisciplinary approach is used to broadly assess environmental responses (e.g., water quality trends, invertebrate and fish community assessments, toxicity testing, etc.).

Long-Term Benthic Macroinvertebrate Community Monitoring to Assess Pollution Abatement Effectiveness

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

Smith, John G; Brandt, Craig C; Christensen, Sigurd W

2011-01-01

The benthic macroinvertebrate community of East Fork Poplar Creek (EFPC) in East Tennessee was monitored for 18 years to evaluate the effectiveness of a water pollution control program implemented at a major United States (U.S.) Department of Energy facility. Several actions were implemented to reduce and control releases of pollutants into the headwaters of the stream. Four of the most significant actions were implemented during different time periods, which allowed assessment of each action. Macroinvertebrate samples were collected annually in April from three locations in EFPC (EFK24, EFK23, and EFK14) and two nearby reference streams from 1986 through 2003. Significantmore » improvements occurred in the macroinvertebrate community at the headwater sites (EFK24 and EFK23) after implementation of each action, while changes detected 9 km further downstream (EFK14) could not be clearly attributed to any of the actions. Because the stream was impacted at its origin, invertebrate recolonization was primarily limited to aerial immigration, thus, recovery has been slow. As recovery progressed, abundances of small pollution-tolerant taxa (e.g., Orthocladiinae chironomids) decreased and longer lived taxa colonized (e.g., hydropsychid caddisflies, riffle beetles, Baetis). While assessments lasting three to four years may be long enough to detect a response to new pollution controls at highly impacted locations, more time may be needed to understand the full effects. Studies on the effectiveness of pollution controls can be improved if impacted and reference sites are selected to maximize spatial and temporal trending, and if a multidisciplinary approach is used to broadly assess environmental responses (e.g., water quality trends, invertebrate and fish community assessments, toxicity testing, etc.).« less

Storm water runoff for the Y-12 Plant and selected parking lots

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

Collins, E.T.

1996-01-01

A comparison of storm water runoff from the Y-12 Plant and selected employee vehicle parking lots to various industry data is provided in this document. This work is an outgrowth of and part of the continuing Non-Point Source Pollution Elimination Project that was initiated in the late 1980s. This project seeks to identify area pollution sources and remediate these areas through the Resource Conservation and Recovery Act/Comprehensive Environmental Response, Compensation, and Liability Act (RCRA/CERCLA) process as managed by the Environmental Restoration Organization staff. This work is also driven by the Clean Water Act Section 402(p) which, in part, deals withmore » establishing a National Pollutant Discharge Elimination System (NPDES) permit for storm water discharges. Storm water data from events occurring in 1988 through 1991 were analyzed in two reports: Feasibility Study for the Best Management Practices to Control Area Source Pollution Derived from Parking Lots at the DOE Y-12 Plant, September 1992, and Feasibility Study of Best Management Practices for Non-Point Source Pollution Control at the Oak Ridge Y-12 Plant, February 1993. These data consisted of analysis of outfalls discharging to upper East Fork Poplar Creek (EFPC) within the confines of the Y-12 Plant (see Appendixes D and E). These reports identified the major characteristics of concern as copper, iron, lead, manganese, mercury, nitrate (as nitrogen), zinc, biological oxygen demand (BOD), chemical oxygen demand (COD), total suspended solids (TSS), fecal coliform, and aluminum. Specific sources of these contaminants were not identifiable because flows upstream of outfalls were not sampled. In general, many of these contaminants were a concern in many outfalls. Therefore, separate sampling exercises were executed to assist in identifying (or eliminating) specific suspected sources as areas of concern.« less

Reactor pressure vessel head vents and methods of using the same

DOEpatents

Gels, John L; Keck, David J; Deaver, Gerald A

2014-10-28

Internal head vents are usable in nuclear reactors and include piping inside of the reactor pressure vessel with a vent in the reactor upper head. Piping extends downward from the upper head and passes outside of the reactor to permit the gas to escape or be forcibly vented outside of the reactor without external piping on the upper head. The piping may include upper and lowers section that removably mate where the upper head joins to the reactor pressure vessel. The removable mating may include a compressible bellows and corresponding funnel. The piping is fabricated of nuclear-reactor-safe materials, including carbon steel, stainless steel, and/or a Ni--Cr--Fe alloy. Methods install an internal head vent in a nuclear reactor by securing piping to an internal surface of an upper head of the nuclear reactor and/or securing piping to an internal surface of a reactor pressure vessel.

The Upper Atmosphere; Threshold of Space.

ERIC Educational Resources Information Center

Bird, John

This booklet contains illustrations of the upper atmosphere, describes some recent discoveries, and suggests future research questions. It contains many color photographs. Sections include: (1) "Where Does Space Begin?"; (2) "Importance of the Upper Atmosphere" (including neutral atmosphere, ionized regions, and balloon and investigations); (3)…

Follow-Up Care for Older Women With Breast Cancer

DTIC Science & Technology

2000-05-01

better predictor of upper body mor therapy, all cause mortality, self -reported function and overall physical function than upper body function, and...outcomes, including primary tu- Major Analytic Variables mor therapy and all cause mortality, as well as self -reported upper body and overall physical ...comorbidity and their relation to a range of patient outcomes, including primary tumor therapy and mortality, self -reported upper body function, and overall

Ceramic substrate including thin film multilayer surface conductor

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

Wolf, Joseph Ambrose; Peterson, Kenneth A.

2017-05-09

A ceramic substrate comprises a plurality of ceramic sheets, a plurality of inner conductive layers, a plurality of vias, and an upper conductive layer. The ceramic sheets are stacked one on top of another and include a top ceramic sheet. The inner conductive layers include electrically conductive material that forms electrically conductive features on an upper surface of each ceramic sheet excluding the top ceramic sheet. The vias are formed in each of the ceramic sheets with each via being filled with electrically conductive material. The upper conductive layer includes electrically conductive material that forms electrically conductive features on anmore » upper surface of the top ceramic sheet. The upper conductive layer is constructed from a stack of four sublayers. A first sublayer is formed from titanium. A second sublayer is formed from copper. A third sublayer is formed from platinum. A fourth sublayer is formed from gold.« less

How do somatosensory deficits in the arm and hand relate to upper limb impairment, activity, and participation problems after stroke? A systematic review.

PubMed

Meyer, Sarah; Karttunen, Auli H; Thijs, Vincent; Feys, Hilde; Verheyden, Geert

2014-09-01

The association between somatosensory impairments and outcome after stroke remains unclear. The aim of this study was to systematically review the available literature on the relationship between somatosensory impairments in the upper limb and outcome after stroke. The electronic databases PubMed, CINAHL, EMBASE, Cochrane Library, PsycINFO, and Web of Science were systematically searched from inception until July 2013. Studies were included if adult patients with stroke (minimum n=10) were examined with reliable and valid measures of somatosensation in the upper limb to investigate the relationship with upper limb impairment, activity, and participation measures. Exclusion criteria included measures of somatosensation involving an overall score for upper and lower limb outcome and articles including only lower limb outcomes. Eligibility assessment, data extraction, and quality evaluation were completed by 2 independent reviewers. A cutoff score of ≥65% of the maximal quality score was used for further inclusion in this review. Six articles met all inclusion criteria. Two-point discrimination was shown to be predictive for upper limb dexterity, and somatosensory evoked potentials were shown to have predictive value in upper limb motor recovery. Proprioception was significantly correlated with perceived level of physical activity and social isolation and had some predictive value in functional movements of the upper limb. Finally, the combination of light touch and proprioception impairment was shown to be significantly related to upper limb motor recovery as well as handicap situations during activities of daily living. Heterogeneity of the included studies warrants caution when interpreting results. Large variation in results was found due to heterogeneity of the studies. However, somatosensory deficits were shown to have an important role in upper limb motor and functional performance after stroke. © 2014 American Physical Therapy Association.

A "reverse direction" technique of single-port left upper pulmonary resection.

PubMed

Zhang, Min; Sihoe, Alan D L; Du, Ming

2016-08-01

Single-port video-assisted thoracoscopic surgery (VATS) left upper lobectomy is difficult amongst all the lobes. At the beginning of single-port lobectomies, the upper lobes were believed not to be amenable for single-port approach due to the difficult angulation for staplers. Gonzalez reported the first single-port VATS left upper lobectomy in 2011. We report a new technique of single-port VATS left upper lobectomy with the concept of "reverse direction". We divide the apical-anterior arterial trunk with upper vein in the last. The procedure sequence is described as follows: posterior artery, lingular artery, bronchus and finally upper vein & apical-anterior arterial trunk. This method could overcome the angular limitations frequently encountered in single-port VATS procedures; reduce the risk of injuries to pulmonary artery; broaden the indications of single-port the upper lobe of the left lung (LUL) to include hypoplastic lung fissures. Limitations of this new practice include the enlargement or severe calcifications of hilar and bronchial lymph nodes. A "reverse direction" technique of single-port left upper pulmonary resection is feasible and safe.

Long-Life Self-Renewing Solar Reflector Stack

DOEpatents

Butler, Barry Lynn

1997-07-08

A long-life solar reflector includes a solar collector substrate and a base layer bonded to a solar collector substrate. The first layer includes a first reflective layer and a first acrylic or transparent polymer layer covering the first reflective layer to prevent exposure of the first reflective layer. The reflector also includes at least one upper layer removably bonded to the first acrylic or transparent polymer layer of the base layer. The upper layer includes a second reflective layer and a second acrylic or transparent polymer layer covering the second reflective layer to prevent exposure of the second reflective layer. The upper layer may be removed from the base reflective layer to expose the base layer, thereby lengthening the useful life of the solar reflector. A method of manufacturing a solar reflector includes the steps of bonding a base layer to a solar collector substrate, wherein the base reflective layer includes a first reflective layer and a first transparent polymer or acrylic layer covering the first reflective layer; and removably bonding a first upper layer to the first transparent polymer or acrylic layer of the base layer. The first upper layer includes a second reflective layer and a second transparent polymer or acrylic layer covering the second reflective layer to prevent exposure of the second reflective layer.

Dynamic upper airway changes during sleep in patients with obstructive sleep apnea syndrome.

PubMed

Chuang, Li-Pang; Chen, Ning-Hung; Li, Hsueh-Yu; Lin, Shih-Wei; Chou, Yu-Ting; Wang, Chao-Jan; Liao, Yu-Fang; Tsai, Ying-Huang

2009-12-01

The narrowing pattern of the upper airway in obstructive sleep apnea patients may be different in sleep as compared with awake. Three different types of obstruction were observed in these subjects during drug-induced sleep. The different obstruction pattern during drug-induced sleep suggests that different strategies should be selected in upper airway management. To identify the sites of narrowing and evaluate dynamic upper airway movement in patients with obstructive sleep apnea syndrome (OSAS) while awake and asleep. This study included 10 patients treated for OSAS between August 2003 and June 2004. Overnight polysomnography was performed on all patients. Parameters including gender, age, neck circumference, and body mass index were recorded. Ultra-fast MRI during awake and drug-induced sleep was arranged to evaluate the dynamic motion of the upper airway. The narrowing pattern of the upper airway during awake differed from the narrowing pattern during drug-induced sleep in 3 of 10 subjects. Three different types, palatal obstruction, combined upper and lower pharyngeal obstruction, and circumferential obstruction of the upper airway, were observed in these patients during drug-induced sleep.

Earth Observations taken by the Expedition 13 crew

NASA Image and Video Library

2006-05-10

ISS013-E-17394 (10 May 2006) --- The central Phoenix Metro Area, Arizona is featured in this image photographed by an Expedition 13 crewmember on the International Space Station. The Phoenix, Arizona metropolitan area is the largest in the southwestern United States, and is comprised of 21 contiguous incorporated municipalities. Such a collection of discrete political entities forming a larger integrated urban landscape is referred to as a conurbation by urban geographers. This portion of a high resolution (approximately 9 meters/pixel) photograph (upper image) of the central metro region includes the boundary area between three of the municipalities included in the conurbation: the Cities of Phoenix (upper image, left), Tempe (upper image, center and lower right), and Scottsdale (upper image, upper right).

Water heater control module

DOEpatents

Hammerstrom, Donald J

2013-11-26

An advanced electric water heater control system that interfaces with a high temperature cut-off thermostat and an upper regulating thermostat. The system includes a control module that is electrically connected to the high-temperature cut-off thermostat and the upper regulating thermostat. The control module includes a switch to open or close the high-temperature cut-off thermostat and the upper regulating thermostat. The control module further includes circuitry configured to control said switch in response to a signal selected from the group of an autonomous signal, a communicated signal, and combinations thereof.

Revisions to the original extent of the Devonian Shale-Middle and Upper Paleozoic Total Petroleum System

USGS Publications Warehouse

Enomoto, Catherine B.; Rouse, William A.; Trippi, Michael H.; Higley, Debra K.

2016-04-11

Technically recoverable undiscovered hydrocarbon resources in continuous accumulations are present in Upper Devonian and Lower Mississippian strata in the Appalachian Basin Petroleum Province. The province includes parts of New York, Pennsylvania, Ohio, Maryland, West Virginia, Virginia, Kentucky, Tennessee, Georgia, and Alabama. The Upper Devonian and Lower Mississippian strata are part of the previously defined Devonian Shale-Middle and Upper Paleozoic Total Petroleum System (TPS) that extends from New York to Tennessee. This publication presents a revision to the extent of the Devonian Shale-Middle and Upper Paleozoic TPS. The most significant modification to the maximum extent of the Devonian Shale-Middle and Upper Paleozoic TPS is to the south and southwest, adding areas in Tennessee, Georgia, Alabama, and Mississippi where Devonian strata, including potential petroleum source rocks, are present in the subsurface up to the outcrop. The Middle to Upper Devonian Chattanooga Shale extends from southeastern Kentucky to Alabama and eastern Mississippi. Production from Devonian shale has been established in the Appalachian fold and thrust belt of northeastern Alabama. Exploratory drilling has encountered Middle to Upper Devonian strata containing organic-rich shale in west-central Alabama. The areas added to the TPS are located in the Valley and Ridge, Interior Low Plateaus, and Appalachian Plateaus physiographic provinces, including the portion of the Appalachian fold and thrust belt buried beneath Cretaceous and younger sediments that were deposited on the U.S. Gulf Coastal Plain.

Association Between Brain-Derived Neurotrophic Factor Genotype and Upper Extremity Motor Outcome After Stroke.

PubMed

Chang, Won Hyuk; Park, Eunhee; Lee, Jungsoo; Lee, Ahee; Kim, Yun-Hee

2017-06-01

The identification of intrinsic factors for predicting upper extremity motor outcome could aid the design of individualized treatment plans in stroke rehabilitation. The aim of this study was to identify prognostic factors, including intrinsic genetic factors, for upper extremity motor outcome in patients with subacute stroke. A total of 97 patients with subacute stroke were enrolled. Upper limb motor impairment was scored according to the upper limb of Fugl-Meyer assessment score at 3 months after stroke. The prediction of upper extremity motor outcome at 3 months was modeled using various factors that could potentially influence this impairment, including patient characteristics, baseline upper extremity motor impairment, functional and structural integrity of the corticospinal tract, and brain-derived neurotrophic factor genotype. Multivariate ordinal logistic regression models were used to identify the significance of each factor. The independent predictors of motor outcome at 3 months were baseline upper extremity motor impairment, age, stroke type, and corticospinal tract functional integrity in all stroke patients. However, in the group with severe motor impairment at baseline (upper limb score of Fugl-Meyer assessment <25), the number of Met alleles in the brain-derived neurotrophic factor genotype was also an independent predictor of upper extremity motor outcome 3 months after stroke. Brain-derived neurotrophic factor genotype may be a potentially useful predictor of upper extremity motor outcome in patients with subacute stroke with severe baseline motor involvement. © 2017 American Heart Association, Inc.

Upper Extremity Deep Vein Thromboses: The Bowler and the Barista.

PubMed

Stake, Seth; du Breuil, Anne L; Close, Jeremy

2016-01-01

Effort thrombosis of the upper extremity refers to a deep venous thrombosis of the upper extremity resulting from repetitive activity of the upper limb. Most cases of effort thrombosis occur in young elite athletes with strenuous upper extremity activity. This article reports two cases who both developed upper extremity deep vein thromboses, the first being a 67-year-old bowler and the second a 25-year-old barista, and illustrates that effort thrombosis should be included in the differential diagnosis in any patient with symptoms concerning DVT associated with repetitive activity. A literature review explores the recommended therapies for upper extremity deep vein thromboses.

Upper Extremity Deep Vein Thromboses: The Bowler and the Barista

PubMed Central

du Breuil, Anne L.; Close, Jeremy

2016-01-01

Effort thrombosis of the upper extremity refers to a deep venous thrombosis of the upper extremity resulting from repetitive activity of the upper limb. Most cases of effort thrombosis occur in young elite athletes with strenuous upper extremity activity. This article reports two cases who both developed upper extremity deep vein thromboses, the first being a 67-year-old bowler and the second a 25-year-old barista, and illustrates that effort thrombosis should be included in the differential diagnosis in any patient with symptoms concerning DVT associated with repetitive activity. A literature review explores the recommended therapies for upper extremity deep vein thromboses. PMID:27800207

Neogene stratigraphy, foraminifera, diatoms, and depositional history of Maria Madre Island, Mexico: Evidence of early Neogene marine conditions in the southern Gulf of California

USGS Publications Warehouse

McCloy, C.; Ingle, J.C.; Barron, J.A.

1988-01-01

Foraminifera and diatoms have been analyzed from an upper Miocene through Pleistocene(?) sequence of marine sediments exposed on Maria Madre Island, largest of the Tre??s Marias Islands off the Pacific coast of Mexico. The Neogene stratigraphic sequence exposed on Maria Madre Island includes a mid-Miocene(?) non-marine and/or shallow marine sandstone unconformably overlain by a lower upper Miocene to uppermost Miocene upper to middle bathyal laminated and massive diatomite, mudstone, and siltstone unit. This unit is unconformably overlain by lower Pliocene middle to lower bathyal sandstones and siltstones which, in turn, are unconformably overlain by upper Pliocene through Pleistocene(?) upper bathyal to upper middle bathyal foraminiferal limestones and siltstones. These beds are unconformably capped by Pleistocene terrace deposits. Basement rocks on the island include Cretaceous granite and granodiorite, and Tertiary(?) andesites and rhyolites. The upper Miocene diatomaceous unit contains a low diversity foraminiferal fauna dominated by species of Bolivina indicating low oxygen conditions in the proto-Gulf Maria Madre basin. The diatomaceous unit grades into a mudstone that contains a latest Miocene upper to middle bathyal biofacies characterized by Baggina californica and Uvigerina hootsi along with displaced neritic taxa. An angular unconformity separates the upper Miocene middle bathyal sediments from overlying lower Pliocene siltstones and mudstones that contain a middle to lower bathyal biofacies and abundant planktonic species including Neogloboquadrina acostaensis and Pulleniatina primalis indicating an early Pliocene age. Significantly, this Pliocene unit contains common occurrences of benthic species restricted to Miocene sediments in California including Bulimina uvigerinaformis. Pliocene to Pleistocene(?) foraminiferal limestones and siltstones characterize submarine bank accumulations formed during uplift of the Tre??s Marias Island area, and include abundant planktonic foraminifera such as Pulleniatina obliquiloculata and Neogloboquadrina duterteri. Common benthic foraminifera in this unit are indicative of upper bathyal water depths. The Neogene depositional history recorded on Maria Madre Island involves an early late Miocene subsidence event marking formation of the Tre??s Marias Basin with relatively undiluted diatomaceous sediment deposited in a low oxygen setting. Subsidence and deepening of the basin continued into the early Pliocene along with rapid deposition of terrigenous clastics. Uplift of the basinal sequence began in late Pliocene time accompanied by deposition of upper Pliocene-Pleistocene foraminiferal limestones on a rising submarine bank. Continued episodic uplift of the Neogene deposits brought the island above sea level by late Pleistocene time. ?? 1988.

Upper Gastrointestinal Involvement in Crohn Disease: Histopathologic and Endoscopic Findings.

PubMed

Diaz, Liege; Hernandez-Oquet, Rafael Enrique; Deshpande, Amar R; Moshiree, Baharak

2015-11-01

Studies describing the prevalence of upper gastrointestinal (GI) Crohn disease (CD) and its histopathologic changes have been inconsistent as a result of different definitions used for upper GI involvement, diverse populations, and varying indications for endoscopy. We reviewed the literature describing endoscopic findings and histologic lesions in gastric and duodenal mucosa of patients with established CD. PubMed, EMBASE, and the Cochrane Library were searched for gastroduodenal biopsy findings in patients with CD from 1970 to 2014. We included all retrospective and prospective studies in adults. We calculated the prevalence of the most common endoscopic and histopathological findings among patients with overall CD and upper GI CD. Of the 385 articles identified, 20 eligible studies were included. A total of 2511 patients had CD and 815 had upper GI CD. In the CD group, the most common histopathological finding was nonspecific gastric inflammation in 32% of patients, followed by gastric granuloma in 7.9%. Focal gastritis was prevalent in 30.9% of patients. In the upper GI CD group, gastric inflammation was present in 84% of patients, followed by duodenal inflammation in 28.2% and gastric granuloma in 23.2%. The most common gastric endoscopic finding in patients with CD was erythema in 5.9%, followed by erosions in 3.7%. Duodenal endoscopic findings included ulcers and erythema in 5.3% and 3.0% of patients, respectively. We found a prevalence of 34% for CD involving the upper GI tract across these 20 studies. Routine upper endoscopy with biopsies of the upper GI tract in the diagnostic workup of patients with CD can correctly classify the distribution and extent of the disease.

Duplex sonography for detection of deep vein thrombosis of upper extremities: a 13-year experience.

PubMed

Chung, Amy S Y; Luk, W H; Lo, Adrian X N; Lo, C F

2015-04-01

To determine the prevalence and characteristics of sonographically evident upper-extremity deep vein thrombosis in symptomatic Chinese patients and identify its associated risk factors. Regional hospital, Hong Kong. Data on patients undergoing upper-extremity venous sonography examinations during a 13-year period from November 1999 to October 2012 were retrieved. Variables including age, sex, history of smoking, history of lower-extremity deep vein thrombosis, major surgery within 30 days, immobilisation within 30 days, cancer (history of malignancy), associated central venous or indwelling catheter, hypertension, diabetes mellitus, sepsis within 30 days, and stroke within 30 days were tested using binary logistic regression to understand the risk factors for upper-extremity deep vein thrombosis. The presence of upper-extremity deep vein thrombosis identified. Overall, 213 patients with upper-extremity sonography were identified. Of these patients, 29 (13.6%) had upper-extremity deep vein thrombosis. The proportion of upper-extremity deep vein thrombosis using initial ultrasound was 0.26% of all deep vein thrombosis ultrasound requests. Upper limb swelling was the most common presentation seen in a total of 206 (96.7%) patients. Smoking (37.9%), history of cancer (65.5%), and hypertension (27.6%) were the more prevalent conditions among patients in the upper-extremity deep vein thrombosis-positive group. No statistically significant predictor of upper-extremity deep vein thrombosis was noted if all variables were included. After backward stepwise logistic regression, the final model was left with only age (P=0.119), female gender (P=0.114), and history of malignancy (P=0.024) as independent variables. History of malignancy remained predictive of upper-extremity deep vein thrombosis. Upper-extremity deep vein thrombosis is uncommon among symptomatic Chinese population. The most common sign is swelling and the major risk factor for upper-extremity deep vein thrombosis identified in this study is malignancy.

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.

Method for testing the strength and structural integrity of nuclear fuel particles

DOEpatents

Lessing, P.A.

1995-10-17

An accurate method for testing the strength of nuclear fuel particles is disclosed. Each particle includes an upper and lower portion, and is placed within a testing apparatus having upper and lower compression members. The upper compression member includes a depression therein which is circular and sized to receive only part of the upper portion of the particle. The lower compression member also includes a similar depression. The compression members are parallel to each other with the depressions therein being axially aligned. The fuel particle is then placed between the compression members and engaged within the depressions. The particle is then compressed between the compression members until it fractures. The amount of force needed to fracture the particle is thereafter recorded. This technique allows a broader distribution of forces and provides more accurate results compared with systems which distribute forces at singular points on the particle. 13 figs.

Method for testing the strength and structural integrity of nuclear fuel particles

DOEpatents

Lessing, Paul A.

1995-01-01

An accurate method for testing the strength of nuclear fuel particles. Each particle includes an upper and lower portion, and is placed within a testing apparatus having upper and lower compression members. The upper compression member includes a depression therein which is circular and sized to receive only part of the upper portion of the particle. The lower compression member also includes a similar depression. The compression members are parallel to each other with the depressions therein being axially aligned. The fuel particle is then placed between the compression members and engaged within the depressions. The particle is then compressed between the compression members until it fractures. The amount of force needed to fracture the particle is thereafter recorded. This technique allows a broader distribution of forces and provides more accurate results compared with systems which distribute forces at singular points on the particle.

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

Yee, Nathan; Barkay, Tamar; Reinfelder, John

Mercury (Hg) associated with mixed waste generated by nuclear weapons manufacturing has contaminated vast areas of the Oak Ridge Reservation (ORR). Neurotoxic methylmercury (MeHg) has been formed from the inorganic Hg wastes discharged into headwaters of East Fork Poplar Creek (EFPC). Thus, understanding the processes and mechanisms that lead to Hg methylation along the flow path of EFPC is critical to predicting the impacts of the contamination and the design of remedial action at the ORR. In part I of our project, we investigated Hg(0) oxidation and methylation by anaerobic bacteria. We discovered that the anaerobic bacterium Desulfovibrio desulfuricans ND132more » can oxidize elemental mercury [Hg(0)]. When provided with dissolved elemental mercury, D. desulfuricans ND132 converts Hg(0) to Hg(II) and neurotoxic methylmercury [MeHg]. We also demonstrated that diverse species of subsurface bacteria oxidizes dissolved elemental mercury under anoxic conditions. The obligate anaerobic bacterium Geothrix fermentans H5, and the facultative anaerobic bacteria Shewanella oneidensis MR-1 and Cupriavidus metallidurans AE104 can oxidize Hg(0) to Hg(II) under anaerobic conditions. In part II of our project, we established anaerobic enrichment cultures and obtained new bacterial strains from the DOE Oak Ridge site. We isolated three new bacterial strains from subsurface sediments collected from Oak Ridge. These isolates are Bradyrhizobium sp. strain FRC01, Clostridium sp. strain FGH, and a novel Negativicutes strain RU4. Strain RU4 is a completely new genus and species of bacteria. We also demonstrated that syntrophic interactions between fermentative bacteria and sulfate-reducing bacteria in Oak Ridge saprolite mediate iron reduction via multiple mechanisms. Finally, we tested the impact of Hg on denitrification in nitrate reducing enrichment cultures derived from subsurface sediments from the Oak Ridge site, where nitrate is a major contaminant. We showed that there is an inverse relationship between Hg concentrations and rates of denitrification in enrichment cultures. In part III of our project, we examined in more detail the effects of microbial interactions on Hg transformations. We discovered that both sulfate reducing and iron reducing bacteria coexist in freshwater sediments and both microbial groups contribute to mercury methylation. We showed that mercury methylation by sulfate reducing and iron reducing bacteria are temporally and spatially separated processes. We also discovered that methanogens can methylate mercury. We showed that Methanospirillum hungatei JF-1 methylated Hg at comparable rates, but with higher yields, than those observed for sulfate-reducing bacteria and iron-reducing bacteria. Finally, we demonstrated that syntrophic interactions between different microbial groups increase mercury methylation rates. We showed that Hg methylation rates are stimulated via inter-species hydrogen and acetate transfer (i) from sulfate-reducing bacteria to methanogens and (ii) from fermenters to the sulfate-reducing bacteria. In part IV of the project, we studied Hg bioavailability and Hg isotope fractionation. We demonstrated that thiol-bound Hg is bioavailable to mercury resistant bacteria. We found that uptake of Hg from Hg-glutathione and Hg-cysteine complexes does not require functioning glutathione and cystine/cysteine transport systems. We demonstrated that a wide range of methylmercury complexes (e.g. MeHgOH, MeHg-cysteine, and MeHg-glutathione) are bioavailable to mercury resistant bacteria. The rate of MeHg demethylation varies more between different species of mercury resistant bacteria than among MeHg complexes. We showed that microbial demethylation of MeHg depends more on the species of microorganism than on the types and relative concentrations of thiols or other MeHg ligands present. Finally, we demonstrated that Hg methylation by Geobacter sulfurreducens PCA and Desulfovibrio desulfuricans ND132 imparts mass-dependent discrimination against 202Hg relative to 198Hg. G. sulfurreducens PCA and D. desulfuricans ND132 have similar kinetic reactant/product Hg fractionation factors. Using the Hg isotope data, we showed that there are multiple intra- and/or extracellular pools provide substrate inorganic Hg for methylation.« less

Ares I Crew Launch Vehicle Upper Stage Element Overview

NASA Technical Reports Server (NTRS)

McArthur, J. Craig

2008-01-01

This viewgraph presentation gives an overview of NASA's Ares I Crew Launch Vehicle Upper Stage Element. The topics include: 1) What is NASA s Mission?; 2) NASA s Exploration Roadmap What is our time line?; 3) Building on a Foundation of Proven Technologies Launch Vehicle Comparisons; 4) Ares I Upper Stage; 5) Upper Stage Primary Products; 6) Ares I Upper Stage Development Approach; 7) What progress have we made?; 8) Upper Stage Subsystem Highlights; 9) Structural Testing; 10) Common Bulkhead Processing; 11) Stage Installation at Stennis Space Center; 12) Boeing Producibility Team; 13) Upper Stage Low Cost Strategy; 14) Ares I and V Production at Michoud Assembly Facility (MAF); 15) Merged Manufacturing Flow; and 16) Manufacturing and Assembly Weld Tools.

Scientific Explanations in Greek Upper Secondary Physics Textbooks

ERIC Educational Resources Information Center

Velentzas, Athanasios; Halkia, Krystallia

2018-01-01

In this study, an analysis of the structure of scientific explanations included in physics textbooks of upper secondary schools in Greece was completed. In scientific explanations for specific phenomena found in the sample textbooks, the "explanandum" is a logical consequence of the "explanans," which in all cases include at…

Assessing the impact of upper limb disability following stroke: a qualitative enquiry using internet-based personal accounts of stroke survivors.

PubMed

Poltawski, Leon; Allison, Rhoda; Briscoe, Simon; Freeman, Jennifer; Kilbride, Cherry; Neal, Debbie; Turton, Ailie J; Dean, Sarah

2016-01-01

Upper limb disability following stroke may have multiple effects on the individual. Existing assessment instruments tend to focus on impairment and function and may miss other changes that are personally important. This study aimed to identify personally significant impacts of upper limb disability following stroke. Accounts by stroke survivors, in the form of web-based diaries (blogs) and stories, were sought using a blog search engine and in stroke-related web-sites. Thematic analysis using the World Health Organisation's International Classification of Functioning Disability and Health (ICF) was used to identify personal impacts of upper limb disability following stroke. Ninety-nine sources from at least four countries were analysed. Many impacts were classifiable using the ICF, but a number of additional themes emerged, including emotional, cognitive and behavioural changes. Blogs and other web-based accounts were easily accessible and rich sources of data, although using them raised several methodological issues, including potential sample bias. A range of impacts was identified, some of which (such as use of information technology and alienation from the upper limb) are not addressed in current assessment instruments. They should be considered in post-stroke assessments. Blogs may help in the development of more comprehensive assessments. A comprehensive assessment of the upper limb following stroke should include the impact of upper limb problems on social participation, as well as associated emotional, cognitive and behavioural changes. Using personalised assessment instruments alongside standardised measures may help ensure that these broader domains are considered in discussions between clinicians and patients. Rehabilitation researchers should investigate whether and how these domains could be addressed and operationalised in standard upper limb assessment instruments.

Neural Control of the Upper Airway: Respiratory and State-Dependent Mechanisms

PubMed Central

Kubin, Leszek

2017-01-01

Upper airway muscles subserve many essential for survival orofacial behaviors, including their important role as accessory respiratory muscles. In the face of certain predisposition of craniofacial anatomy, both tonic and phasic inspiratory activation of upper airway muscles is necessary to protect the upper airway against collapse. This protective action is adequate during wakefulness, but fails during sleep which results in recurrent episodes of hypopneas and apneas, a condition known as the obstructive sleep apnea syndrome (OSA). Although OSA is almost exclusively a human disorder, animal models help unveil the basic principles governing the impact of sleep on breathing and upper airway muscle activity. This article discusses the neuroanatomy, neurochemistry, and neurophysiology of the different neuronal systems whose activity changes with sleep-wake states, such as the noradrenergic, serotonergic, cholinergic, orexinergic, histaminergic, GABAergic and glycinergic, and their impact on central respiratory neurons and upper airway motoneurons. Observations of the interactions between sleep-wake states and upper airway muscles in healthy humans and OSA patients are related to findings from animal models with normal upper airway, and various animal models of OSA, including the chronic-intermittent hypoxia model. Using a framework of upper airway motoneurons being under concurrent influence of central respiratory, reflex and state-dependent inputs, different neurotransmitters, and neuropeptides are considered as either causing a sleep-dependent withdrawal of excitation from motoneurons or mediating an active, sleep-related inhibition of motoneurons. Information about the neurochemistry of state-dependent control of upper airway muscles accumulated to date reveals fundamental principles and may help understand and treat OSA. PMID:27783860

The UARS (Upper Atmosphere Research Satellite): A program to study global ozone change

NASA Technical Reports Server (NTRS)

1989-01-01

NASA's Upper Atmosphere Research Satellite (UARS) program, its goals and objectives are described. Also included are its significance to upper atmosphere science, the experimental and theoretical investigations that comprise it, and the compelling issues of global change, driven by human activities, that led NASA to plan and implement it.

Privatisation of Public Education? The Emergence of Independent Upper Secondary Schools in Sweden

ERIC Educational Resources Information Center

Arreman, Inger Erixon; Holm, Ann-Sofie

2011-01-01

This article explores the upper secondary (or post-16) school market. The study on which it is based, funded by the Swedish Research Council, was entitled "Upper-secondary education as a market". Empirical data include official statistics, policy documents, school publications, company reports and school visits. Printed and other news…

Stenting Prior to Cystectomy is an Independent Risk Factor for Upper Urinary Tract Recurrence.

PubMed

Kiss, Bernhard; Furrer, Marc A; Wuethrich, Patrick Y; Burkhard, Fiona C; Thalmann, George N; Roth, Beat

2017-12-01

Patients with bladder cancer who present with hydronephrosis may require drainage of the affected kidney before receiving further cancer treatment. Drainage can be done by retrograde stenting or percutaneously. However, retrograde stenting carries the risk of tumor cell spillage to the upper urinary tract. The aim of this study was to evaluate whether patients with bladder cancer are at higher risk for upper urinary tract recurrence if retrograde stenting has been performed prior to radical cystectomy. We retrospectively analyzed the records of 1,005 consecutive patients with bladder cancer who underwent radical cystectomy at our department between January 2000 and June 2016. Negative intraoperative ureteral margins were mandatory for study inclusion. Patients received regular followup according to our institutional protocol, including imaging of the upper urinary tract and urine cytology. Preoperative drainage of the upper urinary tract was performed in 114 of the 1,005 patients (11%), including in 53 (46%) by Double-J® stenting and in 61 (54%) by percutaneous nephrostomy. Recurrence developed in the upper urinary tract in 31 patients (3%) at a median of 17 months after cystectomy, including 7 of 53 (13%) in the Double-J group, 0% in the nephrostomy group and 24 of 891 (3%) in the no drainage group. Multivariate regression analysis revealed a higher risk of upper urinary tract recurrence if patients underwent Double-J stenting (HR 4.54, 95% CI 1.43-14.38, p = 0.01) and preoperative intravesical instillations (HR 2.94, 95% CI 1.40-6.16, p = 0.004). Patients who undergo Double-J stenting prior to radical cystectomy are at higher risk for upper urinary tract recurrence. If preoperative upper urinary tract drainage is required, percutaneous drainage might be recommended. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

47 CFR 27.303 - Upper 700 MHz commercial and public safety coordination zone.

Code of Federal Regulations, 2011 CFR

2011-10-01

... safety coordinator. (1) The description must include, at a minimum; (i) The frequency or frequencies on... 47 Telecommunication 2 2011-10-01 2011-10-01 false Upper 700 MHz commercial and public safety... Rules for WCS § 27.303 Upper 700 MHz commercial and public safety coordination zone. (a) General. CMRS...

Cross-Sector Collaboration in Upper Secondary School Vocational Education: Experiences from Two Industrial Towns in Sweden and Norway

ERIC Educational Resources Information Center

Rusten, Grete; Hermelin, Brita

2017-01-01

This study explores industry-education collaboration on vocational education and training (VET) in upper secondary schools in Sweden and Norway, with particular attention to the initiatives, organisation and operational management, and aspects of robustness and lock-in effects. The case studies include two upper secondary schools situated in…

Upflow bioreactor with septum and pressure release mechanism

DOEpatents

Hansen, Conly L.; Hansen, Carl S.; Pack, Kevin; Milligan, John; Benefiel, Bradley C.; Tolman, C. Wayne; Tolman, Kenneth W.

2010-04-20

An upflow bioreactor includes a vessel having an inlet and an outlet configured for upflow operation. A septum is positioned within the vessel and defines a lower chamber and an upper chamber. The septum includes an aperture that provides fluid communication between the upper chamber and lower chamber. The bioreactor also includes means for releasing pressure buildup in the lower chamber. In one configuration, the septum includes a releasable portion having an open position and a closed position. The releasable portion is configured to move to the open position in response to pressure buildup in the lower chamber. In the open position fluid communication between the lower chamber and the upper chamber is increased. Alternatively the lower chamber can include a pressure release line that is selectively actuated by pressure buildup. The pressure release mechanism can prevent the bioreactor from plugging and/or prevent catastrophic damage to the bioreactor caused by high pressures.

Risk of upper gastrointestinal bleeding with selective serotonin reuptake inhibitors with or without concurrent nonsteroidal anti-inflammatory use: a systematic review and meta-analysis.

PubMed

Anglin, Rebecca; Yuan, Yuhong; Moayyedi, Paul; Tse, Frances; Armstrong, David; Leontiadis, Grigorios I

2014-06-01

There is emerging concern that selective serotonin reuptake inhibitors (SSRIs) may be associated with an increased risk of upper gastrointestinal (GI) bleeding, and that this risk may be further increased by concurrent use of nonsteroidal anti-inflammatory (NSAID) medications. Previous reviews of a relatively small number of studies have reported a substantial risk of upper GI bleeding with SSRIs; however, more recent studies have produced variable results. The objective of this study was to obtain a more precise estimate of the risk of upper GI bleeding with SSRIs, with or without concurrent NSAID use. MEDLINE, EMBASE, PsycINFO, the Cochrane central register of controlled trials (through April 2013), and US and European conference proceedings were searched. Controlled trials, cohort, case-control, and cross-sectional studies that reported the incidence of upper GI bleeding in adults on SSRIs with or without concurrent NSAID use, compared with placebo or no treatment were included. Data were extracted independently by two authors. Dichotomous data were pooled to obtain odds ratio (OR) of the risk of upper GI bleeding with SSRIs +/- NSAID, with a 95% confidence interval (CI). The main outcome and measure of the study was the risk of upper GI bleeding with SSRIs compared with placebo or no treatment. Fifteen case-control studies (including 393,268 participants) and four cohort studies were included in the analysis. There was an increased risk of upper GI bleeding with SSRI medications in the case-control studies (OR=1.66, 95% CI=1.44,1.92) and cohort studies (OR=1.68, 95% CI=1.13,2.50). The number needed to harm for upper GI bleeding with SSRI treatment in a low-risk population was 3,177, and in a high-risk population it was 881. The risk of upper GI bleeding was further increased with the use of both SSRI and NSAID medications (OR=4.25, 95% CI=2.82,6.42). SSRI medications are associated with a modest increase in the risk of upper GI bleeding, which is lower than has previously been estimated. This risk is significantly elevated when SSRI medications are used in combination with NSAIDs, and physicians prescribing these medications together should exercise caution and discuss this risk with patients.

Epidermolysis bullosa

MedlinePlus

... Blood test for anemia Culture to check for bacterial infection if wounds are healing poorly Upper endoscopy or an upper GI series if symptoms include swallowing problems Growth rate will be checked often for a baby ...

Upper respiratory tract (image)

MedlinePlus

The major passages and structures of the upper respiratory tract include the nose or nostrils, nasal cavity, mouth, throat (pharynx), and voice box (larynx). The respiratory system is lined with a mucous membrane that ...

Bus bar electrical feedthrough for electrorefiner system

DOEpatents

Williamson, Mark; Wiedmeyer, Stanley G; Willit, James L; Barnes, Laurel A; Blaskovitz, Robert J

2013-12-03

A bus bar electrical feedthrough for an electrorefiner system may include a retaining plate, electrical isolator, and/or contact block. The retaining plate may include a central opening. The electrical isolator may include a top portion, a base portion, and a slot extending through the top and base portions. The top portion of the electrical isolator may be configured to extend through the central opening of the retaining plate. The contact block may include an upper section, a lower section, and a ridge separating the upper and lower sections. The upper section of the contact block may be configured to extend through the slot of the electrical isolator and the central opening of the retaining plate. Accordingly, relatively high electrical currents may be transferred into a glovebox or hot-cell facility at a relatively low cost and higher amperage capacity without sacrificing atmosphere integrity.

Adult obstructive sleep apnoea

PubMed Central

Jordan, Amy S.; McSharry, David G.; Malhotra, Atul

2013-01-01

Obstructive sleep apnoea is an increasingly common disorder of repeated upper airway collapse during sleep, which leads to oxygen desaturation and disrupted sleep. Symptoms include snoring, witnessed apnoeas, and sleepiness. Pathogenesis varies; predisposing factors include small upper airway lumen, unstable respiratory control, low arousal threshold, small lung volume, and dysfunctional upper airway dilator muscles. Risk factors include obesity, male sex, age, menopause, fluid retention, adenotonsillar hypertrophy, and smoking. Obstructive sleep apnoea causes sleepiness, road traffic accidents, and probably systemic hypertension. It has also been linked to myocardial infarction, congestive heart failure, stroke, and diabetes mellitus though not definitively. Continuous positive airway pressure is the treatment of choice, with adherence of 60–70%. Bi-level positive airway pressure or adaptive servo-ventilation can be used for patients who are intolerant to continuous positive airway pressure. Other treatments include dental devices, surgery, and weight loss. PMID:23910433

H-GRASP: the feasibility of an upper limb home exercise program monitored by phone for individuals post stroke

PubMed Central

Simpson, Lisa A.; Eng, Janice J.; Chan, May

2017-01-01

Abstract Purpose: To investigate the feasibility of a phone-monitored home exercise program for the upper limb following stroke. Methods: A pre-post double baseline repeated measures design was used. Participants completed an 8-week home exercise program that included behavioural strategies to promote greater use of the affected upper limb. Participants were monitored weekly by therapists over the phone. The following feasibility outcomes were collected: Process (e.g. recruitment rate); Resources (e.g. exercise adherence rate); Management (e.g. therapist monitoring) and Scientific (e.g. safety, effect sizes). Clinical outcomes included: The Chedoke Arm and Hand Inventory, Motor Activity Log, grip strength and the Canadian Occupational Performance Measure. Results: Eight individuals with stroke were recruited and six participants completed the exercise program. All but one of the six participants met the exercise target of 60 minutes/day, 6 days/week. Participants were stable across the baseline period. The following post-treatment effect sizes were observed: CAHAI (0.944, p = 0.046); MALQ (0.789, p = 0.03) grip strength (0.947, p = 0.046); COPM (0.789, p = 0.03). Improvements were maintained at three and six month follow ups. Conclusions: Community dwelling individuals with stroke may benefit from a phone-monitored upper limb home exercise program that includes behavioural strategies that promote transfer of exercise gains into daily upper limb use.Implications for RehabilitationA repetitive, task-oriented home exercise program that utilizes telephone supervision may be an effective method for the treatment of the upper limb following strokeThis program is best suited for individuals with mild to moderate level impairment and experience a sufficient level of challenge from the exercisesAn exercise program that includes behavioural strategies may promote transfer of exercise gains into greater use of the affected upper limb during daily activities PMID:27017890

Non-steroidal anti-inflammatory drug related upper gastrointestinal bleeding: types of drug use and patient profiles in real clinical practice.

PubMed

Sostres, Carlos; Carrera-Lasfuentes, Patrica; Lanas, Angel

2017-10-01

The best available evidence regarding non-steroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) bleeding comes from randomized controlled trials including patients who use NSAIDs to manage chronic rheumatic diseases; however, patients with varying background profiles commonly take NSAIDs for many other reasons, often without prescription, and such usage has not been well studied. To define the characteristics of patients hospitalized for upper GI bleeding in clinical practice, we conducted a case-control study among patients with endoscopy-proven major upper GI bleeding due to gastroduodenal peptic lesions and control subjects. We used adjusted logistic regression models to estimate bleeding risks. Data analysis was performed using SPSS 22.0. Our analysis included 3785 cases and 6540 controls, including 1270 cases (33.55%) and 834 controls (12.75%) reporting recent use (<30 days) of NSAIDs including high-dose acetylsalicylic acid (ASA). NSAID use was associated with increased risk of upper GI bleeding, with an adjusted relative risk of 4.86 (95% CI, 4.32-5.46). Acute musculoskeletal pain (36.1%), chronic osteoarthritis (13.5%), and headache (13.6%) were the most common reasons for NSAID use. Among cases, only 17.31% took NSAIDs and 6.38% took high dose ASA due to chronic osteoarthritis. Demographic characteristics significantly differed between subjects with chronic vs. acute musculoskeletal pain. Proton pump inhibitor use was significantly higher in patients who used NSAIDs due to chronic osteoarthritis compared to patients with acute musculoskeletal pain. NSAID (65.15%) or high-dose ASA use (65.83%) preceding upper GI bleeding was most often short-term. In over half of cases (63.62%), the upper GI bleeding event was not preceded by dyspeptic warning symptoms. The majority of patients hospitalized due to NSAID-related upper GI bleeding reported short-term NSAID use for reasons other than chronic rheumatic disease. These findings suggest that current prevention strategies may not reach a wide population of short-term NSAID users.

Directional Characteristics of Inner Shelf Internal Tides

DTIC Science & Technology

2007-06-01

Figure 18. YD 202-206 Current vector plot of significant events. Significant events include internal tidal bores, solibores, and solitons . The upper...Events (Bores, Solibores, and Solitons ): Upper column leading-edge cross-shore current velocity and cross-shore wind regression. The small ellipse...Significant Events (Bores, Solibores, and Solitons ): Upper column leading-edge along-shore current velocity and along-shore wind regression. The small

The Role of Migration and Single Motherhood in Upper Secondary Education in Mexico

ERIC Educational Resources Information Center

Creighton, Mathew J.; Park, Hyunjoon; Teruel, Graciela M.

2009-01-01

We investigated the link between migration, family structure, and the risk of dropping out of upper secondary school in Mexico. Using two waves of the Mexican Family Life Survey, which includes 1,080 upper secondary students, we longitudinally modeled the role of family structure in the subsequent risk of dropping out, focusing on the role of…

PWR integral tie plate and locking mechanism

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

Flora, B.S.; Osborne, J.L.

1980-08-26

A locking mechanism for securing an upper tie plate to the tie rods of a nuclear fuel bundle is described. The mechanism includes an upper tie plate assembly and locking sleeves fixed to the ends of the tie rods. The tie plate is part of the upper tie plate assembly and is secured to the fuel bundle by securing the entire upper tie plate assembly to the locking sleeves fixed to the tie rods. The assembly includes, in addition to the tie plate, locking nuts for engaging the locking sleeves, retaining sleeves to operably connect the locking nuts to themore » assembly, a spring biased reaction plate to restrain the locking nuts in the locked position and a means to facilitate the removal of the entire assembly as a unit from the fuel bundle.« less

Safety, Feasibility, and Efficacy of Vagus Nerve Stimulation Paired With Upper-Limb Rehabilitation After Ischemic Stroke.

PubMed

Dawson, Jesse; Pierce, David; Dixit, Anand; Kimberley, Teresa J; Robertson, Michele; Tarver, Brent; Hilmi, Omar; McLean, John; Forbes, Kirsten; Kilgard, Michael P; Rennaker, Robert L; Cramer, Steven C; Walters, Matthew; Engineer, Navzer

2016-01-01

Recent animal studies demonstrate that vagus nerve stimulation (VNS) paired with movement induces movement-specific plasticity in motor cortex and improves forelimb function after stroke. We conducted a randomized controlled clinical pilot study of VNS paired with rehabilitation on upper-limb function after ischemic stroke. Twenty-one participants with ischemic stroke >6 months before and moderate to severe upper-limb impairment were randomized to VNS plus rehabilitation or rehabilitation alone. Rehabilitation consisted of three 2-hour sessions per week for 6 weeks, each involving >400 movement trials. In the VNS group, movements were paired with 0.5-second VNS. The primary objective was to assess safety and feasibility. Secondary end points included change in upper-limb measures (including the Fugl-Meyer Assessment-Upper Extremity). Nine participants were randomized to VNS plus rehabilitation and 11 to rehabilitation alone. There were no serious adverse device effects. One patient had transient vocal cord palsy and dysphagia after implantation. Five had minor adverse device effects including nausea and taste disturbance on the evening of therapy. In the intention-to-treat analysis, the change in Fugl-Meyer Assessment-Upper Extremity scores was not significantly different (between-group difference, 5.7 points; 95% confidence interval, -0.4 to 11.8). In the per-protocol analysis, there was a significant difference in change in Fugl-Meyer Assessment-Upper Extremity score (between-group difference, 6.5 points; 95% confidence interval, 0.4 to 12.6). This study suggests that VNS paired with rehabilitation is feasible and has not raised safety concerns. Additional studies of VNS in adults with chronic stroke will now be performed. URL: https://www.clinicaltrials.gov. Unique identifier: NCT01669161. © 2015 The Authors.

Safety, Feasibility, and Efficacy of Vagus Nerve Stimulation Paired With Upper-Limb Rehabilitation After Ischemic Stroke

PubMed Central

Pierce, David; Dixit, Anand; Kimberley, Teresa J.; Robertson, Michele; Tarver, Brent; Hilmi, Omar; McLean, John; Forbes, Kirsten; Kilgard, Michael P.; Rennaker, Robert L.; Cramer, Steven C.; Walters, Matthew; Engineer, Navzer

2016-01-01

Background and Purpose— Recent animal studies demonstrate that vagus nerve stimulation (VNS) paired with movement induces movement-specific plasticity in motor cortex and improves forelimb function after stroke. We conducted a randomized controlled clinical pilot study of VNS paired with rehabilitation on upper-limb function after ischemic stroke. Methods— Twenty-one participants with ischemic stroke >6 months before and moderate to severe upper-limb impairment were randomized to VNS plus rehabilitation or rehabilitation alone. Rehabilitation consisted of three 2-hour sessions per week for 6 weeks, each involving >400 movement trials. In the VNS group, movements were paired with 0.5-second VNS. The primary objective was to assess safety and feasibility. Secondary end points included change in upper-limb measures (including the Fugl–Meyer Assessment-Upper Extremity). Results— Nine participants were randomized to VNS plus rehabilitation and 11 to rehabilitation alone. There were no serious adverse device effects. One patient had transient vocal cord palsy and dysphagia after implantation. Five had minor adverse device effects including nausea and taste disturbance on the evening of therapy. In the intention-to-treat analysis, the change in Fugl–Meyer Assessment-Upper Extremity scores was not significantly different (between-group difference, 5.7 points; 95% confidence interval, −0.4 to 11.8). In the per-protocol analysis, there was a significant difference in change in Fugl–Meyer Assessment-Upper Extremity score (between-group difference, 6.5 points; 95% confidence interval, 0.4 to 12.6). Conclusions— This study suggests that VNS paired with rehabilitation is feasible and has not raised safety concerns. Additional studies of VNS in adults with chronic stroke will now be performed. Clinical Trial Registration— URL: https://www.clinicaltrials.gov. Unique identifier: NCT01669161. PMID:26645257

Solid oxide fuel cell with monolithic core

DOEpatents

McPheeters, Charles C.; Mrazek, Franklin C.

1988-01-01

A solid oxide fuel cell in which fuel and oxidant gases undergo an electrochemical reaction to produce an electrical output includes a monolithic core comprised of a corrugated conductive sheet disposed between upper and lower generally flat sheets. The corrugated sheet includes a plurality of spaced, parallel, elongated slots which form a series of closed, linear, first upper and second lower gas flow channels with the upper and lower sheets within which a fuel gas and an oxidant gas respectively flow. Facing ends of the fuel cell are generally V-shaped and provide for fuel and oxidant gas inlet and outlet flow, respectively, and include inlet and outlet gas flow channels which are continuous with the aforementioned upper fuel gas and lower oxidant gas flow channels. The upper and lower flat sheets and the intermediate corrugated sheet are preferably comprised of ceramic materials and are securely coupled together such as by assembly in the green state and sintering together during firing at high temperatures. A potential difference across the fuel cell, or across a stacked array of similar fuel cells, is generated when an oxidant gas such as air and a fuel such as hydrogen gas is directed through the fuel cell at high temperatures, e.g., between 700.degree. C. and 1100.degree. C.

Solid oxide fuel cell with monolithic core

DOEpatents

McPheeters, C.C.; Mrazek, F.C.

1988-08-02

A solid oxide fuel cell in which fuel and oxidant gases undergo an electrochemical reaction to produce an electrical output includes a monolithic core comprised of a corrugated conductive sheet disposed between upper and lower generally flat sheets. The corrugated sheet includes a plurality of spaced, parallel, elongated slots which form a series of closed, linear, first upper and second lower gas flow channels with the upper and lower sheets within which a fuel gas and an oxidant gas respectively flow. Facing ends of the fuel cell are generally V-shaped and provide for fuel and oxidant gas inlet and outlet flow, respectively, and include inlet and outlet gas flow channels which are continuous with the aforementioned upper fuel gas and lower oxidant gas flow channels. The upper and lower flat sheets and the intermediate corrugated sheet are preferably comprised of ceramic materials and are securely coupled together such as by assembly in the green state and sintering together during firing at high temperatures. A potential difference across the fuel cell, or across a stacked array of similar fuel cells, is generated when an oxidant gas such as air and a fuel such as hydrogen gas is directed through the fuel cell at high temperatures, e.g., between 700 C and 1,100 C. 8 figs.

Multiple sessions of transcranial direct current stimulation and upper extremity rehabilitation in stroke: A review and meta-analysis.

PubMed

Tedesco Triccas, L; Burridge, J H; Hughes, A M; Pickering, R M; Desikan, M; Rothwell, J C; Verheyden, G

2016-01-01

To systematically review the methodology in particular treatment options and outcomes and the effect of multiple sessions of transcranial direct current stimulation (tDCS) with rehabilitation programmes for upper extremity recovery post stroke. A search was conducted for randomised controlled trials involving tDCS and rehabilitation for the upper extremity in stroke. Quality of included studies was analysed using the Modified Downs and Black form. The extent of, and effect of variation in treatment parameters such as anodal, cathodal and bi-hemispheric tDCS on upper extremity outcome measures of impairment and activity were analysed using meta-analysis. Nine studies (371 participants with acute, sub-acute and chronic stroke) were included. Different methodologies of tDCS and upper extremity intervention, outcome measures and timing of assessments were identified. Real tDCS combined with rehabilitation had a small non-significant effect of +0.11 (p=0.44) and +0.24 (p=0.11) on upper extremity impairments and activities at post-intervention respectively. Various tDCS methods have been used in stroke rehabilitation. The evidence so far is not statistically significant, but is suggestive of, at best, a small beneficial effect on upper extremity impairment. Future research should focus on which patients and rehabilitation programmes are likely to respond to different tDCS regimes. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Follow-Up Care for Older Women With Breast Cancer

DTIC Science & Technology

1999-08-01

range of patient outcomes, including primary tumor therapy and mortality, self -reported upper body function, and overall physical function. Methods...mor therapy, all cause mortality, self -reported function and overall physical function than upper body function, and overall physical was the interview...Major Analytic Variables mor therapy and all cause mortality, as well as self -reported upper body and overall physical Dependent Variables. Our first

Upper atmosphere pollution measurements (GASP)

NASA Technical Reports Server (NTRS)

Rudey, R. A.; Holdeman, J. D.

1975-01-01

The environmental effects are discussed of engine effluents of future large fleets of aircraft operating in the stratosphere. Topics discussed include: atmospheric properties, aircraft engine effluents, upper atmospheric measurements, global air sampling, and data reduction and analysis

Adult obstructive sleep apnoea.

PubMed

Jordan, Amy S; McSharry, David G; Malhotra, Atul

2014-02-22

Obstructive sleep apnoea is an increasingly common disorder of repeated upper airway collapse during sleep, leading to oxygen desaturation and disrupted sleep. Features include snoring, witnessed apnoeas, and sleepiness. Pathogenesis varies; predisposing factors include small upper airway lumen, unstable respiratory control, low arousal threshold, small lung volume, and dysfunctional upper airway dilator muscles. Risk factors include obesity, male sex, age, menopause, fluid retention, adenotonsillar hypertrophy, and smoking. Obstructive sleep apnoea causes sleepiness, road traffic accidents, and probably systemic hypertension. It has also been linked to myocardial infarction, congestive heart failure, stroke, and diabetes mellitus though not definitively. Continuous positive airway pressure is the treatment of choice, with adherence of 60-70%. Bi-level positive airway pressure or adaptive servo-ventilation can be used for patients who are intolerant to continuous positive airway pressure. Other treatments include dental devices, surgery, and weight loss. Copyright © 2014 Elsevier Ltd. All rights reserved.

Vertical axis wind turbine airfoil

DOEpatents

Krivcov, Vladimir; Krivospitski, Vladimir; Maksimov, Vasili; Halstead, Richard; Grahov, Jurij Vasiljevich

2012-12-18

A vertical axis wind turbine airfoil is described. The wind turbine airfoil can include a leading edge, a trailing edge, an upper curved surface, a lower curved surface, and a centerline running between the upper surface and the lower surface and from the leading edge to the trailing edge. The airfoil can be configured so that the distance between the centerline and the upper surface is the same as the distance between the centerline and the lower surface at all points along the length of the airfoil. A plurality of such airfoils can be included in a vertical axis wind turbine. These airfoils can be vertically disposed and can rotate about a vertical axis.

Corium shield

DOEpatents

McDonald, Douglas B.; Buchholz, Carol E.

1994-01-01

A shield for restricting molten corium from flowing into a water sump disposed in a floor of a containment vessel includes upper and lower walls which extend vertically upwardly and downwardly from the floor for laterally bounding the sump. The upper wall includes a plurality of laterally spaced apart flow channels extending horizontally therethrough, with each channel having a bottom disposed coextensively with the floor for channeling water therefrom into the sump. Each channel has a height and a length predeterminedly selected for allowing heat from the molten corium to dissipate through the upper and lower walls as it flows therethrough for solidifying the molten corium therein to prevent accumulation thereof in the sump.

Novel innate and adaptive lymphocytes: The new players in the pathogenesis of inflammatory upper airway diseases.

PubMed

Liu, Y; Yao, Y; Wang, Z-C; Ning, Q; Liu, Z

2018-06-01

Host immunity (innate and adaptive immunity) plays essential roles in the pathogenesis of inflammatory upper airway diseases, including allergic rhinitis and chronic rhinosinusitis. Recently, the discovery of novel innate immune cells, particularly innate lymphoid cells, has renewed our view on the role of innate immunity in inflammatory upper airway diseases. Meanwhile, the identification of new subsets of T helper (Th) cells, including Th22, Th9 and follicular Th cells, and regulatory B cells in the adaptive immunity, has broadened our knowledge on the complex immune networks in inflammatory upper airway diseases. In this review, we focus on these newly identified innate and adaptive lymphocytes with their contributions to the immunological disturbance in allergic rhinitis and chronic rhinosinusitis. We further discuss the perspective for future research and potential clinical utility of regulating these novel lymphocytes for the treatment of allergic rhinitis and chronic rhinosinusitis. © 2018 John Wiley & Sons Ltd.

Association of upper gastrointestinal symptoms with functional and clinical charateristics in elderly.

PubMed

Pilotto, Alberto; Maggi, Stefania; Noale, Marianna; Franceschi, Marilisa; Parisi, Giancarlo; Crepaldi, Gaetano

2011-07-07

To evaluate the prevalence of upper gastrointestinal symptoms and their association with clinical and functional characteristics in elderly outpatients. The study involved 3238 outpatients ≥ 60 years consecutively enrolled by 107 general practitioners. Information on social, behavioral and demographic characteristics, function in the activities of daily living (ADL), co-morbidities and drug use were collected by a structured interview. Upper gastrointestinal symptom data were collected by the 15-items upper gastro-intestinal symptom questionnaire for the elderly, a validated diagnostic tool which includes the following five symptom clusters: (1) abdominal pain syndrome; (2) reflux syndrome; (3) indigestion syndrome; (4) bleeding; and (5) non-specific symptoms. Presence and severity of gastrointestinal symptoms were analyzed through a logistic regression model. 3100 subjects were included in the final analysis. The overall prevalence of upper gastrointestinal symptoms was 43.0%, i.e. cluster (1) 13.9%, (2) 21.9%, (3) 30.2%, (4) 1.2%, and (5) 4.5%. Upper gastrointestinal symptoms were more frequently reported by females (P < 0.0001), with high number of co-morbidities (P < 0.0001), who were taking higher number of drugs (P < 0.0001) and needed assistance in the ADL. Logistic regression analysis demonstrated that female sex (OR = 1.39, 95% CI: 1.17-1.64), disability in the ADL (OR = 1.47, 95% CI: 1.12-1.93), smoking habit (OR = 1.29, 95% CI: 1.00-1.65), and body mass index (OR = 1.06, 95% CI: 1.04-1.08), as well as the presence of upper (OR = 3.01, 95% CI: 2.52-3.60) and lower gastroenterological diseases (OR = 2.25, 95%CI: 1.70-2.97), psychiatric (OR = 1.60, 95% CI: 1.28-2.01) and respiratory diseases (OR = 1.25, 95% CI: 1.01-1.54) were significantly associated with the presence of upper gastrointestinal symptoms. Functional and clinical characteristics are associated with upper gastrointestinal symptoms. A multidimensional comprehensive evaluation may be useful when approaching upper gastrointestinal symptoms in older subjects.

Methods of Testing Thermal Insulation and Associated Test Apparatus

NASA Technical Reports Server (NTRS)

Fesmire, James E. (Inventor); Augustynowicz, Stanislaw D. (Inventor)

2004-01-01

The system and method for testing thermal insulation uses a cryostatic insulation tester having a vacuum chamber and a cold mass including a test chamber and upper and lower guard chambers adjacent thereto. The thermal insulation is positioned within the vacuum chamber and adjacent the cold mass. Cryogenic liquid is supplied to the test chamber, upper guard and lower guard to create a first gas layer in an upper portion of the lower guard chamber and a second gas layer in an upper portion of the test chamber. Temperature are sensed within the vacuum chamber to test the thermal insulation.

No Increase in Female Breast Size or Fat Redistribution to the Upper Body After Liposuction: A Prospective Controlled Photometric Study.

PubMed

Swanson, Eric

2014-08-01

Some studies have indicated that liposuction may cause breast enlargement. Fat redistribution to the upper body as a compensatory mechanism after liposuction has also been reported. To evaluate the possibility of secondary breast hypertrophy and fat redistribution after liposuction, breast size and upper body measurements were obtained and compared for women who did not gain weight postoperatively. Eighty-two women who underwent cosmetic surgery, not including breast surgery, were enrolled in this prospective controlled study. Participants represented 1 of 3 procedure groups: cosmetic surgery not including liposuction (n = 24), liposuction (n = 41), and liposuction combined with abdominoplasty (n = 17). Breast measurements were obtained from standardized lateral photographs matched for size and orientation. Results were compared among the study groups. Postoperatively, there were no significant changes in mean body weight among the study groups. No significant increases in upper pole projection, breast projection, or breast area were found in patients treated with liposuction alone and those who received liposuction plus abdominoplasty. Upper body dimensions were unchanged except for a significant (P < .01) decrease in upper abdominal width in women treated with liposuction plus abdominoplasty. The findings were the same for a subset of 17 women with liposuction aspirate volumes >1500 mL. Results indicate that neither liposuction nor abdominoplasty produces secondary breast enlargement. Upper body dimensions are unchanged, consistent with findings of a previous study and contrary to the theory of fat redistribution. 2. © 2014 The American Society for Aesthetic Plastic Surgery, Inc.

Shingle assembly with support bracket

DOEpatents

Almy, Charles

2007-01-02

A shingle system, mountable to a support surface, includes overlapping shingle assemblies. Each shingle assembly comprises a support bracket, having upper and lower ends, secured to a shingle body. The upper end has an upper support portion, extending away from the shingle body, and an upper support-surface-engaging part, engageable with a support surface so that the upper edge of the shingle body is positionable at a first distance from the support surface to create a first gap therebetween. The lower end has a lower support portion extending away from the lower surface. The support brackets create: (1) a second gap between shingle bodies of the first and second shingle assemblies, and (2) an open region beneath the first shingle assembly fluidly coupling the first and second gaps.

System and method for inventorying multiple remote objects

DOEpatents

Carrender, Curtis L.; Gilbert, Ronald W.

2007-10-23

A system and method of inventorying multiple objects utilizing a multi-level or a chained radio frequency identification system. The system includes a master tag and a plurality of upper level tags and lower level tags associated with respective objects. The upper and lower level tags communicate with each other and the master tag so that reading of the master tag reveals the presence and absence of upper and lower level tags. In the chained RF system, the upper and lower level tags communicate locally with each other in a manner so that more remote tags that are out of range of some of the upper and lower level tags have their information relayed through adjacent tags to the master tag and thence to a controller.

System and method for inventorying multiple remote objects

DOEpatents

Carrender, Curtis L [Morgan Hill, CA; Gilbert, Ronald W [Morgan Hill, CA

2009-12-29

A system and method of inventorying multiple objects utilizing a multi-level or a chained radio frequency identification system. The system includes a master tag and a plurality of upper level tags and lower level tags associated with respective objects. The upper and lower level tags communicate with each other and the master tag so that reading of the master tag reveals the presence and absence of upper and lower level tags. In the chained RF system, the upper and lower level tags communicate locally with each other in a manner so that more remote tags that are out of range of some of the upper and lower level tags have their information relayed through adjacent tags to the master tag and thence to a controller.

Piezoelectric film load cell robot collision detector

DOEpatents

Lembke, J.R.

1988-03-15

A piezoelectric load cell which can be utilized for detecting collisions and obstruction of a robot arm end effector includes a force sensing element of metallized polyvinylidene fluoride (PVDF) film. The piezoelectric film sensing element and a resilient support pad are clamped in compression between upper and lower plates. The lower plate has a central recess in its upper face for supporting the support pad and sensing element, while the upper plate has a corresponding central projection formed on its lower face for bearing on the sensing element and support pad. The upper and lower plates are dowelled together for concentric alignment and screwed together. The upper and lower plates are also adapted for mounting between the robot arm wrist and end effector. 3 figs.

Piezoelectric film load cell robot collision detector

DOEpatents

Lembke, John R.

1989-04-18

A piezoelectric load cell which can be utilized for detecting collisions and obstruction of a robot arm end effector includes a force sensing element of metallized polyvinylidene fluoride (PVDF) film. The piezoelectric film sensing element and a resilient support pad are clamped in compression between upper and lower plates. The lower plate has a central recess in its upper face for supporting the support pad and sensing element, while the upper plate has a corresponding central projection formed on its lower face for bearing on the sensing element and support pad. The upper and lower plates are dowelled together for concentric alignment and screwed together. The upper and lower plates are also adapted for mounting between the robot arm wrist and end effector.

Piezoelectric film load cell robot collision detector

DOEpatents

Lembke, J.R.

1989-04-18

A piezoelectric load cell which can be utilized for detecting collisions and obstruction of a robot arm end effector includes a force sensing element of metallized polyvinylidene fluoride (PVDF) film. The piezoelectric film sensing element and a resilient support pad are clamped in compression between upper and lower plates. The lower plate has a central recess in its upper face for supporting the support pad and sensing element, while the upper plate has a corresponding central projection formed on its lower face for bearing on the sensing element and support pad. The upper and lower plates are doweled together for concentric alignment and screwed together. The upper and lower plates are also adapted for mounting between the robot arm wrist and end effector. 3 figs.

The accuracy and precision of radiostereometric analysis in upper limb arthroplasty.

PubMed

Ten Brinke, Bart; Beumer, Annechien; Koenraadt, Koen L M; Eygendaal, Denise; Kraan, Gerald A; Mathijssen, Nina M C

2017-06-01

Background and purpose - Radiostereometric analysis (RSA) is an accurate method for measurement of early migration of implants. Since a relation has been shown between early migration and future loosening of total knee and hip prostheses, RSA plays an important role in the development and evaluation of prostheses. However, there have been few RSA studies of the upper limb, and the value of RSA of the upper limb is not yet clear. We therefore performed a systematic review to investigate the accuracy and precision of RSA of the upper limb. Patients and methods - PRISMA guidelines were followed and the protocol for this review was published online at PROSPERO under registration number CRD42016042014. A systematic search of the literature was performed in the databases Embase, Medline, Cochrane, Web of Science, Scopus, Cinahl, and Google Scholar on April 25, 2015 based on the keywords radiostereometric analysis, shoulder prosthesis, elbow prosthesis, wrist prosthesis, trapeziometacarpal joint prosthesis, humerus, ulna, radius, carpus. Articles concerning RSA for the analysis of early migration of prostheses of the upper limb were included. Quality assessment was performed using the MINORS score, Downs and Black checklist, and the ISO RSA Results - 23 studies were included. Precision values were in the 0.06-0.88 mm and 0.05-10.7° range for the shoulder, the 0.05-0.34 mm and 0.16-0.76° range for the elbow, and the 0.16-1.83 mm and 11-124° range for the TMC joint. Accuracy data from marker- and model-based RSA were not reported in the studies included. Interpretation - RSA is a highly precise method for measurement of early migration of orthopedic implants in the upper limb. However, the precision of rotation measurement is poor in some components. Challenges with RSA in the upper limb include the symmetrical shape of prostheses and the limited size of surrounding bone, leading to over-projection of the markers by the prosthesis. We recommend higher adherence to RSA guidelines and encourage investigators to publish long-term follow-up RSA studies.

Revised upper limb module for spinal muscular atrophy: Development of a new module.

PubMed

Mazzone, Elena S; Mayhew, Anna; Montes, Jacqueline; Ramsey, Danielle; Fanelli, Lavinia; Young, Sally Dunaway; Salazar, Rachel; De Sanctis, Roberto; Pasternak, Amy; Glanzman, Allan; Coratti, Giorgia; Civitello, Matthew; Forcina, Nicola; Gee, Richard; Duong, Tina; Pane, Marika; Scoto, Mariacristina; Pera, Maria Carmela; Messina, Sonia; Tennekoon, Gihan; Day, John W; Darras, Basil T; De Vivo, Darryl C; Finkel, Richard; Muntoni, Francesco; Mercuri, Eugenio

2017-06-01

There is a growing need for a robust clinical measure to assess upper limb motor function in spinal muscular atrophy (SMA), as the available scales lack sensitivity at the extremes of the clinical spectrum. We report the development of the Revised Upper Limb Module (RULM), an assessment specifically designed for upper limb function in SMA patients. An international panel with specific neuromuscular expertise performed a thorough review of scales currently available to assess upper limb function in SMA. This review facilitated a revision of the existing upper limb function scales to make a more robust clinical scale. Multiple revisions of the scale included statistical analysis and captured clinically relevant changes to fulfill requirements by regulators and advocacy groups. The resulting RULM scale shows good reliability and validity, making it a suitable tool to assess upper extremity function in the SMA population for multi-center clinical research. Muscle Nerve 55: 869-874, 2017. © 2016 Wiley Periodicals, Inc.

Systematic review of mirror therapy compared with conventional rehabilitation in upper extremity function in stroke survivors.

PubMed

Pérez-Cruzado, David; Merchán-Baeza, Jose Antonio; González-Sánchez, Manuel; Cuesta-Vargas, Antonio I

2017-04-01

Stroke is a leading cause of disability in developed countries. One of the most widespread techniques in clinical practice is mirror therapy (MT). To determine the effectiveness of MT over other methods of intervention in the recovery of upper limb function in people who have had a stroke. A systematic review was conducted. The search string was established based on the last systematic review about MT that dated from 2009: "upper extremity" OR "upper limb "AND "mirror therapy" AND stroke. For this search Pubmed, Scopus and SciELO databases were used. Fifteen studies were included in the systematic review. Recovery of the upper limb, upper limb function and gross manual dexterity were frequently measured in these studies. In the primary variables in promoting recovery, MT alone showed better results in acute and chronic stroke patients in upper limb functioning than either conventional rehabilitation (CR) or CR plus MT. PROSPERO registration number: CRD42015026869. © 2016 Occupational Therapy Australia.

The Status of National Values in the Books of Social Studies for the Grades of the Upper Primary Stage in Jordan

ERIC Educational Resources Information Center

Subheyyin, Eid H.; Mawajdeh, Baker S.; Talhouni, Mansour H.; Rfou', Mohammad O.

2017-01-01

This study aimed at determining the most important national values that should be included in the textbooks of social studies for the upper-primary stage grades in Jordan; and then identifying the degree of their inclusion in those books. The study used a descriptive-analytical approach. A study tool which includes twelve national values was…

Inertial Upper Stage (IUS) software analysis

NASA Technical Reports Server (NTRS)

Grayson, W. L.; Nickel, C. E.; Rose, P. L.; Singh, R. P.

1979-01-01

The Inertial Upper Stage (IUS) System, an extension of the Space Transportation System (STS) operating regime to include higher orbits, orbital plane changes, geosynchronous orbits, and interplanetary trajectories is presented. The IUS software design, the IUS software interfaces with other systems, and the cost effectiveness in software verification are described. Tasks of the IUS discussed include: (1) design analysis; (2) validation requirements analysis; (3) interface analysis; and (4) requirements analysis.

Cost and Performance Report of Electrical Resistance Heating (ERH) for Source Treatment. Addendum

DTIC Science & Technology

2008-09-29

and clay. The Upper Cretaceous Severn, Matawan, and Magothy Formations underlie the Brightseat Formation. The groundwater table at the site is...Table 1, the aquifers include, in descending order, the Aquia, the Monmouth, the Magothy , the Upper and Lower Patapsco and the Patuxent. The... Magothy Magothy Aquifer Sand, light-gray to white, with interbedded thin layers of organic clay. _-300(1) Confining Unit _-360(1) Upper Patapsco

An association between Helicobacter pylori and upper respiratory tract disease: Fact or fiction?

PubMed Central

Kariya, Shin; Okano, Mitsuhiro; Nishizaki, Kazunori

2014-01-01

Helicobacter pylori (H. pylori) is a major cause of chronic gastritis and gastric ulcers and considerable evidence supports the notion that infection with this bacterium is also associated with gastric malignancy in addition to various other conditions including pulmonary, vascular and autoimmune disorders. Gastric juice infected with H. pylori might play an important role in upper respiratory tract infection. Although direct and/or indirect mechanisms might be involved in the association between H. pylori and upper respiratory tract diseases, the etiological role of H. pylori in upper respiratory tract disorders has not yet been fully elucidated. Although various studies over the past two decades have suggested a relationship between H. pylori and upper respiratory tract diseases, the findings are inconsistent. The present overview describes the outcomes of recent investigations into the impact of H. pylori on upper respiratory tract and adjacent lesions. PMID:24587622

Evaluation of pediatric upper extremity peripheral nerve injuries.

PubMed

Ho, Emily S

2015-01-01

The evaluation of motor and sensory function of the upper extremity after a peripheral nerve injury is critical to diagnose the location and extent of nerve injury as well as document functional recovery in children. The purpose of this paper is to describe an approach to the evaluation of the pediatric upper extremity peripheral nerve injuries through a critical review of currently used tests of sensory and motor function. Outcome studies on pediatric upper extremity peripheral nerve injuries in the Medline database were reviewed. The evaluation of the outcome in children less than 10 years of age with an upper extremity peripheral nerve injury includes careful observation of preferred prehension patterns, examination of muscle atrophy and sudomotor function, provocative tests, manual muscle testing and tests of sensory threshold and tactile gnosis. The evaluation of outcome in children with upper extremity peripheral nerve injuries warrants a unique approach. Copyright © 2015 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

A comprehensive musculoskeletal and peripheral nervous system assessment of war-related bilateral upper extremity amputees.

PubMed

Allami, Mostafa; Mousavi, Batool; Masoumi, Mehdi; Modirian, Ehsan; Shojaei, Hadi; Mirsalimi, Fatemeh; Hosseini, Maryam; Pirouzi, Pirouz

2016-01-01

Upper limb amputations are one of the unpleasant war injuries that armed forces are exposed to frequently. The present study aimed to assess the musculoskeletal and peripheral nervous systems in Iraq-Iran war veterans with bilateral upper extremity amputation. The study consisted of taking a history and clinical examinations including demographic data, presence and location of pain, level of amputation, passive and active ranges of movement of the joints across the upper and lower extremities and spine, manual palpation, neurological examination, blood circulation pulses and issues related to a prosthetic limb. In this study, 103 Iranian bilateral upper extremity amputees (206 amputations) from the Iran-Iraq war were evaluated, and a detailed questionnaire was also administered. The most common level of amputation was the finger or wrist level (108, 52.4 %). Based on clinical examination, we found high frequencies of limited active and passive joint range of movement across the scapula, shoulder, elbow, wrist and metacarpophalangeal, interphalangeal and thumb joints. Based on muscle strength testing, we found varying degrees of weakness across the upper limbs. Musculoskeletal disorders included epicondylitis (65, 31.6 %), rotator cuff injury (24, 11.7 %), bicipital tendonitis (69, 33.5 %), shoulder drop (42, 20.4 %) and muscle atrophy (19, 9.2 %). Peripheral nerve disorders included carpal tunnel syndrome in 13 (6.3 %) and unilateral brachial plexus injury in 1 (1 %). Fifty-three (51.5 %) were diagnosed with facet joint syndrome at the level of the cervical spine (the most frequent site). Using a prosthesis was reported by 65 (63.1 %), both left and right sides. The back was the most common site of pain (71.8 %). The high prevalence of neuro-musculoskeletal disorders among bilateral upper extremity amputees indicates that they need regular rehabilitation care.

Reconnaissance Report for Upper Mississippi River Navigation Study. (Revised)

DTIC Science & Technology

1992-09-01

Contaminants may include ammonia, arsenic, cadmium , chlordane, chromium, copper, dioxins, lead, nickel, nitrogen, PCBs, phosphorus, zinc, various...al 1981 Rock River, Upper Mississippi River, Little Wabash River, Lower Wabash River Units (I, III-north, aid VIII). In Predictive Models in Illinois

Incentive spirometry for prevention of postoperative pulmonary complications in upper abdominal surgery.

PubMed

Guimarães, Michele Mf; El Dib, Regina; Smith, Andrew F; Matos, Delcio

2009-07-08

Upper abdominal surgical procedures are associated with a high risk of postoperative pulmonary complications. The risk and severity of postoperative pulmonary complications can be reduced by the judicious use of therapeutic manoeuvres that increase lung volume. Our objective was to assess the effect of incentive spirometry (IS) compared to no therapy, or physiotherapy including coughing and deep breathing, on all-cause postoperative pulmonary complications and mortality in adult patients admitted for upper abdominal surgery. To assess the effects of incentive spirometry compared to no such therapy (or other therapy) on all-cause postoperative pulmonary complications (atelectasis, acute respiratory inadequacy) and mortality in adult patients admitted for upper abdominal surgery. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2006, Issue 3), MEDLINE, EMBASE, and LILACS (from inception to July 2006). There were no language restrictions. We included randomized controlled trials of incentive spirometry in adult patients admitted for any type of upper abdominal surgery, including patients undergoing laparoscopic procedures. Two authors independently assessed trial quality and extracted data. We included 11 studies with a total of 1754 participants. Many trials were of only moderate methodological quality and did not report on compliance with the prescribed therapy. Data from only 1160 patients could be included in the meta-analysis. Three trials (120 patients) compared the effects of incentive spirometry with no respiratory treatment. Two trials (194 patients) compared incentive spirometry with deep breathing exercises. Two trials (946 patients) compared incentive spirometry with other chest physiotherapy. All showed no evidence of a statistically significant effect of incentive spirometry. There was no evidence that incentive spirometry is effective in the prevention of pulmonary complications. We found no evidence regarding the effectiveness of the use of incentive spirometry for prevention of postoperative pulmonary complications in upper abdominal surgery. This review underlines the urgent need to conduct well-designed trials in this field. There is a case for large randomized trials of high methodological rigour in order to define any benefit from the use of incentive spirometry regarding mortality.

Evaluation of impairment of the upper extremity.

PubMed

Blair, S J; McCormick, E; Bear-Lehman, J; Fess, E E; Rader, E

1987-08-01

Evaluation of impairment of the upper extremity is the product of a team effort by the physician, occupational therapist, physical therapist, and rehabilitation counselor. A careful recording of the anatomic impairment should be made because this is critical in determining the subsequent functional activities of the extremity. The measurement criteria for clinical and functional evaluation includes condition assessment instruments. Some assess the neurovascular system, others assess movements including the monitoring of articular motion and musculotendinous function. Sensibility assessment instruments measure sympathetic response and detect single joint stimulus, discrimination, quantification, and recognition abilities. A detailed description of each assessment is recorded and physical capacity evaluation is only one component of the entire vocational evaluation. This evaluation answers questions regarding the injured worker's ability to return to his previous job. The work simulator is a useful instrument that allows rehabilitation and testing of the injured upper extremity. Job site evaluation includes assessment criteria for work performance, work behavior, and work environment.

Low thermal resistance power module assembly

DOEpatents

Hassani, Vahab; Vlahinos, Andreas; Bharathan, Desikan

2007-03-13

A power module assembly with low thermal resistance and enhanced heat dissipation to a cooling medium. The assembly includes a heat sink or spreader plate with passageways or openings for coolant that extend through the plate from a lower surface to an upper surface. A circuit substrate is provided and positioned on the spreader plate to cover the coolant passageways. The circuit substrate includes a bonding layer configured to extend about the periphery of each of the coolant passageways and is made up of a substantially nonporous material. The bonding layer may be solder material which bonds to the upper surface of the plate to provide a continuous seal around the upper edge of each opening in the plate. The assembly includes power modules mounted on the circuit substrate on a surface opposite the bonding layer. The power modules are positioned over or proximal to the coolant passageways.

The Chromospheric Lyman-Alpha Spectro-Polarimeter (CLASP)

NASA Technical Reports Server (NTRS)

Ishikawa, Shin-nosuke; Kano, R.; Kobayashi, K.; Bando, T.; Narukage, N..; Ishikawa, R.; Kubo, M.; Katsukawa, Y.; Suematsu, Y.; Hara, H.;

Congenital bilateral upper eyelid eversion: report of a case.

PubMed

Cingü, Abdullah Kürşat; Sahin, Alparslan; Yüksel, Harun; Ozkök, Ahmet; Arı, Seyhmus; Caça, Ihsan

2014-01-01

Congenital bilateral upper eyelid eversion is a rare condition and the definite cause is not known. It is often seen in Black babies or babies with Down's syndrome. With early diagnosis and appropriate treatment, the condition can be managed without surgery. We report a case of congenital upper eyelid eversion in an otherwise healthy Caucasian neonate, born by normal vaginal delivery. The case responded well to conservative treatment, including eyelid repositioning, lubricants, antibiotic ointment, and eyelid patching.

Ares I Integrated Test Approach

NASA Technical Reports Server (NTRS)

Taylor, Jim

2008-01-01

This slide presentation reviews the testing approach that NASA is developing for the Ares I launch vehicle. NASA is planning a complete series of development, qualification and verification tests. These include: (1) Upper stage engine sea-level and altitude testing (2) First stage development and qualification motors (3) Upper stage structural and thermal development and qualification test articles (4) Main Propulsion Test Article (MPTA) (5) Upper stage green run testing (6) Integrated Vehicle Ground Vibration Testing (IVGVT) and (7) Aerodynamic characterization testing.

Upper Extremity Amputations and Prosthetics

PubMed Central

Ovadia, Steven A.; Askari, Morad

2015-01-01

Upper extremity amputations are most frequently indicated by severe traumatic injuries. The location of the injury will determine the level of amputation. Preservation of extremity length is often a goal. The amputation site will have important implications on the functional status of the patient and options for prosthetic reconstruction. Advances in amputation techniques and prosthetic reconstructions promote improved quality of life. In this article, the authors review the principles of upper extremity amputation, including techniques, amputation sites, and prosthetic reconstructions. PMID:25685104

Upper extremity transplantation: current concepts and challenges in an emerging field.

PubMed

Elliott, River M; Tintle, Scott M; Levin, L Scott

2014-03-01

Loss of an isolated upper limb is an emotionally and physically devastating event that results in significant impairment. Patients who lose both upper extremities experience profound disability that affects nearly every aspect of their lives. While prosthetics and surgery can eventually provide the single limb amputee with a suitable assisting hand, limited utility, minimal haptic feedback, weight, and discomfort are persistent problems with these techniques that contribute to high rates of prosthetic rejection. Moreover, despite ongoing advances in prosthetic technology, bilateral amputees continue to experience high levels of dependency, disability, and distress. Hand and upper extremity transplantation holds several advantages over prosthetic rehabilitation. The missing limb is replaced with one of similar skin color and size. Sensibility, voluntary motor control, and proprioception are restored to a greater degree, and afford better dexterity and function than prosthetics. The main shortcomings of transplantation include the hazards of immunosuppression, the complications of rejection and its treatment, and high cost. Hand and upper limb transplantation represents the most commonly performed surgery in the growing field of Vascularized Composite Allotransplantation (VCA). As upper limb transplantation and VCA have become more widespread, several important challenges and controversies have emerged. These include: refining indications for transplantation, optimizing immunosuppression, establishing reliable criteria for monitoring, diagnosing, and treating rejection, and standardizing outcome measures. This article will summarize the historical background of hand transplantation and review the current literature and concepts surrounding it.

MAVEN observations of the Mars upper atmosphere, ionosphere, and solar wind interactions

NASA Astrophysics Data System (ADS)

Jakosky, Bruce M.

2017-09-01

The Mars Atmosphere and Volatile Evolution (MAVEN) mission to Mars has been operating in orbit for more than a full Martian year. Observations are dramatically changing our view of the Mars upper atmosphere system, which includes the upper atmosphere, ionosphere, coupling to the lower atmosphere, magnetosphere, and interactions with the Sun and the solar wind. The data are allowing us to understand the processes controlling the present-day structure of the upper atmosphere and the rates of escape of gas to space. These will tell us the role that escape to space has played in the evolution of the Mars atmosphere and climate.

Three-dimensional coil inductor

DOEpatents

Bernhardt, Anthony F.; Malba, Vincent

2002-01-01

A three-dimensional coil inductor is disclosed. The inductor includes a substrate; a set of lower electrically conductive traces positioned on the substrate; a core placed over the lower traces; a set of side electrically conductive traces laid on the core and the lower traces; and a set of upper electrically conductive traces attached to the side traces so as to form the inductor. Fabrication of the inductor includes the steps of forming a set of lower traces on a substrate; positioning a core over the lower traces; forming a set of side traces on the core; connecting the side traces to the lower traces; forming a set of upper traces on the core; and connecting the upper traces to the side traces so as to form a coil structure.

Boltless flange

DOEpatents

Kirkham, R.J.

1997-04-15

A boltless, reusable flange system for joining metal piping includes a circular, wedge-shaped tongue on an upper flange for mating with a groove containing a fusible alloy in a lower flange. The lower flange includes a heating element for melting the fusible alloy, and a thermocouple device to sense the alloy temperature. Heat can be controlled and supplied from a remote source and monitored by a remote temperature indicator. The upper flange is positioned above the lower flange, tongue and groove aligned, and the lower flange is heated until the fusible alloy melts to allow the upper tongue to settle down within the lower groove. Upon removal of the heat, the alloy hardens to further bring the two flanges together in a solid and sealed couple, compressing an optional gasket. 4 figs.

Boltless flange

DOEpatents

Kirkham, Robert J.

1997-01-01

A boltless, reusable flange system for joining metal piping includes a circular, wedge-shaped tongue on an upper flange for mating with a groove containing a fusible alloy in a lower flange. The lower flange includes a heating element for melting the fusible alloy, and a thermocouple device to sense the alloy temperature. Heat can be controlled and supplied from a remote source and monitored by a remote temperature indicator. The upper flange is positioned above the lower flange, tongue and groove aligned, and the lower flange is heated until the fusible alloy melts to allow the upper tongue to settle down within the lower groove. Upon removal of the heat, the alloy hardens to further bring the two flanges together in a solid and sealed couple, compressing an optional gasket.

FLOW SIMULATION IN THE HUMAN UPPER RESPIRATORY TRACT

EPA Science Inventory

ABSTRACT

Computer simulations of airflow patterns within the human upper respiratory tract (URT) are presented. The URT model includes airways of the head (nasal and oral), throat (pharyngeal and laryngeal), and lungs (trachea and main bronchi). The head and throat mor...

78 FR 17653 - Upper Great Plains Wind Energy Draft Programmatic Environmental Impact Statement (DOE/EIS-0408)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-22

... infrastructure development, including siting wind turbines, access roads, underground collector lines, overhead... Wildlife Service Upper Great Plains Wind Energy Draft Programmatic Environmental Impact Statement (DOE/EIS... Plains Wind Energy Draft Programmatic Environmental Impact Statement (Draft [[Page 17654

Using commercial video games for upper limb stroke rehabilitation: is this the way of the future?

PubMed

Pietrzak, Eva; Cotea, Cristina; Pullman, Stephen

2014-01-01

The increasing number of people living with poststroke sequelae has stimulated the search for novel ways of providing poststroke rehabilitation without putting additional stress on overburdened health care systems. One of them is the use of commercially available technology and off-the-shelf video games for hemiparetic upper limb rehabilitation. The MEDLINE, EMBASE, and Cochrane Library databases were searched using key word synonyms for stroke, upper limb, and video games. Included studies investigated upper limb stroke rehabilitation using commercially available consoles and video games, reported outcomes that included measures of upper limb functionality, and were published in a peer-reviewed journal written in English. Thirteen studies were identified - 6 published as full articles and 7 as abstracts. Studies were generally small and only 3 were randomized. The gaming systems investigated were the Nintendo Wii (n = 10), EyeToy PlayStation (n = 2), and CyWee Z (n = 1). The Nintendo Wii appears to provide the greatest benefits to patients, with improvements seen in upper extremity function measures such as joint range of motion, hand motor function, grip strength, and dexterity. Three studies indicate that video therapy appears to be safe and that long-term improvements continue at follow-up. At present, the evidence that the use of commercial video games in rehabilitation improves upper limb functionality after stroke is very limited. However, this approach has the potential to provide easily available and affordable stroke rehabilitation therapy in settings where access to therapy is limited by geographical or financial constraints.

Integrated Testing Approaches for the NASA Ares I Crew Launch Vehicle

NASA Technical Reports Server (NTRS)

Taylor, James L.; Cockrell, Charles E.; Tuma, Margaret L.; Askins, Bruce R.; Bland, Jeff D.; Davis, Stephan R.; Patterson, Alan F.; Taylor, Terry L.; Robinson, Kimberly L.

2008-01-01

The Ares I crew launch vehicle is being developed by the U.S. National Aeronautics and Space Administration (NASA) to provide crew and cargo access to the International Space Station (ISS) and, together with the Ares V cargo launch vehicle, serves as a critical component of NASA's future human exploration of the Moon. During the preliminary design phase, NASA defined and began implementing plans for integrated ground and flight testing necessary to achieve the first human launch of Ares I. The individual Ares I flight hardware elements - including the first stage five segment booster (FSB), upper stage, and J-2X upper stage engine - will undergo extensive development, qualification, and certification testing prior to flight. Key integrated system tests include the upper stage Main Propulsion Test Article (MPTA), acceptance tests of the integrated upper stage and upper stage engine assembly, a full-scale integrated vehicle ground vibration test (IVGVT), aerodynamic testing to characterize vehicle performance, and integrated testing of the avionics and software components. The Ares I-X development flight test will provide flight data to validate engineering models for aerodynamic performance, stage separation, structural dynamic performance, and control system functionality. The Ares I-Y flight test will validate ascent performance of the first stage, stage separation functionality, validate the ability of the upper stage to manage cryogenic propellants to achieve upper stage engine start conditions, and a high-altitude demonstration of the launch abort system (LAS) following stage separation. The Orion 1 flight test will be conducted as a full, un-crewed, operational flight test through the entire ascent flight profile prior to the first crewed launch.

The effects of prism glasses and intensive upper limb exercise on hemineglect, upper limb function, and activities of daily living in stroke patients: a case series.

PubMed

Oh, Se-Il; Kim, Jin-Kyung; Park, So-Yeon

2015-12-01

[Purpose] This study aimed to examine the effects of visual field with prism glasses, and intensive upper limb functional training on reduction of hemineglect and improvement in upper limb function and activities of daily living in three stroke patients with hemineglect. [Subjects] This study included three stroke patients hospitalized in a sanatorium. [Methods] Intervention treatment involving prism glass use for 12 hours and 30 minutes and paretic side upper limb training was conducted 5 days a week for 15 weeks. Three upper limb training tasks (hitting a balloon, passing through a ring, and reading a newspaper) were performed for 10 minutes each session, for a total of 30 minutes. Line by Section, Motor-Free Visual Perception Test-3 (MVPT-3), Manual Function Test (MFT), Box & Block Test (BBT), and Assessment of Motor and Process Skills (AMPS) were conducted before and after intervention. [Results] Subjects' hemineglect decreased and upper limb function on the paretic side improved after intervention, which enhanced activities of daily living. [Conclusion] Prism glass use and paretic upper limb functional training effectively ameliorated stroke patients' hemineglect and improved upper limb function. Future research should focus on prism glasses that provide a wide visual field for use in patients with different conditions.

Association of upper gastrointestinal symptoms with functional and clinical charateristics in elderly

PubMed Central

Pilotto, Alberto; Maggi, Stefania; Noale, Marianna; Franceschi, Marilisa; Parisi, Giancarlo; Crepaldi, Gaetano

2011-01-01

AIM: To evaluate the prevalence of upper gastrointestinal symptoms and their association with clinical and functional characteristics in elderly outpatients. METHODS: The study involved 3238 outpatients ≥ 60 years consecutively enrolled by 107 general practitioners. Information on social, behavioral and demographic characteristics, function in the activities of daily living (ADL), co-morbidities and drug use were collected by a structured interview. Upper gastrointestinal symptom data were collected by the 15-items upper gastro-intestinal symptom questionnaire for the elderly, a validated diagnostic tool which includes the following five symptom clusters: (1) abdominal pain syndrome; (2) reflux syndrome; (3) indigestion syndrome; (4) bleeding; and (5) non-specific symptoms. Presence and severity of gastrointestinal symptoms were analyzed through a logistic regression model. RESULTS: 3100 subjects were included in the final analysis. The overall prevalence of upper gastrointestinal symptoms was 43.0%, i.e. cluster (1) 13.9%, (2) 21.9%, (3) 30.2%, (4) 1.2%, and (5) 4.5%. Upper gastrointestinal symptoms were more frequently reported by females (P < 0.0001), with high number of co-morbidities (P < 0.0001), who were taking higher number of drugs (P < 0.0001) and needed assistance in the ADL. Logistic regression analysis demonstrated that female sex (OR = 1.39, 95% CI: 1.17-1.64), disability in the ADL (OR = 1.47, 95% CI: 1.12-1.93), smoking habit (OR = 1.29, 95% CI: 1.00-1.65), and body mass index (OR = 1.06, 95% CI: 1.04-1.08), as well as the presence of upper (OR = 3.01, 95% CI: 2.52-3.60) and lower gastroenterological diseases (OR = 2.25, 95%CI: 1.70-2.97), psychiatric (OR = 1.60, 95% CI: 1.28-2.01) and respiratory diseases (OR = 1.25, 95% CI: 1.01-1.54) were significantly associated with the presence of upper gastrointestinal symptoms. CONCLUSION: Functional and clinical characteristics are associated with upper gastrointestinal symptoms. A multidimensional comprehensive evaluation may be useful when approaching upper gastrointestinal symptoms in older subjects. PMID:21799648

Predictive value of the DASH tool for predicting return to work of injured workers with musculoskeletal disorders of the upper extremity.

PubMed

Armijo-Olivo, Susan; Woodhouse, Linda J; Steenstra, Ivan A; Gross, Douglas P

2016-12-01

To determine whether the Disabilities of the Arm, Shoulder, and Hand (DASH) tool added to the predictive ability of established prognostic factors, including patient demographic and clinical outcomes, to predict return to work (RTW) in injured workers with musculoskeletal (MSK) disorders of the upper extremity. A retrospective cohort study using a population-based database from the Workers' Compensation Board of Alberta (WCB-Alberta) that focused on claimants with upper extremity injuries was used. Besides the DASH, potential predictors included demographic, occupational, clinical and health usage variables. Outcome was receipt of compensation benefits after 3 months. To identify RTW predictors, a purposeful logistic modelling strategy was used. A series of receiver operating curve analyses were performed to determine which model provided the best discriminative ability. The sample included 3036 claimants with upper extremity injuries. The final model for predicting RTW included the total DASH score in addition to other established predictors. The area under the curve for this model was 0.77, which is interpreted as fair discrimination. This model was statistically significantly different than the model of established predictors alone (p<0.001). When comparing the DASH total score versus DASH item 23, a non-significant difference was obtained between the models (p=0.34). The DASH tool together with other established predictors significantly helped predict RTW after 3 months in participants with upper extremity MSK disorders. An appealing result for clinicians and busy researchers is that DASH item 23 has equal predictive ability to the total DASH score. 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/.

An Evaluation of the Effects of Personal Resource Techniques

DTIC Science & Technology

1974-10-31

the meditator and either of the two controls or the quitter. The greatest decline oc- curred in the use of psychedelics , "uppers," "downers," and hard...The self-reports showed that these teenagers began with alcohol, moved on to marijuana, then to one of the group that includes psychedelics , "uppers...ALC), marijuana (MJ), psychedelic (PD), "uppers" (UP), "downers" (DN), and hard drugs (HD)--and the format for reporting fre- quency of use for these

Upper-Division Student Difficulties with Separation of Variables

ERIC Educational Resources Information Center

Wilcox, Bethany R.; Pollock, Steven J.

2015-01-01

Separation of variables can be a powerful technique for solving many of the partial differential equations that arise in physics contexts. Upper-division physics students encounter this technique in multiple topical areas including electrostatics and quantum mechanics. To better understand the difficulties students encounter when utilizing the…

Place of upper endoscopy before and after bariatric surgery: A multicenter experience with 3219 patients

PubMed Central

Abd Ellatif, Mohamed E; Alfalah, Haitham; Asker, Walid A; El Nakeeb, Ayman E; Magdy, Alaa; Thabet, Waleed; Ghaith, Mohamed A; Abdallah, Emad; Shahin, Rania; Shoma, Asharf; Dawoud, Ibraheim E; Abbas, Ashraf; Salama, Asaad F; Ali Gamal, Maged

2016-01-01

AIM: To study the preoperative and postoperative role of upper esophagogastroduodenoscopy (EGD) in morbidly obese patients. METHODS: This is a multicenter retrospective study by reviewing the database of patients who underwent bariatric surgery (laparoscopic sleeve gastrectomy, laparoscopic Roux en Y gastric bypass, or laparoscopic minigastric bypass) in the period between 2001 June and 2015 August (Jahra Hospital-Kuwait, Hafr Elbatin Hospital and King Saud Medical City-KSA, and Mansoura University Hospital - Egypt). Patients with age 18-65 years, body mass index (BMI) > 40, or > 35 with comorbidities after failure of many dietetic regimen and acceptable levels of surgical risk were included in the study after having an informed signed consent. We retrospectively reviewed the medical charts of all morbidly obese patients. The patients’ preoperative data included clinical history including upper digestive symptoms and preoperative full workup including EGD. Only patients whose charts revealed weather they were symptomatic or not were studied. We categorized patients accordingly into two groups; with (group A) or without (group B) upper digestive symptoms. The endoscopic findings were categorized into 4 groups based on predetermined criteria. The medical record of patients who developed stricture, leak or bleeding after bariatric surgery was reviewed. Logestic regression analysis was used to identify preoperative predictors that might be associated with abnormal endoscopic findings. RESULTS: Three thousand, two hundred and nineteen patients in the study period underwent bariatric surgery (75% LSG, 10% LRYDB, and 15% MGB). Mean BMI was 43 ± 13, mean age 37 ± 9 years, 79% were female. Twenty eight percent had presented with upper digestive symptoms (group A). EGD was considered normal in 2414 (75%) patients (9% group A vs 66% group B, P = 0.001). The abnormal endoscopic findings were found high in those patients with upper digestive symptoms. Abnormal findings (one or more) were found in 805 (25%) patients (19% group A vs 6% group B, P = 0.001). Seven patients had critical events during conscious sedation due to severe hypoxemia (< 60%). Rate of stricture in our study was 2.6%. Success rate of endoscopic dilation was 100%. One point nine percent patients with gastric leak were identified with 75% success rate of endoscopic therapy. Three point seven percent patients developed acute upper bleeding. Seventy-eight point two percent patients were treated by conservative therapy and EGD was performed in 21.8% with 100% success and 0% complications. CONCLUSION: Our results support the performance of EGD only in patients with upper gastrointestinal symptoms. Endoscopy also offers safe effective tool for anastomotic complications after bariatric surgery. PMID:27247708

Activités volcaniques sous-marines à la limite Jurassique-Crétacé dans le Rif externe (Maroc). Âge et relation avec la sédimentation et la paléogéographie du sillon rifain externe

NASA Astrophysics Data System (ADS)

Benzaggagh, Mohamed

2011-04-01

Following the recent stratigraphic works carried out on the Jurassic-Cretaceous boundary in the external Rif chain (Mesorif area and Bou Haddoud nappe), numerous submarine volcanism traces have been discovered in Upper Oxfordian to Upper Berriasian deposits. These traces display various aspects: volcaniclastic complexes incorporated within Upper Berriasian marls; volcanic lavas and basalt clasts included in the breccias with clay matrix of Upper Oxfordian to Lower Berriasian age, or in brecciated Lower Tothonian calcareous beds of the Early Tithonian. These submarine volcanic activities took place in a carbonate platform environment during the Kimmeridgian to Early Tithonian interval or in a pelagic basin from Late Tithonian onwards. They caused an intense brecciation of Upper Jurassic carbonate formations and a general dismantling of marly calcareous alternations of Upper Tithonian-Lower Berriasian. Therefore, the Upper Tithonian-Lower Berriasian deposits are marked by frequent stratigraphic gaps in many outcrops of Mesorif, Prerif areas and in the Bou Haddoud nappe.

Medicaid program; revision to Medicaid upper payment limit requirements for hospital services, nursing facility services, intermediate care facility services for the mentally retarded, and clinic services. Health Care Financing Administration (HCFA), HHS. Final rule.

PubMed

2001-01-12

This final rule modifies the Medicaid upper payment limits for inpatient hospital services, outpatient hospital services, nursing facility services, intermediate care facility services for the mentally retarded, and clinic services. For each type of Medicaid inpatient service, existing regulations place an upper limit on overall aggregate payments to all facilities and a separate aggregate upper limit on payments made to State-operated facilities. This final rule establishes an aggregate upper limit that applies to payments made to government facilities that are not State government-owned or operated, and a separate aggregate upper limit on payments made to privately-owned and operated facilities. This rule also eliminates the overall aggregate upper limit that had applied to these services. With respect to outpatient hospital and clinic services, this final rule establishes an aggregate upper limit on payments made to State government-owned or operated facilities, an aggregate upper limit on payments made to government facilities that are not State government-owned or operated, and an aggregate upper limit on payments made to privately-owned and operated facilities. These separate upper limits are necessary to ensure State Medicaid payment systems promote economy and efficiency. We are allowing a higher upper limit for payment to non-State public hospitals to recognize the higher costs of inpatient and outpatient services in public hospitals. In addition, to ensure continued beneficiary access to care and the ability of States to adjust to the changes in the upper payment limits, the final rule includes a transition period for States with approved rate enhancement State plan amendments.

51F earth observations

NASA Image and Video Library

2009-06-25

51F-37-014 (29 July-6 Aug 1985) --- This Earth view shows Oregon and Washington including metropolitan Portland at the center. The Columbia River can be seen from Goble (upper left) upstream to Bonneville (upper right). The Willamette River is at the lower photo and seen upstream to east of McMinnville.

Using the Pathophysiology of Obstructive Sleep Apnea to Teach Cardiopulmonary Integration

ERIC Educational Resources Information Center

Levitzky, Michael G.

2008-01-01

Obstructive sleep apnea (OSA) is a common disorder of upper airway obstruction during sleep. The effects of intermittent upper airway obstruction include alveolar hypoventilation, altered arterial blood gases and acid-base status, and stimulation of the arterial chemoreceptors, which leads to frequent arousals. These arousals disturb sleep…

49 CFR 572.181 - General description.

Code of Federal Regulations, 2011 CFR

2011-10-01

... assembly Drawing number Head Assembly 175-1000 Neck Assembly Test/Cert 175-2000 Neck Bracket Including..., dated February 2008. (c) Weights of body segments (head, neck, upper and lower torso, arms and upper and... the convenience of the user, the added and revised text is set forth as follows: § 572.181 General...

[Upper lateral incisor with 2 canals].

PubMed

Fabra Campos, H

1991-01-01

Clinical case summary of the patient with an upper lateral incisor with two root canals. The suspicion that there might be an anatomic anomaly in the root that includes a complex root canal system was made when an advanced radicular groove was detected in the lingual surface or an excessively enlarged cingulum.

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 ...

Synthesis and revision of the lithostratigraphic groups and formations in the Upper Permian?–Lower Jurassic Newark Supergroup of eastern North America

USGS Publications Warehouse

Weems, Robert E.; Tanner, Lawrence H.; Lucas, Spencer G.

2016-01-01

The Upper Permian? - Lower Jurassic Newark Supergroup of eastern North America has a strikingly uniform succession of lithologic units. This uniformity is seen regardless of whether these units are characterized on the basis of their lithostratigraphy, allostratigraphy, biostratigraphy, or chemostratigraphy. After deposition, these units were broken up tectonically and attacked erosionally; parts of them survive today only within localized, down-faulted areas. Many lines of evidence compellingly demonstrate that most or all of these remnant units once were physically continuous between remaining outcrops. It is needlessly confusing to give every remnant of each unit a different name in each area where it persists simply because it is now physically isolated by erosion from other portions of the same unit. Instead, these units should be defined within a regional lithostratigraphic framework that emphasizes their common origins and original stratigraphic continuity. To this end, the formation-level stratigraphy of the Newark Supergroup is reduced from 58 locally applied and locally defined formations to a succession of only 16 uniformly defined and regionally recognizable formations. In all cases the oldest name validly applied to each formation is given priority over more recently erected synonymous names, which are either abandoned or, in a few cases, changed in rank to a member of one of the formations recognized here. The Newark Supergroup is here organized into four regionally recognizable groups, each subdivided into regionally recognizable formations. In ascending order, the Upper Permian?-Middle Triassic Acadia Group (new name) includes the Honeycomb Point Formation, Chedabucto Formation, Economy Formation, and Evangeline Formation. This group is preserved only in the Canadian Fundy and Chedabucto basins. The Upper Triassic (Carnian-Norian) Chatham Group includes the Doswell Formation, Stockton Formation, Lockatong Formation, and Passaic Formation. The Upper Triassic-Lower Jurassic (upper Rhaetian-lower Hettangian) Meriden Group includes the Talcott Formation, Shuttle Meadow Formation, Holyoke Formation, East Berlin Formation, and Hampden Formation. The term "Agawam Group," previously proposed to encompass all Newark Supergroup strata above the highest basalt of the Meriden Group, is here abandoned and replaced with the name "Portland Group" for the same suite of strata. The Lower Jurassic (upper Hettangian-lower Sinemurian) Portland Group includes a lower Boonton Formation, an overlying Longmeadow Sandstone (here reinstated), and the Mount Toby Conglomerate, which laterally intertongues with both the Boonton Formation and the Longmeadow Sandstone. 

Craniocervical chiropractic procedures – a précis of upper cervical chiropractic

PubMed Central

Woodfield, H. Charles; York, Craig; Rochester, Roderic P.; Bales, Scott; Beebe, Mychal; Salminen, Bryan; Scholten, Jeffrey N.

2015-01-01

Presented here is a narrative review of upper cervical procedures intended to facilitate understanding and to increase knowledge of upper cervical chiropractic care. Safety, efficacy, common misconceptions, and research are discussed, allowing practitioners, chiropractic students, and the general public to make informed decisions regarding utilization and referrals for this distinctive type of chiropractic care. Upper cervical techniques share the same theoretical paradigm in that the primary subluxation exists in the upper cervical spine. These procedures use similar assessments to determine if spinal intervention is necessary and successful once delivered. The major difference involves their use of either an articular or orthogonal radiograph analysis model when determining the presence of a misalignment. Adverse events following an upper cervical adjustment consist of mild symptomatic reactions of short-duration (< 24-hours). Due to a lack of quality and indexed references, information contained herein is limited by the significance of literature cited, which included non-indexed and/or non-peer reviewed sources. PMID:26136610

Transfusion strategy for acute upper gastrointestinal bleeding.

PubMed

Handel, James; Lang, Eddy

2015-09-01

Clinical question Does a hemoglobin transfusion threshold of 70 g/L yield better patient outcomes than a threshold of 90 g/L in patients with acute upper gastrointestinal bleeding? Article chosen Villanueva C, Colomo A, Bosch A, et al. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med 2013;368(1):11-21. Study objectives The authors of this study measured mortality, from any cause, within the first 45 days, in patients with acute upper gastrointestinal bleeding, who were managed with a hemoglobin threshold for red cell transfusion of either 70 g/L or 90 g/L. The secondary outcome measures included rate of further bleeding and rate of adverse events.

Ergonomic design and training for preventing work-related musculoskeletal disorders of the upper limb and neck in adults.

PubMed

Hoe, Victor C W; Urquhart, Donna M; Kelsall, Helen L; Sim, Malcolm R

2012-08-15

Work-related upper limb and neck musculoskeletal disorders (MSDs) are one of the most common occupational disorders around the world. Although ergonomic design and training are likely to reduce the risk of workers developing work-related upper limb and neck MSDs, the evidence is unclear. To assess the effects of workplace ergonomic design or training interventions, or both, for the prevention of work-related upper limb and neck MSDs in adults. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, AMED, Web of Science (Science Citation Index), SPORTDiscus, Cochrane Occupational Safety and Health Review Group Database and Cochrane Bone, Joint and Muscle Trauma Group Specialised Register to July 2010, and Physiotherapy Evidence Database, US Centers for Disease Control and Prevention, the National Institute for Occupational Safety and Health database, and International Occupational Safety and Health Information Centre database to November 2010. We included randomised controlled trials (RCTs) of ergonomic workplace interventions for preventing work-related upper limb and neck MSDs. We included only studies with a baseline prevalence of MSDs of the upper limb or neck, or both, of less than 25%. Two review authors independently extracted data and assessed risk of bias. We included studies with relevant data that we judged to be sufficiently homogeneous regarding the intervention and outcome in the meta-analysis. We assessed the overall quality of the evidence for each comparison using the GRADE approach. We included 13 RCTs (2397 workers). Eleven studies were conducted in an office environment and two in a healthcare setting. We judged one study to have a low risk of bias. The 13 studies evaluated effectiveness of ergonomic equipment, supplementary breaks or reduced work hours, ergonomic training, a combination of ergonomic training and equipment, and patient lifting interventions for preventing work-related MSDs of the upper limb and neck in adults.Overall, there was moderate-quality evidence that arm support with alternative mouse reduced the incidence of neck/shoulder disorders (risk ratio (RR) 0.52; 95% confidence interval (CI) 0.27 to 0.99) but not the incidence of right upper limb MSDs (RR 0.73; 95% CI 0.32 to 1.66); and low-quality evidence that this intervention reduced neck/shoulder discomfort (standardised mean difference (SMD) -0.41; 95% CI -0.69 to -0.12) and right upper limb discomfort (SMD -0.34; 95% CI -0.63 to -0.06).There was also moderate-quality evidence that the incidence of neck/shoulder and right upper limb disorders were not reduced when comparing alternative mouse and conventional mouse (neck/shoulder RR 0.62; 95% CI 0.19 to 2.00; right upper limb RR 0.91; 95% CI 0.48 to 1.72), arm support and no arm support with conventional mouse (neck/shoulder RR 0.67; 95% CI 0.36 to 1.24; right upper limb RR 1.09; 95% CI 0.51 to 2.29), and alternative mouse with arm support and conventional mouse with arm support (neck/shoulder RR 0.58; 95% CI 0.30 to 1.12; right upper limb RR 0.92; 95% CI 0.36 to 2.36).There was low-quality evidence that using an alternative mouse with arm support compared to conventional mouse with arm support reduced neck/shoulder discomfort (SMD -0.39; 95% CI -0.67 to -0.10). There was low- to very low-quality evidence that other interventions were not effective in reducing work-related upper limb and neck MSDs in adults. We found moderate-quality evidence to suggest that the use of arm support with alternative mouse may reduce the incidence of neck/shoulder MSDs, but not right upper limb MSDs. Moreover, we found moderate-quality evidence to suggest that the incidence of neck/shoulder and right upper limb MSDs is not reduced when comparing alternative and conventional mouse with and without arm support. However, given there were multiple comparisons made involving a number of interventions and outcomes, high-quality evidence is needed to determine the effectiveness of these interventions clearly. While we found very-low- to low-quality evidence to suggest that other ergonomic interventions do not prevent work-related MSDs of the upper limb and neck, this was limited by the paucity and heterogeneity of available studies. This review highlights the need for high-quality RCTs examining the prevention of MSDs of the upper limb and neck.

Lithofacies of Spencer Formation, western Tualatin Valley, Oregon

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

Van Atta, R.O.

The Spencer Formation crops out in a narrow band that trends north-northwest on the western edge of the Willamette and Tualatin Valleys, Oregon. It apparently conformably overlies mud rocks of either the Yamhill or the Nestucca Formation and is conformably overlain by the Pittsburgh Bluff Formation. The Spencer Formation consists of two members (informal): a lower highly micaceous sandstone (800-1000 ft) and an upper member that is micaceous siltstone and mudstone (1000-1300 ft). The lower member includes an upper part that is light-gray to creamy-gray, silty to muddy, pebbly lithic arkose to feldspathic litharenite, with minor arkose. Sorting is poormore » and beds may be laminated to ripple cross-laminated or massive and bioturbated with abundant mollusk shells, carbonized wood, and burrows. The lower part of the lower member is medium-gray to greenish-gray, silty, pumiceous lithic arkose to feldspathic litharenite. The texture tends to be more uniform and better sorted than that of the upper part of the member. Bedding is commonly massive due to bioturbation. The upper member is medium to dark-gray mudstone with thin pebble-conglomerate lenses. It intertongues with the lower member. Bioturbation, burrows, and carbonized wood are common. The trend in depositional environments appears to be from outer to mid-neritic (lower part, lower member) to shallow neritic, nearshore, and lagoonal (upper part, lower member, and upper member). The provenance of the Spencer Formation includes both proximal volcanics and distant plutonic and high-grade metamorphics.« less

Injuries to the upper extremities in polytrauma: limited effect on outcome more than ten years after injury - a cohort study in 629 patients.

PubMed

Macke, C; Winkelmann, M; Mommsen, P; Probst, C; Zelle, B; Krettek, C; Zeckey, C

2017-02-01

To analyse the influence of upper extremity trauma on the long-term outcome of polytraumatised patients. A total of 629 multiply injured patients were included in a follow-up study at least ten years after injury (mean age 26.5 years, standard deviation 12.4). The extent of the patients' injury was classified using the Injury Severity Score. Outcome was measured using the Hannover Score for Polytrauma Outcome (HASPOC), Short Form (SF)-12, rehabilitation duration, and employment status. Outcomes for patients with and without a fracture of the upper extremity were compared and analysed with regard to specific fracture regions and any additional brachial plexus lesion. In all, 307 multiply-injured patients with and 322 without upper extremity injuries were included in the study. The groups with and without upper limb injuries were similar with respect to demographic data and injury pattern, except for midface trauma. There were no significant differences in the long-term outcome. In patients with brachial plexus lesions there were significantly more who were unemployed, required greater retraining and a worse HASPOC. Injuries to the upper extremities seem to have limited effect on long-term outcome in patients with polytrauma, as long as no injury was caused to the brachial plexus. Cite this article: Bone Joint J 2017;99-B:255-60. ©2017 The British Editorial Society of Bone & Joint Surgery.

Prognostic factors of a satisfactory functional result in patients with unilateral amputations of the upper limb above the wrist that use an upper limb prosthesis.

PubMed

Dabaghi-Richerand, A; Haces-García, F; Capdevila-Leonori, R

2015-01-01

The purpose of this study is to determine the prognostic factors of a satisfactory functional outcome in patients using upper extremity prosthetics with a proximal third forearm stump, and above, level of amputation. All patients with longitudinal deficiencies and traumatic amputations of upper extremity with a level of amputation of proximal third forearm and above were included. A total of 49 patients with unilateral upper extremity amputations that had used the prosthetic for a minimum of 2 years were included in the protocol. The Disability arm shoulder hand (DASH) scale was used to determine a good result with a cut-off of less than 40%. The independent variables were the level of amputation, the etiology for its use, initial age of use and number of hours/day using the prosthesis. It was found that patients with a congenital etiology and those that started using the prosthetic before 6 years of age had better functional results. It was found that when adapting a patient with an upper extremity prosthetic, which has a high rejection rate of up to 49%, better functional outcomes are found in those who started using it before 6 years of age, and preferably because of a congenital etiology. It was also found that the number of hours/day strongly correlates with a favorable functional outcome. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

The eye in sleep apnea syndrome.

PubMed

Abdal, Helen; Pizzimenti, Joseph J; Purvis, Cheryl C

2006-03-01

Sleep apnea syndrome (SAS) is a disease characterized by recurrent complete or partial upper airway obstructions during sleep. The majority of patients with SAS demonstrate this obstruction either at the nasopharynx or the oropharynx. Risk factors for SAS include obesity, male gender, upper airway abnormalities, alcohol use, snoring, and neck girth of more than 17 in. in men or 16 in. in women. Reported ophthalmic findings in patients with SAS include floppy eyelid syndrome (FES), glaucoma, and non-arteritic anterior ischemic optic neuropathy (NAION).

Are pushing and pulling work-related risk factors for upper extremity symptoms? A systematic review of observational studies.

PubMed

Hoozemans, M J M; Knelange, E B; Frings-Dresen, M H W; Veeger, H E J; Kuijer, P P F M

2014-11-01

Systematically review observational studies concerning the question whether workers that perform pushing/pulling activities have an increased risk for upper extremity symptoms as compared to workers that perform no pushing/pulling activities. A search in MEDLINE via PubMed and EMBASE was performed with work-related search terms combined with push/pushing/pull/pulling. Studies had to examine exposure to pushing/pulling in relation to upper extremity symptoms. Two authors performed the literature selection and assessment of the risk of bias in the studies independently. A best evidence synthesis was used to draw conclusions in terms of strong, moderate or conflicting/insufficient evidence. The search resulted in 4764 studies. Seven studies were included, with three of them of low risk of bias, in total including 8279 participants. A positive significant relationship with upper extremity symptoms was observed in all four prospective cohort studies with effect sizes varying between 1.5 and 4.9. Two out of the three remaining studies also reported a positive association with upper extremity symptoms. In addition, significant positive associations with neck/shoulder symptoms were found in two prospective cohort studies with effect sizes of 1.5 and 1.6, and with shoulder symptoms in one of two cross-sectional studies with an effect size of 2.1. There is strong evidence that pushing/pulling is related to upper extremity symptoms, specifically for shoulder symptoms. There is insufficient or conflicting evidence that pushing/pulling is related to (combinations of) upper arm, elbow, forearm, wrist or hand symptoms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Evaluation of postoperative patient satisfaction after covering the nasal dorsum with upper lateral cartilage: "upper lateral closing".

PubMed

Çağıcı, Can Alper

2017-11-16

Following nasal hump removal during septorhinoplasty, the middle vault should be reconstructed to avoid functional and esthetic problems. Middle vault reconstruction, however, may result in widening of the middle vault and may need a camouflage graft to cover dorsal irregularities. To present the results of reconstructing the middle vault with a technique that covers the nasal dorsum with upper lateral cartilage, from the viewpoint of patient satisfaction. Retrospective study of patients who underwent septorhinoplasty that included nasal dorsum closure with upper lateral cartilage from December 1, 2014 to January 31, 2016. Those with postoperative follow-up of less than 3 months were excluded. The final study group included 39 patients. The same surgeon performed all septorhinoplasties. The dorsum was closed using an "upper lateral closing" technique that approximated upper lateral cartilages to each other over the septum. Postoperative patient satisfaction was determined using a visual analog scale and the rhinoplasty outcomes evaluation questionnaire. The questionnaire evaluates patient esthetic and functional satisfaction with the operated nose. High scores indicate improved esthetic results. No dorsal irregularities were seen at postoperative follow-up evaluation of the patients. For esthetic nasal appearance, the median visual analogue scale scores was 86%, and the mean for the questionnaire was 77.03%. The natural dome-shaped anatomy of the nasal dorsum was achieved by approximating the upper lateral cartilages to each other. Closing the dorsum with this technique also covers any dorsal irregularities and results in a smooth dorsum. Patients expressed satisfaction with the esthetic and functional aspects of the smooth, attractive nasal dorsum. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Versatility of Subscapular Chimeric Free Flaps in the Secondary Reconstruction of Composite Posttraumatic Defects of the Upper Face

PubMed Central

Stalder, Mark Winston; Wise, Matthew Whitten; Dupin, Charles L.; St Hilaire, Hugo

2014-01-01

High energy injuries to the upper face present challenging reconstructive problems. In some cases, initial reconstructive efforts result in unfavorable outcomes that require secondary intervention. Chimeric free flaps based on the subscapular system offer the tissue components and volume needed for these complex reconstructions. This is a series of five patients who underwent secondary reconstruction of the middle and upper face following traumatic injury. Mechanism of injury, prior attempts at reconstruction, and characteristics of the tissue defects and the flaps used in their reconstruction are described. Two patients were female and three were male. Three injuries resulted from gunshot wounds, and two from motor vehicle accidents. All patients had multiple prior failed attempts at reconstruction using local/regional tissue. Defects included symptomatic oronasal or oro-orbital fistulas, enophthalmos, and forehead contour deformities. Two of the flaps used included scapular bone and latissimus muscular components, and three included scapular bone and thoracodorsal artery perforator-based skin paddle components. All free tissue transfers were successful, and no patients suffered significant complications. Chimeric free flaps based on the subscapular system offer a valuable secondary strategy for reconstruction of composite defects of the upper face when other options have been exhausted through previous efforts. PMID:25709752

Less common upper limb mononeuropathies.

PubMed

Williams, Faren H; Kumiga, Bryan

2013-05-01

This article will focus on the less commonly injured nerves of the upper extremity. These nerves may be involved when trauma results in fractures, dislocations, or swelling with resultant nerve compression. Tumors and ganglions can also compress nerves, causing pain and, over time, demyelination or axon degeneration with weakness. Other mechanisms for upper limb nerve injury include participation in high-level sports, that is, those that generate torque about the arm and shoulder, abnormal stresses about the joints and muscles, or muscle hypertrophy, which may result in nerve injury. The goals of this review are to discuss the clinical presentation and possible causes of upper extremity nerve entrapments and to formulate an electrodiagnostic plan for evaluation. Descriptions of the appropriate nerve conduction studies or needle electromyographic protocols are included for specific nerves. The purpose of the electrodiagnostic examination is to evaluate the degree of nerve injury, axon loss over time, and later, evidence for reinnervation to assist with prognostication. The latter has implications for management of the neuropathy, including the type of exercises and therapy that may be indicated to help maintain the stability and motion of the involved joint(s) and promote strengthening over time as the nerve regenerates. Copyright © 2013 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Upper tract urothelial carcinomas: frequency of association with mismatch repair protein loss and lynch syndrome.

PubMed

Harper, Holly L; McKenney, Jesse K; Heald, Brandie; Stephenson, Andrew; Campbell, Steven C; Plesec, Thomas; Magi-Galluzzi, Cristina

2017-01-01

Increased risk for upper tract urothelial carcinoma is described in patients with Lynch syndrome, caused by germline mutations in mismatch repair genes. We aimed to identify the frequency of mismatch repair protein loss in upper tract urothelial carcinoma and its potential for identifying an association with Lynch syndrome. We queried our database to identify upper tract urothelial carcinomas. Patients were cross-referenced for history of colorectal carcinoma or other common Lynch syndrome-associated neoplasms to enrich for potential Lynch syndrome cases. Tumor histopathologic characteristics were reviewed and each case was analyzed for loss of mismatch repair proteins, MLH1, MSH2, MSH6, and PMS2, by immunohistochemistry. Of 444 patients with upper tract urothelial carcinoma, a subset of 215 (encompassing 30 with upper tract urothelial carcinoma and another common Lynch syndrome-associated neoplasm) was analyzed for loss of mismatch repair protein expression. Of 30 patients with Lynch syndrome-associated neoplasms, six had documented Lynch syndrome, including two with Muir-Torre syndrome. Mismatch repair protein loss was identified in 7% of total upper tract urothelial carcinomas and 30% of patients with Lynch syndrome-associated neoplasms (including all patients with Lynch syndrome/Muir-Torre syndrome). Of patients without history of Lynch syndrome-associated neoplasms, 5 of 184 (2.7%) had loss of mismatch repair protein expression. Twelve cases with mismatch repair protein loss demonstrated loss of MSH2 and MSH6, and 2 had isolated loss of MSH6. MLH1 and PMS2 expression were consistently retained. Although increased intratumoral lymphocytes, inverted growth, pushing tumor-stromal interface, and lack of nuclear pleomorphism were more commonly seen in cases with mismatch repair protein loss, only intratumoral lymphocytes and presence of pushing borders were statistically significant. MLH1 and PMS2 testing appear to have little utility in upper tract urothelial carcinoma; however, mismatch repair protein loss of MSH2 and/or MSH6 by immunohistochemistry seems relatively sensitive and specific for identifying patients with potential Lynch syndrome.

The influence of premature loss of temporary upper molars on permanent molars.

PubMed

Cernei, E R; Maxim, Dana Cristiana; Zetu, Irina Nicoleta

2015-01-01

Premature loss of primary molars due to dental caries and their complications has been associated with space loss and eruptive difficulties, especially when the loss occurs early. The aim of our study was to determine the impact of premature loss of temporary upper molars upon the longitudinal axis of the first and second upper permanent molar. The study group included 64 patients 6-9 years old with premature loss of primary molars and a control group of 48 patients with intact temporary teeth. It was evaluated the angle between longitudinal axis of first and second upper permanent molars and occlusal plane. The sofware used is Easy Dent 4 Viewer®.The data were analyzed by using the Statistical Package for the Social Sciences (version 20.0; SPSS, Chicago, III). It was observed that premature loss of upper second deciduous molars modifies greater the vertical axis of the permanent molars than the premature loss of first upper primary molar. First upper primary molar loss cause an acceleration eruption of first premolar, which will produce a distal inclintion of the both permanent molars. The use of space maintainers after premature loss of the second upper temporary molar is a last solution in preventing tridimensional lesions in the dental arch and occlusion.

Upper Paleozoic Marine Shale Characteristics and Exploration Prospects in the Northwestern Guizhong Depression, South China

NASA Astrophysics Data System (ADS)

Zhu, Zhenhong; Yao, Genshun; Lou, Zhanghua; Jin, Aimin; Zhu, Rong; Jin, Chong; Chen, Chao

2018-05-01

Multiple sets of organic-rich shales developed in the Upper Paleozoic of the northwestern Guizhong Depression in South China. However, the exploration of these shales is presently at a relatively immature stage. The Upper Paleozoic shales in the northwestern Guizhong Depression, including the Middle Devonian Luofu shale, the Nabiao shale, and the Lower Carboniferous Yanguan shale, were investigated in this study. Mineral composition analysis, organic matter analysis (including total organic carbon (TOC) content, maceral of kerogen and the vitrinite reflection (Ro)), pore characteristic analysis (including porosity and permeability, pore type identification by SEM, and pore size distribution by nitrogen sorption), methane isothermal sorption test were conducted, and the distribution and thickness of the shales were determined, Then the characteristics of the two target shales were illustrated and compared. The results show that the Upper Paleozoic shales have favorable organic matter conditions (mainly moderate to high TOC content, type I and II1 kerogen and high to over maturity), good fracability potential (brittleness index (BI) > 40%), multiple pore types, stable distribution and effective thickness, and good methane sorption capacity. Therefore, the Upper Paleozoic shales in the northern Guizhong Depression have good shale gas potential and exploration prospects. Moreover, the average TOC content, average BI, thickness of the organic-rich shale (TOC > 2.0 wt%) and the shale gas resources of the Middle Devonian shales are better than those of the Lower Carboniferous shale. The Middle Devonian shales have better shale gas potential and exploration prospects than the Lower Carboniferous shales.

Electroencephalographic markers of robot-aided therapy in stroke patients for the evaluation of upper limb rehabilitation.

PubMed

Sale, Patrizio; Infarinato, Francesco; Del Percio, Claudio; Lizio, Roberta; Babiloni, Claudio; Foti, Calogero; Franceschini, Marco

2015-12-01

Stroke is the leading cause of permanent disability in developed countries; its effects may include sensory, motor, and cognitive impairment as well as a reduced ability to perform self-care and participate in social and community activities. A number of studies have shown that the use of robotic systems in upper limb motor rehabilitation programs provides safe and intensive treatment to patients with motor impairments because of a neurological injury. Furthermore, robot-aided therapy was shown to be well accepted and tolerated by all patients; however, it is not known whether a specific robot-aided rehabilitation can induce beneficial cortical plasticity in stroke patients. Here, we present a procedure to study neural underpinning of robot-aided upper limb rehabilitation in stroke patients. Neurophysiological recordings use the following: (a) 10-20 system electroencephalographic (EEG) electrode montage; (b) bipolar vertical and horizontal electrooculographies; and (c) bipolar electromyography from the operating upper limb. Behavior monitoring includes the following: (a) clinical data and (b) kinematic and dynamic of the operant upper limb movements. Experimental conditions include the following: (a) resting state eyes closed and eyes open, and (b) robotic rehabilitation task (maximum 80 s each block to reach 4-min EEG data; interblock pause of 1 min). The data collection is performed before and after a program of 30 daily rehabilitation sessions. EEG markers include the following: (a) EEG power density in the eyes-closed condition; (b) reactivity of EEG power density to eyes opening; and (c) reactivity of EEG power density to robotic rehabilitation task. The above procedure was tested on a subacute patient (29 poststroke days) and on a chronic patient (21 poststroke months). After the rehabilitation program, we observed (a) improved clinical condition; (b) improved performance during the robotic task; (c) reduced delta rhythms (1-4 Hz) and increased alpha rhythms (8-12 Hz) during the resting state eyes-closed condition; (d) increased alpha desynchronization to eyes opening; and (e) decreased alpha desynchronization during the robotic rehabilitation task. We conclude that the present procedure is suitable for evaluation of the neural underpinning of robot-aided upper limb rehabilitation.

Acute upper gastrointestinal bleeding (UGIB) - initial evaluation and management.

PubMed

Khamaysi, Iyad; Gralnek, Ian M

2013-10-01

Acute upper gastrointestinal bleeding (UGIB) is the most common reason that the 'on-call' gastroenterologist is consulted. Despite the diagnostic and therapeutic capabilities of upper endoscopy, there is still significant associated morbidity and mortality in patients experiencing acute UGIB, thus this is a true GI emergency. Acute UGIB is divided into non-variceal and variceal causes. The most common type of acute UGIB is 'non-variceal' and includes diagnoses such as peptic ulcer (gastric and duodenal), gastroduodenal erosions, Mallory-Weiss tears, erosive oesophagitis, arterio-venous malformations, Dieulafoy's lesion, and upper GI tract tumours and malignancies. This article focuses exclusively on initial management strategies for acute upper GI bleeding. We discuss up to date and evidence-based strategies for patient risk stratification, initial patient management prior to endoscopy, potential causes of UGIB, role of proton pump inhibitors, prokinetic agents, prophylactic antibiotics, vasoactive pharmacotherapies, and timing of endoscopy. Copyright © 2013 Elsevier Ltd. All rights reserved.

Diagnosis and management of upper gastrointestinal bleeding in children.

PubMed

Owensby, Susan; Taylor, Kellee; Wilkins, Thad

2015-01-01

Upper gastrointestinal bleeding is an uncommon but potentially serious, life-threatening condition in children. Rapid assessment, stabilization, and resuscitation should precede all diagnostic modalities in unstable children. The diagnostic approach includes history, examination, laboratory evaluation, endoscopic procedures, and imaging studies. The clinician needs to determine carefully whether any blood or possible blood reported by a child or adult represents true upper gastrointestinal bleeding because most children with true upper gastrointestinal bleeding require admission to a pediatric intensive care unit. After the diagnosis is established, the physician should start a proton pump inhibitor or histamine 2 receptor antagonist in children with upper gastrointestinal bleeding. Consideration should also be given to the initiation of vasoactive drugs in all children in whom variceal bleeding is suspected. An endoscopy should be performed once the child is hemodynamically stable. © Copyright 2015 by the American Board of Family Medicine.

A novel simple external fixation for securing silicone stent in patients with upper tracheal stenosis

PubMed Central

Lin, Xiaoxiao; Ye, Min; Li, Yuping

2018-01-01

Upper tracheal stenosis is considered as a potentially life-threatening condition. Silicone stenting is an attractive treatment option for patients with upper tracheal stenosis. However, its use has been compromised by a major complication, stent migration. In the report, we introduced a novel external fixation of silicone stent which only needed one puncture site and involved a silicon chip as an anchoring device. All equipment and materials including the silicon chip were available in routine bronchoscopy suite. The method had been successfully performed in three patients with upper tracheal stenosis at our institution. And the patients were monitored for over 20 months after the intervention, and no spontaneous stent migration occurred. Therefore, we believe this is a simple and reliable approach for improving the outcome of silicone stenting in patients with upper tracheal stenosis and should be introduced in clinical practice.

Low thermal resistance power module assembly

DOEpatents

Hassani, Vahab; Vlahinos, Andreas; Bharathan, Desikan

2010-12-28

A power module assembly (400) with low thermal resistance and enhanced heat dissipation to a cooling medium. The assembly includes a heat sink or spreader plate (410) with passageways or openings (414) for coolant that extend through the plate from a lower surface (411) to an upper surface (412). A circuit substrate (420) is provided and positioned on the spreader plate (410) to cover the coolant passageways. The circuit substrate (420) includes a bonding layer (422) configured to extend about the periphery of each of the coolant passageways and is made up of a substantially nonporous material. The bonding layer (422) may be solder material which bonds to the upper surface (412) of the plate to provide a continuous seal around the upper edge of each opening (414) in the plate. The assembly includes power modules (430) mounted on the circuit substrate (420) on a surface opposite the bonding layer (422). The power modules (430) are positioned over or proximal to the coolant passageways.

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.

Multiweek Cell Culture Project for Use in Upper-Level Biology Laboratories

ERIC Educational Resources Information Center

Marion, Rebecca E.; Gardner, Grant E.; Parks, Lisa D.

2012-01-01

This article describes a laboratory protocol for a multiweek project piloted in a new upper-level biology laboratory (BIO 426) using cell culture techniques. Human embryonic kidney-293 cells were used, and several culture media and supplements were identified for students to design their own experiments. Treatments included amino acids, EGF,…

Sports Adaptations for Unilateral and Bilateral Upper-Limb Amputees: Archery/Badminton/Baseball/Softball/Bowling/Golf/Table Tennis.

ERIC Educational Resources Information Center

Cowart, Jim

1979-01-01

The booklet discusses sports adaptations for unilateral and bilateral upper limb amputees. Designs for adapted equipment are illustrated and information on adaptations are described for archery (including an archery release aid and a stationary bow holder); badminton (serving tray); baseball/softball (adaptations for catching, throwing, and…

COMPOSITIONAL LANDSCAPE METRICS AND LANDCOVER CONNECTIVITY MEASURES FOR THE SUB-WATERSHEDS OF THE UPPER SAN PEDRO RIVER 1997

EPA Science Inventory

Various compositional landscape metrics and landcover connectivity measures for the sub-watersheds of the Upper San Pedro River. Metrics were computed using the ATtILA v.3.03 ArcView extension. Inputs included the sub-watershed coverage obtained from the USDA-ARS-SWRC in Tucson,...

[Restoration of function by microsurgical reconstruction after sarcoma excision in the upper limb].

PubMed

Voigtländer, D; Schmidt, A

2006-08-01

The treatment of soft tissue sarcomas includes different modalities, but the complete excision of the tumor is the most important one. It is often difficult to resect the tumor completely and simultaneously restore a good function of the upper limb. Therefore a microsurgical reconstruction is often necessary as demonstrated here.

Predicting Performance on a Firefighter's Ability Test from Fitness Parameters

ERIC Educational Resources Information Center

Michaelides, Marcos A.; Parpa, Koulla M.; Thompson, Jerald; Brown, Barry

2008-01-01

The purpose of this project was to identify the relationships between various fitness parameters such as upper body muscular endurance, upper and lower body strength, flexibility, body composition and performance on an ability test (AT) that included simulated firefighting tasks. A second intent was to create a regression model that would predict…

Powder Keg on the Upper Missouri: Sources of Blackfeet Hostility, 1730-1810.

ERIC Educational Resources Information Center

Judy, Mark A.

1987-01-01

Evaluates reasons why Blackfeet Indians were bitterly hostile toward white fur traders in the upper Missouri River basin during the early 1800s. Explains causes of internal tribal turmoil including rapid adaptation of horses to tribal culture, devastating effects of disease, and guns disrupting the balance of power among tribes. (JHZ)

A Comprehensive Probability Project for the Upper Division One-Semester Probability Course Using Yahtzee

ERIC Educational Resources Information Center

Wilson, Jason; Lawman, Joshua; Murphy, Rachael; Nelson, Marissa

2011-01-01

This article describes a probability project used in an upper division, one-semester probability course with third-semester calculus and linear algebra prerequisites. The student learning outcome focused on developing the skills necessary for approaching project-sized math/stat application problems. These skills include appropriately defining…

Upper extremity sensory feedback therapy in chronic cerebrovascular accident patients with impaired expressive aphasia and auditory comprehension.

PubMed

Balliet, R; Levy, B; Blood, K M

1986-05-01

Electromyographic (EMG) sensory feedback therapy (SFT) was used in the neuromuscular retraining of the nonfunctional upper extremity in five chronic left cerebrovascular accident (CVA) patients with impaired expressive and auditory comprehension. Speech diagnoses included global, moderate-to-severe Broca, and Wernicke aphasias. These patients had experienced increased despondency associated with previous therapy failures and often had indicated that they wished to have their involved extremity amputated, so that it would no longer be in the way. In this study, specific behavioral training strategies to increase patient involvement were used, including: general relaxation, modified SFT instruction, and home exercises, which were supported by family and/or friends. After an average of 50 therapy sessions, all patients were successfully retrained to use their right upper extremity at the gross-assist level. This resulted in feelings of increased self-esteem to the extent that amputation was no longer requested. It is concluded that EMG SFT can be beneficial in the neuromuscular reeducation of paretic upper extremity muscles of CVA patients with expressive aphasia and (impaired) auditory comprehension.

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)

Quantification of human upper extremity nerves and fascicular anatomy.

PubMed

Brill, Natalie A; Tyler, Dustin J

2017-09-01

In this study we provide detailed quantification of upper extremity nerve and fascicular anatomy. The purpose is to provide values and trends in neural features useful for clinical applications and neural interface device design. Nerve cross-sections were taken from 4 ulnar, 4 median, and 3 radial nerves from 5 arms of 3 human cadavers. Quantified nerve features included cross-sectional area, minor diameter, and major diameter. Fascicular features analyzed included count, perimeter, area, and position. Mean fascicular diameters were 0.57 ± 0.39, 0.6 ± 0.3, 0.5 ± 0.26 mm in the upper arm and 0.38 ± 0.18, 0.47 ± 0.18, 0.4 ± 0.27 mm in the forearm of ulnar, median, and radial nerves, respectively. Mean fascicular diameters were inversely proportional to fascicle count. Detailed quantitative anatomy of upper extremity nerves is a resource for design of neural electrodes, guidance in extraneural procedures, and improved neurosurgical planning. Muscle Nerve 56: 463-471, 2017. © 2016 Wiley Periodicals, Inc.

A geometric morphometric analysis of hominin upper premolars. Shape variation and morphological integration.

PubMed

Gómez-Robles, Aida; Martinón-Torres, María; Bermúdez de Castro, José María; Prado-Simón, Leyre; Arsuaga, Juan Luis

2011-12-01

This paper continues the series of articles initiated in 2006 that analyse hominin dental crown morphology by means of geometric morphometric techniques. The detailed study of both upper premolar occlusal morphologies in a comprehensive sample of hominin fossils, including those coming from the Gran Dolina-TD6 and Sima de los Huesos sites from Atapuerca, Spain, complement previous works on lower first and second premolars and upper first molars. A morphological gradient consisting of the change from asymmetric to symmetric upper premolars and a marked reduction of the lingual cusp in recent Homo species has been observed in both premolars. Although percentages of correct classification based on upper premolar morphologies are not very high, significant morphological differences between Neanderthals (and European middle Pleistocene fossils) and modern humans have been identified, especially in upper second premolars. The study of morphological integration between premolar morphologies reveals significant correlations that are weaker between upper premolars than between lower ones and significant correlations between antagonists. These results have important implications for understanding the genetic and functional factors underlying dental phenotypic variation and covariation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Ubiquitous human upper-limb motion estimation using wearable sensors.

PubMed

Zhang, Zhi-Qiang; Wong, Wai-Choong; Wu, Jian-Kang

2011-07-01

Human motion capture technologies have been widely used in a wide spectrum of applications, including interactive game and learning, animation, film special effects, health care, navigation, and so on. The existing human motion capture techniques, which use structured multiple high-resolution cameras in a dedicated studio, are complicated and expensive. With the rapid development of microsensors-on-chip, human motion capture using wearable microsensors has become an active research topic. Because of the agility in movement, upper-limb motion estimation has been regarded as the most difficult problem in human motion capture. In this paper, we take the upper limb as our research subject and propose a novel ubiquitous upper-limb motion estimation algorithm, which concentrates on modeling the relationship between upper-arm movement and forearm movement. A link structure with 5 degrees of freedom (DOF) is proposed to model the human upper-limb skeleton structure. Parameters are defined according to Denavit-Hartenberg convention, forward kinematics equations are derived, and an unscented Kalman filter is deployed to estimate the defined parameters. The experimental results have shown that the proposed upper-limb motion capture and analysis algorithm outperforms other fusion methods and provides accurate results in comparison to the BTS optical motion tracker.

Development of Korean Academy of Medical Sciences Guideline for rating physical disability of upper extremity.

PubMed

Park, Jung Ho; Kim, Hee-Chun; Lee, Jae Hoon; Kim, Jin Soo; Roh, Si Young; Yi, Cheol Ho; Kang, Yoon Kyoo; Kwon, Bum Sun

2009-05-01

While the lower extremities support the weight and move the body, the upper extremities are essential for the activities of daily living, which require many detailed movements. Therefore, a disability of the upper extremity function should include a limitation of all motions of the joints and sensory loss, which affects the activities. In this study, disabilities of the upper extremities were evaluated according to the following conditions: 1) amputation, 2) joint contracture, 3) diseases of upper extremity, 4) weakness, 5) sensory loss of the finger tips, and 6) vascular and lymphatic diseases. The order of 1) to 6) is the order of major disability and there is no need to evaluate a lower order disability when a higher order one exists in the same joint or a part of the upper extremity. However, some disabilities can be either added or substituted when there are special contributions from multiple disabilities. An upper extremity disability should be evaluated after the completion of treatment and full adaptation when further functional changes are not expected. The dominance of the right or left hand before the disability should not be considered when there is a higher rate of disability.

[Risk for the development of upper gastrointestinal bleeding in children in an intensive care unit].

PubMed

Gutiérrez-Gutiérrez, Glenda Karina; Villasís-Keever, Miguel Angel; González-Ortiz, Beatriz; Troconis-Trens, Germán; Tapia-Monge, Dora María; Flores-Calderón, Judith

2014-01-01

Although gastrointestinal tract bleeding can occur at any age, most studies trying to establish causes or risk factors for its development have been conducted in adults. The aim of this study was to determine risk factors in children admitted in a pediatric intensive care unit. A retrospective case-control study was conducted. Children who developed upper gastrointestinal bleeding children during their stay at the intensive care unit were considered the cases. Variables were obtained from medical records including age, sex, nutritional status, mechanical ventilation, use of nasogastric tube, development of complications, presence of coagulopathy, use of prophylaxis for upper gastrointestinal tract bleeding, fasting and use of steroids. Using a multivariate analysis, risk factors were identified, with odds ratios (OR) and 95 % confidence intervals (95 % CI) calculations. Out of 165 patients, 58 had upper gastrointestinal bleeding (35 %). Risk factors identified were prolonged clotting times (OR = 3.35), thrombocytopenia (OR = 2.39), development of sepsis (OR = 6.74) or pneumonia (OR = 4.37). Prophylaxis for upper gastrointestinal bleeding was not a protective factor. Upper gastrointestinal bleeding frequency in children hospitalized in an intensive care unit was high. Identifying risk factors should help to reduce upper gastrointestinal bleeding frequency.

Stability and growth of continental shields in mantle convection models including recurrent melt production

NASA Astrophysics Data System (ADS)

de Smet, J. H.; van den Berg, A. P.; Vlaar, N. J.

1998-10-01

The long-term growth and stability of compositionally layered continental upper mantle has been investigated by numerical modelling. We present the first numerical model of a convecting mantle including differentiation through partial melting resulting in a stable compositionally layered continental upper mantle structure. This structure includes a continental root extending to a depth of about 200 km. The model covers the upper mantle including the crust and incorporates physical features important for the study of the continental upper mantle during secular cooling of the Earth since the Archaean. Among these features are: a partial melt generation mechanism allowing consistent recurrent melting, time-dependent non-uniform radiogenic heat production, and a temperature- and pressure-dependent rheology. The numerical results reveal a long-term growth mechanism of the continental compositional root. This mechanism operates through episodical injection of small diapiric upwellings from the deep layer of undepleted mantle into the continental root which consists of compositionally distinct depleted mantle material. Our modelling results show the layered continental structure to remain stable during at least 1.5 Ga. After this period mantle differentiation through partial melting ceases due to the prolonged secular cooling and small-scale instabilities set in through continental delamination. This stable period of 1.5 Ga is related to a number of limitations in our model. By improving on these limitations in the future this stable period will be extended to more realistic values.

Mirror therapy for motor function of the upper extremity in patients with stroke: A meta-analysis.

PubMed

Zeng, Wen; Guo, Yonghong; Wu, Guofeng; Liu, Xueyan; Fang, Qian

2018-01-10

To evaluate the mean treatment effect of mirror therapy on motor function of the upper extremity in patients with stroke. Electronic databases, including the Cochrane Library, PubMed, MEDLINE, Embase and CNKSystematic, were searched for relevant studies published in English between 1 January 2007 and 22 June 2017. Randomized controlled trials and pilot randomized controlled trials that compared mirror therapy/mirror box therapy with other rehabilitation approaches were selected. Two authors independently evaluated the searched studies based on the inclusion/exclusion criteria and appraised the quality of included studies according to the criteria of the updated version 5.1.0 of the Cochrane Handbook for Systematic Review of Interventions. Eleven trials, with a total of 347 patients, were included in the meta-analysis. A moderate effect of mirror therapy (standardized mean difference 0.51, 95% confidence interval (CI) 0.29, 0.73) on motor function of the upper extremity was found. However, a high degree of heterogeneity (χ2 = 25.65, p = 0.004; I2 = 61%) was observed. The heterogeneity decreased a great deal (χ2 = 6.26, p = 0.62; I2 = 0%) after 2 trials were excluded though sensitivity analysis. Although the included studies had high heterogeneity, meta-analysis provided some evidence that mirror therapy may significantly improve motor function of the upper limb in patients with stroke. Further well-designed studies are needed.

[The response of the upper respiratory tract to the impact of atmospheric pollution].

PubMed

Mukhamadiev, R A; Ismagilov, Sh M

2015-01-01

The present literature review characterizes the environmental conditions in the Russian Federation in general and the Republic of Tatarstan in particular with special reference to the influence of atmospheric pollution on the development and the clinical picture of the diseases of the respiratory organs including pathology of the upper respiratory tract in the populations of the industrial centres and other environmentally unfriendly areas. The views of the domestic and foreign authors concerning the role of the environmental factors in the clinical picture of the upper respiratory tract disorders are described in detail. The authors emphasize the necessity of the further investigationsinto this problem and the development of the methods for the prevention of diseases of the upper respiratory react.

Progressive Derechos in the Presence of Closed Upper-level Subtropical Anticyclones

NASA Astrophysics Data System (ADS)

Guastini, C.; Bosart, L. F.

2013-12-01

Progressive derechos are a type of long-lived mesoscale convective system that produces large swaths of wind damage. In contrast to their serial derecho counterparts, which form in association with extratropical cyclones, progressive derechos often occur in the presence of benign synoptic conditions on the poleward side of closed upper-level subtropical anticyclones. Forecasters have been known to struggle predicting progressive derechos with any certainty due to the common lack of large-scale support for severe weather in regimes dominated by anticyclonic conditions. This study will classify a group of days on which there was a closed upper-level anticyclone over the United States and a progressive derecho did not occur and a group of days on which there was a closed upper-level anticyclone over the United States and a progressive derecho did occur, examine the synoptic environments of the two groups, and identify derecho null cases. By analyzing the null cases, derecho failure modes will be determined, which will help forecaster situational awareness and reveal the science behind the environmental conditions necessary for, and detrimental to, derecho development. This presentation will include climatologies of both derechos and closed upper-level anticyclones over the United States for June, July, and August of the years 1994-2013 (the modern radar era). The presentation will also include closed anticyclone-relative composites of both derecho cases and derecho null cases. The composites will elucidate which conditions are necessary for, and which are detrimental to, derecho development. The hypothesis is that derecho failure days occur due either to the lack of a triggering mechanism or other phenomena working against convective development such as a strong capping inversion or transverse ageostrophic circulations around an upper-level jet creating subsidence in an otherwise favorable environment. A representative case study will be included to highlight a common derecho failure mode.

Maturation of enabling technologies for the next generation reignitable cryogenic upper stage

NASA Astrophysics Data System (ADS)

Mueller, Mark

Following the ESA decision in November 2008, a pre-development phase (Phase 1) of a future evolution of the Ariane 5 launcher (named Ariane 5 Midlife Evolution, A5ME) was started under Astrium Prime leadership. This upgraded version of the Ariane 5 launcher is based on an enhanced performance Upper Stage including the cryogenic re-ignitable VINCI engine. Thanks to this reignition capability, this new Upper Stage shall be "versatile" in the sense that it shall fulfil customer needs on a broader spectrum of orbits than the "standard" orbits (i.e. Geosynchronous Transfer Orbits, GTO) typically used for commercial telecommunications satellites. In order to meet the challenges of versatility, new technologies are currently being investigated. These technologies are mainly related -but not limited-to propellant management during the extended coasting phases with the related heat transfer into the tanks and the required multiple engine re-ignitions. Within the frame of the ESA Future Launchers Preparatory Programme (Period 2 Slice 1), the Cryogenic Upper Stage Technology project (CUST) aims to mature critical technologies to such a Technology Readiness Level (TRL) that they can be integrated into the baseline A5ME Upper Stage development schedule. In addition to A5ME application, these technologies can also be used on the future next generation European launcher. This paper shows the down-selection process implemented to identify the most crucial enabling technologies for a future versatile Upper Stage and gives a description of each technology finally selected for maturation in the frame of CUST. These include -amongst others-a Sandwich Common Bulkhead for the propellant tank, an external thermal insulation kit and various propellant management devices for the coasting phase. The paper also gives an overview on the related development and maturation plan including the tests to be conducted, as well as first results of the maturation activities themselves.

Fire resistant PV shingle assembly

DOEpatents

Lenox, Carl J.

2012-10-02

A fire resistant PV shingle assembly includes a PV assembly, including PV body, a fire shield and a connection member connecting the fire shield below the PV body, and a support and inter-engagement assembly. The support and inter-engagement assembly is mounted to the PV assembly and comprises a vertical support element, supporting the PV assembly above a support surface, an upper interlock element, positioned towards the upper PV edge, and a lower interlock element, positioned towards the lower PV edge. The upper interlock element of one PV shingle assembly is inter-engageable with the lower interlock element of an adjacent PV shingle assembly. In some embodiments the PV shingle assembly may comprise a ventilation path below the PV body. The PV body may be slidably mounted to the connection member to facilitate removal of the PV body.

Musculoskeletal disorders of the upper cervical spine in women with episodic or chronic migraine.

PubMed

Ferracini, Gabriela N; Florencio, Lidiane L; Dach, Fabíola; Bevilaqua Grossi, Débora; Palacios-Ceña, María; Ordás-Bandera, Carlos; Chaves, Thais C; Speciali, José G; Fernández-de-Las-Peñas, César

2017-06-01

The role of musculoskeletal disorders of the cervical spine in migraine is under debate. To investigate differences in musculoskeletal impairments of the neck including active global and upper cervical spine mobility, the presence of symptomatic upper cervical spine joints, cervicocephalic kinesthesia and head/neck posture between women with episodic migraine, chronic migraine, and controls. A cross-sectional study. Tertiary university-based hospital. Fifty-five women with episodic migraine, 16 with chronic migraine, and 22 matched healthy women. Active cervical range of motion, upper cervical spine mobility (i.e., flexion-rotation test), referred pain from upper cervical joints, cervicocephalic kinesthesia (joint position sense error test, JPSE), and head/neck posture (i.e. the cranio-vertebral and cervical lordosis angles) were assessed by an assessor blinded to the subject's condition. Women with migraine showed reduced cervical rotation than healthy women (P=0.012). No differences between episodic and chronic migraine were found in cervical mobility. Significant differences for flexion-rotation test were also reported, suggesting that upper cervical spine mobility was restricted in both migraine groups (P<0.001). Referred pain elicited on manual examination of the upper cervical spine mimicking pain symptoms was present in 50% of migraineurs. No differences were observed on the frequency of symptomatic upper cervical joints between episodic and chronic migraine. No differences on JPSE or posture were found among groups (P>0.121). Women with migraine exhibit musculoskeletal impairments of the upper cervical spine expressed as restricted cervical rotation, decreased upper cervical rotation, and the presence of symptomatic upper cervical joints. No differences were found between episodic or chronic migraine. Identification treatment of the musculoskeletal impairments of the cervical spine may help to clinician for better management of patients with migraine.

Ground-water quality of the Upper Floridan Aquifer near an abandoned manufactured gas plant in Albany, Georgia

USGS Publications Warehouse

Chapman, M.J.

1993-01-01

Manufactured gas plants produced gas for heating and lighting in the United States from as early as 1816 into the 1960's. By-products including, but not limited to, oil residues and tar, were generated during the gas-manufacturing process. Organic compounds (hydrocarbons) were detected in water in the upper water-bearing zone of the Upper Floridan aquifer near an abandoned manufactured gas plant (MGP) in Albany, Georgia, during an earlier investigation in 1990. Chemical analyses of ground-water samples collected from five existing monitoring wells in 1991 verify the presence of hydrocarbons and metals in the upper water-beating zone of the Upper Floridan aquifer. One well was drilled into the lower water-beating zone of the Upper Floridan aquifer in 1991 for water-quality sampling and water-level monitoring. Analyses of ground water sampled from this well did not show evidence of benzene, toluene, xylene, napthalene, acenaphthlene, or other related compounds detected in the upper water-bearing zone in the study area. Low concentrations of tetrachloroethane, trichloromethane, and l,2-cisdichloroethene were detected in a water sample from the deeper well; however, these compounds were not detected in the upper water-bearing zone in the study area. Inorganic constituent concentrations also were substantially lower in the deeper well. Overall, ground water sampled from the lower water-bearing zone had lower specific conductance and alkalinity; and lower concentrations of dissolved solids, iron, and manganese compared to ground water sampled from the upper water-bearing zone. Water levels for the upper and lower water-bearing zones were similar throughout the study period.

Stimulation of abdominal and upper thoracic muscles with surface electrodes for respiration and cough: Acute studies in adult canines.

PubMed

Walter, James S; Posluszny, Joseph; Dieter, Raymond; Dieter, Robert S; Sayers, Scott; Iamsakul, Kiratipath; Staunton, Christine; Thomas, Donald; Rabbat, Mark; Singh, Sanjay

2018-05-01

To optimize maximal respiratory responses with surface stimulation over abdominal and upper thorax muscles and using a 12-Channel Neuroprosthetic Platform. Following instrumentation, six anesthetized adult canines were hyperventilated sufficiently to produce respiratory apnea. Six abdominal tests optimized electrode arrangements and stimulation parameters using bipolar sets of 4.5 cm square electrodes. Tests in the upper thorax optimized electrode locations, and forelimb moment was limited to slight-to-moderate. During combined muscle stimulation tests, the upper thoracic was followed immediately by abdominal stimulation. Finally, a model of glottal closure for cough was conducted with the goal of increased peak expiratory flow. Optimized stimulation of abdominal muscles included three sets of bilateral surface electrodes located 4.5 cm dorsal to the lateral line and from the 8 th intercostal space to caudal to the 13 th rib, 80 or 100 mA current, and 50 Hz stimulation frequency. The maximal expired volume was 343 ± 23 ml (n=3). Optimized upper thorax stimulation included a single bilateral set of electrodes located over the 2 nd interspace, 60 to 80 mA, and 50 Hz. The maximal inspired volume was 304 ± 54 ml (n=4). Sequential stimulation of the two muscles increased the volume to 600 ± 152 ml (n=2), and the glottal closure maneuver increased the flow. Studies in an adult canine model identified optimal surface stimulation methods for upper thorax and abdominal muscles to induce sufficient volumes for ventilation and cough. Further study with this neuroprosthetic platform is warranted.

Diet of upper paleolithic modern humans: evidence from microwear texture analysis.

PubMed

El Zaatari, Sireen; Hublin, Jean-Jacques

2014-04-01

This article presents the results of the occlusal molar microwear texture analysis of 32 adult Upper Paleolithic modern humans from a total of 21 European sites dating to marine isotope stages 3 and 2. The occlusal molar microwear textures of these specimens were analyzed with the aim of examining the effects of the climatic, as well as the cultural, changes on the diets of the Upper Paleolithic modern humans. The results of this analysis do not reveal any environmentally driven dietary shifts for the Upper Paleolithic hominins indicating that the climatic and their associated paleoecological changes did not force these humans to significantly alter their diets in order to survive. However, the microwear texture analysis does detect culturally related changes in the Upper Paleolithic humans' diets. Specifically, significant differences in diet were found between the earlier Upper Paleolithic individuals, i.e., those belonging to the Aurignacian and Gravettian contexts, and the later Magdalenian ones, such that the diet of the latter group was more varied and included more abrasive foods compared with those of the former. Copyright © 2014 Wiley Periodicals, Inc.

The biomechanics of upper extremity kinematic and kinetic modeling: applications to rehabilitation engineering.

PubMed

Slavens, Brooke A; Harris, Gerald F

2008-01-01

Human motion analysis has evolved from the lower extremity to the upper extremity. Rehabilitation engineering is reliant upon three-dimensional biome-chanical models for a thorough understanding of upper body motions and forces in order to improve treatment methods, rehabilitation strategies and to prevent injury. Due to the complex nature of upper body movements, a standard biomechanical model does not exist. This paper reviews several kinematic and kinetic rehabilitation engineering models from the literature. These models may capture a single joint; multijoints such as the shoulder, elbow and wrist; or a combination of joints and an ambulatory aid, which serves as the extension of the upper arm. With advances in software and hardware, new models continuously arise due to the clinical questions at hand. When designing a biomechanical upper extremity model, several key components must be determined. These include deciding on the anatomic segments of the model, the number of markers and placement on bony landmarks, the definition of joint coordinate systems, and the description of the joint motions. It is critical to apply the proper model to further our understanding of pathologic populations.

"Ballistic Six" Upper-Extremity Plyometric Training for the Pediatric Volleyball Players.

PubMed

Turgut, Elif; Cinar-Medeni, Ozge; Colakoglu, Filiz F; Baltaci, Gul

2017-09-19

The Ballistic Six exercise program includes commonly used upper-body exercises, and the program is recommended for overhead throwing athletes. The purpose of the current study was to investigate the effects of a 12-week the Ballistic Six upper-extremity plyometric training program on upper-body explosive power, endurance, and reaction time in pediatric overhead athletes. Twenty-eight female pediatric volleyball players participated in the study. The participants were randomly divided into 2 study groups: an intervention group (upper-extremity plyometric training in addition to the volleyball training; n = 14) and a control group (the volleyball training only; n = 14). All the participants were assessed before and after a 12-week training program for upper-body power, strength and endurance, and reaction time. Statistical comparison was performed using an analysis of variance test. Comparisons showed that after a 12-week training program, the Ballistic Six upper-body plyometric training program resulted in more improvements in an overhead medicine ball throwing distance and a push-up performance, as well as greater improvements in the reaction time in the nonthrowing arm when compared with control training. In addition, a 12-week training program was found to be effective in achieving improvements in the reaction time in the throwing arm for both groups similarly. Compared with regular training, upper-body plyometric training resulted in additional improvements in upper-body power and strength and endurance among pediatric volleyball players. The findings of the study provide a basis for developing training protocols for pediatric volleyball players.

Predictors of Upper-Extremity Physical Function in Older Adults.

PubMed

Hermanussen, Hugo H; Menendez, Mariano E; Chen, Neal C; Ring, David; Vranceanu, Ana-Maria

2016-10-01

Little is known about the influence of habitual participation in physical exercise and diet on upper-extremity physical function in older adults. To assess the relationship of general physical exercise and diet to upper-extremity physical function and pain intensity in older adults. A cohort of 111 patients 50 or older completed a sociodemographic survey, the Rapid Assessment of Physical Activity (RAPA), an 11-point ordinal pain intensity scale, a Mediterranean diet questionnaire, and three Patient- Reported Outcomes Measurement Information System (PROMIS) based questionnaires: Pain Interference to measure inability to engage in activities due to pain, Upper-Extremity Physical Function, and Depression. Multivariable linear regression modeling was used to characterize the association of physical activity, diet, depression, and pain interference to pain intensity and upper-extremity function. Higher general physical activity was associated with higher PROMIS Upper-Extremity Physical Function and lower pain intensity in bivariate analyses. Adherence to the Mediterranean diet did not correlate with PROMIS Upper-Extremity Physical Function or pain intensity in bivariate analysis. In multivariable analyses factors associated with higher PROMIS Upper-Extremity Physical Function were male sex, non-traumatic diagnosis and PROMIS Pain Interference, with the latter accounting for most of the observed variability (37%). Factors associated with greater pain intensity in multivariable analyses included fewer years of education and higher PROMIS Pain Interference. General physical activity and diet do not seem to be as strongly or directly associated with upper-extremity physical function as pain interference.

Theoretical and experimental investigations of upper atmosphere dynamics

NASA Technical Reports Server (NTRS)

Roper, R. G.; Edwards, H. D.

1980-01-01

A brief overview of the significant contributions made to the understanding of the dynamics of the Earth's upper atmosphere is presented, including the addition of winds and diffusion to the semi-empirical Global Reference Atmospheric Model developed for the design phase of the Space Shuttle, reviews of turbulence in the lower thermosphere, the dynamics of the equatorial mesopause, stratospheric warming effects on mesopause level dynamics, and the relevance of these studies to the proposed Middle Atmosphere Program (1982-85). A chronological bibliography, with abstracts of all papers published, is also included.

Algal toxins in Upper Klamath Lake, Oregon: Linking water quality to juvenile sucker health

USGS Publications Warehouse

VanderKooi, S.P.; Burdick, S.M.; Echols, K.R.; Ottinger, C.A.; Rosen, B.H.; Wood, T.M.

2010-01-01

As the lead science agency for the Department of Interior, the U.S. Geological Survey is actively involved in resource issues in the Klamath River basin. Activities include research projects on endangered Lost River and shortnose suckers, threatened coho salmon, groundwater resources, seasonal runoff forecasting, water quality in Upper Klamath Lake and the Klamath River, nutrient cycling in wetlands, and assessment of land idling programs to reduce water consumption. Many of these studies are collaborations with various partners including Department of Interior agencies, Indian Tribes, and State agencies.

Mathematics Education Research in Finland: Yearbook, 1987-1988. Publication Series B: Theory into Practice 39.

ERIC Educational Resources Information Center

Kupari, Pekka, Ed.

This yearbook includes four articles, one of which is written in German. The first article, "The Development of Mathematics Attitudes on the Upper Level of the Comprehensive School" (Olavi Karjalainen), examines the development of children's attitudes towards mathematics and the factors related to the development during the upper level…

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.

Improvement of Vocational Education Curriculum Implementation through Instructional Materials Production and Utilization in Upper Basic Education in Nigeria

ERIC Educational Resources Information Center

Owoh, Titus M.

2016-01-01

This article describes the development of curriculum as it relates to vocational education in Nigeria Upper Basic Education Curriculum. The definition of Curriculum development was highlighted to reflect contemporary concepts of curriculum integration. Curriculum development was stressed to include the rudiments necessary in its stages of…

COMPOSITIONAL LANDSCAPE METRICS AND LANDCOVER CONNECTIVITY MEASURES FOR THE SUB-WATERSHEDS OF THE UPPER SAN PEDRO RIVER 1973

EPA Science Inventory

Various compositional landscape metrics and landcover connectivity measures for the sub-watersheds of the Upper San Pedro River. Metrics were computed using the ATtILA v3.03 ArcView extension. Inputs included the sub-watershed coverage obtained from the USDA-ARS-SWRC in Tucson, A...

Use of three-point taper systems in timber cruising

Treesearch

James W. Flewelling; Richard L. Ernst; Lawrence M. Raynes

2000-01-01

Tree volumes and profiles are often estimated as functions of total height and DBH. Alternative estimators include form-class methods, importance sampling, the centroid method, and multi-point profile (taper) estimation systems; all of these require some measurement or estimate of upper stem diameters. The multi-point profile system discussed here allows for upper stem...

A River Runs through It: Art, Geology and Life on the Upper Mississippi

ERIC Educational Resources Information Center

Henderson, Lynette K.

2015-01-01

This article presents a pilot interdisciplinary project for middle-school students including visual literacy, studio art, English-language literacy, geology and the study of indigenous groups. The location of the pilot was in the upper Midwest, along the Mississippi river bluffs of St. Paul, Minnesota. English-as-a-Second Language (ESL) students…

Higher Education Financial Assistance Tools for Middle- and Upper-Income Taxpayers

ERIC Educational Resources Information Center

Condon, James V.; Prince, Lori H.

2008-01-01

This article describes higher education financial assistance tools designed mainly for students of middle- and upper-income families who may not be eligible for financial aid from other sources. It includes the 2007 legislative updates for these tools, all of which have been devised and offered by either state or federal governments. The authors…

Regional patterns of major nonnative invasive plants and associated factors in upper Midwest forests

Treesearch

Zhaofei Fan; W. Keith Moser; Mark H. Hansen; Mark D. Nelson

2013-01-01

Nonnative invasive plants (IPs) are rapidly spreading into natural ecosystems (e.g., forests and grasslands). Potential threats of IP invasion into natural ecosystems include biodiversity loss, structural and environmental change, habitat degradation, and economic losses. The Upper Midwest of the United States encompasses the states of Illinois, Indiana, Iowa, Michigan...

78 FR 1166 - Service Rules for the Advanced Wireless Services in the H Block-Implementing Section 6401 of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-08

... proposals regarding the licensing, use, and assignment of the spectrum, including the costs and benefits of... downlink band. Accordingly, we tentatively conclude that licensing the Upper H Block under flexible use... to our expectation, the record results in a determination that licensing the Upper H Block, the Lower...

75 FR 16689 - Airworthiness Directives; Airbus Model A318, A319, A320, and A321 Series Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-02

... other areas (splice/lower rib/upper edge/leading edge/other specified locations), and elasticity laminate checks for de-bonding of the rudders in the trailing edge area and other areas (splice/lower rib/upper edge/leading edge/other specified locations). Corrective actions include contacting Airbus for...

Spatial characterization of dissolved trace elements and heavy metals in the upper Han River (China) using multivariate statistical techniques.

PubMed

Li, Siyue; Zhang, Quanfa

2010-04-15

A data matrix (4032 observations), obtained during a 2-year monitoring period (2005-2006) from 42 sites in the upper Han River is subjected to various multivariate statistical techniques including cluster analysis, principal component analysis (PCA), factor analysis (FA), correlation analysis and analysis of variance to determine the spatial characterization of dissolved trace elements and heavy metals. Our results indicate that waters in the upper Han River are primarily polluted by Al, As, Cd, Pb, Sb and Se, and the potential pollutants include Ba, Cr, Hg, Mn and Ni. Spatial distribution of trace metals indicates the polluted sections mainly concentrate in the Danjiang, Danjiangkou Reservoir catchment and Hanzhong Plain, and the most contaminated river is in the Hanzhong Plain. Q-model clustering depends on geographical location of sampling sites and groups the 42 sampling sites into four clusters, i.e., Danjiang, Danjiangkou Reservoir region (lower catchment), upper catchment and one river in headwaters pertaining to water quality. The headwaters, Danjiang and lower catchment, and upper catchment correspond to very high polluted, moderate polluted and relatively low polluted regions, respectively. Additionally, PCA/FA and correlation analysis demonstrates that Al, Cd, Mn, Ni, Fe, Si and Sr are controlled by natural sources, whereas the other metals appear to be primarily controlled by anthropogenic origins though geogenic source contributing to them. 2009 Elsevier B.V. All rights reserved.

Digital atlas of the upper Washita River basin, southwestern Oklahoma

USGS Publications Warehouse

Becker, Carol J.; Masoner, Jason R.; Scott, Jonathon C.

2008-01-01

Numerous types of environmental data have been collected in the upper Washita River basin in southwestern Oklahoma. However, to date these data have not been compiled into a format that can be comprehensively queried for the purpose of evaluating the effects of various conservation practices implemented to reduce agricultural runoff and erosion in parts of the upper Washita River basin. This U.S. Geological Survey publication, 'Digital atlas of the upper Washita River basin, southwestern Oklahoma' was created to assist with environmental analysis. This atlas contains 30 spatial data sets that can be used in environmental assessment and decision making for the upper Washita River basin. This digital atlas includes U.S. Geological Survey sampling sites and associated water-quality, biological, water-level, and streamflow data collected from 1903 to 2005. The data were retrieved from the U.S. Geological Survey National Water Information System database on September 29, 2005. Data sets are from the Geology, Geography, and Water disciplines of the U.S. Geological Survey and cover parts of Beckham, Caddo, Canadian, Comanche, Custer, Dewey, Grady, Kiowa, and Washita Counties in southwestern Oklahoma. A bibliography of past reports from the U.S. Geological Survey and other State and Federal agencies from 1949 to 2004 is included in the atlas. Additionally, reports by Becker (2001), Martin (2002), Fairchild and others (2004), and Miller and Stanley (2005) are provided in electronic format.

Processing composite materials

NASA Technical Reports Server (NTRS)

Baucom, R. M.

1982-01-01

The fabrication of several composite structural articles including DC-10 upper aft rudders, L-1011 vertical fins and composite biomedical appliances are discussed. Innovative composite processing methods are included.

Risk factors for complications associated with upper gastrointestinal foreign bodies

PubMed Central

Hong, Kyong Hee; Kim, Yoon Jae; Kim, Jae Hak; Chun, Song Wook; Kim, Hee Man; Cho, Jae Hee

2015-01-01

AIM: To investigate predictive risk factors associated with complications in the endoscopic removal of foreign bodies from the upper gastrointestinal tract. METHODS: We retrospectively reviewed the medical records of 194 patients with a diagnosis of foreign body impaction in the upper gastrointestinal tract, confirmed by endoscopy, at two university hospital in South Korea. Patient demographic data, including age, gender, intention to ingestion, symptoms at admission, and comorbidities, were collected. Clinical features of the foreign bodies, such as type, size, sharpness of edges, number, and location, were analyzed. Endoscopic data those were analyzed included duration of foreign body impaction, duration of endoscopic performance, endoscopic device, days of hospitalization, complication rate, 30-d mortality rate, and the number of operations related to foreign body removal. RESULTS: The types of upper gastrointestinal foreign bodies included fish bones, drugs, shells, meat, metal, and animal bones. The locations of impacted foreign bodies were the upper esophagus (57.2%), mid esophagus (28.4%), stomach (10.8%), and lower esophagus (3.6%). The median size of the foreign bodies was 26.2 ± 16.7 mm. Among 194 patients, endoscopic removal was achieved in 189, and complications developed in 51 patients (26.9%). Significant complications associated with foreign body impaction and removal included deep lacerations with minor bleeding (n = 31, 16%), ulcer (n = 11, 5.7%), perforation (n = 3, 1.5%), and abscess (n = 1, 0.5%). Four patients underwent operations because of incomplete endoscopic foreign body extraction. In multivariate analyses, risk factors for endoscopic complications and failure were sharpness (HR = 2.48, 95%CI: 1.07-5.72; P = 0.034) and a greater than 12-h duration of impaction (HR = 2.42, 95%CI: 1.12-5.25, P = 0.025). CONCLUSION: In cases of longer than 12 h since foreign body ingestion or sharp-pointed objects, rapid endoscopic intervention should be provided in patients with ingested foreign bodies. PMID:26185385

Apparatus for testing high pressure injector elements

NASA Technical Reports Server (NTRS)

Myers, William Neill (Inventor); Scott, Ewell M. (Inventor); Forbes, John C. (Inventor); Shadoan, Michael D. (Inventor)

1995-01-01

An apparatus for testing and evaluating the spray pattern of high pressure fuel injector elements for use in supplying fuel to combustion engines is presented. Prior art fuel injector elements were normally tested by use of low pressure apparatuses which did not provide a purge to prevent mist from obscuring the injector element or to prevent frosting of the view windows; could utilize only one fluid during each test; and had their viewing ports positioned one hundred eighty (180 deg) apart, thus preventing optimum use of laser diagnostics. The high pressure fluid injector test apparatus includes an upper hub, an upper weldment or housing, a first clamp and stud/nut assembly for securing the upper hub to the upper weldment, a standoff assembly within the upper weldment, a pair of window housings having view glasses within the upper weldment, an injector block assembly and purge plate within the upper weldment for holding an injector element to be tested and evaluated, a lower weldment or housing, a second clamp and stud/nut assembly for securing the lower weldment to the upper hub, a third clamp and stud/nut assembly for securing the lower hub to the lower weldment, mechanisms for introducing fluid under high pressure for testing an injector element, and mechanisms for purging the apparatus to prevent frosting of view glasses within the window housings and to permit unobstructed viewing of the injector element.

Apparatus for testing high pressure injector elements

NASA Technical Reports Server (NTRS)

Myers, William Neill (Inventor); Scott, Ewell M. (Inventor); Forbes, John C. (Inventor); Shadoan, Michael D. (Inventor)

1993-01-01

An apparatus for testing and evaluating the spray pattern of high pressure fuel injector elements for use in supplying fuel to combustion engines is presented. Prior art fuel injector elements were normally tested by use of low pressure apparatuses which did not provide a purge to prevent mist from obscuring the injector element or to prevent frosting of the view windows; could utilize only one fluid during each test; and had their viewing ports positioned one hundred eighty (180 deg) apart, thus preventing optimum use of laser diagnostics. The high pressure fluid injector test apparatus includes an upper hub, an upper weldment or housing, a first clamp and stud/nut assembly for securing the upper hub to the upper weldment, a standoff assembly within the upper weldment, a pair of window housings having view glasses within the upper weldment, an injector block assembly and purge plate within the upper weldment for holding an injector element to be tested and evaluated, a lower weldment or housing, a second clamp and stud/nut assembly for securing the lower weldment to the upper weldment, a lower hub, a third clamp and stud/nut assembly for securing the lower hub to the lower weldment, mechanisms for introducing fluid under high pressure for testing an injector element, and mechanisms for purging the apparatus to prevent frosting of view glasses within the window housings and to permit unobstructed viewing of the injector element.

Rationale and design of the ARCUS: Effects of trAnsRadial perCUtaneouS coronary intervention on upper extremity function.

PubMed

Zwaan, Eva M; IJsselmuiden, Alexander J J; van Rosmalen, Joost; van Geuns, Robert-Jan M; Amoroso, Giovanni; Moerman, Esther; Ritt, Marco J P F; Schreuders, Ton A R; Kofflard, Marcel J M; Holtzer, Carlo A J

2016-12-01

The aim of this study is to provide a complete insight in the access-site morbidity and upper extremity function after Transradial Percutaneous Coronary Intervention (TR-PCI). In percutaneous coronary intervention the Transradial Approach (TRA) is gaining popularity as a default technique. It is a very promising technique with respect to post-procedure complications, but the exact effects of TRA on upper extremity function are unknown. The effects of trAnsRadial perCUtaneouS coronary intervention on upper extremity function (ARCUS) trial is a multicenter prospective cohort study that will be conducted in all patients admitted for TR-PCI. Clinical outcomes will be monitored during a follow-up of 6 months, with its primary endpoint at two weeks of follow-up. To investigate the complete upper extremity function, a combination of physical examinations and validated questionnaires will be used to provide information on anatomical integrity, strength, range of motion (ROM), coordination, sensibility, pain, and functioning in everyday life. Procedural and material specifications will be registered in order to include all possible aspects influencing upper extremity function. Results from this study will elucidate the effect of TR-PCI on upper extremity function. This creates the opportunity to further optimize TR-PCI, to make improvements in functional outcome and to prevent morbidity regarding full upper extremity function. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Microbes in the upper atmosphere and unique opportunities for astrobiology research.

PubMed

Smith, David J

2013-10-01

Microbial taxa from every major biological lineage have been detected in Earth's upper atmosphere. The goal of this review is to communicate (1) relevant astrobiology questions that can be addressed with upper atmosphere microbiology studies and (2) available sampling methods for collecting microbes at extreme altitudes. Precipitation, mountain stations, airplanes, balloons, rockets, and satellites are all feasible routes for conducting aerobiology research. However, more efficient air samplers are needed, and contamination is also a pervasive problem in the field. Measuring microbial signatures without false positives in the upper atmosphere might contribute to sterilization and bioburden reduction methods for proposed astrobiology missions. Intriguingly, environmental conditions in the upper atmosphere resemble the surface conditions of Mars (extreme cold, hypobaria, desiccation, and irradiation). Whether terrestrial microbes are active in the upper atmosphere is an area of intense research interest. If, in fact, microbial metabolism, growth, or replication is achievable independent of Earth's surface, then the search for habitable zones on other worlds should be broadened to include atmospheres (e.g., the high-altitude clouds of Venus). Furthermore, viable cells in the heavily irradiated upper atmosphere of Earth could help identify microbial genes or enzymes that bestow radiation resistance. Compelling astrobiology questions on the origin of life (if the atmosphere synthesized organic aerosols), evolution (if airborne transport influenced microbial mutation rates and speciation), and panspermia (outbound or inbound) are also testable in Earth's upper atmosphere.

A Prospective Evaluation of Duplex Ultrasound for Thoracic Outlet Syndrome in High-Performance Musicians Playing Bowed String Instruments

PubMed Central

Adam, Garret; Wang, Kevin; Demaree, Christopher J.; Jiang, Jenny S.; Cheung, Mathew; Bechara, Carlos F.

2018-01-01

Thoracic outlet syndrome (TOS) is a neurovascular condition involving the upper extremity, which is known to occur in individuals who perform chronic repetitive upper extremity activities. We prospectively evaluate the incidence of TOS in high-performance musicians who played bowed string musicians. Sixty-four high-performance string instrument musicians from orchestras and professional musical bands were included in the study. Fifty-two healthy volunteers formed an age-matched control group. Bilateral upper extremity duplex scanning for subclavian vessel compression was performed in all subjects. Provocative maneuvers including Elevated Arm Stress Test (EAST) and Upper Limb Tension Test (ULTT) were performed. Abnormal ultrasound finding is defined by greater than 50% subclavian vessel compression with arm abduction, diminished venous waveforms, or arterial photoplethysmography (PPG) tracing with arm abduction. Bowed string instruments performed by musicians in our study included violin (41%), viola (33%), and cello (27%). Positive EAST or ULTT test in the musician group and control group were 44%, and 3%, respectively (p = 0.03). Abnormal ultrasound scan with vascular compression was detected in 69% of musicians, in contrast to 15% of control subjects (p = 0.03). TOS is a common phenomenon among high-performance bowed string instrumentalists. Musicians who perform bowed string instruments should be aware of this condition and its associated musculoskeletal symptoms. PMID:29370085

Examination and treatment of patients with unilateral vestibular damage, with focus on the musculoskeletal system: a case series.

PubMed

Wilhelmsen, Kjersti; Kvåle, Alice

2014-07-01

Persistent dizziness and balance problems have been reported in some patients with unilateral vestibular pathology. The purpose of this case series was to address the examination and treatment of musculoskeletal dysfunction in patients with unilateral vestibular hypofunction. The musculoskeletal system was evaluated with the Global Physiotherapy Examination, dynamic balance was measured during walking with triaxial accelerometers positioned on the lower and upper trunk, and symptoms and functional limitations were assessed with standardized self-report measures. The 4 included patients had symptoms of severe dizziness that had lasted more than 1 year after the onset of vestibular dysfunction and a moderate level of perceived disability. Musculoskeletal abnormalities typically included postural misalignment, restricted abdominal respiration, restricted trunk movements, and tense muscles of the upper trunk and neck. The patients attended a modified vestibular rehabilitation program consisting of body awareness exercises addressing posture, movements, and respiration. After the intervention, self-reported symptoms and perceived disability improved. Improvements in mobility and positive physical changes were found in the upper trunk and respiratory movements. The attenuation of mediolateral accelerations (ie, body oscillations) in the upper trunk changed; a relatively more stable upper trunk and a concomitantly more flexible lower trunk were identified during walking in 3 patients. The recovery process may be influenced by self-inflicted rigid body movements and behavior strategies that prevent compensation. Addressing physical dysfunction and enhancing body awareness directly and dizziness indirectly may help patients with unilateral vestibular hypofunction break a self-sustaining cycle of dizziness and musculoskeletal problems. Considering the body as a functional unit and including both musculoskeletal and vestibular systems in examination and treatment may be important. © 2014 American Physical Therapy Association.

PubMed

Salerno, Silvana

2018-02-01

In Italy and in Europe occupational diseases (OD) claims are growing among women, and international studies show women's lower compensation rate. Analysis of occupational diseases compensation rate among "Italian" women (country of birth: Italy) and "immigrant" women (country of birth: not Italy) focusing on biomechanical overload of the upper limb, the most common OD in Italy. INAIL (Italian National Institute for Insurance against Accidents at Work) statistical data (2010-2013) on ascertained OD in Industry-Services (I-S) were analyzed by gender and country of birth with particular attention to biomechanical overload of the upper limb and to occupational diseases not included in the official OD list. A significantly lower compensation rate was found among women (Italy: 39% females vs 43% males; not Italy: 32.5% females vs 36% males). Women's lower success rate was also found for biomechanical overload of the upper limb (Italy: 73% females vs 76% males; not Italy: 64% females vs 70% males), including carpal tunnel syndrome (Italy: 72% females vs 74% males; not Italy: 62% females vs 64% males) and supraspinatus muscle tendinitis (Italy: 71% females vs 79% males; not Italy: 62.5% females vs 72.5% males). Women's claims were more frequent for OD not in the official list (Italy: 53% females vs 51% males; not Italy: 54% females vs 53% males) and had a lower rate of recognition and compensation (Italy: 13% females vs 19% males; not Italy 10% females vs 14% males). Since 2010 women compensation rate has shown a reduction after the initial amelioration in 2008 when biomechanical overload of the upper limb was included in the official list of OD. An overall lower compensation rate among "Italian" and "immigrant" women was found for biomechanical overload disorders of the upper limb and for not officially recognized occupational diseases. Good gender-oriented preventive practices should be promoted.

Triple bar, high efficiency mechanical sealer

DOEpatents

Pak, Donald J.; Hawkins, Samantha A.; Young, John E.

2013-03-19

A clamp with a bottom clamp bar that has a planar upper surface is provided. The clamp may also include a top clamp bar connected to the bottom clamp bar, and a pressure distribution bar between the top clamp bar and the bottom clamp bar. The pressure distribution bar may have a planar lower surface in facing relation to the upper surface of the bottom clamp bar. An object is capable of being disposed in a clamping region between the upper surface and the lower surface. The width of the planar lower surface may be less than the width of the upper surface within the clamping region. Also, the pressure distribution bar may be capable of being urged away from the top clamp bar and towards the bottom clamp bar.

A novel upper limb rehabilitation system with self-driven virtual arm illusion.

PubMed

Aung, Yee Mon; Al-Jumaily, Adel; Anam, Khairul

2014-01-01

This paper proposes a novel upper extremity rehabilitation system with virtual arm illusion. It aims for fast recovery from lost functions of the upper limb as a result of stroke to provide a novel rehabilitation system for paralyzed patients. The system is integrated with a number of technologies that include Augmented Reality (AR) technology to develop game like exercise, computer vision technology to create the illusion scene, 3D modeling and model simulation, and signal processing to detect user intention via EMG signal. The effectiveness of the developed system has evaluated via usability study and questionnaires which is represented by graphical and analytical methods. The evaluation provides with positive results and this indicates the developed system has potential as an effective rehabilitation system for upper limb impairment.

Bioerosion and encrustation: Evidences from the Middle ‒ Upper Jurassic of central Saudi Arabia

NASA Astrophysics Data System (ADS)

El-Hedeny, Magdy; El-Sabbagh, Ahmed; Al Farraj, Saleh

2017-10-01

The Middle ‒ Upper Jurassic hard substrates of central Saudi Arabia displayed considerable signs of bioerosion and encrustations. They include organic (oysters, other bivalves, gastropods, corals and brachiopods) and an inorganic carbonate hardground that marks the boundary between the Middle Jurassic Tuwaiq Mountain Limestone and the Upper Jurassic Hanifa Formation. Traces of bioerosion in organic substrates include seven ichnotaxa produced by bivalves (Gastrochaenolites Leymerie, 1842), polychaete annelids (Trypanites Mägdefrau, 1932; MaeandropolydoraVoigt, 1965 and CaulostrepsisClarke, 1908), sponges (Entobia Bronn, 1837), acrothoracican cirripedes (Rogerella Saint-Seine, 1951), gastropods (Oichnus Bromley, 1981) and probable ?Centrichnus cf. eccentricus. The encrusting epifauna on these substrates consist of several organisms, including oysters, serpulid worms, corals and foraminifera. In contrast, the carbonate hardground was only bioeroded by Gastrochaenolite, Trypanites and Entobia. Epibionts on this hardground include ;Liostrea Douvillé, 1904-type; oysters, Nanogyra nana Sowerby, 1822 and serpulids. In general, bioerosion and encrustation are less diversified in hardground than in organic substrates, indicating a long time of exposition of organic substrates with slow to moderate rate of deposition in a restricted marine environment. Both organic and inorganic commuinities are correlated with those of other equatorial, subtropical and temperate equivalents.

A survey on robotic devices for upper limb rehabilitation

PubMed Central

2014-01-01

The existing shortage of therapists and caregivers assisting physically disabled individuals at home is expected to increase and become serious problem in the near future. The patient population needing physical rehabilitation of the upper extremity is also constantly increasing. Robotic devices have the potential to address this problem as noted by the results of recent research studies. However, the availability of these devices in clinical settings is limited, leaving plenty of room for improvement. The purpose of this paper is to document a review of robotic devices for upper limb rehabilitation including those in developing phase in order to provide a comprehensive reference about existing solutions and facilitate the development of new and improved devices. In particular the following issues are discussed: application field, target group, type of assistance, mechanical design, control strategy and clinical evaluation. This paper also includes a comprehensive, tabulated comparison of technical solutions implemented in various systems. PMID:24401110

Protein Crystal Growth Apparatus for Microgravity

NASA Technical Reports Server (NTRS)

Carter, Daniel C. (Inventor); Dowling, Timothy E. (Inventor)

1997-01-01

Apparatus for growing protein crystals under microgravity environment includes a plurality of protein growth assemblies stacked one above the other within a canister. Each of the protein growth assemblies includes a tray having a number of spaced apart growth chambers recessed below an upper surface. the growth chambers each having an upstanding pedestal and an annular reservoir about the pedestal for receiving a wick and precipitating agents. A well is recessed below the top of each pedestal to define a protein crystal growth receptacle. A flexible membrane is positioned on the upper surface of each tray and a sealing plate is positioned above each membrane, each sealing plate having a number of bumpers corresponding in number and alignment to the pedestals for forcing the membrane selectively against the upper end of the respective pedestal to seal the reservoir and the receptacle when the sealing plate is forced down.

Wireline tool cable head overload apparatus

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

Roessler, D.E.

1990-05-29

This patent describes a cable head adapted to support a sonde in a well borehole. It comprises: an upper end assembly adapted for connection with a cable extending into a well borehole; a lower end assembly adapted for connection to a sonde to be supported by the cable in the well borehole; yieldable means joining the upper and lower assemblies together in a fixed but yieldable relationship wherein a controllable and variable load is imparted to the cable there above during movement and variations in load on the cable are maintained within specified limits; the yieldable means further including deadmore » weight adjustable means notwithstanding variations in the dead weight of the load, and the yieldable means includes resilient means permitting movements within a desired range dependent on the adjustment thereof and bracketing a selected relative position of the upper and lower end assemblies; and an electrical contact.« less

Bone Lengthening in the Pediatric Upper Extremity.

PubMed

Farr, Sebastian; Mindler, Gabriel; Ganger, Rudolf; Girsch, Werner

2016-09-07

➤Bone lengthening has been used successfully for several congenital and acquired conditions in the pediatric clavicle, humerus, radius, ulna, and phalanges.➤Common indications for bone lengthening include achondroplasia, radial longitudinal deficiency, multiple hereditary exostosis, brachymetacarpia, symbrachydactyly, and posttraumatic and postinfectious growth arrest.➤Most authors prefer distraction rates of <1 mm/day for each bone in the upper extremity except the humerus, which can safely be lengthened by 1 mm/day.➤Most authors define success by the amount of radiographic bone lengthening, joint motion after lengthening, and subjective patient satisfaction rather than validated patient-related outcome measures.➤Bone lengthening of the upper extremity is associated with a high complication rate, with complications including pin-track infections, fixation device failure, nerve lesions, nonunion, fracture of regenerate bone, and joint dislocations. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Tooth demineralization and associated factors in patients on fixed orthodontic treatment.

PubMed

Salmerón-Valdés, Elías Nahúm; Lara-Carrillo, Edith; Medina-Solís, Carlo Eduardo; Robles-Bermeo, Norma Leticia; Scougall-Vilchis, Rogelio José; Casanova-Rosado, Juan Fernando; Pontigo-Loyola, América Patricia; Fernández Barrera, Miguel Ángel

2016-11-02

Dental demineralization was determined in patients at three time points during fixed orthodontic treatment. A multiple cross-sectional study included 108 patients divided into three different groups: (1) beginning of orthodontic treatment; (2) one year into treatment; and (3) two years into treatment. Demineralization was estimated using a DIAGNOdent pen. We obtained data from multiple tooth-by-tooth demineralization readings combined with salivary pH and patients' oral hygienic and dietary behaviors. A t-test for independent samples and Spearman´s correlation were performed. No demineralizations differences were found between the initial stage and one year into treatment. Between one and two years small differences were observed, but demineralization increased between the initial stage and second treatment year, predominating in upper right central incisors (p = 0.056), upper left lateral incisors (p = 0.040), both upper canines (p = 0.055 and p = 0.040, respectively) and first left premolars (p = 0.034 and p = 0.053, respectively). We did not find associations between oral hygiene and dietary behaviours or salivary pH. In conclusion, demineralization occurred in first year of treatment and increased during second year, predominating in the upper arch and the left side mainly in upper right central incisors, upper left lateral incisors, both upper canines, and first left premolars.

The upper limit of vulnerability of the heart

NASA Astrophysics Data System (ADS)

Mazeh, Nachaat

Fibrillation is a major cause of death worldwide and it affects a very large part of the population. Its mechanism is not fully understood and the immediate remedy is to defibrillate. While defibrillation has been very successful, defibrillators apply a shock strength that could itself reinduce fibrillation. There exists an upper limit of vulnerability above which a shock does not induce reentry and therefore does not expose the patient to the reinduction of fibrillation. This upper limit of vulnerability has been predicted theoretically and observed experimentally, but the mechanism of the upper limit has not been well understood. This work will investigate the upper limit of vulnerability using a computer simulation. The bidomain model of the cardiac tissue has been used extensively for the past thirty years. The Beeler-Reuter model of the membrane kinetics has also been used in conjunction with the bidomain. This computer simulation of the bidomain and the Beeler-Reuter model will allow us to investigate the response of the induced virtual electrodes necessary to produce reentry. We will look at the vulnerable window and investigate the upper limit above which defibrillators can safely apply any shock strength to stop a fibrillation. One main conclusion is that widespread, random heterogeneities must be included in our model of cardiac tissue in order to predict an upper limit of vulnerability.

Preliminary stratigraphy and facies analysis of the Upper Cretaceous Kaguyak Formation, including a brief summary of newly discovered oil stain, upper Alaska Peninsula

USGS Publications Warehouse

Wartes, Marwan A.; Decker, Paul L.; Stanley, Richard G.; Herriott, Trystan M.; Helmold, Kenneth P.; Gillis, Robert J.

2013-01-01

The Alaska Division of Geological and Geophysical Surveys has an ongoing program aimed at evaluating the Mesozoic forearc stratigraphy, structure, and petroleum systems of lower Cook Inlet. Most of our field studies have focused on the Jurassic component of the petroleum system (this report). However, in late July and early August of 2012, we initiated a study of the stratigraphy and reservoir potential of the Upper Cretaceous Kaguyak Formation. The Kaguyak Formation is locally well exposed on the upper Alaska Peninsula (fig. 25) and was named by Keller and Reiser (1959) for a sequence of interbedded siltstone and sandstone of upper Campanian to Maastrichtian age that they estimated to be 1,450 m thick.Subsequent work by Detterman and Miller (1985) examined 900 m of section and interpreted the unit as the record of a prograding submarine fan.This interpretation of deep-water deposition contrasts with other Upper Cretaceous rocks exposed along the Alaska Peninsula and lower Cook Inlet that are generally described as nonmarine to shallow marine (Detterman and others, 1996; LePain and others, 2012).Based on foraminifera and palynomorphs from the COST No. 1 well, Magoon (1986) concluded that the Upper Cretaceous rocks were deposited in a variety of water depths and environments ranging from upper bathyal to nonmarine. During our recent fieldwork west and south of Fourpeaked Mountain, we similarly encountered markedly varying lithofacies in the Kaguyak Formation (fig. 25), and we also found oil-stained rocks that are consistent with the existence of an active petroleum system in Upper Cretaceous rocks on the upper Alaska Peninsula and in lower Cook Inlet. These field observations are summarized below.

Upper-extremity and mobility subdomains from the Patient-Reported Outcomes Measurement Information System (PROMIS) adult physical functioning item bank.

PubMed

Hays, Ron D; Spritzer, Karen L; Amtmann, Dagmar; Lai, Jin-Shei; Dewitt, Esi Morgan; Rothrock, Nan; Dewalt, Darren A; Riley, William T; Fries, James F; Krishnan, Eswar

2013-11-01

To create upper-extremity and mobility subdomain scores from the Patient-Reported Outcomes Measurement Information System (PROMIS) physical functioning adult item bank. Expert reviews were used to identify upper-extremity and mobility items from the PROMIS item bank. Psychometric analyses were conducted to assess empirical support for scoring upper-extremity and mobility subdomains. Data were collected from the U.S. general population and multiple disease groups via self-administered surveys. The sample (N=21,773) included 21,133 English-speaking adults who participated in the PROMIS wave 1 data collection and 640 Spanish-speaking Latino adults recruited separately. Not applicable. We used English- and Spanish-language data and existing PROMIS item parameters for the physical functioning item bank to estimate upper-extremity and mobility scores. In addition, we fit graded response models to calibrate the upper-extremity items and mobility items separately, compare separate to combined calibrations, and produce subdomain scores. After eliminating items because of local dependency, 16 items remained to assess upper extremity and 17 items to assess mobility. The estimated correlation between upper extremity and mobility was .59 using existing PROMIS physical functioning item parameters (r=.60 using parameters calibrated separately for upper-extremity and mobility items). Upper-extremity and mobility subdomains shared about 35% of the variance in common, and produced comparable scores whether calibrated separately or together. The identification of the subset of items tapping these 2 aspects of physical functioning and scored using the existing PROMIS parameters provides the option of scoring these subdomains in addition to the overall physical functioning score. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Golf and upper limb injuries: a summary and review of the literature

PubMed Central

McHardy, Andrew J; Pollard, Henry P

2005-01-01

Background Golf is a popular past time that provides exercise with social interaction. However, as with all sports and activities, injury may occur. Many golf-related injuries occur in the upper limb, yet little research on the potential mechanisms of these injuries has been conducted. Objective To review the current literature on golf-related upper limb injuries and report on potential causes of injury as it relates to the golf swing. Discussion An overview of the golf swing is described in terms of its potential to cause the frequently noted injuries. Most injuries occur at impact when the golf club hits the ball. This paper concludes that more research into golf-related upper limb injuries is required to develop a thorough understanding of how injuries occur. Types of research include epidemiology studies, kinematic swing analysis and electromyographic studies of the upper limb during golf. By conducting such research, preventative measures maybe developed to reduce golf related injury. PMID:15967021

Upper limits to trace constituents in Jupiter's atmosphere from an analysis of its 5 micrometer spectrum

NASA Technical Reports Server (NTRS)

Treffers, R. R.; Larson, H. P.; Fink, U.; Gautier, T. N.

1978-01-01

A high-resolution spectrum of Jupiter at 5 micrometers recorded at the Kuiper Airborne Observatory is used to determine upper limits to the column density of 19 molecules. The upper limits to the mixing ratios of SiH4, H2S, HCN, and simple hydrocarbons are discussed with respect to current models of Jupiter's atmosphere. These upper limits are compared to expectations based upon the solar abundance of the elements. This analysis permits upper limit measurements (SiH4), or actual detections (GeH4) of molecules with mixing ratios with hydrogen as low as 10 to the minus 9th power. In future observations at 5 micrometers the sensitivity of remote spectroscopic analyses should permit the study of constituents with mixing ratios as low as 10 to the minus 10th power, which would include the hydrides of such elements as Sn and As as well as numerous organic molecules.

Evaluation of nasogastric tubes to enable differentiation between upper and lower gastrointestinal bleeding in unselected patients with melena.

PubMed

Kessel, Boris; Olsha, Oded; Younis, Aurwa; Daskal, Yaakov; Granovsky, Emil; Alfici, Ricardo

2016-02-01

Gastrointestinal (GI) bleeding is a common surgical problem. The aim of this study was to evaluate how insertion of the nasogastric tube may enable differentiation between upper and lower GI bleeding in patients with melena. A retrospective study involving patients admitted to our surgery division with a melena was carried out between the years 2010 and 2012. A total of 386 patients were included in the study. Of these, 279 (72.2%) patients had negative nasogastric aspirate. The sensitivity of examination of nasogastric aspirate to establish the upper GI as the source of bleeding was only 28% and the negative predictive value of a negative nasogastric aspirate was less than 1%. Most patients who initially presented with melena and were found to have upper GI bleeding had a negative nasogastric aspirate. Insertion of a nasogastric tube does not affect the clinical decision to perform upper endoscopy and should not be routinely carried out.

Assessing upper limb function in nonambulant SMA patients: development of a new module.

PubMed

Mazzone, Elena; Bianco, Flaviana; Martinelli, Diego; Glanzman, Allan M; Messina, Sonia; De Sanctis, Roberto; Main, Marion; Eagle, Michelle; Florence, Julaine; Krosschell, Kristin; Vasco, Gessica; Pelliccioni, Marco; Lombardo, Marilena; Pane, Marika; Finkel, Richard; Muntoni, Francesco; Bertini, Enrico; Mercuri, Eugenio

2011-06-01

We report the development of a module specifically designed for assessing upper limb function in nonambulant SMA patients, including young children and those with severe contractures. The application of the module to a preschool cohort of 40 children (age 30-48 months) showed that all the items could be completed by 30 months. The module was also used in 45 nonambulant SMA patients (age 30 months to 27 years). Their scores were more variable than in the preschool cohort, ranging from 0 to 18. The magnitude of scores was not related to age (r=-0.19). The upper limb scores had a good correlation with the Hammersmith Functional Motor Scale, r=0.75, but the upper limb function did not always strictly follow the overall gross motor function. These findings suggest that even some of the very weak nonambulant children possess upper limb skills that can be measured. Copyright © 2011 Elsevier B.V. All rights reserved.

Wii™-habilitation of upper extremity function in children with cerebral palsy. An explorative study.

PubMed

Winkels, Diny G M; Kottink, Anke I R; Temmink, Rutger A J; Nijlant, Juliëtte M M; Buurke, Jaap H

2013-01-01

Commercially available virtual reality systems can possibly support rehabilitation objectives in training upper arm function in children with Cerebral Palsy (CP). The present study explored the effect of the Nintendo Wii™ training on upper extremity function in children with CP. During six weeks, all children received twice a week training with the Wii™, with their most affected arm. The Melbourne Assessment of Upper Limb Function and ABILHAND-Kids were assessed pre- and post- training. In addition, user satisfaction of both children and health professionals was assessed after training. Enjoyment in gaming was scored on a visual analogue scale scale after each session by the children. Fifteen children with CP participated in the study. The quality of upper extremity movements did not change (-2.1, p > 0.05), while a significant increase of convenience in using hands/arms during performance of daily activities was found (0.6, p < 0.05). Daily activities seem to be easier performed after Wii™ training for most of the included children with CP.

Health of white sucker within the St. Louis River area of concern associated with habitat usage as assessed using stable isotopes

EPA Science Inventory

In Spring 2011, 200 adult white sucker were collected in four areas of the St. Louis River Area of Concern (AOC), located in Minnesota and Wisconsin, USA. The areas included the upper AOC as a reference area, the upper estuary, St. Louis Bay and Superior Bay. Grossly visible abno...

Phosphorus losses from an irrigated watershed in the Northwestern U.S.: Case study of the Upper Snake Rock Watershed

USDA-ARS?s Scientific Manuscript database

Watersheds utilizing surface water for irrigation often return a portion of the water to a water body. This irrigation return flow often includes sediment and nutrients that reduce the quality of the receiving water body. Research in the 82,000 ha Upper Snake Rock (USR) watershed from 2005 to 2008 s...

Impact of Explicit Vocabulary Instruction on Writing Achievement of Upper-Intermediate EFL Learners

ERIC Educational Resources Information Center

Solati-Dehkordi, Seyed Amir; Salehi, Hadi

2016-01-01

Studying explicit vocabulary instruction effects on improving L2 learners' writing skill and their short and long-term retention is the purpose of the present study. To achieve the mentioned goal, a fill-in-the-blank test including 36 single words and 60 lexical phrases were administrated to 30 female upper-intermediate EFL learners. The EFL…

49 CFR 572.125 - Upper and lower torso assemblies and torso flexion test procedure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... of the dummy, the pull cable, and the load cell as shown in Figure N5. (7) Apply a tension force in the midsagittal plane to the pull cable as shown in Figure N5 at any upper torso deflection rate... determine the stiffness effects of the lumbar spine (drawing 127-3002), including cable (drawing 127-8095...

About the Lung and Upper Aerodigestive Cancer Research Group | Division of Cancer Prevention

Cancer.gov

The Lung and Upper Aerodigestive Cancer Research Group conducts and supports research on the prevention and early detection of lung and head and neck cancers, as well as new approaches to clinical prevention studies including cancer immunoprevention.Phase 0/I/II Cancer Prevention Clinical Trials ProgramThe group jointly administers the Phase 0/I/II Cancer Prevention Clinical

Identification of Priority Forests in the Upper Mississippi River System: A Summary

Treesearch

Jason Rohweder; Theresa Heyer; Samuel Osinde; Darrell Zastrow; Steve Westin; Al Todd

2007-01-01

The goal of the Upper Mississippi Forest Partnership is to improve water quality and migratory bird habitat by restoring and enhancing forests in the six-state watershed. This document summarizes the results of a GIS analysis that identified forests where allocation of resources would make the most difference. Also included in this document are case studies that...

Forested Communities of the Upper Montane in the Central and Southern Sierra Nevada

Treesearch

Donald A. Potter

1998-01-01

Upper montane forests in the central and southern Sierra Nevada of California were classified into 26 plant associations by using information collected from 0.1-acre circular plots. Within this region, the forested environment including the physiographic setting, geology, soils, and vegetation is described in detail. A simulation model is presented for this portion of...

Review of spectroscopic parameters for upper atmospheric measurements

NASA Technical Reports Server (NTRS)

Smith, M. A. H. (Editor)

1985-01-01

The workshop included communication of spectroscopic data requirements for the planned upper atmosphere research satellite (UARS) mission, review of the status of currently available spectroscopic parameters, and recommendation of additional studies. The objectives were accomplished and resulted in a series of general and specific recommendations for laboratory spectroscopy research to meet the needs of UARS and other atmospheric remote sensing programs.

Hydrogeology, water quality, and saltwater intrusion in the Upper Floridan Aquifer in the offshore area near Hilton Head Island, South Carolina, and Tybee Island, Georgia, 1999-2002

USGS Publications Warehouse

Falls, W. Fred; Ransom, Camille; Landmeyer, James E.; Reuber, Eric J.; Edwards, Lucy E.

2005-01-01

To assess the hydrogeology, water quality, and the potential for saltwater intrusion in the offshore Upper Floridan aquifer, a scientific investigation was conducted near Tybee Island, Georgia, and Hilton Head Island, South Carolina. Four temporary wells were drilled at 7, 8, 10, and 15 miles to the northeast of Tybee Island, and one temporary well was drilled in Calibogue Sound west of Hilton Head Island. The Upper Floridan aquifer at the offshore and Calibogue sites includes the unconsolidated calcareous quartz sand, calcareous quartz sandstone, and sandy limestone of the Oligocene Lazaretto Creek and Tiger Leap Formations, and the limestone of the late Eocene Ocala Limestone and middle Avon Park Formation. At the 7-, 10-, and 15-mile sites, the upper confining unit between the Upper Floridan and surficial aquifers correlates to the Miocene Marks Head Formation. Paleochannel incisions have completely removed the upper confining unit at the Calibogue site and all but a 0.8-foot-thick interval of the confining unit at the 8-mile site, raising concern about the potential for saltwater intrusion through the paleochannel-fill sediments at these two sites. The paleochannel incisions at the Calibogue and 8-mile sites are filled with fine- and coarse-grained sediments, respectively. The hydrogeologic setting and the vertical hydraulic gradients at the 7- and 10-mile sites favored the absence of saltwater intrusion during predevelopment. After decades of onshore water use in Georgia and South Carolina, the 0-foot contour in the regional cone of depression of the Upper Floridan aquifer is estimated to have been at the general location of the 7- and 10-mile sites by the mid-1950s and at or past the 15-mile site by the 1980s. The upward vertical hydraulic gradient reversed, but the presence of more than 17 feet of upper confining unit impeded the downward movement of saltwater from the surficial aquifer to the Upper Floridan aquifer at the 7- and 10-mile sites. At the 10-mile site, the chloride concentration in the Upper Floridan borehole-water sample and the pore-water samples from the Oligocene and Eocene strata support the conclusion of no noticeable modern saltwater intrusion in the Upper Floridan aquifer. The chloride concentration of 370 milligrams per liter in the borehole-water sample at the 7-mile site from the Upper Floridan aquifer at 78 to 135 feet below North American Vertical Datum of 1988 is considerably higher than the chloride concentration of 25 milligrams per liter measured at the 10-mile site. The higher concentration probably is the result of downward leakage of saltwater through the confining unit at the 7-mile site or could reflect downward leakage of saltwater through an even thinner layer of the upper confining unit beneath the paleochannel to the northeast and lateral movement (encroachment) from the paleochannel to the 7-mile site. Carbon-14 concentrations at both sites, however, are low and indicate that most of the water is relict fresh ground water. The hydrogeology at the 15-mile site includes 17 feet of the upper confining unit. The chloride concentration in the Upper Floridan aquifer is 6,800 milligrams per liter. The setting for the Upper Floridan aquifer beneath the 15-mile site is interpreted as a transitional mixing zone between relict freshwater and relict saltwater. At the Calibogue site, 35 feet of fine-grained paleochannel-fill sediments overlies the Oligocene strata of the Upper Floridan aquifer. The vertical hydraulic conductivity of the paleochannel fill at this site is similar to the upper confining unit and effectively replaces the missing upper confining unit. Chloride concentrations and low carbon-14 and tritium concentrations in borehole water from the Upper Floridan aquifer, and low chloride concentrations in pore water from the upper confining unit indicate relict freshwater confined in the Upper Floridan aquifer at the Calibogue site. The coarse-grained paleochannel-f

The benthic macrofauna from the Lower Maastrichtian chalk of Kronsmoor (northern Germany, Saturn quarry): taxonomic outline and palaeoecologic implications

NASA Astrophysics Data System (ADS)

Engelke, Julia; Esser, Klaus J. K.; Linnert, Christian; Mutterlose, Jörg; Wilmsen, Markus

2016-12-01

The benthic macroinvertebrates of the Lower Maastrichtian chalk of Saturn quarry at Kronsmoor (northern Germany) have been studied taxonomically based on more than 1,000 specimens. Two successive benthic macrofossil assemblages were recognised: the lower interval in the upper part of the Kronsmoor Formation (Belemnella obtusa Zone) is characterized by low abundances of macroinvertebrates while the upper interval in the uppermost Kronsmoor and lowermost Hemmoor formations (lower to middle Belemnella sumensis Zone) shows a high macroinvertebrate abundance (eight times more than in the B. obtusa Zone) and a conspicuous dominance of brachiopods. The palaeoecological analysis of these two assemblages indicates the presence of eight different guilds, of which epifaunal suspension feeders (fixo-sessile and libero-sessile guilds), comprising approximately half of the trophic nucleus of the lower interval, increased to a dominant 86% in the upper interval, including a considerable proportion of rhynchonelliform brachiopods. It is tempting to relate this shift from the lower to the upper interval to an increase in nutrient supply and/or a shallowing of the depositional environment but further data including geochemical proxies are needed to fully understand the macrofossil distribution patterns in the Lower Maastrichtian of Kronsmoor.

Investigation of shortcomings in simulated aerosol vertical profiles

NASA Astrophysics Data System (ADS)

Park, S.; Allen, R.

2017-12-01

The vertical distribution of aerosols is one important factor for aerosol radiative forcing. Previous studies show that climate models poorly reproduce the aerosol vertical profile, with too much aerosol aloft in the upper troposphere. This bias may be related to several factors, including excessive convective mass flux and wet removal. In this study, we evaluate the aerosol vertical profile from several Coupled Model Intercomparison Project 5 (CMIP5) models, as well as the Community Atmosphere Model 5 (CAM5), relative to the Cloud-Aerosol Lidar Infrared Pathfinder Satellite Observation (CALIPSO). The results show that all models significantly underestimate extinction coefficient in the lower troposphere, while overestimating extinction coefficient in the upper troposphere. In addition, the majority of models indicate a land-ocean dependence in the relationship between aerosol extinction coefficient in the upper troposphere and convective mass flux. Over the continents, more convective mass flux is related to more aerosol aloft; over the ocean, more convective mass flux is associated with less aerosol in upper troposphere. Sensitivity experiments are conducted to investigate the role that convection and wet deposition have in contributing to the deficient simulation of the vertical aerosol profile, including the land-ocean dependence.

Non-intrusive cooling system

DOEpatents

Morrison, Edward F.; Bergman, John W.

2001-05-22

A readily replaceable heat exchange cooling jacket for applying fluid to a system conduit pipe. The cooling jacket comprises at least two members, separable into upper and lower portions. A chamber is formed between the conduit pipe and cooling jacket once the members are positioned about the pipe. The upper portion includes a fluid spray means positioned above the pipe and the bottom portion includes a fluid removal means. The heat exchange cooling jacket is adaptable with a drain tank, a heat exchanger, a pump and other standard equipment to provide a system for removing heat from a pipe. A method to remove heat from a pipe, includes the steps of enclosing a portion of the pipe with a jacket to form a chamber between an outside surface of the pipe and the cooling jacket; spraying cooling fluid at low pressure from an upper portion of the cooling jacket, allowing the fluid to flow downwardly by gravity along the surface of the pipe toward a bottom portion of the chamber; and removing the fluid at the bottom portion of the chamber.

Use of clickers and sustainable reform in upper-division physics courses

NASA Astrophysics Data System (ADS)

Dubson, Michael

2008-03-01

At the University of Colorado at Boulder, successful reforms of our freshmen and sophomore-level physics courses are now being extended to upper-division courses, including Mechanics, Math Methods, QM, E&M, and Thermal Physics. Our course reforms include clicker questions (ConcepTests) in lecture, peer instruction, and an added emphasis on conceptual understanding and qualitative reasoning on homework assignments and exams. Student feedback has been strongly positive, and I will argue that such conceptual training improves rather than dilutes, traditional, computationally-intensive problem-solving skills. In order for these reforms to be sustainable, reform efforts must begin with department-wide consensus and agreed-upon measures of success. I will discuss the design of good clicker questions and effective incorporation into upper-level courses, including examples from materials science. Condensed matter physics, which by nature involve intelligent use of approximation, particularly lends itself to conceptual training. I will demonstrate the use of a clicker system (made by iClicker) with audience-participation questions. Come prepared to think and interact, rather than just sit there!

[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.

Eighteen-point abobotulinum toxin a upper face rejuvenation: an eye plastic perspective on 845 subjects.

PubMed

Kashkouli, Mohsen Bahmani; Amani, Afsaneh; Jamshidian-Tehrani, Mansooreh; Yousefi, Sahar; Jazayeri, Anis Alsadat

2014-01-01

To report the method and results of 18-point Abobotulinum toxin A (ABO-BTA, Dysport) upper face rejuvenation on 845 subjects. In a retrospective chart review, all subjects (the first cycle of injection) with ABO-BTA upper face rejuvenation from 2003 to 2009 were included. Excluded were subjects with facial spastic disorders, injection after upper face lifting, and aberrant regeneration of facial nerves. Upper face rejuvenation included 18 points of injection at forehead creases (4), frown lines (5), bunny line (1), crow's feet (4 on both sides), and lower eyelid crease (4 on both sides). They were revisited in 10 to 14 days for assessment of the effects and possible touch-up injection. Demographics, year of injection, topical anesthetic usage, touch-up injection, and adverse effects (AE) were recorded. There were 845 subjects (85.8% women) whose age was below 40 in 49.3%. All but 68 (8%) were happy with the touch-up visit, 10 to 14 days after injection. Touch-up injection was performed in 8% of subjects mainly for the eyebrow asymmetry. AE (22/845, 2.6%) were bruise (15/845, 1.8%), blepharoptosis (3/845, 0.3%), remained eyebrow asymmetry after touch-up injection (2/845, 0.2%), and headache (2/845, 0.2%). They were significantly more in subjects with touch-up injection, younger than 40 years, and in the first and second year of experience (especially for the bruise). Eighteen-point ABO-BTA upper face rejuvenation had a low rate of AE in this series in which majority was bruise at the lateral canthal area. They were significantly more in the first years of experience, subjects younger than 40, and who had touch-up injections.

Rehabilitation of Upper Limb in Children with Acquired Brain Injury: A Preliminary Comparative Study.

PubMed

Beretta, Elena; Cesareo, Ambra; Biffi, Emilia; Schafer, Carolyn; Galbiati, Sara; Strazzer, Sandra

2018-01-01

Acquired brain injuries (ABIs) can lead to a wide range of impairments, including weakness or paralysis on one side of the body known as hemiplegia. In hemiplegic patients, the rehabilitation of the upper limb skills is crucial, because the recovery has an immediate impact on patient quality of life. For this reason, several treatments were developed to flank physical therapy (PT) and improve functional recovery of the upper limbs. Among them, Constraint-Induced Movement Therapy (CIMT) and robot-aided therapy have shown interesting potentialities in the rehabilitation of the hemiplegic upper limb. Nevertheless, there is a lack of quantitative evaluations of effectiveness in a standard clinical setting, especially in children, as well as a lack of direct comparative studies between these therapeutic techniques. In this study, a group of 18 children and adolescents with hemiplegia was enrolled and underwent intensive rehabilitation treatment including PT and CIMT or Armeo®Spring therapy. The effects of the treatments were assessed using clinical functional scales and upper limb kinematic analysis during horizontal and vertical motor tasks. Results showed CIMT to be the most effective in terms of improved functional scales, while PT seemed to be the most significant in terms of kinematic variations. Specifically, PT resulted to have positive influence on distal movements while CIMT conveyed more changes in the proximal kinematics. Armeo treatment delivered improvements mainly in the vertical motor task, showing trends of progresses of the movement efficiency and reduction of compensatory movements of the shoulder with respect to other treatments. Therefore, every treatment gave advantages in a specific and different upper limb district. Therefore, results of this preliminary study may be of help to define the best rehabilitation treatment for each patient, depending on the goal, and may thus support clinical decision.

Improvements in current treatments and emerging therapies for adult obstructive sleep apnea

PubMed Central

2014-01-01

Obstructive sleep apnea (OSA) is common and is associated with a number of adverse outcomes, including an increased risk for cardiovascular disease. Typical treatment approaches, including positive airway pressure, oral appliances, various upper airway surgeries, and/or weight loss, can improve symptoms and reduce the severity of disease in select patient groups. However, these approaches have several potential limitations, including suboptimal adherence, lack of suitability for all patient groups, and/or absence of adequate outcomes data. Emerging potential therapeutic options, including nasal expiratory positive airway pressure (PAP), oral negative pressure, upper airway muscle stimulation, and bariatric surgery, as well as improvements in existing treatments and the utilization of improving technologies are moving the field forward and should offer effective therapies to a wider group of patients with OSA. PMID:24860658

Accuracy of a disability instrument to identify workers likely to develop upper extremity musculoskeletal disorders.

PubMed

Stover, Bert; Silverstein, Barbara; Wickizer, Thomas; Martin, Diane P; Kaufman, Joel

2007-06-01

Work related upper extremity musculoskeletal disorders (MSD) result in substantial disability, and expense. Identifying workers or jobs with high risk can trigger intervention before workers are injured or the condition worsens. We investigated a disability instrument, the QuickDASH, as a workplace screening tool to identify workers at high risk of developing upper extremity MSDs. Subjects included workers reporting recurring upper extremity MSD symptoms in the past 7 days (n = 559). The QuickDASH was reasonably accurate at baseline with sensitivity of 73% for MSD diagnosis, and 96% for symptom severity. Specificity was 56% for diagnosis, and 53% for symptom severity. At 1-year follow-up sensitivity and specificity for MSD diagnosis was 72% and 54%, respectively, as predicted by the baseline QuickDASH score. For symptom severity, sensitivity and specificity were 86% and 52%. An a priori target sensitivity of 70% and specificity of 50% was met by symptom severity, work pace and quality, and MSD diagnosis. The QuickDASH may be useful for identifying jobs or workers with increased risk for upper extremity MSDs. It may provide an efficient health surveillance screening tool useful for targeting early workplace intervention for prevention of upper extremity MSD problems.

Common data items in seven European oesophagogastric cancer surgery registries: towards a European upper GI cancer audit (EURECCA Upper GI).

PubMed

de Steur, W O; Henneman, D; Allum, W H; Dikken, J L; van Sandick, J W; Reynolds, J; Mariette, C; Jensen, L; Johansson, J; Kolodziejczyk, P; Hardwick, R H; van de Velde, C J H

2014-03-01

Seven countries (Denmark, France, Ireland, the Netherlands, Poland, Sweden, United Kingdom) collaborated to initiate a EURECCA (European Registration of Cancer Care) Upper GI project. The aim of this study was to identify a core dataset of shared items in the different data registries which can be used for future collaboration between countries. Item lists from all participating Upper GI cancer registries were collected. Items were scored 'present' when included in the registry, or when the items could be deducted from other items in the registry. The definition of a common item was that it was present in at least six of the seven participating countries. The number of registered items varied between 40 (Poland) and 650 (Ireland). Among the 46 shared items were data on patient characteristics, staging and diagnostics, neoadjuvant treatment, surgery, postoperative course, pathology, and adjuvant treatment. Information on non-surgical treatment was available in only 4 registries. A list of 46 shared items from seven participating Upper GI cancer registries was created, providing a basis for future quality assurance and research in Upper GI cancer treatment on a European level. Copyright © 2013 Elsevier Ltd. All rights reserved.

Development and initial psychometric evaluation of an item bank created to measure upper extremity function in persons with stroke.

PubMed

Higgins, Johanne; Finch, Lois E; Kopec, Jacek; Mayo, Nancy E

2010-02-01

To create and illustrate the development of a method to parsimoniously and hierarchically assess upper extremity function in persons after stroke. Data were analyzed using Rasch analysis. Re-analysis of data from 8 studies involving persons after stroke. Over 4000 patients with stroke who participated in various studies in Montreal and elsewhere in Canada. Data comprised 17 tests or indices of upper extremity function and health-related quality of life, for a total of 99 items related to upper extremity function. Tests and indices included, among others, the Box and Block Test, the Nine-Hole Peg Test and the Stroke Impact Scale. Data were collected at various times post-stroke from 3 days to 1 year. Once the data fit the model, a bank of items measuring upper extremity function with persons and items organized hierarchically by difficulty and ability in log units was produced. This bank forms the basis for eventual computer adaptive testing. The calibration of the items should be tested further psychometrically, as should the interpretation of the metric arising from using the item calibration to measure the upper extremity of individuals.

Combined treatment of botulinumtoxin and robot-assisted rehabilitation therapy on poststroke, upper limb spasticity

PubMed Central

Lee, So Young; Jeon, Young Tae; Kim, Bo Ryun; Han, Eun Young

2017-01-01

Abstract Rationale: Spasticity is a major complication after stroke, and botulinumtoxin A (BoNT-A) injection is commonly used to manage focal spasticity. However, it is uncertain whether BoNT-A can improve voluntary motor control or activities of daily living function of paretic upper limbs. This study investigated whether BoNT-A injection combined with robot-assisted upper limb therapy improves voluntary motor control or functions of upper limbs after stroke. Patient concerns: Two subacute stroke patients were transferred to the Department of Rehabilitation. Diagnoses: Patients demonstrated spasticity in the upper extremity on the affected side. Interventions: BoNT-A was injected into the paretic muscles of the shoulder, arm, and forearm of the 2 patients at the subacute stage. Conventional rehabilitation therapy and robot-assisted upper limb training were performed during the rehabilitation period. Outcomes: Manual dexterity, grip strength, muscle tone, and activities of daily living function were improved after multidisciplinary rehabilitation treatment. Lessons: BoNT-A injection in combination with multidisciplinary rehabilitation treatment, including robot-assisted arm training, should be recommended for subacute spastic stroke patients to enhance appropriate motor recovery. PMID:29390585

Portable upper extremity robotics is as efficacious as upper extremity rehabilitative therapy: a randomized controlled pilot trial.

PubMed

Page, Stephen J; Hill, Valerie; White, Susan

2013-06-01

To compare the efficacy of a repetitive task-specific practice regimen integrating a portable, electromyography-controlled brace called the 'Myomo' versus usual care repetitive task-specific practice in subjects with chronic, moderate upper extremity impairment. Sixteen subjects (7 males; mean age 57.0 ± 11.02 years; mean time post stroke 75.0 ± 87.63 months; 5 left-sided strokes) exhibiting chronic, stable, moderate upper extremity impairment. Subjects were administered repetitive task-specific practice in which they participated in valued, functional tasks using their paretic upper extremities. Both groups were supervised by a therapist and were administered therapy targeting their paretic upper extremities that was 30 minutes in duration, occurring 3 days/week for eight weeks. One group participated in repetitive task-specific practice entirely while wearing the portable robotic, while the other performed the same activity regimen manually. The upper extremity Fugl-Meyer, Canadian Occupational Performance Measure and Stroke Impact Scale were administered on two occasions before intervention and once after intervention. After intervention, groups exhibited nearly identical Fugl-Meyer score increases of ≈2.1 points; the group using robotics exhibited larger score changes on all but one of the Canadian Occupational Performance Measure and Stroke Impact Scale subscales, including a 12.5-point increase on the Stroke Impact Scale recovery subscale. Findings suggest that therapist-supervised repetitive task-specific practice integrating robotics is as efficacious as manual practice in subjects with moderate upper extremity impairment.

PROPOSAL OF A CLINICAL CARE PATHWAY FOR THE MANAGEMENT OF ACUTE UPPER GASTROINTESTINAL BLEEDING.

PubMed

Franco, Matheus Cavalcante; Nakao, Frank Shigueo; Rodrigues, Rodrigo; Maluf-Filho, Fauze; Paulo, Gustavo Andrade de; Libera, Ermelindo Della

2015-12-01

Upper gastrointestinal bleeding implies significant clinical and economic repercussions. The correct establishment of the latest therapies for the upper gastrointestinal bleeding is associated with reduced in-hospital mortality. The use of clinical pathways for the upper gastrointestinal bleeding is associated with shorter hospital stay and lower hospital costs. The primary objective is the development of a clinical care pathway for the management of patients with upper gastrointestinal bleeding, to be used in tertiary hospital. It was conducted an extensive literature review on the management of upper gastrointestinal bleeding, contained in the primary and secondary information sources. The result is a clinical care pathway for the upper gastrointestinal bleeding in patients with evidence of recent bleeding, diagnosed by melena or hematemesis in the last 12 hours, who are admitted in the emergency rooms and intensive care units of tertiary hospitals. In this compact and understandable pathway, it is well demonstrated the management since the admission, with definition of the inclusion and exclusion criteria, passing through the initial clinical treatment, posterior guidance for endoscopic therapy, and referral to rescue therapies in cases of persistent or rebleeding. It was also included the care that must be taken before hospital discharge for all patients who recover from an episode of bleeding. The introduction of a clinical care pathway for patients with upper gastrointestinal bleeding may contribute to standardization of medical practices, decrease in waiting time for medications and services, length of hospital stay and costs.

Focal Dystonia in Hemiplegic Upper Limb: Favorable Effect of Cervical Microsurgical DREZotomy Involving the Ventral Horn - A Report of 3 Patients.

PubMed

Sindou, Marc; Georgoulis, George

2016-01-01

Focal dystonia in hemiplegic upper limbs is poorly responsive to medications or classical neurosurgical treatments. Only repeated botulinum toxin injections show efficacy, but in most severe cases effects are transient. Cervical DREZ lesioning, which has proven efficacious in hyperspasticity when done deeply (3-5 mm) in the dorsal horn, may have favorable effects on the dystonic component when performed down to, and including, the base of the ventral horn (5-6 mm in depth). Three patients underwent deep cervical microsurgical DREZotomy (MDT) for focal dystonia in the upper limb. Hypertonia was reduced, and sustained dystonic postures were suppressed. Residual motor function (hidden behind hypertonia) came to the surface. Cervical MDT may be a useful armamentarium for treating refractory focal dystonia in the upper limb. © 2016 S. Karger AG, Basel.

BOREAS AFM-5 Level-1 Upper Air Network Data

NASA Technical Reports Server (NTRS)

Barr, Alan; Hrynkiw, Charmaine; Newcomer, Jeffrey A. (Editor); Hall, Forrest G. (Editor); Smith, David E. (Technical Monitor)

2000-01-01

The Boreal Ecosystem-Atmosphere Study (BOREAS) Airborne Fluxes and Meteorology (AFM)-5 team collected and processed data from the numerous radiosonde flights during the project. The goals of the AFM-05 team were to provide large-scale definition of the atmosphere by supplementing the existing Atmospheric Environment Service (AES) aerological network, both temporally and spatially. This data set includes basic upper-air parameters collected from the network of upper-air stations during the 1993, 1994, and 1996 field campaigns over the entire study region. The data are contained in tabular ASCII files. The level-1 upper-air network data are available from the Earth Observing System Data and Information System (EOSDIS) Oak Ridge National Laboratory (ORNL) Distributed Active Archive Center (DAAC). The data files also are available on a CD-ROM (see document number 20010000884).

Prior esophagogastroduodenoscopy does not affect the cecal intubation time at bidirectional endoscopies

PubMed Central

Öner, Osman Zekai; Demirci, Rojbin Karakoyun; Gündüz, Umut Rıza; Aslaner, Arif; Koç, Ümit; Bülbüller, Nurullah

2013-01-01

Bidirectional endoscopy (BE) is often used to assess patients for the reason of anemia or to screen asymptomatic population for malignancy. Limited clinical data favors to perform first the upper gastrointestinal system endoscopy, but its effect to the duration of colonoscopy is yet to be determined. The aim of this retrospective study is to evaluate the effect of upper gastrointestinal system endoscopy on the time to achieve cecal intubation during colonoscopy in patients undergoing BE. Patients of four endoscopists at similar experience levels were retrospectively identified and categorized into the upper gastrointestinal system endoscopy before colonoscopy group (group 1) or the colonoscopy only group (group 2). The demographics, clinical data and the time to achieve cecal intubation for each patient were analyzed. The mean time to achieve cecal intubation in the first group that included 319 cases was 8.4 ± 0.93 minutes and the mean time in the second group that included 1672 cases was 8.56 ± 1.16 minutes. There was no statistically significant difference between the groups. There was also no significant difference between the Group 1 and Group 2 when compared according to which of the four endoscopists performed the procedures. Performing the upper gastrointestinal system endoscopy prior to colonoscopy did not affect the time to achieve cecal intubation. Considering that performing the upper gastrointestinal system endoscopy prior to the colonoscopy is more advantageous in terms of patient comfort and analgesic requirement, beginning to BE with it seems more favorable. PMID:23936601

Effect of outflow on spring and summertime distribution and abundance of larval and juvenile fishes in the upper San Francisco Estuary

USGS Publications Warehouse

Dege, M.; Brown, L.R.

2004-01-01

We analyzed data on spring and summertime larval and juvenile fish distribution and abundance in the upper San Francisco Estuary (SFE), California between 1995 and 2001. The upper SFE includes the tidal freshwater areas of the Sacramento-San Joaquin Delta downstream to the euryhaline environment of San Pablo Bay. The sampling period included years with a variety of outflow conditions. Fifty taxa were collected using a larval tow net. Two common native species, delta smelt Hypomesus transpacifucus and longfin smelt Spirinchus thaleichthys, and four common alien taxa, striped bass Morone saxatilis, threadfin shad Dorosoma petenense, gobies of the genus Tridentiger, and yellowfin goby Acanthogobins flavimanus, were selected for detailed analysis. Outflow conditions had a strong influence on the geographic distribution of most of the species, but distribution with respect to the 2 psu isohaline (X2) was not affected. The distribution patterns of delta smelt, longfin smelt, and striped bass were consistent with larvae moving from upstream freshwater spawning areas to down-stream estuarine rearing areas. There were no obvious relationships of outflow with annual abundance indices. Our results support the idea of using X2 as an organizing principle in understanding the ecology of larval fishes in the upper SFE. Additional years of sampling will likely lead to additional insights into the early life history of upper SFE fishes. ?? Copyright by the American Fisheries Society 2004.

C-reactive protein as a prognostic indicator for rebleeding in patients with nonvariceal upper gastrointestinal bleeding.

PubMed

Lee, Han Hee; Park, Jae Myung; Lee, Soon-Wook; Kang, Seung Hun; Lim, Chul-Hyun; Cho, Yu Kyung; Lee, Bo-In; Lee, In Seok; Kim, Sang Woo; Choi, Myung-Gyu

2015-05-01

In patients with acute nonvariceal upper gastrointestinal bleeding, rebleeding after an initial treatment is observed in 10-20% and is associated with mortality. To investigate whether the initial serum C-reactive protein level could predict the risk of rebleeding in patients with acute nonvariceal upper gastrointestinal bleeding. This was a retrospective study using prospectively collected data for upper gastrointestinal bleeding. Initial clinical characteristics, endoscopic features, and C-reactive protein levels were compared between those with and without 30-day rebleeding. A total of 453 patients were included (mean age, 62 years; male, 70.9%). The incidence of 30-day rebleeding was 15.9%. The mean serum C-reactive protein level was significantly higher in these patients than in those without rebleeding (P<0.001). The area under the receiver operating characteristics curve with a cutoff value of 0.5mg/dL was 0.689 (P<0.001). High serum C-reactive protein level (odds ratio, 2.98; confidence interval, 1.65-5.40) was independently associated with the 30-day rebleeding risk after adjustment for the main confounding risk factors, including age, blood pressure, and initial haemoglobin level. The serum C-reactive protein was an independent risk factor for 30-day rebleeding in patients with acute nonvariceal upper gastrointestinal bleeding, indicating a possible role as a useful screening indicator for predicting the risk of rebleeding. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Predictors for the need for endoscopic therapy in patients with presumed acute upper gastrointestinal bleeding.

PubMed

Kim, Su Sun; Kim, Kyung Up; Kim, Sung Jun; Seo, Seung In; Kim, Hyoung Su; Jang, Myoung Kuk; Kim, Hak Yang; Shin, Woon Geon

2017-12-15

Selecting patients with an urgent need for endoscopic hemostasis is difficult based only on simple parameters of presumed acute upper gastrointestinal bleeding. This study assessed easily applicable factors to predict cases in need of urgent endoscopic hemostasis due to acute upper gastrointestinal bleeding. The consecutively included patients were divided into the endoscopic hemostasis and nonendoscopic hemostasis groups. We reviewed the enrolled patients' medical records and analyzed various variables and parameters for acute upper gastrointestinal bleeding outcomes such as demographic factors, comorbidities, symptoms, signs, laboratory findings, rebleeding rate, and mortality to evaluate simple predictive factors for endoscopic treatment. A total of 613 patients were analyzed, including 329 patients in the endoscopic hemostasis and 284 patients in the non-endoscopic hemostasis groups. In the multivariate analysis, a bloody nasogastric lavage (adjusted odds ratio [AOR], 6.786; 95% confidence interval [CI], 3.990 to 11.543; p < 0.0001) and a hemoglobin level less than 8.6 g/dL (AOR, 1.768; 95% CI, 1.028 to 3.039; p = 0.039) were independent predictors for endoscopic hemostasis. Significant differences in the morbidity rates of endoscopic hemostasis were detected between the group with no predictive factors and the group with one or more predictive factors (OR, 2.677; 95% CI, 1.920 to 3.733; p < 0.0001). A bloody nasogastric lavage and hemoglobin < 8.6 g/dL were independent predictors of endoscopic hemostasis in patients with acute upper gastrointestinal bleeding.

Vertebrate paleontological exploration of the Upper Cretaceous succession in the Dakhla and Kharga Oases, Western Desert, Egypt

NASA Astrophysics Data System (ADS)

Sallam, Hesham M.; O'Connor, Patrick M.; Kora, Mahmoud; Sertich, Joseph J. W.; Seiffert, Erik R.; Faris, Mahmoud; Ouda, Khaled; El-Dawoudi, Iman; Saber, Sara; El-Sayed, Sanaa

2016-05-01

The Campanian and Maastrichtian stages are very poorly documented time intervals in Africa's record of terrestrial vertebrate evolution. Upper Cretaceous deposits exposed in southern Egypt, near the Dakhla and Kharga Oases in the Western Desert, preserve abundant vertebrate fossils in nearshore marine environments, but have not yet been the focus of intensive collection and description. Our recent paleontological work in these areas has resulted in the discovery of numerous new vertebrate fossil-bearing localities within the middle Campanian Qusier Formation and the upper Campanian-lower Maastrichtian Duwi Formation. Fossil remains recovered from the Campanian-aged Quseir Formation include sharks, rays, actinopterygian and sarcopterygian fishes, turtles, and rare terrestrial archosaurians, including some of the only dinosaurs known from this interval on continental Africa. The upper Campanian/lower Maastrichtian Duwi Formation preserves sharks, sawfish, actinopterygians, and marine reptiles (mosasaurs and plesiosaurs). Notably absent from these collections are representatives of Mammalia and Avialae, both of which remain effectively undocumented in the Upper Cretaceous rocks of Africa and Arabia. New age constraints on the examined rock units is provided by 23 nannofossil taxa, some of which are reported from the Duwi Formation for the first time. Fossil discoveries from rock units of this age are essential for characterizing the degree of endemism that may have developed as the continent became increasingly tectonically isolated from the rest of Gondwana, not to mention for fully evaluating origin and diversification hypotheses of major modern groups of vertebrates (e.g., crown birds, placental mammals).

Causes of complexity in a fallout dominated plinian eruption sequence: 312 ka Fasnia Member, Diego Hernández Formation, Tenerife, Spain

NASA Astrophysics Data System (ADS)

Edgar, C. J.; Cas, R. A. F.; Olin, P. H.; Wolff, J. A.; Martí, J.; Simmons, J. M.

2017-10-01

The 312 ka Fasnia eruption from the Las Cañadas Caldera on Tenerife, Canary Islands, Spain, produced a complex sequence of twenty-two intercalated units, including 7 pumice fall, 7 ignimbrite and 8 ash surge and fall deposits that define two distinct eruption sequences (Lower and Upper Fasnia sequences). The fallout units themselves are internally complex, reflecting waxing and waning of the eruption column, while many of the ignimbrites reflect multiple intra-plinian partial column collapse events associated with the injection of lithic clasts into the eruption column. The Lower and Upper Fasnia eruption phases were each terminated by caldera collapse and complete column collapse events. Probable blockage of the conduit and vent system during Lower Fasnia caldera collapse event briefly terminated the eruption, resulting in a short-lived period of erosion and sedimentation prior to the onset of the Upper Fasnia phase. The transition to the Upper Fasnia eruption phase coincided with the eruption of more geochemically homogeneous pyroclasts. In total, 62 km3 of tephra were erupted, including 49 km3 of juvenile clasts and > 12 km3 of lithic clasts. The DRE volume of magma erupted was 13 km3 (Lower Fasnia > 5 km3, Upper Fasnia > 8 km3), two thirds of which ( 9-10 km3) was deposited purely by fallout. The Fasnia Member is one of the most complex plinian sequences known.

Visualisation of upper limb activity using spirals: A new approach to the assessment of daily prosthesis usage.

PubMed

Chadwell, Alix; Kenney, Laurence; Granat, Malcolm; Thies, Sibylle; Head, John S; Galpin, Adam

2018-02-01

Current outcome measures used in upper limb myoelectric prosthesis studies include clinical tests of function and self-report questionnaires on real-world prosthesis use. Research in other cohorts has questioned both the validity of self-report as an activity assessment tool and the relationship between clinical functionality and real-world upper limb activity. Previously, 1 we reported the first results of monitoring upper limb prosthesis use. However, the data visualisation technique used was limited in scope. Methodology development. To introduce two new methods for the analysis and display of upper limb activity monitoring data and to demonstrate the potential value of the approach with example real-world data. Upper limb activity monitors, worn on each wrist, recorded data on two anatomically intact participants and two prosthesis users over 1 week. Participants also filled in a diary to record upper limb activity. Data visualisation was carried out using histograms, and Archimedean spirals to illustrate temporal patterns of upper limb activity. Anatomically intact participants' activity was largely bilateral in nature, interspersed with frequent bursts of unilateral activity of each arm. At times when the prosthesis was worn prosthesis users showed very little unilateral use of the prosthesis (≈20-40 min/week compared to ≈350 min/week unilateral activity on each arm for anatomically intact participants), with consistent bias towards the intact arm throughout. The Archimedean spiral plots illustrated participant-specific patterns of non-use in prosthesis users. The data visualisation techniques allow detailed and objective assessment of temporal patterns in the upper limb activity of prosthesis users. Clinical relevance Activity monitoring offers an objective method for the assessment of upper limb prosthesis users' (PUs) activity outside of the clinic. By plotting data using Archimedean spirals, it is possible to visualise, in detail, the temporal patterns of upper limb activity. Further work is needed to explore the relationship between traditional functional outcome measures and real-world prosthesis activity.

Flap noise measurements for STOL configurations using external upper surface blowing

NASA Technical Reports Server (NTRS)

Dorsch, R. G.; Reshotko, M.; Olsen, W. A.

1972-01-01

Screening tests of upper surface blowing on externally blown flaps configurations were conducted. Noise and turning effectiveness data were obtained with small-scale, engine-over-the-wing models. One large model was tested to determine scale effects. Nozzle types included circular, slot, D-shaped, and multilobed. Tests were made with and without flow attachment devices. For STOL applications the particular multilobed mixer and the D-shaped nozzles tested were found to offer little or no noise advantage over the round convergent nozzle. High aspect ratio slot nozzles provided the quietest configurations. In general, upper surface blowing was quieter than lower surface blowing for equivalent EBF models.

Forestry as a possible solution to the environmental and energy difficulties facing semi-arid Africa. The case of Upper Volta

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

Weinstabel, P.E.; Zech, W.

1982-01-01

The total annual demand for wood in Upper Volta is about 4.2 million cubic m solid wood, 94% of the population depends on wood for energy (compared with 84% in the Sahel states as a whole), and more than 30% of income in urban areas is spent on acquiring wood. Any policy aimed at securing adequate food supplies for the population must therefore be accompanied by a programme for safeguarding energy supplies. Measures which should be included in an integrated energy programme are presented and details are given of Upper Volta's forestry programme. 21 references.

Gasket with pushrod retainer

DOEpatents

Knudsen, Julian R.; Welch, Christopher B.

2005-04-26

In an engine having a rocker member adapted to rock about an axis intermediate the rocker member and a pushrod extending from a lower body to an upper body and engaging an end of the rocker member, a gasket for sealing the lower body to the upper body is provided. The gasket includes a sealing portion adapted to substantially seal at least a portion of the upper body to the lower body, and a pushrod support portion extending outwardly from the sealing portion adapted to engage the pushrod. At least a portion of the pushrod support portion engaging the pushrod is constructed from a material that is softer than the material of the pushrod.

Subsystem Hazard Analysis Methodology for the Ares I Upper Stage Source Controlled Items

NASA Technical Reports Server (NTRS)

Mitchell, Michael S.; Winner, David R.

2010-01-01

This article describes processes involved in developing subsystem hazard analyses for Source Controlled Items (SCI), specific components, sub-assemblies, and/or piece parts, of the NASA ARES I Upper Stage (US) project. SCIs will be designed, developed and /or procured by Boeing as an end item or an off-the-shelf item. Objectives include explaining the methodology, tools, stakeholders and products involved in development of these hazard analyses. Progress made and further challenges in identifying potential subsystem hazards are also provided in an effort to assist the System Safety community in understanding one part of the ARES I Upper Stage project.

Interfingering of the Frontier Formation and Aspen Shale, Cumberland Gap, Wyoming.

USGS Publications Warehouse

M'gonigle, J.

1982-01-01

The basal part, or the Chalk Creek Member, of the non-marine lower Frontier Formation (Upper Cretaceous) includes a thin coal bed that grades S into a carbonaceous shale. The latter plus associated sandstones and shales pinch out S of Cumberland Gap and lie stratigraphically below the top of the Aspen Shale. The beds in the upper part of the Aspen, in turn, pinch out within the Frontier Formation. The coal bed and equivalent carbonaceous shale represent in-place accumulation of peat. The interfingering suggests that in SW Wyoming the Lower/Upper Cretaceous boundary is within the Chalk Creek Member. -from Author

Multiple output power supply circuit for an ion engine with shared upper inverter

NASA Technical Reports Server (NTRS)

Cardwell, Jr., Gilbert I. (Inventor); Phelps, Thomas K. (Inventor)

2001-01-01

A power supply circuit for an ion engine suitable for a spacecraft is coupled to a bus having a bus input and a bus return. The power supply circuit has a first primary winding of a first transformer. An upper inverter circuit is coupled to the bus input and the first primary winding. The power supply circuit further includes a first lower inverter circuit coupled to the bus return and the first primary winding. The second primary winding of a second transformer is coupled to the upper inverter circuit. A second lower inverter circuit is coupled to the bus return and the second primary winding.

Development and implications of a sediment budget for the upper Elk River watershed, Humboldt County

Treesearch

Lee H. MacDonald; Michael W. Miles; Shane Beach; Nicolas M. Harrison; Matthew R. House; Patrick Belmont; Ken L. Ferrier

2017-01-01

A number of watersheds on the North Coast of California have been designated as sediment impaired under the Clean Water Act, including the 112 km2 upper Elk River watershed that flows into Humboldt Bay just south of Eureka. The objectives of this paper are to: 1) briefly explain the geomorphic context and anthropogenic uses of the Elk River...

77 FR 24947 - Cedar Creek Hydro, LLC; Notice of Preliminary Permit Application Accepted for Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-26

... consist of: (1) A 60- foot-high, 12,700-foot-long earth embankment upper dam; (2) an upper reservoir with... with a total capacity of 660.0 megawatts; (5) a 140- foot-high, 1,600-foot-long earth embankment lower... system at http://www.ferc.gov/docs-filing/ecomment.asp . You must include your name and contact...

Earth Observation taken by the STS-125 Crew

NASA Image and Video Library

2009-05-13

S125-E-007099 (13 May 2009) --- Part of southern California, including the San Diego area, and the border with Mexico can be seen in this STS-125 still photo taken from the Space Shuttle Atlantis as it passed over the Pacific Coast. The Salton Sea can be seen at upper right. The greater Los Angeles area is just out of frame at upper left.

Fire in upper Midwestern oak forest ecosystems: an oak forest restoration and management handbook

Treesearch

Lee E. Frelich; Peter B. Reich; David W. Peterson

2015-01-01

We reviewed the literature to synthesize what is known about the use of fire to maintain and restore oak forests, woodlands, and savannas of the upper Midwestern United States, with emphasis on Minnesota, Wisconsin, and Michigan. Included are (1) known physical and ecological effects of fire on oaks from acorn through seedling, established sapling, and mature stages of...

Ares I Upper Stage Update

NASA Technical Reports Server (NTRS)

Davis, Daniel J.

2010-01-01

These presentation slides review the progress in the development of the Ares I upper stage. The development includes development of a manufacturing and processing assembly that will reduce the time required over 100 days, development of a weld tool that is a robotic tool that is the largest welder of its kind in the United States, development of avionics and software, and development of logisitics and operations systems.

Echinoderms from Middle and Upper Ordovician rocks of Kentucky

USGS Publications Warehouse

Parsley, R.L.

1981-01-01

The Middle and Upper Ordovician limestones of Kentucky, especially the Lexington Limestone, have yielded a diverse silicified echinoderm fauna, including: Stylophora-Enoploura cf. E. punctata; Paracrinoidea-A mygdalocystites; Crinoidea, Inadunata-Hybocrir/us tumidus, Hybocystites problem,aticus, Carabocrinus sp., Cupulocrinus sp., Heterocrinus sp.; Cyclocystoidea-Cyclocystoides sp. A rhombiferan cystoid, A mecystis laevis, from the Edinburg Formation, Virginia, is also discussed. No new taxa are introduced.

Crossing Boundaries: Exploring Black Middle and Upper Class Preservice Teachers' Perceptions of Teaching and Learning in High Poverty Urban Schools

ERIC Educational Resources Information Center

Lewis, Andrea D.

2012-01-01

The intent of this study was to explore the perceptions of Black middle and upper class preservice teachers as they relate to teaching and learning in high poverty urban schools. Participants included 11 senior early childhood education preservice teachers at a historically Black college in the southeast region of the United States. The study was…

Impact of integrated upper limb spasticity management including botulinum toxin A on patient-centred goal attainment: rationale and protocol for an international prospective, longitudinal cohort study (ULIS-III)

PubMed Central

Turner-Stokes, Lynne; Ashford, Stephen; Jacinto, Jorge; Maisonobe, Pascal; Balcaitiene, Jovita; Fheodoroff, Klemens

2016-01-01

Objectives Describe the rationale and protocol for the Upper Limb International Spasticity (ULIS)-III study, which aims to evaluate the impact of integrated spasticity management, involving multiple botulinum toxin A (BoNT-A) injection cycles and concomitant therapies, on patient-centred goal attainment. Outline novel outcome assessment methods for ULIS-III and report initial evaluation data from goal setting in early stages of the study. Design Large international longitudinal cohort study of integrated upper limb spasticity management, including BoNT-A. Participants and setting ULIS-III is a 2-year study expected to enrol >1000 participants at 58 study centres across 14 countries. Interventions The study design is non-interventional and intended to reflect real-life clinical practice. It will describe injection practices and additional treatment strategies, and record clinical decision-making in a serial approach to long-term spasticity management. Outcome measures ULIS-III will use a goal-directed approach to selection of targeted standardised measures to capture the diversity of presentation, goals and outcomes. ULIS-III will implement the Upper Limb Spasticity Index, a battery of assessments including a structured approach to goal attainment scaling (Goal Attainment Scaling—Evaluation of Outcomes for Upper Limb Spasticity tool), alongside a limited set of standardised measures, chosen according to patients' selected goal areas. Concomitant therapy inputs, patient satisfaction with engagement in goal setting, health economic end points and health-related quality of life data will also be captured. Results of initial evaluation of goal quality Recruitment started in January 2015. By June 2015, 58 sites had been identified and initial data collected for 79 patients across 13 sites in 3 countries. Goal setting data were quality-checked and centres rated on the basis of function-related and Specific, Measurable, Achievable, Realistic, Timed (SMART) characteristics of goal statements. Overall, 11/13 centres achieved the highest rating (A++). Conclusions ULIS-III will provide valuable information regarding treatment of and outcomes from real-life upper limb spasticity management worldwide. Trial registration number NCT02454803; Pre-results. PMID:27315835

Application and measurement properties of EQ-5D to measure quality of life in patients with upper extremity orthopaedic disorders: a systematic literature review.

PubMed

Grobet, Cécile; Marks, Miriam; Tecklenburg, Linda; Audigé, Laurent

2018-04-13

The EuroQol-5 Dimension (EQ-5D) is the most widely used generic instrument to measure quality of life (QoL), yet its application in upper extremity orthopaedics as well as its measurement properties remain largely undefined. We implemented a systematic literature review to provide an overview of the application of EQ-5D in patients with upper extremity disorders and analyse its measurement properties. We searched Medline, EMBASE, Cochrane and Scopus databases for clinical studies including orthopaedic patients with surgical interventions of the upper extremity who completed the EQ-5D. For all included studies, the use of EQ-5D and quantitative QoL data were described. Validation studies of EQ-5D were assessed according to COSMIN guidelines and standard measurement properties were examined. Twenty-three studies were included in the review, 19 of which investigated patients with an intervention carried out at the shoulder region. In 15 studies, EQ-5D assessed QoL as the primary outcome. Utility index scores in non-trauma patients generally improved postoperatively, whereas trauma patients did not regain their recalled pre-injury QoL levels. EQ-5D measurement properties were reported in three articles on proximal humerus fractures and carpal tunnel syndrome. Positive ratings were seen for construct validity (Spearman correlation coefficient ≥ 0.70 with the Short Form (SF)-12 or SF-6D health surveys) and reliability (intraclass correlation coefficient ≥ 0.77) with intermediate responsiveness (standardised response means: 0.5-0.9). However, ceiling effects were identified with 16-48% of the patients scoring the maximum QoL. The methodological quality of the three articles varied from fair to good. For surgical interventions of the upper extremity, EQ-5D was mostly applied to assess QoL as a primary outcome in patients with shoulder disorders. Investigations of the measurement properties were rare, but indicate good reliability and validity as well as moderate responsiveness in patients with upper extremity conditions.

A Study of Cirrus Clouds and Aerosols in the Upper Troposphere using Models and Satellite Data

NASA Technical Reports Server (NTRS)

Bergstrom, Robert W.

2004-01-01

This report is the final report for the Cooperative Agreement NCC2-1213. It is a compilation of publications produced under this Cooperative Agreement and conference presentations. The tasks for the Aerosol Physical Chemistry Model for the Upper Troposphere include: Task 1: To compare APCM predictions against the SUCCESS data and other aircraft campaigns and to investigate the role of aerosol composition on cirrus cloud nucleation; Task 2: To study the seasonal evolution and spatial distribution of upper-tropospheric tropical and polar cirrus; Task 3: To investigate CLAES cirrus data with other complementary (TOGA-COARE and CEPEX) data. Tasks for Upper Tropospheric Cirrus Clouds include: Task 1: Assemble 3-hourly (or more frequent) meteorological satellite data fiom geostationary satellites to obtain a global, or nearly global, dataset of infiared brightness temperatures as a function of time for airborne experimental periods; Task 2: Explore methods to improve the cloud top altitude distributions calculated fiom meteorological satellite data. This will focus on linlung the 6.5 micron channel geostationary brightness temperatures and the 10.5 micron brightness temperatures; Task 3: Explore methods to differentiate convective fiom stratiform cloudiness; Task 4: Perform trajectory analyses using an existing trajectory modeling package that links the cloud data with air mass histories; Task 5: Apply techniques from tasks 1 through 4 to provide meteorological support to the CRYSTAL-FACE mission, both in its preparation and deployment phases. The report include four published articles and two slide presentations.

Frame-mounted wire management device

DOEpatents

Grushkowitz, Tyler; Fischer, Kevin; Danning, Matthew

2016-09-20

A wire management device is disclosed. The device comprises a clip comprising an upper planar member and a lower planar member, each planar member having an inner and outer surface, wherein the inner surface of the upper planar member includes a post extending toward the inner surface of the lower planar member, a stem extending from the outer surface of the lower planar member, the stem including two outwardly-extending flanges, each of the first and second outwardly-extending flanges including an edge portion extending toward the outer surface of the lower planar member, and a transverse passage extending along the outer surface of the lower planar member, the transverse passage extending across the stem, wherein the stem has a recessed portion along the transverse passage.

Enhanced vbasis laser diode package

DOEpatents

Deri, Robert J.; Chen, Diana; Bayramian, Andy; Freitas, Barry; Kotovsky, Jack

2014-08-19

A substrate having an upper surface and a lower surface is provided. The substrate includes a plurality of v-grooves formed in the upper surface. Each v-groove includes a first side and a second side perpendicular to the first side. A laser diode bar assembly is disposed within each of the v-grooves and attached to the first side. The laser diode bar assembly includes a first adhesion layer disposed on the first side of the v-groove, a metal plate attached to the first adhesion layer, a second adhesion layer disposed over the metal plate, and a laser diode bar attached to the second adhesion layer. The laser diode bar has a coefficient of thermal expansion (CTE) substantially similar to that of the metal plate.

Upflow bioreactor having a septum and an auger and drive assembly

DOEpatents

Hansen, Carl S.; Hansen, Conly L.

2007-11-06

An upflow bioreactor includes a vessel having an inlet and an outlet configured for upflow operation. A septum is positioned within the vessel and defines a lower chamber and an upper chamber. The septum includes an aperture that provides fluid communication between the upper chamber and lower chamber. The bioreactor also includes an auger positioned in the aperture of the septum. The vessel includes an opening in the top for receiving the auger. The auger extends from a drive housing, which is position over the opening and provides a seal around the opening. The drive housing is adjustable relative to the vessel. The position of the auger in the aperture can be adjusted by adjusting the drive housing relative to the vessel. The auger adjustment mechanism allows the auger to be accurately positioned within the aperture. The drive housing can also include a fluid to provide an additional seal around the shaft of the auger.

Actuator operated microvalves

NASA Technical Reports Server (NTRS)

Okojie, Robert S. (Inventor)

2008-01-01

An actuator operated microvalve and the method of making same is disclosed and claimed. The microvalve comprises a SiC housing which includes a first lower portion and a second upper portion. The lower portion of the SiC housing includes a passageway therethrough, a microvalve seat, and a moveable SiC diaphragm. The SiC diaphragm includes a centrally located boss and radially extending corrugations which may be sinusoidally shaped. The boss of the SiC diaphragm moves and modulates in a range of positions between a closed position wherein the boss interengages said microvalve seat prohibiting communication of fluid through the passageway and a fully open position when the boss is spaced apart from the seat at its maximum permitting communication of fluid through said passageway. The actuator includes a SiC top plate affixed to the boss of the diaphragm and a first electrode and the second upper portion of the SiC housing further includes a second electrode.

Associations of occupational standing with musculoskeletal symptoms: a systematic review with meta-analysis.

PubMed

Coenen, Pieter; Willenberg, Lisa; Parry, Sharon; Shi, Joyce W; Romero, Lorena; Blackwood, Diana M; Maher, Christopher G; Healy, Genevieve N; Dunstan, David W; Straker, Leon M

2018-02-01

Given the high exposure to occupational standing in specific occupations, and recent initiatives to encourage intermittent standing among white-collar workers, a better understanding of the potential health consequences of occupational standing is required. We aimed to review and quantify the epidemiological evidence on associations of occupational standing with musculoskeletal symptoms. A systematic review was performed. Data from included articles were extracted and described, and meta-analyses conducted when data were sufficiently homogeneous. Electronic databases were systematically searched. Peer-reviewed articles on occupational standing and musculoskeletal symptoms from epidemiological studies were identified. Of the 11 750 articles screened, 50 articles reporting 49 studies were included (45 cross-sectional and 5 longitudinal; n=88 158 participants) describing the associations of occupational standing with musculoskeletal symptoms, including low-back (39 articles), lower extremity (14 articles) and upper extremity (18 articles) symptoms. In the meta-analysis, 'substantial' (>4 hours/workday) occupational standing was associated with the occurrence of low-back symptoms (pooled OR (95% CI) 1.31 (1.10 to 1.56)). Evidence on lower and upper extremity symptoms was too heterogeneous for meta-analyses. The majority of included studies reported statistically significant detrimental associations of occupational standing with lower extremity, but not with upper extremity symptoms. The evidence suggests that substantial occupational standing is associated with the occurrence of low-back and (inconclusively) lower extremity symptoms, but there may not be such an association with upper extremity symptoms. However, these conclusions are tentative as only limited evidence was found from high-quality, longitudinal studies with fully adjusted models using objective measures of standing. 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/.

The home stroke rehabilitation and monitoring system trial: a randomized controlled trial.

PubMed

Linder, Susan M; Rosenfeldt, Anson B; Reiss, Aimee; Buchanan, Sharon; Sahu, Komal; Bay, Curtis R; Wolf, Steven L; Alberts, Jay L

2013-01-01

Because many individuals poststroke lack access to the quality and intensity of rehabilitation to improve upper extremity motor function, a home-based robotic-assisted upper extremity rehabilitation device is being paired with an individualized home exercise program. The primary aim of this project is to determine the effectiveness of robotic-assisted home therapy compared with a home exercise program on upper extremity motor recovery and health-related quality of life for stroke survivors in rural and underserved locations. The secondary aim is to explore whether initial degree of motor function of the upper limb may be a factor in predicting the extent to which patients with stroke may be responsive to a home therapy approach. We hypothesize that the home exercise program intervention, when enhanced with robotic-assisted therapy, will result in significantly better outcomes in motor function and quality of life. A total of 96 participants within six-months of a single, unilateral ischemic, or hemorrhagic stroke will be recruited in this prospective, single-blind, multisite randomized clinical trial. The primary outcome is the change in upper extremity function using the Action Research Arm Test. Secondary outcomes include changes in: upper extremity function (Wolf Motor Function Test), upper extremity impairment (upper extremity portion of the Fugl-Meyer Test), self-reported quality of life (Stroke Impact Scale), and affect (Centers for Epidemiologic Studies Depression Scale). Similar or greater improvements in upper extremity function using the combined robotic home exercise program intervention compared with home exercise program alone will be interpreted as evidence that supports the introduction of in-home technology to augment the recovery of function poststroke. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

Etiological and Endoscopic Profile of Middle Aged and Elderly Patients with Upper Gastrointestinal Bleeding in a Tertiary Care Hospital in North India: A Retrospective Analysis.

PubMed

Mahajan, Pranav; Chandail, Vijant Singh

2017-01-01

Upper gastrointestinal (GI) bleeding is a common medical emergency associated with significant morbidity and mortality. The clinical presentation depends on the amount and location of hemorrhage and the endoscopic profile varies according to different etiology. At present, there are limited epidemiological data on upper GI bleed and associated mortality from India, especially in the middle and elderly age group, which has a higher incidence and mortality from this disease. This study aims to study the clinical and endoscopic profile of middle aged and elderly patients suffering from upper GI bleed to know the etiology of the disease and outcome of the intervention. Out of a total of 1790 patients who presented to the hospital from May 2015 to August 2017 with upper GI bleed, and underwent upper GI endoscopy, data of 1270 patients, aged 40 years and above, was compiled and analyzed retrospectively. All the patients included in the study were above 40 years of age. Majority of the patients were males, with a male to female ratio of 1.6:1. The most common causes of upper GI bleed in these patients were portal hypertension-related (esophageal, gastric and duodenal varices, portal hypertensive gastropathy, and gastric antral vascular ectasia GAVE), seen in 53.62% of patients, followed by peptic ulcer disease (gastric and duodenal ulcers) seen in 17.56% of patients. Gastric erosions/gastritis accounted for 15.20%, and duodenal erosions were seen in 5.8% of upper GI bleeds. The in-hospital mortality rate in our study population was 5.83%. The present study reported portal hypertension as the most common cause of upper GI bleeding, while the most common endoscopic lesions reported were esophageal varices, followed by gastric erosion/gastritis, and duodenal ulcer.

The impact of workplace risk factors on the occurrence of neck and upper limb pain: a general population study.

PubMed

Sim, Julius; Lacey, Rosie J; Lewis, Martyn

2006-09-19

Work-related neck and upper limb pain has mainly been studied in specific occupational groups, and little is known about its impact in the general population. The objectives of this study were to estimate the prevalence and population impact of work-related neck and upper limb pain. A cross-sectional survey was conducted of 10,000 adults in North Staffordshire, UK, in which there is a common local manual industry. The primary outcome measure was presence or absence of neck and upper limb pain. Participants were asked to give details of up to five recent jobs, and to report exposure to six work activities involving the neck or upper limbs. Psychosocial measures included job control, demand and support. Odds ratios (ORs) and population attributable fractions were calculated for these risk factors. The age-standardized one-month period prevalence of neck and upper limb pain was 44%. There were significant independent associations between neck and upper limb pain and: repeated lifting of heavy objects (OR = 1.4); prolonged bending of neck (OR = 2.0); working with arms at/above shoulder height (OR = 1.3); little job control (OR = 1.6); and little supervisor support (OR = 1.3). The population attributable fractions were 0.24 (24%) for exposure to work activities and 0.12 (12%) for exposure to psychosocial factors. Neck and upper limb pain is associated with both physical and psychosocial factors in the work environment. Inferences of cause-and-effect from cross-sectional studies must be made with caution; nonetheless, our findings suggest that modification of the work environment might prevent up to one in three of cases of neck and upper limb pain in the general population, depending on current exposures to occupational risk.

Revised hydrogeologic framework of the Floridan aquifer system in the northern coastal area of Georgia and adjacent parts of South Carolina

USGS Publications Warehouse

Williams, Lester J.; Gill, Harold E.

2010-01-01

The hydrogeologic framework for the Floridan aquifer system has been revised for eight northern coastal counties in Georgia and five coastal counties in South Carolina by incorporating new borehole geophysical and flowmeter log data collected during previous investigations. Selected well logs were compiled and analyzed to determine the vertical and horizontal continuity of permeable zones that make up the Upper and Lower Floridan aquifers and to define more precisely the thickness of confining beds that separate these aquifers. The updated framework generally conforms to the original framework established by the U.S. Geological Survey in the 1980s except for adjustments made to the internal boundaries of the Upper and Lower Floridan aquifers and the individual permeable zones that compose these aquifers. The revised boundaries of the Floridan aquifer system were mapped by taking into account results from local studies and regional correlations of geologic and hydrogeologic units. Because the revised framework does not match the previous regional framework along all edges, additional work will be needed to expand the framework into adjacent areas. The Floridan aquifer system in the northern coastal region of Georgia and parts of South Carolina can be divided into the Upper and Lower Floridan aquifers, which are separated by a middle confining unit of relatively lower permeability. The Upper Floridan aquifer includes permeable and hydraulically connected carbonate rocks of Oligocene and upper Eocene age that represent the most transmissive part of the aquifer system. The middle confining unit consists of low permeability carbonate rocks that lie within the lower part of the upper Eocene in Beaufort and Jasper Counties, South Carolina, and within the upper to middle parts of the middle Eocene elsewhere. Locally, the middle confining unit contains thin zones that have moderate to high permeability and can produce water to wells that tap them. The Lower Floridan aquifer includes all permeable strata that lie below the middle confining unit and above the base of the aquifer system. Beneath Hilton Head Island, South Carolina, the middle Floridan aquifer is now included as part of the Lower Floridan aquifer. The base of the Floridan aquifer system generally is located at the top of lower Eocene rocks in Georgia and the top of Paleocene rocks in South Carolina. The Upper and Lower Floridan aquifers are interconnected to varying degrees depending on the thickness and permeability of the middle confining unit that separates these aquifers. In most places, hydraulic head differences between the two aquifers range from a few inches to a few feet or more. Monitoring at several vertically clustered well-point sites where wells were set at different depths in the aquifer revealed variations in the degree of hydraulic separation with depth. In general, the head separation between the Upper and Lower Floridan aquifers increases with depth, which indicates that the deeper zones are more hydraulically separated than the shallower parts of the Lower Floridan aquifer.

Severe upper extremity injuries in frontal automobile crashes: the effects of depowered airbags.

PubMed

Jernigan, M Virginia; Rath, Amber L; Duma, Stefan M

2005-03-01

The purpose of this study was to determine the effects of depowered frontal airbags on the incidence of severe upper extremity injuries. The National Automotive Sampling System database files from 1993 to 2000 were examined in a study that included 2,413,347 occupants who were exposed to an airbag deployment in the United States. Occupants exposed to a depowered airbag deployment were significantly more likely to sustain a severe upper extremity injury (3.9%) than those occupants exposed to a full-powered airbag deployment (2.5%) (P=.01). Full-powered systems resulted in an injury distribution of 89.2% fractures and 7.9% dislocations compared with depowered systems with 55.3% fractures and 44.3% dislocations. Although depowered airbags were designed to reduce the risk of injuries, they appear to have increased the overall incidence of severe upper extremity injuries through a shift from long bone fractures to joint dislocations.

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

Upper Face: Clinical Anatomy and Regional Approaches with Injectable Fillers.

PubMed

Sykes, Jonathan M; Cotofana, Sebastian; Trevidic, Patrick; Solish, Nowell; Carruthers, Jean; Carruthers, Alastair; Moradi, Amir; Swift, Arthur; Massry, Guy G; Lambros, Val; Remington, B Kent

2015-11-01

The use of facial fillers has been rapidly increased as the range of injectable products and indications continues to expand. Complications may arise from improper placement or technique. This article highlights the importance of anatomic knowledge when using injectable fillers in the face. A detailed review of the clinical anatomy of the upper face is performed. Regional approaches are described using the applied anatomy to efficiently and safely augment the different subunits of the upper face. Key aspects of safe and successful injection of fillers in the upper face include a thorough knowledge of the location of fat compartments and neurovascular structures. Awareness of these structures enables the practitioner to maximize injections, while avoiding damage to important nerves and vessels. A detailed knowledge of the anatomy and properties of the product is paramount to maximize the efficacy while minimizing the risk of complications.

Effect of whole-body vibration exercise in a sitting position prior to therapy on muscle tone and upper extremity function in stroke patients.

PubMed

Boo, Jung-A; Moon, Sang-Hyun; Lee, Sun-Min; Choi, Jung-Hyun; Park, Si-Eun

2016-01-01

[Purpose] The purpose of this study was to determine the effect of whole-body vibration exercise in a sitting position prior to therapy in stroke patients. [Subjects and Methods] Fourteen chronic stroke patients were included in this study. Prior to occupational therapy, whole-body exercise was performed for 10 minutes, 5 times per week, for a total of 8 weeks. Muscle tone and upper extremity function were measured. The Modified Ashworth Scale (MAS) was used to measure muscle tone, and the Manual Function Test (MFT) and Fugl-Meyer Assessment scale (FugM) were used to measure upper extremity function. [Results] MAS score was significantly decreased, and MFT and FugM were significantly increased. [Conclusion] These results indicate that whole-body vibration exercise in a sitting position prior to therapy had a positive effect on muscle tone, and upper extremity function in stroke patients.

Selectively Lockable Knee Brace

NASA Technical Reports Server (NTRS)

Myers, W. Neill (Inventor); Shadoan, Michael D. (Inventor); Forbes, John C. (Inventor); Baker, Kevin J. (Inventor); Rice, Darron C. (Inventor)

1996-01-01

A knee brace for aiding in rehabilitation of damaged leg muscles includes upper and lower housings normally pivotable one relative to the other about the knee joint axis of a patient. The upper housing is attachable to the thigh of the patient above the knee joint while the lower housing is secured to a stirrup which extends downwardly along the patient's leg and is attached to the patient's shoe. An actuation rod is carried within the lower housing and is coupled to a cable. The upper and lower housings carry cooperative clutch/brake elements which normally are disengaged to permit relative movement between the upper and lower housings. When the cable is extended the clutch/brake elements engage and lock the housings together. A heel strike mechanism fastened to the stirrup and the heel of the shoe is connected to the cable to selectively extend the cable and lock the brace in substantially any position when the patient places weight on the heel.

Potentiometric surface of the upper Floridan aquifer in Florida and in parts of Georgia, South Carolina, and Alabama, May 1985

USGS Publications Warehouse

Bush, Peter W.; Barr, G. Lynn; Clarke, John S.; Johnston, Richard H.

1987-01-01

A map, constructed as a part of the Floridan Regional Aquifer-System Analysis (RASA), shows the potentiometric surface of the Upper Floridan aquifer for May 1985. It is based on measurements of water level or artesian pressure made in about 2 ,500 wells during the period May 13 to 24, 1985. Only measurements from tightly cased wells open exclusively to the Upper Floridan aquifer were used to make the map. These included 1,425 wells in Florida, 924 in Georgia, 133 in South Carolina, and 21 in Alabama. The potentiometric surface of the Upper Floridan aquifer changed little between 1980 and 1985. Significant water level declines were observed only in southwest Georgia and west-central Florida. Low rainfall during early 1985 and associated pumping for irrigation caused the declines in both areas. (Lantz-PTT)

Chlamydia trachomatis-induced Fitz-Hugh-Curtis syndrome: a case report.

PubMed

Ekabe, Cyril Jabea; Kehbila, Jules; Njim, Tsi; Kadia, Benjamin Momo; Tendonge, Celestine Ntemlefack; Monekosso, Gottlieb Lobe

2017-01-03

Fitz-Hugh-Curtis syndrome is defined as perihepatitis associated with pelvic inflammatory disease. Chlamydia trachomatis is one of its most common aetiologies. This syndrome usually presents with right upper quadrant abdominal pain mimicking other hepatobiliary and gastrointestinal pathologies, hence, posing a diagnostic dilemma in settings with limited diagnostic tools. A 32 year old African female presented with acute right upper quadrant abdominal pain and vaginal discharge, for which she had previously received treatment in another health center with no improvement. Clinical and laboratory findings were suggestive of Fitz-Hugh-Curtis syndrome. Five days after treatment with oral doxycycline, the patient showed marked clinical improvement. Fitz-Hugh-Curtis syndrome is a common cause of right upper quadrant pain which is often under diagnosed in poor communities. Hence, it should be included as a differential diagnosis in patients presenting with right upper quadrant pain, especially in females of reproductive age.

Selectively lockable knee brace

NASA Technical Reports Server (NTRS)

Myers, Neill (Inventor); Shadoan, Mike (Inventor); Forbes, John (Inventor); Baker, Kevin (Inventor)

1994-01-01

A knee brace for aiding in rehabilitation of damaged leg muscles includes upper and lower housings, normally pivotable, one relative to the other about the knee joint axis of a patient. The upper housing is attachable to the thigh of the patient above the knee joint, while the lower housing is secured to a stirrup which extends downwardly along the patient's leg and is attached to the patient's shoe. An actuation rod is carried within the lower housing and is coupled to a cable. The upper and lower housings carry cooperative clutch/brake elements which normally are disengaged to permit relative movement between the upper and lower housings. When the cable is extended, the clutch/brake elements engage and lock the housings together. A heel strike mechanism fastened to the stirrup and the heel of the shoe is connected to the cable to selectively extend the cable and lock the brace in substantially any position when the patient places weight on the heel.

Comparison of upper extremity kinematics in children with spastic diplegic cerebral palsy using anterior and posterior walkers.

PubMed

Strifling, Kelly M B; Lu, Na; Wang, Mei; Cao, Kevin; Ackman, Jeffrey D; Klein, John P; Schwab, Jeffrey P; Harris, Gerald F

2008-10-01

This prospective study analyzes the upper extremity kinematics of 10 children with spastic diplegic cerebral palsy using anterior and posterior walkers. Although both types of walkers are commonly prescribed by clinicians, no quantitative data comparing the two in regards to upper extremity motion has been published. The study methodology included testing of each subject with both types of walkers in a motion analysis laboratory after an acclimation period of at least 1 month. Overall results showed that statistically, both walkers are relatively similar. With both anterior and posterior walkers, the shoulders were extended, elbows flexed, and wrists extended. Energy expenditure, walking speed and stride length was also similar with both walker types. Several differences were also noted although not statistically significant. Anterior torso tilt was reduced with the posterior walker and shoulder extension and elbow flexion were increased. Outcomes analysis indicated that differences in upper extremity torso and joint motion were not dependent on spasticity or hand dominance. These findings may help to build an understanding of upper extremity motion in walker-assisted gait and potentially to improve walker prescription.

Mechanical Properties of the Upper Airway

PubMed Central

Strohl, Kingman P.; Butler, James P.; Malhotra, Atul

2013-01-01

The importance of the upper airway (nose, pharynx, and larynx) in health and in the pathogenesis of sleep apnea, asthma, and other airway diseases, discussed elsewhere in the Comprehensive Physiology series, prompts this review of the biomechanical properties and functional aspects of the upper airway. There is a literature based on anatomic or structural descriptions in static circumstances, albeit studied in limited numbers of individuals in both health and disease. As for dynamic features, the literature is limited to studies of pressure and flow through all or parts of the upper airway and to the effects of muscle activation on such features; however, the links between structure and function through airway size, shape, and compliance remain a topic that is completely open for investigation, particularly through analyses using concepts of fluid and structural mechanics. Throughout are included both historically seminal references, as well as those serving as signposts or updated reviews. This article should be considered a resource for concepts needed for the application of biomechanical models of upper airway physiology, applicable to understanding the pathophysiology of disease and anticipated results of treatment interventions. PMID:23723026

Mirror therapy enhances upper extremity motor recovery in stroke patients.

PubMed

Mirela Cristina, Luca; Matei, Daniela; Ignat, Bogdan; Popescu, Cristian Dinu

2015-12-01

The purpose of this study was to evaluate the effects of mirror therapy program in addition with physical therapy methods on upper limb recovery in patients with subacute ischemic stroke. 15 subjects followed a comprehensive rehabilitative treatment, 8 subjects received only control therapy (CT) and 7 subjects received mirror therapy (MT) for 30 min every day, five times a week, for 6 weeks in addition to the conventional therapy. Brunnstrom stages, Fugl-Meyer Assessment (upper extremity), the Ashworth Scale, and Bhakta Test (finger flexion scale) were used to assess changes in upper limb motor recovery and motor function after intervention. After 6 weeks of treatment, patients in both groups showed significant improvements in the variables measured. Patients who received MT showed greater improvements compared to the CT group. The MT treatment results included: improvement of motor functions, manual skills and activities of daily living. The best results were obtained when the treatment was started soon after the stroke. MT is an easy and low-cost method to improve motor recovery of the upper limb.

Systematic review of the effectiveness of mirror therapy in upper extremity function.

PubMed

Ezendam, Daniëlle; Bongers, Raoul M; Jannink, Michiel J A

2009-01-01

This review gives an overview of the current state of research regarding the effectiveness of mirror therapy in upper extremity function. A systematic literature search was performed to identify studies concerning mirror therapy in upper extremity. The included journal articles were reviewed according to a structured diagram and the methodological quality was assessed. Fifteen studies were identified and reviewed. Five different patient categories were studied: two studies focussed on mirror therapy after an amputation of the upper limb, five studies focussed on mirror therapy after stroke, five studies focussed on mirror therapy with complex regional pain syndrome type 1 (CRPS1) patients, one study on mirror therapy with complex regional pain syndrome type 2 (CRPS2) and two studies focussed on mirror therapy after hand surgery other than amputation. Most of the evidence for mirror therapy is from studies with weak methodological quality. The present review showed a trend that mirror therapy is effective in upper limb treatment of stroke patients and patients with CRPS, whereas the effectiveness in other patient groups has yet to be determined.

Clinical presentation and manual therapy for upper quadrant musculoskeletal conditions

PubMed Central

Isabel de-la-Llave-Rincón, Ana; Puentedura, Emilio J; Fernández-de-las-Peñas, César

2011-01-01

In recent years, increased knowledge of the pathogenesis of upper quadrant pain syndromes has translated to better management strategies. Recent studies have demonstrated evidence of peripheral and central sensitization mechanisms in different local pain syndromes of the upper quadrant such as idiopathic neck pain, lateral epicondylalgia, whiplash-associated disorders, shoulder impingement, and carpal tunnel syndrome. Therefore, a treatment-based classification approach where subjects receive matched interventions has been developed and, it has been found that these patients experience better outcomes than those receiving non-matched interventions. There is evidence suggesting that the cervical and thoracic spine is involved in upper quadrant pain. Spinal manipulation has been found to be effective for patients with elbow pain, neck pain, or cervicobrachial pain. Additionally, it is known that spinal manipulative therapy exerts neurophysiological effects that can activate pain modulation mechanisms. This paper exposes some manual therapies for upper quadrant pain syndromes, based on a nociceptive pain rationale for modulating central nervous system including trigger point therapy, dry needling, mobilization or manipulation, and cognitive pain approaches. PMID:23115473

Applicability of Thermal Storage Systems to Air Force Facilities

DTIC Science & Technology

1990-09-01

Analisis of Region 6 Upper Limit Retrofit Scenario 30% Reduction .... ............. 4.52 4.58 Economic Analysis of Region 7 Upper Limit Retrofit Scenario...or a dynamic-direct contact type. They usually include all the controls, chilling and storage equipment in one self-contained, skid mounted, factory ...SCS technology. One promising trend in reducing system construction costs is the factory -packaged thermal storage cooling unit. As of February 1989

Waste Away--Information and Activities for Investigating Trash Problems and Solutions for Upper Elementary and Junior High School Students.

ERIC Educational Resources Information Center

Vermont Inst. of Natural Science, Woodstock.

The solid waste problem is so pervasive that it can no longer be ignored. The purpose of this set of materials is to encourage a lifestyle that includes the use of the three R's: Reduce, Reuse, Recycle. It was designed to educate upper elementary and junior high school students who may educate their classmates, families, and community about the…

Integrated analysis of landscape management scenarios using state and transition models in the upper Grande Ronde River subbasin, Oregon, USA.

Treesearch

Miles A. Hemstrom; James Merzenich; Allison Reger; Barbara. Wales

2007-01-01

We modeled the integrated effects of natural disturbances and management activities for three disturbance scenarios on a 178 000-ha landscape in the upper Grande Ronde subbasin of northeast Oregon. The landscape included three forest environments (warm-dry, cool-moist, and cold) as well as a mixture of publicly and privately owned lands. Our models were state and...

Geohydrologic data from Port Royal Sound, Beaufort County, South Carolina

USGS Publications Warehouse

Burt, R.A.; Belval, D.L.; Crouch, Michael; Hughes, W.B.

1986-01-01

Nine offshore wells were drilled through overlying sediments into the Upper Floridan aquifer in Port Royal Sound, South Carolina and the adjacent Atlantic Ocean, to obtain geologic, hydrologic, and water quality data. The Upper Floridan aquifer consists predominantly of light-gray, poorly consolidated, fossiliferous limestone. In the Port Royal Sound area, the Upper Floridan is overlain by olive-gray, medium to course sand and silty sand. Falling-head permeability tests on these overlying clastic sediments indicate permeabilities of 1,100 to 4.3 x 10 to the 7th power centimeters/sec. Other geologic and hydrologic data, including geophysical logs, sieve analyses, and detailed core descriptions were obtained, along with continuous water level records of the wells, tidal records, and barometric pressure records. Water collected from the Upper Floridan aquifer beneath Port Royal Sound and the ocean ranged in concentration of chloride from 54 to 12,000 mg/l. Measured pH ranged from 6.8 to 8.4, and alkalinity ranged from 122 to 368 mg/l as CaC03. Other water quality data obtained include temperature, specific conductance, carbon-13, carbon-14, tritium , deuterium, oxygen-18, dissolved oxygen, dissolved solids, nitrogen species, phosphorus, organic carbon, cyanide, sulfide, calcium, magnesium, sodium, potassium, sulfate, fluoride, silica , bromide, iodide, and selected trace metals. (USGS)

Relationship between self-reported upper limb disability and quantitative tests in hand-arm vibration syndrome.

PubMed

Poole, Kerry; Mason, Howard

2007-03-15

To establish the relationship between quantitative tests of hand function and upper limb disability, as measured by the Disability of the Arm, Shoulder and Hand (DASH) questionnaire, in hand-arm vibration syndrome (HAVS). A total of 228 individuals with HAVS were included in this study. Each had undergone a full HAVS assessment by an experienced physician, including quantitative tests of vibrotactile and thermal perception thresholds, maximal hand-grip strength (HG) and the Purdue pegboard (PP) test. Individuals were also asked to complete a DASH questionnaire. PP and HG of the quantitative tests gave the best and statistically significant individual correlations with the DASH disability score (r2 = 0.168 and 0.096). Stepwise linear regression analysis revealed that only PP and HG measurements were statistically significant predictors of upper limb disability (r2 = 0.178). Overall a combination of the PP and HG measurements, rather than each alone, gave slightly better discrimination, although not statistically significant, between normal and abnormal DASH scores with a sensitivity of 73.1% and specificity of 64.3%. Measurements of manual dexterity and hand-grip strength using PP and HG may be useful in helping to confirm lack of upper limb function and 'perceived' disability in HAVS.

Voluntary ambulation using voluntary upper limb muscle activity and Hybrid Assistive Limb® (HAL®) in a patient with complete paraplegia due to chronic spinal cord injury: A case report.

PubMed

Shimizu, Yukiyo; Kadone, Hideki; Kubota, Shigeki; Suzuki, Kenji; Saotome, Kousaku; Ueno, Tomoyuki; Abe, Tetsuya; Marushima, Aiki; Watanabe, Hiroki; Endo, Ayumu; Tsurumi, Kazue; Ishimoto, Ryu; Matsushita, Akira; Koda, Masao; Matsumura, Akira; Sankai, Yoshiyuki; Hada, Yasushi; Yamazaki, Masashi

2018-01-19

We sought to describe our experience with the Hybrid Assistive Limb® (HAL®) for active knee extension and voluntary ambulation with remaining muscle activity in a patient with complete paraplegia after spinal cord injury. A 30-year-old man with complete paraplegia used the HAL® for 1 month (10 sessions) using his remaining muscle activity, including hip flexor and upper limb activity. Electromyography was used to evaluate muscle activity of the gluteus maximus, tensor fascia lata, quadriceps femoris, and hamstring muscles in synchronization with the Vicon motion capture system. A HAL® session included a knee extension session with the hip flexor and voluntary gait with upper limb activity. After using the HAL® for one month, the patient's manual muscle hip flexor scores improved from 1/5 to 2/5 for the right and from 2/5 to 3/5 for the left knee, and from 0/5 to 1/5 for the extension of both knees. Knee extension sessions with HAL®, and hip flexor and upper-limb-triggered HAL® ambulation seem a safe and feasible option in a patient with complete paraplegia due to spinal cord injury.

Effect of upper body plyometric training on physical performance in healthy individuals: A systematic review.

PubMed

Singla, Deepika; Hussain, M Ejaz; Moiz, Jamal Ali

2018-01-01

To determine the impact of upper body plyometric training (UBPT) on physical performance parameters such as strength, ball throwing speed, ball throw distance and power in healthy individuals. PubMed, Scopus, ResearchGate and ERIC databases were searched up to August 2017. Selection of articles was done if they described the outcomes of an upper body plyometric exercise intervention; included measures of strength, ball throwing speed, ball throw distance, or power; included healthy individuals; used a randomized control trial; and had full text available in English language. The exclusion criteria were unpublished research work and clubbing of UBPT with some other type(s) of training apart from routine sports training. PEDro scale was used to rate the quality of studies eligible for this review. Initially 264 records were identified and out of them only 11 articles met the eligibility criteria and were selected (PEDro score = 4 to 6). Though large to very small effects observed in improving ball throwing velocity, ball throwing distance, power and strength of upper limb muscles after UBPT, the results should be implemented with caution. Inconclusive results obtained preclude any strong conclusion regarding the efficacy of UBPT on physical performance in healthy individuals. Copyright © 2017 Elsevier Ltd. All rights reserved.

Present state of knowledge of the upper atmosphere 1990: An assessment report

NASA Technical Reports Server (NTRS)

Watson, R. T.; Kurylo, M. J.; Prather, M. J.; Ormond, F. M.

1990-01-01

NASA is charged with the responsibility to report on the state of the knowledge of the Earth's upper atmosphere, particularly the stratosphere. Part 1 of this report, issued earlier this year, summarized the objectives, status, and accomplishments of the research tasks supported under NASA's Upper Atmosphere Research Program during the last two years. New findings since the last report to Congress was issued in 1988 are presented. Several scientific assessments of the current understanding of the chemical composition and physical structure of the stratosphere are included, in particular how the abundance and distribution of ozone is predicted to change in the future. These reviews include: a summary of the most recent international assessment of stratospheric ozone; a study of future chlorine and bromine loading of the atmosphere; a review of the photochemical and chemical kinetics data that are used as input parameters for the atmospheric models; a new assessment of the impact of Space Shuttle launches on the stratosphere; a summary of the environmental issues and needed research to evaluate the impact of the newly re-proposed fleet of stratospheric supersonic civil aircraft; and a list of the contributors to this report and the science assessments which have formed our present state of knowledge of the upper atmosphere and ozone depletion.

ENDOSCOPIC FINDINGS OF UPPER GASTROINTESTINAL BLEEDING IN PATIENTS WITH LIVER CIRROSIS.

PubMed

Hadayat, Rania; Jehangiri, Attique-ur-Rehman; Gul, Rahid; Khan, Adil Naseer; Said, Khalid; Gandapur, Asadullah

2015-01-01

Acute upper gastrointestinal (GI) bleeding is a common medical emergency. A common risk factor of upper GI bleeding is cirrhosis of liver, which can lead to variceal haemorrhage. 30-40% of cirrhotic patients who bleed may have non-variceal upper GI bleeding and it is frequently caused by peptic ulcers, portal gastropathy, Mallory-Weiss tear, and gastroduodenal erosions. The objective of this study was to determine the frequency of upper gastrointestinal endoscopic findings among patients presenting with upper gastrointestinal bleeding with liver cirrhosis. This descriptive cross-sectional study was carried out in Gastroenterology & Hepatology Department of Ayub Teaching Hospital, Abbottabad from February 2012 to June 2013. 252 patients diagnosed with cirrhosis, presenting with upper GI bleed, age 50 years of either gender, and were included in the study. Non-probability consecutive sampling was used, Endoscopy was performed on each patient and the findings documented. The mean age was 57.84 +/- 6.29 years. There were 158 (62.7%) males and 94 (37.3%) females. The most common endoscopic finding was oesophageal varices (92.9%, n=234) followed by portal hypertensive gastropathy (38.9%, n=98) with almost equal distribution among males and females. Gastric varices were found in 33.3% of patients (n=84). Among other non-variceal lesions, peptic ulcer disease was seen in 26 patients (10.3%) while gastric erosions were found in 8 patients (3.2%). In patients with acute upper GI bleeding and liver cirrhosis, the most common endoscopic finding is oesophageal varices, with a substantially higher value in our part of the country, apart from other non-variceal causes.

Measures of upper limb function for people with neck pain: a systematic review of measurement and practical properties (protocol).

PubMed

Alreni, Ahmad Salah Eldin; Harrop, Deborah; Gumber, Anil; McLean, Sionnadh

2015-04-07

Upper limb disability is a common musculoskeletal condition frequently associated with neck pain. Recent literature has reported the need to utilise validated upper limb outcome measures in the assessment and management of patients with neck pain. However, there is a lack of clear guidance about the suitability of available measures, which may impede utilisation. This review will identify all available measures of upper limb function developed for use in neck pain patients and evaluate their measurement and practical properties in order to identify those measures that are most appropriate for use in clinical practice and research. This review will be performed in two phases. Phase one will identify all measures used to assess upper limb function for patients with neck pain. Phase two will identify all available studies of the measurement and practical properties of identified instrument. The COnsensus-based Standards for selection of health Measurement INstrument (COSMIN) will be used to evaluate the methodological quality of the included studies. To ensure methodological rigour, the findings of this review will be reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guideline. Optimal management of patients with neck pain should incorporate upper limb rehabilitation. The findings of this study will assist clinicians who seek to utilise suitable and accurate measures to assess upper limb function for a patient with neck pain. In addition, the findings of this study may suggest new research directions to support the development of upper limb outcome measures for patients with neck pain. PROSPERO CRD42015016624.

The Contribution of Upper Body Movements to Dynamic Balance Regulation during Challenged Locomotion

PubMed Central

Boström, Kim J.; Dirksen, Tim; Zentgraf, Karen; Wagner, Heiko

2018-01-01

Recent studies suggest that in addition to movements between ankle and hip joints, movements of the upper body, in particular of the arms, also significantly contribute to postural control. In line with these suggestions, we analyzed regulatory movements of upper and lower body joints supporting dynamic balance regulation during challenged locomotion. The participants walked over three beams of varying width and under three different verbally conveyed restrictions of arm posture, to control the potential influence of arm movements on the performance: The participants walked (1) with their arms stretched out perpendicularly in the frontal plane, (2) spontaneously, i.e., without restrictions to the arm movements, and (3) with their hands on their thighs. After applying an inverse-dynamics analysis to the measured joint kinematics, we investigated the contribution of upper and lower body joints to balance regulation in terms of torque amplitude and variation. On the condition with the hands on the thighs, the contribution of the upper body remains significantly lower than the contribution of the lower body irrespective of beam widths. For spontaneous arm movements and for outstretched arms we find that the upper body (including the arms) contributes to the balancing to a similar extent as the lower body. Moreover, when the task becomes more difficult, i.e., for narrower beam widths, the contribution of the upper body increases, while the contribution of the lower body remains nearly constant. These findings lend further support to the hypothetical existence of an “upper body strategy” complementing the ankle and hip strategies especially during challenging dynamic balance tasks. PMID:29434544

Portable Upper Extremity Robotics is as Efficacious as Upper Extremity Rehabilitative Therapy: A Randomized Controlled Pilot Trial

PubMed Central

Page, Stephen J.; Hill, Valerie; White, Susan

2013-01-01

Objective To compare the efficacy of a repetitive task specific practice regimen integrating a portable, electromyography-controlled brace called the “Myomo” versus usual care repetitive task specific practice in subjects with chronic, moderate upper extremity impairment. Subjects 16 subjects (7 males; mean age = 57.0 ± 11.02 years; mean time post stroke = 75.0 ± 87.63 months; 5 left-sided strokes) exhibiting chronic, stable, moderate upper extremity impairment. Interventions Subjects were administered repetitive task specific practice in which they participated in valued, functional tasks using their paretic upper extremities. Both groups were supervised by a therapist and were administered therapy targeting their paretic upper extremities that was 30-minutes in duration, occurring 3 days/week for 8 weeks. However, one group participated in repetitive task specific practice entirely while wearing the portable robotic while the other performed the same activity regimen manually.. Main Outcome Measures The upper extremity Fugl-Meyer, Canadian Occupational Performance measure and Stroke Impact Scale were administered on two occasions before intervention and once after intervention. Results After intervention, groups exhibited nearly-identical Fugl-Meyer score increases of ≈ 2.1 points; the group using robotics exhibited larger score changes on all but one of the Canadian occupational performance measure and Stroke Impact Scale subscales, including a 12.5-point increase on the Stroke Impact Scale recovery subscale. Conclusions Findings suggest that therapist-supervised repetitive task specific practice integrating robotics is as efficacious as manual in subjects with moderate upper extremity impairment. PMID:23147552

Carbon Dioxide Gas Sensors and Method of Manufacturing and Using Same

NASA Technical Reports Server (NTRS)

Liu, Chung Chiun (Inventor); Ward, Benjamin J. (Inventor); Hunter, Gary W. (Inventor); Xu, Jennifer C. (Inventor)

2011-01-01

A gas sensor includes a substrate and a pair of interdigitated metal electrodes selected from the group consisting of Pt, Pd, Au, Ir, Ag, Ru, Rh, In, and Os. The electrodes each include an upper surface. A first solid electrolyte resides between the interdigitated electrodes and partially engages the upper surfaces of the electrodes. The first solid electrolyte is selected from the group consisting of NASICON, LISICON, KSICON, and .beta.''-Alumina (beta prime-prime alumina in which when prepared as an electrolyte is complexed with a mobile ion selected from the group consisting of Na.sup.+, K.sup.+, Li.sup.+, Ag.sup.+, H.sup.+, Pb.sup.2+, Sr.sup.2+ or Ba.sup.2+). A second electrolyte partially engages the upper surfaces of the electrodes and engages the first solid electrolyte in at least one point. The second electrolyte is selected from the group of compounds consisting of Na.sup.+, K.sup.+, Li.sup.+, Ag.sup.+, H.sup.+, Pb.sup.2+, Sr.sup.2+ or Ba.sup.2+ ions or combinations thereof.

Gram stain microbiological pattern of upper extremities suppuration at Baptist Medical Centre, Ogbomoso Nigeria: a fifteen month review.

PubMed

Oke, A J; Olaolorun, D A; Meier, D E; Tarpley, J L

2011-06-01

Sixty-eight (68) patients with serious upper extremity suppurative infections, presenting within a period of fifteen (15) months, were prospectively studied clinically, Gram stain of aspirates/pus were performed, specimen cultured, planted, and where indicated glucose levels and haemoglobin genotype determined. Half of the patients had hand infections. Staphylococcus aureus was isolated from thirty-nine (39) patients. Gram Negative bacilli, including Salmonella were more isolated from patients with diabetes mellitus or Hgb SS or SC. The Gram stain results correlated with the culture result 90%. When Gram Positive cocci were demonstrated in the primary microscopic examination, cultures were not mandatory. When no organism was demonstrated on primary Gram stain or the patient was diabetic or a sickler, cultures of the specimens were done. The Gram stain, well performed, remains a useful, inexpensive, technologically appropriate laboratory test for abetting decision making in patients with upper extremity suppurative infections. Organisms encountered in this study included: Staphylococcus aureus, Streptococcus pyogenes, Salmonella typhi, Proteus mirabilis, Pseudomonas aeruginosa, and Coliforms.

Determination of design and operation parameters for upper atmospheric research instrumentation to yield optimum resolution with deconvolution

NASA Technical Reports Server (NTRS)

Ioup, George E.; Ioup, Juliette W.

1991-01-01

The final report for work on the determination of design and operation parameters for upper atmospheric research instrumentation to yield optimum resolution with deconvolution is presented. Papers and theses prepared during the research report period are included. Among all the research results reported, note should be made of the specific investigation of the determination of design and operation parameters for upper atmospheric research instrumentation to yield optimum resolution with deconvolution. A methodology was developed to determine design and operation parameters for error minimization when deconvolution is included in data analysis. An error surface is plotted versus the signal-to-noise ratio (SNR) and all parameters of interest. Instrumental characteristics will determine a curve in this space. The SNR and parameter values which give the projection from the curve to the surface, corresponding to the smallest value for the error, are the optimum values. These values are constrained by the curve and so will not necessarily correspond to an absolute minimum in the error surface.

Anatomy of Old Faithful From Subsurface Seismic Imaging of the Yellowstone Upper Geyser Basin

NASA Astrophysics Data System (ADS)

Wu, Sin-Mei; Ward, Kevin M.; Farrell, Jamie; Lin, Fan-Chi; Karplus, Marianne; Smith, Robert B.

2017-10-01

The Upper Geyser Basin in Yellowstone National Park contains one of the highest concentrations of hydrothermal features on Earth including the iconic Old Faithful geyser. Although this system has been the focus of many geological, geochemical, and geophysical studies for decades, the shallow (<200 m) subsurface structure remains poorly characterized. To investigate the detailed subsurface geologic structure including the hydrothermal plumbing of the Upper Geyser Basin, we deployed an array of densely spaced three-component nodal seismographs in November of 2015. In this study, we extract Rayleigh wave seismic signals between 1 and 10 Hz utilizing nondiffusive seismic waves excited by nearby active hydrothermal features with the following results: (1) imaging the shallow subsurface structure by utilizing stationary hydrothermal activity as a seismic source, (2) characterizing how local geologic conditions control the formation and location of the Old Faithful hydrothermal system, and (3) resolving a relatively shallow (10-60 m) and large reservoir located 100 m southwest of Old Faithful geyser.

Algal Data from Selected Sites in the Upper Colorado River Basin, Colorado, Water Years 1996-97

USGS Publications Warehouse

Mize, Scott V.; Deacon, Jeffrey R.

2001-01-01

Algal community samples were collected at 15 sites in the Upper Colorado River Basin in Colorado as part of the National Water-Quality Assessment Program during water years 1996-97. Sites sampled were located in two physiographic provinces, the Southern Rocky Mountains and the Colorado Plateaus, and represented agricultural, mining, urban, and mixed land uses and background conditions. Algal samples were collected once per year during low-flow conditions. Quantitative algal samples were collected within two targeted instream habitat types including a taxonomically richest-targeted habitat and a depositional-targeted habitat. This report presents the algal community data collected at the fixed sites in the Upper Colorado River Basin study unit. Algal data include densities (abundance of cells per square centimeter of substrate) and biovolumes (cubic micrometers of cells per square centimeter of substrate) for the two habitat types. Quality-assurance and quality-control results for algal samples indicate that the largest sampling variability tends to occur in samples from small streams.

Monolithic multi-color light emission/detection device

DOEpatents

Wanlass, Mark W.

1995-01-01

A single-crystal, monolithic, tandem, multi-color optical transceiver device is described, including (a) an InP substrate having upper and lower surfaces, (b) a first junction on the upper surface of the InP substrate, (c) a second junction on the first junction. The first junction is preferably GaInAsP of defined composition, and the second junction is preferably InP. The two junctions are lattice matched. The second junction has a larger energy band gap than the first junction. Additional junctions having successively larger energy band gaps may be included. The device is capable of simultaneous and distinct multi-color emission and detection over a single optical fiber.

Anaerobic bacteria in upper respiratory tract and head and neck infections: microbiology and treatment.

PubMed

Brook, Itzhak

2012-04-01

Anaerobes are the predominant components of oropharyngeal mucous membranes bacterial flora, and are therefore a common cause of bacterial infections of endogenous origin of upper respiratory tract and head and neck. This review summarizes the aerobic and anaerobic microbiology and antimicrobials therapy of these infections. These include acute and chronic otitis media, mastoiditis and sinusitis, pharyngo-tonsillitis, peritonsillar, retropharyngeal and parapharyngeal abscesses, suppurative thyroiditis, cervical lymphadenitis, parotitis, siliadenitis, and deep neck infections including Lemierre Syndrome. The recovery from these infections depends on prompt and proper medical and when indicated also surgical management. Copyright © 2012 Elsevier Ltd. All rights reserved.

Rotary Series Elastic Actuator

NASA Technical Reports Server (NTRS)

Ihrke, Chris A. (Inventor); Mehling, Joshua S. (Inventor); Parsons, Adam H. (Inventor); Griffith, Bryan Kristian (Inventor); Radford, Nicolaus A. (Inventor); Permenter, Frank Noble (Inventor); Davis, Donald R. (Inventor); Ambrose, Robert O. (Inventor); Junkin, Lucien Q. (Inventor)

2013-01-01

A rotary actuator assembly is provided for actuation of an upper arm assembly for a dexterous humanoid robot. The upper arm assembly for the humanoid robot includes a plurality of arm support frames each defining an axis. A plurality of rotary actuator assemblies are each mounted to one of the plurality of arm support frames about the respective axes. Each rotary actuator assembly includes a motor mounted about the respective axis, a gear drive rotatably connected to the motor, and a torsion spring. The torsion spring has a spring input that is rotatably connected to an output of the gear drive and a spring output that is connected to an output for the joint.

Rotary series elastic actuator

NASA Technical Reports Server (NTRS)

Ihrke, Chris A. (Inventor); Mehling, Joshua S. (Inventor); Parsons, Adam H. (Inventor); Griffith, Bryan Kristian (Inventor); Radford, Nicolaus A. (Inventor); Permenter, Frank Noble (Inventor); Davis, Donald R. (Inventor); Ambrose, Robert O. (Inventor); Junkin, Lucien Q. (Inventor)

2012-01-01

A rotary actuator assembly is provided for actuation of an upper arm assembly for a dexterous humanoid robot. The upper arm assembly for the humanoid robot includes a plurality of arm support frames each defining an axis. A plurality of rotary actuator assemblies are each mounted to one of the plurality of arm support frames about the respective axes. Each rotary actuator assembly includes a motor mounted about the respective axis, a gear drive rotatably connected to the motor, and a torsion spring. The torsion spring has a spring input that is rotatably connected to an output of the gear drive and a spring output that is connected to an output for the joint.

A nonreflecting upper boundary condition for anelastic nonhydrostatic mesoscale gravity-wave models

NASA Technical Reports Server (NTRS)

Kim, Young-Joon; Kar, Sajal K.; Arakawa, Akio

1993-01-01

A sponge layer is formulated to prevent spurious reflection of vertically propagating quasi-stationary gravity waves at the upper boundary of a two-dimensional numerical anelastic nonhydrostatic model. The sponge layer includes damping of both Newtonian-cooling type and Rayleigh-friction type, whose coefficients are determined in such a way that the reflectivity of wave energy at the bottom of the layer is zero. Unlike the formulations in earlier studies, our formulation includes the effects of vertical discretization, vertical mean density variation, and nonhydrostaticity. This sponge formulation is found effective in suppressing false downward reflection of waves for various types of quasi-stationary forcing.

Upper Airway Injury in Dogs Secondary to Trauma: 10 Dogs (2000-2011).

PubMed

Basdani, Eleni; Papazoglou, Lysimachos G; Patsikas, Michail N; Kazakos, Georgios M; Adamama-Moraitou, Katerina K; Tsokataridis, Ioannis

2016-01-01

Ten dogs that presented with trauma-induced upper airway rupture or stenosis were reviewed. Tracheal rupture was seen in seven dogs, tracheal stenosis in one dog, and laryngeal rupture in two dogs. Clinical abnormalities included respiratory distress in five dogs, subcutaneous emphysema in eight, air leakage through the cervical wound in seven, stridor in three dogs, pneumomediastinum in four and pneumothorax in one dog. Reconstruction with simple interrupted sutures was performed in four dogs, tracheal resection and end-to-end anastomosis in five dogs, and one dog was euthanized intraoperatively. Complications were seen in three dogs including aspiration pneumonia in one and vocalization alterations in two dogs.

Belt conveyor apparatus

DOEpatents

Oakley, David J.; Bogart, Rex L.

1987-01-01

A belt conveyor apparatus according to this invention defines a conveyance path including a first pulley and at least a second pulley. An endless belt member is adapted for continuous travel about the pulleys and comprises a lower portion which engages the pulleys and an integral upper portion adapted to receive objects therein at a first location on said conveyance path and transport the objects to a second location for discharge. The upper belt portion includes an opposed pair of longitudinally disposed crest-like members, biased towards each other in a substantially abutting relationship. The crest-like members define therebetween a continuous, normally biased closed, channel along the upper belt portion. Means are disposed at the first and second locations and operatively associated with the belt member for urging the normally biased together crest-like members apart in order to provide access to the continuous channel whereby objects can be received into, or discharged from the channel. Motors are in communication with the conveyance path for effecting the travel of the endless belt member about the conveyance path. The conveyance path can be configured to include travel through two or more elevations and one or more directional changes in order to convey objects above, below and/or around existing structures.

High EDSS can predict risk for upper urinary tract damage in patients with multiple sclerosis.

PubMed

Ineichen, Benjamin V; Schneider, Marc P; Hlavica, Martin; Hagenbuch, Niels; Linnebank, Michael; Kessler, Thomas M

2018-04-01

Neurogenic lower urinary tract dysfunction (NLUTD) is very common in patients with multiple sclerosis (MS), and it might jeopardize renal function and thereby increase mortality. Although there are well-known urodynamic risk factors for upper urinary tract damage, no clinical prediction parameters are available. We aimed to assess clinical parameters potentially predicting urodynamic risk factors for upper urinary tract damage. A consecutive series of 141 patients with MS referred from neurologists for primary neuro-urological work-up including urodynamics were prospectively evaluated. Clinical parameters taken into account were age, sex, duration, and clinical course of MS and Expanded Disability Status Scale (EDSS). Multivariate modeling revealed EDSS as a clinical parameter significantly associated with urodynamic risk factors for upper urinary tract damage (odds ratio = 1.34, 95% confidence interval (CI) = 1.06-1.71, p = 0.02). Using receiver operator characteristic (ROC) curves, an EDSS of 5.0 as cutoff showed a sensitivity of 86%-87% and a specificity of 52% for at least one urodynamic risk factor for upper urinary tract damage. High EDSS is significantly associated with urodynamic risk factors for upper urinary tract damage and allows a risk-dependent stratification in daily neurological clinical practice to identify MS patients requiring further neuro-urological assessment and treatment.

Expansion joint for guideway for magnetic levitation transportation system

DOEpatents

Rossing, Thomas D.

1993-01-01

An expansion joint that allows a guideway of a magnetic levitation transportation system to expand and contract while minimizing transients occurring in the magnetic lift and drag forces acting on a magnetic levitation vehicle traveling over the joint includes an upper cut or recess extending downwardly from the upper surface of the guideway and a non-intersecting lower cut or recess that extends upwardly from the lower surface of the guideway. The sidewalls of the cuts can be parallel to each other and the vertical axis of the guideway; the depth of the lower cut can be greater than the depth of the upper cut; and the overall combined lengths of the cuts can be greater than the thickness of the guideway from the upper to lower surface so that the cuts will overlap, but be spaced apart from each other. The distance between the cuts can be determined on the basis of the force transients and the mechanical behavior of the guideway. A second pair of similarly configured upper and lower cuts may be disposed in the guideway; the expansion joint may consist of two upper cuts and one lower cut; or the cuts may have non-parallel, diverging sidewalls so that the cuts have a substantially dove-tail shape.

Kinetic analysis of the function of the upper body for elite race walkers during official men 20 km walking race.

PubMed

Hoga-Miura, Koji; Ae, Michiyoshi; Fujii, Norihisa; Yokozawa, Toshiharu

2016-10-01

This study investigated the function of the upper extremities of elite race walkers during official 20 km races, focusing on the angular momentum about the vertical axis and other parameters of the upper extremities. Sixteen walkers were analysed using the three-dimensional direct linear transformation method during three official men's 20 km walking races. The subjects, included participants at the Olympics and World Championships, who finished without disqualification and had not been disqualified during the two years prior to or following the races analysed in the present study. The angular momenta of the upper and lower body were counterbalanced as in running and normal walking. The momentum of the upper body was mainly generated by the upper extremities. The joint force moment of the right shoulder and the joint torque at the left shoulder just before right toe-off were significantly correlated with the walking speed. These were counterbalanced by other moments and torques to the torso torque, which worked to obtain a large mechanical energy flow from the recovery leg to the support leg in the final phase of the support phase. Therefore, a function of the shoulder torque was to counterbalance the torso torque to gain a fast walking speed with substantial mechanical energy flow.

Seasonal and pandemic human influenza viruses attach better to human upper respiratory tract epithelium than avian influenza viruses.

PubMed

van Riel, Debby; den Bakker, Michael A; Leijten, Lonneke M E; Chutinimitkul, Salin; Munster, Vincent J; de Wit, Emmie; Rimmelzwaan, Guus F; Fouchier, Ron A M; Osterhaus, Albert D M E; Kuiken, Thijs

2010-04-01

Influenza viruses vary markedly in their efficiency of human-to-human transmission. This variation has been speculated to be determined in part by the tropism of influenza virus for the human upper respiratory tract. To study this tropism, we determined the pattern of virus attachment by virus histochemistry of three human and three avian influenza viruses in human nasal septum, conchae, nasopharynx, paranasal sinuses, and larynx. We found that the human influenza viruses-two seasonal influenza viruses and pandemic H1N1 virus-attached abundantly to ciliated epithelial cells and goblet cells throughout the upper respiratory tract. In contrast, the avian influenza viruses, including the highly pathogenic H5N1 virus, attached only rarely to epithelial cells or goblet cells. Both human and avian viruses attached occasionally to cells of the submucosal glands. The pattern of virus attachment was similar among the different sites of the human upper respiratory tract for each virus tested. We conclude that influenza viruses that are transmitted efficiently among humans attach abundantly to human upper respiratory tract, whereas inefficiently transmitted influenza viruses attach rarely. These results suggest that the ability of an influenza virus to attach to human upper respiratory tract is a critical factor for efficient transmission in the human population.

Expansion joint for guideway for magnetic levitation transportation system

DOEpatents

Rossing, T.D.

1993-02-09

An expansion joint that allows a guideway of a magnetic levitation transportation system to expand and contract while minimizing transients occurring in the magnetic lift and drag forces acting on a magnetic levitation vehicle traveling over the joint includes an upper cut or recess extending downwardly from the upper surface of the guideway and a non-intersecting lower cut or recess that extends upwardly from the lower surface of the guideway. The side walls of the cuts can be parallel to each other and the vertical axis of the guideway; the depth of the lower cut can be greater than the depth of the upper cut; and the overall combined lengths of the cuts can be greater than the thickness of the guideway from the upper to lower surface so that the cuts will overlap, but be spaced apart from each other. The distance between the cuts can be determined on the basis of the force transients and the mechanical behavior of the guideway. A second pair of similarly configured upper and lower cuts may be disposed in the guideway; the expansion joint may consist of two upper cuts and one lower cut; or the cuts may have non-parallel, diverging side walls so that the cuts have a substantially dove-tail shape.

The Influence of Dopaminergic Striatal Innervation on Upper Limb Locomotor Synergies

PubMed Central

Isaias, Ioannis U.; Volkmann, Jens; Marzegan, Alberto; Marotta, Giorgio; Cavallari, Paolo; Pezzoli, Gianni

2012-01-01

To determine the role of striatal dopaminergic innervation on upper limb synergies during walking, we measured arm kinematics in 13 subjects with Parkinson disease. Patients were recruited according to several inclusion criteria to represent the best possible in vivo model of dopaminergic denervation. Of relevance, we included only subjects with normal spatio-temporal parameters of the stride and gait speed to avoid an impairment of upper limbs locomotor synergies as a consequence of gait impairment per se. Dopaminergic innervation of the striatum was measured by FP-CIT and SPECT. All patients showed a reduction of gait-associated arms movement. No linear correlation was found between arm ROM reduction and contralateral dopaminergic putaminal innervation loss. Still, a partition analysis revealed a 80% chance of reduced arm ROM when putaminal dopamine content loss was >47%. A significant correlation was described between the asymmetry indices of the swinging of the two arms and dopaminergic striatal innervation. When arm ROM was reduced, we found a positive correlation between upper-lower limb phase shift modulation (at different gait velocities) and striatal dopaminergic innervation. These findings are preliminary evidence that dopaminergic striatal tone plays a modulatory role in upper-limb locomotor synergies and upper-lower limb coupling while walking at different velocities. PMID:23236504

The effects of very early mirror therapy on functional improvement of the upper extremity in acute stroke patients.

PubMed

Yeldan, Ipek; Huseyınsınoglu, Burcu Ersoz; Akıncı, Buket; Tarakcı, Ela; Baybas, Sevim; Ozdıncler, Arzu Razak

2015-11-01

[Purpose] The aim of the study was to evaluate the effects of a very early mirror therapy program on functional improvement of the upper extremity in acute stroke patients. [Subjects] Eight stroke patients who were treated in an acute neurology unit were included in the study. [Methods] The patients were assigned alternatively to either the mirror therapy group receiving mirror therapy and neurodevelopmental treatment or the neurodevelopmental treatment only group. The primary outcome measures were the upper extremity motor subscale of the Fugl-Meyer Assessment, Motricity Index upper extremity score, and the Stroke Upper Limb Capacity Scale. Somatosensory assessment with the Ayres Southern California Sensory Integration Test, and the Barthel Index were used as secondary outcome measures. [Results] No statistically significant improvements were found for any measures in either group after the treatment. In terms of minimally clinically important differences, there were improvements in Fugl-Meyer Assessment and Barthel Index in both mirror therapy and neurodevelopmental treatment groups. [Conclusion] The results of this pilot study revealed that very early mirror therapy has no additional effect on functional improvement of upper extremity function in acute stroke patients. Multicenter trials are needed to determine the results of early application of mirror therapy in stroke rehabilitation.

Robot-assisted upper extremity rehabilitation for cervical spinal cord injuries: a systematic scoping review.

PubMed

Singh, Hardeep; Unger, Janelle; Zariffa, José; Pakosh, Maureen; Jaglal, Susan; Craven, B Catharine; Musselman, Kristin E

2018-01-15

Abstact Purpose: To provide an overview of the feasibility and outcomes of robotic-assisted upper extremity training for individuals with cervical spinal cord injury (SCI), and to identify gaps in current research and articulate future research directions. A systematic search was conducted using Medline, Embase, PsycINFO, CCTR, CDSR, CINAHL and PubMed on June 7, 2017. Search terms included 3 themes: (1) robotics; (2) SCI; (3) upper extremity. Studies using robots for upper extremity rehabilitation among individuals with cervical SCI were included. Identified articles were independently reviewed by two researchers and compared to pre-specified criteria. Disagreements regarding article inclusion were resolved through discussion. The modified Downs and Black checklist was used to assess article quality. Participant characteristics, study and intervention details, training outcomes, robot features, study limitations and recommendations for future studies were abstracted from included articles. Twelve articles (one randomized clinical trial, six case series, five case studies) met the inclusion criteria. Five robots were exoskeletons and three were end-effectors. Sample sizes ranged from 1 to 17 subjects. Articles had variable quality, with quality scores ranging from 8 to 20. Studies had a low internal validity primarily from lack of blinding or a control group. Individuals with mild-moderate impairments showed the greatest improvements on body structure/function and performance-level measures. This review is limited by the small number of articles, low-sample sizes and the diversity of devices and their associated training protocols, and outcome measures. Preliminary evidence suggests robot-assisted interventions are safe, feasible and can reduce active assistance provided by therapists. Implications for rehabilitation Robot-assisted upper extremity training for individuals with cervical spinal cord injury is safe, feasible and can reduce hands-on assistance provided by therapists. Future research in robotics rehabilitation with individuals with spinal cord injury is needed to determine the optimal device and training protocol as well as effectiveness.

Albian-Paleocene flora of the north pacific: Systematic composition, palaeofloristics and phytostratigraphy

NASA Astrophysics Data System (ADS)

Herman, A. B.

2013-12-01

Principal attention is focused on phytostratigraphy and comparative palaeofloristics of the Anadyr-Koryak (AKSR) and Northern Alaska (NASR) subregions of the North Pacific Region. The high-resolution Upper Albian-Paleocene phytostratigraphic schemes of these subregions are based on perceived stages of their floral evolution. In the AKSR the scheme includes seven subdivisions of subregional extent: the Early Ginter (upper Albian), Grebenka (upper Albian-Cenomanian-lower Turonian), Penzhina (upper Turonian), Kaivayam (Coniacian), Barykov (Santonian-lower to ?middle Campanian), Gornorechenian (?upper Campanian-lower Maastrichtian), and Koryak (lower to upper Maastrichtian-?Danian) phytostratigraphic horizons. The phytostratigraphic scheme of the NASR includes three subregional phytostratigraphic horizons and five plant-bearing beds. These are the Kukpowruk (?lower to middle-?upper Albian), Niakogon (upper Albian-Cenomanian), Kaolak (Turonian) horizons and beds with the Tuluvak (Coniacian), Early Kogosukruk (upper Santonian-Campanian), Late Kogosukruk (Campanian-Maastrichtian), Early Sagwon (Danian-Selandian), and Late Sagwon (Selandian-Thanetian) floras. The comparative analysis of coeval (or close in age) floras distinguished in the AKSR and NASR shows that they are either similar to each other (floras Early Ginter and Kukpowruk, Grebenka and Niakogon, Penzhina and Kaolak, Koryak and Early Sagwon) or different in systematic composition (floras Kaivayam and Tuluvak, Gornorechenian and Kogosukruk). Similarities between the floras imply that plant assemblages of two subregions evolved under comparable climatic conditions and freely intercommunicated via the Bering Land Bridge during the Albian-Turonian and terminal Maastrichtian-Paleocene. Floras of the AKSR and NASR, which are of different composition, existed in particular intervals of geological history when trans-Beringian plant migrations were limited or even ceased because of palaeoclimatic difference between the subregions. Floras of the AKSR and NASR survived crisis at the Cretaceous-Paleogene boundary without essential evolutionary consequence which does not support a hypothesis of a global ecological crisis at this boundary. From the analysis of the Arctic end-Cretaceous flora and palaeoclimate we conclude that the large Northern Alaskan dinosaurs were driven by lack of resources (food and shelter) to migrate 1200-1300 kilometres to the South to find forage, warmer temperatures and better light conditions before winter set in. A scenario of the Albian-Late Cretaceous florogenesis in the North Pacific Region is proposed. A primary driver of Albian-Late Cretaceous florogenesis was the gradual invasion by novel angiosperm-rich plant communities into the Asiatic continental interiors and a replacement of pre-existing vegetation dominated by ancient ferns and gymnosperms. Plant fossils representing Mesophytic and Cenophytic communities usually do not mix in the individual assemblages.

Treatment of Class III malocclusion in a young adult patient: a case report.

PubMed

Kiran, B H Jyothi; Kumar, Prashanth; Ravi, S; Shivalinga, B M; Bhagyalaxmi; Pradeep; Kudagi, Vishal

2012-01-01

This article describes the treatment of a young adult male with a concave profile, skeletal class III malocclusion because of a prognathic mandible and proclined upper incisors. The therapy included stages: 1. Pre-surgical orthodontics involving leveling and aligning of upper and lower arches, protraction of lower molars and retraction of upper incisors; 2. Surgical phase involving BSSO with mandibular setback and 3. Post-surgical orthodontics for finishing and detailing. The treatment lasted 23 months and improved facial esthetics significantly The treatment resulted in a functional occlusion with a lack of lateral cuspid guidance that could be accepted considering the difficulty of the case. Over jet and overbite are within norms.

Initial Assessment and Resuscitation in Nonvariceal Upper Gastrointestinal Bleeding.

PubMed

Simon, Tracey G; Travis, Anne C; Saltzman, John R

2015-07-01

Acute nonvariceal upper gastrointestinal bleeding remains an important cause of hospital admission with an associated mortality of 2-14%. Initial patient evaluation includes rapid hemodynamic assessment, large-bore intravenous catheter insertion and volume resuscitation. A hemoglobin transfusion threshold of 7 g/dL is recommended, and packed red blood cell transfusion may be necessary to restore intravascular volume and improve tissue perfusion. Patients should be risk stratified into low- and high-risk categories, using validated prognostic scoring systems such as the Glasgow-Blatchford, AIMS65 or Rockall scores. Effective early management of acute, nonvariceal upper gastrointestinal hemorrhage is critical for improving patient outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

Assessing the quality of humidity measurements from global operational radiosonde sensors

NASA Astrophysics Data System (ADS)

Moradi, Isaac; Soden, Brian; Ferraro, Ralph; Arkin, Phillip; Vömel, Holger

2013-07-01

The quality of humidity measurements from global operational radiosonde sensors in upper, middle, and lower troposphere for the period 2000-2011 were investigated using satellite observations from three microwave water vapor channels operating at 183.31±1, 183.31±3, and 183.31±7 GHz. The radiosonde data were partitioned based on sensor type into 19 classes. The satellite brightness temperatures (Tb) were simulated using radiosonde profiles and a radiative transfer model, then the radiosonde simulated Tb's were compared with the observed Tb's from the satellites. The surface affected Tb's were excluded from the comparison due to the lack of reliable surface emissivity data at the microwave frequencies. Daytime and nighttime data were examined separately to see the possible effect of daytime radiation bias on the sonde data. The error characteristics among different radiosondes vary significantly, which largely reflects the differences in sensor type. These differences are more evident in the mid-upper troposphere than in the lower troposphere, mainly because some of the sensors stop responding to tropospheric humidity somewhere in the upper or even in the middle troposphere. In the upper troposphere, most sensors have a dry bias but Russian sensors and a few other sensors including GZZ2, VZB2, and RS80H have a wet bias. In middle troposphere, Russian sensors still have a wet bias but all other sensors have a dry bias. All sensors, including Russian sensors, have a dry bias in lower troposphere. The systematic and random errors generally decrease from upper to lower troposphere. Sensors from China, India, Russia, and the U.S. have a large random error in upper troposphere, which indicates that these sensors are not suitable for upper tropospheric studies as they fail to respond to humidity changes in the upper and even middle troposphere. Overall, Vaisala sensors perform better than other sensors throughout the troposphere exhibiting the smallest systematic and random errors. Because of the large differences between different radiosonde humidity sensors, it is important for long-term trend studies to only use data measured using a single type of sensor at any given station. If multiple sensor types are used then it is necessary to consider the bias between sensor types and its possible dependence on humidity and temperature.

Sequence stratigraphy, geodynamics, and detrital geothermochronology of Cretaceous foreland basin deposits, western interior U.S.A

NASA Astrophysics Data System (ADS)

Painter, Clayton S.

Three studies on Cordilleran foreland basin deposits in the western U.S.A. constitute this dissertation. These studies differ in scale, time and discipline. The first two studies include basin analysis, flexural modeling and detailed stratigraphic analysis of Upper Cretaceous depocenters and strata in the western U.S.A. The third study consists of detrital zircon U-Pb analysis (DZ U-Pb) and thermochronology, both zircon (U-Th)/He and apatite fission track (AFT), of Upper Jurassic to Upper Cretaceous foreland-basin conglomerates and sandstones. Five electronic supplementary files are a part of this dissertation and are available online; these include 3 raw data files (Appendix_A_raw_isopach_data.txt, Appendix_C_DZ_Data.xls, Appendix_C_U-Pb_apatite.xls), 1 oversized stratigraphic cross section (Appendix_B_figure_5.pdf), and 1 figure containing apatite U-Pb concordia plots (Appendix_C_Concordia.pdf). Appendix A is a combination of detailed isopach maps of the Upper Cretaceous Western Interior, flexural modeling and a comparison to dynamic subsidence models as applied to the region. Using these new isopach maps and modeling, I place the previously recognized but poorly constrained shift from flexural to non-flexural subsidence at 81 Ma. Appendix B is a detailed stratigraphic study of the Upper Cretaceous, (Campanian, ~76 Ma) Sego Sandstone Member of the Mesaverde Group in northwestern Colorado, an area where little research has been done on this formation. Appendix C is a geo-thermochronologic study to measure the lag time of Upper Jurassic to Upper Cretaceous conglomerates and sandstones in the Cordilleran foreland basin. The maximum depositional ages using DZ U-Pb match existing biostratigraphic age controls. AFT is an effective thermochronometer for Lower to Upper Cretaceous foreland stratigraphy and indicates that source material was exhumed from >4--5 km depth in the Cordilleran orogenic belt between 118 and 66 Ma, and zircon (U-Th)/He suggests that it was exhumed from <8--9 km depth. Apatite U-Pb analyses indicate that volcanic contamination is a significant issue, without which, one cannot exclude the possibility that the youngest detrital AFT population is contaminated with significant amounts of volcanogenic apatite and does not represent source exhumation. AFT lag times are <5 Myr with relatively steady-state to slightly increasing exhumation rates. Lag time measurements indicate exhumation rates of ~0.9->>1 km/Myr.

Relations among questionnaire and laboratory measures of rhinovirus infection.

PubMed

Barrett, B; Brown, R; Voland, R; Maberry, R; Turner, R

2006-08-01

Due to high incidence and quality-of-life impact, upper respiratory infection substantially impacts on population health. To test or compare treatment effectiveness, a well-designed and validated illness-specific quality-of-life instrument is needed. Data reported in the current study were obtained from a trial testing echinacea for induced rhinovirus infection. Laboratory-assessed biomarkers included interleukin (IL)-8, nasal neutrophil count (polymorphonuclear neutrophils (PMN)), mucus weight, viral titre and seroconversion. The questionnaires used included the general health short form (SF)-8 (24-h recall version), the eight-item Jackson cold scale, and the 44-item Wisconsin Upper Respiratory Symptom Survey (WURSS). In total, 399 participants were inoculated with rhinovirus and monitored over 2,088 person-days. Statistically significant associations were found among nearly all variables. Between-questionnaire correlations were: WURSS-Jackson = 0.81; WURSS-SF-8 = 0.62; and Jackson-SF-8 = 0.60. Correlations with laboratory values were as follows: WURSS-mucus weight = 0.53; Jackson-mucus weight = 0.55; WURSS-viral titre = 0.37; Jackson-viral titre = 0.46; WURSS-IL-8 = 0.31; Jackson-IL-8 = 0.36; WURSS-PMN = 0.31; and Jackson-PMN = 0.28. Neither WURSS nor Jackson yielded satisfactory cut-off scores for diagnosis of infection. Symptomatic and biological outcomes of upper respiratory infection are highly variable, with only modest associations. While Wisconsin Upper Respiratory Symptom Survey and Jackson questionnaires both correlate with biomarkers, neither is a good predictor of induced infection. The inclusion of functional and quality-of-life items in the Wisconsin Upper Respiratory Symptom Survey does not significantly decrease the strength of association with laboratory-assessed biomarkers.

Hydrogeology, water quality, and water-supply potential of the Lower Floridan Aquifer, coastal Georgia, 1999-2002

USGS Publications Warehouse

Falls, W. Fred; Harrelson, Larry G.; Conlon, Kevin J.; Petkewich, Matthew D.

2005-01-01

The hydrogeology and water quality of the upper permeable and Fernandina permeable zones of the Lower Floridan aquifer were studied at seven sites in the 24-county study area encompassed by the Georgia Coastal Sound Science Initiative. Although substantially less than the Upper Floridan aquifer in coastal Georgia, transmissivities for the Lower Floridan aquifer are in the same range as other water-supply aquifers in Georgia and South Carolina and could meet the needs of public drinking-water supply. Water of the upper permeable zone of the Lower Floridan aquifer exceeds the Federal secondary drinking-water standards for sulfate and total dissolved solids at most coastal Georgia sites and the Federal secondary drinking-water standard for chloride at the Shellman Bluff site. The top of the Lower Floridan aquifer correlates within 50 feet of the previously reported top, except at the St Simons Island site where the top is more than 80 feet higher. Based on the hydrogeologic characteristics, the seven sites are divided into the northern sites at Shellman Bluff, Richmond Hill, Pembroke, and Pineora; and southern sites at St Marys, Brunswick, and St Simons Island. At the northern sites, the Lower Floridan aquifer does not include the Fernandina permeable zone, is thinner than the overlying Upper Floridan aquifer, and consists of only strata of the middle Eocene Avon Park Formation. Transmissivities in the Lower Floridan aquifer are 8,300 feet squared per day at Richmond Hill and 6,000 feet squared per day at Shellman Bluff, generally one tenth the transmissivity of the Upper Floridan aquifer at these sites. At the southern sites, the upper permeable zone of the Lower Floridan aquifer is thicker than the Upper Floridan aquifer and consists of porous limestone and dolomite interbedded with nonporous strata of the middle Eocene Avon Park and early Eocene Oldsmar Formations. Transmissivities for the upper permeable zone of the Lower Floridan aquifer are 500 feet squared per day at the St Simons Island site and 13,000 feet squared per day at the St Marys site. The Lower Floridan aquifer at the Brunswick and St Marys sites includes the Fernandina permeable zone, which consists of saltwater-bearing dolomite. Hydrographs of Coastal Sound Science Initiative wells and other nearby wells open to the Upper Floridan aquifer, and the upper permeable and Fernandina permeable zones of the Lower Floridan aquifer have similar trends. Water levels in wells open to the Upper and Lower Floridan aquifers are below land surface at the northern sites and the St Simons Island site, and above land surface at the Brunswick and St Marys sites, as of January 1, 2004. Freshwater is present in the Lower Floridan aquifer at Pineora, Pembroke, and St Marys, and from 1,259 to 1,648 feet below land surface at Brunswick. Slightly saline water is present in the Lower Floridan aquifer at Richmond Hill, Shellman Bluff, St Simons Island, and from 1,679 to 1,970 feet below land surface in well 34H495 at Brunswick. The upper permeable zone of the Lower Floridan aquifer contains bicarbonate water at the Pembroke site, sulfate-bicarbonate water at the Brunswick site, and sulfate water at the St Simons Island, Shellman Bluff, St Marys, and Richmond Hill sites. The bicarbonate, sulfate-bicarbonate, and sulfate waters are saturated relative to calcite and dolomite, and undersaturated with gypsum and anhydrite. The Fernandina permeable zone in well 34H495 includes moderately saline water, very saline water, and brine. The Fernandina permeable zone of the Lower Floridan aquifer beneath downtown Brunswick contains chloride water that is slightly undersaturated to saturated with gypsum and anhydrite. Concentrations of total dissolved solids, sulfate, and chloride exceeded the Federal secondary drinking-water standards. The chloride-contaminated plumes beneath downtown Brunswick would require at least a 12- to 20-percent contribution of very saline water from the Fernandi

Impact of smoking on the age at diagnosis of upper tract urothelial carcinoma: Subanalysis of the Japanese Urological Association multi-institutional national database.

PubMed

Miyazaki, Jun; Nishiyama, Hiroyuki; Fujimoto, Hiroyuki; Ohyama, Chikara; Koie, Takuya; Hinotsu, Shiro; Kikuchi, Eiji; Sakura, Mizuaki; Inokuchi, Junichi; Hara, Tomohiko

2015-11-01

To examine the influence of smoking history on the diagnosis and other tumor characteristics of upper tract urothelial carcinoma in Japan. A total of 1509 patients with upper tract urothelial carcinoma who were diagnosed in 2005 from 348 Japanese institutions were registered using the multi-institutional national database of the Japanese Urological Association and included in this analysis. Clinical data of the patients were collected in 2011. The associations between the patients' self-reported smoking history and their age at the diagnosis of upper tract urothelial carcinoma, sex, pathological T stage and tumor grade were analyzed. The mean age at the diagnosis of upper tract urothelial carcinoma was approximately 5 years earlier for the 238 current smokers than for the 618 current non-smokers (P < 0.0001). Similar associations between smoking and the early diagnosis of upper tract urothelial carcinoma were shown in the sex subgroups and in subgroups stratified by pathological T stages. Among the current smokers, the age at diagnosis for the smoking ≥ 20 cigarettes per day group was 6.5 years lower than that of the < 20 cigarettes per day group, which was significantly different (P < 0.0001). Current smoking is a significant risk factor for the earlier diagnosis of upper tract urothelial carcinoma. The finding is important from the perspective of both healthcare and medical economies. © 2015 The Japanese Urological Association.

Antiplatelet agents and/or anticoagulants are not associated with worse outcome following nonvariceal upper gastrointestinal bleeding.

PubMed

Teles-Sampaio, Elvira; Maia, Luís; Salgueiro, Paulo; Marcos-Pinto, Ricardo; Dinis-Ribeiro, Mário; Pedroto, Isabel

2016-11-01

Nonvariceal upper gastrointestinal bleeding emerges as a major complication of using antiplatelet agents and/or anticoagulants and represents a clinical challenge in patients undergoing these therapies. To characterize patients with nonvariceal upper gastrointestinal bleeding related to antithrombotics and their management, and to determine clinical predictors of adverse outcomes. Retrospective cohort of adults who underwent upper gastrointestinal endoscopy after nonvariceal upper gastrointestinal bleeding from 2010 to 2012. The outcomes were compared between patients exposed and not exposed to antithrombotics. Five hundred and forty-eight patients with nonvariceal upper gastrointestinal bleeding (67% men; mean age 66.5 ± 16.4 years) were included, of which 43% received antithrombotics. Most patients had comorbidities. Peptic ulcer was the main diagnosis and endoscopic therapy was performed in 46% of cases. The 30-day mortality rate was 7.7% (n = 42), and 36% were bleeding-related. The recurrence rate was 9% and 14% of patients with initial endoscopic treatment needed endoscopic retreatment. There were no significant differences between the exposed and non-exposed groups in most outcomes. Co-morbidities, hemodynamic instability, high Rockall score, low hemoglobin (7.76 ± 2.72 g/dL) and higher international normalized ratio (1.63 ± 1.13) were associated significantly with mortality in a univariate analysis. Adverse outcomes were not associated with antithrombotic use. The management of nonvariceal upper gastrointestinal bleeding constitutes a challenge to clinical performance optimization and clinical cooperation.

Advanced upper limb prosthetic devices: implications for upper limb prosthetic rehabilitation.

PubMed

Resnik, Linda; Meucci, Marissa R; Lieberman-Klinger, Shana; Fantini, Christopher; Kelty, Debra L; Disla, Roxanne; Sasson, Nicole

2012-04-01

The number of catastrophic injuries caused by improvised explosive devices in the Afghanistan and Iraq Wars has increased public, legislative, and research attention to upper limb amputation. The Department of Veterans Affairs (VA) has partnered with the Defense Advanced Research Projects Agency and DEKA Integrated Solutions to optimize the function of an advanced prosthetic arm system that will enable greater independence and function. In this special communication, we examine current practices in prosthetic rehabilitation including trends in adoption and use of prosthetic devices, financial considerations, and the role of rehabilitation team members in light of our experiences with a prototype advanced upper limb prosthesis during a VA study to optimize the device. We discuss key challenges in the adoption of advanced prosthetic technology and make recommendations for service provision and use of advanced upper limb prosthetics. Rates of prosthetic rejection are high among upper limb amputees. However, these rates may be reduced with sufficient training by a highly specialized, multidisciplinary team of clinicians, and a focus on patient education and empowerment throughout the rehabilitation process. There are significant challenges emerging that are unique to implementing the use of advanced upper limb prosthetic technology, and a lack of evidence to establish clinical guidelines regarding prosthetic prescription and treatment. Finally, we make recommendations for future research to aid in the identification of best practices and development of policy decisions regarding insurance coverage of prosthetic rehabilitation. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Upper gastrointestinal alterations in kidney transplant candidates.

PubMed

Homse Netto, João Pedro; Pinheiro, João Pedro Sant'Anna; Ferrari, Mariana Lopes; Soares, Mirella Tizziani; Silveira, Rogério Augusto Gomes; Maioli, Mariana Espiga; Delfino, Vinicius Daher Alvares

2018-05-14

The incidence of gastrointestinal disorders among patients with chronic kidney disease (CKD) is high, despite the lack of a good correlation between endoscopic findings and symptoms. Many services thus perform upper gastrointestinal (UGI) endoscopy on kidney transplant candidates. This study aims to describe the alterations seen on the upper endoscopies of 96 kidney-transplant candidates seen from 2014 to 2015. Ninety-six CKD patients underwent upper endoscopic examination as part of the preparation to receive kidney grafts. The data collected from the patients' medical records were charted on Microsoft Office Excel 2016 and presented descriptively. Mean values, medians, interquartile ranges and 95% confidence intervals of the clinic and epidemiological variables were calculated. Possible associations between endoscopic findings and infection by H. pylori were studied. Males accounted for 54.17% of the 96 patients included in the study. Median age and time on dialysis were 50 years and 50 months, respectively. The most frequent upper endoscopy finding was enanthematous pangastritis (57.30%), followed by erosive esophagitis (30.20%). Gastric intestinal metaplasia and peptic ulcer were found in 8.33% and 7.30% of the patients, respectively. H. pylori tests were positive in 49 patients, and H. pylori infection was correlated only with non-erosive esophagitis (P = 0.046). Abnormal upper endoscopy findings were detected in all studied patients. This study suggested that upper endoscopy is a valid procedure for kidney transplant candidates. However, prospective studies are needed to shed more light on this matter.

Petrology and diagenetic history of the upper shale member of the Late Devonian-Early Mississippian Bakken Formation, Williston Basin, North Dakota

USGS Publications Warehouse

Neil S. Fishman,; Sven O. Egenhoff,; Boehlke, Adam; Lowers, Heather A.

2015-01-01

The organic-rich upper shale member of the upper Devonian–lower Mississippian Bakken Formation (Williston Basin, North Dakota, USA) has undergone significant diagenetic alteration, irrespective of catagenesis related to hydrocarbon generation. Alteration includes precipitation of numerous cements, replacement of both detrital and authigenic minerals, multiple episodes of fracturing, and compaction. Quartz authigenesis occurred throughout much of the member, and is represented by multiple generations of microcrystalline quartz. Chalcedonic quartz fills radiolarian microfossils and is present in the matrix. Sulfide minerals include pyrite and sphalerite. Carbonate diagenesis is volumetrically minor and includes thin dolomite overgrowths and calcite cement. At least two generations of fractures are observed. Based on the authigenic minerals and their relative timing of formation, the evolution of pore waters can be postulated. Dolomite and calcite resulted from early postdepositional aerobic oxidation of some of the abundant organic material in the formation. Following aerobic oxidation, conditions became anoxic and sulfide minerals precipitated. Transformation of the originally opaline tests of radiolaria resulted in precipitation of quartz, and quartz authigenesis is most common in more distal parts of the depositional basin where radiolaria were abundant. Because quartz authigenesis is related to the distribution of radiolaria, there is a link between diagenesis and depositional environment. Furthermore, much of the diagenesis in the upper shale member preceded hydrocarbon generation, so early postdepositional processes were responsible for occlusion of significant original porosity in the member. Thus, diagenetic mineral precipitation was at least partly responsible for the limited ability of these mudstones to provide porosity for storage of hydrocarbons.

Physical symptoms and working performance in female breast cancer survivors: a systematic review.

PubMed

Zomkowski, Kamilla; Cruz de Souza, Bruna; Pinheiro da Silva, Fabiana; Moreira, Géssica Maria; de Souza Cunha, Natália; Sperandio, Fabiana Flores

2018-06-01

The aim of this systematic review was to summarize and systematize the information about physical symptoms and its relation with work activity on female Breast Cancer Survivors (BCS). A systematic search was performed on the databases MEDLINE/PubMed (via National Library of Medicine), SCOPUS (Elsevier), Web of Science (Thomson Reuters Scientific) and CINAHL with full text (EBSCO), including papers about physical impairments experienced by female workers who have had breast cancer. The search retrieved 238 studies, and another 5 were identified in the articles' references, totaling 243 papers. After removing duplicates and applying the inclusion criteria and a full text reading, 13 articles were included for qualitative analysis. Concerning physical limitations, most complaints were related to the elevation of upper limbs, carrying heavy objects, driving and holding manual movements. The most referred symptoms were breast/arm pain, fatigue, lymphedema, reduced range of motion and weakness in the upper limbs, scar tissue adherence in the breast/axilla and paresthesia in the arm/breast. These symptoms and physical limitations led to the difficulty or impossibility of performing work tasks, which also diminished work productivity, as well as the increase in time to return to work. The present results suggest higher unemployment rates and the need for modifying work conditions. Implication for Rehabilitation Health professionals should include risk assessment at daily routine to identify possible sources of physical impairments for upper limbs. Provide the support and orientations according to personal and job characteristics of the patient. Focus the aims of treatment over upper limbs impairments, reducing the prevalence and the gravity of symptoms.

Recombination device for storage batteries

DOEpatents

Kraft, H.; Ledjeff, K.

1984-01-01

A recombination device including a gas-tight enclosure connected to receive the discharge gases from a rechargeable storage battery. Catalytic material for the recombination of hydrogen and oxygen to form water is supported within the enclosure. The enclosure is sealed from the atmosphere by a liquid seal including two vertical chambers interconnected with an inverted U-shaped overflow tube. The first chamber is connected at its upper portion to the enclosure and the second chamber communicates at its upper portion with the atmosphere. If the pressure within the enclosure differs as overpressure or vacuum by more than the liquid level, the liquid is forced into one of the two chambers and the overpressure is vented or the vacuum is relieved. The recombination device also includes means for returning recombined liquid to the battery and for absorbing metal hydrides.

Recombination device for storage batteries

DOEpatents

Kraft, Helmut; Ledjeff, Konstantin

1985-01-01

A recombination device including a gas-tight enclosure connected to receive he discharge gases from a rechargeable storage battery. Catalytic material for the recombination of hydrogen and oxygen to form water is supported within the enclosure. The enclosure is sealed from the atmosphere by a liquid seal including two vertical chambers interconnected with an inverted U-shaped overflow tube. The first chamber is connected at its upper portion to the enclosure and the second chamber communicates at its upper portion with the atmosphere. If the pressure within the enclosure differs as overpressure or vacuum by more than the liquid level, the liquid is forced into one of the two chambers and the overpressure is vented or the vacuum is relieved. The recombination device also includes means for returning recombined liquid to the battery and for absorbing metal hydrides.

A Sociolinguistic Profile of 100 Mothers from Middle to Upper-Middle Socio-Economic Backgrounds in Penang-Chinese Community: What Languages Do They Speak at Home with Their Children?

ERIC Educational Resources Information Center

Low, Hui Min; Nicholas, Howard; Wales, Roger

2010-01-01

This paper reports the findings of a survey of 100 mothers of Chinese children aged between 6 and 36 months from middle to upper-middle socio-economic backgrounds in Penang, Malaysia. The findings include the language backgrounds of these mothers, their contextual uses of multiple languages and their language choices with their children. Through…

Linear mass actuator

NASA Technical Reports Server (NTRS)

Holloway, Sidney E., III (Inventor); Crossley, Edward A., Jr. (Inventor); Jones, Irby W. (Inventor); Miller, James B. (Inventor); Davis, C. Calvin (Inventor); Behun, Vaughn D. (Inventor); Goodrich, Lewis R., Sr. (Inventor)

1992-01-01

A linear mass actuator includes an upper housing and a lower housing connectable to each other and having a central passageway passing axially through a mass that is linearly movable in the central passageway. Rollers mounted in the upper and lower housings in frictional engagement with the mass translate the mass linearly in the central passageway and drive motors operatively coupled to the roller means, for rotating the rollers and driving the mass axially in the central passageway.

Residual Upper Arm Motor Function Primes Innervation of Paretic Forearm Muscles in Chronic Stroke after Brain-Machine Interface (BMI) Training

PubMed Central

Curado, Marco Rocha; Cossio, Eliana Garcia; Broetz, Doris; Agostini, Manuel; Cho, Woosang; Brasil, Fabricio Lima; Yilmaz, Oezge; Liberati, Giulia; Lepski, Guilherme

2015-01-01

Background Abnormal upper arm-forearm muscle synergies after stroke are poorly understood. We investigated whether upper arm function primes paralyzed forearm muscles in chronic stroke patients after Brain-Machine Interface (BMI)-based rehabilitation. Shaping upper arm-forearm muscle synergies may support individualized motor rehabilitation strategies. Methods Thirty-two chronic stroke patients with no active finger extensions were randomly assigned to experimental or sham groups and underwent daily BMI training followed by physiotherapy during four weeks. BMI sessions included desynchronization of ipsilesional brain activity and a robotic orthosis to move the paretic limb (experimental group, n = 16). In the sham group (n = 16) orthosis movements were random. Motor function was evaluated with electromyography (EMG) of forearm extensors, and upper arm and hand Fugl-Meyer assessment (FMA) scores. Patients performed distinct upper arm (e.g., shoulder flexion) and hand movements (finger extensions). Forearm EMG activity significantly higher during upper arm movements as compared to finger extensions was considered facilitation of forearm EMG activity. Intraclass correlation coefficient (ICC) was used to test inter-session reliability of facilitation of forearm EMG activity. Results Facilitation of forearm EMG activity ICC ranges from 0.52 to 0.83, indicating fair to high reliability before intervention in both limbs. Facilitation of forearm muscles is higher in the paretic as compared to the healthy limb (p<0.001). Upper arm FMA scores predict facilitation of forearm muscles after intervention in both groups (significant correlations ranged from R = 0.752, p = 0.002 to R = 0.779, p = 0.001), but only in the experimental group upper arm FMA scores predict changes in facilitation of forearm muscles after intervention (R = 0.709, p = 0.002; R = 0.827, p<0.001). Conclusions Residual upper arm motor function primes recruitment of paralyzed forearm muscles in chronic stroke patients and predicts changes in their recruitment after BMI training. This study suggests that changes in upper arm-forearm synergies contribute to stroke motor recovery, and provides candidacy guidelines for similar BMI-based clinical practice. PMID:26495971

Residual Upper Arm Motor Function Primes Innervation of Paretic Forearm Muscles in Chronic Stroke after Brain-Machine Interface (BMI) Training.

PubMed

Curado, Marco Rocha; Cossio, Eliana Garcia; Broetz, Doris; Agostini, Manuel; Cho, Woosang; Brasil, Fabricio Lima; Yilmaz, Oezge; Liberati, Giulia; Lepski, Guilherme; Birbaumer, Niels; Ramos-Murguialday, Ander

2015-01-01

Abnormal upper arm-forearm muscle synergies after stroke are poorly understood. We investigated whether upper arm function primes paralyzed forearm muscles in chronic stroke patients after Brain-Machine Interface (BMI)-based rehabilitation. Shaping upper arm-forearm muscle synergies may support individualized motor rehabilitation strategies. Thirty-two chronic stroke patients with no active finger extensions were randomly assigned to experimental or sham groups and underwent daily BMI training followed by physiotherapy during four weeks. BMI sessions included desynchronization of ipsilesional brain activity and a robotic orthosis to move the paretic limb (experimental group, n = 16). In the sham group (n = 16) orthosis movements were random. Motor function was evaluated with electromyography (EMG) of forearm extensors, and upper arm and hand Fugl-Meyer assessment (FMA) scores. Patients performed distinct upper arm (e.g., shoulder flexion) and hand movements (finger extensions). Forearm EMG activity significantly higher during upper arm movements as compared to finger extensions was considered facilitation of forearm EMG activity. Intraclass correlation coefficient (ICC) was used to test inter-session reliability of facilitation of forearm EMG activity. Facilitation of forearm EMG activity ICC ranges from 0.52 to 0.83, indicating fair to high reliability before intervention in both limbs. Facilitation of forearm muscles is higher in the paretic as compared to the healthy limb (p<0.001). Upper arm FMA scores predict facilitation of forearm muscles after intervention in both groups (significant correlations ranged from R = 0.752, p = 0.002 to R = 0.779, p = 0.001), but only in the experimental group upper arm FMA scores predict changes in facilitation of forearm muscles after intervention (R = 0.709, p = 0.002; R = 0.827, p<0.001). Residual upper arm motor function primes recruitment of paralyzed forearm muscles in chronic stroke patients and predicts changes in their recruitment after BMI training. This study suggests that changes in upper arm-forearm synergies contribute to stroke motor recovery, and provides candidacy guidelines for similar BMI-based clinical practice.

21 CFR 870.2300 - Cardiac monitor (including cardiotachometer and rate alarm).

Code of Federal Regulations, 2010 CFR

2010-04-01

... cardiac monitor (including cardiotachometer and rate alarm) is a device used to measure the heart rate.... This device may sound an alarm when the heart rate falls outside preset upper and lower limits. (b...

21 CFR 870.2300 - Cardiac monitor (including cardiotachometer and rate alarm).

Code of Federal Regulations, 2012 CFR

2012-04-01

... cardiac monitor (including cardiotachometer and rate alarm) is a device used to measure the heart rate.... This device may sound an alarm when the heart rate falls outside preset upper and lower limits. (b...

21 CFR 870.2300 - Cardiac monitor (including cardiotachometer and rate alarm).

Code of Federal Regulations, 2013 CFR

2013-04-01

... cardiac monitor (including cardiotachometer and rate alarm) is a device used to measure the heart rate.... This device may sound an alarm when the heart rate falls outside preset upper and lower limits. (b...

21 CFR 870.2300 - Cardiac monitor (including cardiotachometer and rate alarm).

Code of Federal Regulations, 2011 CFR

2011-04-01

... cardiac monitor (including cardiotachometer and rate alarm) is a device used to measure the heart rate.... This device may sound an alarm when the heart rate falls outside preset upper and lower limits. (b...

21 CFR 870.2300 - Cardiac monitor (including cardiotachometer and rate alarm).

Code of Federal Regulations, 2014 CFR

2014-04-01

... cardiac monitor (including cardiotachometer and rate alarm) is a device used to measure the heart rate.... This device may sound an alarm when the heart rate falls outside preset upper and lower limits. (b...

Complicated Genitourinary Tract Infections and Mimics.

PubMed

Yu, Michael; Robinson, Kathryn; Siegel, Cary; Menias, Christine

This article provides pictorial review of complicated upper and lower genitourinary infections and their mimics. Imaging features of upper urinary tract infections including uncomplicated acute pyelonephritis, xanthogranulomatous pyelonephritis (XGPN), emphysematous pyelonephritis, perirenal abscess, and pyonephrosis are first reviewed and then followed by pictorial review of their mimics including contrast-associated nephrotoxicity, renal infarcts, malakoplakia, renal cell cancer, leukemia or lymphoma and Castleman's disease. Next, imaging features of lower urinary tract infections including cystitis, emphysematous cystitis, enterovesical, colovesical and vesicovaginal fistulas, Fournier gangrene, prostatitis, epididymitis, and orchitis are reviewed and then followed by pictorial review of their mimics including gas in the bladder and perineum related to instrumentation, radiation cystitis, bladder cancer, testicular torsion, testicular trauma, and testicular cancer and lymphoma. Recognizing imaging characteristics of complicated genitourinary infections and their mimics would allow clinicians to provide appropriate timely management. Copyright © 2016 Elsevier Inc. All rights reserved.

Three Dimensional Viscoelastic Postseismic Deformation of the 2013 Mw8.3 Okhotsk Deep-Focus Earthquake

NASA Astrophysics Data System (ADS)

Hu, Y.; Burgmann, R.; Shestakov, N.; Titkov, N. N.; Serovetnikov, S.; Prytkov, A.; Vasilenko, N. F.; Wang, K.

2016-12-01

The upper mantle rheology at depths within a few hundred kilometers has been well studied through shallow great megathrust earthquakes. However, understanding of the mantle rheology at greater depths, such as in the vicinity of the transition zone, has been limited by the lack of direct or indirect measurements. The largest well-recorded deep earthquake with magnitude Mw 8.3 occurred within the subducting Pacific plate at 600 km depth beneath the Okhotsk Sea on May 24, 2013. Twenty-seven continuous GPS stations in this region recorded coseismic displacements of up to 15 mm in the horizontal direction and up to 20 mm in the vertical direction. Within three years after the earthquake seventeen continuous GPS stations underwent transient westward motion of up to 8 mm/yr and vertical motion of up to 10 mm/yr. The geodetically delineated postseismic crustal deformation thus provides a unique opportunity to study the three dimensional heterogeneity of the mantle rheology and properties of the subducting slab at great depths. We have developed three-dimensional viscoelastic finite element models of the 2013 Okhotsk earthquake to explore these questions. Our initial model includes an elastic lithosphere including the subducting slab, a viscoelastic continental upper mantle and a viscoelastic oceanic upper mantle. We assume that the upper mantle is characterized by a bi-viscous Burgers rheology. For simplicity, we assume that the transient Kelvin viscosity is one order of magnitude lower than that of the steady-state Maxwell viscosity. Our preliminary models indicate that the viscosity of the upper mantle beneath the transition zone has to be at least one order of magnitude lower than that of the upper mantle at shallower depths. A viscoelastic subducting slab at depths >400 km with viscosities of 2-3 orders of magnitude higher than that of the mantle wedge provides a better fit to the observed surface velocities.

Upper Campanian calciclastic turbidite sequences from the Hacımehmet area (eastern Pontides, NE Turkey): integrated biostratigraphy and microfacies analysis

NASA Astrophysics Data System (ADS)

Sari, Bilal; Kandemir, Raif; Özer, Sacit; Walaszczyk, Ireneusz; Görmüş, Muhittin; Demircan, Huriye; Yilmaz, Cemil

2014-12-01

The upper Campanian (Cretaceous) of the Hacımehmet area (south of the city of Trabzon; Eastern Pontides) is mainly composed of calciclastic turbidites. The basinal unit of the 119 m thick succession includes thin red pelagic limestone interlayers and conglomerates dominated by volcanic clasts. The overlying upper slope and lower slope units of the sequence consist of an alternation of allochthonous calcarenite/calcirudite beds and pelagic marls and mudstones. Calcarenite/calcirudite beds dominate the upper slope unit of the succession and are composed of transported material, including benthic foraminifers, red algae, bryozoan, crinoid and rudist fragments, inoceramid bivalve prisms and neritic and pelagic carbonate lithoclasts. The occurrence of Helicorbitoides boluensis (Sirel) extracted from the calcarenite/calcirudite beds indicates a Campanian age. Identifiable rudists such as Joufia reticulata Boehm, Bournonia cf. anatolica Ozer, Biradiolites cf. bulgaricus Pamouktchiev and ?Biradiolites sp. from the upper slope unit of the succession indicate a late Campanian- Maastrichtian age. The planktonic foraminifers within the red pelagic limestone beds, marls and mudstones throughout the succession consist mainly of Campanian-Maastrichtian forms and suggest mainly basinal depositional conditions. The presence of Radotruncana cf. calcarata (Cushman) accompanied by Globotruncanita elevata (Brotzen) in the basinal unit of the succession indicates an early late Campanian age for the lower part of the succession. Inoceramid bivalves have been collected from the upper part of the succession. The fauna is dominated by `Inoceramus' tenuilineatus Hall and Meek, 1854 and Cataceramus haldemensis (Giers, 1964); other taxa recognised are: `Inoceramus' algeriensis Heinz, 1932, Platyceramus vanuxemi (Meek and Hayden, 1860), `Inoceramus' cf. nebrascensis Owen, 1852, Cataceramus aff. barabini (Morton, 1834), Cataceramus gandjaensis (Aliev, 1956), and `Inoceramus' sp.; the assemblage indicates the `Inoceramus' tenuilineatus Zone; corresponding to the middle-late Campanian boundary interval. The uppermost part of the succession is characterized by the presence of the trace fossils Scolicia strozzii and Scolicia isp., indicating a mixed Skolithos-Cruziana ichnofacies. This ichnofacies suggests a well-oxygenated environment.

Geophysical data collected from the St. Clair River between Michigan and Ontario, Canada (2008-016-FA)

USGS Publications Warehouse

Denny, Jane F.; Foster, D.S.; Worley, C.R.; Irwin, Barry J.

2011-01-01

In 2008, the U.S. Geological Survey (USGS), Woods Hole Coastal and Marine Science Center (WHCMSC), in cooperation with the U.S. Army Corps of Engineers conducted a geophysical and sampling survey of the riverbed of the Upper St. Clair River between Port Huron, Mich., and Sarnia, Ontario, Canada. The objectives were to define the Quaternary geologic framework of the riverbed of the St. Clair River to evaluate the relationship between morphologic change of the riverbed and underlying stratigraphy. This report presents the geophysical and sample data collected from the St. Clair River, May 29-June 6, 2008, as part of the International Upper Great Lakes Study, a 5-year project funded by the International Joint Commission of the United States and Canada to examine whether physical changes in the St. Clair River are affecting water levels within upper Great Lakes, to assess regulation plans for outflows from Lake Superior, and to examine the potential effect of climate change on the Great Lakes water levels (http://www.iugls.org). This document makes available the data that were used in a separate report, U.S. Geological Survey Open-File Report 2009-1137, which detailed the interpretations of the Quaternary geologic framework of the region. This report includes a description of the high-resolution acoustic and sediment-sampling systems that were used to map the morphology, surficial sediment distribution, and underlying geology of the Upper St. Clair River during USGS field activity 2008-016-FA (http://quashnet.er.usgs.gov/cgi-bin/datasource/public_ds_info.pl?fa=2008-016-FA). Video and photographs of the riverbed were also collected and are included in this data release. Future analyses will be focused on substrate erosion and its effects on river-channel morphology and geometry. Ultimately, the International Upper Great Lakes Study will attempt to determine where physical changes in the St. Clair River affect water flow and, subsequently, water levels in the Upper Great Lakes.

Do work-related factors affect care-seeking in general practice for back pain or upper extremity pain?

PubMed

Jensen, Jens Christian; Haahr, Jens Peder; Frost, Poul; Andersen, Johan Hviid

2013-10-01

Musculoskeletal pain conditions remain a major cause of care-seeking in general practice. Not all patients with musculoskeletal pain (MP) seek care at their general practitioner (GP), but for those who do, the GP's knowledge of what work-related factors might have influenced the patient's decision to seek care could be important in order to give more well-founded advice to our patients. The objective of this study was to elucidate the effects of workloads on care-seeking for back pain or upper extremity pain during an eighteen-month follow-up period. This is a prospective study with a baseline questionnaire and eighteen-month follow-up. Among the registered patients of 8 GPs, we identified 8,517 persons between 17 and 65 years of age, who all received the questionnaire. A total of 5,068 (59.5 %) persons answered. During the eighteen months of follow-up, we used the International Classification for Primary Care (ICPC) to identify all care-seekers with either back pain or upper extremity pain. Of these, all currently employed persons were included in our analysis, in all 4,325 persons. For analysis, we used Cox proportional hazards regression analysis. Analyses were stratified by gender. High levels of heavy lifting, defined as the upper tertile on a categorical scale, were associated with care-seeking for back pain (HR 1.90 [95 % CI: 1.14-3.15]) and upper extremity pain (HR 2.09 [95 % CI: 1.30-3.38]) among males, but not in a statistically significant way among females. Repetitive work and psychosocial factors did not have any statistically significant impact on care-seeking for neither back pain nor upper extremity pain. Work-related factors such as heavy lifting do, to some extent, contribute to care-seeking with MP. We suggest that asking the patient about physical workloads should be routinely included in consultations dealing with MP.

Prevalence and Spectrum of Gastro Esophageal Reflux Disease in Bronchial Asthma.

PubMed

Rameschandra, Sahoo; Acharya, Vishak; Kunal; Vishwanath, Tantry; Ramkrishna, Anand; Acharya, Preetam

2015-10-01

There exists a complex interplay between asthma and gastroesophageal reflux disease. Both these diseases are known to aggravate each other and amelioration of one is necessary for the control of the other. There is a paucity of studies in Indian population on this subject. To evaluate the clinical features and the endoscopic findings of the upper gastrointestinal tract in patients with bronchial asthma. Study was conducted at KMC group of hospitals, Mangalore in the Department of chest medicine in association with Department of gastroenterology. Subjects included 50 cases of bronchial asthma and controls were 58 non asthmatic patients with allergic rhinitis and chronic urticaria. All patients were queried about presence or absence of symptoms of upper gastro intestinal tract disorders by gastro oesophageal reflux disease (GERD) questionnaire and all the included patients underwent upper gastro intestinal endoscopy. The study showed that symptoms of gastroesophageal reflux were significantly more in asthmatics (52%) as compared to the controls (28%). The common presenting features of gastroesophageal reflux in asthmatics were heartburn (40%) retrosternal pain (24%), nocturnal cough (18%), dyspepsia (16%) and regurgitation (14%) and the above symptoms were significantly more common in asthmatics as compared to controls. Gastroesophageal reflux disease was found to be significantly more common in the asthmatics (58%) as compared to the control group where it was present in 32.75% of the subjects. Clinical or endoscopic evidence of any upper gastrointestinal disorder was found in 68% of the asthmatics as compared to 37.93% of the controls. This difference was found to be statistically significant. The study showed that gastroesophageal reflux disease was significantly more in asthmatics as compared to the controls. Upper gastrointestinal symptoms were more common in asthmatics as against controls. Clinical or endoscopic evidence of upper gastrointestinal disorder and gastroesophageal reflux disease was found in significantly higher proportion of the asthmatics as compared to the controls. Clinically silent gastroesophageal reflux disease was however seen in both control and asthmatic groups equally with a lower prevalence.

Cerebral Small Vessel Disease Burden Is Associated with Motor Performance of Lower and Upper Extremities in Community-Dwelling Populations

PubMed Central

Su, Ning; Zhai, Fei-Fei; Zhou, Li-Xin; Ni, Jun; Yao, Ming; Li, Ming-Li; Jin, Zheng-Yu; Gong, Gao-Lang; Zhang, Shu-Yang; Cui, Li-Ying; Tian, Feng; Zhu, Yi-Cheng

2017-01-01

Objective: To investigate the correlation between cerebral small vessel disease (CSVD) burden and motor performance of lower and upper extremities in community-dwelling populations. Methods: We performed a cross-sectional analysis on 770 participants enrolled in the Shunyi study, which is a population-based cohort study. CSVD burden, including white matter hyperintensities (WMH), lacunes, cerebral microbleeds (CMBs), perivascular spaces (PVS), and brain atrophy were measured using 3T magnetic resonance imaging. All participants underwent quantitative motor assessment of lower and upper extremities, which included 3-m walking speed, 5-repeat chair-stand time, 10-repeat pronation–supination time, and 10-repeat finger-tapping time. Data on demographic characteristics, vascular risk factors, and cognitive functions were collected. General linear model analysis was performed to identify potential correlations between motor performance measures and imaging markers of CSVD after controlling for confounding factors. Results: For motor performance of the lower extremities, WMH was negatively associated with gait speed (standardized β = -0.092, p = 0.022) and positively associated with chair-stand time (standardized β = 0.153, p < 0.0001, surviving FDR correction). For motor performance of the upper extremities, pronation–supination time was positively associated with WMH (standardized β = 0.155, p < 0.0001, surviving FDR correction) and negatively with brain parenchymal fraction (BPF; standardized β = -0.125, p = 0.011, surviving FDR correction). Only BPF was found to be negatively associated with finger-tapping time (standardized β = -0.123, p = 0.012). However, lacunes, CMBs, or PVS were not found to be associated with motor performance of lower or upper extremities in multivariable analysis. Conclusion: Our findings suggest that cerebral microstructural changes related to CSVD may affect motor performance of both lower and upper extremities. WMH and brain atrophy are most strongly associated with motor function deterioration in community-dwelling populations. PMID:29021757

Cerebral Small Vessel Disease Burden Is Associated with Motor Performance of Lower and Upper Extremities in Community-Dwelling Populations.

PubMed

Su, Ning; Zhai, Fei-Fei; Zhou, Li-Xin; Ni, Jun; Yao, Ming; Li, Ming-Li; Jin, Zheng-Yu; Gong, Gao-Lang; Zhang, Shu-Yang; Cui, Li-Ying; Tian, Feng; Zhu, Yi-Cheng

2017-01-01

Objective: To investigate the correlation between cerebral small vessel disease (CSVD) burden and motor performance of lower and upper extremities in community-dwelling populations. Methods: We performed a cross-sectional analysis on 770 participants enrolled in the Shunyi study, which is a population-based cohort study. CSVD burden, including white matter hyperintensities (WMH), lacunes, cerebral microbleeds (CMBs), perivascular spaces (PVS), and brain atrophy were measured using 3T magnetic resonance imaging. All participants underwent quantitative motor assessment of lower and upper extremities, which included 3-m walking speed, 5-repeat chair-stand time, 10-repeat pronation-supination time, and 10-repeat finger-tapping time. Data on demographic characteristics, vascular risk factors, and cognitive functions were collected. General linear model analysis was performed to identify potential correlations between motor performance measures and imaging markers of CSVD after controlling for confounding factors. Results: For motor performance of the lower extremities, WMH was negatively associated with gait speed (standardized β = -0.092, p = 0.022) and positively associated with chair-stand time (standardized β = 0.153, p < 0.0001, surviving FDR correction). For motor performance of the upper extremities, pronation-supination time was positively associated with WMH (standardized β = 0.155, p < 0.0001, surviving FDR correction) and negatively with brain parenchymal fraction (BPF; standardized β = -0.125, p = 0.011, surviving FDR correction). Only BPF was found to be negatively associated with finger-tapping time (standardized β = -0.123, p = 0.012). However, lacunes, CMBs, or PVS were not found to be associated with motor performance of lower or upper extremities in multivariable analysis. Conclusion: Our findings suggest that cerebral microstructural changes related to CSVD may affect motor performance of both lower and upper extremities. WMH and brain atrophy are most strongly associated with motor function deterioration in community-dwelling populations.

Clinical pattern and prevalence of upper gastrointestinal toxicity in patients abusing ketamine.

PubMed

Liu, Shirley Yuk Wah; Ng, Stephen Ka Kei; Tam, Yuk Him; Yee, Samuel Chi Hang; Lai, Franco Pui Tak; Hong, Cindy Yuek Lam; Chiu, Philip Wai Yan; Ng, Enders Kwok Wai; Ng, Chi Fai

2017-09-01

Evaluations of upper gastrointestinal toxicity from ketamine abuse are uncommon. This study investigated the clinical pattern of upper gastrointestinal symptoms in patients inhaling ketamine. In a cross-sectional study of 611 consecutive patients who were seeking treatment for ketamine uropathy in a tertiary hospital setting between August 2008 and June 2016, their clinical pattern of upper gastrointestinal symptoms was evaluated and compared with a control population of 804 non-users. A total of 168 (27.5%) patients abusing ketamine (mean age 26.3 years, 58.9% female) reported the presence of upper gastrointestinal symptoms. These symptoms were significantly more prevalent in patients inhaling ketamine than in those who were not (27.5% vs 5.2%, P < 0.001). Their mean duration of ketamine abuse before symptom presentation was 5.0 ± 3.1 years. The presenting symptoms included epigastric pain (n = 155, 25.4%), recurrent vomiting (n = 48, 7.9%), anemia (n = 36, 5.9%) and gastrointestinal bleeding (n = 20, 3.3%). Uropathy symptoms were preceded by upper gastrointestinal symptoms for 4.4 ± 3.0 years in 141 (83.9%) patients. Logistic regression showed that elder age (odds ratio [OR] 1.06, P = 0.04), active abuser status (OR 1.60, P = 0.04) and longer duration of ketamine abuse (OR 1.00, P = 0.04) were independent factors associated with upper gastrointestinal toxicity. Although epigastric symptoms are unusual in the young population, upper gastrointestinal toxicity was highly prevalent in those inhaling ketamine. Enquiries about ketamine abuse are recommended when assessing young patients with epigastric symptoms. © 2017 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

[The effect of neurorehabilitation on the functional state and muscle tone of upper limb in patients after ischaemic stroke].

PubMed

Klimkiewicz, Paulina; Kubsik, Anna; Jankowska, Agnieszka; Woldańska-Okońska, Marta

2014-03-01

Rehabilitation of upper limb in patients after ischemic stroke is a major challenge for modern neurorehabilitation. Function of upper limb of patients after ischemic stroke returns on the end of the rehabilitation comparing with another parts of the body. Below presents two groups of patients after ischemic stroke who were rehabilitated with use of the following methods: kinesiotherapy combined with NDT- Bobath method and kinesiotherapy only. The aim of this study was to assess the impact of kinesiotherapy only and NDT- Bobath method combined with kinesiotherapy on the functional state and muscle tone of upper limb in patients after ischemic stroke. The study involved a group of 40 patients after ischemic stroke with motor control and muscle tone problems of upper limb. Patients were divided into two groups, each of them included 20 people. Upper limb in group I was rehabilitated with the use of kinesiotherapy exercise however group II with the use of kinesiotherapy exercise combined with NDT- Bobath method (Neurodevelopmental Treatment Bobath). To evaluate the patients before and after rehabilitation muscle tone Asworth scale was used and to assess functional status Rivermead Motor Assessment (RMAIII) scale was used. After 5 weeks of rehabilitation in group II in majority patients were observed decrease of muscle tone and improvement in upper limb functional status. In group I the muscle tone were also decreased and functional status were better but in smaller impact than in II group. Classical kinesiotherapy combined with the NDT-Bobath method gives better results in neurorehabilitation of upper limb than the use of kinesiotherapy exercises only in patients after ischemic stroke.

Multibody system of the upper limb including a reverse shoulder prosthesis.

PubMed

Quental, C; Folgado, J; Ambrósio, J; Monteiro, J

2013-11-01

The reverse shoulder replacement, recommended for the treatment of several shoulder pathologies such as cuff tear arthropathy and fractures in elderly people, changes the biomechanics of the shoulder when compared to the normal anatomy. Although several musculoskeletal models of the upper limb have been presented to study the shoulder joint, only a few of them focus on the biomechanics of the reverse shoulder. This work presents a biomechanical model of the upper limb, including a reverse shoulder prosthesis, to evaluate the impact of the variation of the joint geometry and position on the biomechanical function of the shoulder. The biomechanical model of the reverse shoulder is based on a musculoskeletal model of the upper limb, which is modified to account for the properties of the DELTA® reverse prosthesis. Considering two biomechanical models, which simulate the anatomical and reverse shoulder joints, the changes in muscle lengths, muscle moment arms, and muscle and joint reaction forces are evaluated. The muscle force sharing problem is solved for motions of unloaded abduction in the coronal plane and unloaded anterior flexion in the sagittal plane, acquired using video-imaging, through the minimization of an objective function related to muscle metabolic energy consumption. After the replacement of the shoulder joint, significant changes in the length of the pectoralis major, latissimus dorsi, deltoid, teres major, teres minor, coracobrachialis, and biceps brachii muscles are observed for a reference position considered for the upper limb. The shortening of the teres major and teres minor is the most critical since they become unable to produce active force in this position. Substantial changes of muscle moment arms are also observed, which are consistent with the literature. As expected, there is a significant increase of the deltoid moment arms and more fibers are able to elevate the arm. The solutions to the muscle force sharing problem support the biomechanical advantages attributed to the reverse shoulder design and show an increase in activity from the deltoid, teres minor, and coracobrachialis muscles. The glenohumeral joint reaction forces estimated for the reverse shoulder are up to 15% lower than those in the normal shoulder anatomy. The data presented here complements previous publications, which, all together, allow researchers to build a biomechanical model of the upper limb including a reverse shoulder prosthesis.

Extensive Middle Amazonian mantling of debris aprons and plains in Deuteronilus Mensae, Mars: Implications for the record of mid-latitude glaciation

NASA Astrophysics Data System (ADS)

Baker, David M. H.; Head, James W.

2015-11-01

The mid-latitudes of Mars are host to a record of recent episodes of accumulations of ice-rich materials. The record includes debris aprons, interpreted to be debris-covered glaciers, that may represent the preserved remnants of a much more extensive ice sheet. We assessed the possibility of former glacial extents by examining debris aprons and the surrounding plains in Deuteronilus Mensae. Geomorphic units and stratigraphic relationships were mapped and documented from Mars Reconnaissance Orbiter (MRO) Context (CTX) and High Resolution Imaging Science Experiment (HiRISE) camera images, and crater retention ages were estimated from crater size-frequency distributions. Three major units are observed within the study area: debris aprons, lower plains, and upper plains. Debris aprons exhibit characteristics typical for these features documented elsewhere and in previous studies, including integrated flow lineations and patterns, convex-upward profiles, and knobby and brain terrain surface textures. A lower bound on the age for debris aprons is estimated to be 0.9 Ga. Debris aprons are superposed on a lower plains unit having a lower bound age of 3.3-3.5 Ga. A 50-100 m thick upper plains unit superposes both debris apron landforms and lower plains units and has a best-fit minimum age of 0.6 Ga. The upper plains unit exhibits characteristics of atmospherically-emplaced mantle material, including fine-grained nature, sublimation textures, cyclic layering, draping character, and widespread spatial distribution. Fracturing and subsequent sublimation/erosion of upper plains on debris aprons has contributed to many of the surface textures on debris aprons. The upper plains unit has also been eroded from the lower plains and plateaus, evidenced by isolated blocks of upper plains in the interiors of craters and on the walls and tops of plateaus. While no conclusive evidence diagnostic of former cold-based ice sheets are observed in the plains within the study region, such landforms and units may have been poorly developed or absent, as is often the case on Earth, and would have been covered and reworked by later mantling episodes. These observations suggest that emplacement of thick ice-rich mantle deposits extended at least to near the Early/Middle Amazonian boundary and overlapped with the waning stages of glaciation in Deuteronilus Mensae.

How do you say 'Global Warming' in Your Language?" Linguistic Research on Climate Change in the Upper Tanana Valley, Alaska

NASA Astrophysics Data System (ADS)

Lovick, O.

2006-12-01

The Upper Tanana valley in the interior of Alaska used to be one of the most remote regions on the North American continent. This changed rapidly about 100 years ago, with the onset of the gold rush. Ever since, change has come to the Upper Tanana valley in many forms, from the intrusion of white people to climate change and pollution. The changes are severe and on-going, and they affect everyday life in every possible way. It is obvious that the ideal consultant for long-term studies like studies on climate change has to be older rather than younger. In rural communities of Alaska, including the ones targeted in this study, older consultants, that is, consultants in their 60s or older, usually have a first language different from English, in our case Upper Tanana Athabascan. Even though most of these consultants do have some knowledge of English, their skills in this language can be limited. Thus, communication between the (English-speaking) scientist and the (Upper Tanana-speaking) consultant is bound to be problematic and error-prone. This can be avoided by conducting the research in the Native language. This poster illustrates as part of IPY research how the kinds of change mentioned above are regarded by the Upper Tanana Athabascans, and how the Upper Tanana language reflects them. Concepts like 'global warming' or 'greenhouse effect' are relatively new even to the English language. Speakers are asked to translate such and similar terms into their language, and to explain their choice of words. While the Upper Tanana translations of these terms do not necessarily reflect the English original accurately, discussion of such concepts is still possible for a fluent speaker. Still, the ways of expression such concepts differ from language to language, a different pool of metaphors is employed in the formation of words, and there are nuances in Upper Tanana that can easily get lost in translation to English. Thus, the use of the Upper Tanana language reflects to some degree the Upper Tanana views on climate change. Additionally, scientific interpretations are very much affected by more accurate translations and by less misapprehension of Upper Tanana concepts.

Upper Grades Ideas.

ERIC Educational Resources Information Center

Thornburg, David; Beane, Pam

1983-01-01

Presents programming ideas using LOGO, activity for converting flowchart into a computer program, and a Pascal program for generating music using paddles. Includes the article "Helping Computers Adapt to Kids" by Philip Nothnagle; a program for estimating length of lines is included. (JN)

Effectiveness of temporary deafferentation of the arm on somatosensory and motor functions following stroke: a systematic review.

PubMed

Opsommer, Emmanuelle; Zwissig, Camille; Korogod, Natalya; Weiss, Thomas

2016-12-01

After stroke, regaining functional use of the upper limb can be challenging. Temporary deafferentation (TD) is a novel approach used in neurorehabilitation to voluntarily reduce the somatosensory input in a body part by temporary anesthesia; which has been shown to improve sensorimotor functions in the affected limb. The primary objective of this systematic review was to present the best available evidence related to the effects of TD of the affected arm on the recovery of motor function and activity of the upper limb (arm and hand) following stroke. Further, this review aimed to assess the effects of TD on sensory function, activities of daily living (ADL) and quality of life following stroke, the acceptability and safety of the intervention as well as adverse events. Adult patients (18 years and older) with a clinical diagnosis of stroke, either hemorrhagic or ischemic. Reports of rehabilitation that included the use of a pneumatic tourniquet, regional anesthesia or nerve block to achieve TD of an arm, or the use of TD as a stand-alone intervention. Primary outcomes were motor function and activity of the upper limb using assessment scales, motor tests and global motor functions.Secondary outcomes included measures of sensory function, ADL, impact of stroke and quality of life and pain.Additional outcomes were neurophysiological changes as studied with functional magnetic resonance imaging, magnetoencephalography and/or transcranial magnetic stimulation.Acceptability and safety of the intervention as well as adverse events were also included. We included any experimental and epidemiological studies. There were no randomized controlled trials. We included non-randomized controlled trials, quasi-experimental, before and after studies and case-control studies. We searched for both published and unpublished studies in major databases and all reference lists of relevant articles in English, German or French languages. We included studies published from January 1980 to October 2015. Data were extracted from included studies using a standardized data extraction tool from the Joanna Briggs Institute. There was heterogeneity in the types of intervention and outcome measures, therefore statistical pooling of the findings was not appropriate. As such, the studies were grouped according to type of outcome where possible. Findings are presented in a narrative form. Eight studies met the eligibility criteria. All outcome parameters related to the primary outcome (motor function and activity of the more affected upper extremity) showed an improvement during or after TD. The sensory functions significantly improved during or after TD when measured either by the grating orienting task or the grating orientation accuracy, and slightly improved when measured using the von Frey hair testing during TD. There is evidence supporting the use of TD of the upper extremity in adults after stroke. Temporary deafferentation can be recommended (Grade B).

Superstrate sub-cell voltage-matched multijunction solar cells

DOEpatents

Mascarenhas, Angelo; Alberi, Kirstin

2016-03-15

Voltage-matched thin film multijunction solar cell and methods of producing cells having upper CdTe pn junction layers formed on a transparent substrate which in the completed device is operatively positioned in a superstate configuration. The solar cell also includes a lower pn junction formed independently of the CdTe pn junction and an insulating layer between CdTe and lower pn junctions. The voltage-matched thin film multijunction solar cells further include a parallel connection between the CdTe pn junction and lower pn junctions to form a two-terminal photonic device. Methods of fabricating devices from independently produced upper CdTe junction layers and lower junction layers are also disclosed.

Joint US Navy/US Air Force climatic study of the upper atmosphere. Volume 1: January

NASA Astrophysics Data System (ADS)

Changery, Michael J.; Williams, Claude N.; Dickenson, Michael L.; Wallace, Brian L.

1989-07-01

The upper atmosphere was studied based on 1980 to 1985 twice daily gridded analyses produced by the European Centre for Medium Range Weather Forecasts. This volume is for the month of January. Included are global analyses of: (1) Mean temperature standard deviation; (2) Mean geopotential height standard deviation; (3) Mean density standard deviation; (4) Mean density standard deviation (all for 13 levels - 1000, 850, 700, 500, 400, 300, 250, 200, 150, 100, 70, 50, 30 mb); (5) Mean dew point standard deviation for the 13 levels; and (6) Jet stream at levels 500 through 30 mb. Also included are global 5 degree grid point wind roses for the 13 pressure levels.

Monolithic multi-color light emission/detection device

DOEpatents

Wanlass, M.W.

1995-02-21

A single-crystal, monolithic, tandem, multi-color optical transceiver device is described, including (a) an InP substrate having upper and lower surfaces, (b) a first junction on the upper surface of the InP substrate, (c) a second junction on the first junction. The first junction is preferably GaInAsP of defined composition, and the second junction is preferably InP. The two junctions are lattice matched. The second junction has a larger energy band gap than the first junction. Additional junctions having successively larger energy band gaps may be included. The device is capable of simultaneous and distinct multi-color emission and detection over a single optical fiber. 5 figs.

Investigation of the external flow analysis for density measurements at high altitude. [shuttle upper atmosphere mass spectrometer experiment

NASA Technical Reports Server (NTRS)

Bienkowski, G. K.

1983-01-01

A Monte Carlo program was developed for modeling the flow field around the space shuttle in the vicinity of the shuttle upper atmosphere mass spectrometer experiment. The operation of the EXTERNAL code is summarized. Issues associated with geometric modeling of the shuttle nose region and the modeling of intermolecular collisions including rotational energy exchange are discussed as well as a preliminary analysis of vibrational excitation and dissociation effects. The selection of trial runs is described and the parameters used for them is justified. The original version and the modified INTERNAL code for the entrance problem are reviewed. The code listing is included.

Virtual Reality for Sensorimotor Rehabilitation Post-Stroke: The Promise and Current State of the Field.

PubMed

Fluet, Gerard G; Deutsch, Judith E

2013-03-01

Developments over the past 2 years in virtual reality (VR) augmented sensorimotor rehabilitation of upper limb use and gait post-stroke were reviewed. Studies were included if they evaluated comparative efficacy between VR and standard of care, and or differences in VR delivery methods; and were CEBM (center for evidence based medicine) level 2 or higher. Eight upper limb and two gait studies were included and described using the following categories hardware (input and output), software (virtual task and feedback and presentation) intervention (progression and dose), and outcomes. Trends in the field were commented on, gaps in knowledge identified, and areas of future research and translation of VR to practice were suggested.

Computer program for prediction of fuel consumption statistical data for an upper stage three-axes stabilized on-off control system

NASA Technical Reports Server (NTRS)

1982-01-01

A FORTRAN coded computer program and method to predict the reaction control fuel consumption statistics for a three axis stabilized rocket vehicle upper stage is described. A Monte Carlo approach is used which is more efficient by using closed form estimates of impulses. The effects of rocket motor thrust misalignment, static unbalance, aerodynamic disturbances, and deviations in trajectory, mass properties and control system characteristics are included. This routine can be applied to many types of on-off reaction controlled vehicles. The pseudorandom number generation and statistical analyses subroutines including the output histograms can be used for other Monte Carlo analyses problems.

Laboratory Studies of Homogeneous and Heterogeneous Chemical Processes of Importance in the Upper Atmosphere

NASA Technical Reports Server (NTRS)

Molina, Mario J.

2001-01-01

The objective of this study is to conduct measurements of chemical kinetics parameters for reactions of importance in the stratosphere and upper troposphere, and to study the interaction of trace gases such as HCl with ice surfaces in order to elucidate the mechanism of heterogeneous chlorine activation processes, using both a theoretical and an experimental approach. The measurements will be carried out under temperature and pressure conditions covering those applicable to the stratosphere and upper troposphere. The techniques to be employed include turbulent flow - chemical ionization mass spectrometry, and optical ellipsometry. The next section summarizes our research activities during the second year of the project, and the section that follows consists of the statement of work for the third year.

BOREAS AFM-5 Level-2 Upper Air Network Standard Pressure Level Data

NASA Technical Reports Server (NTRS)

Barr, Alan; Hrynkiw, Charmaine; Hall, Forrest G. (Editor); Newcomer, Jeffrey A. (Editor); Smith, David E. (Technical Monitor)

2000-01-01

The BOREAS AFM-5 team collected and processed data from the numerous radiosonde flights during the project. The goals of the AFM-05 team were to provide large-scale definition of the atmosphere by supplementing the existing AES aerological network, both temporally and spatially. This data set includes basic upper-air parameters interpolated at 0.5 kiloPascal increments of atmospheric pressure from data collected from the network of upper-air stations during the 1993, 1994, and 1996 field campaigns over the entire study region. The data are contained in tabular ASCII files. The data files are available on a CD-ROM (see document number 20010000884) or from the Oak Ridge National Laboratory (ORNL) Distributed Active Archive Center (DAAC).

Duct closure

DOEpatents

Vowell, Kennison L.

1987-01-01

A closure for an inclined duct having an open upper end and defining downwardly extending passageway. The closure includes a cap for sealing engagement with the open upper end of the duct. Associated with the cap are an array of vertically aligned plug members, each of which has a cross-sectional area substantially conforming to the cross-sectional area of the passageway at least adjacent the upper end of the passageway. The plug members are interconnected in a manner to provide for free movement only in the plane in which the duct is inclined. The uppermost plug member is attached to the cap means and the cap means is in turn connected to a hoist means which is located directly over the open end of the duct.

Upper aerodigestive tract disorders and gastro-oesophageal reflux disease.

PubMed

Ciorba, Andrea; Bianchini, Chiara; Zuolo, Michele; Feo, Carlo Vittorio

2015-02-16

A wide variety of symptoms and diseases of the upper aerodigestive tract are associated to gastro-oesophageal reflux disease (GORD). These disorders comprise a large variety of conditions such as asthma, chronic otitis media and sinusitis, chronic cough, and laryngeal disorders including paroxysmal laryngospasm. Laryngo-pharyngeal reflux disease is an extraoesophageal variant of GORD that can affect the larynx and pharynx. Despite numerous research efforts, the diagnosis of laryngopharyngeal reflux often remains elusive, unproven and controversial, and its treatment is then still empiric. Aim of this paper is to review the current literature on upper aerodigestive tract disorders in relation to pathologic gastro-oesophageal reflux, focusing in particular on the pathophysiology base and results of the surgical treatment of GORD.

Upper aerodigestive tract disorders and gastro-oesophageal reflux disease

PubMed Central

Ciorba, Andrea; Bianchini, Chiara; Zuolo, Michele; Feo, Carlo Vittorio

2015-01-01

A wide variety of symptoms and diseases of the upper aerodigestive tract are associated to gastro-oesophageal reflux disease (GORD). These disorders comprise a large variety of conditions such as asthma, chronic otitis media and sinusitis, chronic cough, and laryngeal disorders including paroxysmal laryngospasm. Laryngo-pharyngeal reflux disease is an extraoesophageal variant of GORD that can affect the larynx and pharynx. Despite numerous research efforts, the diagnosis of laryngopharyngeal reflux often remains elusive, unproven and controversial, and its treatment is then still empiric. Aim of this paper is to review the current literature on upper aerodigestive tract disorders in relation to pathologic gastro-oesophageal reflux, focusing in particular on the pathophysiology base and results of the surgical treatment of GORD. PMID:25685756

Ulnar nerve injury associated with trampoline injuries.

PubMed

Maclin, Melvin M; Novak, Christine B; Mackinnon, Susan E

2004-08-01

This study reports three cases of ulnar neuropathy after trampoline injuries in children. A chart review was performed on children who sustained an ulnar nerve injury from a trampoline accident. In all cases, surgical intervention was required. Injuries included upper-extremity fractures in two cases and an upper-extremity laceration in one case. All cases required surgical exploration with internal neurolysis and ulnar nerve transposition. Nerve grafts were used in two cases and an additional nerve transfer was used in one case. All patients had return of intrinsic hand function and sensation after surgery. Children should be followed for evolution of ulnar nerve neuropathy after upper-extremity injury with consideration for electrical studies and surgical exploration if there is no improvement after 3 months.

Underfed stoker boiler for burning bituminous coal and other solid fuel particles

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

Marcotte, R.P.; Dumont, J.W. Jr.

1987-10-06

An automatic stoker boiler is described for space or process heating with steam or hot water. The boiler includes a heat transfer compartment having a water inlet and an outlet for steam or hot water, an exhaust, a combustion chamber, a transverse partition in the chamber, drive and driven shafts below the chamber, sprockets supported by the shaft and an endless belt of the link type trained about the sprockets. There are also means to deliver underfire air upwardly through the upper course. The upper portion has a throat opening adjacent to the second end, heat exchanging passageways extending throughmore » the compartment, means to deliver overfire air into the chamber, means to deliver solid fuel particles to the upper course adjacent to the first end, means in the exhaust operable to induce draft in the upper portion and control means operable to effect the advance of the belt. There are means operable to deliver solid fuel to the upper course in predetermined, proportional increments, means to vary the induced draft by predetermined, proportional increments and means to adjust the underfire air volume by predetermined, proportional increments.« less

[Routine fluoroscopic investigations after primary bariatric surgery].

PubMed

Gärtner, D; Ernst, A; Fedtke, K; Jenkner, J; Schöttler, A; Reimer, P; Blüher, M; Schön, M R

2016-03-01

Staple line and anastomotic leakages are life-threatening complications after bariatric surgery. Upper gastrointestinal (GI) tract X-ray examination with oral administration of a water-soluble contrast agent can be used to detect leaks. The aim of this study was to evaluate the impact of routine upper GI tract fluoroscopy after primary bariatric surgery. Between January 2009 and December 2014 a total of 658 bariatric interventions were carried out of which 442 were primary bariatric operations. Included in this single center study were 307 sleeve gastrectomies and 135 Roux-en-Y gastric bypasses. Up to December 2012 upper GI tract fluoroscopy was performed routinely between the first and third postoperative days and the detection of leakages was evaluated. In the investigation period 8 leakages (2.6 %) after sleeve gastrectomy, 1 anastomotic leakage in gastrojejunostomy and 1 in jejunojejunostomy after Roux-en-Y gastric bypass occurred. All patients developed clinical symptoms, such as abdominal pain, tachycardia or fever. In one case the leakage was detected by upper GI fluoroscopy and in nine cases radiological findings were unremarkable. No leakages were detected in asymptomatic patients. Routine upper GI fluoroscopy is not recommended for uneventful postoperative courses after primary bariatric surgery.

Bleeding and starving: fasting and delayed refeeding after upper gastrointestinal bleeding.

PubMed

Fonseca, Jorge; Meira, Tânia; Nunes, Ana; Santos, Carla Adriana

2014-01-01

Early refeeding after nonvariceal upper gastrointestinal bleeding is safe and reduces hospital stay/costs. The aim of this study was obtaining objective data on refeeding after nonvariceal upper gastrointestinal bleeding. From 1 year span records of nonvariceal upper gastrointestinal bleeding patients that underwent urgent endoscopy: clinical features; rockall score; endoscopic data, including severity of lesions and therapy; feeding related records of seven days: liquid diet prescription, first liquid intake, soft/solid diet prescription, first soft/solid intake. From 133 patients (84 men) Rockall classification was possible in 126: 76 score ≥5, 50 score <5. One persistent bleeding, eight rebled, two underwent surgery, 13 died. Ulcer was the major bleeding cause, 63 patients underwent endoscopic therapy. There was 142/532 possible refeeding records, no record 37% patients. Only 16% were fed during the first day and half were only fed on third day or later. Rockall <5 patients started oral diet sooner than Rockall ≥5. Patients that underwent endoscopic therapy were refed earlier than those without endotherapy. Most feeding records are missing. Data reveals delayed refeeding, especially in patients with low-risk lesions who should have been fed immediately. Nonvariceal upper gastrointestinal bleeding patients must be refed earlier, according to guidelines.

Robotics, assistive technology, and occupational therapy management to improve upper limb function in pediatric neuromuscular diseases.

PubMed

Rahman, Tariq; Basante, Joseph; Alexander, Michael

2012-08-01

This article presents an overview of occupational therapy assessments and treatment options for individuals with neuromuscular disabilities, with a particular focus on children with neuromuscular disorders. The discussion includes descriptions of standard treatments, commercial adaptive equipment, and homemade adaptive solutions. The state of the art in therapeutic and assistive robots and orthoses for the upper and lower extremity is also provided. Copyright © 2012. Published by Elsevier Inc.

NASA upper atmosphere research program: Research summaries, 1990 - 1991. Report to the Congress and the Environmental Protection Agency

NASA Technical Reports Server (NTRS)

1992-01-01

The objectives, status, and accomplishments of the research tasks supported under the NASA Upper Atmosphere Research Program (UARP) are presented. The topics covered include the following: balloon-borne in situ measurements; balloon-borne remote measurements; ground-based measurements; aircraft-borne measurements; rocket-borne measurements; instrument development; reaction kinetics and photochemistry; spectroscopy; stratospheric dynamics and related analysis; stratospheric chemistry, analysis, and related modeling; and global chemical modeling.

Ground-water and water-chemistry data for the upper Deschutes Basin, Oregon

USGS Publications Warehouse

Caldwell, Rodney R.; Truini, Margot

1997-01-01

This report presents ground-water data collected and compiled as part of a study of the ground-water resources of the upper Deschutes Basin, Oregon. Data in this report include tabulated information and a location map for more than 1,500 field-located water wells, hydrographs showing water-level fluctuations over various time periods for 102 of the wells, and water-chemistry analyses from 26 wells, 7 springs, and 5 surface-water sites.

Creating and maintaining a gas cap in tar sands formations

DOEpatents

Vinegar, Harold J.; Karanikas, John Michael; Dinkoruk, Deniz Sumnu; Wellington, Scott Lee

2010-03-16

Methods for treating a tar sands formation are disclosed herein. Methods for treating a tar sands formation may include providing heat to at least part of a hydrocarbon layer in the formation from one or more heaters located in the formation. Pressure may be allowed to increase in an upper portion of the formation to provide a gas cap in the upper portion. At least some hydrocarbons are produced from a lower portion of the formation.

Wave-mean flow interactions in the upper atmosphere

NASA Technical Reports Server (NTRS)

Lindzen, R. S.

1973-01-01

The nature of internal gravity waves is described with special emphasis on their ability to transport energy and momentum. The conditions under which these fluxes interact with the mean state of the atmosphere are described and the results are applied to various problems of the upper atmosphere, including the quasi-biennial oscillation, the heat budget of the thermosphere, the general circulation of the mesosphere, turbulence in the mesosphere, and the 4-day circulation of the Venusian atmosphere.

Monolithic tandem solar cell

DOEpatents

Wanlass, M.W.

1994-06-21

A single-crystal, monolithic, tandem, photovoltaic solar cell is described which includes (a) an InP substrate having upper and lower surfaces, (b) a first photoactive subcell on the upper surface of the InP substrate, (c) a second photoactive subcell on the first subcell; and (d) an optically transparent prismatic cover layer over the second subcell. The first photoactive subcell is GaInAsP of defined composition. The second subcell is InP. The two subcells are lattice matched. 9 figs.

Monolithic tandem solar cell

DOEpatents

Wanlass, Mark W.

1994-01-01

A single-crystal, monolithic, tandem, photovoltaic solar cell is described which includes (a) an InP substrate having upper and lower surfaces, (b) a first photoactive subcell on the upper surface of the InP substrate, (c) a second photoactive subcell on the first subcell; and (d) an optically transparent prismatic cover layer over the second subcell. The first photoactive subcell is GaInAsP of defined composition. The second subcell is InP. The two subcells are lattice matched.

Percutaneous Resection of Renal Urothelial Carcinoma Using Bipolar Electrocautery

PubMed Central

Kwan, Kevin G.; Chew, Ben H.; Luke, Patrick P.W.; Denstedt, John D.

2006-01-01

Percutaneous approaches to upper tract urothelial cancers have been performed in patients unsuitable for radical nephroureterectomy. We present the case of an 82-year-old man with significant comorbidities including dependency on a cardiac pacemaker. Without deactivating the pacemaker, we used bipolar cautery to percutaneously resect a large upper tract urothelial tumor in the renal pelvis. Bipolar cautery is a suitable method of percutaneous or transurethral resection in patients who are pacemaker dependent. PMID:17575777

Breast cancer in Poland syndrome.

PubMed

Havlik, R J; Sian, K U; Wagner, J D; Binford, R; Broadie, T A

1999-07-01

A 33-year-old African-American woman with a severe manifestation of Poland syndrome developed breast cancer in the ipsilateral breast. She had a severely hypoplastic upper extremity, including symbrachydactyly, and a hypoplastic forearm and upper arm. In addition, she lacked the sternal origin of the pectoralis muscle. She had a very small nipple-areola complex and no axillary hair. This is the first case report of breast cancer developing in the ipsilateral breast of a patient with Poland syndrome.

Improving surgical results in complex nerve anatomy during implantation of selective upper airway stimulation.

PubMed

Zhu, Zhaojun; Hofauer, Benedikt; Heiser, Clemens

2018-06-01

The following report presents a case of two late embedded hypoglossus branches during implantation of an upper airway stimulation device that caused a mixed activation of the tongue when included in the stimulation cuff. In the end, correct cuff placement could be achieved by careful examination of the hypoglossal nerve anatomy, precise nerve dissection, tongue motion analysis and intraoperative nerve monitoring. Copyright © 2018 Elsevier B.V. All rights reserved.

Defense Communications Agency Cost and Planning Factors Manual. Change 1.

DTIC Science & Technology

1984-06-11

shows the total costs for placing payloads in orbit. This includes reimbursement to NASA for Shuttle services, purchase of the upper stage, and upper...23-6 DCAC 600-60-1 SECTION D Change I ’" = TABLE 23-2. DCA MILITARY LABOR RATES : ANNLAL RATES : HCURLY RATES : REIMBURS -: :PTS FRCP:REIPEURS...DCAC 600-60-1 23-7 SECTION D Change I # : - TABLE 23-3. DCA MILITARY LABOR RATES - MAJOR : ANNLAL RATES : HCURLY RATES : REIMBURS -: : : : : : TS

Coastal ground water at risk - Saltwater contamination at Brunswick, Georgia and Hilton Head Island, South Carolina

USGS Publications Warehouse

Krause, Richard E.; Clarke, John S.

2001-01-01

IntroductionSaltwater contamination is restricting the development of ground-water supply in coastal Georgia and adjacent parts of South Carolina and Florida. The principal source of water in the coastal area is the Upper Floridan aquifer—an extremely permeable and high-yielding aquifer—which was first developed in the late 1800s. Pumping from the aquifer has resulted in substantial ground-water-level decline and subsequent saltwater intrusion of the aquifer from underlying strata containing highly saline water at Brunswick, Georgia, and with encroachment of sea-water into the aquifer at the northern end of Hilton Head Island, South Carolina. The saltwater contamination at these locations has constrained further development of the Upper Floridan aquifer in the coastal area and has created competing demands for the limited supply of freshwater. The Georgia Department of Natural Resources, Georgia Environmental Protection Division (GaEPD) has restricted permitted withdrawal of water from the Upper Floridan aquifer in parts of the coastal area (including the Savannah and Brunswick areas) to 1997 rates, and also has restricted additional permitted pumpage in all 24 coastal area counties to 36 million gallons per day above 1997 rates. These actions have prompted interest in alternative management of the aquifer and in the development of supplemental sources of water supply including those from the shallower surficial and upper and lower Brunswick aquifers and from the deeper Lower Floridan aquifer.

Nuclear reactor melt-retention structure to mitigate direct containment heating

DOEpatents

Tutu, Narinder K.; Ginsberg, Theodore; Klages, John R.

1991-01-01

A light water nuclear reactor melt-retention structure to mitigate the extent of direct containment heating of the reactor containment building. The structure includes a retention chamber for retaining molten core material away from the upper regions of the reactor containment building when a severe accident causes the bottom of the pressure vessel of the reactor to fail and discharge such molten material under high pressure through the reactor cavity into the retention chamber. In combination with the melt-retention chamber there is provided a passageway that includes molten core droplet deflector vanes and has gas vent means in its upper surface, which means are operable to deflect molten core droplets into the retention chamber while allowing high pressure steam and gases to be vented into the upper regions of the containment building. A plurality of platforms are mounted within the passageway and the melt-retention structure to direct the flow of molten core material and help retain it within the melt-retention chamber. In addition, ribs are mounted at spaced positions on the floor of the melt-retention chamber, and grid means are positioned at the entrance side of the retention chamber. The grid means develop gas back pressure that helps separate the molten core droplets from discharged high pressure steam and gases, thereby forcing the steam and gases to vent into the upper regions of the reactor containment building.

Upper Devonian outcrop stratigraphy, southwestern Virginia and southeastern West Virginia

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

Dennison, J.M.; Filer, J.K.; Rossbach, T.J.

Ongoing outcrop studies are resulting in the extension of existing formal lithostratigraphic units and revision of previously less refined subdivisions of Upper Devonian strata in southwestern Virginia and southeastern West Virginia. A 425 km (263 mi) long stratigraphic cross-section has been constructed primarily from the outcrop belt along the Allegheny Structural Front, supplemented by sections from nearby outcrop belts. This NE-SW striking cross-section is oblique to the nearly due N-S depositional strike of the Upper Devonian Acadian orogenic wedge. To the southwest, the Upper Devonian section thins from 2,100 meters (6,900 feet) to 230 meters (756 feet) as progressively moremore » distal deposits are encountered. An integrated approach has been taken to establish chronostratigraphic control within the cross-section. The best time markers include particularly regressive parasequences which can be identified across facies boundaries (especially the Pound and Briery Gap Sandstones and their equivalents), volcanic ashes, and an organic-rich shale zone marking the base of a major transgression (equivalent to the base of the Huron Shale in Ohio and the Dunkirk Shale of New York). These tools provide chronostratigraphic correlation through the undivided Brallier Formation. Supplemental control includes biostratigraphic markers as well as marine dull redbeds within the Foreknobs which parallel other time lines and may represent partially reduced influxes of oxidized coastal plain sediments during minor parasequence scale regressions.« less

Brachioplasty outcomes: a review of a multipractice cohort.

PubMed

Zomerlei, Terri A; Neaman, Keith C; Armstrong, Shannon D; Aitken, Marguerite E; Cullen, William T; Ford, Ronald D; Renucci, John D; VanderWoude, Douglas L

2013-04-01

Upper arm deformities secondary to massive weight loss or senile elastosis have led to an increased demand for aesthetic contouring procedures such as brachioplasty. The records of all patients who underwent a brachioplasty procedure from a multipractice medical center were reviewed. Outcomes measured included patient demographics, operative interventions, and postoperative course. Ninety-six patients were analyzed. Fifty-three patients (55.2 percent) underwent a concomitant procedure, with 53.1 percent undergoing arm liposuction at the time of brachioplasty. Major and minor complications rates were 17.7 percent and 44.8 percent, respectively. Common complications included hypertrophic scarring (24.0 percent) and infection (14.6 percent). The total revision rate was 22.9 percent, with residual contour deformity (40.9 percent of revisions) and hypertrophic scarring (36.4 percent of revisions) representing the most common causes for revision. Patients who underwent a previous bariatric procedure were at an increased risk of developing a major complication (p = 0.02). Concomitant upper arm liposuction and concomitant procedures were not associated with a significantly increased complication rate. Brachioplasty, despite being an effective treatment for contour irregularities of the upper arm, is associated with significant revision and complication rates. Post-bariatric surgery patients should be informed of the potential for increased complications. Additional procedures performed at the time of brachioplasty do not significantly increase complications. Liposuction of the upper arm can be performed safely in conjunction with brachioplasty.

Sponges of the Permian Upper Capitan Limestone Guadalupe Mountains, New Mexico and Texas

USGS Publications Warehouse

Rigby, J.K.; Senowbari-Daryan, B.; Liu, H.

1998-01-01

Demosponge "sphinctozoans" and inozoid calcareous sponges are major constituents of the Upper Permian, Upper Capitan Limestone in the Guadalupe Mountains of New Mexico and Texas. Systematic description, taxonomy, and the stratigraphic distribution of these sponges are documented in collections from exposures of the Upper Capitan Limestone in the vicinity of Carlsbad Caverns in New Mexico. The fauna appears diverse on a local scale, but when compared to diversity of assemblages of similar age in Tunisia and in Southern China, the assemblage is species poor, with 34 species of "calcareous" sponges and demosponges. Whether this is a local time or geographic gradient must wait additional investigations of sponge faunas from older parts of the Guadalupian series in the Guadalupe Mountains, as well as in localities southward in Texas and Mexico. Upper Capitan exposures near Carlsbad Caverns are at the northernmost end of the long Delaware Basin that was restricted by the Hovey channel to the south. As a consequence of either that restricted ecologic limitation or a time stratigraphic factor, Late Capitan assemblages are characterized by abundant individuals of only a few endemic species, and by relatively primitive cosmopolitan genera and species that were able to persist beyond the ranges of more specialized forms. Species in the collections include the ceractinomorphid porate "sphinctozoans" Cystothalamia guadalupensis (Girty, 1908a), Amblysiphonella cf. A. merlai Parona, 1933, Amblysiphonella species A, Amblysiphonella species B, Discosiphonella mammilosa (King, 1943), Tristratocoelia rhythmica Senowbari-Daryan and Rigby, 1988, Exaulipora permica (Senowbari-Daryan, 1990), type species of the new genus Exaulipora, Parauvanella minima Senowbari-Daryan, 1990, and Platythalamiella(?) sp., all from the families Sebargasiidae Steinmann, 1882, and Colospongiidae Senowbari-Daryan, 1990. The family Solenolmiidae Engeser, 1986 is represented by the new species Preverticillites parva. Among the ceractinomorphid Aporata, the family Thaumastocoeliidae Ott, 1967 is represented by Sollasia ostiolata Steinmann, 1882, and Girtyocoelia beedei (Girty, 1908b). The sclerospongiid Guadalupiidae Termier and Termier, in Termier, et al., 1977a, which includes the family Guadalupiidae Girty, 1908a, is represented by the species Guadalupia zitteliana Girty, 1908a, and Guadalupia explanata (King, 1943), Lemonea cylindrica (Girty, 1908a), Lemonea conica Senowbari-Daryan, 1990, Lemonea polysiphonata Senowbari-Daryan, 1990, and the new species Lemonea exaulifera and Lemonea micra. The Calcarea are represented within the subclass Aspiculata Rigby and Senowbari-Daryan, 1996a, and order Inozoida Rigby and Senowbari-Daryan, 1996a, by the Auriculospongiidae Termier and Termier, 1977a, which includes the large Gigantospongia discoforma Rigby and Senowbari-Daryan, 1996b. and Cavusonella caverna Rigby, Fan, and Zhang, 1989b. Also included are the Peronidellidae Wu, 1991, represented by the species Peronidella cf. P. rigbyi Senowbari-Daryan, 1991, Peronidella(?) delicata new species, and Minispongia constricta (Girty, 1908a), and the new genus and species Bicoelia guadalupensis. The family Virgulidae Termier and Termier, 1977a, is redefined to include the genus Virgola and the species Virgola neptunia (Girty, 1908a), and Virgola rigida (Girty, 1908a,). The family Polysiphonellidae Wu, 1991, (not Polysiphonellidae Belyaeva in Boiko, et al., 1991) is interpreted to include most of the subfamilies originally included by Rigby and Senowbari-Daryan (1996a) in the Virgulispongiidae. The sponge Grossotubinella parallela Rigby, Fan, and Zhang, 1989b is included there in the Preeudinae, with Pseudovirgula tenuis Girty, 1908a. Heliospongid demosponges are represented in the Upper Capitan by Heliospongia ramosa Girty, 1908b, Heliospongia vokesi King, 1943, and Neoheliospongia(?) cf. N. typica Deng, 1981. Fossils of unknown taxonomy, possibly sponges, hydrozoans or algae, are incl

Investigation of hand function among children diagnosed with autism spectrum disorder with upper extremity trauma history.

PubMed

Huri, Meral; Şahin, Sedef; Kayıhan, Hülya

2016-11-01

The present study was designed to compare hand function in autistic children with history of upper extremity trauma with that of autistic children those who do not have history of trauma. The study group included total of 65 children diagnosed with autism spectrum disorder (ASD) and was divided into 2 groups: children with trauma history (Group I) and control group (Group II) (Group I: n=28; Group II: n=37). Hand function was evaluated with 9-Hole Peg Test and Jebsen Hand Function Test. Somatosensory function was evaluated using somatosensory subtests of Sensory Integration and Praxis Test. Results were analyzed with Student's t-test and Mann-Whitney U test using SPSS version 20 software. Hand function and somatosensory perception test scores were statistically significantly better in children without upper extremity trauma history (p<0.05). When association between hand function tests and upper extremity somatosensory perception tests was taken into account, statistically significant correlations were found between all parameters of hand function tests and Manual Form Perception and Localization of Tactile Stimuli Test results (p<0.05). Autistic children with upper extremity trauma history had poor somatosensory perception and hand function. It is important to raise awareness among emergency service staff and inform them about strong relationship between somatosensory perception, hand function, and upper extremity trauma in children with ASD in order to develop appropriate rehabilitation process and prevent further trauma.

Assessing Upper-Level Winds on Day-of-Launch

NASA Technical Reports Server (NTRS)

Bauman, William H., III; Wheeler, Mark M.

2012-01-01

On the day-or-launch. the 45th Weather Squadron Launch Weather Officers (LWOS) monitor the upper-level winds for their launch customers to include NASA's Launch Services Program (LSP). During launch operations, the payload launch team sometimes asks the LWO if they expect the upper level winds to change during the countdown but the LWOs did not have the capability to quickly retrieve or display the upper-level observations and compare them to the numerical weather prediction model point forecasts. The LWOs requested the Applied Meteorology Unit (AMU) develop a capability in the form of a graphical user interface (GUI) that would allow them to plot upper-level wind speed and direction observations from the Kennedy Space Center Doppler Radar Wind Profilers and Cape Canaveral Air Force Station rawinsondes and then overlay model point forecast profiles on the observation profiles to assess the performance of these models and graphically display them to the launch team. The AMU developed an Excel-based capability for the LWOs to assess the model forecast upper-level winds and compare them to observations. They did so by creating a GUI in Excel that allows the LWOs to first initialize the models by comparing the O-hour model forecasts to the observations and then to display model forecasts in 3-hour intervals from the current time through 12 hours.

Method and apparatus for enhanced sensitivity filmless medical x-ray imaging, including three-dimensional imaging

DOEpatents

Parker, S.

1995-10-24

A filmless X-ray imaging system includes at least one X-ray source, upper and lower collimators, and a solid-state detector array, and can provide three-dimensional imaging capability. The X-ray source plane is distance z{sub 1} above upper collimator plane, distance z{sub 2} above the lower collimator plane, and distance z{sub 3} above the plane of the detector array. The object to be X-rayed is located between the upper and lower collimator planes. The upper and lower collimators and the detector array are moved horizontally with scanning velocities v{sub 1}, v{sub 2}, v{sub 3} proportional to z{sub 1}, z{sub 2} and z{sub 3}, respectively. The pattern and size of openings in the collimators, and between detector positions is proportional such that similar triangles are always defined relative to the location of the X-ray source. X-rays that pass through openings in the upper collimator will always pass through corresponding and similar openings in the lower collimator, and thence to a corresponding detector in the underlying detector array. Substantially 100% of the X-rays irradiating the object (and neither absorbed nor scattered) pass through the lower collimator openings and are detected, which promotes enhanced sensitivity. A computer system coordinates repositioning of the collimators and detector array, and X-ray source locations. The computer system can store detector array output, and can associate a known X-ray source location with detector array output data, to provide three-dimensional imaging. Detector output may be viewed instantly, stored digitally, and/or transmitted electronically for image viewing at a remote site. 5 figs.

Method and apparatus for enhanced sensitivity filmless medical x-ray imaging, including three-dimensional imaging

DOEpatents

Parker, Sherwood

1995-01-01

A filmless X-ray imaging system includes at least one X-ray source, upper and lower collimators, and a solid-state detector array, and can provide three-dimensional imaging capability. The X-ray source plane is distance z.sub.1 above upper collimator plane, distance z.sub.2 above the lower collimator plane, and distance z.sub.3 above the plane of the detector array. The object to be X-rayed is located between the upper and lower collimator planes. The upper and lower collimators and the detector array are moved horizontally with scanning velocities v.sub.1, v.sub.2, v.sub.3 proportional to z.sub.1, z.sub.2 and z.sub.3, respectively. The pattern and size of openings in the collimators, and between detector positions is proportional such that similar triangles are always defined relative to the location of the X-ray source. X-rays that pass through openings in the upper collimator will always pass through corresponding and similar openings in the lower collimator, and thence to a corresponding detector in the underlying detector array. Substantially 100% of the X-rays irradiating the object (and neither absorbed nor scattered) pass through the lower collimator openings and are detected, which promotes enhanced sensitivity. A computer system coordinates repositioning of the collimators and detector array, and X-ray source locations. The computer system can store detector array output, and can associate a known X-ray source location with detector array output data, to provide three-dimensional imaging. Detector output may be viewed instantly, stored digitally, and/or transmitted electronically for image viewing at a remote site.

[Treatment of eyelid retraction in Grave's disease by recession of the levator complex].

PubMed

Fichter, N; Schittkowski, M; Guthoff, R F

2004-11-01

The chronic stage in Grave's orbitopathy is characterised by fibrotic changes within the orbital soft tissues, especially the extraocular muscles. Retraction of the eyelids is a common clinical feature of this phenomenon. To solve this problem several techniques for lengthening the upper eyelid have been described with variable rates of success. In this report we describe our modified Harvey's technique for the correction of upper eyelid retraction which includes a complete recession of the Muller's muscle/levator complex from the tarsal plate without the interposition of a spacer. Finally only the skin and the superficial orbicularis muscle are sutured. We also report about our results with this procedure. 8 patients (1 male, 7 female) with lid retraction in Grave's ophthalmopathy were recorded who had undergone the modified lengthening technique by an external approach between 2001 and 2004. Four patients underwent a bilateral procedure and 1 patient showed a significant under-correction, necessitating reoperation. So a total of 13 procedures were included in this follow-up study. Beside the common ophthalmological examination, special interest was put in the difference of the two eyelid apertures in primary position pre- and postoperatively. Within a follow-up period of at least 3 months we recorded an averaged lengthening of the upper eyelid of 3.1 mm. The difference of the two eyelid apertures in primary position improved from 2.2 mm preoperatively to 1.0 mm postoperatively. Only 1 patient needed reoperation because of a significant under-correction. There were no late over-corrections observed. The modified Harvey's technique to lengthen the upper eyelid is a safe and effective method to reduce upper eyelid retraction in Grave's disease. An eventually required orbital decompression or extraocular muscle surgery has to be done before the lid surgery.

Stratigraphy and depositional environments of Fox Hills Formation in Williston basin

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

Daly, D.J.

The Fox Hills Formation (Maestrichtian), representing part of a regressive wedge deposited during the withdrawal of the sea from the Western Interior at the close of the Cretaceous, consists of marginal marine strata transitional between the offshore deposits of the underlying Pierre Shale and the terrestrial deltaic and coastal deposits of the overlying Hell Creek Formation. An investigation of outcrops of the Fox Hills Formation along the western and southern flanks of the Williston basin and study of over 300 oil and gas well logs from the central part of the basin indicate that the formation can be divided bothmore » stratigraphically and areally. Stratigraphically, the Fox Hills can be divided into lower and upper sequences; the lower includes the Trail City and Timber Lake Members, and the upper sequence includes the Colgate Member in the west and the Iron Lightning and Linton Members in the east. Areally, the formation can be divided into a northeastern and western part, where the strata are 30-45 m thick and are dominated by the lower sequence, and into a southeastern area where both the lower and upper sequences are well developed in a section 80-130 m thick. Typically, the lower Fox Hills consists of upward-coarsening shoreface or delta-front sequences containing hummocky bedding and a limited suite of trace fossils, most notably Ophiomorpha. In the southeast, however, these strata are dominated by bar complexes, oriented northeast-southwest, composed of cross-bedded medium to very fine-grained sand with abundant trace and body fossils. The upper Fox Hills represents a variety of shoreface, deltaic, and channel environments. The strata of the Fox Hills Formation exhibit facies similar to those reported for Upper Cretaceous gas reservoirs in the northern Great Plains.« less

Transcatheter arterial embolization for endoscopically unmanageable non-variceal upper gastrointestinal bleeding.

PubMed

Lee, Han Hee; Park, Jae Myung; Chun, Ho Jong; Oh, Jung Suk; Ahn, Hyo Jun; Choi, Myung-Gyu

2015-07-01

Transcatheter arterial embolization (TAE) is a therapeutic option for endoscopically unmanageable upper gastrointestinal (GI) bleeding. We aimed to assess the efficacy and clinical outcomes of TAE for acute non-variceal upper GI bleeding and to identify predictors of recurrent bleeding within 30 days. Visceral angiography was performed in 66 patients (42 men, 24 women; mean age, 60.3 ± 12.7 years) who experienced acute non-variceal upper GI bleeding that failed to be controlled by endoscopy during a 7-year period. Clinical information was reviewed retrospectively. Outcomes included technical success rates, complications, and 30-day rebleeding and mortality rates. TAE was feasible in 59 patients. The technical success rate was 98%. Rebleeding within 30 days was observed in 47% after an initial TAE and was managed with re-embolization in 8, by endoscopic intervention in 5, by surgery in 2, and by conservative care in 12 patients. The 30-day overall mortality rate was 42.4%. In the case of initial endoscopic hemostasis failure (n = 34), 31 patients underwent angiographic embolization, which was successful in 30 patients (96.8%). Rebleeding occurred in 15 patients (50%), mainly because of malignancy. Two factors were independent predictors of rebleeding within 30 days by multivariate analysis: coagulopathy (odds ratio [OR] = 4.37; 95% confidence interval [CI]: 1.25-15.29; p = 0.021) and embolization in ≥2 territories (OR = 4.93; 95% CI: 1.43-17.04; p = 0.012). Catheterization-related complications included hepatic artery dissection and splenic embolization. TAE controlled acute non-variceal upper GI bleeding effectively. TAE may be considered when endoscopic therapy is unavailable or unsuccessful. Correction of coagulopathy before TAE is recommended.

U.S. Geological Survey Georgia Water Science Center and City of Brunswick- Glynn County Cooperative Water Program-Summary of Activities, July 2005 through June 2006

USGS Publications Warehouse

Cherry, Gregory S.

2007-01-01

Since 1959, the U.S. Geological Survey has conducted a cooperative water resources program (CWP) with the City of Brunswick and Glynn County in the Brunswick, Georgia, area. Since the late 1950s, the salinity of ground water in the Upper Floridan aquifer near downtown Brunswick, Georgia, has been increasing, and its occurrence has been detected across an area of increasing size. Pumping of the Upper Floridan aquifer near downtown Brunswick has lowered water levels in the aquifer and resulted in an upward hydraulic gradient between the highly saline parts of the Lower Floridan aquifer and the normally fresh Upper Floridan aquifer. Saltwater likely enters the Upper Floridan aquifer through localized, vertically oriented conduits of relatively high permeability and moves laterally in response to the distribution of stresses within the aquifer. The Brunswick-Glynn County CWP for fiscal year 2006 includes the operation and maintenance of 12 continuous water-level recorders. In addition, water-level data were collected from 52 wells and water from 70 wells was analyzed for chloride concentration during June 2005. Geophysical logs were obtained from one well to assess whether the cause of elevated chloride concentration could be due to leaky well casing. A summary of the Georgia Department of Natural Resources, Environmental Protection Division (GaEPD) Georgia Coastal Sound Science Initiative (CSSI) activities that directly benefit the CWP-Brunswick-Glynn County is included in this report. The GaEPD CSSI is a program of scientific and feasibility studies to support development of a final strategy to protect the Upper Floridan aquifer from saltwater contamination. These data presented in this report are needed by State and local authorities to manage water resources effectively in the coastal area of Georgia.

[Effect of disease severity on upper extremity muscle strength, exercise capacity, and activities of daily living in individuals with pulmonary arterial hypertension].

PubMed

Özcan Kahraman, Buse; Özsoy, İsmail; Acar, Serap; Özpelit, Ebru; Akdeniz, Bahri; Sevinç, Can; Savcı, Sema

2017-07-01

Pulmonary arterial hypertension (PAH) is a rare disease. Although muscle strength, exercise capacity, quality of life, and activities of daily living of patients with PAH are affected, it is not known how they are affected by disease severity. The purpose of the present study was to investigate effects of disease severity on upper extremity muscle strength, exercise capacity, and performance of activities of daily living in patients with PAH. Twenty-five patients with disease severity classified according to the New York Heart Association (NYHA) as functional class II (n=14) or class III (n=11) were included in the study. Upper-extremity exercise capacity and limitations in performing activities of daily living were assessed with 6-minute pegboard and ring test (6PBRT) and the Milliken activities of daily living scale (MAS), respectively. Shoulder flexion, elbow extension, elbow flexion muscle strength, and handgrip strength were measured with dynamometer. There were no significant differences in age, gender, body mass index, or mean pulmonary artery pressure between groups (p>0.05). The 6PBRT, MAS, and elbow flexion (right) and grip strength (right and left) results were significantly lower in NYHA III group than in NYHA II group (p=0.004, p=0.002, p=0.043, p=0.002 and p=0.003, respectively). There was no significant difference in shoulder flexion, elbow flexion (left), or elbow extension between groups (p>0.05). Results suggest that upper extremity exercise capacity, elbow flexion muscle strength (right), and handgrip strength decrease and that limitations in activities of daily living grow as disease severity increases in patients with PAH. When planning rehabilitation programs, disease severity should be considered and evaluations and treatments for the upper extremities should be included.

Contemporary surgical trends in the management of upper tract calculi.

PubMed

Oberlin, Daniel T; Flum, Andrew S; Bachrach, Laurie; Matulewicz, Richard S; Flury, Sarah C

2015-03-01

Upper tract nephrolithiasis is a common surgical condition that is treated with multiple surgical techniques, including shock wave lithotripsy, ureteroscopy and percutaneous nephrolithotomy. We analyzed case logs submitted to the ABU by candidates for initial certification and recertification to help elucidate the trends in management of upper tract urinary calculi. Annualized case logs from 2003 to 2012 were analyzed. We used logistic regression models to assess how surgeon specific attributes affected the way that upper tract stones were treated. Cases were identified by the CPT code of the corresponding procedure. A total of 6,620 urologists in 3 certification groups recorded case logs, including 2,275 for initial certification, 2,381 for first recertification and 1,964 for second recertification. A total of 441,162 procedures were logged, of which 54.2% were ureteroscopy, 41.3% were shock wave lithotripsy and 4.5% were percutaneous nephrolithotomy. From 2003 to 2013 there was an increase in ureteroscopy from 40.9% to 59.6% and a corresponding decrease in shock wave lithotripsy from 54% to 36.3%. For new urologists ureteroscopy increased from 47.6% to 70.9% of all stones cases logged and for senior clinicians ureteroscopy increased from 40% to 55%. Endourologists performed a significantly higher proportion of percutaneous nephrolithotomies than nonendourologists (10.6% vs 3.69%, p <0.0001) and a significantly smaller proportion of shock wave lithotripsies (34.2% vs 42.2%, p = 0.001). Junior and senior clinicians showed a dramatic adoption of endoscopic techniques. Treatment of upper tract calculi is an evolving field and provider specific attributes affect how these stones are treated. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Outcome of index upper gastrointestinal endoscopy in patients presenting with dysphagia in a tertiary care hospital-A 10 years review

PubMed Central

Qureshi, Nafees A; Hallissey, Michael T; Fielding, John W

2007-01-01

Background Patients with malignant tumours of the upper gastrointestinal tract tumours exhibit important alarm symptoms such as dysphagia that warrant clinical investigations. An endoscopic examination of the upper gastrointestinal tract will be required in most cases. This study evaluates the diagnostic potential of index endoscopy in a random population of patients with dysphagia. Methods This is a retrospective analysis of prospectively collected data over 10 years. Patients with previous endoscopic evaluation or upper gastrointestinal pathology were excluded from the study. Data was analysed to see the number and frequency of abnormal findings in upper gastrointestinal tract, and their significance in relation to the presenting symptoms. Results Total number of index endoscopies was 13, 881. 913 patients were included in the study including 465 males (age range: 17–92 years, median: 55 years) and 448 females (age range: 18–100, median: 59 years), with male to female ratio of 1.04: 1. Oesophagus was abnormal in 678 cases (74%) and biopsies were taken in 428 patients (47%). Superficial oesophagitis, Barrett's oesophagus, oesophageal cancer, and oesophageal ulcer were main histological findings. Age more than 50 years and weight loss were significant predictors of oesophageal cancer (p < 0.0001). Male gender, heartburn, epigastric pain, weight loss and vomiting were significantly related to Barrett's oesophagus. A total of 486 gastric and 56 duodenal biopsies were also taken. There were 20 cases of gastric adenocarcinoma. Conclusion OGD is an effective initial investigation to assess patients with dysphagia, especially males above the age of 50 years. Patients may be started on treatment or referred for further investigations, for example, a barium meal in the absence of any anatomical abnormality. PMID:18034883

Full band all-sky search for periodic gravitational waves in the O1 LIGO data

NASA Astrophysics Data System (ADS)

Abbott, B. P.; Abbott, R.; Abbott, T. D.; Acernese, F.; Ackley, K.; Adams, C.; Adams, T.; Addesso, P.; Adhikari, R. X.; Adya, V. B.; Affeldt, C.; Afrough, M.; Agarwal, B.; Agathos, M.; Agatsuma, K.; Aggarwal, N.; Aguiar, O. D.; Aiello, L.; Ain, A.; Allen, B.; Allen, G.; Allocca, A.; Altin, P. A.; Amato, A.; Ananyeva, A.; Anderson, S. B.; Anderson, W. G.; Angelova, S. V.; Antier, S.; Appert, S.; Arai, K.; Araya, M. C.; Areeda, J. S.; Arnaud, N.; Ascenzi, S.; Ashton, G.; Ast, M.; Aston, S. M.; Astone, P.; Atallah, D. V.; Aufmuth, P.; Aulbert, C.; AultONeal, K.; Austin, C.; Avila-Alvarez, A.; Babak, S.; Bacon, P.; Bader, M. K. M.; Bae, S.; Baker, P. T.; Baldaccini, F.; Ballardin, G.; Ballmer, S. W.; Banagiri, S.; Barayoga, J. C.; Barclay, S. E.; Barish, B. C.; Barker, D.; Barkett, K.; Barone, F.; Barr, B.; Barsotti, L.; Barsuglia, M.; Barta, D.; Bartlett, J.; Bartos, I.; Bassiri, R.; Basti, A.; Batch, J. C.; Bawaj, M.; Bayley, J. C.; Bazzan, M.; Bécsy, B.; Beer, C.; Bejger, M.; Belahcene, I.; Bell, A. S.; Berger, B. K.; Bergmann, G.; Bero, J. J.; Berry, C. P. L.; Bersanetti, D.; Bertolini, A.; Betzwieser, J.; Bhagwat, S.; Bhandare, R.; Bilenko, I. A.; Billingsley, G.; Billman, C. R.; Birch, J.; Birney, R.; Birnholtz, O.; Biscans, S.; Biscoveanu, S.; Bisht, A.; Bitossi, M.; Biwer, C.; Bizouard, M. A.; Blackburn, J. K.; Blackman, J.; Blair, C. D.; Blair, D. G.; Blair, R. M.; Bloemen, S.; Bock, O.; Bode, N.; Boer, M.; Bogaert, G.; Bohe, A.; Bondu, F.; Bonilla, E.; Bonnand, R.; Boom, B. A.; Bork, R.; Boschi, V.; Bose, S.; Bossie, K.; Bouffanais, Y.; Bozzi, A.; Bradaschia, C.; Brady, P. R.; Branchesi, M.; Brau, J. E.; Briant, T.; Brillet, A.; Brinkmann, M.; Brisson, V.; Brockill, P.; Broida, J. E.; Brooks, A. F.; Brown, D. A.; Brown, D. D.; Brunett, S.; Buchanan, C. C.; Buikema, A.; Bulik, T.; Bulten, H. J.; Buonanno, A.; Buskulic, D.; Buy, C.; Byer, R. L.; Cabero, M.; Cadonati, L.; Cagnoli, G.; Cahillane, C.; Bustillo, J. Calderón; Callister, T. A.; Calloni, E.; Camp, J. B.; Canepa, M.; Canizares, P.; Cannon, K. C.; Cao, H.; Cao, J.; Capano, C. D.; Capocasa, E.; Carbognani, F.; Caride, S.; Carney, M. F.; Casanueva Diaz, J.; Casentini, C.; Caudill, S.; Cavaglià, M.; Cavalier, F.; Cavalieri, R.; Cella, G.; Cepeda, C. B.; Cerdá-Durán, P.; Cerretani, G.; Cesarini, E.; Chamberlin, S. J.; Chan, M.; Chao, S.; Charlton, P.; Chase, E.; Chassande-Mottin, E.; Chatterjee, D.; Cheeseboro, B. D.; Chen, H. Y.; Chen, X.; Chen, Y.; Cheng, H.-P.; Chia, H. Y.; Chincarini, A.; Chiummo, A.; Chmiel, T.; Cho, H. S.; Cho, M.; Chow, J. H.; Christensen, N.; Chu, Q.; Chua, A. J. K.; Chua, S.; Chung, A. K. W.; Chung, S.; Ciani, G.; Ciecielag, P.; Ciolfi, R.; Cirelli, C. E.; Cirone, A.; Clara, F.; Clark, J. A.; Clearwater, P.; Cleva, F.; Cocchieri, C.; Coccia, E.; Cohadon, P.-F.; Cohen, D.; Colla, A.; Collette, C. G.; Cominsky, L. R.; Constancio, M.; Conti, L.; Cooper, S. J.; Corban, P.; Corbitt, T. R.; Cordero-Carrión, I.; Corley, K. R.; Cornish, N.; Corsi, A.; Cortese, S.; Costa, C. A.; Coughlin, E. T.; Coughlin, M. W.; Coughlin, S. B.; Coulon, J.-P.; Countryman, S. T.; Couvares, P.; Covas, P. B.; Cowan, E. E.; Coward, D. M.; Cowart, M. J.; Coyne, D. C.; Coyne, R.; Creighton, J. D. E.; Creighton, T. D.; Cripe, J.; Crowder, S. G.; Cullen, T. J.; Cumming, A.; Cunningham, L.; Cuoco, E.; Dal Canton, T.; Dálya, G.; Danilishin, S. L.; D'Antonio, S.; Danzmann, K.; Dasgupta, A.; Da Silva Costa, C. F.; Dattilo, V.; Dave, I.; Davier, M.; Davis, D.; Daw, E. J.; Day, B.; De, S.; DeBra, D.; Degallaix, J.; De Laurentis, M.; Deléglise, S.; Del Pozzo, W.; Demos, N.; Denker, T.; Dent, T.; De Pietri, R.; Dergachev, V.; De Rosa, R.; DeRosa, R. T.; De Rossi, C.; DeSalvo, R.; de Varona, O.; Devenson, J.; Dhurandhar, S.; Díaz, M. C.; Di Fiore, L.; Di Giovanni, M.; Di Girolamo, T.; Di Lieto, A.; Di Pace, S.; Di Palma, I.; Di Renzo, F.; Doctor, Z.; Dolique, V.; Donovan, F.; Dooley, K. L.; Doravari, S.; Dorosh, O.; Dorrington, I.; Douglas, R.; Dovale Álvarez, M.; Downes, T. P.; Drago, M.; Dreissigacker, C.; Driggers, J. C.; Du, Z.; Ducrot, M.; Dupej, P.; Dwyer, S. E.; Edo, T. B.; Edwards, M. C.; Effler, A.; Eggenstein, H.-B.; Ehrens, P.; Eichholz, J.; Eikenberry, S. S.; Eisenstein, R. A.; Essick, R. C.; Estevez, D.; Etienne, Z. B.; Etzel, T.; Evans, M.; Evans, T. M.; Factourovich, M.; Fafone, V.; Fair, H.; Fairhurst, S.; Fan, X.; Farinon, S.; Farr, B.; Farr, W. M.; Fauchon-Jones, E. J.; Favata, M.; Fays, M.; Fee, C.; Fehrmann, H.; Feicht, J.; Fejer, M. M.; Fernandez-Galiana, A.; Ferrante, I.; Ferreira, E. C.; Ferrini, F.; Fidecaro, F.; Finstad, D.; Fiori, I.; Fiorucci, D.; Fishbach, M.; Fisher, R. P.; Fitz-Axen, M.; Flaminio, R.; Fletcher, M.; Fong, H.; Font, J. A.; Forsyth, P. W. F.; Forsyth, S. S.; Fournier, J.-D.; Frasca, S.; Frasconi, F.; Frei, Z.; Freise, A.; Frey, R.; Frey, V.; Fries, E. M.; Fritschel, P.; Frolov, V. V.; Fulda, P.; Fyffe, M.; Gabbard, H.; Gadre, B. U.; Gaebel, S. M.; Gair, J. R.; Gammaitoni, L.; Ganija, M. R.; Gaonkar, S. G.; Garcia-Quiros, C.; Garufi, F.; Gateley, B.; Gaudio, S.; Gaur, G.; Gayathri, V.; Gehrels, N.; Gemme, G.; Genin, E.; Gennai, A.; George, D.; George, J.; Gergely, L.; Germain, V.; Ghonge, S.; Ghosh, Abhirup; Ghosh, Archisman; Ghosh, S.; Giaime, J. A.; Giardina, K. D.; Giazotto, A.; Gill, K.; Glover, L.; Goetz, E.; Goetz, R.; Gomes, S.; Goncharov, B.; González, G.; Gonzalez Castro, J. M.; Gopakumar, A.; Gorodetsky, M. L.; Gossan, S. E.; Gosselin, M.; Gouaty, R.; Grado, A.; Graef, C.; Granata, M.; Grant, A.; Gras, S.; Gray, C.; Greco, G.; Green, A. C.; Gretarsson, E. M.; Groot, P.; Grote, H.; Grunewald, S.; Gruning, P.; Guidi, G. M.; Guo, X.; Gupta, A.; Gupta, M. K.; Gushwa, K. E.; Gustafson, E. K.; Gustafson, R.; Halim, O.; Hall, B. R.; Hall, E. D.; Hamilton, E. Z.; Hammond, G.; Haney, M.; Hanke, M. M.; Hanks, J.; Hanna, C.; Hannam, M. D.; Hannuksela, O. A.; Hanson, J.; Hardwick, T.; Harms, J.; Harry, G. M.; Harry, I. W.; Hart, M. J.; Haster, C.-J.; Haughian, K.; Healy, J.; Heidmann, A.; Heintze, M. C.; Heitmann, H.; Hello, P.; Hemming, G.; Hendry, M.; Heng, I. S.; Hennig, J.; Heptonstall, A. W.; Heurs, M.; Hild, S.; Hinderer, T.; Hoak, D.; Hofman, D.; Holt, K.; Holz, D. E.; Hopkins, P.; Horst, C.; Hough, J.; Houston, E. A.; Howell, E. J.; Hreibi, A.; Hu, Y. M.; Huerta, E. A.; Huet, D.; Hughey, B.; Husa, S.; Huttner, S. H.; Huynh-Dinh, T.; Indik, N.; Inta, R.; Intini, G.; Isa, H. N.; Isac, J.-M.; Isi, M.; Iyer, B. R.; Izumi, K.; Jacqmin, T.; Jani, K.; Jaranowski, P.; Jawahar, S.; Jiménez-Forteza, F.; Johnson, W. W.; Jones, D. I.; Jones, R.; Jonker, R. J. G.; Ju, L.; Junker, J.; Kalaghatgi, C. V.; Kalogera, V.; Kamai, B.; Kandhasamy, S.; Kang, G.; Kanner, J. B.; Kapadia, S. J.; Karki, S.; Karvinen, K. S.; Kasprzack, M.; Katolik, M.; Katsavounidis, E.; Katzman, W.; Kaufer, S.; Kawabe, K.; Kéfélian, F.; Keitel, D.; Kemball, A. J.; Kennedy, R.; Kent, C.; Key, J. S.; Khalili, F. Y.; Khan, I.; Khan, S.; Khan, Z.; Khazanov, E. A.; Kijbunchoo, N.; Kim, Chunglee; Kim, J. C.; Kim, K.; Kim, W.; Kim, W. S.; Kim, Y.-M.; Kimbrell, S. J.; King, E. J.; King, P. J.; Kinley-Hanlon, M.; Kirchhoff, R.; Kissel, J. S.; Kleybolte, L.; Klimenko, S.; Knowles, T. D.; Koch, P.; Koehlenbeck, S. M.; Koley, S.; Kondrashov, V.; Kontos, A.; Korobko, M.; Korth, W. Z.; Kowalska, I.; Kozak, D. B.; Krämer, C.; Kringel, V.; Krishnan, B.; Królak, A.; Kuehn, G.; Kumar, P.; Kumar, R.; Kumar, S.; Kuo, L.; Kutynia, A.; Kwang, S.; Lackey, B. D.; Lai, K. H.; Landry, M.; Lang, R. N.; Lange, J.; Lantz, B.; Lanza, R. K.; Lartaux-Vollard, A.; Lasky, P. D.; Laxen, M.; Lazzarini, A.; Lazzaro, C.; Leaci, P.; Leavey, S.; Lee, C. H.; Lee, H. K.; Lee, H. M.; Lee, H. W.; Lee, K.; Lehmann, J.; Lenon, A.; Leonardi, M.; Leroy, N.; Letendre, N.; Levin, Y.; Li, T. G. F.; Linker, S. D.; Littenberg, T. B.; Liu, J.; Lo, R. K. L.; Lockerbie, N. A.; London, L. T.; Lord, J. E.; Lorenzini, M.; Loriette, V.; Lormand, M.; Losurdo, G.; Lough, J. D.; Lovelace, G.; Lück, H.; Lumaca, D.; Lundgren, A. P.; Lynch, R.; Ma, Y.; Macas, R.; Macfoy, S.; Machenschalk, B.; MacInnis, M.; Macleod, D. M.; Magaña Hernandez, I.; Magaña-Sandoval, F.; Magaña Zertuche, L.; Magee, R. M.; Majorana, E.; Maksimovic, I.; Man, N.; Mandic, V.; Mangano, V.; Mansell, G. L.; Manske, M.; Mantovani, M.; Marchesoni, F.; Marion, F.; Márka, S.; Márka, Z.; Markakis, C.; Markosyan, A. S.; Markowitz, A.; Maros, E.; Marquina, A.; Martelli, F.; Martellini, L.; Martin, I. W.; Martin, R. M.; Martynov, D. V.; Mason, K.; Massera, E.; Masserot, A.; Massinger, T. J.; Masso-Reid, M.; Mastrogiovanni, S.; Matas, A.; Matichard, F.; Matone, L.; Mavalvala, N.; Mazumder, N.; McCarthy, R.; McClelland, D. E.; McCormick, S.; McCuller, L.; McGuire, S. C.; McIntyre, G.; McIver, J.; McManus, D. J.; McNeill, L.; McRae, T.; McWilliams, S. T.; Meacher, D.; Meadors, G. D.; Mehmet, M.; Meidam, J.; Mejuto-Villa, E.; Melatos, A.; Mendell, G.; Mercer, R. A.; Merilh, E. L.; Merzougui, M.; Meshkov, S.; Messenger, C.; Messick, C.; Metzdorff, R.; Meyers, P. M.; Miao, H.; Michel, C.; Middleton, H.; Mikhailov, E. E.; Milano, L.; Miller, A. L.; Miller, B. B.; Miller, J.; Millhouse, M.; Milovich-Goff, M. C.; Minazzoli, O.; Minenkov, Y.; Ming, J.; Mishra, C.; Mitra, S.; Mitrofanov, V. P.; Mitselmakher, G.; Mittleman, R.; Moffa, D.; Moggi, A.; Mogushi, K.; Mohan, M.; Mohapatra, S. R. P.; Montani, M.; Moore, C. J.; Moraru, D.; Moreno, G.; Morriss, S. R.; Mours, B.; Mow-Lowry, C. M.; Mueller, G.; Muir, A. W.; Mukherjee, Arunava; Mukherjee, D.; Mukherjee, S.; Mukund, N.; Mullavey, A.; Munch, J.; Muñiz, E. A.; Muratore, M.; Murray, P. G.; Napier, K.; Nardecchia, I.; Naticchioni, L.; Nayak, R. K.; Neilson, J.; Nelemans, G.; Nelson, T. J. N.; Nery, M.; Neunzert, A.; Nevin, L.; Newport, J. M.; Newton, G.; Ng, K. Y.; Nguyen, T. T.; Nichols, D.; Nielsen, A. B.; Nissanke, S.; Nitz, A.; Noack, A.; Nocera, F.; Nolting, D.; North, C.; Nuttall, L. K.; Oberling, J.; O'Dea, G. D.; Ogin, G. H.; Oh, J. J.; Oh, S. H.; Ohme, F.; Okada, M. A.; Oliver, M.; Oppermann, P.; Oram, Richard J.; O'Reilly, B.; Ormiston, R.; Ortega, L. F.; O'Shaughnessy, R.; Ossokine, S.; Ottaway, D. J.; Overmier, H.; Owen, B. J.; Pace, A. E.; Page, J.; Page, M. A.; Pai, A.; Pai, S. A.; Palamos, J. R.; Palashov, O.; Palomba, C.; Pal-Singh, A.; Pan, Howard; Pan, Huang-Wei; Pang, B.; Pang, P. T. H.; Pankow, C.; Pannarale, F.; Pant, B. C.; Paoletti, F.; Paoli, A.; Papa, M. A.; Parida, A.; Parker, W.; Pascucci, D.; Pasqualetti, A.; Passaquieti, R.; Passuello, D.; Patil, M.; Patricelli, B.; Pearlstone, B. L.; Pedraza, M.; Pedurand, R.; Pekowsky, L.; Pele, A.; Penn, S.; Perez, C. J.; Perreca, A.; Perri, L. M.; Pfeiffer, H. P.; Phelps, M.; Piccinni, O. J.; Pichot, M.; Piergiovanni, F.; Pierro, V.; Pillant, G.; Pinard, L.; Pinto, I. M.; Pirello, M.; Pisarski, A.; Pitkin, M.; Poe, M.; Poggiani, R.; Popolizio, P.; Porter, E. K.; Post, A.; Powell, J.; Prasad, J.; Pratt, J. W. W.; Pratten, G.; Predoi, V.; Prestegard, T.; Prijatelj, M.; Principe, M.; Privitera, S.; Prodi, G. A.; Prokhorov, L. G.; Puncken, O.; Punturo, M.; Puppo, P.; Pürrer, M.; Qi, H.; Quetschke, V.; Quintero, E. A.; Quitzow-James, R.; Raab, F. J.; Rabeling, D. S.; Radkins, H.; Raffai, P.; Raja, S.; Rajan, C.; Rajbhandari, B.; Rakhmanov, M.; Ramirez, K. E.; Ramos-Buades, A.; Rapagnani, P.; Raymond, V.; Razzano, M.; Read, J.; Regimbau, T.; Rei, L.; Reid, S.; Reitze, D. H.; Ren, W.; Reyes, S. D.; Ricci, F.; Ricker, P. M.; Rieger, S.; Riles, K.; Rizzo, M.; Robertson, N. A.; Robie, R.; Robinet, F.; Rocchi, A.; Rolland, L.; Rollins, J. G.; Roma, V. J.; Romano, R.; Romel, C. L.; Romie, J. H.; Rosińska, D.; Ross, M. P.; Rowan, S.; Rüdiger, A.; Ruggi, P.; Rutins, G.; Ryan, K.; Sachdev, S.; Sadecki, T.; Sadeghian, L.; Sakellariadou, M.; Salconi, L.; Saleem, M.; Salemi, F.; Samajdar, A.; Sammut, L.; Sampson, L. M.; Sanchez, E. J.; Sanchez, L. E.; Sanchis-Gual, N.; Sandberg, V.; Sanders, J. R.; Sassolas, B.; Saulson, P. R.; Sauter, O.; Savage, R. L.; Sawadsky, A.; Schale, P.; Scheel, M.; Scheuer, J.; Schmidt, J.; Schmidt, P.; Schnabel, R.; Schofield, R. M. S.; Schönbeck, A.; Schreiber, E.; Schuette, D.; Schulte, B. W.; Schutz, B. F.; Schwalbe, S. G.; Scott, J.; Scott, S. M.; Seidel, E.; Sellers, D.; Sengupta, A. S.; Sentenac, D.; Sequino, V.; Sergeev, A.; Shaddock, D. A.; Shaffer, T. J.; Shah, A. A.; Shahriar, M. S.; Shaner, M. B.; Shao, L.; Shapiro, B.; Shawhan, P.; Sheperd, A.; Shoemaker, D. H.; Shoemaker, D. M.; Siellez, K.; Siemens, X.; Sieniawska, M.; Sigg, D.; Silva, A. D.; Singer, L. P.; Singh, A.; Singhal, A.; Sintes, A. M.; Slagmolen, B. J. J.; Smith, B.; Smith, J. R.; Smith, R. J. E.; Somala, S.; Son, E. J.; Sonnenberg, J. A.; Sorazu, B.; Sorrentino, F.; Souradeep, T.; Spencer, A. P.; Srivastava, A. K.; Staats, K.; Staley, A.; Steinke, M.; Steinlechner, J.; Steinlechner, S.; Steinmeyer, D.; Stevenson, S. P.; Stone, R.; Stops, D. J.; Strain, K. A.; Stratta, G.; Strigin, S. E.; Strunk, A.; Sturani, R.; Stuver, A. L.; Summerscales, T. Z.; Sun, L.; Sunil, S.; Suresh, J.; Sutton, P. J.; Swinkels, B. L.; Szczepańczyk, M. J.; Tacca, M.; Tait, S. C.; Talbot, C.; Talukder, D.; Tanner, D. B.; Tao, D.; Tápai, M.; Taracchini, A.; Tasson, J. D.; Taylor, J. A.; Taylor, R.; Tewari, S. V.; Theeg, T.; Thies, F.; Thomas, E. G.; Thomas, M.; Thomas, P.; Thorne, K. A.; Thrane, E.; Tiwari, S.; Tiwari, V.; Tokmakov, K. V.; Toland, K.; Tonelli, M.; Tornasi, Z.; Torres-Forné, A.; Torrie, C. I.; Töyrä, D.; Travasso, F.; Traylor, G.; Trinastic, J.; Tringali, M. C.; Trozzo, L.; Tsang, K. W.; Tse, M.; Tso, R.; Tsukada, L.; Tsuna, D.; Tuyenbayev, D.; Ueno, K.; Ugolini, D.; Unnikrishnan, C. S.; Urban, A. L.; Usman, S. A.; Vahlbruch, H.; Vajente, G.; Valdes, G.; van Bakel, N.; van Beuzekom, M.; van den Brand, J. F. J.; Van Den Broeck, C.; Vander-Hyde, D. C.; van der Schaaf, L.; van Heijningen, J. V.; van Veggel, A. A.; Vardaro, M.; Varma, V.; Vass, S.; Vasúth, M.; Vecchio, A.; Vedovato, G.; Veitch, J.; Veitch, P. J.; Venkateswara, K.; Venugopalan, G.; Verkindt, D.; Vetrano, F.; Viceré, A.; Viets, A. D.; Vinciguerra, S.; Vine, D. J.; Vinet, J.-Y.; Vitale, S.; Vo, T.; Vocca, H.; Vorvick, C.; Vyatchanin, S. P.; Wade, A. R.; Wade, L. E.; Wade, M.; Walet, R.; Walker, M.; Wallace, L.; Walsh, S.; Wang, G.; Wang, H.; Wang, J. Z.; Wang, W. H.; Wang, Y. F.; Ward, R. L.; Warner, J.; Was, M.; Watchi, J.; Weaver, B.; Wei, L.-W.; Weinert, M.; Weinstein, A. J.; Weiss, R.; Wen, L.; Wessel, E. K.; Weßels, P.; Westerweck, J.; Westphal, T.; Wette, K.; Whelan, J. T.; Whiting, B. F.; Whittle, C.; Wilken, D.; Williams, D.; Williams, R. D.; Williamson, A. R.; Willis, J. L.; Willke, B.; Wimmer, M. H.; Winkler, W.; Wipf, C. C.; Wittel, H.; Woan, G.; Woehler, J.; Wofford, J.; Wong, W. K.; Worden, J.; Wright, J. L.; Wu, D. S.; Wysocki, D. M.; Xiao, S.; Yamamoto, H.; Yancey, C. C.; Yang, L.; Yap, M. J.; Yazback, M.; Yu, Hang; Yu, Haocun; Yvert, M.; Zadroźny, A.; Zanolin, M.; Zelenova, T.; Zendri, J.-P.; Zevin, M.; Zhang, L.; Zhang, M.; Zhang, T.; Zhang, Y.-H.; Zhao, C.; Zhou, M.; Zhou, Z.; Zhu, S. J.; Zhu, X. J.; Zucker, M. E.; Zweizig, J.; LIGO Scientific Collaboration; Virgo Collaboration

2018-05-01

We report on a new all-sky search for periodic gravitational waves in the frequency band 475-2000 Hz and with a frequency time derivative in the range of [-1.0 ,+0.1 ] ×1 0-8 Hz /s . Potential signals could be produced by a nearby spinning and slightly nonaxisymmetric isolated neutron star in our Galaxy. This search uses the data from Advanced LIGO's first observational run O1. No gravitational-wave signals were observed, and upper limits were placed on their strengths. For completeness, results from the separately published low-frequency search 20-475 Hz are included as well. Our lowest upper limit on worst-case (linearly polarized) strain amplitude h0 is ˜4 ×1 0-25 near 170 Hz, while at the high end of our frequency range, we achieve a worst-case upper limit of 1.3 ×1 0-24. For a circularly polarized source (most favorable orientation), the smallest upper limit obtained is ˜1.5 ×1 0-25.

Determining the Probability of Violating Upper-Level Wind Constraints for the Launch of Minuteman Ill Ballistic Missiles At Vandenberg Air Force Base

NASA Technical Reports Server (NTRS)

Shafer, Jaclyn A.; Brock, Tyler M.

2013-01-01

The 30th Operational Support Squadron Weather Flight (30 OSSWF) provides comprehensive weather services to the space program at Vandenberg Air Force Base (VAFB) in California. One of their responsibilities is to monitor upper-level winds to ensure safe launch operations of the Minuteman Ill ballistic missile. The 30 OSSWF requested the Applied Meteorology Unit (AMU) analyze VAFB sounding data to determine the probability of violating (PoV) upper-level thresholds for wind speed and shear constraints specific to this launch vehicle, and to develop a graphical user interface (GUI) that will calculate the PoV of each constraint on the day of launch. The AMU suggested also including forecast sounding data from the Rapid Refresh (RAP) model. This would provide further insight for the launch weather officers (LWOs) when determining if a wind constraint violation will occur over the next few hours, and help to improve the overall upper winds forecast on launch day.

A review of supernumerary and absent limbs and digits of the upper limb.

PubMed

Klaassen, Zachary; Choi, Monica; Musselman, Ruth; Eapen, Deborah; Tubbs, R Shane; Loukas, Marios

2012-03-01

For years people have been enamored by anomalies of the human limbs, particularly supernumerary and absent limbs and digits. Historically, there are a number of examples of such anomalies, including royal families of ancient Chaldea, tribes from Arabia, and examples from across nineteenth century Europe. The development of the upper limbs in a growing embryo is still being elucidated with the recent advent of homeobox genes, but researchers agree that upper limbs develop between stages 12-23 through a complex embryological process. Maternal thalidomide intake during limb development is known to cause limb reduction and subsequent amelia or phocomelia. Additionally, a number of clinical reports have illustrated different limb anomaly cases, with each situation unique in phenotype and developmental abnormality. Supernumerary and absent limbs and digits are not unique to humans, and a number of animal cases have also been reported. This review of the literature illustrates the historical, anatomical, and clinical aspects of supernumerary and absent limbs and digits for the upper limb.

An investigation of the processes controlling ozone in the upper stratosphere

NASA Technical Reports Server (NTRS)

Patten, Kenneth O., Jr.; Connell, Peter S.; Kinnison, Douglas E.; Wuebbles, Donald J.; Waters, Joe; Froidevaux, Lucien; Slanger, Tom G.

1994-01-01

Photolysis of vibrationally excited oxygen produced by ultraviolet photolysis of ozone in the upper stratosphere is incorporated into the Lawrence Livermore National Laboratory 2-D zonally averaged chemical-radiative-transport model of the troposphere and stratosphere. The importance of this potential contributor of odd oxygen to the concentration of ozone is evaluated based upon recent information on vibrational distributions of excited oxygen and upon preliminary studies of energy transfer from the excited oxygen. When the energy transfer rate constants of previous work are assumed, increases in model ozone concentrations of up to 40 percent in the upper stratosphere are found, and the ozone concentrations of the model agree with measurements, including data from the Upper Atmosphere Research Satellite. However, the increase is about 0.4 percent when the larger energy transfer rate constants suggested by more recent experimental work are applied in the model. This indicates the importance of obtaining detailed information on vibrationally excited oxygen properties to evaluation of this process for stratospheric modelling.

New options for vascularized bone reconstruction in the upper extremity.

PubMed

Houdek, Matthew T; Wagner, Eric R; Wyles, Cody C; Nanos, George P; Moran, Steven L

2015-02-01

Originally described in the 1970s, vascularized bone grafting has become a critical component in the treatment of bony defects and non-unions. Although well established in the lower extremity, recent years have seen many novel techniques described to treat a variety of challenging upper extremity pathologies. Here the authors review the use of different techniques of vascularized bone grafts for the upper extremity bone pathologies. The vascularized fibula remains the gold standard for the treatment of large bone defects of the humerus and forearm, while also playing a role in carpal reconstruction; however, two other important options for larger defects include the vascularized scapula graft and the Capanna technique. Smaller upper extremity bone defects and non-unions can be treated with the medial femoral condyle (MFC) free flap or a vascularized rib transfer. In carpal non-unions, both pedicled distal radius flaps and free MFC flaps are viable options. Finally, in skeletally immature patients, vascularized fibular head epiphyseal transfer can provide growth potential in addition to skeletal reconstruction.

Experience and learning curve of retroperitoneal laparoscopic ureterolithotomy for upper ureteral calculi.

PubMed

Fan, Tianyong; Xian, Peng; Yang, Lu; Liu, Yong; Wei, Qiang; Li, Hong

2009-11-01

To summarize our experience and evaluate the learning curve of retroperitoneal laparoscopic ureterolithotomy of the upper ureter. Between May 2004 and May 2007, 40 patients underwent retroperitoneal laparoscopic ureterolithotomy of the upper ureter. We divided the first and last 20 patients into group I and group II. There was no statistical difference in stone size between groups. Operative time and complications were measured as a basis for the assessment of the learning curve. In group I, the complication rate was 15% (3/20), including two patients whose procedure was converted to open surgery because of intraoperative bleeding, and one patient who experienced urine leakage because of a displaced Double-J ureteral stent. In group II, no postoperative complications occurred, while the mean operative time was significantly shorter compared with the earlier operations (65 vs 120 min). Retroperitoneal laparoscopic ureterolithotomy is safe and effective for large or impacted stones of the upper ureter. It is associated with a short learning curve in the setting of an active laparoscopic practice for selected patients.

Toward a New Capability for Upper Atmospheric Research using Atomic Oxygen Lidar

NASA Astrophysics Data System (ADS)

Clemmons, J. H.; Steinvurzel, P.; Mu, X.; Beck, S. M.; Lotshaw, W. T.; Rose, T. S.; Hecht, J. H.; Westberg, K. R.; Larsen, M. F.; Chu, X.; Fritts, D. C.

2017-12-01

Progress on development of a lidar system for probing the upper atmosphere based on atomic oxygen resonance is presented and discussed. The promise of a fully-developed atomic oxygen lidar system, which must be based in space to measure the upper atmosphere, for yielding comprehensive new insights is discussed in terms of its potential to deliver global, height-resolved measurements of winds, temperature, and density at a high cadence. An overview of the system is given, and its measurement principles are described, including its use of 1) a two-photon transition to keep the optical depth low; 2) laser tuning to provide the Doppler information needed to measure winds; and 3) laser tuning to provide a Boltzmann temperature measurement. The current development status is presented with a focus on what has been done to demonstrate capability in the laboratory and its evolution to a funded sounding rocket investigation designed to make measurements of three-dimensional turbulence in the upper mesosphere and lower thermosphere.

Hemospray for treatment of acute bleeding due to upper gastrointestinal tumours.

PubMed

Arena, Monica; Masci, Enzo; Eusebi, Leonardo Henry; Iabichino, Giuseppe; Mangiavillano, Benedetto; Viaggi, Paolo; Morandi, Elisabetta; Fanti, Lorella; Granata, Antonino; Traina, Mario; Testoni, Pier Alberto; Opocher, Enrico; Luigiano, Carmelo

2017-05-01

Hemospray is a new endoscopic haemostatic powder that can be used in the management of upper gastrointestinal bleedings. To assess the efficacy and safety of Hemospray as monotherapy for the treatment of acute upper gastrointestinal bleeding due to cancer. The endoscopy databases of 3 Italian Endoscopic Units were reviewed retrospectively and 15 patients (8 males; mean age 74 years) were included in this study. Immediate haemostasis was achieved in 93% of cases. Among the successful cases, 3 re-bled, one case treated with Hemospray and injection had a good outcome, while 2 cases died both re-treated with Hemospray, injection and thermal therapy. No complications related to Hemospray occurred. Finally, 80% of patients had a good clinical outcome at 30days and 50% at six months. Hemospray may be considered an effective and safe method for the endoscopic management of acute neoplastic upper gastrointestinal bleedings. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Atypical Initial Presentation of Painful Muscle Cramps in a Patient with Amyotrophic Lateral Sclerosis: A Case Report and Brief Review of the Literature.

PubMed

Kuzel, Aaron R; Lodhi, Muhammad Uzair; Syed, Intekhab Askari; Rahim, Mustafa

2017-11-10

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder characterized clinically by progressive muscle weakness that can occur proximally or distally in either the upper or lower extremities. It includes both upper motor neuron signs (spasticity, hyperreflexia, clonus, and Babinski sign) and lower motor neuron signs (atrophy, weakness, and muscle fasciculation). Initial presentation of progressively painful muscle cramps should lead the physician to screen for other signs of amyotrophic lateral sclerosis. We report the case of a 51-year-old male, who presented with dull muscle cramps in the right upper shoulder and arm. After a careful history and physical exam, it was found that patient had both upper and lower motor neuron signs; therefore, a diagnosis of amyotrophic lateral sclerosis was made. Amyotrophic lateral sclerosis should strongly be considered in the differential diagnosis of patients presenting with an atypical initial presentation of progressively painful muscle cramps.

Nasopharyngeal culture

MedlinePlus

Culture - nasopharyngeal; Swab for respiratory viruses; Swab for staph carriage ... test identifies viruses and bacteria that cause upper respiratory tract symptoms. These include: Bordetella pertussis Neisseria meningitidis ...

Refractory gastro-oesophageal reflux disease: diagnosis and management.

PubMed

Liu, Julia J; Saltzman, John R

2009-10-01

Refractory gastro-oesophageal reflux disease (GORD) is described when reflux symptoms have not responded to 4-8 weeks of proton pump inhibitor therapy and occurs in a heterogeneous mixture of patients. The causes of refractory GORD include inadequate acid suppression, non-acid gastro-oesophageal reflux, and non-reflux causes of GORD symptoms including achalasia, gastroparesis and functional heartburn. Upper gastrointestinal tract endoscopy should initially be performed to identify the presence of oesophagitis, and exclude other diagnoses including eosinophilic oesophagitis and peptic ulcer disease. Patients with refractory symptoms but with a normal upper endoscopy are more difficult to diagnose and may require ambulatory pH monitoring, impedance testing, oesophageal motility tests and gastric emptying scans. The primary goal of treatment is symptom reduction and eventual elimination, which can be achieved with proper identification of the underlying cause of the symptoms.

The Differential Effect of Arm Movements during Gait on the Forward Acceleration of the Centre of Mass in Children with Cerebral Palsy and Typically Developing Children.

PubMed

Meyns, Pieter; Molenaers, Guy; Duysens, Jacques; Jonkers, Ilse

2017-01-01

Background: We aimed to study the contribution of upper limb movements to propulsion during walking in typically developing (TD) children ( n = 5) and children with hemiplegic and diplegic cerebral palsy (CP; n = 5 and n = 4, respectively). Methods: Using integrated three-dimensional motion capture data and a scaled generic musculoskeletal model that included upper limbs, we generated torque driven simulations of gait in OpenSim. Induced acceleration analyses were then used to determine the contributions of the individual actuators located at the relevant degrees of freedoms of the upper and lower limb joints to the forward acceleration of the COM at each time point of the gait simulation. The mean values of the contribution of the actuators of upper limbs, lower limbs, and gravity in different phases of the gait cycle were compared between the three groups. Findings: The results indicated a limited contribution of the upper limb actuators to COM forward acceleration compared to the contribution of lower limbs and gravity, in the three groups. In diplegic CP, the contribution of the upper limbs seemed larger compared to TD during the preswing and swing phases of gait. In hemiplegic CP, the unaffected arm seemed to contribute more to COM deceleration during (pre)swing, while the affected side contributed to COM acceleration. Interpretation: These findings suggest that in the presence of lower limb dysfunction, the contribution of the upper limbs to forward propulsion is altered, although they remain negligible compared to the lower limbs and gravity.

Influence of socio-economic status on access to different components of SCI management across Indian population.

PubMed

Chhabra, H S; Bhalla, A M

2015-11-01

To assess the influence of financial constraints on access to different components of spinal cord injury (SCI) management in various socio-economic strata of the Indian population. Indian Spinal Injuries Centre (ISIC). One hundred fifty SCI individuals who came for follow-up at ISIC between March 2009 and March 2013 with at least 1 year of community exposure after discharge were included in the study. Socio-economic classification was carried out according to the Kuppuswamy scale, a standard scale for the Indian population. A self-designed questionnaire was administered. No sample was available from the lower group. There was a statistically significant difference (P<0.05) for the levels of difficulty perceived by different socio-economic groups in accessing different components of SCI management. Aided upper lower group was dependent on welfare schemes for in-hospital treatment but could not access other components of management once discharged. Unaided upper lower group either faced severe difficulty or could not access management. Majority of lower middle group faced severe difficulty. Upper middle group was equally divided into facing severe, moderate or no difficulty. Most patients in the upper group faced no difficulty, whereas some faced moderate and a small number of severe difficulty. Financial constraints affected all components of SCI management in all except the upper group. The results of the survey suggest that a very large percentage of the Indian population would find it difficult to access comprehensive SCI management and advocate extension of essential medical coverage to unaided upper lower, lower middle and upper middle groups.

Upper limb performance and the structuring of joint movement in teenagers with cerebral palsy: the reciprocal role of task demands and action capabilities.

PubMed

Figueiredo, Priscilla Rezende Pereira; Silva, Paula Lanna; Avelar, Bruna Silva; da Fonseca, Sérgio Teixeira; Bootsma, Reinoud J; Mancini, Marisa Cotta

2015-04-01

Individuals with unilateral cerebral palsy (CP) demonstrate reduced performance in upper limb tasks compared to typically developing (TD) peers. We examined whether task conditions modify differences between teenagers with and without CP during a reciprocal aiming task. Twenty teenagers (nine CP and 11 TD) moved a pointer between two targets as fast as possible without missing a target. Task conditions were manipulated by changing the targets' size, by modifying the inertial properties of the pointer and by varying the upper limb used to perform the task (preferred/non-affected and non-preferred/affected upper limbs). While compared to TD peers, CP teenagers exhibited lower performance (longer movement times). Such differences were attenuated when the task was performed with the preferred upper limb and when accuracy requirements were less stringent. CP teenagers were not differentially affected by the pointer inertia manipulation. Task conditions not only affected performance but also joint kinematics. CP teenagers revealed less movement at the elbow and more movement at the shoulder when performing the task with their less skilled upper limb. However, both CP and TD teenagers demonstrated a larger contribution of trunk movement when facing more challenging task conditions. The overall pattern of results indicated that the joint kinematics employed by individuals with unilateral CP constituted adaptive responses to task requirements. Thus, the explanation of the effects of unilateral CP on upper limb behavior needs to go beyond a context-indifferent manifestation of the brain injury to include the interaction between task demands and action capabilities.

Chronic gastritis in China: a national multi-center survey

PubMed Central

2014-01-01

Background Chronic gastritis is one of the most common findings at upper endoscopy in the general population, and chronic atrophic gastritis is epidemiologically associated with the occurrence of gastric cancer. However, the current status of diagnosis and treatment of chronic gastritis in China is unclear. Methods A multi-center national study was performed; all patients who underwent diagnostic upper endoscopy for evaluation of gastrointestinal symptoms from 33 centers were enrolled. Data including sex, age, symptoms and endoscopic findings were prospectively recorded. Results Totally 8892 patients were included. At endoscopy, 4389, 3760 and 1573 patients were diagnosed to have superficial gastritis, erosive gastritis, and atrophic gastritis, respectively. After pathologic examination, it is found that atrophic gastritis, intestinal metaplasia and dysplasia were prevalent, which accounted for 25.8%, 23.6% and 7.3% of this patient population. Endoscopic features were useful for predicting pathologic atrophy (PLR = 4.78), but it was not useful for predicting erosive gastritis. Mucosal-protective agents and PPI were most commonly used medications for chronic gastritis. Conclusions The present study suggests non-atrophic gastritis is the most common endoscopic finding in Chinese patients with upper GI symptoms. Precancerous lesions, including atrophy, intestinal metaplasia and dysplasia are prevalent in Chinese patients with chronic gastritis, and endoscopic features are useful for predicting pathologic atrophy. PMID:24502423

Chronic gastritis in China: a national multi-center survey.

PubMed

Du, Yiqi; Bai, Yu; Xie, Pei; Fang, Jingyuan; Wang, Xiaozhong; Hou, Xiaohua; Tian, Dean; Wang, Chengdang; Liu, Yandi; Sha, Weihong; Wang, Bangmao; Li, Yanqing; Zhang, Guoliang; Li, Yan; Shi, Ruihua; Xu, Jianming; Li, Youming; Huang, Minghe; Han, Shengxi; Liu, Jie; Ren, Xu; Xie, Pengyan; Wang, Zhangliu; Cui, Lihong; Sheng, Jianqiu; Luo, Hesheng; Wang, Zhaohui; Zhao, Xiaoyan; Dai, Ning; Nie, Yuqiang; Zou, Yiyou; Xia, Bing; Fan, Zhining; Chen, Zhitan; Lin, Sanren; Li, Zhao-Shen

2014-02-07

Chronic gastritis is one of the most common findings at upper endoscopy in the general population, and chronic atrophic gastritis is epidemiologically associated with the occurrence of gastric cancer. However, the current status of diagnosis and treatment of chronic gastritis in China is unclear. A multi-center national study was performed; all patients who underwent diagnostic upper endoscopy for evaluation of gastrointestinal symptoms from 33 centers were enrolled. Data including sex, age, symptoms and endoscopic findings were prospectively recorded. Totally 8892 patients were included. At endoscopy, 4389, 3760 and 1573 patients were diagnosed to have superficial gastritis, erosive gastritis, and atrophic gastritis, respectively. After pathologic examination, it is found that atrophic gastritis, intestinal metaplasia and dysplasia were prevalent, which accounted for 25.8%, 23.6% and 7.3% of this patient population. Endoscopic features were useful for predicting pathologic atrophy (PLR = 4.78), but it was not useful for predicting erosive gastritis. Mucosal-protective agents and PPI were most commonly used medications for chronic gastritis. The present study suggests non-atrophic gastritis is the most common endoscopic finding in Chinese patients with upper GI symptoms. Precancerous lesions, including atrophy, intestinal metaplasia and dysplasia are prevalent in Chinese patients with chronic gastritis, and endoscopic features are useful for predicting pathologic atrophy.

Differences in myoelectric and body-powered upper-limb prostheses: Systematic literature review.

PubMed

Carey, Stephanie L; Lura, Derek J; Highsmith, M Jason

2015-01-01

The choice of a myoelectric or body-powered upper-limb prosthesis can be determined using factors including control, function, feedback, cosmesis, and rejection. Although body-powered and myoelectric control strategies offer unique functions, many prosthesis users must choose one. A systematic review was conducted to determine differences between myoelectric and body-powered prostheses to inform evidence-based clinical practice regarding prescription of these devices and training of users. A search of 9 databases identified 462 unique publications. Ultimately, 31 of them were included and 11 empirical evidence statements were developed. Conflicting evidence has been found in terms of the relative functional performance of body-powered and myoelectric prostheses. Body-powered prostheses have been shown to have advantages in durability, training time, frequency of adjustment, maintenance, and feedback; however, they could still benefit from improvements of control. Myoelectric prostheses have been shown to improve cosmesis and phantom-limb pain and are more accepted for light=intensity work. Currently, evidence is insufficient to conclude that either system provides a significant general advantage. Prosthetic selection should be based on a patient's individual needs and include personal preferences, prosthetic experience, and functional needs. This work demonstrates that there is a lack of empirical evidence regarding functional differences in upper-limb prostheses.

Assessing the efficacy of different upper limb hemiparesis interventions on improving health-related quality of life in stroke patients: a systematic review.

PubMed

Pulman, Jennifer; Buckley, Emily

2013-01-01

This review aims to assess the efficacy of upper limb interventions on stroke survivors' health-related quality of life (QOL). Published studies were identified following a systematic search of the literature from 10 electronic databases, 3 subject-relevant journals, a Web search via a popular search engine, and reference lists of the included articles. In total, 22 articles met the inclusion criteria and were subjected to data extraction to establish the effectiveness of the intervention on QOL scores. Interventions varied according to their content, including acupuncture treatment, botulinum toxin type A (BTX-A) injections, constraint-induced movement therapy (CIMT), task training, and therapeutic exercise. Studies were required to have at least 1 quantitative outcome QOL measure. Of the 22 studies, 12 reported significant findings within groups and between control groups. Interventions including BTX-A injections, CIMT, exercise programs, baclofen pump, robotic-assisted therapy, electrical stimulation, and acupuncture were reported to significantly improve either overall health-related QOL or certain individual QOL domains, such as strength, hand function, memory, mood, activities of daily living, mobility, social participation, communication, energy, pain, and sleep. The review demonstrates the need for upper limb intervention studies to focus on QOL as a primary outcome measure in addition to the functional outcomes currently used.

Groundwater quality in the Upper Susquehanna River Basin, New York, 2009

USGS Publications Warehouse

Reddy, James E.; Risen, Amy J.

2012-01-01

Water samples were collected from 16 production wells and 14 private residential wells in the Upper Susquehanna River Basin from August through December 2009 and were analyzed to characterize the groundwater quality in the basin. Wells at 16 of the sites were completed in sand and gravel aquifers, and 14 were finished in bedrock aquifers. In 2004–2005, six of these wells were sampled in the first Upper Susquehanna River Basin study. Water samples from the 2009 study were analyzed for 10 physical properties and 137 constituents that included nutrients, organic carbon, major inorganic ions, trace elements, radionuclides, pesticides, volatile organic compounds, and 4 types of bacterial analyses. Results of the water-quality analyses are presented in tabular form for individual wells, and summary statistics for specific constituents are presented by aquifer type. The results are compared with Federal and New York State drinking-water standards, which typically are identical. The results indicate that groundwater genrally is of acceptable quality, although concentrations of some constituents exceeded at least one drinking-water standard at 28 of the 30 wells. These constituents include: pH, sodium, aluminum, manganese, iron, arsenic, radon-222, residue on evaporation, total and fecal coliform including Escherichia coli and heterotrophic plate count.

Vocal Cord Paralysis

MedlinePlus

... paralysis. Known causes may include: Injury to the vocal cord during surgery. Surgery on or near your neck or upper ... Factors that may increase your risk of developing vocal cord paralysis include: Undergoing throat or chest surgery. People who need surgery on their thyroid, throat ...

The Multi-Stage History of Mt. Sharp

NASA Technical Reports Server (NTRS)

Allen, C.; Dapremont, A.

2013-01-01

The Curiosity rover is exploring Gale crater and Mt. Sharp, Gale's 5-km high central mound. We are investigating the history of alteration and erosion of Mt. Sharp using orbital imagery, spectroscopy and rover observations. Our results suggest a significant time gap between emplacement of the upper and lower sections of the mound. Crater counts show that the lower mound was formed soon after Gale itself, and that it contains distinct units ranging in altitude from approximately -4,500 to -1,800 m. Spectral data suggest that many units contain phyllosilicates. We found that these clay-bearing rocks occur in distinct layers concentrated below -2,900 m. Parts of the lower mound exhibit a transition from clays to sulfates with increasing altitude. The lower mound shows evidence of flowing water, including canyons and inverted channels. Wind erosion produced km-scale yardangs and scalloped cliffs. Our mapping shows that many yardangs in the lower mound are clay-bearing, with a predominant orientation of around N-S. Curiosity's ground-level images show myriad fine-scale, mainly horizontal layers in the lower mound. The rover has found stream beds and conglomerates, indicating that water once flowed on the crater floor. Drilling near the deepest point in Gale produced abundant clay, providing additional evidence of aqueous alteration. Upper mound units range in altitude from -2,100 m to +500 m, and mantle the lower mound above an angular unconformity. Most upper mound units are composed of layers. The formation age of the upper mound is unknown, since few craters are preserved. Clay-bearing layers are detectable in several locations, mainly at altitudes near -2,000 m. There is no evidence of water flow, but wind erosion has scalloped the surfaces and edges of layers, and fine-scale yardangs are common. Correlations between yardangs and clay spectra are apparent only in the lowermost units of the upper mound. Yardang orientations vary, and include N-S, NW-SE, and NE-SW. Upper mound units resemble the planet-wide Medusae Fossae formation, dated as Hesperian and argued to be composed of ignimbrites. Medusae Fossae layers are easily eroded by wind, and our mapping demonstrates their resemblance to upper mound fine-scale yardangs. The history of Mt. Sharp started with deposition and lithification of sediments shortly after crater formation. Some lower mound layers were partially altered to clays and sulfates, and water formed streams and canyons. Wind erosion of the lower mound produced large-scale yardangs, particularly in clay-rich layers, oriented generally N-S. Upper mound units were emplaced following a considerable period of wind erosion. The absence of water flow on the upper mound suggests that these units were emplaced after atmospheric loss rendered water unstable at the surface. The shift in dominant wind direction, as indicated by yardang orientations, also argues for a time gap between erosion of the lower and upper mound. These observations are consistent with upper mound units being related to the Hesperian Medusae Fossae formation. During 2014 Curiosity is expected to reach the foot of Mt. Sharp and ascend through the clay-rich layers, into the sulfate-rich layers, and possibly past the interface with the upper mound. This will be a unique opportunity to field check geologic models on the surface of Mars.

Drug induced sleep endoscopy: its role in evaluation of the upper airway obstruction and patient selection for surgical and non-surgical treatment

PubMed Central

De Vito, Andrea

2018-01-01

Sleep related breathing disorders cause obstruction of the upper airway which can be alleviated by continuous positive airway pressure (CPAP) therapy, oral devices or surgical intervention. Non-surgical treatment modalities are not always accepted by patients and in order to attain successful surgical outcomes, evaluation of the upper airway is necessary to carefully select the patients who would benefit from surgery. There are numerous techniques available to assess the upper airway obstruction and these include imaging, acoustic analysis, pressure transducer recording and endoscopic evaluation. It is essential to note that the nocturnal obstructive upper airway has limited muscle control compared to the tone of the upper airway lumen during wakefulness. Thus, if one were to attempt to identify the anatomical segments contributing to upper airway obstruction in sleep related breathing disorders; it must be borne in mind that evaluation of the airway must be performed if possible when the patient is awake and asleep albeit during drug induced sleep. This fact as such limits the use of imaging techniques for the purpose. Drug induced sleep endoscopy (DISE) was pioneered at Royal National Throat, Nose and Ear Hospital, London in 1990 and initially introduced as sleep nasendoscopy. The nomenclature and the technique has been modified by various Institutions but the core value of this evaluation technique remains similar and extremely useful for identifying the anatomical segment responsible for obstructing the upper airway during sleep in patients with sleep related breathing disorders. There have been numerous controversies that have surrounded this technique but over the last two decades most of these have been addressed and it now remains in the forefront of methods of evaluating the upper airway obstruction. A variety of sedative agents and different grading systems have been described and efforts to unify various aspects of the technique have been made. This article will look at its usefulness and advantages and will discuss some important contributions made to the field of evaluation of the upper airway using DISE. PMID:29445527

Upper extremity deep venous thrombosis after port insertion: What are the risk factors?

PubMed

Tabatabaie, Omidreza; Kasumova, Gyulnara G; Kent, Tara S; Eskander, Mariam F; Fadayomi, Ayotunde B; Ng, Sing Chau; Critchlow, Jonathan F; Tawa, Nicholas E; Tseng, Jennifer F

2017-08-01

Totally implantable venous access devices (ports) are widely used, especially for cancer chemotherapy. Although their use has been associated with upper extremity deep venous thrombosis, the risk factors of upper extremity deep venous thrombosis in patients with a port are not studied adequately. The Healthcare Cost and Utilization Project's Florida State Ambulatory Surgery and Services Database was queried between 2007 and 2011 for patients who underwent outpatient port insertion, identified by Current Procedural Terminology code. Patients were followed in the State Ambulatory Surgery and Services Database, State Inpatient Database, and State Emergency Department Database for upper extremity deep venous thrombosis occurrence. The cohort was divided into a test cohort and a validation cohort based on the year of port placement. A multivariable logistic regression model was developed to identify risk factors for upper extremity deep venous thrombosis in patients with a port. The model then was tested on the validation cohort. Of the 51,049 patients in the derivation cohort, 926 (1.81%) developed an upper extremity deep venous thrombosis. On multivariate analysis, independently significant predictors of upper extremity deep venous thrombosis included age <65 years (odds ratio = 1.22), Elixhauser score of 1 to 2 compared with zero (odds ratio = 1.17), end-stage renal disease (versus no kidney disease; odds ratio = 2.63), history of any deep venous thrombosis (odds ratio = 1.77), all-cause 30-day revisit (odds ratio = 2.36), African American race (versus white; odds ratio = 1.86), and other nonwhite races (odds ratio = 1.35). Additionally, compared with genitourinary malignancies, patients with gastrointestinal (odds ratio = 1.55), metastatic (odds ratio = 1.76), and lung cancers (odds ratio = 1.68) had greater risks of developing an upper extremity deep venous thrombosis. This study identified major risk factors of upper extremity deep venous thrombosis. Further studies are needed to evaluate the appropriateness of thromboprophylaxis in patients at greater risk of upper extremity deep venous thrombosis. Copyright © 2017 Elsevier Inc. All rights reserved.

Upper Cervical Epidural Abscess in Clinical Practice: Diagnosis and Management

PubMed Central

Al-Hourani, Khalid; Al-Aref, Rami; Mesfin, Addisu

2015-01-01

Study Design Narrative review. Objective Upper cervical epidural abscess (UCEA) is a rare surgical emergency. Despite increasing incidence, uncertainty remains as to how it should initially be managed. Risk factors for UCEA include immunocompromised hosts, diabetes mellitus, and intravenous drug use. Our objective is to provide a comprehensive overview of the literature including the history, clinical manifestations, diagnosis, and management of UCEA. Methods Using PubMed, studies published prior to 2015 were analyzed. We used the keywords “Upper cervical epidural abscess,” “C1 osteomyelitis,” “C2 osteomyelitis,” “C1 epidural abscess,” “C2 epidural abscess.” We excluded cases with tuberculosis. Results The review addresses epidemiology, etiology, imaging, microbiology, and diagnosis of this condition. We also address the nonoperative and operative management options and the relative indications for each as reviewed in the literature. Conclusion A high index of suspicion is required to diagnose this rare condition with magnetic resonance imaging being the imaging modality of choice. There has been a shift toward surgical management of this condition in recent times, with favorable outcomes. PMID:27190742

Automated lidar-derived canopy height estimates for the Upper Mississippi River System

USGS Publications Warehouse

Hlavacek, Enrika

2015-01-01

Land cover/land use (LCU) classifications serve as important decision support products for researchers and land managers. The LCU classifications produced by the U.S. Geological Survey’s Upper Midwest Environmental Sciences Center (UMESC) include canopy height estimates that are assigned through manual aerial photography interpretation techniques. In an effort to improve upon these techniques, this project investigated the use of high-density lidar data for the Upper Mississippi River System to determine canopy height. An ArcGIS tool was developed to automatically derive height modifier information based on the extent of land cover features for forest classes. The measurement of canopy height included a calculation of the average height from lidar point cloud data as well as the inclusion of a local maximum filter to identify individual tree canopies. Results were compared to original manually interpreted height modifiers and to field survey data from U.S. Forest Service Forest Inventory and Analysis plots. This project demonstrated the effectiveness of utilizing lidar data to more efficiently assign height modifier attributes to LCU classifications produced by the UMESC.

The Jurassic section along McElmo Canyon in southwestern Colorado

USGS Publications Warehouse

O'Sullivan, Robert B.

1997-01-01

In McElmo Canyon, Jurassic rocks are 1500-1600 ft thick. Lower Jurassic rocks of the Glen Canyon Group include (in ascending order) Wingate Sandstone, Kayenta Formation and Navajo Sandstone. Middle Jurassic rocks are represented by the San Rafael Group, which includes the Entrada Sandstone and overlying Wanakah Formation. Upper Jurassic rocks comprise the Junction Creek Sandstone overlain by the Morrison Formation. The Burro Canyon Formation, generally considered to be Lower Cretaceous, may be Late Jurassic in the McElmo Canyon area and is discussed with the Jurassic. The Upper Triassic Chinle Formation in the subsurface underlies, and the Upper Cretaceous Dakota Sandstone overlies, the Jurassic section. An unconformity is present at the base of the Glen Canyon Group (J-0), at the base of the San Rafael Group (J-2), and at the base of the Junction Creek Sandstone (J-5). Another unconformity of Cretaceous age is at the base of the Dakota Sandstone. Most of the Jurassic rocks consist of fluviatile, lacustrine and eolian deposits. The basal part of the Entrada Sandstone and the Wanakah Formation may be of marginal marine origin.

Impact of the 1993 flood on the distribution of organic contaminants in bed sediments of the Upper Mississippi River

USGS Publications Warehouse

Barber, L.B.; Writer, J.H.

1998-01-01

The 1500 km Upper Mississippi River (UMR) consists of 29 navigation pools and can be divided into the upper reach (pools 1-4), the middle reach (pools 5-13), and the lower reach (pools 14-26). Comparison of composite bed sediment samples collected from the downstream third of 24 pools before and after the 1993 UMR flood provides fieldscale data on the effect of the flood on sediment organic compound distributions. The sediments were analyzed for organic carbon, coprostanol, polynuclear aromatic hydrocarbons including pyrene, linear alkylbenzene-sulfonates, polychlorinated biphenyls (PCBs), and organochlorine pesticides. Most of the target compounds were detected in all of the sediment samples, although concentrations were generally <1 mg/kg. The highest concentrations typically occurred in the upper reach, an urbanized area on a relatively small river. Pool 4 (Lake Pepin) is an efficient sediment trap, and concentrations of the compounds below pool 4 were substantially lower than those in pools 2-4. Differences in concentrations before and after the 1993 flood also were greatest in the upper reach. In pools 1-4, concentrations of pyrene and PCBs decreased after the flood whereas coprostanol increased. These results suggest that bed sediments stored in the pools were diluted or buried by sediments with different organic compound compositions washed in from urban and agricultural portions of the watershed.The 1500 km Upper Mississippi River (UMR) consists of 29 navigation pools and can be divided into the upper reach (pools 1-4), the middle reach (pools 5-13), and the lower reach (pools 14-26). Comparison of composite bed sediment samples collected from the downstream third of 24 pools before and after the 1993 UMR flood provides field-scale data on the effect of the flood on sediment organic compound distributions. The sediments were analyzed for organic carbon, coprostanol, polynuclear aromatic hydrocarbons including pyrene, linear alkylbenzene-sulfonates, polychlorinated biphenyls (PCBs), and organochlorine pesticides. Most of the target compounds were detected in all of the sediment samples, although concentrations were generally <1 mg/kg. The highest concentrations typically occurred in the upper reach, an urbanized area on a relatively small river. Pool 4 (Lake Pepin) is an efficient sediment trap, and concentrations of the compounds below pool 4 were substantially lower than those in pools 2-4. Differences in concentrations before and after the 1993 flood also were greatest in the upper reach. In pools 1-4, concentrations of pyrene and PCBs decreased after the flood whereas coprostanol increased. These results suggest that bed sediments stored in the pools were diluted or buried by sediments with different organic compound compositions washed in from urban and agricultural portions of the watershed.

3D printing-assisted preoperative plan of pedicle screw placement for middle-upper thoracic trauma: a cohort study.

PubMed

Xu, Wei; Zhang, Xuming; Ke, Tie; Cai, Hongru; Gao, Xiang

2017-08-11

This study aimed to evaluate the application of 3D printing in assisting preoperative plan of pedicle screw placement for treating middle-upper thoracic trauma. A preoperative plan was implemented in seven patients suffering from middle-upper thoracic (T3-T7) trauma between March 2013 and February 2016. In the 3D printing models, entry points of 56 pedicle screws (Magerl method) and 4 important parameters of the pedicle screws were measured, including optimal diameter (ϕ, mm), length (L, mm), inclined angle (α), head-tilting angle (+β), and tail-tilting angle (-β). In the surgery, bare-hands fixation of pedicle screws was performed using 3D printing models and the measured parameters as guidance. A total of seven patients were enrolled, including five men and two women, with the age of 21-62 years (mean age of 37.7 years). The position of the pedicle screw was evaluated postoperatively using a computerized tomography scan. Totally, 56 pedicle screws were placed, including 33 pieces of level 0, 18 pieces of level 1, 4 pieces of level 2 (pierced lateral wall), and 1 piece of level 3 (pierced lateral wall, no adverse consequences), with a fine rate of 91.0%. 3D printing technique is an intuitive and effective assistive technology to pedicle screw fixation for treating middle-upper thoracic vertebrae, which improve the accuracy of bare-hands screw placement and reduce empirical errors. The trial was approved by the Ethics Committee of the Fujian Provincial Hospital. It was registered on March 1st, 2013, and the registration number was K2013-03-001.

Can therapeutic Thai massage improve upper limb muscle strength in Parkinson's disease? An objective randomized-controlled trial.

PubMed

Miyahara, Yuka; Jitkritsadakul, Onanong; Sringean, Jirada; Aungkab, Nicharee; Khongprasert, Surasa; Bhidayasiri, Roongroj

2018-04-01

Muscle weakness is a frequent complaint amongst Parkinson's disease (PD) patients. However, evidence-based therapeutic options for this symptom are limited. We objectively measure the efficacy of therapeutic Thai massage (TTM) on upper limb muscle strength, using an isokinetic dynamometer. A total of 60 PD patients with muscle weakness that is not related to their 'off' periods or other neurological causes were equally randomized to TTM intervention (n = 30), consisting of six TTM sessions over a 3-week period, or standard medical care (no intervention, n = 30). Primary outcomes included peak extension and flexion torques. Scale-based outcomes, including Unified Parkinson's Disease Rating Scale (UPDRS) and visual analogue scale for pain (VAS) were also performed. From baseline to end of treatment, patients in the intervention group showed significant improvement on primary objective outcomes, including peak flexion torque (F = 30.613, p  < .001) and peak extension torque (F = 35.569, p  < .001) and time to maximal flexion speed (F = 14.216, p  = .001). Scale-based assessments mirrored improvements in the objective outcomes with a significant improvement from baseline to end of treatment of the UPDRS-bradykinesia of a more affected upper limb (F = 9.239, p  = .005), and VAS (F = 69.864, p  < .001) following the TTM intervention, compared to the control group. No patients reported adverse events in association with TTM. Our findings provide objective evidence that TTM used in combination with standard medical therapies is effective in improving upper limb muscle strength in patients with PD. Further studies are needed to determine the efficacy of TTM on other motor and non-motor symptoms in PD.

The WISTAH hand study: A prospective cohort study of distal upper extremity musculoskeletal disorders

PubMed Central

2012-01-01

Background Few prospective cohort studies of distal upper extremity musculoskeletal disorders have been performed. Past studies have provided somewhat conflicting evidence for occupational risk factors and have largely reported data without adjustments for many personal and psychosocial factors. Methods/design A multi-center prospective cohort study was incepted to quantify risk factors for distal upper extremity musculoskeletal disorders and potentially develop improved methods for analyzing jobs. Disorders to analyze included carpal tunnel syndrome, lateral epicondylalgia, medial epicondylalgia, trigger digit, deQuervain’s stenosing tenosynovitis and other tendinoses. Workers have thus far been enrolled from 17 different employment settings in 3 diverse US states and performed widely varying work. At baseline, workers undergo laptop administered questionnaires, structured interviews, two standardized physical examinations and nerve conduction studies to ascertain demographic, medical history, psychosocial factors and current musculoskeletal disorders. All workers’ jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of musculoskeletal disorders. Repeat nerve conduction studies are performed for those with symptoms of tingling and numbness in the prior six months. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. Case definitions have been established. Point prevalence of carpal tunnel syndrome is a combination of paraesthesias in at least two median nerve-served digits plus an abnormal nerve conduction study at baseline. The lifetime cumulative incidence of carpal tunnel syndrome will also include those with a past history of carpal tunnel syndrome. Incident cases will exclude those with either a past history or prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. Discussion A prospective cohort study of distal upper extremity musculoskeletal disorders is underway and has successfully enrolled over 1,000 workers to date. PMID:22672216

The success rate of TED upper eyelid retraction reoperations.

PubMed

Golan, Shani; Rootman, Dan B; Goldberg, Robert A

2016-12-01

Although reoperation rates for upper lid retraction surgery for thyroid eye disease (TED) typically range between 8% and 23%, there is little literature describing the outcomes of these second operations. In this retrospective observational cohort study, all patients that underwent surgery for upper eyelid retraction over a 14-year period at a single institution were included. Cases were included if a second eyelid retraction surgery was performed during the study period. Success of surgery was defined as a marginal reflex distance (MRD1) of 2.5 to 4.5 mm in each eye and less than 1 mm difference in MRD1 between the eyes. Overcorrection and undercorrection were defined as above and below these bounds, respectively. 72 eyes in 49 patients were included in the study. The mean age was 56.6 (±11.5) years. By definition, all patients had at least 1 lid lengthening surgery for upper eyelid retraction, and at least 1 subsequent surgery. For this second surgery, 61 eyes (85%) underwent retraction surgery and 11 eyes (15%) underwent ptosis surgery. After this second operation, 31% were undercorrected and 33% were overcorrected. A third surgery was performed in 19 eyes (25%), 12 had surgery for residual retraction and 7 for ptosis. After the third operation 10% of eyes were under corrected and 11% were over corrected. Four patients underwent a fourth surgery: one for retraction and three for ptosis. Success was noted in 35% after the second surgery and 44% after the third. Surgical success in eyelid retraction surgery increases from a second to a third consecutive surgery, and residual asymmetry was roughly equally distributed between over- and undercorrection.

Phytase in non-ruminant animal nutrition: a critical review on phytase activities in the gastrointestinal tract and influencing factors

PubMed Central

Dersjant-Li, Yueming; Awati, Ajay; Schulze, Hagen; Partridge, Gary

2015-01-01

This review focuses on phytase functionality in the digestive tract of farmed non-ruminant animals and the factors influencing in vivo phytase enzyme activity. In pigs, feed phytase is mainly active in the stomach and upper part of the small intestine, and added phytase activity is not recovered in the ileum. In poultry, feed phytase activities are mainly found in the upper part of the digestive tract, including the crop, proventriculus and gizzard. For fish with a stomach, phytase activities are mainly in the stomach. Many factors can influence the efficiency of feed phytase in the gastrointestinal tract, and they can be divided into three main groups: (i) phytase related; (ii) dietary related and (iii) animal related. Phytase-related factors include type of phytase (e.g. 3- or 6-phytase; bacterial or fungal phytase origin), the pH optimum and the resistance of phytase to endogenous protease. Dietary-related factors are mainly associated with dietary phytate content, feed ingredient composition and feed processing, and total P, Ca and Na content. Animal-related factors include species, gender and age of animals. To eliminate the antinutritional effects of phytate (IP6), it needs to be hydrolyzed as quickly as possible by phytase in the upper part of the digestive tract. A phytase that works over a wide range of pH values and is active in the stomach and upper intestine (along with several other characteristics and in addition to being refractory to endogenous enzymes) would be ideal. © 2014 The Authors. Journal of the Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry. PMID:25382707

Phytase in non-ruminant animal nutrition: a critical review on phytase activities in the gastrointestinal tract and influencing factors.

PubMed

Dersjant-Li, Yueming; Awati, Ajay; Schulze, Hagen; Partridge, Gary

2015-03-30

This review focuses on phytase functionality in the digestive tract of farmed non-ruminant animals and the factors influencing in vivo phytase enzyme activity. In pigs, feed phytase is mainly active in the stomach and upper part of the small intestine, and added phytase activity is not recovered in the ileum. In poultry, feed phytase activities are mainly found in the upper part of the digestive tract, including the crop, proventriculus and gizzard. For fish with a stomach, phytase activities are mainly in the stomach. Many factors can influence the efficiency of feed phytase in the gastrointestinal tract, and they can be divided into three main groups: (i) phytase related; (ii) dietary related and (iii) animal related. Phytase-related factors include type of phytase (e.g. 3- or 6-phytase; bacterial or fungal phytase origin), the pH optimum and the resistance of phytase to endogenous protease. Dietary-related factors are mainly associated with dietary phytate content, feed ingredient composition and feed processing, and total P, Ca and Na content. Animal-related factors include species, gender and age of animals. To eliminate the antinutritional effects of phytate (IP6), it needs to be hydrolyzed as quickly as possible by phytase in the upper part of the digestive tract. A phytase that works over a wide range of pH values and is active in the stomach and upper intestine (along with several other characteristics and in addition to being refractory to endogenous enzymes) would be ideal. © 2014 The Authors. Journal of the Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

The WISTAH hand study: a prospective cohort study of distal upper extremity musculoskeletal disorders.

PubMed

Garg, Arun; Hegmann, Kurt T; Wertsch, Jacqueline J; Kapellusch, Jay; Thiese, Matthew S; Bloswick, Donald; Merryweather, Andrew; Sesek, Richard; Deckow-Schaefer, Gwen; Foster, James; Wood, Eric; Kendall, Richard; Sheng, Xiaoming; Holubkov, Richard

2012-06-06

Few prospective cohort studies of distal upper extremity musculoskeletal disorders have been performed. Past studies have provided somewhat conflicting evidence for occupational risk factors and have largely reported data without adjustments for many personal and psychosocial factors. A multi-center prospective cohort study was incepted to quantify risk factors for distal upper extremity musculoskeletal disorders and potentially develop improved methods for analyzing jobs. Disorders to analyze included carpal tunnel syndrome, lateral epicondylalgia, medial epicondylalgia, trigger digit, deQuervain's stenosing tenosynovitis and other tendinoses. Workers have thus far been enrolled from 17 different employment settings in 3 diverse US states and performed widely varying work. At baseline, workers undergo laptop administered questionnaires, structured interviews, two standardized physical examinations and nerve conduction studies to ascertain demographic, medical history, psychosocial factors and current musculoskeletal disorders. All workers' jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of musculoskeletal disorders. Repeat nerve conduction studies are performed for those with symptoms of tingling and numbness in the prior six months. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. Case definitions have been established. Point prevalence of carpal tunnel syndrome is a combination of paraesthesias in at least two median nerve-served digits plus an abnormal nerve conduction study at baseline. The lifetime cumulative incidence of carpal tunnel syndrome will also include those with a past history of carpal tunnel syndrome. Incident cases will exclude those with either a past history or prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. A prospective cohort study of distal upper extremity musculoskeletal disorders is underway and has successfully enrolled over 1,000 workers to date.

Taxonomic differences in deciduous upper second molar crown outlines of Homo sapiens, Homo neanderthalensis and Homo erectus.

PubMed

Bailey, Shara E; Benazzi, Stefano; Souday, Caroline; Astorino, Claudia; Paul, Kathleen; Hublin, Jean-Jacques

2014-07-01

A significant number of Middle to Late Pleistocene sites contain primarily (and sometimes only) deciduous teeth (e.g., Grotta del Cavallo, Mezmaiskaya, Blombos). Not surprisingly, there has been a recent renewed interest in deciduous dental variation, especially in the context of distinguishing Homo neanderthalensis and Homo sapiens. Most studies of the deciduous dentition of fossil hominins have focused on standard metrical variation but morphological (non-metric and morphometric) variation also promises to shed light on long standing taxonomic questions. This study examines the taxonomic significance of the crown outline of the deciduous upper second molar through principal components analysis and linear discriminant analysis. We examine whether or not the crown shape of the upper deciduous second molar separates H. neanderthalensis from H. sapiens and explore whether it can be used to correctly assign individuals to taxa. It builds on previous studies by focusing on crown rather than cervical outline and by including a large sample of geographically diverse recent human populations. Our samples include 17 H. neanderthalensis, five early H. sapiens, and 12 Upper Paleolithic H. sapiens. In addition, we include two Homo erectus specimens in order to evaluate the polarity of crown shape differences observed between H. neanderthalensis and H. sapiens. Our results show that crown outline shape discriminates H. sapiens and H. neanderthalensis quite well, but does not do well at distinguishing H. erectus from H. sapiens. We conclude that the crown outline shape observed in H. sapiens is a primitive retention and that the skewed shape observed in H. neanderthalensis is a derived condition. Finally, we explore the phylogenetic implications of the results for the H. erectus molars. Copyright © 2014 Elsevier Ltd. All rights reserved.

Foreign body ingestion in children

PubMed Central

Dereci, Selim; Koca, Tuğba; Serdaroğlu, Filiz; Akçam, Mustafa

2015-01-01

Aim: Foreign bodies ingested by the oral route enter into the gastrointestinal tract and are considered a significant health problem in the childhood. In this study, we evaluated the pediatric patients who presented to our hospital with the complaint of ingestion of foreign body. Material and Methods: The hospital records of all children who presented to our clinic because of ingestion of foreign body between January 2008 and January 2015 were examined retrospectively. The complaints at admission, the types of foreign bodies ingested, the localization of the foreign body in the gastrointestinal tract and the approaches and treatment methods used were examined. Results: Thirty-six (56%) of 64 patients included in the study were male and 28 (44%) were female and the mean age was 5.7±4.6 years (10 months–17 years). Thirty eight (59%) of 64 children who were included in the assessment were below the age of five years. The most common complaint at presentation was parental recognition of the ingested object and dysphagia. The most commonly ingested foreign bodies included coins, sewing pins, safety pins and hairclips. Nail clipper detected in the stomach, sewing pin which penetrated through the duodenal wall and stuck to hepatic parenchyma were the first pediatric cases in the literature. Upper esophagus was the most common location for foreign bodies. Endoscopic examinations were performed in 55 of 64 children. Conclusions: Early detection and treatment of ingested foreign bodies in the upper gastrointestinal system is important in terms of preventing possible complications. In our study, the most frequent foreign bodies detected in the upper digestive tract were coins and they were most frequently detected in the upper esophagus. Most of our patients were below the age of five years. Flexible endoscopic method was used commonly for treatment. PMID:26884693

Virtual reality for stroke rehabilitation: an abridged version of a Cochrane review.

PubMed

Laver, K; George, S; Thomas, S; Deutsch, J E; Crotty, M

2015-08-01

Virtual reality and interactive video gaming have emerged as new treatment approaches in stroke rehabilitation settings over the last ten years. The primary objective of this review was to determine the effectiveness of virtual reality on upper limb function and activity after stroke. The impact on secondary outcomes including gait, cognitive function and activities of daily living was also assessed. Randomized and quasi-randomized controlled trials comparing virtual reality with an alternative intervention or no intervention were eligible to be included in the review. The authors searched a number of electronic databases including: the Cochrane Stroke Group Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, clinical trial registers, reference lists, Dissertation Abstracts and contacted key researchers in the field. Search results were independently examined by two review authors to identify studies meeting the inclusion criteria. A total of 37 randomized or quasi randomized controlled trials with a total of 1019 participants were included in the review. Virtual reality was found to be significantly more effective than conventional therapy in improving upper limb function (standardized mean difference [SMD] 0.28, 95% confidence intervals [CI] 0.08 to 0.49) based on 12 studies and significantly more effective than no therapy in improving upper limber function (SMD 0.44 [95% CI 0.15 to 0.73]) based on nine studies. The use of virtual reality also significantly improved activities of daily living function when compared to more conventional therapy approaches (SMD 0.43 [95% CI 0.18 to 0.69]) based on eight studies. While there are a large number of studies assessing the efficacy of virtual reality they tend to be small and many are at risk of bias. While there is evidence to support the use of virtual reality intervention as part of upper limb training programs, more research is required to determine whether it is beneficial in terms of improving lower limb function and gait and cognitive function.

[Postoperative complications and survival analysis of 1 118 cases of open splenectomy and azygoportal disconnection in the treatment of portal hypertension].

PubMed

Qi, R Z; Zhao, X; Wang, S Z; Zhang, K; Chang, Z Y; Hu, X L; Wu, M L; Zhang, P R; Yu, L X; Xiao, C H; Shi, X J; Li, Z W

2018-06-01

Objective: To analyze the recent postoperative and long-term postoperative complications of open-splenectomy and disconnection in patients with portal hypertension. Methods: There were 1 118 cases with portal hypertension who underwent open splenectomy and azygoportal disconnection from April 2010 to September 2015 at Department of Surgery, People's Liberation Army 302 Hospital. Retrospective case investigation and telephone follow-up were conducted in October 2016. All patients had history of upper gastrointestinal bleeding before operation. Short-term complications after surgery were recorded including secondary laparotomy of postoperative abdominal hemostasis, severe infection, intake disorders, liver insufficiency, postoperative portal vein thrombosis and perioperative mortality. Long-term data including postoperative upper gastrointestinal rebleeding, postoperative survival rate and incidence of postoperative malignancy were recorded, too. GraphPad Prism 5 software for data survival analysis and charting. Results: Postoperative short-term complications in 1 118 patients included secondary laparotomy of postoperative abdominal hemostasis(1.8%, 21/1 118), severe infection(2.9%, 32/1 118), intake disorders(1.0%, 11/1 118), liver dysfunction (1.6%, 18/1 118), postoperative portal vein thrombosis(47.1%, 526/1 118)and perioperative mortality(0.5%, 5/1 118). After phone call following-up, 942 patients' long-term data were completed including 1, 3, 5 years postoperative upper gastrointestinal rebleeding rate(4.4%, 12.1%, 17.2%), 1, 3, 5-year postoperative survival rate(97.0%, 93.5%, 90.3%); the incidence of postoperative malignant tumors in 1, 3 and 5 years were 1.7%, 4.4% and 6.2%. Conclusions: Reasonable choosing of surgical indications and timing, proper performing the surgery process, effective conducting perioperative management of portal hypertension are directly related to the patient's short-term prognosis after portal hypertension. Surgical intervention can reduce the rates of patients with upper gastrointestinal rebleeding, improve survival, and do not increase the incidence of malignant tumors.

Making sense of 'lower' and 'upper' stem-group Euarthropoda, with comments on the strict use of the name Arthropoda von Siebold, 1848.

PubMed

Ortega-Hernández, Javier

2016-02-01

The ever-increasing number of studies that address the origin and evolution of Euarthropoda - whose extant representatives include chelicerates, myriapods, crustaceans and hexapods - are gradually reaching a consensus with regard to the overall phylogenetic relationships of some of the earliest representatives of this phylum. The stem-lineage of Euarthropoda includes numerous forms that reflect the major morphological transition from a lobopodian-type to a completely arthrodized body organization. Several methods of classification that aim to reflect such a complex evolutionary history have been proposed as a consequence of this taxonomic diversity. Unfortunately, this has also led to a saturation of nomenclatural schemes, often in conflict with each other, some of which are incompatible with cladistic-based methodologies. Here, I review the convoluted terminology associated with the classification of stem-group Euarthropoda, and propose a synapomorphy-based distinction that allows 'lower stem-Euarthropoda' (e.g. lobopodians, radiodontans) to be separated from 'upper stem-Euarthropoda' (e.g. fuxianhuiids, Cambrian bivalved forms) in terms of the structural organization of the head region and other aspects of overall body architecture. The step-wise acquisition of morphological features associated with the origins of the crown-group indicate that the node defining upper stem-Euarthropoda is phylogenetically stable, and supported by numerous synapomorphic characters; these include the presence of a deutocerebral first appendage pair, multisegmented head region with one or more pairs of post-ocular differentiated limbs, complete body arthrodization, posterior-facing mouth associated with the hypostome/labrum complex, and post-oral biramous arthropodized appendages. The name 'Deuteropoda' nov. is proposed for the scion (monophyletic group including the crown-group and an extension of the stem-group) that comprises upper stem-Euarthropoda and Euarthropoda. A brief account of common terminological inaccuracies in recent palaeontological studies evinces the utility of Deuteropoda nov. as a reference point for discussing aspects of early euarthropod phylogeny. © 2014 Cambridge Philosophical Society.

Great River Environmental Action Team (GREAT II). Upper Mississippi River (Guttenberg, Iowa to Saverton, Missouri). Environmental Report. Supplement.

DTIC Science & Technology

1980-12-01

extracted will a!.’, e - , C! C. Rationale for Selected Alternative - This statement ic based upon information contained in the Preliminary Impact...UPPER MI SS ISS--E UCASSTFT EC94190TION 33 The President’s Council on Environmental Quality has established a I National Oil and Hazardous Substance...liasons. The RRT is to provide for efficient, coordinated and effective action to minimize damage from oil and hazardous substances discharges, includ

14. UPPER SHOES, FIXED SHOES, ROLLER SHOES, CENTER WEB, AND ...

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

14. UPPER SHOES, FIXED SHOES, ROLLER SHOES, CENTER WEB, AND ROLLER BED PLATES. (Also includes a sheet index and a schedule of parts). American Bridge Company, Ambridge Plant No. 5, sheet no. 4, dated April 7, 1928, order no. F5073. For U.S. Steel Products Company, Pacific Coast Depot, order no. SF578. For Southern Pacific Company, order no. 8873-P-28746. various scales. - Napa River Railroad Bridge, Spanning Napa River, east of Soscol Avenue, Napa, Napa County, CA

Upper Mississippi River Land Use Allocation Plan. Master Plan for Public Use Development and Resource Management. Parts 1 and 2.

DTIC Science & Technology

1983-09-01

many broad-based and long- associated with the Upper Mississippi les of such problems include increasing water quality issues, balancing growth 1...farther west. In the pioneer the end of the St. Paul District portion sites (disturbed sites without previous growth where Mississippi River. species of...have a high water table in lower areas. The percolation rate is generally less than 10 minutes per inch. These *soils tend to be acid and low in

Upper stage technology evaluation studies

NASA Technical Reports Server (NTRS)

1972-01-01

Studies to evaluate advanced technology relative to chemical upper stages and orbit-to-orbit stages are reported. The work described includes: development of LH2/LOX stage data, development of data to indicate stage sensitivity to engine tolerance, modified thermal routines to accommodate storable propellants, added stage geometries to computer program for monopropellant configurations, determination of the relative gain obtainable through improvement of stage mass fraction, future propulsion concepts, effect of ultrahigh chamber-pressure increases, and relative gains obtainable through improved mass fraction.

Monolithic tandem solar cell

DOEpatents

Wanlass, Mark W.

1991-01-01

A single-crystal, monolithic, tandem, photovoltaic solar cell is described which includes (a) an InP substrate having upper and lower surfaces, (b) a first photoactive subcell on the upper surface of the InP substrate, and (c) a second photoactive subcell on the first subcell. The first photoactive subcell is GaInAsP of defined composition. The second subcell is InP. The two subcells are lattice matched. The solar cell can be provided as a two-terminal device or a three-terminal device.

High temperature polyimide foams for shuttle upper surface thermal insulation

NASA Technical Reports Server (NTRS)

Ball, G. L., III; Leffingwell, J. W.; Salyer, I. O.; Werkmeister, D. W.

1974-01-01

Polyimide foams developed by Monsanto Company were examined for use as upper surface space shuttle thermal insulation. It was found that postcured polyimide foams having a density of 64 kg/cu m (4 lb/cu ft) had acceptable physical properties up to and exceeding 700 K (800 F). Physical tests included cyclic heating and cooling in vacuum, weight and dimensional stability, mechanical strength and impact resistance, acoustic loading and thermal conductivity. Molding and newly developed postcuring procedures were defined.

Characterization of yields for Pinus taeda genotypes at the half-sib, full-sib, and varietal levels of genetic improvement at two planting densities at age 5 in the upper coastal plain of Georgia

Treesearch

Derek Dougherty; Michael Kane; Robert Teskey; Richard Daniels; Jeff Wright

2012-01-01

Seedling deployment options for the establishment of operational Pinus taeda plantations in the Southeastern U.S. now include half-sib families, full-sib crosses, and varietals. In 2005, a study to evaluate the effects of genotype and density on yield and quality was established on a moderately well-drained upland site in the Upper Coastal Plain in...

Crustal and Upper Mantle Structure from Joint Inversion of Body Wave and Gravity Data

DTIC Science & Technology

2012-09-01

CRUSTAL AND UPPER MANTLE STRUCTURE FROM JOINT INVERSION OF BODY WAVE AND GRAVITY DATA Eric A. Bergman1, Charlotte Rowe2, and Monica Maceira2...for these events include many readings of direct crustal P and S phases, as well as regional (Pn and Sn) and teleseismic phases. These data have been...the usefulness of the gravity data, we apply high-pass filtering, yielding gravity anomalies that possess higher resolving power for crustal and

Relationship between diversity and the vertical structure of the upper ocean

NASA Astrophysics Data System (ADS)

Longhurst, Alan R.

1985-12-01

The sources of diversity in the plankton ecosystem of the upper 250 m in the eastern tropical Pacific Ocean are explored in the data from LHPR plankton profiles. Though there is good evidence for resource partitioning among feeding guilds of congeners, and for specialization in predation—both known to create diversity in simple aquatic ecosystems—the existence of a stable vertical structure, including a thermocline, may be one of the more important causes of variation in regional plankton diversity in the euphotic zone.

Design and Stability of an On-Orbit Attitude Control System Using Reaction Control Thrusters

NASA Technical Reports Server (NTRS)

Hall, Robert A.; Hough, Steven; Orphee, Carolina; Clements, Keith

2016-01-01

NASA is providing preliminary design and requirements for the Space Launch System Exploration Upper Stage (EUS). The EUS will provide upper stage capability for vehicle ascent as well as on-orbit control capability. Requirements include performance of on-orbit burn to provide Orion vehicle with escape velocity. On-orbit attitude control is accommodated by a on-off Reaction Control System (RCS). Paper provides overview of approaches for design and stability of an attitude control system using a RCS.

Using High-Resolution, Regional-Scale Data to Characterize Floating Aquatic Nuisance Vegetation in Coastal Louisiana Navigation Channels

DTIC Science & Technology

2014-01-01

Comparison of footprints from various image sensors used in this study . Landsat (blue) is in the upper left panel, SPOT (yellow) is in the upper right...the higher resolution sensors evaluated as part of this study are limited to four spectral bands. Moderate resolution processing. ArcGIS ...moderate, effective useful coverage may be much more limited for a scene that includes significant amounts of water. Throughout the study period, SPOT 4

Incentive spirometry for prevention of postoperative pulmonary complications in upper abdominal surgery.

PubMed

do Nascimento Junior, Paulo; Módolo, Norma S P; Andrade, Sílvia; Guimarães, Michele M F; Braz, Leandro G; El Dib, Regina

2014-02-08

This is an update of a Cochrane Review first published in The Cochrane Library 2008, Issue 3.Upper abdominal surgical procedures are associated with a high risk of postoperative pulmonary complications. The risk and severity of postoperative pulmonary complications can be reduced by the judicious use of therapeutic manoeuvres that increase lung volume. Our objective was to assess the effect of incentive spirometry compared to no therapy or physiotherapy, including coughing and deep breathing, on all-cause postoperative pulmonary complications and mortality in adult patients admitted to hospital for upper abdominal surgery. Our primary objective was to assess the effect of incentive spirometry (IS), compared to no such therapy or other therapy, on postoperative pulmonary complications and mortality in adults undergoing upper abdominal surgery.Our secondary objectives were to evaluate the effects of IS, compared to no therapy or other therapy, on other postoperative complications, adverse events, and spirometric parameters. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 8), MEDLINE, EMBASE, and LILACS (from inception to August 2013). There were no language restrictions. The date of the most recent search was 12 August 2013. The original search was performed in June 2006. We included randomized controlled trials (RCTs) of IS in adult patients admitted for any type of upper abdominal surgery, including patients undergoing laparoscopic procedures. Two authors independently assessed trial quality and extracted data. We included 12 studies with a total of 1834 participants in this updated review. The methodological quality of the included studies was difficult to assess as it was poorly reported, so the predominant classification of bias was 'unclear'; the studies did not report on compliance with the prescribed therapy. We were able to include data from only 1160 patients in the meta-analysis. Four trials (152 patients) compared the effects of IS with no respiratory treatment. We found no statistically significant difference between the participants receiving IS and those who had no respiratory treatment for clinical complications (relative risk (RR) 0.59, 95% confidence interval (CI) 0.30 to 1.18). Two trials (194 patients) IS compared incentive spirometry with deep breathing exercises (DBE). We found no statistically significant differences between the participants receiving IS and those receiving DBE in the meta-analysis for respiratory failure (RR 0.67, 95% CI 0.04 to 10.50). Two trials (946 patients) compared IS with other chest physiotherapy. We found no statistically significant differences between the participants receiving IS compared to those receiving physiotherapy in the risk of developing a pulmonary condition or the type of complication. There was no evidence that IS is effective in the prevention of pulmonary complications. There is low quality evidence regarding the lack of effectiveness of incentive spirometry for prevention of postoperative pulmonary complications in patients after upper abdominal surgery. This review underlines the urgent need to conduct well-designed trials in this field. There is a case for large RCTs with high methodological rigour in order to define any benefit from the use of incentive spirometry regarding mortality.

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.

Upper-atmospheric Space and Earth Weather eXperiment (USEWX)

NASA Technical Reports Server (NTRS)

Wiley, Scott Lee

2014-01-01

This presentation is an update from the 2011 and 2012 talks given to Teachers in Space. These slides include some recent space weather issues that are hot topics, including the adding our USEWX and USEWX partners, and information relevant to GSFC researchers.

30 CFR 250.1910 - What safety and environmental information is required?

Code of Federal Regulations, 2011 CFR

2011-07-01

... information including, as appropriate, a simplified process flow diagram and acceptable upper and lower limits, where applicable, for items such as temperature, pressure, flow and composition; and (3) mechanical design information including, as appropriate, piping and instrument diagrams; electrical area...

About Foregut Cancers | Center for Cancer Research

Cancer.gov

About Foregut Cancers The foregut is the section of the upper gastrointestinal tract that includes the esophagus, stomach, pancreas, liver and bile ducts. The focus of the NIH Foregut Team is clinical research and care of patients with tumors of the foregut, including:

Accuracy of Intraoral Digital Impressions for Whole Upper Jaws, Including Full Dentitions and Palatal Soft Tissues.

PubMed

Gan, Ning; Xiong, Yaoyang; Jiao, Ting

2016-01-01

Intraoral digital impressions have been stated to meet the clinical requirements for some teeth-supported restorations, though fewer evidences were proposed for larger scanning range. The aim of this study was to compare the accuracy (trueness and precision) of intraoral digital impressions for whole upper jaws, including the full dentitions and palatal soft tissues, as well as to determine the effect of different palatal vault height or arch width on accuracy of intraoral digital impressions. Thirty-two volunteers were divided into three groups according to the palatal vault height or arch width. Each volunteer received three scans with TRIOS intraoral scanner and one conventional impression of whole upper jaw. Three-dimensional (3D) images digitized from conventional gypsum casts by a laboratory scanner were chose as the reference models. All datasets were imported to a specific software program for 3D analysis by "best fit alignment" and "3D compare" process. Color-coded deviation maps showed qualitative visualization of the deviations. For the digital impressions for palatal soft tissues, trueness was (130.54±33.95)μm and precision was (55.26±11.21)μm. For the digital impressions for upper full dentitions, trueness was (80.01±17.78)μm and precision was (59.52±11.29)μm. Larger deviations were found between intraoral digital impressions and conventional impressions in the areas of palatal soft tissues than that in the areas of full dentitions (p<0.001). Precision of digital impressions for palatal soft tissues was slightly better than that for full dentitions (p = 0.049). There was no significant effect of palatal vault height on accuracy of digital impressions for palatal soft tissues (p>0.05), but arch width was found to have a significant effect on precision of intraoral digital impressions for full dentitions (p = 0.016). A linear correlation was found between arch width and precision of digital impressions for whole upper jaws (r = 0.326, p = 0.034 for palatal soft tissues and r = 0.485, p = 0.002 for full dentitions). It was feasible to use the intraoral scanner to obtain digital impressions for whole upper jaws. Wider dental arch contributed to lower precision of an intraoral digital impression. It should be confirmed in further studies that whether accuracy of digital impressions for whole upper jaws is clinically acceptable.

Oblique reactivation of lithosphere-scale lineaments controls rift physiography - the upper-crustal expression of the Sorgenfrei-Tornquist Zone, offshore southern Norway

NASA Astrophysics Data System (ADS)

Phillips, Thomas B.; Jackson, Christopher A.-L.; Bell, Rebecca E.; Duffy, Oliver B.

2018-04-01

Pre-existing structures within sub-crustal lithosphere may localise stresses during subsequent tectonic events, resulting in complex fault systems at upper-crustal levels. As these sub-crustal structures are difficult to resolve at great depths, the evolution of kinematically and perhaps geometrically linked upper-crustal fault populations can offer insights into their deformation history, including when and how they reactivate and accommodate stresses during later tectonic events. In this study, we use borehole-constrained 2-D and 3-D seismic reflection data to investigate the structural development of the Farsund Basin, offshore southern Norway. We use throw-length (T-x) analysis and fault displacement backstripping techniques to determine the geometric and kinematic evolution of N-S- and E-W-striking upper-crustal fault populations during the multiphase evolution of the Farsund Basin. N-S-striking faults were active during the Triassic, prior to a period of sinistral strike-slip activity along E-W-striking faults during the Early Jurassic, which represented a hitherto undocumented phase of activity in this area. These E-W-striking upper-crustal faults are later obliquely reactivated under a dextral stress regime during the Early Cretaceous, with new faults also propagating away from pre-existing ones, representing a switch to a predominantly dextral sense of motion. The E-W faults within the Farsund Basin are interpreted to extend through the crust to the Moho and link with the Sorgenfrei-Tornquist Zone, a lithosphere-scale lineament, identified within the sub-crustal lithosphere, that extends > 1000 km across central Europe. Based on this geometric linkage, we infer that the E-W-striking faults represent the upper-crustal component of the Sorgenfrei-Tornquist Zone and that the Sorgenfrei-Tornquist Zone represents a long-lived lithosphere-scale lineament that is periodically reactivated throughout its protracted geological history. The upper-crustal component of the lineament is reactivated in a range of tectonic styles, including both sinistral and dextral strike-slip motions, with the geometry and kinematics of these faults often inconsistent with what may otherwise be inferred from regional tectonics alone. Understanding these different styles of reactivation not only allows us to better understand the influence of sub-crustal lithospheric structure on rifting but also offers insights into the prevailing stress field during regional tectonic events.

Lithostratigraphy, biostratigraphy and chemostratigraphy of Upper Cretaceous sediments from southern Tanzania: Tanzania drilling project sites 21-26

NASA Astrophysics Data System (ADS)

Jiménez Berrocoso, Álvaro; MacLeod, Kenneth G.; Huber, Brian T.; Lees, Jacqueline A.; Wendler, Ines; Bown, Paul R.; Mweneinda, Amina K.; Isaza Londoño, Carolina; Singano, Joyce M.

2010-04-01

The 2007 drilling season by the Tanzania drilling project (TDP) reveals a much more expanded Upper Cretaceous sequence than was recognized previously in the Lindi region of southern Tanzania. This TDP expedition targeted recovery of excellently preserved microfossils (foraminifera and calcareous nannofossils) for Late Cretaceous paleoclimatic, paleoceanographic and biostratigraphic studies. A total of 501.17 m of core was drilled at six Upper Cretaceous sites (TDP Sites 21, 22, 23, 24, 24B and 26) and a thin Miocene-Pleistocene section (TDP Site 25). Microfossil preservation at all these sites is good to excellent, with foraminifera often showing glassy shells and consistently good preservation of small and delicate nannofossil taxa. In addition to adding to our knowledge of the subsurface geology, new surface exposures were mapped and the geological map of the region is revised herein. TDP Sites 24, 24B and 26 collectively span the upper Albian to lower-middle Turonian (planktonic foraminiferal Planomalina buxtorfi- Whiteinella archaeocretacea Zones and calcareous nannofossil zones UC0a-UC8a). The bottom of TDP Site 21 is barren, but the rest of the section represents the uppermost Cenomanian-Coniacian ( W. archaeocretacea- Dicarinella concavata Zones and nannofossil zones UC5c-UC10). Bulk organic δ 13C data suggest recovery of part of Ocean Anoxic Event 2 (OAE2) from these four sites. In the upper part of this interval, the lower Turonian nannofossil zones UC6a-7 are characterized by a low-diversity nannoflora that may be related to OAE2 surface-water conditions. TDP Site 22 presents a 122-m-thick, lower-middle Turonian ( W. archaeocretacea- Helvetoglobotruncana helvetica Zones) sequence that includes the nannofossil zones UC6a(-7?), but invariable isotopic curves. Further, a lower to upper Campanian ( Globotruncana ventricosa- Radotruncana calcarata Zones and nannofossil subzones UC15b TP-UC15d TP) succession was drilled at TDP Site 23. Lithologies of the new sites include thin units of gray, medium to coarse sandstones, separating much thicker intervals of dark claystones with organic-rich laminated parts, irregular silty to fine sandstone partings, and rare inoceramid and ammonite debris. These lithofacies are interpreted to have been deposited in outer shelf and upper slope settings and indicate relatively stable sedimentary conditions during most of the Late Cretaceous on the Tanzanian margin.

Dorsal scapular nerve neuropathy: a narrative review of the literature

PubMed Central

Muir, Brad

2017-01-01

Objective The purpose of this paper is to elucidate this little known cause of upper back pain through a narrative review of the literature and to discuss the possible role of the dorsal scapular nerve (DSN) in the etiopathology of other similar diagnoses in this area including cervicogenic dorsalgia (CD), notalgia paresthetica (NP), SICK scapula and a posterolateral arm pain pattern. Background Dorsal scapular nerve (DSN) neuropathy has been a rarely thought of differential diagnosis for mid scapular, upper to mid back and costovertebral pain. These are common conditions presenting to chiropractic, physiotherapy, massage therapy and medical offices. Methods The methods used to gather articles for this paper included: searching electronic databases; and hand searching relevant references from journal articles and textbook chapters. Results One hundred-fourteen articles were retrieved. After removing duplicates, there were 57 articles of which 29 were retrieved. There were 26 articles and textbook chapters retrieved by hand searching equaling 55 articles retrieved of which 47 relevant articles were used in this report. Discussion The anatomy, pathway and function of the dorsal scapular nerve can be varied and exceptionally rarely may include a sensory component. The signs and symptoms, therefore, may include pain, atrophy, scapular winging, and dysesthesia. The mechanism of injury to the DSN is also quite varied ranging from postural to overuse in overhead work and sport. Other conditions in this area, including CD, NP, SICK scapula and a posterolateral arm pain pattern bear a striking resemblance to DSN neuropathy. Conclusion DSN neuropathy should be included in the list of common differential diagnoses of upper and mid-thoracic pain, stiffness, dysesthesia and dysfunction. The study also brings forward interesting connections between DSN neuropathy, CD, NP, SICK scapula and a posterolateral arm pain pattern. PMID:28928496

Medicine use practices in management of symptoms of acute upper respiratory tract infections in children (≤12 years) in Kampala city, Uganda.

PubMed

Ocan, Moses; Aono, Mary; Bukirwa, Clare; Luyinda, Emmanuel; Ochwo, Cathy; Nsambu, Elastus; Namugonza, Stella; Makoba, Joseph; Kandaruku, Enock; Muyende, Hannington; Nakawunde, Aida

2017-09-21

Medicines are commonly accessed and used for management of illness in children without a prescription. This potentially increases the risk of unwanted treatment outcomes. We investigated medicine use practices in management of symptoms of acute upper respiratory tract infections among children (≤12 years) in households in Nakawa division, Kampala city. This was a cross-sectional study conducted among 390 randomly selected children. Data on use of medicines in children (≤12 years) during recent episode of acute upper respiratory tract infection was collected from their care takers using an interviewer administered questionnaire. A recall period of two weeks (14 days) was used in during data collection. The prevalence of giving children non-prescription antimicrobial medicines was 44.8% (38.3-52.2). The most common disease symptoms that the children reportedly had included flu, 84.9% (331/390), cough, 83.1% (324/390), and undefined fever, 69.7% (272/390). Medicines commonly given to children included, paracetamol 53.1% (207/390), Coartem 29.7% (116/390), cough linctus 20.8% (81/390), amoxicillin 18.9% (74/390), Co-trimoxazole 18.5% (72/390), and diphenhydramine 15.4% (60/390). The major sources of medicines given to the children was hospital/clinic, 57.26% (223/390). Most of the children, 81% were given more than one medicine at a time. The majority, 62.3% (243/390) of the care takers who gave the children medicine during the recent illness were not aware of any medicine (s) that should not be given to children. The predictors of non-prescription use of antimicrobial medicines in managing symptoms of acute upper respiratory tract infections in children included, medicines obtained from drug shop (PR: 1.45, CI: 1.14-1.85), medicines at home (PR: 1.8, CI: 0.83-1.198) and type of medicine (antimalarial) (PR: 2.8, CI: 1.17-6.68). Children are commonly given multiple medicines during episodes of acute upper respiratory tract infections with most antimicrobial agents accessed and used without a prescription in Kampala city, Uganda.

The Inskip Formation, the Harmony Formation, and the Havallah Sequence of Northwestern Nevada - An Interrelated Paleozoic Assemblage in the Home of the Sonoma Orogeny

USGS Publications Warehouse

Ketner, Keith B.

2008-01-01

An area between the towns of Winnemucca and Battle Mountain in northwestern Nevada, termed the arkosic triangle, includes the type areas of the middle to upper Paleozoic Inskip Formation and Havallah sequence, the Upper Devonian to Mississippian Harmony Formation, the Sonoma orogeny, and the Golconda thrust. According to an extensive body of scientific literature, the Havallah sequence, a diverse assemblage of oceanic rocks, was obducted onto the continent during the latest Permian or earliest Triassic Sonoma orogeny by way of the Golconda thrust. This has been the most commonly accepted theory for half a century, often cited but rarely challenged. The tectonic roles of the Inskip and Harmony Formations have remained uncertain, and they have never been fully integrated into the accepted theory. New, and newly interpreted, data are incompatible with the accepted theory and force comprehensive stratigraphic and tectonic concepts that include the Inskip and Harmony Formations as follows: middle to upper Paleozoic strata, including the Inskip, Harmony, and Havallah, form an interrelated assemblage that was deposited in a single basin on an autochthonous sequence of Cambrian, Ordovician, and lowest Silurian strata of the outer miogeocline. Sediments composing the Upper Devonian to Permian sequence entered the basin from both sides, arkosic sands, gravel, limestone olistoliths, and other detrital components entered from the west, and quartz, quartzite, chert, and other clasts from the east. Tectonic activity was expressed as: (1) Devonian uplift and erosion of part of the outer miogeocline; (2) Late Devonian depression of the same area, forming a trough, probably fault-bounded, in which the Inskip, Harmony, and Havallah were deposited; (3) production of intraformational and extrabasinal conglomerates derived from the basinal rocks; and (4) folding or tilting of the east side of the depositional basin in the Pennsylvanian. These middle to upper Paleozoic deposits were compressed in the Jurassic, causing east-verging thrusts in the eastern part of the depositional basin (Golconda thrust) and west-verging thrusts and folds in the western part. Hypotheses involving a far-traveled allochthon that was obducted from an ocean or back-arc basin are incompatible with modern observations and concepts.

On the likelihood of single-peaked preferences.

PubMed

Lackner, Marie-Louise; Lackner, Martin

2017-01-01

This paper contains an extensive combinatorial analysis of the single-peaked domain restriction and investigates the likelihood that an election is single-peaked. We provide a very general upper bound result for domain restrictions that can be defined by certain forbidden configurations. This upper bound implies that many domain restrictions (including the single-peaked restriction) are very unlikely to appear in a random election chosen according to the Impartial Culture assumption. For single-peaked elections, this upper bound can be refined and complemented by a lower bound that is asymptotically tight. In addition, we provide exact results for elections with few voters or candidates. Moreover, we consider the Pólya urn model and the Mallows model and obtain lower bounds showing that single-peakedness is considerably more likely to appear for certain parameterizations.

Interventional Therapy for Upper Extremity Deep Vein Thrombosis

PubMed Central

Carlon, Timothy A.; Sudheendra, Deepak

2017-01-01

Approximately 10% of all deep vein thromboses occur in the upper extremity, and that number is increasing due to the use of peripherally inserted central catheters. Sequelae of upper extremity deep vein thrombosis (UEDVT) are similar to those for lower extremity deep vein thrombosis (LEDVT) and include postthrombotic syndrome and pulmonary embolism. In addition to systemic anticoagulation, there are multiple interventional treatment options for UEDVT with the potential to reduce the incidence of these sequelae. To date, there have been no randomized trials to define the optimal management strategy for patients presenting with UEDVT, so many conclusions are drawn from smaller, single-center studies or from LEDVT research. In this article, the authors describe the evidence for the currently available treatment options and an approach to a patient with acute UEDVT. PMID:28265130

Semiconductor laser devices having lateral refractive index tailoring

DOEpatents

Ashby, Carol I. H.; Hadley, G. Ronald; Hohimer, John P.; Owyoung, Adelbert

1990-01-01

A broad-area semiconductor laser diode includes an active lasing region interposed between an upper and a lower cladding layer, the laser diode further comprising structure for controllably varying a lateral refractive index profile of the diode to substantially compensate for an effect of junction heating during operation. In embodiments disclosed the controlling structure comprises resistive heating strips or non-radiative linear junctions disposed parallel to the active region. Another embodiment discloses a multi-layered upper cladding region selectively disordered by implanted or diffused dopant impurities. Still another embodiment discloses an upper cladding layer of variable thickness that is convex in shape and symmetrically disposed about a central axis of the active region. The teaching of the invention is also shown to be applicable to arrays of semiconductor laser diodes.

Two-statge sorption type cryogenic refrigerator including heat regeneration system

NASA Technical Reports Server (NTRS)

Jones, Jack A. (Inventor); Wen, Liang-Chi (Inventor); Bard, Steven (Inventor)

1989-01-01

A lower stage chemisorption refrigeration system physically and functionally coupled to an upper stage physical adsorption refrigeration system. Waste heat generated by the lower stage cycle is regenerated to fuel the upper stage cycle thereby greatly improving the energy efficiency of a two-stage sorption refrigerator. The two stages are joined by disposing a first pressurization chamber providing a high pressure flow of a first refrigerant for the lower stage refrigeration cycle within a second pressurization chamber providing a high pressure flow of a second refrigerant for the upper stage refrigeration cycle. The first pressurization chamber is separated from the second pressurization chamber by a gas-gap thermal switch which at times is filled with a thermoconductive fluid to allow conduction of heat from the first pressurization chamber to the second pressurization chamber.

Upper Albian to Lower Turonian deposits and associated breccias along the Dahar cuestas (southeastern Tunisia): Origin and depositional environments

NASA Astrophysics Data System (ADS)

Krimi, Mabrouk; Ouaja, Mohamed; Zargouni, Fouad

2017-11-01

The carbonate Zebbag Formation of Upper Albian to Lower Turonian age which outcrops along the Dahar cuestas (south eastern Tunisia) includes several breccia intervals. The stratigraphic hierarchy of these breccia levels led to achieving a detailed sequential analysis within a spectrum of depositional environments extending from subtidal to inner to middle ramp settings. Six major transgressive/regressive sequences make up the stacking of the elementary sequences beginning with transgressive and/or storm wave breccias capped by desiccation and/or collapse breccias. The stratigraphic evolutionary history of the breccia facies are interpreted as the result of the interplay between eustatic and tectonic factors. This model is in accord with the tectonic activities common during Upper Albian-Lower Turonian responsible for the sequences onlapping.

Pretest analysis of Semiscale Mod-3 baseline test S-07-8 and S-07-9

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

Fineman, C.P.; Steiner, J.L.; Snider, D.M.

This document contains a pretest analysis of the Semiscale Mod-3 system thermal-hydraulic response for the second and third integral tests in Test Series 7 (Tests S-07-8 and S-07-9). Test Series 7 is the first test series to be conducted with the Semiscale Mod-3 system. The design of the Mod-3 system includes an improved representation of certain portions of a pressurized water reactor (PWR) when compared to the previously operated Semiscale Mod-1 system. The improvements include a new vessel which contains a full length (3.66 m) core, a full length upper plenum and upper head, and an external downcomer. An activemore » pump and active steam generator scaled to their pressurized water reactor (PWR) counterparts have been added to the broken loop. The upper head design includes the capability to simulate emergency core coolant (ECC) injection into this region. Test Series 7 is divided into three groups of tests that emphasize the evaluation of the Mod-3 system performance during different phases of the loss-of-coolant experiment (LOCE) transient. The last test group, which includes Tests S-07-8 and S-07-9, will be used to evaluate the integral behavior of the system. The previous two test groups were used to evaluate the blowdown behavior and the reflood behavior of the system. 3 refs., 35 figs., 12 tabs.« less

Perception of midline deviations in smile esthetics by laypersons.

PubMed

Ferreira, Jamille Barros; Silva, Licínio Esmeraldo da; Caetano, Márcia Tereza de Oliveira; Motta, Andrea Fonseca Jardim da; Cury-Saramago, Adriana de Alcantara; Mucha, José Nelson

2016-01-01

To evaluate the esthetic perception of upper dental midline deviation by laypersons and if adjacent structures influence their judgment. An album with 12 randomly distributed frontal view photographs of the smile of a woman with the midline digitally deviated was evaluated by 95 laypersons. The frontal view smiling photograph was modified to create from 1 mm to 5 mm deviations in the upper midline to the left side. The photographs were cropped in two different manners and divided into two groups of six photographs each: group LCN included the lips, chin, and two-thirds of the nose, and group L included the lips only. The laypersons performed the rate of each smile using a visual analog scale (VAS). Wilcoxon test, Student's t-test and Mann-Whitney test were applied, adopting a 5% level of significance. Laypersons were able to perceive midline deviations starting at 1 mm. Statistically significant results (p< 0.05) were found for all multiple comparisons of the values in photographs of group LCN and for almost all comparisons in photographs of group L. Comparisons between the photographs of groups LCN and L showed statistically significant values (p< 0.05) when the deviation was 1 mm. Laypersons were able to perceive the upper dental midline deviations of 1 mm, and above when the adjacent structures of the smiles were included. Deviations of 2 mm and above when the lips only were included. The visualization of structures adjacent to the smile demonstrated influence on the perception of midline deviation.

Acrofacial dysostosis syndrome type Rodriguez: prenatal diagnosis and autopsy findings.

PubMed

Sermer, David; Quercia, Nada; Chong, Karen; Chitayat, David

2007-12-15

A new lethal form of acrofacial dysostosis (AFD) syndrome was delineated by Rodriguez et al. [Rodriguez et al. (1990); Am J Med Genet 35:484-489]. We report on a male fetus with mandibulofacial dysostosis, including phocomelia-like upper limb deficiencies and lower limb anomalies which are characteristic of AFD Rodriguez type. The diagnosis was made on prenatal sonogram at 20 and at 24.1 weeks gestation. The severity of the upper limb defects, the involvement of lower limbs, and the absence of eyelid coloboma and polythelia excluded the possibility of other conditions associated with acrofacial dysostosis (AFD) including Nager acrofacial dysostosis syndrome (NADS) and postaxial acrofacial dysostosis syndrome (POADS). This case further delineates the AFD syndrome type Rodriguez. (c) 2007 Wiley-Liss, Inc.

Joint US Navy/US Air Force climatic study of the upper atmosphere. Volume 7: July

NASA Astrophysics Data System (ADS)

Changery, Michael J.; Williams, Claude N.; Dickenson, Michael L.; Wallace, Brian L.

1989-07-01

The upper atmosphere was studied based on 1980 to 1985 twice daily gridded analysis produced by the European Centre for Medium Range Weather Forecasts. This volume is for the month of July. Included are global analyses of: (1) Mean temperature/standard deviation; (2) Mean geopotential height/standard deviation; (3) Mean density/standard deviation; (4) Height and vector standard deviation (all at 13 pressure levels - 1000, 850, 700, 500, 400, 300, 250, 200, 150, 100, 70, 50, 30 mb); (5) Mean dew point standard deviation at levels 1000 through 30 mb; and (6) Jet stream at levels 500 through 30 mb. Also included are global 5 degree grid point wind roses for the 13 pressure levels.

Joint US Navy/US Air Force climatic study of the upper atmosphere. Volume 10: October

NASA Astrophysics Data System (ADS)

Changery, Michael J.; Williams, Claude N.; Dickenson, Michael L.; Wallace, Brian L.

1989-07-01

The upper atmosphere was studied based on 1980 to 1985 twice daily gridded analysis produced by the European Centre for Medium Range Weather Forecasts. This volume is for the month of October. Included are global analyses of: (1) Mean temperature/standard deviation; (2) Mean geopotential height/standard deviation; (3) Mean density/standard deviation; (4) Height and vector standard deviation (all at 13 pressure levels - 1000, 850, 700, 500, 400, 300, 250, 200, 150, 100, 70, 50, 30 mb); (5) Mean dew point/standard deviation at levels 1000 through 30 mb; and (6) Jet stream at levels 500 through 30 mb. Also included are global 5 degree grid point wind roses for the 13 pressure levels.

Joint US Navy/US Air Force climatic study of the upper atmosphere. Volume 3: March

NASA Astrophysics Data System (ADS)

Changery, Michael J.; Williams, Claude N.; Dickenson, Michael L.; Wallace, Brian L.

1989-11-01

The upper atmosphere was studied based on 1980 to 1985 twice daily gridded analysis produced by the European Centre for Medium Range Weather Forecasts. This volume is for the month of March. Included are global analyses of: (1) Mean Temperature Standard Deviation; (2) Mean Geopotential Height Standard Deviation; (3) Mean Density Standard Deviation; (4) Height and Vector Standard Deviation (all for 13 pressure levels - 1000, 850, 700, 500, 400, 300, 250, 200, 150, 100, 70, 50, 30 mb); (5) Mean Dew Point Standard Deviation for levels 1000 through 30 mb; and (6) Jet stream for levels 500 through 30 mb. Also included are global 5 degree grid point wind roses for the 13 pressure levels.

Joint US Navy/US Air Force climatic study of the upper atmosphere. Volume 2: February

NASA Astrophysics Data System (ADS)

Changery, Michael J.; Williams, Claude N.; Dickenson, Michael L.; Wallace, Brian L.

1989-09-01

The upper atmosphere was studied based on 1980 to 1985 twice daily gridded analyses produced by the European Centre for Medium Range Weather Forecasts. This volume is for the month of February. Included are global analyses of: (1) Mean temperature standard deviation; (2) Mean geopotential height standard deviation; (3) Mean density standard deviation; (4) Height and vector standard deviation (all for 13 pressure levels - 1000, 850, 700, 500, 400, 300, 250, 200, 150, 100, 70, 50, 30 mb); (5) Mean dew point standard deviation for the 13 levels; and (6) Jet stream for levels 500 through 30 mb. Also included are global 5 degree grid point wind roses for the 13 pressure levels.

Joint US Navy/US Air Force climatic study of the upper atmosphere. Volume 4: April

NASA Astrophysics Data System (ADS)

Changery, Michael J.; Williams, Claude N.; Dickenson, Michael L.; Wallace, Brian L.

1989-07-01

The upper atmosphere was studied based on 1980 to 1985 twice daily gridded analyses produced by the European Centre for Medium Range Weather Forecasts. This volume is for the month of April. Included are global analyses of: (1) Mean temperature standard deviation; (2) Mean geopotential height standard deviation; (3) Mean density standard deviation; (4) Height and vector standard deviation (all for 13 pressure levels - 1000, 850, 700, 500, 400, 300, 250, 200, 150, 100, 70, 50, 30 mb); (5) Mean dew point standard deviation for the 13 levels; and (6) Jet stream for levels 500 through 30 mb. Also included are global 5 degree grid point wind roses for the 13 pressure levels.

Five-Axis, Three-Magnetic-Bearing Dynamic Spin Rig

NASA Technical Reports Server (NTRS)

Morrison, Carlos R.; Provenza, Andrew; Kurkov, Anatole; Mehmed, Oral; Johnson, Dexter; Montague, Gerald; Duffy, Kirsten; Jansen, Ralph

2005-01-01

The Five-Axis, Three-Magnetic-Bearing Dynamic Spin Rig is an apparatus for vibration testing of turbomachine blades in a vacuum at rotational speeds from 0 to 40,000 rpm. This rig includes (1) a vertically oriented shaft on which is mounted an assembly comprising a rotor holding the blades to be tested, (2) two actively controlled heteropolar radial magnetic bearings at opposite ends of the shaft, and (3) an actively controlled magnetic thrust bearing at the upper end of the shaft. This rig is a more capable successor to a prior apparatus, denoted the Dynamic Spin Rig (DSR), that included a vertically oriented shaft with a mechanical thrust bearing at the upper end and a single actively controlled heteropolar radial magnetic bearing at the lower end.

Terahertz lasers and amplifiers based on resonant optical phonon scattering to achieve population inversion

NASA Technical Reports Server (NTRS)

Hu, Qing (Inventor); Williams, Benjamin S. (Inventor)

2007-01-01

The present invention provides quantum cascade lasers and amplifier that operate in a frequency range of about 1 Terahertz to about 10 Terahertz. In one aspect, a quantum cascade laser of the invention includes a semiconductor heterostructure that provides a plurality of lasing modules connected in series. Each lasing module includes a plurality of quantum well structure that collectively generate at least an upper lasing state, a lower lasing state, and a relaxation state such that the upper and the lower lasing states are separated by an energy corresponding to an optical frequency in a range of about 1 to about 10 Terahertz. The lower lasing state is selectively depopulated via resonant LO-phonon scattering of electrons into the relaxation state.

Terahertz lasers and amplifiers based on resonant optical phonon scattering to achieve population inversion

NASA Technical Reports Server (NTRS)

Williams, Benjamin S. (Inventor); Hu, Qing (Inventor)

2009-01-01

The present invention provides quantum cascade lasers and amplifier that operate in a frequency range of about 1 Terahertz to about 10 Terahertz. In one aspect, a quantum cascade laser of the invention includes a semiconductor heterostructure that provides a plurality of lasing modules connected in series. Each lasing module includes a plurality of quantum well structure that collectively generate at least an upper lasing state, a lower lasing state, and a relaxation state such that the upper and the lower lasing states are separated by an energy corresponding to an optical frequency in a range of about 1 to about 10 Terahertz. The lower lasing state is selectively depopulated via resonant LO-phonon scattering of electrons into the relaxation state.

Virtual Reality for Sensorimotor Rehabilitation Post-Stroke: The Promise and Current State of the Field

PubMed Central

Fluet, Gerard G.

2013-01-01

Developments over the past 2 years in virtual reality (VR) augmented sensorimotor rehabilitation of upper limb use and gait post-stroke were reviewed. Studies were included if they evaluated comparative efficacy between VR and standard of care, and or differences in VR delivery methods; and were CEBM (center for evidence based medicine) level 2 or higher. Eight upper limb and two gait studies were included and described using the following categories hardware (input and output), software (virtual task and feedback and presentation) intervention (progression and dose), and outcomes. Trends in the field were commented on, gaps in knowledge identified, and areas of future research and translation of VR to practice were suggested. PMID:24579058

A Holistic Approach to Water Ecology.

ERIC Educational Resources Information Center

Koyama, Keith

1980-01-01

Outlined is a water ecology unit included within a one-semester field biology course for upper level high school students. Activities described include a visit to a water treatment plant, an abiotic stream study, a biotic stream study, interactions and questioning topics, and individual projects. (CS)

From the Fur Trade to Acid Rain: A Study of Canadian Natural Resources.

ERIC Educational Resources Information Center

Winans, Linda

1988-01-01

Presents a teaching module for upper elementary students that devotes eight class periods of study to Canadian resources. Includes study of the Canadian fur trade, fishing industry, forestry, and the problems caused by acid rain. Includes the unit evaluation. (DB)

Study of a High-Energy Upper Stage for Future Shuttle Missions

NASA Technical Reports Server (NTRS)

Dressler, Gordon A.; Matuszak, Leo W.; Stephenson, David D.

2003-01-01

Space Shuttle Orbiters are likely to remain in service to 2020 or beyond for servicing the International Space Station and for launching very high value spacecraft. There is a need for a new STS-deployable upper stage that can boost certain Orbiter payloads to higher energy orbits, up to and including Earth-escape trajectories. The inventory of solid rocket motor Inertial Upper Stages has been depleted, and it is unlikely that a LOX/LH2-fueled upper stage can fly on Shuttle due to safety concerns. This paper summarizes the results of a study that investigated a low cost, low risk approach to quickly developing a new large upper stage optimized to fly on the existing Shuttle fleet. Two design reference missions (DRMs) were specified: the James Webb Space Telescope (JWST) and the Space Interferometry Mission (SIM). Two categories of upper stage propellants were examined in detail: a storable liquid propellant and a storable gel propellant. Stage subsystems 'other than propulsion were based largely on heritage hardware to minimize cost, risk and development schedule span. The paper presents the ground rules and guidelines for conducting the study, the preliminary conceptual designs margins, assessments of technology readiness/risk, potential synergy with other programs, and preliminary estimates of development and production costs and schedule spans. Although the Orbiter Columbia was baselined for the study, discussion is provided to show how the results apply to the remaining STS Orbiter fleet.

Magnetic resonance imaging of the proximal upper extremity musculature in boys with Duchenne muscular dystrophy

PubMed Central

Willcocks, RJ; Triplett, WT; Forbes, SC; Arora, H; Senesac, CR; Lott, DJ; Nicholson, TR; Rooney, WD; Walter, GA; Vandenborne, K

2016-01-01

There is a pressing need for biomarkers and outcomes that can be used across disease stages in Duchenne muscular dystrophy (DMD), to facilitate the inclusion of a wider range of participants in clinical trials and to improve our understanding of the natural history of DMD. Quantitative magnetic resonance imaging (qMRI) and spectroscopy (MRS) biomarkers show considerable promise in both the legs and forearms of individuals with DMD, but have not yet been examined in functionally important proximal upper extremity muscles such as the biceps brachii and deltoid. The primary objective of this study was to examine the feasibility of implementing qMRI and MRS biomarkers in the proximal upper extremity musculature, and the secondary objective was to examine the relationship between MR measures of arm muscle pathology and upper extremity functional endpoints. Biomarkers included MRS and MRI measures of fat fraction and transverse relaxation time (T2). The MR exam was well tolerated in both ambulatory and nonambulatory boys. qMR biomarkers differentiated affected and unaffected participants and correlated strongly with upper extremity function (r=0.91 for biceps brachii T2 versus Performance of Upper Limb score). These qMR outcome measures could be highly beneficial to the neuromuscular disease community, allowing measurement of the quality of functionally important muscles across disease stages to understand the natural history of DMD and particularly to broaden the opportunity for clinical trial participation. PMID:27778157

Periocular mexametric melanin and erythema indexes in adult glaucoma patients treated with topical prostaglandin analogs.

PubMed

Duman, Nilay; Duman, Reşat; Yavaş, Güliz Fatma; Doğruk Kaçar, Seval; Özuğuz, Pınar; Çetinkaya, Ersan

2017-03-01

Although topical prostaglandin analogs (PGAs) have been previously associated with periocular skin hyperpigmentation, studies using objective clinical methods are lacking. Furthermore changes in periocular skin erythema indexes associated with topical PGAs have not been reported previously. The purpose of the present study was to evaluate periocular melanin and erythema indexes in patients treated with topical PGA using an objective clinical method - Mexameter. About 45 glaucoma patients treated with topical PGA therapy, and 30 age-, and sex-matched controls were enrolled in the study. Demographic data, medical history including duration of therapy, PGA type, involved eye (unilateral, bilateral) were noted, and skin phototypes were evaluated. Melanin and erythema indexes on medial and lateral upper and lower eyelids, and normal skin from the upper cheeks were measured using Mexameter MX-18. The index of difference for lower/upper eyelid was calculated. Reading results of patients and controls were compared. Melanin and erythema indexes of upper/lower eyelids, and the index of differences for upper/lower eyelids were significantly higher in patients despite similar clinical findings (p < 0.05). Duration of therapy and type of PGA were not associated with skin changes (p > 0.05). Both periocular melanin and erythema indexes increased in both upper and lower eyelids due to PGA therapy compared to controls, despite similar clinical findings. Mexametric evaluation is more sensitive than clinical evaluation, and may be used as an objective, sensitive clinical method to evaluate periocular skin changes, even smallest changes, in such patients.

The role of leukotrienes in upper and lower airway inflammation and the implications for treatment.

PubMed

Borish, Larry

2002-04-01

This article reviews the proinflammatory effects of the cysteinyl leukotrienes (CysLTs) in the upper and lower airways, along with evidence of their role in allergic rhinitis and chronic hyperplastic sinusitis with nasal polyposis (CHS/NP). After reading this article, readers should have a greater understanding of the effects of the CysLTs on both upper and lower airways and their implications for treatment. Relevant and appropriately controlled studies on the inflammatory processes associated with leukotrienes (LTs) were reviewed. Only literature in the English language was reviewed. Material was taken from peer-reviewed journals and data generated from the author's laboratory. The CysLTs possess proinflammatory effects that contribute to the increase of tissue eosinophilia. Emerging data support their importance in diseases of the upper airways, including allergic rhinitis and CHS/NP. The LT modifiers may be appropriate agents for treating inflammatory disorders of the upper airways because of their proven effectiveness in reducing inflammation in asthma. Results from studies in patients with allergic rhinitis demonstrated improved nasal rhinorrhea, sneezing, and congestion. LT modifiers have improved nasal congestion and restored the sense of smell in patients with CHS/NP. The LT receptor antagonists have proven to be an effective antiinflammatory treatment for asthma. Emerging data indicate that LTs play a pivotal role in inflammatory upper airway disease, providing a growing rationale for the use of LT receptor antagonists to treat allergic rhinitis and CHS/NP.

Anode shroud for off-gas capture and removal from electrolytic oxide reduction system

DOEpatents

Bailey, James L.; Barnes, Laurel A.; Wiedmeyer, Stanley G.; Williamson, Mark A.; Willit, James L.

2014-07-08

An electrolytic oxide reduction system according to a non-limiting embodiment of the present invention may include a plurality of anode assemblies and an anode shroud for each of the anode assemblies. The anode shroud may be used to dilute, cool, and/or remove off-gas from the electrolytic oxide reduction system. The anode shroud may include a body portion having a tapered upper section that includes an apex. The body portion may have an inner wall that defines an off-gas collection cavity. A chimney structure may extend from the apex of the upper section and be connected to the off-gas collection cavity of the body portion. The chimney structure may include an inner tube within an outer tube. Accordingly, a sweep gas/cooling gas may be supplied down the annular space between the inner and outer tubes, while the off-gas may be removed through an exit path defined by the inner tube.

Neck and Upper Limb Dysfunction in Patients following Neck Dissection: Looking beyond the Shoulder.

PubMed

Gane, Elise M; O'Leary, Shaun P; Hatton, Anna L; Panizza, Benedict J; McPhail, Steven M

2017-10-01

Objective To measure patient-perceived upper limb and neck function following neck dissection and to investigate potential associations between clinical factors, symptoms, and function. Study Design Cross-sectional. Setting Two tertiary hospitals in Brisbane, Australia. Subjects and Methods Inclusion criteria: patients treated with neck dissection (2009-2014). aged <18 years, accessory nerve or sternocleidomastoid sacrifice, previous neck dissection, preexisting shoulder/neck injury, and inability to provide informed consent (cognition, insufficient English). Primary outcomes were self-reported function of the upper limb (Quick Disabilities of the Arm, Shoulder, and Hand) and neck (Neck Disability Index). Secondary outcomes included demographics, oncological management, self-efficacy, and pain. Generalized linear models were prepared to examine relationships between explanatory variables and self-reported function. Results Eighty-nine participants (male n = 63, 71%; median age, 62 years; median 3 years since surgery) reported mild upper limb and neck dysfunction (median [quartile 1, quartile 3] scores of 11 [3, 32] and 12 [4, 28], respectively). Significant associations were found between worse upper limb function and longer time since surgery (coefficient, 1.76; 95% confidence interval [CI], 0.01-3.51), having disease within the thyroid (17.40; 2.37-32.44), postoperative radiation therapy (vs surgery only) (13.90; 6.67-21.14), and shoulder pain (0.65; 0.44-0.85). Worse neck function was associated with metastatic cervical lymph nodes (coefficient, 6.61; 95% CI, 1.14-12.08), shoulder pain (0.19; 0.04-0.34), neck pain (0.34; 0.21-0.47), and symptoms of neuropathic pain (0.61; 0.25-0.98). Conclusion Patients can experience upper limb and neck dysfunction following nerve-preserving neck dissection. The upper quadrant as a whole should be considered when assessing rehabilitation priorities after neck dissection.

The Effect of Geographic Location on Circannual Adrenocorticotropic Hormone Plasma Concentrations in Horses in Australia.

PubMed

Secombe, C J; Tan, R H H; Perara, D I; Byrne, D P; Watts, S P; Wearn, J G

2017-09-01

Longitudinal evaluation of plasma endogenous ACTH concentration in clinically normal horses has not been investigated in the Southern Hemisphere. To longitudinally determine monthly upper reference limits for plasma ACTH in 2 disparate Australian geographic locations and to examine whether location affected the circannual rhythm of endogenous ACTH in the 2 groups of horses over a 12-month period. Clinically normal horses <20 years of age from 4 properties (institutional herd and client owned animals) in Perth (n = 40) and Townsville (n = 41) were included in the study. A prospective longitudinal descriptive study to determine the upper reference limit and confidence intervals for plasma ACTH in each geographic location using the ASVCP reference interval (RI) guidelines, for individual months and monthly groupings for 12 consecutive months. Plasma endogenous ACTH concentrations demonstrated a circannual rhythm. The increase in endogenous ACTH was not confined to the autumnal months but was associated with changes in photoperiod. During the quiescent period, plasma ACTH concentrations were lower, ≤43 pg/mL (upper limit of the 90% confidence interval (CI)) in horses from Perth and ≤67 pg/mL (upper limit of the 90% CI) in horses from Townsville, than at the acrophase, ≤94 pg/mL (upper limit of the 90% CI) in horses from Perth, ≤101 pg/mL (upper limit of the 90% CI) in horses from Townsville. Circannual rhythms of endogenous ACTH concentrations vary between geographic locations, this could be due to changes in photoperiod or other unknown factors, and upper reference limits should be determined for specific locations. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Perioperative patient radiation exposure in the endoscopic removal of upper urinary tract calculi.

PubMed

Jamal, Joseph E; Armenakas, Noel A; Sosa, R Ernest; Fracchia, John A

2011-11-01

The efficacy of computed tomography (CT) in detailing upper urinary tract calculi is well established. There is no established acceptable annual recommended limit for medical exposure, yet the global accepted upper limit for occupational radiation exposure is <50 millisieverts (mSv) in any one year. We sought to appreciate the CT and fluoroscopic radiation exposure to our patients undergoing endoscopic removal of upper tract calculi during the periprocedure period. All patients undergoing upper urinary endoscopic stone removal between 2005 and 2009 were identified. To calculate the cumulative radiation exposure, we included all ionizing radiation imaging performed during a periprocedure period, which we defined as ≤90 days pre- and post-therapeutic procedure. A total of 233 upper urinary tract therapeutic patient stone procedures were identified; 127 patients underwent ureteroscopy (URS) and 106 patients underwent percutaneous nephrolithotomy (PCNL). A mean 1.58 CTs were performed per patient. Ninety (38.6%) patients underwent ≥2 CTs in the periprocedure period, with an average number in this group of 2.49 CT/patient, resulting in approximately 49.8 mSv of CT radiation exposure. Patients who were undergoing URS were significantly more likely to have multiple CTs (P=0.003) than those undergoing PCNL. Median fluoroscopic procedure exposures were 43.3 mGy for patients who were undergoing PCNL and 27.6 mGy for those patients undergoing URS. CT radiation exposure in the periprocedure period for patients who were undergoing endoscopic upper tract stone removal is considerable. Added to this is the procedure-related fluoroscopic radiation exposure. Urologic surgeons should be aware of the cumulative amount of ionizing radiation received by their patients from multiple sources.

Detecting severe injuries of the upper body in multiple trauma patients.

PubMed

Horst, Klemens; Hildebrand, Frank; Kobbe, Philipp; Pfeifer, Roman; Lichte, Philipp; Andruszkow, Hagen; Lefering, Rolf; Pape, Hans Christoph

2015-12-01

The clavicle limits the upper thoracic cage and connects the body and upper extremities. The clavicle is easy to examine and is visible on standard emergency room radiographs. We hypothesized that clavicular fracture in polytrauma patients would indicate the presence of further injuries of the upper extremities, head, neck, and thorax. A population-based trauma registry was used. All patients were documented between 2002 and 2013. Inclusion criteria were age ≥16 y and injury severity score (ISS) ≥16. Patients were divided into two groups according to the presence or absence of a clavicular fracture (group C+ and group C-). Scoring was based on the abbreviated injury scale, ISS, and new injury severity score. Trauma mechanisms, demographics, and the posttraumatic clinical course were compared. In total, 4790 patients with clavicular fracture (C+) and 41,775 without (C-) were included; the mean ISS was 30 ± 11 (C+) versus 28 ± 12 (C-). Patients with clavicular fracture had a longer stay on the intensive care unit with 12 ± 14 versus 10 ± 13 d. Injuries to the thoracic wall, severe lung injuries as well as injuries to the cervical spine were significantly increased in C+ patients. Thoracic injuries as well as injuries of the shoulder girdle and/or arm showed an increased abbreviated injury scale in the C+ group. A clinically relevant coincidence of clavicular fractures with injuries of the chest and upper extremity was found. As clavicular fractures can be diagnosed easily, it might also help to reduce the incidence of missed injuries of the chest and upper extremity. Therefore, special attention should be paid on thoracic as well as upper extremity injures during the second and tertiary surveys in case of clavicular fractures. Copyright © 2015 Elsevier Inc. All rights reserved.

Summary and evaluation of hydraulic property data available for the Hanford Site upper basalt confined aquifer system

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

Spane, F.A. Jr.; Vermeul, V.R.

Pacific Northwest Laboratory, as part of the Hanford Site Ground-Water Surveillance Project, examines the potential for offsite migration of contamination within the upper basalt confined aquifer system. For the past 40 years, hydrologic testing of the upper basalt confined aquifer has been conducted by a number of Hanford Site programs. Hydraulic property estimates are important for evaluating aquifer flow characteristics (i.e., ground-water flow patterns, flow velocity, transport travel time). Presented are the first comprehensive Hanford Site-wide summary of hydraulic properties for the upper basalt confined aquifer system (i.e., the upper Saddle Mountains Basalt). Available hydrologic test data were reevaluated usingmore » recently developed diagnostic test analysis methods. A comparison of calculated transmissivity estimates indicates that, for most test results, a general correspondence within a factor of two between reanalysis and previously reported test values was obtained. For a majority of the tests, previously reported values are greater than reanalysis estimates. This overestimation is attributed to a number of factors, including, in many cases, a misapplication of nonleaky confined aquifer analysis methods in previous analysis reports to tests that exhibit leaky confined aquifer response behavior. Results of the test analyses indicate a similar range for transmissivity values for the various hydro-geologic units making up the upper basalt confined aquifer. Approximately 90% of the calculated transmissivity values for upper basalt confined aquifer hydrogeologic units occur within the range of 10{sup 0} to 10{sup 2} m{sup 2}/d, with 65% of the calculated estimate values occurring between 10{sup 1} to 10{sup 2} m{sup 2}d. These summary findings are consistent with the general range of values previously reported for basalt interflow contact zones and sedimentary interbeds within the Saddle Mountains Basalt.« less

Black breast cancer survivors experience greater upper extremity disability.

PubMed

Dean, Lorraine T; DeMichele, Angela; LeBlanc, Mously; Stephens-Shields, Alisa; Li, Susan Q; Colameco, Chris; Coursey, Morgan; Mao, Jun J

2015-11-01

Over one-third of breast cancer survivors experience upper extremity disability. Black women present with factors associated with greater upper extremity disability, including: increased body mass index (BMI), more advanced disease stage at diagnosis, and varying treatment type compared with Whites. No prior research has evaluated the relationship between race and upper extremity disability using validated tools and controlling for these factors. Data were drawn from a survey study among 610 women with stage I-III hormone receptor positive breast cancer. The disabilities of the arm, shoulder and hand (QuickDASH) is an 11-item self-administered questionnaire that has been validated for breast cancer survivors to assess global upper extremity function over the past 7 days. Linear regression and mediation analysis estimated the relationships between race, BMI and QuickDASH score, adjusting for demographics and treatment types. Black women (n = 98) had 7.3 points higher average QuickDASH scores than White (n = 512) women (p < 0.001). After adjusting for BMI, age, education, cancer treatment, months since diagnosis, and aromatase inhibitor status, Black women had an average 4-point (95 % confidence interval 0.18-8.01) higher QuickDASH score (p = 0.04) than White women. Mediation analysis suggested that BMI attenuated the association between race and disability by 40 %. Even several years post-treatment, Black breast cancer survivors had greater upper extremity disability, which was partially mediated by higher BMIs. Close monitoring of high BMI Black women may be an important step in reducing disparities in cancer survivorship. More research is needed on the relationship between race, BMI, and upper extremity disability.

Linear dimensions of normal upper airway structure by magnetic resonance imaging in Chinese Han infants and preschool children.

PubMed

Yi, Xiaoli; Yao, Linyin; Yuan, Xinyu; Wei, Yongxiang; Wang, Zhenchang

2017-09-01

To establish normative data of upper airway structure in Chinese Han infants and preschool children. Magnetic resonance imaging (MRI) scans of 521 Chinese Han infants and preschool children (225 girls, 296 boys) aged from 1 day to 72 months were selected from the children who underwent head MRI at the Capital Institute of Pediatrics Affiliated Children Hospital, Beijing, China. No subjects had sleep-disordered breathing or associated conditions that may have affected the upper airway anatomy. The upper airway dimensions and surrounding soft tissue sizes were measured along the mid-sagittal and axial images. On images from the mid-sagittal image, the normative values of the following were obtained for all age group: thickness of the adenoid and nasopharyngeal area, length and thickness of the soft palate, length and height of the tongue, length of upper airway, distance between the mental spine and clivus, and the adenoid oblique width, soft palate oblique width, and tongue oblique width along the mental spine-clivus line. Normative values of the mean tonsillar width and intertonsillar space on the axial images were also obtained. There were no differences in any measurements between boys and girls in either infants or preschool children. Older children had larger airway dimensions, as expected. Normative values for upper airway structure in Chinese Han infants and preschool children assessed by MRI were established. The upper airway dimension and surrounding soft tissues size, including soft palate, adenoid, tongue, and tonsils, were increased with age. There were no gender differences during the first six years of life. These data may prove useful when studying airway disease in Chinese Han children. Copyright © 2017 Elsevier B.V. All rights reserved.

A cross-sectional survey to assess the effect of socioeconomic status on the oral hygiene habits

PubMed Central

Oberoi, Sukhvinder Singh; Sharma, Gaurav; Oberoi, Avneet

2016-01-01

Background: It is widely accepted that there are socioeconomic inequalities in oral health. A socioeconomic gradient is found in a range of clinical and self-reported oral health outcomes. Aim: The present study was conducted to assess the differences in oral hygiene practices among patients from different socioeconomic status (SES) visiting the Outpatient Department of the Sudha Rustagi College of Dental Sciences. Materials and Methods: A cross-sectional survey was conducted from June to October 2014 to assess the effect of SES on the oral hygiene habits. The questionnaire included the questions related to the demographic profile and assessment of the oral hygiene habits of the study population. Results: Toothbrush and toothpaste were being used significantly (P < 0.05) more by lower middle class (84.4%) and upper middle class (100.0%). A significantly higher frequency of cleaning teeth (twice a day) was reported among the lower middle class (17.2%) and upper middle class (21.5%). The majority (34.3%) of the study population changed their toothbrush once in 3 months. The cleaning of tongue was reported by patients belonging to the upper middle (62.0%), lower middle (52.1%), and upper lower class (30.0%). The use of tongue cleaner was reported to be significantly (P < 0.05) more among upper middle (10.1%) class patients. A significantly higher number of patients from the lower class (81.3%) never visited a dentist. Conclusion: The oral hygiene practices of the patients from upper and lower middle class was found to be satisfactory whereas it was poor among patients belonging to lower and upper lower class. PMID:29242690

Mirror therapy in chronic stroke survivors with severely impaired upper limb function: a randomized controlled trial.

PubMed

Colomer, Carolina; NOé, Enrique; Llorens, Roberto

2016-06-01

Mirror therapy (MT) has been proposed to improve the motor function of chronic individuals with stroke with mild to moderate impairment. With regards to severe upper limb paresis, MT has shown to provide limited motor improvement in the acute or sub-acute phase. However, no previous research has described the effects of MT in chronic individuals with stroke with severely impaired upper limb function. The aim of this study was to determine the effectiveness of MT on chronic stroke survivors with severe upper-limb impairment in comparison with passive mobilization. A randomized controlled trial. Rehabilitative outpatient unit. A total of 31 chronic subjects poststroke with severely impaired upper limb function were randomly assigned to either an experimental group (N.=15), or a control group (N.=16). Twenty-four intervention sessions were performed for both groups. Each session included 45-minute period of MT (experimental group) or passive mobilization (control group), administered three days a week. Participants were assessed before and after the intervention with the Wolf Motor Function Test, the Fugl-Meyer Assessment, and the Nottingham Sensory Assessment. Improvement in motor function was observed in both groups on the time (P=0.002) and ability (P=0.001) subscales of the Wolf Motor Function Test. No differences were detected in kinesthesis or stereognosis. However, the experimental group showed a significant improvement in tactile sensation that was mainly observed as an increased sensitivity to light touches. In comparison with passive mobilization, MT in chronic stroke survivors with severely impaired upper-limb function may provide a limited but positive effect on light touch sensitivity while providing similar motor improvement. MT is a therapeutic approach that can be used in the rehabilitation of severely impaired upper limb in chronic stroke survivors, specifically to address light touch sensitivity deficits.

Outcomes of the Bobath concept on upper limb recovery following stroke.

PubMed

Luke, Carolyn; Dodd, Karen J; Brock, Kim

2004-12-01

To determine the effectiveness of the Bobath concept at reducing upper limb impairments, activity limitations and participation restrictions after stroke. Electronic databases were searched to identify relevant trials published between 1966 and 2003. Two reviewers independently assessed articles for the following inclusion criteria: population of adults with upper limb disability after stroke; stated use of the Bobath concept aimed at improving upper limb disability in isolation from other approaches; outcomes reflecting changes in upper limb impairment, activity limitation or participation restriction. Of the 688 articles initially identified, eight met the inclusion criteria. Five were randomized controlled trials, one used a single-group crossover design and two were single-case design studies. Five studies measured impairments including shoulder pain, tone, muscle strength and motor control. The Bobath concept was found to reduce shoulder pain better than cryotherapy, and to reduce tone compared to no intervention and compared to proprioceptive neuromuscular facilitation (PNF). However, no difference was detected for changes in tone between the Bobath concept and a functional approach. Differences did not reach significance for measures of muscle strength and motor control. Six studies measured activity limitations, none of these found the Bobath concept was superior to other therapy approaches. Two studies measured changes in participation restriction and both found equivocal results. Comparisons of the Bobath concept with other approaches do not demonstrate superiority of one approach over the other at improving upper limb impairment, activity or participation. However, study limitations relating to methodological quality, the outcome measures used and contextual factors investigated limit the ability to draw conclusions. Future research should use sensitive upper limb measures, trained Bobath therapists and homogeneous samples to identify the influence of patient factors on the response to therapy approaches.

Using Free Internet Videogames in Upper Extremity Motor Training for Children with Cerebral Palsy.

PubMed

Sevick, Marisa; Eklund, Elizabeth; Mensch, Allison; Foreman, Matthew; Standeven, John; Engsberg, Jack

2016-06-07

Movement therapy is one type of upper extremity intervention for children with cerebral palsy (CP) to improve function. It requires high-intensity, repetitive and task-specific training. Tedium and lack of motivation are substantial barriers to completing the training. An approach to overcome these barriers is to couple the movement therapy with videogames. This investigation: (1) tested the feasibility of delivering a free Internet videogame upper extremity motor intervention to four children with CP (aged 8-17 years) with mild to moderate limitations to upper limb function; and (2) determined the level of intrinsic motivation during the intervention. The intervention used free Internet videogames in conjunction with the Microsoft Kinect motion sensor and the Flexible Action and Articulated Skeleton Toolkit software (FAAST) software. Results indicated that the intervention could be successfully delivered in the laboratory and the home, and pre- and post- impairment, function and performance assessments were possible. Results also indicated a high level of motivation among the participants. It was concluded that the use of inexpensive hardware and software in conjunction with free Internet videogames has the potential to be very motivating in helping to improve the upper extremity abilities of children with CP. Future work should include results from additional participants and from a control group in a randomized controlled trial to establish efficacy.