Board foot volumes of young growth mixed conifer timber

Treesearch

W. L. Jackson

1961-01-01

Board foot volumes have been determined for ponderosa pine, sugar pine, white fir, and Douglas-fir in 90-year-old mixed-conifer stands on the Challenge Experimental Forest, near Oroville, California. Productivity is high—site index 140 feet at 100 years. Following the technique described by Boe, the scaled volumes of felled trees were plotted on logarithmic...

Accuracy of Standing-Tree Volume Estimates Based on McClure Mirror Caliper Measurements

Treesearch

Noel D. Cost

1971-01-01

The accuracy of standing-tree volume estimates, calculated from diameter measurements taken by a mirror caliper and with sectional aluminum poles for height control, was compared with volume estimates calculated from felled-tree measurements. Twenty-five trees which varied in species, size, and form were used in the test. The results showed that two estimates of total...

An in vitro method for comparing biocompatibility of materials for extracorporeal circulation.

PubMed

Peek, Giles J; Scott, Richard; Killer, Hilliary M; Firmin, Richard K

2002-03-01

We measured the response of fresh heparinized human blood to recirculation through circuits made of LVA (Portex Industries, Hythe, Kent, UK), SRT (Rehau UK, Langley, Slough, UK) and Tygon S-65-HL (Norton Performance Plastics, Corby, Northants, UK), as control. Circuit construction: 1/2 in. tubing, heat exchanger (Dideco D-720P), Stockert roller pump, just underoccluded, Cincinnati Sub Zero heater, circuit volume of 500 ml. Flow 3.45 l/min, 37 degrees C. at 10 min, 1, 2, 4 and 6 h. n=5 in each group; 2/5 SRT experiments were stopped at 45 and 60 min due to overpressurization. Baseline activated clotting time (ACT) of 300 s, increasing in all groups as fibrinogen fell to zero with SRT and LVA. Minimum fibrinogen was 1 g/l for Tygon. Absolute thrombocytopenia occurred (SRT and LVA 60 min and Tygon 240 min). International normalized ratio (INR) in both the SRT and LVA circuits increased, but mean increase for Tygon (0.56) was smaller than the other two materials. Plasma free haemoglobin increased in all three materials; the increase was greater in the LVA circuits compared to the control. C5b9 levels increased equally in all groups. Lactoferrin levels rose equally in all groups to a maximum at 150 min. The neutrophil counts fell, mirroring the lactoferrin. The total white cell counts also fell in all groups; in the LVA circuits, the fall was significantly lower than in the control. Rapid disappearance of platelets and fibrinogen from the blood in the SRT and LVA circuits excludes them both from extracorporeal use. Paradoxically, SRT caused the least complement activation of the three materials. This method can be used to compare biocompatibility.

Hemodynamics, renal function, plasma renin, and aldosterone in man after 5 to 14 days of bedrest

NASA Technical Reports Server (NTRS)

Melada, G. A.; Goldman, R. H.; Luetscher, J. A.; Zager, P. G.

1975-01-01

Continuous bedrest for 5 to 14 days had no significant effect on resting heart rate, blood pressure, or cardiac output in six normal men. Head-up tilt induced greater tachycardia in 5 of 6 patients after bed rest than in the control period. Propranolol diminished both tachycardia and the incidence of hypotension and faintness in upright posture. Plasma volume fell, extracellular fluid volume increased, and plasma renin activity was significantly elevated following bedrest. Unusually large increases in plasma renin followed head-up tilt or administration of isoproterenol during bedrest and after resuming normal activity. During bedrest, plasma aldosterone was often increased in the early morning. It is concluded that after bedrest, upright posture evokes strong beta-adrenergic activity as well as exaggerated metabolic and circulatory responses which can be reduced or abolished by the beta-adrenergic blocker, propranolol.

Prenatal programming of renal salt wasting resets postnatal salt appetite, which drives food intake in the rat.

PubMed

Alwasel, Saleh H; Barker, David J P; Ashton, Nick

2012-03-01

Sodium retention has been proposed as the cause of hypertension in the LP rat (offspring exposed to a maternal low-protein diet in utero) model of developmental programming because of increased renal NKCC2 (Na+/K+/2Cl- co-transporter 2) expression. However, we have shown that LP rats excrete more rather than less sodium than controls, leading us to hypothesize that LP rats ingest more salt in order to maintain sodium balance. Rats were fed on either a 9% (low) or 18% (control) protein diet during pregnancy; male and female offspring were studied at 4 weeks of age. LP rats of both sexes held in metabolism cages excreted more sodium and urine than controls. When given water to drink, LP rats drank more and ate more food than controls, hence sodium intake matched excretion. However, when given a choice between saline and water to drink, the total volume of fluid ingested by LP rats fell to control levels, but the volume of saline taken was significantly larger [3.8±0.1 compared with 8.8±1.3 ml/24 h per 100 g of body weight in control and LP rats respectively; P<0.001]. Interestingly food intake also fell to control levels. Total body sodium content and ECF (extracellular fluid) volumes were greater in LP rats. These results show that prenatal programming of renal sodium wasting leads to a compensatory increase in salt appetite in LP rats. We speculate that the need to maintain salt homoeostasis following malnutrition in utero stimulates greater food intake, leading to accelerated growth and raised BP (blood pressure).

Mechanisms of decreased left ventricular preload during continuous positive pressure ventilation in ARDS

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

Dhainaut, J.F.; Devaux, J.Y.; Monsallier, J.F.

1986-07-01

Continuous positive pressure ventilation is associated with a reduction in left ventricular preload and cardiac output, but the mechanisms responsible are controversial. The decrease in left ventricular preload may result exclusively from a decreased systemic venous return due to increased pleural pressure, or from an additional effect such as decreased left ventricular compliance. To determine the mechanisms responsible, we studied the changes in cardiac output induced by continuous positive pressure ventilation in eight patients with the adult respiratory distress syndrome. We measured cardiac output by thermodilution, and biventricular ejection fraction by equilibrium gated blood pool scintigraphy. Biventricular end-diastolic volumes weremore » then calculated by dividing stroke volume by ejection fraction. As positive end-expiratory pressure increased from 0 to 20 cm H/sub 2/O, stroke volume and biventricular end-diastolic volumes fell about 25 percent, and biventricular ejection fraction remained unchanged. At 20 cm H/sub 2/O positive end-expiratory pressure, volume expansion for normalizing cardiac output restored biventricular end-diastolic volumes without markedly changing biventricular end-diastolic transmural pressures. The primary cause of the reduction in left ventricular preload with continuous positive pressure ventilation appears to be a fall in venous return and hence in right ventricular stroke volume, without evidence of change in left ventricular diastolic compliance.« less

Positive inotropic and vasodilator actions of milrinone in patients with severe congestive heart failure. Dose-response relationships and comparison to nitroprusside.

PubMed Central

Jaski, B E; Fifer, M A; Wright, R F; Braunwald, E; Colucci, W S

1985-01-01

Milrinone is a potent positive inotropic and vascular smooth muscle-relaxing agent in vitro, and therefore, it is not known to what extent each of these actions contributes to the drug's hemodynamic effects in patients with heart failure. In 11 patients with New York Heart Association class III or IV congestive heart failure, incremental intravenous doses of milrinone were administered to determine the dose-response relationships for heart rate, systemic vascular resistance, and inotropic state, the latter measured by peak positive left ventricular derivative of pressure with respect to time (dP/dt). To clarify further the role of a positive inotropic action, the relative effects of milrinone and nitroprusside on left ventricular stroke work and dP/dt were compared in each patient at doses matched to cause equivalent reductions in mean arterial pressure or systemic vascular resistance, indices of left ventricular afterload. Milrinone caused heart rate, stroke volume, and dP/dt to increase, and systemic vascular resistance to decrease in a concentration-related manner. At the two lowest milrinone doses resulting in serum concentrations of 63 +/- 4 and 156 +/- 5 ng/ml, respectively, milrinone caused significant increases in stroke volume and dP/dt, but no changes in systemic vascular resistance or heart rate. At the maximum milrinone dose administered (mean serum concentration, 427 +/- 11 ng/ml), heart rate increased from 92 +/- 4 to 99 +/- 4 bpm (P less than 0.01), mean aortic pressure fell from 82 +/- 3 to 71 +/- 3 mmHg (P less than 0.01), right atrial pressure fell from 15 +/- 2 to 7 +/- 1 mmHg (P less than 0.005), left ventricular end-diastolic pressure fell from 26 +/- 3 to 18 +/- 3 (P less than 0.005), stroke volume index increased from 20 +/- 2 to 30 +/- 2 ml/m2 (P less than 0.005), stroke work index increased from 14 +/- 2 to 21 +/- 2 g X m/m2 (P less than 0.01), and dP/dt increased from 858 +/- 54 to 1,130 +/- 108 mmHg/s (P less than 0.005). When compared with nitroprusside for a matched reduction in mean aortic pressure or systemic vascular resistance, milrinone caused a significantly greater increase in stroke work index at the same or lower left ventricular end-diastolic pressure. Milrinone caused a concentration-related increase in dP/dt (32% increase at maximum milrinone dose), whereas nitroprusside had no effect. These data in patients with severe heart failure indicate that in addition to a vasodilating effect, milrinone exerts a concentration-related positive inotropic action that contributes significantly to the drug's overall hemodynamic effects. The positive inotropic action occurs at drug levels that do not exert significant chronotropic or vasodilator effects. Images PMID:3973022

Comparison of optical dendrometers for prediction of standing tree volume

Treesearch

Robert C. Parker; Thomas G. Matney

2000-01-01

Enhanced sets of compatible stem profile equations were used with data collected from felled and standing pine trees to calculate tree volumes to various top merchantability limits. Standing trees were measured with the Criterion 400 Laser, Tele-Relaskop, and Wheeler Pentaprism. These measurements were used to compare accuracies of the optical dendrometers for the...

Merchantable Volume and Weights of Mahoe in Puerto Rican Plantations

Treesearch

John K. Francis

1989-01-01

Mahoe (Hibiscus elatus Sw.), a fast-growing tree whose wood is considered valuable, is planted and managed primarily in the West Indies. Until now, volume and weight tables have not been available for the species. Data used in this paper were collected from 50 felled trees in a range of sizes from plantations across Puerto Rico. Using linear...

Lodgepole pine bole wood density 1 and 11 years after felling in central Montana

Treesearch

Duncan C. Lutes; Colin C. Hardy

2013-01-01

Estimates of large dead and down woody material biomass are used for evaluating ecological processes and making ecological assessments, such as for nutrient cycling, wildlife habitat, fire effects, and climate change science. Many methods are used to assess the abundance (volume) of woody material, which ultimately require an estimate of wood density to convert volume...

Medicare patients' use of overpriced procedures before and after the Omnibus Budget Reconciliation Act of 1987.

PubMed Central

Escarce, J J

1993-01-01

OBJECTIVES. Under the Omnibus Budget Reconciliation Act of 1987, Medicare reduced physician fees for 12 procedures identified as overprices. This paper describes trends in the use of these procedures and other physician services by Medicare patients during the 4-year period surrounding the implementation of the 1987 budget act. METHODS. Medicare physician claims files were used to develop trends in physician-services use from 1986 to 1989. Services were grouped into four categories: overpriced procedures, other surgery, medical care, and ancillary tests. RESULTS. Growth in the volume of overpriced procedures slowed substantially after the 1987 budget act was implemented. Moreover, the reduction in the rate of volume growth for these procedures differed little among specialities or areas. In comparison, the rate of volume growth fell modestly for other surgery, was unchanged for medical care, and increased for ancillary tests. CONCLUSIONS. Increases do not necessarily occur in the volume of surgical procedures whose Medicare fees are reduced. Although the conclusions that may be drawn from a descriptive analysis are limited, these findings suggest that concerns that the resource-based Medicare fee schedule will lead to higher surgery rates may be unwarranted. PMID:8438971

Comparative seed-tree and selection harvesting costs in young-growth mixed-conifer stands

Treesearch

William A. Atkinson; Dale O. Hall

1963-01-01

Little difference was found between yarding and felling costs in seed-tree and selection harvest cuts. The volume per acre logged was 23,800 board feet on the seed-tree compartments and 10,600 board feet on the selection compartments. For a comparable operation with this range of volumes, cutting method decisions should be based on factors other than logging costs....

Compatible taper and volume equations for young longleaf pine plantations in southwest Georgia

Treesearch

Lichun Jiang; John R. Brooks; Alexander Clark

2010-01-01

Inside and outside bark taper equations as well as compatible cubic foot volume equations were developed from felled tree data selected from young longleaf pine plantations that are part of an existing growth and yield study located in the Flint River drainage of southwest Georgia. A Max-Burkhart taper model was selected as the basic model form due to the accuracy...

Blood rheology and 2,3-diphosphoglycerate levels after erythropoietin treatment.

PubMed

Crowley, J P; Chazan, J A; Metzger, J B; Pono, L; Valeri, C R

1993-01-01

Twenty-seven transfusion dependent patients with end-stage renal disease on long-term dialysis had blood cell counts, serum chemistries, blood pressure, and whole blood viscosity measured, as well as having transfusion requirements assessed. Three months after the institution of recombinant human erythropoietin (rHU-EPO) (75 u per kg per wk), there was an 88 percent fall in transfusion requirement. After four months, the hematocrit increased from 24 +/- 3.8 to 25.6 +/- 4.2 percent, mean corpuscular volume from 93 +/- 4.9 to 97 +/- 6.6 fl, 2-3-diphosphoglycerate (2,3-DPG) from 13.2 +/- 3.2 to 15.6 +/- 4.3 microM per g of Hb. Whole blood viscosity fell from 14.1 +/- 2.1 to 12.7 +/- 2.3 seconds, and ferritin levels fell from 3282 +/- 3889 to 2131 +/- 2441 ng per ml. In eight patients in whom the dose of rHU-EPO was further increased by up to 50 units per kg three times weekly for three months, the hematocrit rose further to 29.3 +/- 3.0 percent and the rise in hematocrit was accompanied by a further increase in 2,3-DPG to 17.9 +/- 2.8 microM per g of Hb (p < 0.03). There were no major side effects or vascular complications.

Trends in radical prostatectomy: centralization, robotics, and access to urologic cancer care.

PubMed

Stitzenberg, Karyn B; Wong, Yu-Ning; Nielsen, Matthew E; Egleston, Brian L; Uzzo, Robert G

2012-01-01

Robotic surgery has been widely adopted for radical prostatectomy. We hypothesized that this change is rapidly shifting procedures away from hospitals that do not offer robotics and consequently increasing patient travel. A population-based observational study of all prostatectomies for cancer in New York, New Jersey, and Pennsylvania from 2000 to 2009 was performed using hospital discharge data. Hospital procedure volume was defined as the number of prostatectomies performed for cancer in a given year. Straight-line travel distance to the treating hospital was calculated for each case. Hospitals were contacted to determine the year of acquisition of the first robot. From 2000 to 2009, the total number of prostatectomies performed annually increased substantially. The increase occurred almost entirely at the very high-volume centers (≥ 106 prostatectomies/year). The number of hospitals performing prostatectomy fell 37% from 2000 to 2009. By 2009, the 9% (21/244) of hospitals that had very high volume performed 57% of all prostatectomies, and the 35% (86/244) of hospitals with a robot performed 85% of all prostatectomies. The median travel distance increased 54% from 2000 to 2009 (P<.001). The proportion of patients traveling ≥ 15 miles increased from 24% to 40% (P < .001). Over the past decade, the number of radical prostatectomies performed has risen substantially. These procedures have been increasingly centralized at high-volume centers, leading to longer patient travel distances. Few prostatectomies are now performed at hospitals that do not offer robotic surgery. Copyright © 2011 American Cancer Society.

Harvesting Productionin Uneven-Aged Loblolly-Shortleaf Pine Stands:The Crossett Farm Forestry Forties

Treesearch

R. Kluender; B. Stokes; S. Woodfin

1992-01-01

Twostands managed using uneven-aged techniques werehar- vested aspar-t of a5-year entry schedule. Felling and skidding productivity varied significantly with average stem diameter and volume and was affected by diameter distribution of the removed material.

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

Redies, C.; Hoffer, L.J.; Beil, C.

In prolonged fasting, the brain derives a large portion of its oxidative energy from the ketone bodies, beta-hydroxybutyrate and acetoacetate, thereby reducing whole body glucose consumption. Energy substrate utilization differs regionally in the brain of fasting rat, but comparable information has hitherto been unavailable in humans. We used positron emission tomography (PET) to study regional brain glucose and oxygen metabolism, blood flow, and blood volume in four obese subjects before and after a 3-wk total fast. Whole brain glucose utilization fell to 54% of control (postabsorptive) values (P less than 0.002). The whole brain rate constant for glucose tracer phosphorylationmore » fell to 51% of control values (P less than 0.002). Both parameters decreased uniformly throughout the brain. The 2-fluoro-2-deoxy-D-glucose lumped constant decreased from a control value of 0.57 to 0.43 (P less than 0.01). Regional blood-brain barrier transfer coefficients for glucose tracer, regional oxygen utilization, blood flow, and blood volume were unchanged.« less

Trends in Radical Prostatectomy: Centralization, Robotics, and Access to Urologic Cancer Care

PubMed Central

Stitzenberg, Karyn B.; Wong, Yu-Ning; Nielsen, Matthew E.; Egleston, Brian L.; Uzzo, Robert G.

2011-01-01

Background Robotic surgery has been widely adopted for radical prostatectomy. We hypothesize that this change is rapidly shifting procedures away from hospitals that do not offer robotics and consequently increasing patient travel. Methods A population-based observational study of all prostatectomies for cancer in NY, NJ, and PA from 2000–2009 was performed using hospital discharge data. Hospital procedure volume was defined as the number of prostatectomies performed for cancer in a given year. Straight-line travel distance to treating hospital was calculated for each case. Hospitals were contacted to determine year of acquisition of first robot. Results From 2000–2009, the total number of prostatectomies performed annually increased substantially. The increase occurred almost entirely at the very high volume centers (≥106 prostatectomies/year). The number of hospitals performing prostatectomy fell 37% from 2000–2009. By 2009, the 9% (21/244) of hospitals that had very high volume performed 57% of all prostatectomies, and the 35% (86/244) of hospitals with a robot performed 85% of all prostatectomies. Median travel increased 54% from 2000–2009, p<0.001. The proportion of patients traveling ≥15 miles increased from 24% to 40%, p<0.001. Conclusions Over the past decade, the number of radical prostatectomies performed has risen substantially. These procedures have been increasingly centralized at high volume centers, leading to longer patient travel distances. Few prostatectomies are now performed at hospitals that do not offer robotic surgery. Future work should focus on the impact of these trends on cancer control, functional outcomes, access to care and cost. PMID:21717436

Gill and lung ventilation responses to steady-state aquatic hypoxia and hyperoxia in the bullfrog tadpole.

PubMed

West, N H; Burggren, W W

1982-02-01

Gill ventilation frequency (fG), the pressure amplitude (PBC) and stroke volume (VS) of buccal ventilation cycles, the frequency of air breaths (fL), water flow over the gills (VW), gill oxygen uptake (MGO2), oxygen utilization (U), and heart frequency (fH) have been measured in unanaesthetized, air breathing Rana catesbeiana tadpoles (stage XVI-XIX). The animals were unrestrained except for ECG leads or cannulae, and were able to surface voluntarily for air breathing. They were subjected to aquatic normoxia, hyperoxia and three levels of aquatic hypoxia, and their respiratory responses recorded in the steady state. The experiments were performed at 20 +/- 0.5 degrees C. In hyperoxia there was an absence of air breathing, and fG, PBC and VW fell from the normoxic values, while U increased, resulting in no significant change in MGO2. Animals in normoxia showed a very low fL which increased in progressively more hypoxic states. VW increased from the normoxic value in mild hypoxia (PO2 = 96 +/- 2 mm Hg), but fell, associated with a reduction in PBC, in moderate (PO2 = 41 +/- 1 mm Hg) and severe (PO2 = 21 +/- 3 mm Hg) hypoxia in the presence of lung ventilation. Gill MGO2 was not significantly different from the normoxic value in mild hypoxia but fell in moderate hypoxia, while in severe hypoxia oxygen was lost to the ventilating water from the blood perfusing the gills. There was no significant change in fH from the normoxic value in either hypoxia or hyperoxia. These data indicate, that in the bimodally breathing bullfrog tadpole, aquatic PO2 exerts a strong control over both gill and lung ventilation. Furthermore, there is an interaction between gill and lung ventilation such that the onset of a high frequency of lung ventilation in moderate and severe hypoxia promotes a suppression of gill ventilation cycles.

Is Swimming Safe in Heart Failure? A Systematic Review.

PubMed

Shah, Parin; Pellicori, Pierpaolo; Macnamara, Alexandra; Urbinati, Alessia; Clark, Andrew L

It is not clear whether swimming is safe in patients with chronic heart failure. Ten studies examining the hemodynamic effects of acute water immersion (WI) (155 patients; average age 60 years; 86% male; mean left ventricular ejection fraction (LVEF) 29%) and 6 randomized controlled trials of rehabilitation comparing swimming with either medical treatment only (n = 3) or cycling (n = 1) or aerobic exercise (n = 2), (136 patients, average age 59 years; 84% male, mean LVEF 31%) were considered. In 7 studies of warm WI (30-35°C): heart rate (HR) fell (2% to -15%), and both cardiac output (CO) (7-37%) and stroke volume (SV) increased (13-41%). In 1 study of hot WI (41°C), systemic vascular resistance (SVR) fell (41%) and HR increased (33%). In 2 studies of cold WI (12-22°C), there were no consistent effects on HR and CO. Compared with medical management, swimming led to a greater increase in peak VO2 (7-14%) and 6 minute walk test (6MWT) (7-13%). Compared with cycle training, combined swimming and cycle training led to a greater reduction in resting HR (16%), a greater increase in resting SV (23%) and SVR (15%), but no changes in resting CO and a lesser increase in peak VO2 (6%). Compared with aerobic training, combined swimming and aerobic training lead to a reduction in resting HR (19%) and SVR (54%) and a greater increase in SV (34%), resting CO (28%), LVEF (9%), and 6MWT (70%). Although swimming appears to be safe, the studies conducted have been small, very heterogeneous, and inconclusive.

Respiratory modulation of human autonomic function: long‐term neuroplasticity in space

PubMed Central

Diedrich, André; Cooke, William H.; Biaggioni, Italo; Buckey, Jay C.; Pawelczyk, James A.; Ertl, Andrew C.; Cox, James F.; Kuusela, Tom A.; Tahvanainen, Kari U.O.; Mano, Tadaaki; Iwase, Satoshi; Baisch, Friedhelm J.; Levine, Benjamin D.; Adams‐Huet, Beverley; Robertson, David; Blomqvist, C. Gunnar

2016-01-01

Key points We studied healthy astronauts before, during and after the Neurolab Space Shuttle mission with controlled breathing and apnoea, to identify autonomic changes that might contribute to postflight orthostatic intolerance.Measurements included the electrocardiogram, finger photoplethysmographic arterial pressure, respiratory carbon dioxide levels, tidal volume and peroneal nerve muscle sympathetic activity.Arterial pressure fell and then rose in space, and drifted back to preflight levels after return to Earth.Vagal metrics changed in opposite directions: vagal baroreflex gain and two indices of vagal fluctuations rose and then fell in space, and descended to preflight levels upon return to Earth.Sympathetic burst frequencies (but not areas) were greater than preflight in space and on landing day, and astronauts’ abilities to modulate both burst areas and frequencies during apnoea were sharply diminished.Spaceflight triggers long‐term neuroplastic changes reflected by reciptocal sympathetic and vagal motoneurone responsiveness to breathing changes. Abstract We studied six healthy astronauts five times, on Earth, in space on the first and 12th or 13th day of the 16 day Neurolab Space Shuttle mission, on landing day, and 5–6 days later. Astronauts followed a fixed protocol comprising controlled and random frequency breathing and apnoea, conceived to perturb their autonomic function and identify changes, if any, provoked by microgravity exposure. We recorded the electrocardiogram, finger photoplethysmographic arterial pressure, tidal carbon dioxide concentrations and volumes, and peroneal nerve muscle sympathetic activity on Earth (in the supine position) and in space. (Sympathetic nerve recordings were made during three sessions: preflight, late mission and landing day.) Arterial pressure changed systematically from preflight levels: pressure fell during early microgravity exposure, rose as microgravity exposure continued, and drifted back to preflight levels after return to Earth. Vagal metrics changed in opposite directions: vagal baroreflex gain and two indices of vagal fluctuations (root mean square of successive normal R‐R intervals; and proportion of successive normal R‐R intervals greater than 50 ms, divided by the total number of normal R‐R intervals) rose significantly during early microgravity exposure, fell as microgravity exposure continued, and descended to preflight levels upon return to Earth. Sympathetic mechanisms also changed. Burst frequencies (but not areas) during fixed frequency breathing were greater than preflight in space and on landing day, but their control during apnoea was sharply altered: astronauts increased their burst frequencies from already high levels, but they could not modulate either burst areas or frequencies appropriately. Space travel provokes long‐lasting sympathetic and vagal neuroplastic changes in healthy humans. PMID:27029027

Is forest management a significant source of monoterpenes into the boreal atmosphere?

NASA Astrophysics Data System (ADS)

Haapanala, S.; Hakola, H.; Hellén, H.; Vestenius, M.; Levula, J.; Rinne, J.

2011-08-01

Volatile organic compounds (VOCs) including terpenoids are emitted into the atmosphere from various natural sources. Damaging the plant tissue is known to strongly increase their monoterpene release. We measured the terpenoid emissions caused by timber felling, i.e. those from stumps and logging residue. The emissions from stumps were studied using enclosures and those from the whole felling area using an ecosystem scale micrometeorological method, disjunct eddy accumulation (DEA). The compounds analyzed were isoprene, monoterpenes and sesquiterpenes. Strong emissions of monoterpenes were measured from both the stumps and from the whole felling area. The emission rate fell down rapidly within few months after the logging. In addition to fresh logging residue, the results suggest also other strong monoterpene sources to be present at the felling area. Those could include pre-existing litter, increased microbial activity and remaining undergrowth. To evaluate the possible importance of monoterpenes emitted from cut Scots pine forests in Finland annually, we conducted a rough upscaling. The resulting monoterpene release was about 15 kilotonnes per year which is more than 10 % of the monoterpene release from intact forests in Finland.

Following the fate of harvest-damaged trees 13 years after harvests

Treesearch

Randy G. Jensen; John M. Kabrick

2014-01-01

Logging damage to residual trees during harvest operations can reduce the future volume, quality, and value of wood products. Timber harvests in 1996 on the Missouri Ozark Forest Ecosystem Project (MOFEP) provided a rare opportunity to follow the fate of trees wounded by felling or by skidding with rubber-tired skidders.

The Development of an Occupational Information System (OIS), Volume II.

ERIC Educational Resources Information Center

Louisiana State Univ., Baton Rouge. Div. of Continuing Education.

Suppliers of postsecondary trained manpower data in Louisiana were surveyed during a project to obtain labor market information and occupational supply/demand information. All supply data were computerized and assigned to the appropriate training file. The data compiled fell into four major categories with regard to the method(s) of capture and…

Prenatal exposure to cigarette smoke or alcohol and cerebellum volume in attention-deficit/hyperactivity disorder and typical development

PubMed Central

de Zeeuw, P; Zwart, F; Schrama, R; van Engeland, H; Durston, S

2012-01-01

Prenatal exposure to teratogenic substances, such as nicotine or alcohol, increases the risk of developing attention-deficit/hyperactivity disorder (ADHD). To date, studies examining this relationship have used symptom scales as outcome measures to assess the effect of prenatal exposure, and have not investigated the neurobiological pathways involved. This study explores the effect of prenatal exposure to cigarettes or alcohol on brain volume in children with ADHD and typically developing controls. Children with ADHD who had been exposed prenatally to either substance were individually matched to children with and without ADHD who had not been. Controls who had been exposed prenatally were also individually matched to controls who had not been. For prenatal exposure to both smoking and alcohol, we found a pattern where subjects with ADHD who had been exposed had the smallest brain volumes and unexposed controls had the largest, with intermediate volumes for unexposed subjects with ADHD. This effect was most pronounced for cerebellum. A similar reduction fell short of significance for controls who had been exposed to cigarettes, but not alcohol. Our results are consistent with an additive effect of prenatal exposure and ADHD on brain volume, with the effects most pronounced for cerebellum. PMID:22832850

Green synthesized conditions impacting on the reactivity of Fe NPs for the degradation of malachite green.

PubMed

Huang, Lanlan; Luo, Fang; Chen, Zuliang; Megharaj, Mallavarapu; Naidu, Ravendra

2015-02-25

This study investigates green tea extract synthesized conditions impacting on the reactivity of iron nanoparticles (Fe NPs) used for the degradation of malachite green (MG), including the volume ratio of Fe(2+) and tea extract, the solution pH and temperature. Results indicated that the reactivity of Fe NPs increased with higher temperature, but fell with increasing pH and the volume ratio of Fe(2+) and tea extract. Scanning electron microscope (SEM), energy-dispersive spectrometer (EDS), Fourier transform infrared spectroscope (FTIR) and X-ray diffraction (XRD) indicated that Fe NPs were spherical in shape, their diameter was 70-80 nm and they were mainly composed of iron oxide nanoparticles. UV-visible (UV-vis) indicated that reactivity of Fe NPs used in degradation of MG significantly depended on the synthesized conditions of Fe NPs. This was due to their impact on the reactivity and morphology of Fe NPs. Finally, degradation of MG showed that 90.56% of MG was removed using Fe NPs. Copyright © 2014 Elsevier B.V. All rights reserved.

A comparison of case volumes among urologic surgeons identified on an industry-sponsored website to an all provider peer group.

PubMed

See, William A; Jacobson, Kenneth; Derus, Sue; Langenstroer, Peter

2014-11-01

Industry-sponsored websites for robotic surgery direct to surgeons listed as performing specific robotic surgical procedures. The purpose of this study was to compare average annual, surgeon-specific, case volumes for those procedures for which they were listed as performing on the commercial website with the volumes of all providers performing these same procedures across a defined geographic region. A list of providers within the state of Wisconsin cited as performing specific urologic procedures was obtained through the Intuitive Surgical website 〈http://www.davincisurgery.com/da-vinci-urology/〉. Surgeon-specific annual case volumes from 2009 to 2013 for these same cases were obtained for all Wisconsin providers through DataBay Resources (Warrendale, PA) based on International classification of diseases-9 codes. Procedural activity was rank ordered, and surgeons were placed in "volume deciles" derived from the total annual number of cases performed by all surgeons. The distribution of commercially listed surgeon volumes, both 5-year average and most recent year, was compared with the average and 2013 volumes of all surgeons performing a specific procedure. A total of 35 individual urologic surgeons listed as performing robotic surgery in Wisconsin were identified through a "search" using the Intuitive Surgical website. Specific procedure analysis returned 5, 12, 9, and 15 surgeon names for cystectomy, partial nephrectomy, radical nephrectomy, and prostatectomy, respectively. This compared with the total number of surgeons who had performed the listed procedure in Wisconsin at least 1 time during the prior 5 years of 123, 153, 242, and 165, respectively. When distributed by surgeon-volume deciles, surgeons listed on industry-sponsored sites varied widely in their respective volume decile. More than half of site-listed, procedure-specific surgeons fell below the fifth decile for surgeon volume. Data analysis based solely on 2013 case volumes had no effect on the number of website-listed surgeons whose volumes fell below the fifth decile. Surgeons listed on an industry-sponsored website demonstrate wide variation in the actual volume of specific procedures performed. The inferred endorsement of competence by commercial sites has the potential to mislead patients seeking surgical expertise. Providers should consider the ethical and legal implications of these commercial advertising that do not have volume or outcome data. Published by Elsevier Inc.

Weighted linear regression using D2H and D2 as the independent variables

Treesearch

Hans T. Schreuder; Michael S. Williams

1998-01-01

Several error structures for weighted regression equations used for predicting volume were examined for 2 large data sets of felled and standing loblolly pine trees (Pinus taeda L.). The generally accepted model with variance of error proportional to the value of the covariate squared ( D2H = diameter squared times height or D...

The Coast Artillery Journal. Volume 81, Number 4, July-August 1938

DTIC Science & Technology

1938-08-01

in the back, a la franc;ais. Orders thereupon went forth for a retreat parade with our coats so draped and we fell in looking for all the world like...very little value in the attack in that their fire power is insignificant and their armour too weak; moreover, their ability to move freely is unduly

Computer programs for optical dendrometer measurements of standing tree profiles

Treesearch

Jacob R. Beard; Thomas G. Matney; Emily B. Schultz

2015-01-01

Tree profile equations are effective volume predictors. Diameter data for building these equations are collected from felled trees using diameter tapes and calipers or from standing trees using optical dendrometers. Developing and implementing a profile function from the collected data is a tedious and error prone task. This study created a computer program, Profile...

Recovery of forest structure and spectral properties after selective logging in lowland Bolivia.

PubMed

Broadbent, Eben N; Zarin, Daniel J; Asner, Gregory P; Peña-Claros, Marielos; Cooper, Amanda; Littell, Ramon

2006-06-01

Effective monitoring of selective logging from remotely sensed data requires an understanding of the spatial and temporal thresholds that constrain the utility of those data, as well as the structural and ecological characteristics of forest disturbances that are responsible for those constraints. Here we assess those thresholds and characteristics within the context of selective logging in the Bolivian Amazon. Our study combined field measurements of the spatial and temporal dynamics of felling gaps and skid trails ranging from <1 to 19 months following reduced-impact logging in a forest in lowland Bolivia with remote-sensing measurements from simultaneous monthly ASTER satellite overpasses. A probabilistic spectral mixture model (AutoMCU) was used to derive per-pixel fractional cover estimates of photosynthetic vegetation (PV), non-photosynthetic vegetation (NPV), and soil. Results were compared with the normalized difference in vegetation index (NDVI). The forest studied had considerably lower basal area and harvest volumes than logged sites in the Brazilian Amazon where similar remote-sensing analyses have been performed. Nonetheless, individual felling-gap area was positively correlated with canopy openness, percentage liana coverage, rates of vegetation regrowth, and height of remnant NPV. Both liana growth and NPV occurred primarily in the crown zone of the felling gap, whereas exposed soil was limited to the trunk zone of the gap. In felling gaps >400 m2, NDVI, and the PV and NPV fractions, were distinguishable from unlogged forest values for up to six months after logging; felling gaps <400 m2 were distinguishable for up to three months after harvest, but we were entirely unable to distinguish skid trails from our analysis of the spectral data.

Unregulated proliferation of trauma centers undermines cost efficiency of population-based injury control.

PubMed

Tepas, Joseph J; Kerwin, Andrew J; Ra, Jin Hee

2014-03-01

We evaluated the impact on coverage and regional cost of trauma care produced by the activation of a Level II center with no preceding needs analysis in an established trauma region with a Level I center. Patient deidentified trauma registry data for years 2010, 2011, and 2012 were analyzed to assess the effect on trauma service volume during a period at the midpoint of which the Level II center was activated. Trends for each year were evaluated by patient volume, mechanism, resource use as reflected in a transfer to the intensive care unit (ICU) and ICU stay, patient severity as defined by Injury Severity Score (ISS), and patient injury profile determined by mean body region Abbreviated Injury Scale (AIS) score. Between 2010 and 2011, during which the Level II opened, overall volume at the Level I center dropped by 3.7%, and blunt volume remained unchanged. From 2011 to 2012, overall Level I volume dropped by 9.4%, and blunt injury fell by 14%. Proportions requiring immediate operating room or ICU care did not change. ISS distribution at the Level I center across the years was similar. Head, chest, and abdominal injuries, as assessed by AIS body region, increased slightly in severity and decreased in volume by 25%, 17%, and 18%, respectively. For 2012, the new center publically reported treating 1,100 patients, which, in concert with the Level I decrease, translates to increasing regional trauma center access by 25% while increasing expense of necessary core personnel by 217%. Addition of a second trauma center in a stable region, in which injury incidence was actually decreasing, doubled the cost of personnel, one of the most expensive components of the trauma system and decreased the volume of injuries necessary for training and education. Trauma system expansion must be based on needs assessment, which assures system survival and controls societal cost. Economic & value-based evaluation, level III.

Respiratory modulation of human autonomic function: long-term neuroplasticity in space.

PubMed

Eckberg, Dwain L; Diedrich, André; Cooke, William H; Biaggioni, Italo; Buckey, Jay C; Pawelczyk, James A; Ertl, Andrew C; Cox, James F; Kuusela, Tom A; Tahvanainen, Kari U O; Mano, Tadaaki; Iwase, Satoshi; Baisch, Friedhelm J; Levine, Benjamin D; Adams-Huet, Beverley; Robertson, David; Blomqvist, C Gunnar

2016-10-01

We studied healthy astronauts before, during and after the Neurolab Space Shuttle mission with controlled breathing and apnoea, to identify autonomic changes that might contribute to postflight orthostatic intolerance. Measurements included the electrocardiogram, finger photoplethysmographic arterial pressure, respiratory carbon dioxide levels, tidal volume and peroneal nerve muscle sympathetic activity. Arterial pressure fell and then rose in space, and drifted back to preflight levels after return to Earth. Vagal metrics changed in opposite directions: vagal baroreflex gain and two indices of vagal fluctuations rose and then fell in space, and descended to preflight levels upon return to Earth. Sympathetic burst frequencies (but not areas) were greater than preflight in space and on landing day, and astronauts' abilities to modulate both burst areas and frequencies during apnoea were sharply diminished. Spaceflight triggers long-term neuroplastic changes reflected by reciptocal sympathetic and vagal motoneurone responsiveness to breathing changes. We studied six healthy astronauts five times, on Earth, in space on the first and 12th or 13th day of the 16 day Neurolab Space Shuttle mission, on landing day, and 5-6 days later. Astronauts followed a fixed protocol comprising controlled and random frequency breathing and apnoea, conceived to perturb their autonomic function and identify changes, if any, provoked by microgravity exposure. We recorded the electrocardiogram, finger photoplethysmographic arterial pressure, tidal carbon dioxide concentrations and volumes, and peroneal nerve muscle sympathetic activity on Earth (in the supine position) and in space. (Sympathetic nerve recordings were made during three sessions: preflight, late mission and landing day.) Arterial pressure changed systematically from preflight levels: pressure fell during early microgravity exposure, rose as microgravity exposure continued, and drifted back to preflight levels after return to Earth. Vagal metrics changed in opposite directions: vagal baroreflex gain and two indices of vagal fluctuations (root mean square of successive normal R-R intervals; and proportion of successive normal R-R intervals greater than 50 ms, divided by the total number of normal R-R intervals) rose significantly during early microgravity exposure, fell as microgravity exposure continued, and descended to preflight levels upon return to Earth. Sympathetic mechanisms also changed. Burst frequencies (but not areas) during fixed frequency breathing were greater than preflight in space and on landing day, but their control during apnoea was sharply altered: astronauts increased their burst frequencies from already high levels, but they could not modulate either burst areas or frequencies appropriately. Space travel provokes long-lasting sympathetic and vagal neuroplastic changes in healthy humans. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

[Effects of simulated weightlessness on pressure-volume relationships of femoral vein of New Zealand Rabbits].

PubMed

Yue, Yong; Yao, Yong-jie; Xie, Xiao-ping; Wang, Bing; Zhu, Qing-sheng; Wu, Xing-yu

2002-12-01

Objective. To observe the changes of pressure-volume relationships of rabbit femoral veins and their structural changes caused by simulated weightlessness. Method. Head-Down Tilt (HDT) -20 degrees rabbit model was used to simulate weightlessness. Twenty four healthy male New Zealand Rabbits were randomly divided into 21 d HDT group,10 d HDT group and control group, (8 in each group). Pressure-volume (P-V) relationship of rabbits femoral veins was measured and the microstructure of the veins was observed. Result. The femoral vein P-V relationship curves of HDT groups showed a larger volume change ratio than that of control group. This change was that 21 d HDT group was even more obvious than that of HDT-10 d group. B1 and B2 in quadratic equations of 21 d HDT group were significantly higher than the values of both 10 d HDT group and control group during expansion (inflow) and collapse (outflow) (P<0.01). The result of histological examination showed that the contents and structure of femoral vein wall of HDT-rabbits changed significantly. Endothelial cells of femoral vein became short and columnar or cubic, some of which fell off. Smooth muscle layer became thinner. Conclusion. Femoral venous compliance increased after weightlessness-simulation and the femoral venous compliance in 21 d-HDT rabbits increased more obviously than that in 10 d-HDT rabbits. The structure of femoral vein wall had changed obviously.

Pressure overload-dependent membrane type 1-matrix metalloproteinase induction: relationship to LV remodeling and fibrosis.

PubMed

Zile, Michael R; Baicu, Catalin F; Stroud, Robert E; Van Laer, An; Arroyo, Jazmine; Mukherjee, Rupak; Jones, Jeffrey A; Spinale, Francis G

2012-04-01

Increased myocardial extracellular matrix collagen represents an important structural milestone during the development of left ventricular (LV) pressure overload (PO); however, the proteolytic pathways that contribute to this process are not fully understood. This study tested the hypothesis that membrane type 1-matrix metalloproteinase (MT1-MMP) is directly induced at the transcriptional level in vivo during PO and is related to changes in LV collagen content. PO was induced in vivo by transverse aortic constriction in transgenic mice containing the full length human MT1-MMP promoter region ligated to luciferase (MT1-MMP Prom mice). MT1-MMP promoter activation (luciferase expression), expression, and activity; collagen volume fraction (CVF); and left atrial dimension were measured at 1 (n = 8), 2 (n = 12), and 4 (n = 17) wk following PO. Non-PO mice (n = 10) served as controls. Luciferase expression increased by fivefold at 1 wk, fell at 2 wk, and increased again by ninefold at 4 wk of PO (P < 0.05). MT1-MMP expression and activity increased at 1 wk, fell at 2 wk, and increased again at 4 wk after PO. CVF increased at 1 wk, remained unchanged at 2 wk, and increased by threefold at 4 wk of PO (P < 0.05). There was a strong positive correlation between CVF and MT1-MMP activity (r = 0.80, P < 0.05). Left atrial dimension remained unchanged at 1 and 2 wk but increased by 25% at 4 wk of PO. When a mechanical load was applied in vitro to LV papillary muscles isolated from MT1-MMP Prom mice, increased load caused MT1-MMP promoter activation to increase by twofold and MT1-MMP expression to increase by fivefold (P < 0.05). These findings challenge the canonical belief that PO suppresses overall matrix proteolytic activity, but rather supports the concept that certain proteases, such as MT1-MMP, play a pivotal role in PO-induced matrix remodeling and fibrosis.

Midstory removal methods tested for timely release of newly established oak seedlings under oak shelterwoods

Treesearch

Ronald A. Rathfon

2011-01-01

The oak shelterwood method calls for the removal of shade-tolerant, undesirable midstory species to create adequate diffuse light conditions at the forest floor for oak seedling establishment, preferably timed to coincide with a large acorn crop. Injection (INJ) with an herbicide, chainsaw felling and girdling with herbicide application (SAW), and a low-volume basal...

Identifying changes in tree form for harvested ponderosa pine in the Black Hills

Treesearch

Michael S. Williams; Raymond L. Czaplewski; Don L. Martinez

1996-01-01

Recent underestimates of total volume for timber sales in the Black Hills National Forest prompted analysis of two felled ponderosa pine (Pinus ponderosa Laws.) data sets that were collected approximately 10 years apart. Though neither data set collected was a representative sample of the Black Hills, both were similar in terms of diameter at breast height and total...

Forest management strategy affects saproxylic beetle assemblages: A comparison of even and uneven-aged silviculture using direct and indirect sampling.

PubMed

Joelsson, Klara; Hjältén, Joakim; Gibb, Heloise

2018-01-01

Management of forest for wood production has altered ecosystem structures and processes and led to habitat loss and species extinctions, worldwide. Deadwood is a key resource supporting forest biodiversity, and commonly declines following forest management. However, different forest management methods affect dead wood differently. For example, uneven-aged silviculture maintains an age-stratified forest with ongoing dead wood production, while even-aged silviculture breaks forest continuity, leading to long periods without large trees. We asked how deadwood-dependent beetles respond to different silvicultural practices and if their responses depend on deadwood volume, and beetles preference for decay stages of deadwood. We compared beetle assemblages in five boreal forest types with different management strategies: clearcutting and thinning (both representing even-aged silviculture), selective felling (representing uneven-aged silviculture), reference and old growth forest (both uneven-aged controls without a recent history [~50 years] of management, but the latter with high conservation values). We collected beetles using window traps and by sieving the bark from experimental logs (bolts). Beetle assemblages on clear-cuts differed from all other stand types, regardless of trapping method or decay stage preference. Thinning differed from reference stands, indicating incomplete recovery after clear-cutting, while selective felling differed only from clear-cuts. In contrast to our predictions, early and late successional species responded similarly to different silvicultural practices. However, there were indications of marginal assemblage differences both between thinned stands and selective felling and between thinned and old growth stands (p = 0.10). The stand volume of early decay stage wood influenced assemblage composition of early, but not late successional species. Uneven-aged silviculture maintained species assemblages similar to those of the reference and old growth stands and might therefore be a better management option when considering biodiversity conservation.

Plant succession and community restoration following felling and burning in the Southern Appalachian Mountains

Treesearch

Barton D. Clinton; James M. Vose

2000-01-01

Recent declines in the yellow pine component of pine-hardwood stands in the Southern Appalachian Mountains has prompted managers to increase the use of fire as a silvicultural tool. The fell and burn treatment is designed to remove competing vegetation (hardwoods and mountain laurel...

Effect of the economic recession on pharmaceutical policy and medicine sales in eight European countries.

PubMed

Leopold, Christine; Mantel-Teeuwisse, Aukje K; Vogler, Sabine; Valkova, Silvia; de Joncheere, Kees; Leufkens, Hubert G M; Wagner, Anita K; Ross-Degnan, Dennis; Laing, Richard

2014-09-01

To identify pharmaceutical policy changes during the economic recession in eight European countries and to determine whether policy measures resulted in lower sales of, and less expenditure on, pharmaceuticals. Information on pharmaceutical policy changes between 2008 and 2011 in eight European countries was obtained from publications and pharmaceutical policy databases. Data on the volume and value of the quarterly sales of products between 2006 and 2011 in the 10 highest-selling therapeutic classes in each country were obtained from a pharmaceutical market research database. We compared these indicators in economically stable countries; Austria, Estonia and Finland, to those in economically less stable countries, Greece, Ireland, Portugal, Slovakia and Spain. Economically stable countries implemented two to seven policy changes each, whereas less stable countries implemented 10 to 22 each. Of the 88 policy changes identified, 33 occurred in 2010 and 40 in 2011. They involved changing out-of-pocket payments for patients in 16 cases, price mark-up schemes in 13 and price cuts in 11. Sales volumes increased moderately in all countries except Greece and Portugal, which experienced slight declines after 2009. Sales values decreased in both groups of countries, but fell more in less stable countries. Less economically stable countries implemented more pharmaceutical policy changes during the recession than economically stable countries. Unexpectedly, pharmaceutical sales volumes increased in almost all countries, whereas sales values declined, especially in less stable countries.

The impact of BMI on sperm parameters and the metabolite changes of seminal plasma concomitantly.

PubMed

Guo, Dan; Wu, Wei; Tang, Qiuqin; Qiao, Shanlei; Chen, Yiqiu; Chen, Minjian; Teng, Mengying; Lu, Chuncheng; Ding, Hongjuan; Xia, Yankai; Hu, Lingqing; Chen, Daozhen; Sha, Jiahao; Wang, Xinru

2017-07-25

The development of male infertility increased rapidly worldwide, which coinciding with the epidemic of obesity. However, the impact of weight abnormalities on sperm quality is still contestable. To assess the correlation between BMI and sperm parameters, we searched relevant articles in PubMed, Embase, Web of science, and Wanfang database published until June 2015 without language restriction. Otherwise, we also recruited some participants who attended fertility clinic as well as some general populations in this report. We performed a systematic review and meta-analysis about BMI and sperm parameters containing total sperm count, concentration, semen volume and sperm motility (overall and progressive). Metabolomic analysis of seminal plasma was performed to explore the mechanism from a new perspective. This study found standardized weighted mean differences (SMD) in sperm parameters (total sperm count, sperm concentration, and semen volume) of abnormal weight groups decreased to different degree compared to normal weight. Dose-response analysis found SMD of sperm count, sperm concentration and semen volume respectively fell 2.4%, 1.3% and 2.0% compared with normal weight for every 5-unit increase in BMI. Metabolomic analysis of seminal plasma showed that spermidine and spermine were likely to play a vital role in the spermatogenesis progress. This systematic review with meta-analysis has confirmed there was a relationship between BMI and sperm quality, suggesting obesity may be a detrimental factor of male infertility.

Transthoracic Electrical Impedance in Cases of High-altitude Hypoxia

PubMed Central

Roy, Sujoy B.; Balasubramanian, V.; Khan, M. R.; Kaushik, V. S.; Manchanda, S. C.; Guha, S. K.

1974-01-01

Changes in transthoracic electrical impedance (T.E.I.) due to high-altitude hypoxia (3,658 m) have been measured in 20 young, healthy Indian soldiers. They were first studied at sea level (198 m) and then rapidly transported by air to 3,658 m, where they were studied daily from day 1 to day 5 and then on days 8 and 10. The mean (±S.D.) T.E.I. at sea level (34·6±0·6Ω) fell sharply to 29·6±0·8Ω, 30·3±0·9Ω, and 30·5±1·1Ω on days 1, 2, and 3 (P <0·001) and levelled off at 31·5±0·7Ω on day 10, which was comparable to the mean value obtained in 13 persons permanently resident at high altitude (32·2±0·7Ω). Five sea-level residents who had acute mountain sickness (A.M.S.) or high-altitude pulmonary oedema (H.A.P.O.) had a still lower mean value (22·5±1·1Ω). One normal healthy subject who at sea level had a T.E.I. of 34·7Ω developed H.A.P.O. when the T.E.I. fell to 21·1Ω. Ninety minutes after the administration of 80 mg of intravenous frusemide the value increased to 35·5Ω. In another subject with A.M.S. who received 40 mg of frusemide intravenously the T.E.I. rose from 21·9 to 33·2Ω. Since the study was non-invasive the changes in impedance could not be correlated objectively with alterations in either pulmonary blood volume or pulmonary extravascular water space. In the subject, however, with x-ray evidence of H.A.P.O. and a low T.E.I. intravenous frusemide produced a marked rise in T.E.I. together with clearing of the chest x-ray picture within 24 hours, indicating an inverse relationship between impedance and thoracic fluid volume. It is suggested that with further objective verification in man the measurement of T.E.I. may be a potentially promising technique for the early detection of increased pulmonary fluid volume. ImagesFIG. 3FIG. 4 PMID:4416705

A new harvest operation cost model to evaluate forest harvest layout alternatives

Treesearch

Mark M. Clark; Russell D. Meller; Timothy P. McDonald; Chao Chi Ting

1997-01-01

The authors develop a new model for harvest operation costs that can be used to evaluate stands for potential harvest. The model is based on felling, extraction, and access costs, and is unique in its consideration of the interaction between harvest area shapes and access roads. The scientists illustrate the model and evaluate the impact of stand size, volume, and road...

Clearcut harvesting costs and production rates for young-growth mixed-conifer stands

Treesearch

William A. Atkinson; Dale O. Hall

1966-01-01

In clearcutting 90-year-old stands at the Challenge Experimental Forest, all merchantable trees greater than 12 inches d.b.h. were removed. Felling costs averaged $3.86 and required 0.55 man-hours per M bd. ft. in cut volumes averaging 19,700 bd. ft. per acre. Yarding, at a rate of 0.54 hours per M bd. ft., cost $4.42.

Do high tuition fees make a difference? Characteristics of applicants to UK medical and dental schools before and after the introduction of high tuition fees in 2012.

PubMed

Gallagher, J E; Calvert, A; Niven, V; Cabot, L

2017-02-10

Aim To compare trends in the volume, socio-demography and academic experience of UK applicants and entrants to medicine and dentistry in the UK with university in general, before and after the major increase in university fees in England in 2012.Methods Descriptive trend analyses of University and College Admissions Services (UCAS) data for focused (preferred subject was medicine or dentistry) and accepted applicants, 2010-14, compared with university in general in relation to socio-demography (age, sex, ethnicity, POLAR 2, region) and academic experience (school type). POLAR2 data provide an indication of the likelihood of young people in the area participating in further or higher education.Results In 2012 the volume of applicants to medicine and dentistry fell by 2.4% and 7.8% respectively, compared with 6.6% for university overall. Medical applications remained buoyant and by 2014 had risen by 10.2% from 2010 to 23,365. While dental applications fell in both 2012 and 2013, they had increased by 15.6% to 3,410 in 2014, above 2010 levels. Females formed the majority of applicants, and admissions, with the proportion gaining admission to dentistry in 2014 reaching an all-time high (64%), exceeding medicine (56%), and university in general (56%). Mature admissions to dentistry were at their highest in 2010 (29%) falling to 21% in 2014, compared with 22-24% in medicine. Black and minority ethnic group admissions to university, although rising (24% in 2014), are still less than for medicine (34%) and dentistry (48%). In 2013, just over half of the students admitted to dentistry were from BME groups (51%) for dentistry. Among UK applicants <19 years, over 60% of applicants, and 70% of accepted applicants, to medicine and dentistry are from the top two POLAR2 quintiles representing areas of high participation in education; however, in 2014 there was a notable increase in the proportion of applications from the lower two quintiles to dentistry (19%) and medicine (20%), with a very modest increase in those gaining admission over 2012 (14% of both; cf 10% and 12% respectively).Discussion The findings suggest that the short-term impact of the 2012 rise in fees had a greater influence on the volume and nature of applicants to dentistry than medicine, and that both programmes are gaining in popularity, despite high fees and reduced places. Dentistry remains particularly attractive to Asians, and females, the latter forming an increasing majority of students. While there is some recovery, social inequalities exist and present a challenge for widening participation in the professions.

Slow and deep respiration suppresses steady-state sympathetic nerve activity in patients with chronic heart failure: from modeling to clinical application.

PubMed

Harada, Daisuke; Asanoi, Hidetsugu; Takagawa, Junya; Ishise, Hisanari; Ueno, Hiroshi; Oda, Yoshitaka; Goso, Yukiko; Joho, Shuji; Inoue, Hiroshi

2014-10-15

Influences of slow and deep respiration on steady-state sympathetic nerve activity remain controversial in humans and could vary depending on disease conditions and basal sympathetic nerve activity. To elucidate the respiratory modulation of steady-state sympathetic nerve activity, we modeled the dynamic nature of the relationship between lung inflation and muscle sympathetic nerve activity (MSNA) in 11 heart failure patients with exaggerated sympathetic outflow at rest. An autoregressive exogenous input model was utilized to simulate entire responses of MSNA to variable respiratory patterns. In another 18 patients, we determined the influence of increasing tidal volume and slowing respiratory frequency on MSNA; 10 patients underwent a 15-min device-guided slow respiration and the remaining 8 had no respiratory modification. The model predicted that a 1-liter, step increase of lung volume decreased MSNA dynamically; its nadir (-33 ± 22%) occurred at 2.4 s; and steady-state decrease (-15 ± 5%), at 6 s. Actually, in patients with the device-guided slow and deep respiration, respiratory frequency effectively fell from 16.4 ± 3.9 to 6.7 ± 2.8/min (P < 0.0001) with a concomitant increase in tidal volume from 499 ± 206 to 1,177 ± 497 ml (P < 0.001). Consequently, steady-state MSNA was decreased by 31% (P < 0.005). In patients without respiratory modulation, there were no significant changes in respiratory frequency, tidal volume, and steady-state MSNA. Thus slow and deep respiration suppresses steady-state sympathetic nerve activity in patients with high levels of resting sympathetic tone as in heart failure. Copyright © 2014 the American Physiological Society.

Parallel imports and the pricing of pharmaceutical products: evidence from the European Union.

PubMed

Ganslandt, Mattias; Maskus, Keith E

2004-09-01

We consider policy issues regarding parallel imports (PIs) of brand-name pharmaceuticals in the European Union, where such trade is permitted. We develop a simple model in which an original manufacturer competes in its home market with PI firms. The model suggests that for small trade costs the original manufacturer will accommodate the import decisions of parallel traders and that the price in the home market falls as the volume of parallel imports rises. Using data from Sweden we find that the prices of drugs subject to competition from parallel imports fell relative to other drugs over the period 1994-1999. Econometric analysis finds that parallel imports significantly reduced manufacturing prices, by 12-19%. There is evidence that this effect increases with multiple PI entrants.

Non-pulp utilization of above-ground biomass of mixed-species forests of small trees

Treesearch

P. Koch

1982-01-01

This soulution propose to rehabilitate annually- by clear felling, site preparation, and planting- 25,000 acres of level to rolling land averaging about490 cubic feet per acre of stemwood in small hardwood trees 5 inches in diameter at breast height (dbh) and larger, and of many species, plus all equal volume of above-ground biomass in stembark and tops, and in trees...

Fuel oil and kerosene sales, 1989

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

Not Available

1991-01-22

Despite the rise in petroleum products prices, a colder-than-normal winter in the latter part of 1989 spurred an increase in demand for distillate fuel oils. The shipping and electric utilities industries contributed to a significant rise in demand for both distillate and residual fuels oils in 1989. A total of 72.9 billion gallons of fuel oil and kerosene were sold to consumers in 1989, an increase of 3.0 percent over 1988 sales volumes. Of all fuel oil sold during 1989, distillate fuel oil accounted for 68.3 percent, which was an increase over 1988 when distillate fuel oil accounted for 67.2more » percent of all fuel oil products sold in the United States. Residual fuel oil's share of total fuel oil sold fell slightly to 29.9 percent from 30.7 percent in 1988. Kerosene followed with a 1.8 percent share, also falling from the previous year when it accounted for a 2.1 percent share of total fuel oil sold. 3 figs., 24 tabs.« less

Case studies in international tobacco surveillance: cigarette smuggling in Brazil.

PubMed

Shafey, O; Cokkinides, V; Cavalcante, T M; Teixeira, M; Vianna, C; Thun, M

2002-09-01

This article is the first in a series of international case studies developed by the American Cancer Society to illustrate use of publicly available surveillance data for regional tobacco control. A descriptive analysis of Brazil and Paraguay cigarette production and trade data from official sources. Per capita cigarette consumption for Brazil and its neighbour was calculated from 1970 to 1998 using data on production, imports, and exports from NATIONS, the National Tobacco Information Online System. A 63% decrease was observed in the estimate of per capita consumption of cigarettes in Brazil between 1986 and 1998 (from 1913 cigarettes per person in 1986 to 714 cigarettes per person in 1998) and a 16-fold increase in Paraguay was observed during the same period (from 678 cigarettes per person in 1986 to 10 929 cigarettes per person in 1998). Following Brazil's 1999 passage of a 150% cigarette export tax, cigarette exports fell 89% and Brazil's estimated per capita consumption rose to 1990 levels (based on preliminary data). Per capita consumption in Paraguay also fell to 1990 levels. These trends coincide with local evidence that large volumes of cigarettes manufactured in Brazil for export to Paraguay are smuggled back and consumed as tax-free contraband in Brazil. It is hoped that this case study will draw wider public attention to the problems that smuggling presents for tobacco control, help identify other countries confronting similar issues, and stimulate effective interventions.

Effect of prolonged space flight on cardiac function and dimensions

NASA Technical Reports Server (NTRS)

Henry, W. L.; Epstein, S. E.; Griffith, J. M.; Goldstein, R. E.; Redwood, D. R.

1974-01-01

Echocardiographic studies were performed preflight 5 days before launch and on recovery day and 1, 2, 4, 11, 31 and 68 days postflight. From these echocardiograms measurements were made. From these primary measurements, left ventricular end-diastolic volume, end-systolic volume, stroke volume, and mass were derived using the accepted assumptions. Findings in the Scientist Pilot and Pilot resemble those seen in trained distance runners. Wall thickness measurements were normal in all three crewmembers preflight. Postflight basal studies were unchanged in the Commander on recovery day through 68 days postflight in both the Scientist Pilot and Pilot, however, the left ventricular end-diastolic volume, stroke volume, and mass were decreased slightly. Left ventricular function curves were constructed for the Commander and Pilot by plotting stroke volume versus end-diastolic volume. In both astronauts, preflight and postflight data fell on the same straight line demonstrating that no deterioration in cardiac function had occurred. These data indicate that the cardiovascular system adapts well to prolonged weightlessness and suggest that alterations in cardiac dimensions and function are unlikely to limit man's future in space.

Is forest management a significant source of monoterpenes into the boreal atmosphere?

NASA Astrophysics Data System (ADS)

Haapanala, S.; Hakola, H.; Hellén, H.; Vestenius, M.; Levula, J.; Rinne, J.

2012-04-01

Volatile organic compounds (VOCs) including terpenoids are emitted into the atmosphere from various natural sources. Damaging the plant tissue is known to strongly increase their monoterpene release. We measured the terpenoid emissions caused by timber felling, i.e. those from stumps and logging residue. The emissions from stumps were studied using enclosures and those from the whole felling area using an ecosystem-scale micrometeorological method, disjunct eddy accumulation (DEA). The compounds analyzed were isoprene, monoterpenes and sesquiterpenes. Strong emissions of monoterpenes were measured from both the stumps and from the whole felling area. The emission rate decreased rapidly within a few months after the logging. In addition to fresh logging residue, the results suggest also other strong monoterpene sources may be present in the felling area. These could include pre-existing litter, increased microbial activity and remaining undergrowth. In order to evaluate the possible importance of monoterpenes emitted annually from cut Scots pine forests in Finland, we conducted a rough upscaling calculation. The resulting monoterpene release was approximated to be on the order of 15 kilotonnes per year, which corresponds to about one tenth of the monoterpene release from intact forests in Finland.

Effects of brash removal after clear felling on soil and soil-solution chemistry and field-layer biomass in an experimental nitrogen gradient.

PubMed

Ring, E; Högbom, L; Nohrstedt, H O

2001-10-12

Biofuels, such as brash from forest fellings, have been proposed as an alternative energy source. Brash removal may affect the sustainability of forest production, e.g., through a change in the availability of cations and N in the soil. We report initial effects of brash removal on inorganic N content in humus and mineral soil, soil-solution chemistry, and field-layer biomass after clear felling an N-fertilisation experiment in central Sweden. The experiment comprised six different fertiliser levels, ranging from 0 to 600 kg N ha(-1). Urea was given every 5th year during 1967 to 1982 to replicated plots, giving total doses of 0 to 2400 kg N ha(-1). Clear felling took place in 1995, 13 years after the last fertilisation. The removal of brash decreased the NO3- content in the humus layer after clear felling. A decrease in the NO3- concentration of the soil solution was indicated during most of the study period as well. No effect of the previous N fertilisation was found in the humus layer, but in the mineral soil there was an increase in NO3- content for the highest N dose after clear felling ( p = 0.06). The soil-solution chemistry and the field-layer biomass showed an irregular pattern with no consistent effects of brash removal or previous fertilisation.

Effect of the economic recession on pharmaceutical policy and medicine sales in eight European countries

PubMed Central

Mantel-Teeuwisse, Aukje K; Vogler, Sabine; Valkova, Silvia; de Joncheere, Kees; Leufkens, Hubert GM; Wagner, Anita K; Ross-Degnan, Dennis; Laing, Richard

2014-01-01

Abstract Objective To identify pharmaceutical policy changes during the economic recession in eight European countries and to determine whether policy measures resulted in lower sales of, and less expenditure on, pharmaceuticals. Methods Information on pharmaceutical policy changes between 2008 and 2011 in eight European countries was obtained from publications and pharmaceutical policy databases. Data on the volume and value of the quarterly sales of products between 2006 and 2011 in the 10 highest-selling therapeutic classes in each country were obtained from a pharmaceutical market research database. We compared these indicators in economically stable countries; Austria, Estonia and Finland, to those in economically less stable countries, Greece, Ireland, Portugal, Slovakia and Spain. Findings Economically stable countries implemented two to seven policy changes each, whereas less stable countries implemented 10 to 22 each. Of the 88 policy changes identified, 33 occurred in 2010 and 40 in 2011. They involved changing out-of-pocket payments for patients in 16 cases, price mark-up schemes in 13 and price cuts in 11. Sales volumes increased moderately in all countries except Greece and Portugal, which experienced slight declines after 2009. Sales values decreased in both groups of countries, but fell more in less stable countries. Conclusion Less economically stable countries implemented more pharmaceutical policy changes during the recession than economically stable countries. Unexpectedly, pharmaceutical sales volumes increased in almost all countries, whereas sales values declined, especially in less stable countries. PMID:25378754

The Coast Artillery Journal. Volume 58, Number 6, June 1923

DTIC Science & Technology

1923-06-01

far from the shore. THE DARDANELLES EXPEDITIOX 505 At Beach V the defensive arrangements were excellent. A collier , the River Clyde, was utilized by...almost wiped out of existence. About 400 from the collier -assisted by naval personnel employed in constructing a short floating pier from the collier ...to the shore-managed to get ashore, but these were unable to accomplish anything. \\\\Then darkness fell, about a thousand more troops from the collier

Intelligence Scotomas in Central and South America (The Proteus Monograph Series, Volume 1, Issue 4, March 2008)

DTIC Science & Technology

2008-03-01

amerIca 3 catastrophic event was resident inside the intelligence community , and there were individuals shouting warnings, which tragically fell on deaf...riots of an unprecedented scale broke out in Sao Paulo. These were initiated by the Primeiro Comando Capital or PCC, (in English, the First...reality showed that with urban guerilla tactics and sophisticated command and control, communications , logistics, and superior intelligence networks

Sharps injury reduction: a six-year, three-phase study comparing use of a small patient-room sharps disposal container with a larger engineered container

PubMed Central

Naisoro, W

2014-01-01

A 350-bed Sydney hospital noted excessive container-associated sharps injuries (CASI) using small sharps containers and compared the effect from 2004 to 2010 of using a larger container engineered to reduce CASI. In Phase 1 (Ph1), disposable 1.4L containers (BD Australia) were carried to/from patients’ rooms. In Phase 2 (Ph2), this stopped and a safety-engineered 32L reusable container (the Device; Sharpsmart, SteriHealth) was mounted in medication stations only and sharps were carried to and from patient rooms using kidney dishes. In Phase 3 (Ph3), the Device was wall-mounted in patient rooms. Sharps injuries were categorised as ‘during-procedure’, ‘after-procedure but before disposal’, ‘CASI’, and ‘improper disposal SI’. Disposal-related SI comprised CASI plus improper-disposal SI. Injuries per 100 full-time-equivalent staff were analysed using Chi2; p ≤ 0.05; and relative risk and 95% confidence limits were calculated. In Ph1 (small containers) 19.4% of SI were CASI and transport injuries were zero. In Ph2 (Device in medication station) CASI fell 94.9% (p <0.001); Disposal-related SI fell 71.1% (p=0.002) but transport injuries rose significantly. In Ph3 (Device in patient room) zero CASI occurred (p<0.001); Disposal-related SI fell 83.1% (p=0.001). Recapping SI fell 85.1% (p=0.01) with the Device. The Device’s volume, large aperture, passive overfill-protection and close-at-hand siting are postulated as SI reduction factors. PMID:28989381

Computer simulated modeling of healthy and diseased right ventricular and pulmonary circulation.

PubMed

Chou, Jody; Rinehart, Joseph B

2018-01-12

We have previously developed a simulated cardiovascular physiology model for in-silico testing and validation of novel closed-loop controllers. To date, a detailed model of the right heart and pulmonary circulation was not needed, as previous controllers were not intended for use in patients with cardiac or pulmonary pathology. With new development of controllers for vasopressors, and looking forward, for combined vasopressor-fluid controllers, modeling of right-sided and pulmonary pathology is now relevant to further in-silico validation, so we aimed to expand our existing simulation platform to include these elements. Our hypothesis was that the completed platform could be tuned and stabilized such that the distributions of a randomized sample of simulated patients' baseline characteristics would be similar to reported population values. Our secondary outcomes were to further test the system in representing acute right heart failure and pulmonary artery hypertension. After development and tuning of the right-sided circulation, the model was validated against clinical data from multiple previously published articles. The model was considered 'tuned' when 100% of generated randomized patients converged to stability (steady, physiologically-plausible compartmental volumes, flows, and pressures) and 'valid' when the means for the model data in each health condition were contained within the standard deviations for the published data for the condition. A fully described right heart and pulmonary circulation model including non-linear pressure/volume relationships and pressure dependent flows was created over a 6-month span. The model was successfully tuned such that 100% of simulated patients converged into a steady state within 30 s. Simulation results in the healthy state for central venous volume (3350 ± 132 ml) pulmonary blood volume (405 ± 39 ml), pulmonary artery pressures (systolic 20.8 ± 4.1 mmHg and diastolic 9.4 ± 1.8 mmHg), left atrial pressure (4.6 ± 0.8 mmHg), PVR (1.0 ± 0.2 wood units), and CI (3.8 ± 0.5 l/min/m 2 ) all met criteria for acceptance of the model, though the standard deviations of LAP and CI were somewhat narrower than published comparators. The simulation results for right ventricular infarction also fell within the published ranges: pulmonary blood volume (727 ± 102 ml), pulmonary arterial pressures (30 ± 4 mmHg systolic, 12 ± 2 mmHg diastolic), left atrial pressure (13 ± 2 mmHg), PVR (1.6 ± 0.3 wood units), and CI (2.0 ± 0.4 l/min/m 2 ) all fell within one standard deviation of the reported population values and vice-versa. In the pulmonary hypertension model, pulmonary blood volume of 615 ± 90 ml, pulmonary arterial pressures of 80 ± 14 mmHg systolic, 36 ± 7 mmHg diastolic, and the left atrial pressure of 11 ± 2 mmHg all met criteria for acceptance. For CI, the simulated value of 2.8 ± 0.4 l/min/m 2 once again had a narrower spread than most of the published data, but fell inside of the SD of all published data, and the PVR value of 7.5 ± 1.6 wood units fell in the middle of the four published studies. The right-ventricular and pulmonary circulation simulation appears to be a reasonable approximation of the right-sided circulation for healthy physiology as well as the pathologic conditions tested.

The Milieu Manager: A Nursing Staffing Strategy to Reduce Observer Use in the Acute Psychiatric Inpatient Setting.

PubMed

Triplett, Patrick; Dearholt, Sandra; Cooper, Mary; Herzke, John; Johnson, Erin; Parks, Joyce; Sullivan, Patricia; Taylor, Karin F; Rohde, Judith

Rising acuity levels in inpatient settings have led to growing reliance on observers and increased the cost of care. Minimizing use of observers, maintaining quality and safety of care, and improving bed access, without increasing cost. Nursing staff on two inpatient psychiatric units at an academic medical center pilot-tested the use of a "milieu manager" to address rising patient acuity and growing reliance on observers. Nursing cost, occupancy, discharge volume, unit closures, observer expense, and incremental nursing costs were tracked. Staff satisfaction and reported patient behavioral/safety events were assessed. The pilot initiatives ran for 8 months. Unit/bed closures fell to zero on both units. Occupancy, patient days, and discharges increased. Incremental nursing cost was offset by reduction in observer expense and by revenue from increases in occupancy and patient days. Staff work satisfaction improved and measures of patient safety were unchanged. The intervention was effective in reducing observation expense and improved occupancy and patient days while maintaining patient safety, representing a cost-effective and safe approach for management of acuity on inpatient psychiatric units.

Learning lessons from natural disasters - sectorial or holistic perspectives?

NASA Astrophysics Data System (ADS)

Johansson, M.; Blumenthal, B.; Nyberg, L.

2009-04-01

Lessons learning from systematic analyses of past natural disasters is of great importance for future risk reduction and vulnerability management. It is one crucial piece of a puzzle towards disaster resilient societies, together with e.g. models of future emerging climate-related risks, globalization or demographic changes. Systematic analyses of impact and management of past events have commonly been produced in many sectors, but the knowledge is seldom shared outside the own organization or produced for other actors. To increase the availability of reports and documents, the Swedish Rescue Services Agency has created the Swedish Natural Hazards Information System, in accordance with a government commission from 2005. The system gathers accident reports, investigations and in-depth analyses, together with societal additional costs and mappings of consequences from central and local governments, NGO's and private actors. Evaluation of the collection reveals large differences in quality, systematic approach, depth and extent, clearly consistent with the lack of coherent harmonization of investigation and reporting approaches. Type of hazard, degree of impact and time elapsed since present are decisive for the collected volume. LPHC (low probability high consequences) disasters usually comprise most data and analytical activities, since they often are met with surprise and highlight the failure to integrate resilience into normal societal planning. During the last 50 years, several LPHC events in Sweden have functioned as alarm clocks and entailed major changes and improvements in government policies or legislations, safety management systems, risk assessments, response training, stakeholder communication, etc. Such an event occurred in January 2005 when Northern Europe was confronted with one of the most severe storms in modern history. Accidents that caused 24 fatalities occurred (17 in Sweden), several regions in UK and Germany were flooded and extensive areas of storm-felled forests left nearly one million households in Scandinavia without electricity. In Sweden the quantity of storm-felled trees was equivalent to the combined volume felled by other storms during the whole of the 20th century, which caused exceptional damage to forests, roads, railways and electricity and telecommunications networks, including cell-phones. Follow-ups and evaluations at local level, as regulated by law, together with government commissions to central authorities and interest from research communities, have resulted in an extensive production of documented lessons learning. Our case study describes their thematic extent, identifies different perspectives in relation to their basis for analyses, emphasizes the complementary need of a holistic perspective and puts the Swedish systematic procedure into an international comparison.

A study of parotid salivation in the horse

PubMed Central

Alexander, F.

1966-01-01

1. Saliva flowed from the horse's parotid duct only during mastication. 2. The surface-active local anaesthetic administered by mouth inhibited salivary secretion. 3. Salivary secretion was stimulated by pilocarpine and inhibited by atropine. 4. The volume and composition of saliva secreted in 24 hr from one parotid duct was determined. 5. The concentration of sodium, potassium, calcium, chloride and bicarbonate depended upon the rate of flow. The highest concentrations of these electrolytes were observed during periods of high flow rates. 6. Horse parotid saliva contained a high concentration of calcium. 7. In the absence of a dietary supplement of sodium bicarbonate, the sodium concentration of the saliva fell after about 21 days. There was an associated increase in the potassium concentration. The addition of a sodium supplement restored the sodium concentration of the saliva within 24 hr. PMID:5963737

Interactive effects between N addition and disturbance on boreal forest ecosystem structure and function

NASA Astrophysics Data System (ADS)

Nordin, Annika; Strengbom, Joachim; From, Fredrik

2014-05-01

In management of boreal forests, nitrogen (N) enrichment from atmospheric deposition or from forest fertilization can appear in combination with land-use related disturbances, i.e. tree harvesting by clear-felling. Long-term interactive effects between N enrichment and disturbance on boreal forest ecosystem structure and function are, however, poorly known. We investigated effects of N enrichment by forest fertilization done > 25 years ago on forest understory species composition in old-growth (undisturbed) forests, and in forests clear-felled 10 years ago (disturbed). In clear-felled forests we also investigated effects of the previous N addition on growth of tree saplings. The results show that the N enrichment effect on the understory species composition was strongly dependent on the disturbance caused by clear-felling. In undisturbed forests, there were small or no effects on understory species composition from N addition. In contrast, effects were large in forests first exposed to N addition and subsequently disturbed by clear-felling. Effects of N addition differed among functional groups of plants. Abundance of graminoids increased (+232%) and abundance of dwarf shrubs decreased (-44%) following disturbance in N fertilized forests. For vascular plants, the two perturbations had contrasting effects on α-(within forests) and β-diversity (among forests): in disturbed forests, N addition reduced, or had no effect on α-diversity, while β-diversity increased. For bryophytes, negative effects of disturbance on α-diversity were smaller in N fertilized forests than in forests not fertilized, while neither N addition nor disturbance had any effects on β-diversity. Moreover, sapling growth in forests clear-felled 10 years ago was significantly higher in previously N fertilized forests than in forests not fertilized. Our study show that effects of N addition on plant communities may appear small, short-lived, or even absent until exposed to a disturbance. This highlights the importance of considering interactive effects with disturbance when evaluating long-term effects of N enrichment on boreal forest ecosystem structure and function.

Moisture patterns in douglas-fir and tanoak slash

Treesearch

Norman C. Scott

1964-01-01

Moisture content in Douglas-fir cull logs and boles of felled tanoaks was sampled periodically at 2-inch intervals to a depth of 6 inches from October 1960-0ctober 1961. The study area had been clear cut in 1958 and the hardwoods felled in 1959. Analysis of the data showed that the moisture level in tanoak stems decreased at an increasing rate from a 6-inch depth to...

Ninety day mortality following pancreatoduodenectomy in England: has the optimum centre volume been identified?

PubMed

Liu, Z; Peneva, I S; Evison, F; Sahdra, S; Mirza, D F; Charnley, R M; Savage, R; Moss, P A; Roberts, K J

2018-06-09

Mortality following pancreatoduodenectomy is related to centre volume although the optimal volume is not defined. Patients undergoing PD between 2001 and 2016 were identified from UK national databases. The effects of patient variables, centre volume and time period upon 90 day mortality were studied. 90 day mortality (970/14,935, 6.5%) was related to advanced age, comorbidity, diagnosis, ethnicity, deprivation, centre volume and time period. Mortality rates fell markedly from 10.0% in 2001-4 to 4.1% in 2013-16. There was no difference in 90 day mortality between high (36 -60 PD per year) and very high volume (>60) centres. However, patients operated upon at very high volume centres were more elderly (66, 58 -73 vs 65, 56 -72; median, IQR; p = 0.006), deprived (38.7 vs 34.6%; p < 0.001) and co morbid (48.9 vs 46.1%; p = 0.027). Although a plateau in the centre volume and mortality relationship appears to have been demonstrated those patients treated at the highest volume centres were at higher risk of mortality. This data suggests therefore that to further understand outcomes from specialist centres characteristics of the patient population should be defined, not just centre volume. Copyright © 2018. Published by Elsevier Ltd.

Evaluation and optimization of compound solubilization and delivery methods in a two-tiered ion channel lead optimization triage.

PubMed

Hendricson, Adam W; Gallagher, Liz; Matchett, Michele; Ferrante, Meredith; Spence, Steve; Paiva, Tony; Shou, Wilson; Tertyshnikova, Svetlana; Krambis, Mike; Post-Munson, Deborah; Zhang, Litao; Knox, Ron

2012-04-01

Low-volume dispensing of neat dimethyl sulfoxide (DMSO) into plate-based assays conserves compound, assay reagents, and intermediate dilution plate cost and, as we demonstrate here, significantly improves structure-activity relationship resolution. Acoustic dispensing of DMSO solutions into standard volume 384W plates yielded inconsistent results in studies with 2 cell lines because of apparent effects on the integrity of the cell monolayer (increased intracellular Ca⁺⁺ levels as indicated by elevated basal dye fluorescence after acoustic transfer). PocketTip-mediated transfer was successful at increasing apparent potency on a more consistent basis. Notably, the correlation coefficient among fluorescence imaging plate reader (FLIPR):electrophysiology (EP) across a representative ~125 compound collection was increased ~5× via conversion to a PocketTip direct dispensation, indicating a triage assay more predictive of activity in the decisional patch-clamp assay. Very importantly, the EP-benchmarked false-negative rate as measured by compounds with FLIPR EC₅₀ more than the highest concentration tested fell from >11% to 5% assay-wide, and the relative FLIPR:EP rank-order fidelity increased from 55% to 78%. Elimination of the aqueous intermediate step provided additional benefits, including reduced assay cost, decreased cycle time, and reduced wet compound consumption rate. Direct DMSO dispensing has broad applicability to cell-based functional assays of multiple varieties, especially in cases where limit solubility in assay buffer is a recognized impediment to maximizing interassay connectivity.

Renal effects of continuous negative pressure breathing

NASA Technical Reports Server (NTRS)

Kinney, M. J.

1975-01-01

Continuous negative pressure breathing (CNPB) was utilized to simulate the thoracic vascular distension of zero G in 11 anesthetized rats. The animals underwent renal clearance and micropuncture renal nephron studies before, during, and after CNPB. Four rats were pretreated with a high salt diet and I-M desoxycorticosterone (DOCA) in excess. None of these rats diuresed with CNPB. In contrast, five of the seven remaining rats increased the fraction of the filtered sodium excreted and their urinary flow rate. Potassium excretion increased. End proximal tubular fluid specimen's TF/P inulin ratios were unchanged. Whole kidney and single nephron glomerular filtration rates fell 10%. CNPB, a mechanism for atrial distension, appears to cause in the rat a decrease in distal tubular sodium and water reabsorption. Exogenous mineral-corticoid prevents the diuresis, saluresis, and kaluresis. The adequacy of other nonatrial volume control mechanisms in regulating renal salt and water conservation in opposition to the studied atrial-renal (Henry-Gauer) reflex of thoracic vascular distension is confirmed.

Schedule-induced drinking as functions of interpellet interval and draught size in the Java macaque1

PubMed Central

Allen, Joseph D.; Kenshalo, Dan R.

1978-01-01

Three Java monkeys received food pellets that were assigned by both ascending and descending series of fixed-time schedules whose values varied between 8 and 256 seconds. The draught size dispensed by a concurrently available water-delivery tube was systematically varied between 1.0 and 0.3 milliliter per lick at various fixed-time values during the second and third series determinations. Session water intake was bitonically related to the interpellet interval and was determined by the interaction of (1) the probability of initiating a drinking bout, which fell off at the highest interpellet intervals and, (2) the size of the bout, which increased directly with increases in interpellet interval. Variations in draught size had little effect on total session intakes, but reduced bout size at draught sizes of 0.5 milliliter and below. Thus, a volume-regulation process of schedule-induced drinking operated generally at the session-intake level, but was limited to higher draught sizes at the bout level. PMID:16812093

Schedule-induced drinking as functions of interpellet interval and draught size in the Java macaque.

PubMed

Allen, J D; Kenshalo, D R

1978-09-01

Three Java monkeys received food pellets that were assigned by both ascending and descending series of fixed-time schedules whose values varied between 8 and 256 seconds. The draught size dispensed by a concurrently available water-delivery tube was systematically varied between 1.0 and 0.3 milliliter per lick at various fixed-time values during the second and third series determinations. Session water intake was bitonically related to the interpellet interval and was determined by the interaction of (1) the probability of initiating a drinking bout, which fell off at the highest interpellet intervals and, (2) the size of the bout, which increased directly with increases in interpellet interval. Variations in draught size had little effect on total session intakes, but reduced bout size at draught sizes of 0.5 milliliter and below. Thus, a volume-regulation process of schedule-induced drinking operated generally at the session-intake level, but was limited to higher draught sizes at the bout level.

Beta-erythropoietin effects on ventricular remodeling, left and right systolic function, pulmonary pressure, and hospitalizations in patients affected with heart failure and anemia.

PubMed

Palazzuoli, Alberto; Silverberg, Donald S; Calabrò, Anna; Spinelli, Tommaso; Quatrini, Ilaria; Campagna, Maria S; Franci, Beatrice; Nuti, Ranuccio

2009-06-01

Anemia in heart failure is related to advanced New York Heart Association classes, severe systolic dysfunction, and reduced exercise tolerance. Although anemia is frequently found in congestive heart failure (CHF), little is known about the effect of its' correction with erythropoietin (EPO) on cardiac structure and function. The present study examines, in patients with advanced CHF and anemia, the effects of beta-EPO on left ventricular volumes, left ventricular ejection fraction (LVEF), left and right longitudinal function mitral anular plane systolic excursion (MAPSE), tricuspid anular plane excursion (TAPSE), and pulmonary artery pressures in 58 patients during 1-year follow-up in a double-blind controlled study of correction of anemia with subcutaneous beta-EPO. Echocardiographic evaluation, B-Type natriuretic peptide (BNP) levels, and hematological parameters are reported at 4 and 12 months. The patients in group A after 4 months of follow-up period demonstrated an increase in LVEF and MAPSE (P < 0.05 and P < 0.01, respectively) with left ventricular systolic volume reduction (P < 0.02) with respect to baseline and controls. After 12 months, results regarding left ventricular systolic volume LVEF and MAPSE persisted (P < 0.001). In addition, TAPSE increased and pulmonary artery pressures fell significantly in group A (P < 0.01). All these changes occurred together with a significant BNP reduction and significant hemoglobin increase in the treated group. Therefore, we revealed a reduced hospitalization rate in treated patients with respect to the controls (25% in treated vs. 54% in controls). In patients with anemia and CHF, correction of anemia with beta-EPO and oral iron over 1 year leads to an improvement in left and right ventricular systolic function by reducing cardiac remodeling, BNP levels, and hospitalization rate.

Case studies in international tobacco surveillance: cigarette smuggling in Brazil

PubMed Central

Shafey, O; Cokkinides, V; Cavalcante, T; Teixeira, M; Vianna, C; Thun, M

2002-01-01

Objective: This article is the first in a series of international case studies developed by the American Cancer Society to illustrate use of publicly available surveillance data for regional tobacco control. Design: A descriptive analysis of Brazil and Paraguay cigarette production and trade data from official sources. Methods: Per capita cigarette consumption for Brazil and its neighbour was calculated from 1970 to 1998 using data on production, imports, and exports from NATIONS, the National Tobacco Information Online System. Results: A 63% decrease was observed in the estimate of per capita consumption of cigarettes in Brazil between 1986 and 1998 (from 1913 cigarettes per person in 1986 to 714 cigarettes per person in 1998) and a 16-fold increase in Paraguay was observed during the same period (from 678 cigarettes per person in 1986 to 10 929 cigarettes per person in 1998). Following Brazil's 1999 passage of a 150% cigarette export tax, cigarette exports fell 89% and Brazil's estimated per capita consumption rose to 1990 levels (based on preliminary data). Per capita consumption in Paraguay also fell to 1990 levels. Conclusions: These trends coincide with local evidence that large volumes of cigarettes manufactured in Brazil for export to Paraguay are smuggled back and consumed as tax-free contraband in Brazil. It is hoped that this case study will draw wider public attention to the problems that smuggling presents for tobacco control, help identify other countries confronting similar issues, and stimulate effective interventions. PMID:12198271

Effect of a central redistribution of fluid volume on response to lower-body negative pressure

NASA Technical Reports Server (NTRS)

Tomaselli, Clare M.; Frey, Mary A. B.; Kenney, Richard A.; Hoffler, G. Wyckliffe

1990-01-01

Cardiovascular responses to lower-body negative pressure (LBNP) were studied following 1 hour of 6-deg head-down tilt to determine whether a redistribution of blood volume toward the central circulation modifies the subsequent response to orthostatic stress. Responses of 12 men, ages 30-39 years, were evaluated by electrocardiography, impedance cardiography, sphygmomanometry, and measurement of calf circumference. During the LBNP that followed head-down tilt, as compared with control LBNP (no preceding head-down tilt) subjects, had smaller stroke volume and cardiac output, greater total peripheral resistance, and less calf enlargement. These differences reflect differences in the variables immediately preceding LBNP. Magnitudes of the responses from pre-LBNP to each pressure stage of the LBNP procedure did not differ between protocols. Mean and diastolic arterial pressures were slightly elevated after LBNP-control, but they fell slightly during LBNP post-tilt.

Continuous distributions of specific ventilation recovered from inert gas washout

NASA Technical Reports Server (NTRS)

Lewis, S. M.; Evans, J. W.; Jalowayski, A. A.

1978-01-01

A new technique is described for recovering continuous distributions of ventilation as a function of tidal ventilation/volume ratio from the nitrogen washout. The analysis yields a continuous distribution of ventilation as a function of tidal ventilation/volume ratio represented as fractional ventilations of 50 compartments plus dead space. The procedure was verified by recovering known distributions from data to which noise had been added. Using an apparatus to control the subject's tidal volume and FRC, mixed expired N2 data gave the following results: (a) the distributions of young, normal subjects were narrow and unimodal; (b) those of subjects over age 40 were broader with more poorly ventilated units; (c) patients with pulmonary disease of all descriptions showed enlarged dead space; (d) patients with cystic fibrosis showed multimodal distributions with the bulk of the ventilation going to overventilated units; and (e) patients with obstructive lung disease fell into several classes, three of which are illustrated.

Military Review. Volume 83, Number 6, November-December 2003

DTIC Science & Technology

2003-12-01

Chechnya on 20 January 1996 is an example of a typical insurgent attack. As darkness fell, a team of from 10 to 12 insurgents surrounded the CP un- noticed...their posts and withdrew haphazardly to the regi- mental field site. On 31 May 1996 , a rebel detachment captured a regimental CP near Shuanya. Before...personnel. An insurgent group might include one or two snip- ers (an observer and a shooter ) and combat engi- neers who mine the firing position after

Does Price Transparency Improve Market Efficiency? Implications of Empirical Evidence in Other Markets for the Health Sector

DTIC Science & Technology

2007-07-24

for many high-volume stocks of CRS-3 1 William H. Christie and Paul H. Schultz, “Did NASDAQ Market Makers Implicitly Collude?,” Journal of Economic...abandoned, and spreads for several major stocks fell by about half.1 Some other examples of transparency in financial markets suggested transparency lowered...losses. CRS-34 67 For a more detailed description of the structure of modern financial markets, see Hans R. Stoll, “Electronic Trading in Stock

Evaluation of stem rot in 339 Bornean tree species: implications of size, taxonomy, and soil-related variation for aboveground biomass estimates

NASA Astrophysics Data System (ADS)

Heineman, K. D.; Russo, S. E.; Baillie, I. C.; Mamit, J. D.; Chai, P. P.-K.; Chai, L.; Hindley, E. W.; Lau, B.-T.; Tan, S.; Ashton, P. S.

2015-10-01

Fungal decay of heart wood creates hollows and areas of reduced wood density within the stems of living trees known as stem rot. Although stem rot is acknowledged as a source of error in forest aboveground biomass (AGB) estimates, there are few data sets available to evaluate the controls over stem rot infection and severity in tropical forests. Using legacy and recent data from 3180 drilled, felled, and cored stems in mixed dipterocarp forests in Sarawak, Malaysian Borneo, we quantified the frequency and severity of stem rot in a total of 339 tree species, and related variation in stem rot with tree size, wood density, taxonomy, and species' soil association, as well as edaphic conditions. Predicted stem rot frequency for a 50 cm tree was 53 % of felled, 39 % of drilled, and 28 % of cored stems, demonstrating differences among methods in rot detection ability. The percent stem volume infected by rot, or stem rot severity, ranged widely among trees with stem rot infection (0.1-82.8 %) and averaged 9 % across all trees felled. Tree taxonomy explained the greatest proportion of variance in both stem rot frequency and severity among the predictors evaluated in our models. Stem rot frequency, but not severity, increased sharply with tree diameter, ranging from 13 % in trees 10-30 cm DBH to 54 % in stems ≥ 50 cm DBH across all data sets. The frequency of stem rot increased significantly in soils with low pH and cation concentrations in topsoil, and stem rot was more common in tree species associated with dystrophic sandy soils than with nutrient-rich clays. When scaled to forest stands, the maximum percent of stem biomass lost to stem rot varied significantly with soil properties, and we estimate that stem rot reduces total forest AGB estimates by up to 7 % relative to what would be predicted assuming all stems are composed strictly of intact wood. This study demonstrates not only that stem rot is likely to be a significant source of error in forest AGB estimation, but also that it strongly covaries with tree size, taxonomy, habitat association, and soil resources, underscoring the need to account for tree community composition and edaphic variation in estimating carbon storage in tropical forests.

Age hardening of 6061/alumina-silica fiber composite

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

Khangaonkar, P.R.; Shamsul, J.B.; Azmi, R.

1994-12-31

Continuous alumina-silica fiber (Altex of Sumitomo) which yields high performance composites with some aluminium alloys was tried for squeeze cast 6061 based composites with volume fractions of 0.5 and 0.32, and the matrix microhardness and resistivity changes during age hardening were studied. The matrix in the composites hardened much more than the unreinforced alloy. Microhardness increases of up to 70 VPN above the solution treated condition at various aging temperatures were observed. The resistivity variation indicated an appreciable state of internal stress which continued to persist even when hardness fell by overaging. Energy dispersive X-ray analysis indicated that the regionsmore » close to the fibers had a higher silicon content than the matrix, and amorphous silica in the fiber may have a role in the formation of an enriched layer which may help the bonding and strength in the composite.« less

Effect of standing on neurohumoral responses and plasma volume in healthy subjects

NASA Technical Reports Server (NTRS)

Jacob, G.; Ertl, A. C.; Shannon, J. R.; Furlan, R.; Robertson, R. M.; Robertson, D.

1998-01-01

Upright posture leads to rapid pooling of blood in the lower extremities and shifts plasma fluid into surrounding tissues. This results in a decrease in plasma volume (PV) and in hemoconcentration. There has been no integrative evaluation of concomitant neurohumoral and PV shifts with upright posture in normal subjects. We studied 10 healthy subjects after 3 days of stable Na+ and K+ intake. PV was assessed by the Evans blue dye method and by changes in hematocrit. Norepinephrine (NE), NE spillover, epinephrine (Epi), vasopressin, plasma renin activity, aldosterone, osmolarity, and kidney response expressed by urine osmolality and by Na+ and K+ excretion of the subjects in the supine and standing postures were all measured. We found that PV fell by 13% (375 +/- 35 ml plasma) over approximately 14 min, after which time it remained relatively stable. There was a concomitant decrease in systolic blood pressure and an increase in heart rate that peaked at the time of maximal decrease in PV. Plasma Epi and NE increased rapidly to this point. Epi approached baseline by 20 min of standing. NE spillover increased 80% and clearance decreased 30% with 30 min of standing. The increase in plasma renin activity correlated with an increase in aldosterone. Vasopressin increased progressively, but there was no change in plasma osmolarity. The kidney response showed a significant decrease in Na+ and an increase in K+ excretion with upright posture. We conclude that a cascade of neurohumoral events occurs with upright posture, some of which particularly coincide with the decrease in PV. Plasma Epi levels may contribute to the increment in heart rate with maintained upright posture.

Effects of Heat Treatment on the Microstructure and Mechanical Properties of Low-Carbon Steel with Magnesium-Based Inclusions

NASA Astrophysics Data System (ADS)

Zhang, Jian; Feng, Pei-Hsien; Pan, Yan-Chi; Hwang, Weng-Sing; Su, Yen-Hao; Lu, Muh-Jung

2016-10-01

The effects of heat treatment on the microstructure and mechanical properties of Mg-containing (7 ppm), low-carbon commercial steel (SS400) were investigated. Twenty different heat treatment paths were performed using a Gleeble 1500 thermomechanical simulator. It was observed by using an optical microscope that as the cooling rate increased and holding temperature decreased, the volume fractions of pearlite, Widmanstätten ferrite, and grain boundary allotriomorphs ferrite fell, whereas that of acicular ferrite (AF) increased. Quantifying the fractions of AF and other phases by using electron backscatter diffraction shows that the heat treatment path with a cooling rate of 20 K/s and holding temperature of 723 K (450 °C) induced the highest volume fraction (44 pct) of AF. As such, the toughness of the sample was increased 12.4 times compared with that observed in the sample containing 4 pct AF. Typical inclusions were analyzed using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy. The results showed that the magnesium-based complex inclusions could act as nucleation sites of AF. Inclusions with a size of about 5 μm can serve as heterogeneous nucleation sites for AF. Mg-containing SS400 steel also has excellent hot-ductility in the temperature range of 973 K to 1273 K (700 °C to 1000 °C), and the minimum percentage reduction in area (R.A pct) value of around 63 pct at 1073 K (800 °C).

Reducing nosocomial infections in neonatal intensive care.

PubMed

Rogers, Eileen; Alderdice, Fiona; McCall, Emma; Jenkins, John; Craig, Stanley

2010-09-01

Nosocomial infection is a common problem in neonatal intensive care. A pilot quality improvement initiative focussing on hand hygiene and aimed at reducing nosocomial infection in very low birth weight (VLBW) infants was introduced in five Neonatal Intensive Care Units. Line associated laboratory confirmed bloodstream infection (LCBSI) and ventilator associated pneumonia (VAP) were chosen as main outcome measures. In VLBW infants, the rate of line associated LCBSI per 1000 central venous catheter days fell by 24%. The rate of VAP per 1000 ventilator days in VLBW infants fell by 38%. Pre- and post-intervention questionnaires showed a statistically significant increase in use of alcohol-based gels and increased knowledge of hand hygiene.

Traditional Medicare Versus Private Insurance: How Spending, Volume, And Price Change At Age Sixty-Five.

PubMed

Wallace, Jacob; Song, Zirui

2016-05-01

To slow the growth of Medicare spending, some policy makers have advocated raising the Medicare eligibility age from the current sixty-five years to sixty-seven years. For the majority of affected adults, this would delay entry into Medicare and increase the time they are covered by private insurance. Despite its policy importance, little is known about how such a change would affect national health care spending, which is the sum of health care spending for all consumers and payers-including governments. We examined how spending differed between Medicare and private insurance using longitudinal data on imaging and procedures for a national cohort of individuals who switched from private insurance to Medicare at age sixty-five. Using a regression discontinuity design, we found that spending fell by $38.56 per beneficiary per quarter-or 32.4 percent-upon entry into Medicare at age sixty-five. In contrast, we found no changes in the volume of services at age sixty-five. For the previously insured, entry into Medicare led to a large drop in spending driven by lower provider prices, which may reflect Medicare's purchasing power as a large insurer. These findings imply that increasing the Medicare eligibility age may raise national health care spending by replacing Medicare coverage with private insurance, which pays higher provider prices than Medicare does. Project HOPE—The People-to-People Health Foundation, Inc.

Traditional Medicare Versus Private Insurance: How Spending, Volume, And Price Change At Age Sixty-Five

PubMed Central

Wallace, Jacob; Song, Zirui

2016-01-01

To slow the growth of Medicare spending, some policy makers have advocated raising the Medicare eligibility age from the current sixty-five years to sixty-seven years. For the majority of affected adults, this would delay entry into Medicare and increase the time they are covered by private insurance. Despite its policy importance, little is known about how such a change would affect national health care spending, which is the sum of health care spending for all consumers and payers—including governments. We examined how spending differed between Medicare and private insurance using longitudinal data on imaging and procedures for a national cohort of individuals who switched from private insurance to Medicare at age sixty-five. Using a regression discontinuity design, we found that spending fell by $38.56 per beneficiary per quarter—or 32.4 percent—upon entry into Medicare at age sixty-five. In contrast, we found no changes in the volume of services at age sixty-five. For the previously insured, entry into Medicare led to a large drop in spending driven by lower provider prices, which may reflect Medicare's purchasing power as a large insurer. These findings imply that increasing the Medicare eligibility age may raise national health care spending by replacing Medicare coverage with private insurance, which pays higher provider prices than Medicare does. PMID:27140993

Relative contributions of set-asides and tree retention to the long-term availability of key forest biodiversity structures at the landscape scale.

PubMed

Roberge, Jean-Michel; Lämås, Tomas; Lundmark, Tomas; Ranius, Thomas; Felton, Adam; Nordin, Annika

2015-05-01

Over previous decades new environmental measures have been implemented in forestry. In Fennoscandia, forest management practices were modified to set aside conservation areas and to retain trees at final felling. In this study we simulated the long-term effects of set-aside establishment and tree retention practices on the future availability of large trees and dead wood, two forest structures of documented importance to biodiversity conservation. Using a forest decision support system (Heureka), we projected the amounts of these structures over 200 years in two managed north Swedish landscapes, under management scenarios with and without set-asides and tree retention. In line with common best practice, we simulated set-asides covering 5% of the productive area with priority to older stands, as well as ∼5% green-tree retention (solitary trees and forest patches) including high-stump creation at final felling. We found that only tree retention contributed to substantial increases in the future density of large (DBH ≥35 cm) deciduous trees, while both measures made significant contributions to the availability of large conifers. It took more than half a century to observe stronger increases in the densities of large deciduous trees as an effect of tree retention. The mean landscape-scale volumes of hard dead wood fluctuated widely, but the conservation measures yielded values which were, on average over the entire simulation period, about 2.5 times as high as for scenarios without these measures. While the density of large conifers increased with time in the landscape initially dominated by younger forest, best practice conservation measures did not avert a long-term decrease in large conifer density in the landscape initially comprised of more old forest. Our results highlight the needs to adopt a long temporal perspective and to consider initial landscape conditions when evaluating the large-scale effects of conservation measures on forest biodiversity. Copyright © 2015 Elsevier Ltd. All rights reserved.

Polygenic Risk Score for Alzheimer's Disease: Implications for Memory Performance and Hippocampal Volumes in Early Life.

PubMed

Axelrud, Luiza K; Santoro, Marcos L; Pine, Daniel S; Talarico, Fernanda; Gadelha, Ary; Manfro, Gisele G; Pan, Pedro M; Jackowski, Andrea; Picon, Felipe; Brietzke, Elisa; Grassi-Oliveira, Rodrigo; Bressan, Rodrigo A; Miguel, Eurípedes C; Rohde, Luis A; Hakonarson, Hakon; Pausova, Zdenka; Belangero, Sintia; Paus, Tomas; Salum, Giovanni A

2018-06-01

Alzheimer's disease is a heritable neurodegenerative disorder in which early-life precursors may manifest in cognition and brain structure. The authors evaluate this possibility by examining, in youths, associations among polygenic risk score for Alzheimer's disease, cognitive abilities, and hippocampal volume. Participants were children 6-14 years of age in two Brazilian cities, constituting the discovery (N=364) and replication samples (N=352). As an additional replication, data from a Canadian sample (N=1,029), with distinct tasks, MRI protocol, and genetic risk, were included. Cognitive tests quantified memory and executive function. Reading and writing abilities were assessed by standardized tests. Hippocampal volumes were derived from the Multiple Automatically Generated Templates (MAGeT) multi-atlas segmentation brain algorithm. Genetic risk for Alzheimer's disease was quantified using summary statistics from the International Genomics of Alzheimer's Project. Analyses showed that for the Brazilian discovery sample, each one-unit increase in z-score for Alzheimer's polygenic risk score significantly predicted a 0.185 decrement in z-score for immediate recall and a 0.282 decrement for delayed recall. Findings were similar for the Brazilian replication sample (immediate and delayed recall, β=-0.259 and β=-0.232, both significant). Quantile regressions showed lower hippocampal volumes bilaterally for individuals with high polygenic risk scores. Associations fell short of significance for the Canadian sample. Genetic risk for Alzheimer's disease may affect early-life cognition and hippocampal volumes, as shown in two independent samples. These data support previous evidence that some forms of late-life dementia may represent developmental conditions with roots in childhood. This result may vary depending on a sample's genetic risk and may be specific to some types of memory tasks.

Maple sap uptake, exudation, and pressure changes correlated with freezing exotherms and thawing endotherms.

PubMed

Tyree, M T

1983-10-01

Sap flow rates and sap pressure changes were measured in dormant sugar maple trees (Acer saccharum Marsh.). In the forest, sap flow rates and pressure changes were measured from tap holes drilled into tree trunks in mature trees and sap flow rates were measured from the base of excised branches. Excised branches were also brought into the laboratory where air temperature could be carefully controlled in a refrigerated box and sap flow rates and sap pressures were measured from the cut base of the branches.Under both forest and laboratory conditions, sap uptake occurred as the wood temperature declined but much more rapid sap uptake correlated with the onset of the freezing exotherm. When sap pressures were measured under conditions of negligible volume displacement, the sap pressure rapidly fell to -60 to -80 kilopascals at the start of the freezing exotherm. The volume of water uptake and the rate of uptake depended on the rate of freezing. A slow freezing rate correlated with a large volume of water uptake, a fast freezing rate induced a smaller volume of water uptake. The volume of water uptake ranged from 0.02 to 0.055 grams water per gram dry weight of sapwood. The volume of water exuded after thawing was usually less than the volume of uptake so that after several freezing and thawing cycles the sapwood water content increased from 0.7 to 0.8 grams water per gram dry weight.These results are discussed in terms of a physical model of the mechanism of maple sap uptake and exudation first proposed by P. E. R. O'Malley. The proposed mechanism of sap uptake is by vapor distillation in air filled wood fiber lumina during the freezing of minor branches. Gravity and pressurized air bubbles (compressed during freezing) cause sap flow from the canopy down the tree after the thaw.

Maple Sap Uptake, Exudation, and Pressure Changes Correlated with Freezing Exotherms and Thawing Endotherms 1

PubMed Central

Tyree, Melvin T.

1983-01-01

Sap flow rates and sap pressure changes were measured in dormant sugar maple trees (Acer saccharum Marsh.). In the forest, sap flow rates and pressure changes were measured from tap holes drilled into tree trunks in mature trees and sap flow rates were measured from the base of excised branches. Excised branches were also brought into the laboratory where air temperature could be carefully controlled in a refrigerated box and sap flow rates and sap pressures were measured from the cut base of the branches. Under both forest and laboratory conditions, sap uptake occurred as the wood temperature declined but much more rapid sap uptake correlated with the onset of the freezing exotherm. When sap pressures were measured under conditions of negligible volume displacement, the sap pressure rapidly fell to −60 to −80 kilopascals at the start of the freezing exotherm. The volume of water uptake and the rate of uptake depended on the rate of freezing. A slow freezing rate correlated with a large volume of water uptake, a fast freezing rate induced a smaller volume of water uptake. The volume of water uptake ranged from 0.02 to 0.055 grams water per gram dry weight of sapwood. The volume of water exuded after thawing was usually less than the volume of uptake so that after several freezing and thawing cycles the sapwood water content increased from 0.7 to 0.8 grams water per gram dry weight. These results are discussed in terms of a physical model of the mechanism of maple sap uptake and exudation first proposed by P. E. R. O'Malley. The proposed mechanism of sap uptake is by vapor distillation in air filled wood fiber lumina during the freezing of minor branches. Gravity and pressurized air bubbles (compressed during freezing) cause sap flow from the canopy down the tree after the thaw. PMID:16663208

Effect of regional trauma centralization on volume, injury severity and outcomes of injured patients admitted to trauma centres.

PubMed

Metcalfe, D; Bouamra, O; Parsons, N R; Aletrari, M O; Lecky, F E; Costa, M L

2014-07-01

Centralization of complex healthcare services into specialist high-volume centres is believed to improve outcomes. For injured patients, few studies have evaluated the centralization of major trauma services. The aim of this study was to evaluate how a regional trauma network affected trends in admissions, case mix, and outcomes of injured patients. A retrospective before-after study was undertaken of severely injured patients attending four hospitals that became major trauma centres (MTCs) in March 2012. Consecutive patients with major trauma were identified from a national registry and divided into two groups according to injury before or after the launch of a new trauma network. The two cohorts were compared for differences in case mix, demand on hospital resources, and outcomes. Patient volume increased from 442 to 1326 (200 per cent), operations from 349 to 1231 (253 per cent), critical care bed-days from 1100 to 3704 (237 per cent), and total hospital bed-days from 7910 to 22,772 (188 per cent). Patient age increased on MTC designation from 45.0  years before March 2012 to 48.2 years afterwards (P = 0.021), as did the proportion of penetrating injuries (1.8 versus 4.1 per cent; P = 0.025). Injury severity fell as measured by median Injury Severity Score (16 versus 14) and Revised Trauma Score (4.1 versus 7.8). Fewer patients required secondary transfer to a MTC from peripheral hospitals (19.9 versus 16.1 per cent; P = 0.100). There were no significant differences in total duration of hospital stay, critical care requirements or mortality. However, there was a significant increase, from 55.5 to 62.3 per cent (P < 0.001), in the proportion of patients coded as having a 'good recovery' at discharge after institution of the trauma network. MTC designation leads to an increased case volume with considerable implications for operating theatre capacity and bed occupancy. Although no mortality benefit was demonstrated within 6 months of establishing this trauma network, early detectable advantages included improved functional outcome at discharge. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

MCNP simulation of radiation doses distributions in a water phantoms simulating interventional radiology patients

NASA Astrophysics Data System (ADS)

He, Wenjun; Mah, Eugene; Huda, Walter; Selby, Bayne; Yao, Hai

2011-03-01

Purpose: To investigate the dose distributions in water cylinders simulating patients undergoing Interventional Radiological examinations. Method: The irradiation geometry consisted of an x-ray source, dose-area-product chamber, and image intensifier as currently used in Interventional Radiology. Water cylinders of diameters ranging between 17 and 30 cm were used to simulate patients weighing between 20 and 90 kg. X-ray spectra data with peak x-ray tube voltages ranging from 60 to 120 kV were generated using XCOMP3R. Radiation dose distributions inside the water cylinder (Dw) were obtained using MCNP5. The depth dose distribution along the x-ray beam central axis was normalized to free-in-air air kerma (AK) that is incident on the phantom. Scattered radiation within the water cylinders but outside the directly irradiated region was normalized to the dose at the edge of the radiation field. The total absorbed energy to the directly irradiated volume (Ep) and indirectly irradiated volume (Es) were also determined and investigated as a function of x-ray tube voltage and phantom size. Results: At 80 kV, the average Dw/AK near the x-ray entrance point was 1.3. The ratio of Dw near the entrance point to Dw near the exit point increased from ~ 26 for the 17 cm water cylinder to ~ 290 for the 30 cm water cylinder. At 80 kV, the relative dose for a 17 cm water cylinder fell to 0.1% at 49 cm away from the central ray of the x-ray beam. For a 30 cm water cylinder, the relative dose fell to 0.1% at 53 cm away from the central ray of the x-ray beam. At a fixed x-ray tube voltage of 80 kV, increasing the water cylinder diameter from 17 to 30 cm increased the Es/(Ep+Es) ratio by about 50%. At a fixed water cylinder diameter of 24 cm, increasing the tube voltage from 60 kV to 120 kV increased the Es/(Ep+Es) ratio by about 12%. The absorbed energy from scattered radiation was between 20-30% of the total energy absorbed by the water cylinder, and was affected more by patient size than x-ray beam energy. Conclusion: MCNP offers a powerful tool to study the absorption and transmission of x-ray energy in phantoms that can be designed to represent patients undergoing Interventional Radiological procedures. This ability will permit a systematic investigation of the relationship between patient dose and diagnostic image quality, and thereby keep patient doses As Low As Reasonably Achievable (ALARA).

Anti-Mullerian hormone-tailored stimulation protocols improve outcomes whilst reducing adverse effects and costs of IVF.

PubMed

Yates, A P; Rustamov, O; Roberts, S A; Lim, H Y N; Pemberton, P W; Smith, A; Nardo, L G

2011-09-01

Anti-Müllerian hormone (AMH) is increasingly used to quantify ovarian reserve, but it has not yet realized its full clinical potential in assisted reproduction technology. We investigated the possible benefits of using novel, stratified ovarian hyperstimulation protocols, tailored to individual AMH levels, compared with conventional stimulation. Retrospective data were collected from 769 women (first cycle of IVF, using fresh embryos), in a UK tertiary care unit: 346 women using conventional stimulation protocols; 423 women treated under new AMH-tailored protocols. Embryo transfer rates increased significantly (79-87%: P= 0.002) after the introduction of AMH-tailored stimulation protocols. Pregnancy rate per cycle started and live birth rate also increased significantly compared with conventionally treated women (17.9-27.7%, P= 0.002 and 15.9-23.9%, P = 0.007, respectively). Moreover, in the AMH group, the incidence of the ovarian hyperstimulation syndrome (OHSS) fell significantly (6.9-2.3%, P = 0.002) and failed fertilization fell from 7.8 to 4.5%. The cost of fertility drug treatment fell by 29% per patient and the overall cost of clinical management of OHSS fell by 43% in the AMH group. GnRH antagonist protocols, introduced as part of AMH-tailored treatment, may have contributed to the observed improvements: however, within the AMH-tailored group, the live birth rate was not significantly different between agonist and antagonist-treated groups. Although large, prospective, multicentre studies are indicated, we have clearly demonstrated that individualized, AMH-guided, controlled ovarian hyperstimulation protocols significantly improved positive clinical outcomes, reduced the incidence of complications and reduced the financial burden associated with assisted reproduction.

Effects of Clear-Fell Harvest on Bat Home Range

PubMed Central

Borkin, Kerry M.; Parsons, Stuart

2014-01-01

We investigated effects of roost loss due to clear-fell harvest on bat home range. The study took place in plantation forest, inhabited by the New Zealand long-tailed bat (Chalinolobus tuberculatus), in which trees are harvested between the ages 26–32 years. We determined home ranges by radiotracking different bats in areas that had and had not been recently clear-fell harvested. Home ranges were smaller in areas that had been harvested. Adult male bats selected 20–25 year old stands within home ranges before and after harvest. Males selected edges with open unplanted areas when harvest had not occurred but no longer selected these at proportions greater than their availability post harvest, probably because they were then readily available. This is the first radiotracking study to demonstrate a change in home range size and selection concomitant with felling of large areas of plantation forest, and thus quantify negative effects of forestry operations on this speciose group. The use of smaller home ranges post-harvest may reflect smaller colony sizes and lower roost availability, both of which may increase isolation of colonies and vulnerability to local extinction. PMID:24465938

A Continuation of Base-line Studies for Environmentally Monitoring Space Transportation Systems at John F. Kennedy Space Center. Volume 2; Chemical Studies of Rainfall and Soil Analysis

NASA Technical Reports Server (NTRS)

Madsen, B. C.

1980-01-01

The results of a study which was designed to monitor, characterize, and evaluate the chemical composition of precipitation (rain) which fell at the Kennedy Space Center, Florida (KSC) during the period July 1977 to March 1979 are reported. Results which were obtained from a soil sampling and associated chemical analysis are discussed. The purpose of these studies was to determine the environmental perturbations which might be caused by NASA space activities.

Retrospective economic analysis of the transfer of services from hospitals to the community: an application to an enhanced eye care service.

PubMed

Mason, Thomas; Jones, Cheryl; Sutton, Matt; Konstantakopoulou, Evgenia; Edgar, David F; Harper, Robert A; Birch, Stephen; Lawrenson, John G

2017-07-10

This research aims to evaluate the wider health system effects of the introduction of an intermediate-tier service for eye care. This research employs the Minor Eye Conditions Scheme (MECS), an intermediate-tier eye care service introduced in two London boroughs, Lewisham and Lambeth, in April 2013. Retrospective difference-in-differences analysis comparing changes over time in service use and costs between April 2011 and October 2014 in two commissioning areas that introduced an intermediate-tier service programme with changes in a neighbouring area that did not introduce the programme. MECS audit data; unit costs for MECS visits; volumes of first and follow-up outpatient attendances to hospital ophthalmology; the national schedule of reference costs. Volumes and costs of patients treated. In one intervention area (Lewisham), general practitioner (GP) referrals to hospital ophthalmology decreased differentially by 75.2% (95% CI -0.918% to -0.587%) for first attendances, and by 40.3% for follow-ups (95% CI -0.489% to -0.316%). GP referrals to hospital ophthalmology decreased differentially by 30.2% (95% CI -0.468% to -0.137%) for first attendances in the other intervention area (Lambeth). Costs increased by 3.1% in the comparison area between 2011/2012 and 2013/2014. Over the same period, costs increased by less (2.5%) in one intervention area and fell by 13.8% in the other intervention area. Intermediate-tier services based in the community could potentially reduce volumes of patients referred to hospitals by GPs and provide replacement services at lower unit costs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

X-ray examinations during pregnancy: National Natality Surveys, 1963 and 1980.

PubMed Central

Kaczmarek, R G; Moore, R M; Keppel, K G; Placek, P J

1989-01-01

Based on 1963 and 1980 National Natality Surveys, the rate of medical x-ray examinations during pregnancy per 100 mothers fell 34.2 percent. A decrease in chest x-ray examinations accounted for almost all of the decline in total x-ray examinations. The reductions were greater for older mothers and those who were not White. While the number of births fell from 4,071,000 in 1963 to 3,612,000 in 1980, the number of pelvimetry examinations actually increased by 45,000. PMID:2909188

Felling Infected Oaks in Natural Stands Reduces Dissemination of Polyporus Hispidus Spores

Treesearch

E. R. Toole; F. I. McCracken

1974-01-01

Felling or girdling willow oaks which exhibited Polyporus hispidus cankers reduced sporophore production within 3 yr. Since spore dissemination was horizontal and downward, spores produced on felled trees did not spread as far as those from standing trees. Felling, therefore, is a more advantageous means of control.

Microvasculature of the nasal salt gland of the duckling, Anas platyrhynchos: quantitative responses to osmotic adaptation and deadaptation studied with vascular corrosion casting.

PubMed

Hossler, F E; Olson, K R

1990-06-01

The three-dimensional microvasculature of the nasal salt gland of the duckling was studied by vascular corrosion casting and scanning electron microscopy. Changes in the vascular volume of the gland in response to osmotic stress were also determined using cast weights and densities. The richly vascularized gland is supplied on its medial surface by large branches of the supraorbital and ethmoidal arteries. Numerous arterial branches enter the gland and distribute to lobes via the interlobar connective tissue. Lobar arterioles penetrate to the periductal areas of the lobes before dividing into capillaries supplying the ductal epithelium and secretory tubules. Capillaries envelope the secretory tubules and run radially from the ducts toward the lobe periphery, so that blood flows counter to the tubular secretion. Blood is collected via venous plexuses seen as distinct drainage units on the periphery of each lobe. Veins exhibit large numbers of bicuspid valves. Following 1 day and 4 days of osmotic loading (feeding 1% NaCl), vascular volume of the gland increased fivefold and ninefold, respectively, a response that precedes and exceeds that of the gland weight or Na,K-ATPase activity. When salt water-adapted ducklings were fed fresh water for only 24 hr (deadaptation), vascular volume fell to 2.8 times the control level. Changes in blood flow to the gland during osmotic adaptation and deadaptation are rapid and dramatic and may represent the initial steps in the control of gland secretion.

Microbleeds versus macrobleeds: evidence for distinct entities.

PubMed

Greenberg, Steven M; Nandigam, R N Kaveer; Delgado, Pilar; Betensky, Rebecca A; Rosand, Jonathan; Viswanathan, Anand; Frosch, Matthew P; Smith, Eric E

2009-07-01

Small, asymptomatic microbleeds commonly accompany larger symptomatic macrobleeds. It is unclear whether microbleeds and macrobleeds represent arbitrary categories within a single continuum versus truly distinct events with separate pathophysiologies. We performed 2 complementary retrospective analyses. In a radiographic analysis, we measured and plotted the volumes of all hemorrhagic lesions detected by gradient-echo MRI among 46 consecutive patients with symptomatic primary lobar intracerebral hemorrhage diagnosed as probable or possible cerebral amyloid angiopathy. In a second neuropathologic analysis, we performed blinded qualitative and quantitative examinations of amyloid-positive vessel segments in 6 autopsied subjects whose MRI scans demonstrated particularly high microbleed counts (>50 microbleeds on MRI, n=3) or low microbleed counts (<3 microbleeds, n=3). Plotted on a logarithmic scale, the volumes of 163 hemorrhagic lesions identified on scans from the 46 subjects fell in a distinctly bimodal distribution with mean volumes for the 2 modes of 0.009 cm(3) and 27.5 cm(3). The optimal cut point for separating the 2 peaks (determined by receiver operating characteristics) corresponded to a lesion diameter of 0.57 cm. On neuropathologic analysis, the high microbleed-count autopsied subjects showed significantly thicker amyloid-positive vessel walls than the low microbleed-count subjects (proportional wall thickness 0.53+/-0.01 versus 0.37+/-0.01; P<0.0001; n=333 vessel segments analyzed). These findings suggest that cerebral amyloid angiopathy-associated microbleeds and macrobleeds comprise distinct entities. Increased vessel wall thickness may predispose to formation of microbleeds relative to macrobleeds.

Microbleeds versus Macrobleeds: Evidence for Distinct Entities

PubMed Central

Greenberg, SM; Nandigam, RNK; Delgado, P; Betensky, RA; Rosand, J; Viswanathan, A; Frosch, MP; Smith, EE

2009-01-01

Background and Purpose Small, asymptomatic microbleeds commonly accompany larger symptomatic macrobleeds. It is unclear whether microbleeds and macrobleeds represent arbitrary categories within a single continuum versus truly distinct events with separate pathophysiologies. Methods We performed two complementary retrospective analyses. In a radiographic analysis, we measured and plotted the volumes of all hemorrhagic lesions detected by gradient-echo MRI among 46 consecutive patients with symptomatic primary lobar intracerebral hemorrhage diagnosed as probable or possible cerebral amyloid angiopathy (CAA). In a second neuropathologic analysis, we performed blinded qualitative and quantitative examinations of amyloid-positive vessel segments in 6 autopsied subjects whose MRI scans demonstrated particularly high microbleed counts (>50 microbleeds on MRI, n=3) or low microbleed counts (<3 microbleeds, n=3). Results Plotted on a logarithmic scale, the volumes of 163 hemorrhagic lesions identified on scans from the 46 subjects fell in a distinctly bimodal distribution with mean volumes for the two modes of 0.009 cm3 and 27.5 cm3. The optimal cut-point for separating the two peaks (determined by receiver operating characteristics) corresponded to a lesion diameter of 0.57 cm. On neuropathologic analysis, the high microbleed-count autopsied subjects showed significantly thicker amyloid-positive vessel walls than the low microbleed-count subjects (proportional wall thickness 0.53±0.01 versus 0.37±0.01, p<.0001, n=333 vessel segments analyzed). Conclusions These findings suggest that CAA-associated microbleeds and macrobleeds comprise distinct entities. Increased vessel wall thickness may predispose to formation of microbleeds relative to macrobleeds. PMID:19443797

Beat by beat stroke volume assessment by PDE in upright and supine exercise

NASA Technical Reports Server (NTRS)

1980-01-01

A 3.0 MHz pulse Doppler echocardiograph was used to estimate instantaneous stroke volume and cardiac output in 8 men during steady state supine and upright exercise at 300 kpm/min which were compared with other studies utilizing invasive procedures. The mean transients in heart rate and stroke volume and cardiac output for the first 20 sec of exercise in each posture were then determined. Centerline blood velocities were obtained in the ascending aorta with the transducer positioned manually in the suprasternal notch. Mean supine values for stroke volume and cardiac output at rest and exercise were 111 (6.4) and 112 ml (9.7 L/min), respectively, for supine. The corresponding results for upright were 76 (5.6) and 92 ml (8.4 L/min). These values compare favorably with prior studies. The transient response of cardiac output following the onset of upright was about twice as fast as in S because of the rapid and almost immediate upsurge in stroke volume. In supine, only heart rate served to augment cardiac output as stroke volume initially fell. The faster initial aortic flow in upright must represent the rapid mobilization of pooled venous blood from the leg veins which more than accounts for the additional volume (184 ml) of blood passing through the aorta during upright compared with supine in the first 20 sec.

Urocortin-2 infusion in acute decompensated heart failure: findings from the UNICORN study (urocortin-2 in the treatment of acute heart failure as an adjunct over conventional therapy).

PubMed

Chan, W Y Wandy; Frampton, Christopher M; Crozier, Ian G; Troughton, Richard W; Richards, A Mark

2013-10-01

The purpose of this study is to investigate the effects of urocortin-2 as adjunct therapy in acute decompensated heart failure (ADHF). Urocortin-2 produced favorable integrated effects in experimental heart failure but there are no equivalent human data. We describe the first therapeutic study of urocortin-2 infusion in ADHF. Fifty-three patients with ADHF were randomly assigned to 5 ng/kg/min of urocortin-2 or placebo infusion for 4 h as an adjunct therapy. Changes in vital signs, plasma neurohormonal and renal indices during treatment were compared using repeated-measures analysis of covariance. Ten patients in each arm underwent more detailed invasive hemodynamic evaluation. Urocortin-2 produced greater falls in systolic blood pressure compared to placebo (16 ± 5.8 mm Hg, p < 0.001) with nonsignificant increases in heart rate (5.7 ± 3.8 beats/min, p = 0.07) and increased cardiac output (2.1 ± 0.4 l/min vs. -0.1 ± 0.4 l/min, p < 0.001) associated with a 47% reduction in calculated total peripheral resistance (p = 0.015). Falls in pulmonary artery and pulmonary capillary wedge pressures did not differ significantly between groups. Urocortin-2 reduced urine volume and creatinine clearance during infusion but these returned to above baseline level in the 8 h after infusion. Plasma renin activity rose briefly with urocortin-2 coinciding with reductions in blood pressure (p < 0.001). B-type natriuretic peptide levels fell significantly over 24 h with urocortin-2 (p < 0.01) but not with placebo. Urocortin-2 infusion in ADHF markedly augmented cardiac output without significant reflex tachycardia. Renal indices fell transiently concurrent with urocortin-2-induced reductions in blood pressure. Further investigations are required to uncover the full potential of urocortin-2 in treating ADHF. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Growth responses of mature loblolly pine to dead wood.manipulations.

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

Ulyshen, Michael D.; Horn, Scott; Hanula, James L.

Large-scale manipulations of dead wood in mature Pinus taeda L. stands in the southeastern United States included a major one-time input of logs (fivefold increase in log volume) created by felling trees onsite, annual removals of all dead wood above >10 cm in diameter and >60 cm in length, and a reference in which no manipulations took place. We returned over a decade later to determine how these treatments affected tree growth using increment cores. There were no significant differences in tree density, basal area or tree diameters among treatments at the time of sampling. Although tree growth was consistentlymore » higher in the log-input plots and lower in the removal plots, this was true even during the 5 year period before the experiment began. When growth data from this initial period were included in the model as a covariate, no differences in post-treatment tree growth were detected. It is possible that treatment effects will become apparent after more time has passed, however.« less

Cardiorespiratory effects of inelastic chest wall restriction.

PubMed

Miller, Jordan D; Beck, Kenneth C; Joyner, Michael J; Brice, A Glenn; Johnson, Bruce D

2002-06-01

We examined the effects of chest wall restriction (CWR) on cardiorespiratory function at rest and during exercise in healthy subjects in an attempt to approximate the cardiorespiratory interactions observed in clinical conditions that result in restrictive lung and/or chest wall changes and a reduced intrathoracic space. Canvas straps were applied around the thorax and abdomen so that vital capacity was reduced by >35%. Data were acquired at rest and during cycle ergometry at 25 and 45% of peak workloads. CWR elicited significant increases in the flow-resistive work performed on the lung (160%) and the gastric pressure-time integral (>400%) at the higher workload, but it resulted in a decrease in the elastic work performed on the lung (56%) compared with control conditions. With CWR, heart rate increased and stroke volume (SV) fell, resulting in >10% fall in cardiac output at rest and during exercise at matched workloads (P < 0.05). Blood pressure and catecholamines were significantly elevated during CWR exercise conditions (P < 0.05). We conclude that CWR significantly impairs SV during exercise and that a compensatory increase in heart rate does not prevent a significant reduction in cardiac output. O(2) consumption appears to be maintained via increased extraction and a redistribution of blood flow via sympathetic activation.

The potential of woody waste biomass from the logging activity at the natural forest of Berau District, East Kalimantan

NASA Astrophysics Data System (ADS)

Sari, D. R.; Ariyanto

2018-04-01

The fifth principles of Sustainable Forest Management of the Forest Stewardship Council (FSC) is to encourage the efficient use of forest products and services to ensure economic viability and a wide range of environmental and social benefits, and one of the criteria is to minimize logging waste. Therefore, identification, calculations, and monitoring of logging waste should be done. The purpose of this study were to know the potential of logging waste in logging area and to know the estimated volume of waste based on the Annual Allowable Cut (AAC). This research was carried out at PT Karya Lestari, Berau District, East Kalimantan. It was found that the highest percentage of waste was in the form of the main trunk canopy, followed by the branches, stump, twigs and the rest of the bucking. It was also found that there was quite strong positive relationship between the volume of felled trees with its logging waste volume, and the estimated volume of logging waste based on AAC was 40,623 m3 per year. This result shows that the potential logging waste is high and it is recommended for the company to do logging on trees with small volumes or lower diameter class (40-89 cm).

The relationship between wheezing and lung mechanics during methacholine-induced bronchoconstriction in asthmatic subjects.

PubMed

Spence, D P; Graham, D R; Jamieson, G; Cheetham, B M; Calverley, P M; Earis, J E

1996-08-01

Wheeze is a classic sign of airflow obstruction but relatively little is known of its mechanism of production or its relationship to the development of airflow obstruction. We studied eight asthmatic subjects age (mean +/- 5D) 42 +/- 5 yr, FEV1 2.46 +/- 0.36 L during an extended, symptom-limited methacholine challenge test. Breath sounds were detected by a microphone over the right upper anterior chest. Spectral analysis was by a fast Fourier transform algorithm. Mean FEV1 fell by 51 +/- 14% to 1.28 +/- 0.61 L during the challenge and airways resistance increased by 119 +/- 50%. There were no consistent changes in breathing pattern or tidal volume during the challenge. Wheeze occurred late in the challenge at the highest concentration of methacholine administered and only after expiratory tidal flow limitation had been reached. Five subjects developed wheeze on tidal breathing, the remaining three only wheezed on deep breathing. Wheezing sounds were reproducible between breaths, coefficient of variation of starting sound frequency was 4.2% and ending frequency 12%. Mean frequency of expiratory wheezes was 669 +/- 100 Hz and inspiratory wheezes 710 +/- 76 Hz. Expiratory wheeze fell in pitch during a breath (mean fall in sound frequency 187 +/- 43 Hz) but inspiratory wheezes were more variable. Expiratory wheezes occurred late in the respiratory cycle at a mean of 58% of the maximal tidal expiratory flow, whereas inspiratory wheezes occurred around maximal tidal inspiratory flows, suggesting that the mechanisms of production of inspiratory and expiratory wheezes may be different. In this model, the presence of wheeze during tidal breathing was a sign of severe airflow limitation.

Effect of aminophylline on tryptophan and other aromatic amino acids in plasma, brain and other tissues and on brain 5-hydroxytryptamine metabolism.

PubMed

Curzon, G; Fernando, J C

1976-12-01

1 Aminophylline and other methylxanthines increase brain tryptophan and hence 5-hydroxytryptamine turnover. The mechanism of this effect of aminophylline was investigated. 2 At lower doses (greater than 100 mg/kg i.p.) the brain tryptophan increase could be explained by the lipolytic action of the drug, i.e. increased plasma unesterified fatty acid freeing plasma tryptophan from protein binding so that it became available to the brain. 3 Plasma unesterified fatty acid did not increase when aminophylline (109 mg/kg i.p.) was given to nicotinamide-treated rats but as both plasma total and free tryptophan rose, a tryptophan increase in the brain still occurred. 4 The rise in brain tryptophan concentration following the injection of a higher dose of the drug (150 mg/kg i.p.) could no longer be explained by a rise of plasma free tryptophan as the ratio of brain tryptophan to plasma free tryptophan rose considerably. Plasma total tryptophan fell and the plasma insulin concentration rose. 5 The increase of brain tryptophan concentration after injection of 150 mg/kg aminophylline appeared specific for this amino acid as brain tyrosine and phenyllanine did not increase. However as their plasma concentrations fell the brain/plasma ratio for all three amino acids rose. 6 The higher dose of aminophylline increased the muscle concentration of tryptophan but that of tyrosine fell and that of phenylalanine remained unaltered. The liver concentrations were not affected. 7 The aminophylline-induced increase of the ratio of brain tryptophan of plasma free tryptophan no longer occurred when the drug was given to animals injected with the beta-adrenoreceptor blocking agent propranolol or the diabetogenic agent streptozotocin. 8 The changes in brain tryptophan upon aminophylline injection may be explained by (a) increased availability of plasma tryptophan to the brain due to increased lipolysis and (b) increased effectiveness of uptake of tryptophan by the brain due to increased insulin secretion.

Neonatal Hypoxia, Hippocampal Atrophy, and Memory Impairment: Evidence of a Causal Sequence

PubMed Central

Cooper, Janine M.; Gadian, David G.; Jentschke, Sebastian; Goldman, Allan; Munoz, Monica; Pitts, Georgia; Banks, Tina; Chong, W. Kling; Hoskote, Aparna; Deanfield, John; Baldeweg, Torsten; de Haan, Michelle; Mishkin, Mortimer; Vargha-Khadem, Faraneh

2015-01-01

Neonates treated for acute respiratory failure experience episodes of hypoxia. The hippocampus, a structure essential for memory, is particularly vulnerable to such insults. Hence, some neonates undergoing treatment for acute respiratory failure might sustain bilateral hippocampal pathology early in life and memory problems later in childhood. We investigated this possibility in a cohort of 40 children who had been treated neonatally for acute respiratory failure but were free of overt neurological impairment. The cohort had mean hippocampal volumes (HVs) significantly below normal control values, memory scores significantly below the standard population means, and memory quotients significantly below those predicted by their full scale IQs. Brain white matter volume also fell below the volume of the controls, but brain gray matter volumes and scores on nonmnemonic neuropsychological tests were within the normal range. Stepwise linear regression models revealed that the cohort's HVs were predictive of degree of memory impairment, and gestational age at treatment was predictive of HVs: the younger the age, the greater the atrophy. We conclude that many neonates treated for acute respiratory failure sustain significant hippocampal atrophy as a result of the associated hypoxia and, consequently, show deficient memory later in life. PMID:24343890

Neonatal hypoxia, hippocampal atrophy, and memory impairment: evidence of a causal sequence.

PubMed

Cooper, Janine M; Gadian, David G; Jentschke, Sebastian; Goldman, Allan; Munoz, Monica; Pitts, Georgia; Banks, Tina; Chong, W Kling; Hoskote, Aparna; Deanfield, John; Baldeweg, Torsten; de Haan, Michelle; Mishkin, Mortimer; Vargha-Khadem, Faraneh

2015-06-01

Neonates treated for acute respiratory failure experience episodes of hypoxia. The hippocampus, a structure essential for memory, is particularly vulnerable to such insults. Hence, some neonates undergoing treatment for acute respiratory failure might sustain bilateral hippocampal pathology early in life and memory problems later in childhood. We investigated this possibility in a cohort of 40 children who had been treated neonatally for acute respiratory failure but were free of overt neurological impairment. The cohort had mean hippocampal volumes (HVs) significantly below normal control values, memory scores significantly below the standard population means, and memory quotients significantly below those predicted by their full scale IQs. Brain white matter volume also fell below the volume of the controls, but brain gray matter volumes and scores on nonmnemonic neuropsychological tests were within the normal range. Stepwise linear regression models revealed that the cohort's HVs were predictive of degree of memory impairment, and gestational age at treatment was predictive of HVs: the younger the age, the greater the atrophy. We conclude that many neonates treated for acute respiratory failure sustain significant hippocampal atrophy as a result of the associated hypoxia and, consequently, show deficient memory later in life. © The Author 2013. Published by Oxford University Press.

Nonoccupational logging fatalities--Vermont, 1997-2007.

PubMed

2008-03-14

Professional logging is one of the most hazardous occupations in the United States, and the factors contributing to injuries and fatalities associated with this occupation are well documented. However, little has been reported about logging fatalities in the nonoccupational setting. To better characterize nonoccupational logging fatalities, the Vermont Department of Health analyzed medical examiner data from Vermont for the period 1997-2007. This report describes four cases and summarizes data on all nonoccupational logging fatalities. The findings indicated that tree felling accounted for 15 (83%) of the 18 nonoccupational logging fatalities during the 11-year period and that 14 (78%) of the fatalities were attributed to injuries resulting from being struck by a falling tree or limb. Contributing factors in these incidents included absence of personal protective equipment (PPE), misjudgment of the path of falling trees, and being alone. Measures to reduce nonoccupational logging fatalities should focus on promoting safe tree-felling practices and increasing helmet use among nonprofessional woodcutters. Ideally, however, nonprofessionals should not participate in tree felling.

Reduction in diabetic amputations over 11 years in a defined U.K. population: benefits of multidisciplinary team work and continuous prospective audit.

PubMed

Krishnan, Singhan; Nash, Fiona; Baker, Neil; Fowler, Duncan; Rayman, Gerry

2008-01-01

To assess changes in diabetic lower-extremity amputation rates in a defined relatively static population over an 11-year period following the introduction of a multidisciplinary foot team. All diabetic patients with foot problems admitted to Ipswich Hospital, a large district general hospital, were identified by twice-weekly surveillance of all relevant in-patient areas and outcomes including amputations recorded. The incidence of major amputations fell 62%, from 7.4 to 2.8 per 100,000 of the general population. Total amputation rates also decreased (40.3%) but to a lesser extent due to a small increase in minor amputations. Expressed as incidence per 10,000 people with diabetes, total amputations fell 70%, from 53.2 to 16.0, and major amputations fell 82%, from 36.4 to 6.7. Significant reductions in total and major amputation rates occurred over the 11-year period following improvements in foot care services including multidisciplinary team work.

Impact of drying and composting procedures on the concentrations of 4-nonylphenols, di-(2-ethylhexyl)phthalate and polychlorinated biphenyls in anaerobically digested sewage sludge.

PubMed

Gibson, Richard W; Wang, Min-Jian; Padgett, Emma; Lopez-Real, Joe M; Beck, Angus J

2007-07-01

Enhanced treatments of sewage sludge produce a more manageable product for agricultural use by stabilizing the material, removing water, and reducing the possibility of pathogen transfer. We investigated the impact of pilot-scale composting and drying of sludge on physicochemical characteristics and on the concentrations of some organic contaminants. During the 143 day composting procedure, organic matter fell 22% and moisture by half. Concentrations of 4-nonylphenols (4-NPs) fell by 88% and di-(2-ethylhexyl) phthalate (DEHP) by 60%; losses continued throughout the procedure. Losses of total polychlorinated biphenyls (PCBs) were 11%, mostly from the lower molecular weight congeners, suggesting volatilization as the most likely loss mechanism. The drying process was much shorter, 40 days, yet organic matter content decreased by 27% and moisture by 85%. Losses of 4-NPs (39%) and DEHP (22%) were less than in composting and stopped when moisture content became constant. There were no losses of PCBs. Both treatments are simple, practical procedures that reduce the volume of waste and are applicable in situ on farms. Composting would be the method of choice for reducing organic contaminants but requires much longer times than drying.

The 18 May 1980 eruption of Mount St. Helens: The nature of the eruption, with an atmospheric perspective

NASA Technical Reports Server (NTRS)

Rose, W. I., Jr.; Hoffman, M. F.

1982-01-01

Mount St. Helens erupted somewhat less than 0.5 cu km of magma (dense rock equivalent) on May 18, 1980. The May 18 event was usually violent. As much 35% of the volume of the airfall material fell outside of the 2.5 mm isopach, which encloses about 88,000 sq km. This extraordinary dispersive power was transmitted by an eruption column which reached heights of more than 20 km. There was a lateral blast (or surge) of unusually large dimensions associated with the onset of the eruption. The magma is dacitic in composition and had a low ( 500 ppm) sulfur content. Distal ashes contain much nonmagmatic (lithic) material, but smaller ( 50 microns m) particles are mostly finely divided magmatic dacite. The grain size distributions of the ash are multimodal, frequently with peaks at 90, 25, and 10 microns. The finer populations fell out faster than their terminal velocities as simple particles would suggest. It is inferred that large proportions of the fine ash fell out as composite particles. This condition greatly reduces the atmospheric burden of silicate particles. Some of the unusual aspects (violence, intense surges, multimodal grain size distributions, lithic content of the ashes) of the eruption may be due to its phreatomagmatic character. The hydrothermal system above the magma may have infiltrated the magma body at the onset of the eruption. An "overprint" of the geochemistry of this hydrothermal system on the geochemistry of the magmatic gas system is likely. One important feature is that reduced gas species may be much more abundant than in many eruptions. Another is that fine ash may form aggregates more readily.

[Physiological responses of five plants in northwest China arid area under drought stress].

PubMed

Ding, Long; Zhao, Hui Min; Zeng, Wen Jing; Li, Qing; Wang, Yang; Wang, Si Qing

2017-05-18

Effects of drought stress on photosynthetic characteristics, water status, physiological and biochemical indexes were studied in five arid area plants in northwest China, including Potentilla fruticosa, Lycium ruthenicum, Caryopteris mongholica, Caragana korshinskii and Hedysarum scoparium, using pot experiments. The results showed that with the prolongation of drought stress, the water conservation capacity of leaves totally increased in above five plants, the leaf relative water content rose first and then fell, and the relative chlorophyll content and chlorophyll fluorescence parameters decreased to some extent. Overall, the photosynthetic system of H. scoparium and L. ruthenicum least affected by the stress, and P. fruticosa suffered with the most serious damage. The electric conductivity and malondialdehyde (MDA) content of P. fruticosa firstly decreased and then sharply increased, while superoxide dismutase (SOD) and peroxidase (POD) activities firstly increased and then dramatically decreased. With the decrease of soil water content, the electric conductivity rose firstly and then fell in the other four plants,the change of MDA content rose first and then fell, or fell first and then rose, and the activities of SOD and POD almost displayed upward trend. Especially, SOD activity of C. mongholica and POD activity of H. scoparium had the biggest increment among the five plants after 28 days of drought stress, increasing by 1.1 and 13.1 times respectively, compared with before processing. Additionally, there was significant variance in the accumulation of organic solutes among the five plants during the drought stress treatment. The accumulation of soluble sugar and free proline was the most in P. fruticosa, increasing by 1.1 and 22.4 times respectively, after 28 days of drought treatment. H. sco-parium accumulated the most soluble protein, increasing by 1.0 times after 28 days of drought treatment. The result of membership function method showed that the drought tolerance decreased in order of H. scoparium ＞ L. ruthenicum ＞ C. korshinskii ＞ C. mongholica ＞ P. fruticosa. The research revealed that all five plants could make positive response to drought stress through improving the activity of antioxidant enzymes and accumulating organic solutes, which could help to reduce cell damage. P. fruticos was most sensitive to water deficit in the five plants, and the degree of drought had exceeded its own regulated capacity threshold during the experiment.

Composition and functionality of bone affected by dietary glycated compounds.

PubMed

Delgado-Andrade, Cristina; Roncero-Ramos, Irene; Carballo, José; Rufián-Henares, Joséángel; Seiquer, Isabel; Navarro, María Pilar

2013-04-25

Our aim was to investigate the effects of Maillard reaction products (MRPs) from bread crust (BC) on bone composition and its mechanical properties, determining whether any such effects are related to the molecular weight of different MRPs. For 88 days after weaning rats were fed a control diet or diets containing BC, or its soluble low molecular weight (LMW), soluble high molecular weight (HMW) or insoluble fractions. Animals' food consumption and body weights were monitored. After sacrifice, the femur, pelvic bone and tibia were removed for composition, physical and biomechanical properties analysis. It was found that body and femur weights, density, volume and organic matrix decreased, whereas pentosidine increased after consumption of experimental diets, especially in the HMW and insoluble groups (104.7 and 102.9 mmol mol(-1) collagen) vs. the control group (41.7 mmol mol(-1) collagen). Bone stiffness fell by 50% in the LMW, HMW and insoluble groups and failure load and energy to failure tended to decrease in the same animals after MRPs intake. Consumption of diets containing assayed MRPs during growth leads to lower bone size and introduces some changes in its mechanical behavior which appear to be related to an increase in the pentosidine level of bone.

Physiological adjustment to salt stress in Jatropha curcas is associated with accumulation of salt ions, transport and selectivity of K+, osmotic adjustment and K+/Na+ homeostasis.

PubMed

Silva, E N; Silveira, J A G; Rodrigues, C R F; Viégas, R A

2015-09-01

This study assessed the capacity of Jatropha curcas to physiologically adjust to salinity. Seedlings were exposed to increasing NaCl concentrations (25, 50, 75 and 100 mm) for 15 days. Treatment without NaCl was adopted as control. Shoot dry weight was strongly reduced by NaCl, reaching values of 35% to 65% with 25 to 100 mm NaCl. The shoot/root ratio was only affected with 100 mm NaCl. Relative water content (RWC) increased only with 100 mm NaCl, while electrolyte leakage (EL) was much enhanced with 50 mm NaCl. The Na(+) transport rate to the shoot was more affected with 50 and 100 mm NaCl. In parallel, Cl(-) transport rate increased with 75 and 100 mm NaCl, while K(+) transport rate fell from 50 mm to 100 mm NaCl. In roots, Na(+) and Cl(-) transport rates fell slightly only in 50 mm (to Na(+)) and 50 and 100 mm (to Cl(-)) NaCl, while K(+) transport rate fell significantly with increasing NaCl. In general, our data demonstrate that J. curcas seedlings present changes in key physiological processes that allow this species to adjust to salinity. These responses are related to accumulation of Na(+) and Cl(-) in leaves and roots, K(+)/Na(+) homeostasis, transport of K(+) and selectivity (K-Na) in roots, and accumulation of organic solutes contributing to osmotic adjustment of the species. © 2015 German Botanical Society and The Royal Botanical Society of the Netherlands.

[Changes in gastric function in rats after intragastric introduction of corvitin at high doses].

PubMed

Vovkun, T V; Ianchuk, P I; Shtanova, L Ia; Vesel'skyĭ, S P; Baranovs'kyĭ, V A

2014-01-01

Intragastric administration of corvitin at doses of 10, 20 and 40 mg/kg dose-dependently increased the volume of gastric juice and the total production of hydrochloric acid (HA). Amplification of hexosamines and cysteine production was observed only when the study drug was administered at a dose of 10 mg/kg. When corvitin was used at 20 and 40 mg/kg, these parameters were at the level of control values. Protein production increased in response to 10 and 20 mg/kg corvitin, but fell below the control values after administration of 40 mg/kg of the drug. The level of blood flow in the gastric mucosa increased following administration of 10 mg/kg corvitin, was not different from the baseline after 20 mg/kg of the drug and significantly decreased in response to 40 mg/kg of flavonoid. Our results indicate that a single intragastric application of corvitin at dose of 10 mg/kg activates gastric defense mechanisms. At 20 and 40 mg/kg, corvitin does not affect them but gradually reduces blood flow in gastric mucosa, causes a disturbance of protein synthesis and hypersecretion of HA into the cavity of the stomach, which can lead to disruption of the digestive process and the integrity of gastric mucosa.

Role of splanchnic constriction in governing the hemodynamic responses to gravitational stress in conscious dogs

PubMed Central

Wong, Brett J.

2011-01-01

Octreotide is a somatostatin analog that constricts the splanchnic circulation, thereby improving orthostatic tolerance. We tested the hypotheses that octreotide improves orthostatic tolerance by 1)increasing cardiac filling (right atrial) pressure via reductions in vascular capacity; 2) by causing an upward (i.e., cranial) shift of the hydrostatic indifferent point; and 3) by increasing arterial pressure via a reduction in total vascular conductance. Studies were carried out in acepromazine-sedated, hexamethonium-treated atrioventricular-blocked conscious dogs lightly restrained in lateral recumbency. Beat-by-beat cardiac output was held constant via computer-controlled ventricular pacing at rest and during 30 s of 30° head-up tilt. Octreotide (1.5 μg/kg iv) raised right atrial pressure by 0.5 mmHg and raised mean arterial pressure by 11 mmHg by reducing total vascular conductance (all P < 0.05). Right atrial pressure fell by a similar amount in response to tilting before and after octreotide, thus there was no difference in location of the hydrostatic indifferent point. These data indicate that octreotide improves orthostatic tolerance by decreasing total vascular conductance and by increasing cardiac filling pressure via a reduction in unstressed vascular volume and not by eliciting a cranial shift of the location of the hydrostatic indifferent point. PMID:21512154

Changing pattern of drugs used for self-poisoning.

PubMed Central

Proudfoot, A T; Park, J

1978-01-01

In 1967-76 the annual number of admissions to a poisoning treatment centre rose from 964 to 2134. The proportion of admissions caused by taking barbiturate hypnotics and methaqualone fell considerably while that caused by taking benzodiazepines and tricyclic antidepressants increased. As a result the proportion of patients admitted unconscious fell from 23% to 15%. The declining contributions of barbiturates and methaqualone and increased importance of tricyclic antidepressants were significant in all grades of coma. The change in drugs taken, however, has not yet reduced the percentage of unconscious patients needing endotracheal intubation or assisted ventilation, and hypothermia remains as common. Only hypotension has become less frequent as antidepressants replace barbiturates as the main cause of drug-induced coma. The use of salicylates for self-poisoning is declining slowly, and paracetamol poisoning is now as common. PMID:620215

School-based individualised lifestyle intervention decreases obesity and the metabolic syndrome in Mexican children.

PubMed

Elizondo-Montemayor, L; Gutierrez, N G; Moreno, D M; Martínez, U; Tamargo, D; Treviño, M

2013-07-01

Currently, there is limited evidence about effective strategies to manage childhood obesity and the metabolic syndrome in school settings. The present study aims to analyse changes in the prevalence of being overweight/obese and having the metabolic syndrome in relation to a 10-month lifestyle intervention based on individualised face-to-face sessions and parental education in school settings. The study sample comprised a cross-sectional sample of 96 overweight/obese Mexican children aged 6-12 years from eight schools. Clinical, anthropometric measurements and 24-h recalls were obtained during each of 13 visits. Laboratory measurements were determined at the beginning and end. The energy-reduced diet was based on dietary recommended intakes. Individualised structured daily meals and a physical activity plan, tailored-made for each child, were provided every 3 weeks at the schools. Parental attendance was required. Student's t-test, McNemar and Shapiro-Wilk tests and simple linear regression were used for the statistical analysis. The prevalence of metabolic syndrome fell significantly from 44% to 16% (P < 0.01), high blood pressure fell from 19% to 0%, hypertrigliceridaemia fell from 64% to 35%, high-density lipoprotein-cholesterol ≤ 40 fell from 60% to 41%, hyperglycaemia fell from 1% to 0%, and waist circumference ≥90th percentile fell from 72% to 57%. There was a 2.84 [95% confidence interval (CI) = -4.10 to -1.58; P < 0.01] significant decrease in body mass index percentile and in body-fat percentage (95% CI = -3.31 to -1.55; P < 0.01). Of the overweight children, 32% achieved normal-weight, whereas 24% of the obese ones converted to overweight and 1% reached normal-weight. Physical activity increased 16 min/day(-1) (P = 0.02) and 2 days/week(-1) . A school-setting lifestyle intervention led to a decreased prevalence of being overweight/obese and to a striking reduction in the prevalence of the metabolic syndrome in a sample of Mexican children. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Target volume motion during anal cancer image guided radiotherapy using cone-beam computed tomography.

PubMed

Brooks, Corrinne J; Bernier, Laurence; Hansen, Vibeke N; Tait, Diana M

2018-05-01

Literature regarding image-guidance and interfractional motion of the anal canal (AC) during anal cancer radiotherapy is sparse. This study investigates interfractional AC motion during anal cancer radiotherapy. Bone matched cone beam CT (CBCT) images were acquired for 20 patients receiving anal cancer radiotherapy allowing population systematic and random error calculations. 12 were selected to investigate interfractional AC motion. Primary anal gross tumour volume and clinical target volume (CTVa) were contoured on each CBCT. CBCT CTVa volumes were compared to planning CTVa. CBCT CTVa volumes were combined into a CBCT-CTVa envelope for each patient. Maximum distortion between each orthogonal border of the planning CTVa and CBCT-CTVa envelope was measured. Frequency, volume and location of CBCT-CTVa envelope beyond the planning target volume (PTVa) was analysed. Population systematic and random errors were 1 and 3 mm respectively. 112 CBCTs were analysed in the interfractional motion study. CTVa varied between each imaging session particularly T location patients of anorectal origin. CTVa border expansions ≥ 1 cm were seen inferiorly, anteriorly, posteriorly and left direction. The CBCT-CTVa envelope fell beyond the PTVa ≥ 50% imaging sessions (n = 5). Of these CBCT CTVa distortions beyond PTVa, 44% and 32% were in the upper and lower thirds of PTVa respectively. The AC is susceptible to volume changes and shape deformations. Care must be taken when calculating or considering reducing the PTV margin to the anus. Advances in knowledge: Within a limited field of research, this study provides further knowledge of how the AC deforms during anal cancer radiotherapy.

[Combined lumbosacral and vaginal physiotherapy in the treatment of overactive bladder in postmenopausal women].

PubMed

Neĭmark, B A; Neĭmark, A I; Raĭgorodskiĭ, Iu M; Tishchenko, G E; Gol'braĭkh, G E

2011-01-01

Efficacy of combined application of physical factors including lumbosacral magnetotherapy and vaginal vibromagnetic impact is shown in 48 postmenopausal women (mean age 62.5 +/- 1.6 years) with overactive bladder (OAB). Choice of this combination is explained by a multifactorial OAB pathogenesis and degenerative spinal diseases often encountered in postmenopausal women (70.8% in this study). The exposures of the spine and the bladder (vaginal) were made one after the other with duration of the first stage 10-15 min, of the second--5-7 min, the course consisted of 10-12 procedures. The results of the treatment were assessed by urination rhythm, volume, number of incontinence episodes. Quality of life was evaluated according to special questionnaires. Trophic function of the spinal cord and innervation of the bladder were studied by n. tibialis conduction measured by electroneuromyography (ENMG). The following results were obtained: reduction of urinations for 24 hours by 36.9%, urgent episodes--by 44%, urgent incontinence--by 59.7%. Voiding volume significantly increased (by 26%). A total score of anxiety related to OAB fell by 51.3%. M-response amplitude in ENMG rose 1.5-fold, while velocity of the impulse conduction along the n. tibialis enhanced 1.2-fold. The technique was accomplished with AMUS-01-Intramag device and attachment to it Rectomassager made in Russia.

Roots and the stability of forested slopes

Treesearch

R. R. Ziemer

1981-01-01

Abstract - Root decay after timber cutting can lead to slope failure. In situ measurements of soil with tree roots showed that soil strength increased linearly as root biomass increased. Forests clear-felled 3 years earlier contained about one-third of the root biomass of old-growth forests. Nearly all of the roots

Observed Methods for Felling Hardwood Trees with Chain Saws

Treesearch

Jerry L. Koger

1983-01-01

The angles and lengths of the cutting surfaces made by chain saw operators on hardwood tree stumps are described by means, standard deviations, ranges, and regression equations. Recommended felling guidelines are compared with observed felling methods used by experienced timber cutters in the southern Appalachian Mountains.

Fall in new HIV diagnoses among men who have sex with men (MSM) at selected London sexual health clinics since early 2015: testing or treatment or pre-exposure prophylaxis (PrEP)?

PubMed Central

Brown, Alison E; Mohammed, Hamish; Ogaz, Dana; Kirwan, Peter D; Yung, Mandy; Nash, Sophie G; Furegato, Martina; Hughes, Gwenda; Connor, Nicky; Delpech, Valerie C; Gill, O Noel

2017-01-01

Since October 2015 up to September 2016, HIV diagnoses fell by 32% compared with October 2014–September 2015 among men who have sex with men (MSM) attending selected London sexual health clinics. This coincided with high HIV testing volumes and rapid initiation of treatment on diagnosis. The fall was most apparent in new HIV testers. Intensified testing of high-risk populations, combined with immediately received anti-retroviral therapy and a pre-exposure prophylaxis (PrEP) programme, may make elimination of HIV achievable. PMID:28662762

Nocturnal, every-other-day, online haemodiafiltration: an effective therapeutic alternative.

PubMed

Maduell, Francisco; Arias, Marta; Durán, Carlos E; Vera, Manel; Fontseré, Néstor; Azqueta, Manel; Rico, Nayra; Pérez, Nuria; Sentis, Alexis; Elena, Montserrat; Rodriguez, Néstor; Arcal, Carola; Bergadá, Eduardo; Cases, Aleix; Bedini, Jose Luis; Campistol, Josep M

2012-04-01

Longer and more frequent dialysis sessions have demonstrated excellent survival and clinical advantages, while online haemodiafiltration (OL-HDF) provides the most efficient form of dialysis treatment. The aim of this study was to evaluate the beneficial effects of a longer (nocturnal) and more frequent (every-other-day) dialysis schedule with OL-HDF at the same or the highest convective volume. This prospective, in-centre crossover study was carried out in 26 patients, 18 males and 8 females, 49.2±14 years old, on 4-5 h thrice-weekly post-dilution OL-HDF, switched to nocturnal every-other-day OL-HDF. Patient inclusion criteria consisted of stable patients with good vascular access and with good prospects for improved occupational, psychological and social rehabilitation. Patients were randomly assigned into two groups: Group A received the same convective volume as previously for 6 months followed by a higher convective volume for a further 6 months, while Group B received the same schedule in reverse order. Nocturnal every-other-day OL-HDF was well tolerated and 56% of patients who were working during the baseline period continued to work throughout the study with practically no absenteeism. The convective volume was 26.7±2 L at baseline, 27.5±2 with the unchanged volume and 42.9±4 L with the higher volume. eKt/V increased from 1.75±0.4 to 3.37±0.9. Bicarbonate, blood urea nitrogen (BUN) and creatinine values decreased, while phosphate levels fell markedly with a 90% reduction in phosphate binders. Blood pressure and left ventricular hypertrophy (LVH) improved and the use of anti-hypertensive drugs decreased. In both groups, BUN, creatinine and β2-microglobulin reduction ratios improved. Different removal patterns were observed for myoglobin, prolactin and α1-acid glycoprotein. Nocturnal every-other-day OL-HDF could be an excellent therapeutic alternative since good tolerance and occupational rehabilitation, marked improvement in dialysis dose, nutritional status, LVH, phosphate and hypertension control and a substantial reduction in drug requirements were observed. In this crossover study, different removal patterns of large solutes were identified.

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

Richardson, B.; Robinson, B.; Mosher, T.

From 1982 through 1986, Philadelphia Electric Company (PECo) hosted the test of a communication system proposed for distribution automation and load management. The system included a utility control center (UCC), a broadcast interface unit in the AM station transmitter, and receiving units. To implement two-way communications, transmitters operating in the VHF spectrum at 154.463750 MHz were coupled with AM receivers. The VHF signal was received by four central receivers installed in the PECo service territory, and communicated to the UCC by either microwave or telephone links. The AM carrier signal provided communications and a synchronous time reference for the communicationmore » system. Station WCAU, 1210 kHz, was the broadcaster for the test. The test results confirmed the effectiveness of the AM broadcast link. However, in this particular implementation, the VHF link fell short of both expectation and acceptablity for return-path communications. The data is summarized and discussed in Volume I, and presented with additional detail in Volume II. A communications system consultant developed analytical models for the AM and VHF signal paths, and analyzed the data with respect to the models. Volume I of the two-volume report describes the communications system in general, presents the major data interpretations and conclusions, and describes the chronology and background for the project. It must be read and understood as a prerequisite for studying the information in Volume II. 14 figs., 1 tab.« less

A microfabricated bio-sensor for erythrocytes deformability and volume distributions analysis

NASA Astrophysics Data System (ADS)

Bransky, Avishay; Korin, Natanel; Nemirovski, Yael; Dinnar, Uri

2007-12-01

The deformability of erythrocytes is of great importance for oxygen delivery in the microcirculation. Reduced RBC deformability is associated with several types of hemolytic anaemias, malaria, sepsis and diabetes. Aging of erythrocytes is also associated with loss of deformability as well as reduction in cell volume. An automated rheoscope has been developed, utilizing a microfabricated glass flow cell, high speed camera and advanced image-processing software. RBCs suspended in a high viscosity medium were filmed flowing through a microchannel. The system produces valuable data such as velocity profiles of RBCs, spatial distribution within the microchannel, cell volume and deformation index (DI) curves. The variation of DI across the channel height, due to change in shear stress, was measured for the first time. Such DI curves were obtained for normal and Thalassemia RBCs and their diagnostic potential was demonstrated. The spatial distribution and velocity of RBCs and rigid microspheres were measured. Both RBC and rigid spheres showed enhanced inward lateral migration, however the RBCs form a depletion region at the center of flow. The volume and surface area of the flowing cells have been estimated based on a fluid mechanics model and experimental results and fell within the normal range. Hence, the system developed, provides means for examining the behavior of individual RBCs in microchannels, and may serve as a microfabricated diagnostic device for deformability and volume measurements.

Felling of individual freestanding nanoobjects using focused-ion-beam milling for investigations of structural and transport properties.

PubMed

Li, Wuxia; Fenton, J C; Cui, Ajuan; Wang, Huan; Wang, Yiqian; Gu, Changzhi; McComb, D W; Warburton, P A

2012-03-16

We report that, to enable studies of their compositional, structural and electrical properties, freestanding individual nanoobjects can be selectively felled in a controllable way by the technique of low-current focused-ion-beam (FIB) milling with the ion beam at a chosen angle of incidence to the nanoobject. To demonstrate the suitability of the technique, we report results for zigzag/straight tungsten nanowires grown vertically on support substrates and then felled for characterization. We also describe a systematic investigation of the effect of the experimental geometry and parameters on the felling process and on the induced wire-bending phenomenon. The method of felling freestanding nanoobjects using FIB is an advantageous new technique enabling investigations of the properties of selected individual nanoobjects.

Felling of individual freestanding nanoobjects using focused-ion-beam milling for investigations of structural and transport properties

NASA Astrophysics Data System (ADS)

Li, Wuxia; Fenton, J. C.; Cui, Ajuan; Wang, Huan; Wang, Yiqian; Gu, Changzhi; McComb, D. W.; Warburton, P. A.

2012-03-01

We report that, to enable studies of their compositional, structural and electrical properties, freestanding individual nanoobjects can be selectively felled in a controllable way by the technique of low-current focused-ion-beam (FIB) milling with the ion beam at a chosen angle of incidence to the nanoobject. To demonstrate the suitability of the technique, we report results for zigzag/straight tungsten nanowires grown vertically on support substrates and then felled for characterization. We also describe a systematic investigation of the effect of the experimental geometry and parameters on the felling process and on the induced wire-bending phenomenon. The method of felling freestanding nanoobjects using FIB is an advantageous new technique enabling investigations of the properties of selected individual nanoobjects.

A controlled evaluation of comprehensive geriatric assessment in the emergency department: the ‘Emergency Frailty Unit’

PubMed Central

Conroy, Simon Paul; Ansari, Kharwar; Williams, Mark; Laithwaite, Emily; Teasdale, Ben; Dawson, Jeremey; Mason, Suzanne; Banerjee, Jay

2014-01-01

Background: the ageing demographic means that increasing numbers of older people will be attending emergency departments (EDs). Little previous research has focused on the needs of older people in ED and there have been no evaluations of comprehensive geriatric assessment (CGA) embedded within the ED setting. Methods: a pre-post cohort study of the impact of embedding CGA within a large ED in the East Midlands, UK. The primary outcome was admission avoidance from the ED, with readmissions, length of stay and bed-day use as secondary outcomes. Results: attendances to ED increased in older people over the study period, whereas the ED conversion rate fell from 69.6 to 61.2% in people aged 85+, and readmission rates in this group fell from 26.0% at 90 days to 19.9%. In-patient bed-day use increased slightly, as did the mean length of stay. Discussion: it is possible to embed CGA within EDs, which is associated with improvements in operational outcomes. PMID:23880143

Falls and health status in elderly women following first eye cataract surgery: a randomised controlled trial

PubMed Central

Harwood, R H; Foss, A J E; Osborn, F; Gregson, R M; Zaman, A; Masud, T

2005-01-01

Background/aim: A third of elderly people fall each year. Poor vision is associated with increased risk of falls. The authors aimed to determine if first eye cataract surgery reduces the risk of falling, and to measure associated health gain. Methods: 306 women aged over 70, with cataract, were randomised to expedited (approximately 4 weeks) or routine (12 months wait) surgery. Falls were ascertained by diary, with follow up every 3 months. Health status was measured after 6 months. Results: Visual function improved in the operated group (corrected binocular acuity improved by 0.25 logMAR units; 8% had acuity worse than 6/12 compared with 37% of controls). Over 12 months of follow up, 76 (49%) operated participants fell at least once, and 28 (18%) fell more than once. 69 (45%) unoperated participants fell at least once, 38 (25%) fell more than once. Rate of falling was reduced by 34% in the operated group (rate ratio 0.66, 95% confidence interval 0.45 to 0.96, p = 0.03). Activity, anxiety, depression, confidence, visual disability, and handicap all improved in the operated group compared with the control group. Four participants in the operated group had fractures (3%), compared with 12 (8%) in the control group (p = 0.04). Conclusion: First eye cataract surgery reduces the rate of falling, and risk of fractures and improves visual function and general health status. PMID:15615747

Hepatic amino nitrogen conversion and organ N-contents in hypothyroidism, with thyroxine replacement, and in hyperthyroid rats.

PubMed

Grøfte, T; Wolthers, T; Jensen, D S; Møller, N; Jørgensen, J O; Orskov, H; Vilstrup, H

1997-02-01

The role of thyroid hormones in the regulation of hepatic conversions of amino nitrogen to urea is unresolved. The present study was designed to assess ureagenesis in rats with experimentally well-established hypo- and hyperthyroidism. The possible role of propylthiuracil (PTU), used for induction of hypothyroidism, was ascertained during thyroxine replacement of PTU treated hypothyroid rats. Basal blood amino nitrogen concentrations (AAN), the urea nitrogen synthesis rate (UNSR) and the maximal hepatic capacity for urea nitrogen synthesis (CUNS) obtained during alanine infusion were determined together with N-contents in the soleus muscle and kidneys in experimentally hypothyroid rats (n = 19), upon thyroxine replacement (n = 14) and in experimentally hyperthyroid rats (n = 19). Hypothyroidism was induced by adding propylthiouracil (0.05%) to the drinking water for 5 weeks. Hyperthyroidism was induced by thyroxine 100 micrograms/100 g body weight. During hyperthyroidism, T3 fell to less than 10%, food intake was halved, and body weight fell by 13%. Basal blood AAN fell by 25% (p < 0.01), UNSR more than doubled (p < 0.01), and CUNS rose by 45% (p < 0.05). N-contents of the soleus muscle fell by 13% and by 20% in kidneys, respectively (p < 0.05). Thyroxine replacement normalized AAN, UNSR, CUNS and reduced N-loss to 7% in the soleus muscle (NS) and kidneys (p < 0.05), respectively. During hyperthyroidism, T3 rose five-fold, food intake rose by two thirds, and body weight fell by 10%. Basal AAN rose by 20% (p < 0.05), UNSR doubled (p < 0.01), and CUNS rose by 25% (p < 0.05). N-contents of the soleus muscle decreased by 19%, whereas kidney N-contents increased by 25% (p < 0.05). Overall liver function assessed by galactose elimination capacity did not differ among groups. Both conditions increased the rate of urea synthesis; in the hypothyroid state the hepatic waste of amino-N was limited by low blood concentration of amino-N, probably due to lower proteolysis. In the hyperthyroid state hepatic amino-N loss was aggravated by higher blood concentration of amino-N, probably due to higher proteolysis. This difference may explain the markedly different dietary nitrogen economy between the two groups. The findings suggest that distinct hepatic acceleration of urea synthesis may contribute to the protein loss seen in both myxedema and in thyrotoxicosis in humans.

Midsouth Pulpwood Prices, 1990

Treesearch

Patrick E. Miller

1992-01-01

In 1990, the average delivered price for a cord of Midsouth roundwood was $52.95, an increase of 5.7 percent since 1989. The average delivered price for a green ton of chipped residues increased about 3.7 percent to $22.51. The total pulpwood expenditure for Midsouth pulpmills increased 13 percent to $1,883 million in 1990. In terms of 1981 dollars, real prices fell...

[Global climate change and carbon balance in forest ecosystems of boreal zones: imitating modeling as a forecast tool].

PubMed

Shanin, V N; Mikhaĭlov, A V; Bykhovets, S S; Komarov, A S

2010-01-01

The individually oriented system of the EFIMOD models simulating carbon and nitrogen flows in forest ecosystems has been used for forecasting the response of forest ecosystems to various forest exploitation regimes with climate change. As input data the forest management materials for the Manturovskii forestry of the Kostroma region were used. It has been shown that increase of mid-annual temperatures and rainfall influence the redistribution of carbon and nitrogen supply in organic form: supply increase of these elements in phytomass simultaneously with depletion of them in soil occurred. The most carbon and nitrogen accumulation in forest ecosystems occurs in the scenario without felling. In addition, in this scenario only the ecosystems of the modeling territory function as a carbon drain; in the other two scenarios (with selective and total felling) they function as a source of carbon. Climate changes greatly influence the decomposition rate of organic matter in soil, which leads to increased emission of carbonic acid. The second consequence of the increase in the destruction rate is nitrogen increase in the soil in a form available for plants that entails production increase of plantations.

A comparison of two different 2400 mOsm solutions for resuscitation of major burns.

PubMed

Milner, S M; Kinsky, M P; Guha, S C; Herndon, D N; Phillips, L G; Kramer, G C

1997-01-01

The reduction of burn edema is a common goal in the resuscitation of patients with thermal injury. Initial infusion of a 2400 mOsm hypertonic 7.5% NaCl 6% dextran (HSD) has been shown to reduce volume needs, but elevated serum sodium levels limit the dose that can be safely used. This study tested the hypothesis that a 2400 mOsm solution of NaCl, amino acids, glucose, and 6% dextran (Isosal-D) would reduce similar volume requirements while maintaining normal plasma sodium levels. Hemodynamics, plasma sodium, fluid balance, and tissue water content were measured after an initial baseline period and during resuscitation of a large scald injury in 21 anesthetized sheep. Resuscitation was begun 30 minutes after the scald with infusion of 10 ml/kg of either lactated Ringer's (LR), Isosal-D, or HSD and was continued with LR to restore and maintain baseline oxygen delivery throughout the 8-hour period. Oxygen delivery, cardiac output, and mean arterial pressure were rapidly reestablished by all three solutions, although a persistent tachycardia was noted with Isosal-D. Net fluid requirements of both HSD (35 +/- 13 ml/kg) and Isosal-D (72 +/- 13 ml/kg) were significantly lower than in the LR group (203 +/- 39 ml/kg). Mean serum sodium increased 11 mEq with HSD to a peak after 4 hours of 152 +/- 5 mEq, whereas with LR sodium fell 7 mEq to 132 +/- 4. Isosal-treated animals had minimal change in serum sodium. HSD significantly decreased tissue water content in colon, liver, pancreas, and nonburned skin compared with LR, whereas Isosal-D reduced edema only in the colon. It is concluded that in this protocol Isosal-D was not as effective as HSD at reducing volume needs and edema and had unexpected chronotropic effects.

Do Changes in Hospital Outpatient Payments Affect the Setting of Care?

PubMed Central

He, Daifeng; Mellor, Jennifer M

2013-01-01

Objective To examine whether decreases in Medicare outpatient payment rates under the Outpatient Prospective Payment System (OPPS) caused outpatient care to shift toward the inpatient setting. Data Sources/Study Setting Hospital inpatient and outpatient discharge files from the Florida Agency for Health Care Administration from 1997 through 2008. Study Design This study focuses on inguinal hernia repair surgery, one of the most commonly performed surgical procedures in the United States. We estimate multivariate regressions of inguinal hernia surgery counts in the outpatient setting and in the inpatient setting. The key explanatory variable is the time-varying Medicare payment rate specific to the procedure and hospital. Control variables include time-varying hospital and county characteristics and hospital and year-fixed effects. Principal Findings Outpatient hernia surgeries fell in response to OPPS-induced rate cuts. The volume of inpatient hernia repair surgeries did not increase in response to reductions in the outpatient reimbursement rate. Conclusions Potential substitution from the outpatient setting to the inpatient setting does not pose a serious threat to Medicare's efforts to contain hospital outpatient costs. PMID:23701048

Diuretics, Limited Ultrafiltration, and Residual Renal Function in Incident Hemodialysis Patients: A Case Series.

PubMed

Sjolund, Jessica; Garcia Anton, Desiree; Bayes, Liz Y; Hoekstra, Tiny; Dekker, Friedo W; Munoz Mendoza, Jair

2016-09-01

The effect of diuretics on residual renal function expressed as residual GFR (rGFR) and urine volume (rUV) using 24-hour urine collections has not been well examined in hemodialysis (HD) patients. We present a small (seven patient) but provocative case series describing a strikingly low rate of decline in rUV and rGFR (average of creatinine and urea clearances, 24-hour urine collections) in patients treated with increasing doses of furosemide (up to 360 mg/day) during the first 2 years after initiation of HD. Between 6 and 12 months, the mean rUV fell by 1 ml/month, whereas rGFR declined by 0.03 ml/min/1.73 m(2) /month. The mean rate of decline from 12 to 24 months for rUV (33 ml/month) and rGFR (0.02 ml/min/1.73 m(2) /month) were also low. While data are clearly limited and the observation retrospective, they are consistent with the better documented benefit of diuretics observed in end-stage renal disease patients treated with peritoneal dialysis. © 2016 Wiley Periodicals, Inc.

Localized Glacier Deformation Associated with Filling and Draining of a Glacier-Dammed Lake and Implications for Outburst Flood Hydraulics

NASA Astrophysics Data System (ADS)

Cunico, M. L.; Walder, J. S.; Fountain, A. G.; Trabant, D. C.

2001-12-01

During the summer of 2000, we measured displacements of 22 survey targets on the surface of Kennicott Glacier, Alaska, in the vicinity of Hidden Creek Lake, an ice-dammed lake in a tributary valley that fills and drains annually. Targets were distributed over a domain about equal in width to the lake, from near the glacier/lake margin to a distance of about 1 km from the margin. Targets were surveyed over a 24-day period as the lake filled and then drained. Lake stage was independently monitored. Vertical movement of targets generally fell off with distance d from the lake. As the lake filled, targets with d < 300 to 400 m rose at nearly the same rate as the lake--typically about 0.5 m/d--with a few targets rising slightly faster than the lake. The rate of vertical movement fell off rapidly with distance from the lake: for d = ca. 600 m--roughly twice the local ice thickness--targets moved upward only about 10% as fast as lake stage. Vertical movement of targets with d > ca. 1 km seemed to be uncorrelated with lake stage. The general pattern is consistent with the idea that a wedge of water extended beneath the glacier to a distance of perhaps 300 to 400 m from the visible margin of the lake and exerts buoyant stresses on the ice that were transmitted into the main body of the glacier and caused flexure. This scenario bears some resemblance to tidal deflections of ice shelves or tidewater glaciers. For a given value of lake stage, target elevations were invariably higher as the lake drained than as the lake filled. Moreover, survey targets at a distance of about 400 m or more from the lake continued to rise for some time even after the lake began to drain. The lag time between the beginning of lake drainage and the beginning of target downdrop increased with distance from the lake, with the lag being about 14 hours at a distance of 400 m from the lake. (The lake drained completely in approximately 75 hours.) The likeliest explanations for the departure from reversibility and the existence of the time lag are either (i) a "viscous" response of the glacier to the flexural stresses imposed by the subglacial water wedge, or (ii) movement of water from the lake into temporary storage--a sort of hydraulic jacking. We favor the latter explanation and suggest that as the lake drained, water "backed up" from a main drainage channel into a basal cavity system and perhaps englacial voids as well; the stored water then drained back out as pressure eventually fell in the main channel. Assuming that all the vertical downdrop of the ice is due to the evacuation of water, the total volume of the putative subglacial "wedge" plus the water released from distributed storage is about 7 to 11 million cubic meters, or about 25 to 40% of the volume of the subaerial lake.

Frequency, triggering factors and possible consequences of mass movements on outlet glaciers in Iceland.

NASA Astrophysics Data System (ADS)

Saemundsson, Thorsteinn; Margeirsson, Guðbjörn

2016-04-01

During the last 15 years several mass movements of various size and origin, e.g. rock avalanches, rock slides and debris slides have been observed to have fall on outlet glaciers in Iceland. This should not come as a surprise in this type of glacial environment, but in a way it does. When looking at the history only few mass movements are recorded to have fall on outlet glaciers in Iceland, during the decades before the year 2000 or since 1960. This "lack of mass movements" can be explained by the fact that fewer observations and monitoring were done in the past, but is it so or are we seeing increasing activity? Looking at the distribution of the known mass movements, two activity periods cam be identified. The former one around 1970 and the second one starting around 2000 and is still ongoing. Both of these periods are characterized by warmer climate leading to retreating phases of glaciers. Two larger mass movements are known from these two retreating periods. The former one occurred in January 1967. Then a large rockslide fell on the snout and into the glacial lake of the Steinholtsjökull outlet glacier in the northern side of the Eyjafjallajökull ice cap. The rockslide broke up the snout of the glacier and caused large floodwave bursting down the Steinholtsdalur valley transporting large volume of sediments down its path. The later one occurred in 2007, when a large rockavalanche fell on the Morsárjökull outlet glacier, in the southern side of the Vatnajökull ice cap. The avalanche debris covered around 1/5 of the glacier surface. Today the retreat and thinning of glaciers in Iceland are extremely rapid. The consequences of such a rapid retreat are e.g. unstable valley slopes surrounding the outlet glaciers, both in loose sediments and bedrock, thawing of mountain permafrost and not least formation of glacial lakes in front of the rapid retreating ice margins. Such conditions can become extremely hazardous, as seen by the above mentioned examples, both for all infrastructure but not least for the rapidly increasing tourism in Iceland.

Influence of tree size, taxonomy, and edaphic conditions on heart rot in mixed-dipterocarp Bornean rainforests: implications for aboveground biomass estimates

NASA Astrophysics Data System (ADS)

Heineman, K. D.; Russo, S. E.; Baillie, I. C.; Mamit, J. D.; Chai, P. P.-K.; Chai, L.; Hindley, E. W.; Lau, B.-T.; Tan, S.; Ashton, P. S.

2015-05-01

Fungal decay of heartwood creates hollows and areas of reduced wood density within the stems of living trees known as heart rot. Although heart rot is acknowledged as a source of error in forest aboveground biomass estimates, there are few datasets available to evaluate the environmental controls over heart rot infection and severity in tropical forests. Using legacy and recent data from drilled, felled, and cored stems in mixed dipterocarp forests in Sarawak, Malaysian Borneo, we quantified the frequency and severity of heart rot, and used generalized linear mixed effect models to characterize the association of heart rot with tree size, wood density, taxonomy, and edaphic conditions. Heart rot was detected in 55% of felled stems > 30 cm DBH, while the detection frequency was lower for stems of the same size evaluated by non-destructive drilling (45%) and coring (23%) methods. Heart rot severity, defined as the percent stem volume lost in infected stems, ranged widely from 0.1-82.8%. Tree taxonomy explained the greatest proportion of variance in heart rot frequency and severity among the fixed and random effects evaluated in our models. Heart rot frequency, but not severity, increased sharply with tree diameter, ranging from 56% infection across all datasets in stems > 50 cm DBH to 11% in trees 10-30 cm DBH. The frequency and severity of heart rot increased significantly in soils with low pH and cation concentrations in topsoil, and heart rot was more common in tree species associated with dystrophic sandy soils than with nutrient-rich clays. When scaled to forest stands, the percent of stem biomass lost to heart rot varied significantly with soil properties, and we estimate that 7% of the forest biomass is in some stage of heart rot decay. This study demonstrates not only that heart rot is a significant source of error in forest carbon estimates, but also that it strongly covaries with soil resources, underscoring the need to account for edaphic variation in estimating carbon storage in tropical forests.

The effect of changing the contact surface area between pleural liquid and pleura on the turnover of pleural liquid.

PubMed

Nakamura, T; Hara, H; Ijima, F; Arai, T; Kira, S

1984-03-01

To study the dynamics of pleural liquid, 250 ml of saline labeled with markers were injected into the pleural cavity of anesthetized dogs. For 3 h, liquid volume and concentration of these markers were measured. In a control group of dogs, the turnover rate of pleural liquid was 19.6 +/- 5.6 ml/min and lymphatic flow was 0.58 +/- 0.07 ml/min. In a group of pneumonectomized dogs, the turnover rate and lymphatic flow fell to about one fourth of those in the control group. When the left pulmonary artery was occluded, the turnover rate was halved, but lymphatic flow was not significantly different from that in the control group. These results suggest that the turnover rate of pleural liquid is dependent on the area of contact between pleural liquid and pleura and on the blood flow of the pleura. In addition, it appears that changes in pleural liquid volume are dependent on lymphatic flow.

7 CFR 301.50-5 - Issuance and cancellation of certificates and limited permits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... source tree has been felled during the period of July 1 through October 31 or if the regulated article is pine bark products produced from a tree felled and debarked during the period of July 1 through October..., pine lumber with bark attached, or pine stump from a tree felled during the period of July 1 through...

NREL Report Shows Utility-Scale Solar PV System Cost Fell Nearly 30% Last

Science.gov Websites

Year | NREL | News | NREL Report Shows Utility-Scale Solar PV System Cost Fell Nearly 30% Last Year News Release: NREL Report Shows Utility-Scale Solar PV System Cost Fell Nearly 30% Last Year September 12, 2017 Record-low costs enabled by decline in module and inverter prices The installed cost of

Regeneration of mahogany (Swietenia macrophylla) in the Yucatan

Treesearch

M.B. Dickinson; D.F. Whigham; D.F. Whigham

1999-01-01

Low rates of natural regeneration of big-leaf mahogany were found in gaps due to felling and natural treefalls in the Yucatan. This finding is consistent with low post-logging abundances of reproductive-sized trees as well as relatively low growth rates of planted mahogany seedlings in small felling gaps. High growth rates of seedlings in large felling gaps and...

Natural falling of beetle-killed ponderosa pine

Treesearch

J. M. Schmid; S. A. Mata; W. F. McCambridge

1985-01-01

Beetle-killed trees in the Front Range of Colorado were observed for their rate and direction of falling. No trees fell within the 2 years following infestation. Thereafter, trees generally fell at the rate of 3-5% per year unless winds exceeded 75 mph. Most trees fell to the east and broke off between ground level and 2 feet above ground.

Impacts of mechanical tree felling on development of water tupelo regeneration in the Mobile Delta, Alabama

Treesearch

Emile S. Gardiner; D. Ramsey Russell; John D. Hodges; T. Conner Fristoe

2000-01-01

Two water tupelo (Nyssa aquatica L.) stands in the Mobile Delta of Alabama were selected to test the hypothesis that mechanized felling does not reduce establishment and growth of natural water tupelo regeneration relative to traditional tree felling with chainsaws. To test the hypothesis, we established six 2 acre treatment plots in each of two...

Adolescent prescription ADHD medication abuse is rising along with prescriptions for these medications.

PubMed

Setlik, Jennifer; Bond, G Randall; Ho, Mona

2009-09-01

We sought to better understand the trend for prescription attention-deficit/hyperactivity disorder (ADHD) medication abuse by teenagers. We queried the American Association of Poison Control Center's National Poison Data System for the years of 1998-2005 for all cases involving people aged 13 to 19 years, for which the reason was intentional abuse or intentional misuse and the substance was a prescription medication used for ADHD treatment. For trend comparison, we sought data on the total number of exposures. In addition, we used teen and preteen ADHD medication sales data from IMS Health's National Disease and Therapeutic Index database to compare poison center call trends with likely availability. Calls related to teenaged victims of prescription ADHD medication abuse rose 76%, which is faster than calls for victims of substance abuse generally and teen substance abuse. The annual rate of total and teen exposures was unchanged. Over the 8 years, estimated prescriptions for teenagers and preteenagers increased 133% for amphetamine products, 52% for methylphenidate products, and 80% for both together. Reports of exposure to methylphenidate fell from 78% to 30%, whereas methylphenidate as a percentage of ADHD prescriptions decreased from 66% to 56%. Substance-related abuse calls per million adolescent prescriptions rose 140%. The sharp increase, out of proportion to other poison center calls, suggests a rising problem with teen ADHD stimulant medication abuse. Case severity increased over time. Sales data of ADHD medications suggest that the use and call-volume increase reflects availability, but the increase disproportionately involves amphetamines.

Fall in new HIV diagnoses among men who have sex with men (MSM) at selected London sexual health clinics since early 2015: testing or treatment or pre-exposure prophylaxis (PrEP)?

PubMed

Brown, Alison E; Mohammed, Hamish; Ogaz, Dana; Kirwan, Peter D; Yung, Mandy; Nash, Sophie G; Furegato, Martina; Hughes, Gwenda; Connor, Nicky; Delpech, Valerie C; Gill, O Noel

2017-06-22

Since October 2015 up to September 2016, HIV diagnoses fell by 32% compared with October 2014-September 2015 among men who have sex with men (MSM) attending selected London sexual health clinics. This coincided with high HIV testing volumes and rapid initiation of treatment on diagnosis. The fall was most apparent in new HIV testers. Intensified testing of high-risk populations, combined with immediately received anti-retroviral therapy and a pre-exposure prophylaxis (PrEP) programme, may make elimination of HIV achievable. This article is copyright of The Authors, 2017.

Forest structure of oak plantations after silvicultural treatment to enhance habitat for wildlife

USGS Publications Warehouse

Twedt, Daniel J.; Phillip, Cherrie-Lee P.; Guilfoyle, Michael P.; Wilson, R. Randy; Schweitzer, Callie Jo; Clatterbuck, Wayne K.; Oswalt, Christopher M.

2016-01-01

During the past 30 years, thousands of hectares of oak-dominated bottomland hardwood plantations have been planted on agricultural fields in the Mississippi Alluvial Valley. Many of these plantations now have closed canopies and sparse understories. Silvicultural treatments could create a more heterogeneous forest structure, with canopy gaps and increased understory vegetation for wildlife. Lack of volume sufficient for commercial harvest in hardwood plantations has impeded treatments, but demand for woody biomass for energy production may provide a viable means to introduce disturbance beneficial for wildlife. We assessed forest structure in response to prescribed pre-commercial perturbations in hardwood plantations resulting from silvicultural treatments: 1) row thinning by felling every fourth planted row; 2) multiple patch cuts with canopy gaps of <1 0.25 – 2 ha; and 3) tree removal on intersecting corridors diagonal to planted rows. These 3 treatments, and an untreated control, were applied to oak plantations (20 - 30 years post-planting) on three National Wildlife Refuges (Cache River, AR; Grand Cote, LA; and Yazoo, MS) during summer 2010. We sampled habitat using fixed-radius plots in 2009 (pre-treatment) and in 2012 (post-treatment) at random locations. Retained basal area was least in diagonal corridor treatments but had greater variance in patch-cut treatments. All treatments increased canopy openness and the volume of coarse woody debris. Occurrence of birds using early successional habitats was greater on sites treated with patch cuts and diagonal intersections. Canopy openings on row-thinned stands are being filled by lateral crown growth of retained trees whereas patch cut and diagonal intersection gaps appear likely to be filled by regenerating saplings.

The influence of conservation tillage methods on soil water regimes in semi-arid southern Zimbabwe

NASA Astrophysics Data System (ADS)

Mupangwa, W.; Twomlow, S.; Walker, S.

Planting basins and ripper tillage practices are major components of the recently introduced conservation agriculture package that is being extensively promoted for smallholder farming in Zimbabwe. Besides preparing land for crop planting, these two technologies also help in collecting and using rainwater more efficiently in semi-arid areas. The basin tillage is being targeted for households with limited or no access to draught animals while ripping is meant for smallholder farmers with some draught animal power. Trials were established at four farms in Gwanda and Insiza in southern Zimbabwe to determine soil water contributions and runoff water losses from plots under four different tillage treatments. The tillage treatments were hand-dug planting basins, ripping, conventional spring and double ploughing using animal-drawn implements. The initial intention was to measure soil water changes and runoff losses from cropped plots under the four tillage practices. However, due to total crop failure, only soil water and runoff were measured from bare plots between December 2006 and April 2007. Runoff losses were highest under conventional ploughing. Planting basins retained most of the rainwater that fell during each rainfall event. The amount of rainfall received at each farm significantly influenced the volume of runoff water measured. Runoff water volume increased with increase in the amount of rainfall received at each farm. Soil water content was consistently higher under basin tillage than the other three tillage treatments. Significant differences in soil water content were observed across the farms according to soil types from sand to loamy sand. The basin tillage method gives a better control of water losses from the farmers’ fields. The planting basin tillage method has a greater potential for providing soil water to crops than ripper, double and single conventional ploughing practices.

Effects of oxygen inhalation on cardiac output, coronary blood flow and oxygen delivery in healthy individuals, assessed with MRI.

PubMed

Bodetoft, Stefan; Carlsson, Marcus; Arheden, Håkan; Ekelund, Ulf

2011-02-01

Oxygen (O2) is a cornerstone in the treatment of critically ill patients, and the guidelines prescribe 10-15 l of O2/min even to those who are initially normoxic. Studies using indirect or invasive methods suggest, however, that supplemental O2 may have negative cardiovascular effects. The aim of this study was to test the hypothesis, using noninvasive cardiac magnetic resonance imaging, that inhaled supplemental O2 decreases cardiac output (CO) and coronary blood flow in healthy individuals. Sixteen healthy individuals inhaled O2 at 1, 8 and 15 l/min through a standard reservoir bag mask. A 1.5 T magnetic resonance imaging scanner was used to measure stroke volume, CO and coronary sinus blood flow. Left ventricular (LV) perfusion was calculated as coronary sinus blood flow/LV mass. The O2 response was dose-dependent. At 15 l of O2/min, blood partial pressure of O2 increased from an average 11.7 to 51.0 kPa with no significant changes in blood partial pressure of CO2 or arterial blood pressure. At the same dose, LV perfusion decreased by 23% (P=0.005) and CO decreased by 10% (P=0.003) owing to a decrease in heart rate (by 9%, P<0.002), with no significant changes in stroke volume or LV dimensions. Owing to the decreased CO and LV perfusion, systemic and coronary O2 delivery fell by 4 and 11% at 8 l of O2/min, despite the increased blood oxygen content. Our data indicate that O2 administration decreases CO, LV perfusion and systemic and coronary O2 delivery in healthy individuals. Further research should address the effects of O2 therapy in normoxic patients.

Contrasting physiological responses of two co-occurring eucalypts to seasonal drought at restored bauxite mine sites.

PubMed

Szota, Christopher; Farrell, Claire; Koch, John M; Lambers, Hans; Veneklaas, Erik J

2011-10-01

This study describes the physiological response of two co-occurring tree species (Eucalyptus marginata and Corymbia calophylla) to seasonal drought at low- and high-quality restored bauxite mine sites in south-western Australia. Seasonal changes in photosynthesis (A), stomatal conductance (g(s)), leaf water potential (ψ), leaf osmotic potential (ψ), leaf relative water content (RWC) and pressure-volume analysis were captured over an 18-month field study to (i) determine the nature and severity of physiological stress in relation to site quality and (ii) identify any physiological differences between the two species. Root system restriction at the low-quality site reduced maximum rates of gas exchange (g(s) and A) and increased water stress (midday ψ and daily RWC) in both species during drought. Both species showed high stomatal sensitivity during drought; however, E. marginata demonstrated a higher dehydration tolerance where ψ and RWC fell to -3.2 MPa and 73% compared with -2.4 MPa and 80% for C. calophylla. Corymbia calophylla showed lower g(s) and higher ψ and RWC during drought, indicating higher drought tolerance. Pressure-volume curves showed that cell-wall elasticity of E. marginata leaves increased in response to drought, while C. calophylla leaves showed lower osmotic potential at zero turgor in summer than in winter, indicating osmotic adjustment. Both species are clearly able to tolerate seasonal drought at hostile sites; however, by C. calophylla closing stomata earlier in the drought cycle, maintaining a higher water status during drought and having the additional mechanism of osmotic adjustment, it may have a greater capacity to survive extended periods of drought.

Midsouth Pulpwood Prices, 1988

Treesearch

John S. Vissage

1990-01-01

In 1988, the average price per cord of Midsouth roundwood pulpwood was $49.21, an increase of approximately 4 percent since 1987. The average price per green ton of chipped residues fell 3 percent to $20.99. The total expenditure by Midsouth pulpmills for pulpwood increased about one-half percent to $1,569 million in 1988. However, the real prices, in terms of...

Timing and magnitude of Miocene eustasy derived from the mixed siliciclastic-carbonate stratigraphic record of the northeastern Australian margin

NASA Astrophysics Data System (ADS)

John, Cédric M.; Karner, Garry D.; Browning, Emily; Leckie, R. Mark; Mateo, Zenon; Carson, Brooke; Lowery, Chris

2011-04-01

Eustasy is a key parameter to understand sedimentary sequences on continental margins and to reconstruct continental ice volume in the Cenozoic, but timing and magnitude of global sea level changes remain controversial, especially for the Miocene Epoch. We analyzed sediment cores recovered from the Marion Plateau, offshore northeastern Australia, during Ocean Drilling Program (ODP) Leg 194 to define the mechanisms and timing of sequence formation on mixed carbonate-siliciclastic margins, and to estimate the amplitude of Miocene eustatic adjustments. We identified sequence boundaries on seismic reflection lines, significantly revised the existing biostratigraphic age models, and investigated the sedimentary response to sea-level changes across the Marion Plateau. We subdivided the Miocene sediments into three sequence sets comprising a set of prograding clinoforms, a muddy prograding carbonate ramp evolving into an aggrading platform, and a lowstand ramp evolving into a backstepping ramp. We recognized eight individual sequences dated at 18.0 Ma, 17.2 Ma, 16.5 Ma, 15.4 Ma, 14.7 Ma, 13.9 Ma, 13.0 Ma, and 11.9 Ma. We demonstrate that sequences on the Marion Plateau are controlled by glacio-eustasy since sequence boundaries are marked by increases in δ 18O (deep-sea Miocene isotope events Mi1b, Mbi-3, Mi2, Mi2a, Mi3a, Mi3, Mi4, and Mi5, respectively), which reflects increased ice volume primarily on Antarctica. Our backstripping estimates suggest that sea-level fell by 26-28 m at 16.5 Ma, 26-29 m at 15.4 Ma, 29-38 m at 14.7 Ma, and 53-81 m at 13.9 Ma. Combining backstripping with δ 18O estimates yields sea-level fall amplitudes of 27 ± 1 m at 16.5 Ma, 27 ± 1 m at 15.4 Ma, 33 ± 3 m at 14.7 Ma, and 59 ± 6 m at 13.9 Ma. We use a similar approach to estimate eustatic rises of 19 ± 1 m between 16.5 and 15.4 Ma, 23 ± 3 m between 15.4 and 14.7 Ma, and 33 ± 3 m between 14.7 and 13.9 Ma. These estimates can be combined into a eustatic curve that suggests that sea-level fell by 53-69 m between 16.5 and 13.9 Ma. This implies that at least 90% of the East Antarctic Icesheet was formed during the middle Miocene. The new independent amplitude estimates are crucial as the Miocene is the geologic Epoch for which the New Jersey margin sea-level record is poorly constrained.

Radiological and biochemical resolution of nutritional rickets with calcium

PubMed Central

Oginni, L; Sharp, C; Badru, O; Risteli, J; Davie, M; Worsfold, M; Fischer, P; Oginni, L; Badru, O; Sharp, C; Davie, M; Worsfold, M; Risteli, J

2003-01-01

Aims: To determine the response to oral calcium in Nigerian children with rickets. Methods: In a teaching hospital in Western Nigeria, 26 children (13 boys, 13 girls, aged 2–5 years) with confirmed rickets received calcium lactate (2.7 g/day). Results: Within one month of treatment leg pain was relieved and the children were more active. The mean x ray score improved from 3.3 at baseline to 1.7 at three months and 0.9 at six months (arbitrary scoring system, 0–6). Twelve cases were healed radiologically after six months, 11 others improved considerably, two showed no significant improvement, and a non-compliant patient was worse. There was progressive reversal of biochemical features. Median plasma alkaline phosphatase fell from 519 (range 178–1078) to 283 (209–443) IU/l (p = 0.04) in four months, while mean 1,25-dihydroxyvitamin D fell from 473 (251–1057) to 281 (155–481) pmol/l (p = 0.04), and mean plasma calcium increased from 2.26 (1.63–2.54) to 2.37 (2.06–2.54) mmol/l (p = 0.13). Parathyroid hormone fell from 5.3 (0.4–21.5) to 1.7 (0.45–7.4) pmol/l. Type I collagen carboxy terminal cross linked telopeptide was very high at baseline (20 (7.2–103) to 14 (11–24) µg/l) (p = 0.03) and fell promptly to normal. Conclusion: Calcium supplementation alone effected healing of rickets in most of these Nigerian children and may provide sufficient treatment in this environment. PMID:12937108

Changes in sexual behaviour and the fall in incidence of HIV infection among homosexual men.

PubMed Central

van Griensven, G. J.; de Vroome, E. M.; Goudsmit, J.; Coutinho, R. A.

1989-01-01

To investigate the epidemiology and normal course of infection with HIV the prevalence and incidence of the infection were studied among two cohorts of homosexual men in Amsterdam in 1980-7. The cumulative incidence of infection increased from a weighted 2.2% in 1980 to 39.0% in 1987. The estimated yearly incidence of HIV was 3.0% in 1981, rose to 8.8% in 1984, and fell gradually to 0% in 1987. During the study the sexual behaviour of the cohorts was examined. The number of men with whom anopenetrative intercourse was practised fell from a mean of 10.6 to 1.4 for those positive for HIV antibody, whereas the number with whom anoreceptive intercourse was practised fell from a mean of 3.7 to 0.5 for those negative for the antibody. In addition, there was a reduction in the number of cases of hepatitis B and syphilis among men in general. The decline in infection with HIV was assumed to be linked to changes in sexual behaviour. Such changes practised early in the course of the epidemic probably had a strong effect on the number of cases of AIDS among homosexual men in Amsterdam. PMID:2493866

Esophagogastric junction distensibility assessed using the functional lumen imaging probe

PubMed Central

Chen, Joan W; Rubenstein, Joel H

2017-01-01

AIM To assess reference values in the literature for esophageal distensibility and cross-sectional area in healthy and diseased subjects measured by the functional lumen imaging probe (FLIP). METHODS Systematic search and review of articles in Medline and Embase pertaining to the use of FLIP in the esophagus was conducted in accordance with the PRISMA guidelines. Cross-sectional area and distensibility at the esophagogastric junction (EGJ) were abstracted for normal subjects, achalasia, and gastroesophageal reflux disease (GERD) patients, stratified by balloon length and volume of inflation. RESULTS Six achalasia studies (n = 154), 3 GERD (n = 52), and 5 studies including healthy controls (n = 98) were included in the systematic review. Normative data varied widely amongst studies of healthy volunteers. In contrast, studies in achalasia patients uniformly demonstrated low point estimates in distensibility ≤ 1.6 mm2/mmHg prior to treatment that increased to ≥ 3.4 mm2/mmHg following treatment at 40mL bag volume. In GERD patients, distensibility fell to the range of untreated achalasia (≤ 2.85 mm2/mmHg) following fundoplication. CONCLUSION FLIP may be a useful tool in assessment of treatment efficacy in achalasia. The drastic drop in EGJ distensibility after fundoplication suggests that FLIP measurements need to be interpreted in the context of esophageal body motility and highlights the importance of pre-operative screening for dysmotility. Future studies using standardized FLIP protocol and balloon size are needed. PMID:28275309

Design and evaluation of a grid reciprocation scheme for use in digital breast tomosynthesis

NASA Astrophysics Data System (ADS)

Patel, Tushita; Sporkin, Helen; Peppard, Heather; Williams, Mark B.

2016-03-01

This work describes a methodology for efficient removal of scatter radiation during digital breast tomosynthesis (DBT). The goal of this approach is to enable grid image obscuration without a large increase in radiation dose by minimizing misalignment of the grid focal point (GFP) and x-ray focal spot (XFS) during grid reciprocation. Hardware for the motion scheme was built and tested on the dual modality breast tomosynthesis (DMT) scanner, which combines DBT and molecular breast tomosynthesis (MBT) on a single gantry. The DMT scanner uses fully isocentric rotation of tube and x-ray detector for maintaining a fixed tube-detector alignment during DBT imaging. A cellular focused copper prototype grid with 80 cm focal length, 3.85 mm height, 0.1 mm thick lamellae, and 1.1 mm hole pitch was tested. Primary transmission of the grid at 28 kV tube voltage was on average 74% with the grid stationary and aligned for maximum transmission. It fell to 72% during grid reciprocation by the proposed method. Residual grid line artifacts (GLAs) in projection views and reconstructed DBT images are characterized and methods for reducing the visibility of GLAs in the reconstructed volume through projection image flat-field correction and spatial frequency-based filtering of the DBT slices are described and evaluated. The software correction methods reduce the visibility of these artifacts in the reconstructed volume, making them imperceptible both in the reconstructed DBT images and their Fourier transforms.

Effect of peptide YY on gastric, pancreatic, and biliary function in humans.

PubMed

Adrian, T E; Savage, A P; Sagor, G R; Allen, J M; Bacarese-Hamilton, A J; Tatemoto, K; Polak, J M; Bloom, S R

1985-09-01

The effect of peptide YY (PYY) on gastric and pancreatico-biliary secretion was studied in humans. Peptide YY was infused into groups of 6 healthy volunteers at doses of 0.59, 0.20, and 0.064 pmol X kg-1 X min-1. The two higher doses caused a significant suppression of gastric acid and pepsin output during background stimulation with pentagastrin. The middle dose of PYY (0.20 pmol X kg-1 X min-1) that increased plasma PYY levels by 27 +/- 2 pM caused a 90% +/- 18% (mean +/- SEM; p less than 0.001) reduction in the incremental gastric volume response to pentagastrin. Similarly this dose of PYY caused a substantial inhibition of the acid (77% +/- 14%; p less than 0.005) and pepsin (96% +/- 22%; p less than 0.01) response to pentagastrin; in 2 subjects, pepsin output fell to below basal levels. In contrast, the highest dose of PYY (0.62 pmol X kg-1 X min-1) had no significant influence on duodenal juice volume, output of bicarbonate, trypsin, or bilirubin during low dose stimulation with secretin (0.25 pmol X kg-1 X min-1) and cholecystokinin-8 (0.15 pmol X kg-1 X min-1). Thus PYY concentrations in the circulation similar to those seen after the ingestion of food cause a marked reduction in gastric secretion. This peptide should therefore be considered as one of the possible candidates for the classical enterogastrone.

Secondary analysis of outcomes after 11,085 hip fracture operations from the prospective UK Anaesthesia Sprint Audit of Practice (ASAP-2).

PubMed

White, S M; Moppett, I K; Griffiths, R; Johansen, A; Wakeman, R; Boulton, C; Plant, F; Williams, A; Pappenheim, K; Majeed, A; Currie, C T; Grocott, M P W

2016-05-01

We re-analysed prospective data collected by anaesthetists in the Anaesthesia Sprint Audit of Practice (ASAP-1) to describe associations with linked outcome data. Mortality was 165/11,085 (1.5%) 5 days and 563/11,085 (5.1%) 30 days after surgery and was not associated with anaesthetic technique (general vs. spinal, with or without peripheral nerve blockade). The risk of death increased as blood pressure fell: the odds ratio (95% CI) for mortality within five days after surgery was 0.983 (0.973-0.994) for each 5 mmHg intra-operative increment in systolic blood pressure, p = 0.0016, and 0.980 (0.967-0.993) for each mmHg increment in mean pressure, p = 0.0039. The equivalent odds ratios (95% CI) for 30-day mortality were 0.968 (0.951-0.985), p = 0.0003 and 0.976 (0.964-0.988), p = 0.0001, respectively. The lowest systolic blood pressure after intrathecal local anaesthetic relative to before induction was weakly correlated with a higher volume of subarachnoid bupivacaine: r(2) -0.10 and -0.16 for hyperbaric and isobaric bupivacaine, respectively. A mean 20% relative fall in systolic blood pressure correlated with an administered volume of 1.44 ml hyperbaric bupivacaine. Future research should focus on refining standardised anaesthesia towards administering lower doses of spinal (and general) anaesthesia and maintaining normotension. © 2016 The Association of Anaesthetists of Great Britain and Ireland.

[Prescription drug consumption recovery following the co-payment change: Evidence from a regional health service].

PubMed

Sánchez, Diego P; Guillén, José J; Torres, Alberto M; Arense, Julián J; López, Ángel; Sánchez, Fernando I

2015-01-01

In the past few decades, increasing pharmaceutical expenditures in Spain and other western countries led to the adoption of reforms in order to reduce this trend. The aim of our study was to analyze if reforms concerning the pharmaceutical reimbursement scheme in Spain have been associated with changes in the volume and trend of pharmaceutical consumption. Retrospective observational study. Region of Murcia. Prescription drug in primary care and external consultations. Records of prescribed medicines between January 1, 2008 and December 31, 2013. Segmented regression analysis of interrupted time-series of prescription drug consumption. Dispensing of all five therapeutic classes fell immediately after co-payment changes. The segmented regression model suggested that per patient drug consumption in pensioners may have decreased by about 6.76% (95% CI; -8.66% to -5.19%) in the twelve months after the reform, compared with the absence of such a policy. Furthermore the slope of the series of consumption increased from 6.08 (P<.001) to 12.17 (P<.019). The implementation of copayment policies could be associated with a significant decrease in the level of prescribed drug use in Murcia Region, but this effect seems to have been only temporary in the five therapeutic groups analyzed, since almost simultaneously there has been an increase in the growth trend. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

The effect of bladder outlet obstruction on tissue oxygen tension and blood flow in the pig bladder.

PubMed

Greenland, J E; Hvistendahl, J J; Andersen, H; Jörgensen, T M; McMurray, G; Cortina-Borja, M; Brading, A F; Frøkiaer, J

2000-06-01

To investigate the effect of partial bladder outlet obstruction on detrusor blood flow and oxygen tension (PdetO2) in female pigs. Detrusor-layer oxygen tension and blood flow were measured using oxygen-sensitive electrode and radiolabelled microsphere techniques in five female Large White pigs with a partial urethral obstruction and in five sham-operated controls. The effects of chronic outlet obstruction on bladder weight, and cholinergic nerve density and distribution, are also described. In the obstructed bladders, blood flow and oxygen tension were, respectively, 54.9% and 74.3% of control values at low bladder volume, and 47.5% and 42.5% at cystometric capacity. Detrusor blood flow declined by 27.8% and 37.5% in the control and obstructed bladders, respectively, as a result of bladder filling, whilst PdetO2 did not decrease in the controls, but fell by 42.7% in the obstructed bladders. Bladder weight increased whilst cholinergic nerve density decreased in the obstructed animals. In pigs with chronic bladder outlet obstruction, blood flow and oxygen tension in the detrusor layer were lower than in control animals. In addition, increasing detrusor pressure during filling caused significantly greater decreases in blood flow and oxygen tension in the obstructed than in the control bladders.

Spectral changes in conifers subjected to air pollution and water stress: Experimental studies

NASA Technical Reports Server (NTRS)

Westman, Walter E.; Price, Curtis V.

1988-01-01

The roles of leaf anatomy, moisture and pigment content, and number of leaf layers on spectral reflectance in healthy, pollution-stressed, and water-stressed conifer needles were examined experimentally. Jeffrey pine (Pinus jeffreyi) and giant sequoia (Sequoiadendron gigantea) were exposed to ozone and acid mist treatments in fumigation chambers; red pine (Pinus resinosa) needles were artificially dried. Infrared reflectance from stacked needles rose with free water loss. In an air-drying experiment, cell volume reductions induced by loss of turgor caused near-infrared reflectance (TM band 4) to drop after most free water was lost. Under acid mist fumigation, stunting of tissue development similarly reduced band 4 reflectance. Both artificial drying and pollutant fumigation caused a blue shift of the red edge of spectral reflectance curves in conifers, attributable to chlorophyll denaturation. Thematic mapper band ratio 4/3 fell and 5/4 rose with increasing pollution stress on artificial drying. Loss of water by air-drying, freeze-drying, or oven-drying enhanced spectral features, due in part to greater scattering and reduced water absorption. Grinding of the leaf tissue further enhanced the spectral features by increasing reflecting surfaces and path length. In a leaf-stacking experiment, an asymptote in visible and infrared reflectance was reached at 7-8 needle layers of red pine.

Somatotroph Hyperplasia

PubMed Central

Thorner, M. O.; Perryman, R. L.; Cronin, M. J.; Rogol, A. D.; Draznin, M.; Johanson, A.; Vale, W.; Horvath, E.; Kovacs, K.

1982-01-01

A 21-yr-old woman with Turner's syndrome presented with signs and symptoms of acromegaly. The serum growth hormone (GH) (95±9.4 ng/ml; mean±SEM) and somatomedin C (11 U/ml) levels were elevated, and an increase in GH levels after glucose instead of normal suppression, increase after thyrotropin-releasing hormone (TRH) administration instead of no change, and decrease after dopamine administration instead of stimulation were observed. The pituitary fossa volume was greater than normal (1,440 mm3) and the presence of a pituitary tumor was assumed. After tissue removal at transsphenoidal surgery, histological study revealed somatotroph hyperplasia rather than a discrete adenoma. Postoperatively, she remained clinically acromegalic and continued to show increased GH and somatomedin levels. A search was made for ectopic source of a growth hormone-releasing factor (GRF). Computer tomographic scan revealed a 5-cm Diam tumor in the tail of the pancreas. Following removal of this tumor, serum GH fell from 70 to 3 ng/ml over 2 h, and remained low for the subsequent 5 mo. Serum somatomedin C levels fell from 7.2 to normal by 6 wk postoperatively. There were no longer paradoxical GH responses to glucose, TRH, and dopamine. Both the medium that held the tumor cells at surgery and extracts of the tumor contained a peptide with GRF activity. The GRF contained in the tumor extract coeluted on Sephadex G-50 chromatography with rat hypothalamic GH-releasing activity. Stimulation of GH from rat somatotrophs in vitro was achieved at the nanomolar range, using the tumor extract. The patient's course demonstrates the importance of careful interpretation of pituitary histology. Elevated serum GH and somatomedin C levels in a patient with an enlarged sella turcica and the characteristic responses seen in acromegaly to TRH, dopamine, and glucose do not occur exclusively in patients with discrete pituitary tumors and acromegaly. This condition can also occur with somatotroph hyperplasia and then revert to normal after removal of the GRF source. Thus, in patients with acromegaly a consideration of ectopic GRF secretion should be made, and therefore, careful pituitary histology is mandatory. Consideration for chest and abdominal computer tomographic scans before pituitary surgery, in spite of their low yield, may be justified. Images PMID:6290540

A case study of methane gas migration through sealed mine GOB into active mine workings

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

Garcia, F.; McCall, F.E.; Trevits, M.A.

1995-12-31

The U.S. Bureau of Mines investigated the influence of atmospheric pressure changes on methane gas migration through mine seals at a mine site located in the Pittsburgh Coalbed. The mine gained access to a coal reserve through part of an abandoned mine and constructed nine seals to isolate the extensive old workings from the active mine area. Underground problems were experienced when atmospheric pressure fell, causing methane gas to migrate around the seals and into the active workings. During mining operations, methane gas levels exceeded legal limits and coal production was halted until the ventilation system could be improved. Whenmore » mining resumed with increased air flow, methane gas concentrations occasionally exceeded the legal limits and production had to be halted until the methane level fell within the mandated limit. To assist the ventilation system, a pressure relief borehole located in the abandoned workings near the mine seals was proposed. Preliminary estimates by a gob gas simulator (computer model) suggested that a 0.76 m (2.5 ft) diameter pressure relief borehole with an exhaust fan would be necessary to remove enough methane from the abandoned area so that the ventilation system could dilute the gas in the active workings. However, by monitoring methane gas emissions and seal pressure, during periods of low atmospheric pressure, the amount of methane gas that migrated into the active mine workings was calculated. Researchers then determined that a relief borehole, 20.3 cm (8-in) with an exhaust fan could remove at least twice the maximum measured volume of migrating methane gas. Because gas concentrations in the abandoned workings could potentially reach explosive limits, it was proposed that the mine eliminate the exhaust fan. Installation of the recommended borehole and enlarging two other ventilation boreholes located In the abandoned area reduced methane gas leakage through the seals by at least 63%.« less

Chronic obstructive pulmonary disease mortality and prevalence: the associations with smoking and poverty--a BOLD analysis.

PubMed

Burney, Peter; Jithoo, Anamika; Kato, Bernet; Janson, Christer; Mannino, David; Nizankowska-Mogilnicka, Ewa; Studnicka, Michael; Tan, Wan; Bateman, Eric; Koçabas, Ali; Vollmer, William M; Gislason, Thorarrin; Marks, Guy; Koul, Parvaiz A; Harrabi, Imed; Gnatiuc, Louisa; Buist, Sonia

2014-05-01

Chronic obstructive pulmonary disease (COPD) is a commonly reported cause of death and associated with smoking. However, COPD mortality is high in poor countries with low smoking rates. Spirometric restriction predicts mortality better than airflow obstruction, suggesting that the prevalence of restriction could explain mortality rates attributed to COPD. We have studied associations between mortality from COPD and low lung function, and between both lung function and death rates and cigarette consumption and gross national income per capita (GNI). National COPD mortality rates were regressed against the prevalence of airflow obstruction and spirometric restriction in 22 Burden of Obstructive Lung Disease (BOLD) study sites and against GNI, and national smoking prevalence. The prevalence of airflow obstruction and spirometric restriction in the BOLD sites were regressed against GNI and mean pack years smoked. National COPD mortality rates were more strongly associated with spirometric restriction in the BOLD sites (<60 years: men rs=0.73, p=0.0001; women rs=0.90, p<0.0001; 60+ years: men rs=0.63, p=0.0022; women rs=0.37, p=0.1) than obstruction (<60 years: men rs=0.28, p=0.20; women rs=0.17, p<0.46; 60+ years: men rs=0.28, p=0.23; women rs=0.22, p=0.33). Obstruction increased with mean pack years smoked, but COPD mortality fell with increased cigarette consumption and rose rapidly as GNI fell below US$15 000. Prevalence of restriction was not associated with smoking but also increased rapidly as GNI fell below US$15 000. Smoking remains the single most important cause of obstruction but a high prevalence of restriction associated with poverty could explain the high 'COPD' mortality in poor countries.

Rooting stem cuttings of northern red oak (Quercus rubra L.) utilizing hedged stump sprouts formed on recently felled trees

Treesearch

Matthew H. Gocke; Daniel J. Robinson

2010-01-01

The ability to root stem cuttings collected from hedged stump sprouts formed on recently felled trees was evaluated for 26 codominant northern red oak (Quercus rubra L.) trees growing in Durham County, NC. Sprouting occurred, the same year as felling, on 23 of the 26 tree stumps and sprout number was significantly and positively correlated with stump diameter. The...

Shifts in Aboveground and Forest Floor Carbon and Nitrogen Pools After Felling and Burning in the Southern Appalachians

Treesearch

Barton D. Clinton; James M. Vose; Wayne T. Swank

1996-01-01

Changes in aboveground and forest floor mass, carbon (C), and nitrogen (N) pools were quantified on three sites in the southern Appalachians 2 yr after felling and burning. Before felling and burning, stands were characterized by sparse overstories and dense Kalmia latifolia L. understories. Two years after burning, foliar C and N pools had reached 25% and 29% of...

Haemodynamic responses in chronically painful, human trapezius muscle to cold pressor stimulation.

PubMed

Acero, C O; Kuboki, T; Maekawa, K; Yamashita, A; Clark, G T

1999-10-01

The aim was to compare haemodynamic responses in trapezius muscles to cold pressor stimulation in individuals with localized trapezius myalgia and asymptomatic controls. Nine males with chronic localized pain in the trapezius (mean age, 23.2 years) and nine male controls (mean age, 24.6 years) who had no medical history of migraine, hypertension or sustained pain in the trapezius region were investigated. Two experimental (cold pressor and mock) trials were performed in a randomly assigned sequence. In the cold pressor trial the participant's left foot and ankle were immersed in 4 degrees C cold water for 2 min; the mock trial was done without that stimulus. Blood volume was continuously recorded 1 min before, 2 min during, and 5 min after cold pressor stimulation using near-infrared spectroscopy. Each participant's blood-volume data were baseline-corrected and submitted to statistical analysis. Results showed that the individuals with muscle pain exhibited a significantly lower mean blood volume than the controls during cold pressor stimulation (p = 0.0367). Upon withdrawal of that stimulation, the mean blood volume in both groups fell below the baseline. These results suggest that individuals with chronic regional trapezius myalgia have less capacity to vasodilate this muscle during cold pressor stimulation than those without such myalgia. It is not yet known if this difference in the haemodynamic response is a cause or an effect of the myalgia.

Fell runners and walking walls: towards a sociology of living landscapes and aesthetic atmospheres as an alternative to a Lakeland picturesque.

PubMed

Nettleton, Sarah

2015-12-01

This article draws on analysis of data generated by way of an ethnography of fell running in the English Lake District and suggests that participants who have lived and run in the area for many years experience a particular mode of aesthetic. The Lake District has long been valued for its outstanding scenery represented in the aesthetic of the picturesque comprising relatively static landscapes that should be conserved. Established fell runners who have run in the area for many decades apprehend and appreciate the landscape in more complex, rooted and situated ways. The anthropologist Ingold, distinguishes between landscape and landsceppan, and this insight is instructive for grasping the way in which the runners do not simply scope scenery but work with the land: they shape it and are shaped by it. Fell runners are elements within the living environment and along with walls, sheep, becks, sun, rain--what Ingold evocatively calls the 'weather-world'--are mobile. Movement is central to their aesthetic, they enjoy not so much the scenic but rather a fellsceppan and do so through their fast eye-gait-footwork and their lively, variable occupation with the terrain. The fells infiltrate and interpenetrate the runners and movement through the fells generates a somatic aesthetic. The pleasure in turn breeds existential capital an embodied gratification that serves as an attractor that binds those who appreciate feelings of being alive with and in the fells. © London School of Economics and Political Science 2015.

Certified and uncertified logging concessions compared in Gabon: changes in stand structure, tree species, and biomass.

PubMed

Medjibe, V P; Putz, Francis E; Romero, Claudia

2013-03-01

Forest management certification is assumed to promote sustainable forest management, but there is little field-based evidence to support this claim. To help fill this gap, we compared a Forest Stewardship Council (FSC)-certified with an adjacent uncertified, conventionally logged concession (CL) in Gabon on the basis of logging damage, above-ground biomass (AGB), and tree species diversity and composition. Before logging, we marked, mapped, and measured all trees >10 cm dbh in 20 and twelve 1-ha permanent plots in the FSC and CL areas, respectively. Soil and tree damage due to felling, skidding, and road-related activities was then assessed 2-3 months after the 508 ha FSC study area and the 200 ha CL study area were selectively logged at respective intensities of 5.7 m(3)/ha (0.39 trees/ha) and 11.4 m(3)/ha (0.76 trees/ha). For each tree felled, averages of 9.1 and 20.9 other trees were damaged in the FSC and CL plots, respectively; when expressed as the impacts per timber volume extracted, the values did not differ between the two treatments. Skid trails covered 2.9 % more of the CL surface, but skid trail length per unit timber volume extracted was not greater. Logging roads were wider in the CL than FSC site and disturbed 4.7 % more of the surface. Overall, logging caused declines in AGB of 7.1 and 13.4 % at the FSC and CL sites, respectively. Changes in tree species composition were small but greater for the CL site. Based on these findings and in light of the pseudoreplicated study design with less-than perfect counterfactual, we cautiously conclude that certification yields environmental benefits even after accounting for differences in logging intensities.

The rise in metastasectomy across cancer types over the past decade.

PubMed

Bartlett, Edmund K; Simmons, Kristina D; Wachtel, Heather; Roses, Robert E; Fraker, Douglas L; Kelz, Rachel R; Karakousis, Giorgos C

2015-03-01

Although studies of metastasectomy have been limited primarily to institutional experiences, reports of favorable long-term outcomes have generated increasing interest. In the current study, the authors attempted to define the national practice patterns in metastasectomy for 4 common malignancies with varying responsiveness to systemic therapy. The National (Nationwide) Inpatient Sample was used to estimate the national incidence of metastasectomy for colorectal cancer, lung cancer, breast cancer, and melanoma from 2000 through 2011. Incidence-adjusted rates were determined for liver, lung, brain, small bowel, and adrenal metastasectomies. The average annual percentage change (AAPC) in metastasectomy by cancer type was calculated using joinpoint regression. Colorectal cancer was the most common indication for metastasectomy (87,407 cases; 95% confidence interval [95% CI], 86,307-88,507 cases) followed by lung cancer (58,245 cases; 95% CI, 57,453-59,036 cases), breast cancer (26,271 cases; 95% CI, 25,672-26,870 cases), and melanoma (20,298 cases; 95% CI, 19,897-20,699 cases). Metastasectomy increased significantly for all cancer types over the study period: colorectal cancer (AAPC, 6.83; 95% CI, 5.7-7.9), lung cancer (AAPC, 5.8; 95% CI, 5.1-6.4), breast cancer (AAPC, 5.5; 95% CI, 3.7-7.3), and melanoma (AAPC, 4.03; 95% CI, 2.1-6.0). Despite an increasing number of comorbidities in patients undergoing metastasectomy (P<.05 for each cancer type), inpatient mortality rates after metastasectomy fell for all cancer types, most significantly for colorectal (AAPC, -5.49; 95% CI, -8.2 to -2.7) and lung (AAPC, -6.2; 95% CI, -11.7 to -0.3) cancers. The increasing performance of metastasectomy was largely driven by high-volume institutions, in which patients had a lower mean number of comorbidities (P<.01 for all cancer types) and lower inpatient mortality (P<.01 for all cancers except melanoma). From 2000 through 2011, the performance of metastasectomy increased substantially across common cancer types, notwithstanding various advances in systemic therapies. Metastasectomy was performed more safely, despite increasing patient comorbidity. High-volume institutions appeared to drive practice patterns. © 2014 American Cancer Society.

What Do Unions Do for Women? Research-in-Brief.

ERIC Educational Resources Information Center

Braunstein, Jill; And Others

Although union membership has been declining overall, the number of women union members continues to increase. Currently, 37 percent of union membership are women. The proportion of women workers who are union members increased from 16.3 percent in 1965 to 19.3 percent in 1975 and fell to 14 percent in 1990; 7.4 million women were represented by…

Regenerating mahogany (Swietenia macrophylla) from seed in Quintana Roo, Mexico: the effects of sowing method and clearing treatment.

Treesearch

Patricia Negreros-Castilloa; Laura K. Snookb; Carl W. Mize

2003-01-01

Honduras or bigleaf mahogany (Swietenia macrophylla King) is the most commercially important timber species in the Neotropics, but it often does not regenerate successfully after harvesting. Effective methods are needed to sustain or increase mahogany yields by increasing regeneration. This study evaluates the effects of three treatments (slash, fell and burn; slash,...

Midsouth Pulpwood Prices, 1983

Treesearch

Dennis M. May

1985-01-01

The average price per cord for Midsouth roundwood pulpwood increased less than 1 percent to $48.38 in 1983. The average price for a green ton of chipped mill residues fell 9.3 percent to $23.34. Sawdust prices averaged $13.04 per green ton, a 42.2 percent increase over 1982 prices. Prices for rail delivery of wood fiber continue to be slightly lower than truck...

Quantitative and qualitative measures of decomposition: is there a link?

Treesearch

Robert J. Eaton; Felipe G. Sanchez

2009-01-01

Decomposition rates of loblolly pine coarse woody debris (CWD) were determined by mass loss and wood density changes for trees that differed in source of mortality (natural, girdle-poison, and felling). Specifically, three treatments were examined: (1) control (CON): natural mortality; (2) CD: 5-fold increase in CWD compared with the CON; and (3) CS: 12-fold increase...

Forest statistics for the Southern Coastal Plain of South Carolina

Treesearch

Benjamin L. Koontz; Raymond M. Sheffield

1993-01-01

Since 1987, area of timberland in the Southern Coastal Plain of South Carolina increased by 3 percent to 3.3 million acres. Nonindustrial private forest landowners control nearly three-fourths of the region's timberland. The area classified as pine increased by 14 percent, while hardwood acreage dropped by 12 percent. The area harvested annually fell to 87.000...

Remission death in acute lymphoblastic leukaemia: a changing pattern.

PubMed Central

Atra, A; Richards, S M; Chessells, J M

1993-01-01

The pattern of remission deaths was examined in 842 children with acute lymphoblastic leukaemia (ALL) treated at a single centre over 18 years. The mortality rate from leukaemia fell significantly during three consecutive time periods during which treatment became progressively more intensive and that during remission induction fell from 3.5% to under 1%, but the rate of death in remission stayed constant at 5-6%. The factors associated with an increased risk of remission death were: young age, a higher leucocyte count, bone marrow transplantation, and Down's syndrome. The pattern of remission deaths changed over the years; measles and herpes viruses decreased while deaths associated with periods of intensification and gut toxicity increased. Four children developed second neoplasms. Treatment of ALL is still associated with a significant risk of death in remission but the pattern of infective deaths has changed. Many should be avoidable by provision of adequate supportive care, close supervision after periods of intensive treatment, and appropriate antibiotic, antifungal, and cytokine therapy. PMID:8257173

The effect of critical thinking education on nursing students' problem-solving skills.

PubMed

Kanbay, Yalçın; Okanlı, Ayşe

2017-06-01

The aim of this study is to examine the effect of critical thinking education on nursing students' problem-solving skills. This study was conducted with 93 nursing students, 49 in the control group and 44 in the education group. The California Critical Thinking Disposition Inventory and the Problem-solving Inventory were administered to them before and after 12 weeks of critical thinking education. The education group's mean critical thinking score was 253.61 on the pretest and 268.72 on the posttest. This increase was statistically significant (p < .001). The posttest mean score of the control group fell to 258.18 on the posttest after a pretest mean score of 260.79, and this difference was statistically significant (p < .001). According to the posttest results, the problem-solving skills of education group increased significantly (p < .001), while the control group's score fell significantly (p < .001). This study determined that critical thinking education improves problem-solving skills.

Evaluating the effectiveness of contour-felled log erosion barriers as a post-fire runoff and erosion mitigation treatment in the western United States

Treesearch

P. R. Robichaud; J. W. Wagenbrenner; R. E. Brown; P. M. Wohlgemuth; J. L. Beyers

2008-01-01

Between 1998 and 2002, six sites were established immediately after large wildfires in the western United States to determine the effectiveness of contour-felled log erosion barriers in mitigating post-wildfire runoff and erosion. In each pair of matched, burned, and small watersheds (1-13 ha), one was treated with contour-felled log erosion barriers and one was left...

Urban sprawl as a risk factor in motor vehicle occupant and pedestrian fatalities.

PubMed

Ewing, Reid; Schieber, Richard A; Zegeer, Charles V

2003-09-01

We sought to determine the association between urban sprawl and traffic fatalities. We created a sprawl index by applying principal components analysis to data for 448 US counties in the largest 101 metropolitan areas. Regression analysis was used to determine associations between the index and traffic fatalities. For every 1% increase in the index (i.e., more compact, less sprawl), all-mode traffic fatality rates fell by 1.49% (P <.001) and pedestrian fatality rates fell by 1.47% to 3.56%, after adjustment for pedestrian exposure (P <.001). Urban sprawl was directly related to traffic fatalities and pedestrian fatalities. Subsequent studies should investigate relationships at a finer geographic scale and should strive to improve on the measure of exposure used to adjust pedestrian fatality rates.

Rakshasutra movement: a women's campaign to save Uttarakhand forests.

PubMed

Bhai, S

1999-01-01

Villagers, particularly the women, have once again come forward to launch another novel movement to save Uttarakhand forests and the environment. Established in July 1995, the Rakshasutra (Safety thread) movement struggled to stop the operations of Uttar Pradesh Forest Corporation (UPFC). Through the help of the Himalayan Environmental Education Society volunteers, women consolidated and unite to protest against illegal felling and selling of trees in the region. Moreover, the National Commission for Women also voiced their concerns regarding this issue and supported women in this movement to save the forests. In Tehri, a group of environmentalists, social workers, and women activists initiated an action program to investigate the increasing tree felling activities of UPFC. Their campaign, and the strong public opinion it generated, forced UPFC to put an end to its illegal business.

Increased negatively of interstitial fluid pressure in rat skin contributes to the edema formation induced by Zymosan.

PubMed

Ostgaard, G; Reed, R K

1993-11-01

Increased negatively of interstitial fluid pressure (Pif) contributes to rapid edema formation in several acute inflammatory reactions attesting to an "active" role for the loose connective tissues in the transcapillary fluid exchange and edema formation under these circumstances. The present study reports the effect of the complement activator Zymosan on Pif, transcapillary fluid, and albumin flux. Micropipettes (tip diameter 5 to 7 microns) connected to a servo-controlled counterpressure system were used to measure Pif in rat dermis. When compared to saline injection, subdermal injection of 1 mg Zymosan in 10 microliters 0.15 M NaCl increased total tissue water by 1.6 ml/g dry weight in 5 min, corresponding to about 150% increase in interstitial fluid volume. Pif increased from +0.4 to +3.7 mm Hg. Increased negativity of Pif can be masked by the edema formation which will increase Pif. Measurements were therefore also performed after circulatory arrest, when transcapillary fluid flux and edema formation are abolished. Using this experimental protocol Pif fell from +0.3 mm Hg to -2.5 mm Hg 5 min after subdermal injection of Zymosan and remained at this level throughout the observation period of 90 min. Injection of saline alone after circulatory arrest increased Pif transiently by about 1 mm Hg. Thus, subdermal injection of Zymosan causes increased negativity of Pif by about 4 mm Hg. Although the lowering of Pif itself will explain a minor part of the increased fluid filtration, the results attest to the role of loose connective tissues being active in the edema-generating process also in the inflammatory reaction induced by Zymosan.

LiDAR monitoring of retrogressive processes on the steep rockslope of a large landslide in the Japanese Alps

NASA Astrophysics Data System (ADS)

Nishii, R.; Imaizumi, F.; Murakami, W.; Daimaru, H.; Miyamae, T.; Ogawa, Y.

2012-04-01

Akakuzure landslide in Japanese Alps is located in a steep mountain slope experienced deep-seated gravitational slope deformation. The landslide is 700 m high (1200-1900 m a.s.l.), 700 m wide and 400000 m2 in area with post-collapsed sediment ca 27 million m3 in volume. The steep rockslope (>40°) in the landslide shows anaclinal structure consisting of sandstone interbedding with shale. Large volume of sediment produced from the landslide has actively formed an alluvial fan on the outlet of the landslide. The volume and processes of the sediment production in the upper part (ca.40000 m^2) of the landslide were evaluated by geodetic surveys using techniques of airborne and ground-based LiDAR (Light Detection and Ranging). The airborne and ground-based LiDAR surveys were performed twice (2003 and 2007) and 3 times (2010-2011), respectively. Ground surface temperatures were monitored at 3 locations within the landslide from 2010 to 2011. Precipitation and air temperature have been also observed on a meteorological station near the study site. The average erosion depths in the observed rockslope reached 0.89 m (0.22 m/yr) during the first 4 years (2003-2007) and 0.55 m (0.18 m/yr) during the later 3 years (2007-2010). The erosion mainly occurred within the landslide rather than on the edge of the landslide (i.e. no significant retreat of the main scarp). Such large sediment production can be divided into three processes based on the depth of detachment. Deep detachment (>5 m in depth), significantly contributing to the retreat of the rockslope, happened to large blocks had located just above knick lines. During the observation period, at least five large blocks fell down, which appears to originate from sliding along the detachment zone steeper than 30°. Second, anaclinal bedding-parallel blocks (1-2 m in depth) fell down, which mainly occurred around sandstone layers. Finally, thin detachment (<1 m in depth) widely occurred on the rockslope. On one part of shale layers, the erosion depth reached 0.35 m from 2010 to 2011. In Akakuzure landside, numerous fractures of the bedrock, probably produced by gravitational deformation, play an important role to promote the rapid erosion, in addition to external triggers such as heavy rainfalls and frost actions.

Effects of a 3-day fast and of ethanol on splanchnic metabolism of FFA, amino acids, and carbohydrates in healthy young men.

PubMed

Wolfe, B M; Havel, J R; Marliss, E B; Kane, J P; Seymour, J; Ahuja, S P

1976-02-01

Splanchnic metabolism was studied to quantify changes underlying the fatty liver, hyperlipemia, and hypoglycemia produced by ethanol. Four subjects fasted for 15 h were compared with five subjects fasted for 69 h under basal conditions and during continuous intravenous infusion of sufficient ethanol to give a concentration of 3-5 mM in arterial blood plasma. Splanchnic storage of fatty acids was estimated from the difference between uptake of FFA and secretion of derived products. Basal values for splanchnic uptake of FFA were twofold higher after the 69-h fast while splanchnic storage of fatty acids and production of ketone bodies increased threefold. Values for basal secreation into the blood of triglycerides derived from FFA were similar in the two groups. In both nutritional states, the fraction of FFA taken up in the splanchnic region oxidized to ketone bodies and to CO2 fell when ethanol was given because of preferential oxidation of ethanol to acetate, and the fraction esterified rose. However, systemic transport and splanchnic uptake of FFA fell with ethanol in subjects fasted 15 h, so that neither storage of triglycerides in splanchnic tissues nor secretion into the blood increased. In subjects fasted 69 h, ethanol increased transport of FFA and splanchnic storage of fat. In all but one subject it also increased secretion of triglycerides into the blood. The concentration of glucose in blood fell during ethanol infusion in all five subjects undergoing the 69-h fast. Mean splanchnic glucose production was maintained at about one-half of the pre-ethanol value, despite virtual cessation of splanchnic uptake of lactate and of those amino acids that are metabolized via malate. Quantitative estimates of extrasplanchnic metabolism suggest that enhanced formation of alpha-glycerophosphate from glucose, in addition to impaired hepatic gluconeogenesis, may contribute to ethanol-induced hypoglycemia in man.

The effects on increasing cardiac output with adrenaline or isoprenaline on arterial haemoglobin oxygen saturation and shunt during one-lung ventilation.

PubMed

Russell, W J; James, M F

2000-12-01

Theoretically, if the cardiac output were increased in the presence of a given intrapulmonary shunt, the arterial haemoglobin oxygen saturation (SaO2) should improve as the venous oxygen extraction per ml of blood decreases. To test this hypothesis, eight pigs were subjected to one-lung ventilation and adrenaline and isoprenaline infusions used to increase the cardiac output. The mixed venous oxygen, shunt fraction and oxygen consumption were measured. With both adrenaline and isoprenaline, although there was a small rise in mixed venous oxygen content, there was a fall in SaO2. With adrenaline, the mean shunt rose from 48% to 65%, the mean oxygen consumption rose from 126 ml/min to 134 ml/min and the mean SaO2 fell from 86.9% to 82.5%. With isoprenaline, the mean shunt rose from 45% to 59%, the mean oxygen consumption rose from 121 ml/min to 137 ml/min and the mean SaO2 fell from 89.5% to 84.7%. It is concluded that potential improvement in SaO2, which might occur from a catecholamine-induced increase in mixed venous oxygen content during one-lung ventilation, is more than offset by increased shunting and oxygen consumption which reduce SaO2.

Depletion of intracellular zinc from neurons by use of an extracellular chelator in vivo and in vitro.

PubMed

Frederickson, Christopher J; Suh, Sang W; Koh, Jae-Young; Cha, Yoo K; Thompson, Richard B; LaBuda, Christopher J; Balaji, Rengarajan V; Cuajungco, Math P

2002-12-01

The membrane-impermeable chelator CaEDTA was introduced extracellularly among neurons in vivo and in vitro for the purpose of chelating extracellular Zn(2+). Unexpectedly, this treatment caused histochemically reactive Zn(2+) in intracellular compartments to drop rapidly. The same general result was seen with intravesicular Zn(2+), which fell after CaEDTA infusion into the lateral ventricle of the brain, with perikaryal Zn(2+) in Purkinje neurons (in vivo) and with cortical neurons (in vitro). These findings suggest either that the volume of zinc ion efflux and reuptake is higher than previously suspected or that EDTA can enter cells and vesicles. Caution is therefore warranted in attempting to manipulate extracellular or intracellular Zn(2+) selectively.

Why are patients prescribed proton pump inhibitors? Retrospective analysis of link between morbidity and prescribing in the General Practice Research Database

PubMed Central

Bashford, James N R; Norwood, Jeff; Chapman, Stephen R

1998-01-01

Objectives: To establish the relation between new prescriptions for proton pump inhibitors and recorded upper gastrointestinal morbidity within a large computerised general practitioner database. Design: Retrospective survey of morbidity and prescribing data linked to new prescriptions for proton pump inhibitors and comparison with licensed indications between 1991 and 1995. Setting: General Practice Research Database and prescribing analysis and cost (PACT) data for the former West Midlands region. Subjects: Information for 612 700 patients in the General Practice Research Database. Anonymous PACT data for all general practitioners in West Midlands region. Main outcome measures: Diagnostic codes linked to the first prescriptions issued for proton pump inhibitors; relation between new prescriptions and licensed indications; yearly change in ratio of new to repeat prescriptions and prescribing volumes measured as defined daily doses. Results: Oesophagitis was the commonest recorded indication in 1991, accounting for 31% of new prescriptions, but was third in 1995 (14%). During the study new prescriptions increased substantially, especially for duodenal disease (780%) and non-ulcer dyspepsia (690%). In 1995 non-specific morbidity accounted for 46% of new prescriptions. The total volume of prescribing rose 10-fold between 1991 and 1995, when repeat prescribing accounted for 77% of the total. Conclusions: Changes in recorded morbidity associated with new prescriptions of proton pump inhibitors did not necessarily reflect changes in licensed indications. Although general practitioners seemed to respond to changes in licensing, particularly for duodenal and gastric disease, prescribing for unlicensed indications non-ulcer dyspepsia and non-specific abdominal pain increased. Key messages There has been much speculation about the reasons behind the substantial rise in prescribing of proton pump inhibitors, especially their use for minor symptoms. We used the General Practitioner Research Database for the former West Midlands region to show that the volume of proton pump inhibitor prescribing rose 10-fold between 1992 and 1995 and repeat prescribing had risen to 77% of the volume by 1995 Prescribing for uncomplicated dyspepsia and non-specific abdominal symptoms, which were outside the licensed indications, accounted for 46% of new prescribing by 1995 The proportion of prescribing for the licensed indication of oesophagitis fell during the study, but that for duodenal ulceration increased in line with the expansion of licensed indications Analysis of PACT data showed similar prescribing trends to those found with the General Practitioner Research Database PMID:9703528

Private Giving to Colleges Is up, but Fewer Alumni Make Donations

ERIC Educational Resources Information Center

Strout, Erin

2006-01-01

Colleges in the US raised a collective US$25.6-billion in private donations during the 2005 fiscal year, which is a 4.9% increase from the previous year, but the proportion of alumni who made gifts fell again. The wealth was also not evenly distributed, with the increase in giving to just the top ten institutions accounting for half of the total…

Midsouth Pulpwood Prices, 1984

Treesearch

Dennis M. May

1986-01-01

In 1984, the average price for a cord of Midsouth roundwood was $50.55, an increase of 4.5 percent from 1983. The average price for a green ton of chipped residues also increased, up 9.0 percent to $25.44. However, the average price for a green ton of sawdust fell 17.3 percent to $10.79. Rail delivery prices for wood fiber continue to be lower than truck delivery...

Effect of weightlessness on mineral saturation of bone tissue

NASA Technical Reports Server (NTRS)

Krasnykh, I. G.

1975-01-01

X-ray photometry of bone density established dynamic changes in mineral saturation of bone tissues for Soyuz spacecraft and Salyut orbital station crews. Calcaneus optical bone densities in all crew members fell below initial values; an increase in spacecrew exposure time to weightlessness conditions also increased the degree of decalcification. Demineralization under weightlessness conditions took place at a higher rate than under hypodynamia.

Suppression of muscle protein turnover and amino acid degradation by dietary protein deficiency

NASA Technical Reports Server (NTRS)

Tawa, N. E. Jr; Goldberg, A. L.

1992-01-01

To define the adaptations that conserve amino acids and muscle protein when dietary protein intake is inadequate, rats (60-70 g final wt) were fed a normal or protein-deficient (PD) diet (18 or 1% lactalbumin), and their muscles were studied in vitro. After 7 days on the PD diet, both protein degradation and synthesis fell 30-40% in skeletal muscles and atria. This fall in proteolysis did not result from reduced amino acid supply to the muscle and preceded any clear decrease in plasma amino acids. Oxidation of branched-chain amino acids, glutamine and alanine synthesis, and uptake of alpha-aminoisobutyrate also fell by 30-50% in muscles and adipose tissue of PD rats. After 1 day on the PD diet, muscle protein synthesis and amino acid uptake decreased by 25-40%, and after 3 days proteolysis and leucine oxidation fell 30-45%. Upon refeeding with the normal diet, protein synthesis also rose more rapidly (+30% by 1 day) than proteolysis, which increased significantly after 3 days (+60%). These different time courses suggest distinct endocrine signals for these responses. The high rate of protein synthesis and low rate of proteolysis during the first 3 days of refeeding a normal diet to PD rats contributes to the rapid weight gain ("catch-up growth") of such animals.

Electrical impedance tomography can rapidly detect small pneumothoraces in surfactant-depleted piglets.

PubMed

Bhatia, Risha; Schmölzer, Georg M; Davis, Peter G; Tingay, David G

2012-02-01

Diagnosis of pneumothorax relies on clinical suspicion and chest X-ray, and is often delayed. We aimed to determine whether electrical impedance tomography (EIT) can accurately identify the presence of surgically created pneumothoraces before significant changes in clinical parameters. Six anesthetized and muscle-relaxed piglets with surfactant-depleted lungs were studied. Following chest drain insertion into the right ventral chest, 10-20 ml aliquots of air were instilled into the pleural space to a maximum volume of 200 ml. The pneumothorax was drained by attaching a Heimlich valve to the chest drain. At each instillation and after draining the pneumothorax, global and regional end-expiratory intra-thoracic volumes (EEV) were measured using respiratory inductive plethysmography (RIP) and EIT concurrently with [Formula: see text], heart rate and blood pressure. A significantly greater change in both global EEV(RIP) and EEV within the right ventral quadrant was seen at all volume instillations, from as little as 10 ml, compared with all other quadrants. There was no difference in EEV within the left ventral and both dorsal quadrants. Sp(O)(2) fell below 90% at 100 ml instillation. Tachycardia occurred at 140 ml instillation. EIT identified a 60% resolution of pneumothoraces within 60 s of attachment of the Heimlich valve. EIT accurately detects very small pneumothoraces before physiological parameters change.

Markets and Childhood Obesity Policy

ERIC Educational Resources Information Center

Cawley, John

2006-01-01

In examining the childhood obesity epidemic from the perspective of economics, John Cawley looks at both possible causes and possible policy solutions that work through markets. The operation of markets, says Cawley, has contributed to the recent increase in childhood overweight in three main ways. First, the real price of food fell. In…

Arboreal nests of Phenacomys longgicaudus in Oregon.

Treesearch

A.M. Gillesberg; A.B. Carey

1991-01-01

Searching felled trees proved effective for finding nests of Phenacomys longicaudus; 117 nests were found in 50 trees. Nests were located throughout the live crowns, but were concentrated in the lower two-thirds of the canopy. Abundance of nests increased with tree size; old-growth forests provide optimum habitat.

Toward Explaining Earlier Retirement after 1970.

ERIC Educational Resources Information Center

Ippolito, Richard A.

1990-01-01

Rule changes in the social security system and pension plans suggest that labor force participation rates for men aged 55 to 64 fell by 20 percent from 1970 through 1986 because of the increase in social security benefits and a change in private pension rules encouraging earlier retirement. (Author/JOW)

Preharvest herbicide treatment improves regeneration in Southern Appalachian Hardwoods

Treesearch

David Loftis

2009-01-01

Preharvest herbicide treatment of undesirable and unmerchantable vegetation was compared to postharvest felling. Ten years after the clearcut harvesting, the preharvest treatment had increased the number and proportion of diserable stems and decreased the number and proportion of undesirable sprouts in the dominant stand. Stands that developed after the preharvest...

The role of the cardiac nerves in regulation of sodium excretion in conscious dogs.

PubMed

Kaczmarczyk, G; Drake, A; Eisele, R; Mohnhaupt, R; Noble, M I; Simgen, B; Stubbs, J; Reinhardt, H W

1981-05-01

Conscious, chronically instrumented dogs, maintained on a high sodium intake, were used to investigate whether surgical cardiac denervation impairs the natriuresis associated with left atrial pressure increase produced in three ways: during an increase in left atrial pressure by means of a reversible mitral stenosis (protocol 1); after an i.v. saline load (1.0 ml 0.9% saline min-1 . kg-1 over 60 min) (protocol 2); after an oral saline load (14.5 mmol Na . kg-1 given with the food as isotonic solution) (protocol 3). During a reversible mitral stenosis, in intact dogs, urine volume and sodium excretion increased markedly (from 34--145 microliters . min-1 . kg-1 and from 3--12 mumol . min-1 . kg-1); mean arterial pressure increased by an average of 2 kPa (15 mm Hg) and heart rate by 53 b/min; plasma renin activity fell from 0.37--0.21 ng AI . ml-1 . h-1 . Cardiac denervation eliminated these effects of left atrial distension except for a small increase in heart rate (12 b/min). This indicates that the natriuresis and diuresis during left atrial distension resulted from stimulation of receptors located in the left atrium. In contrast, during protocol 2 and 3, the same amounts of sodium and water were excreted in the cardiac denervated dogs as compared to the intact dogs. A comparable decrease in plasma renin activity also was observed. -- Apparently the presence of the cardiac nerves is not a prerequisite for maintenance of sodium and water homeostasis.

Moderately high frequency ventilation with a conventional ventilator allows reduction of tidal volume without increasing mean airway pressure.

PubMed

Cordioli, Ricardo Luiz; Park, Marcelo; Costa, Eduardo Leite Vieira; Gomes, Susimeire; Brochard, Laurent; Amato, Marcelo Britto Passos; Azevedo, Luciano Cesar Pontes

2014-12-01

The aim of this study was to explore if positive-pressure ventilation delivered by a conventional ICU ventilator at a moderately high frequency (HFPPV) allows a safe reduction of tidal volume (V T) below 6 mL/kg in a porcine model of severe acute respiratory distress syndrome (ARDS) and at a lower mean airway pressure than high-frequency oscillatory ventilation (HFOV). This is a prospective study. In eight pigs (median weight 34 [29,36] kg), ARDS was induced by pulmonary lavage and injurious ventilation. The animals were ventilated with a randomized sequence of respiratory rates: 30, 60, 90, 120, 150, followed by HFOV at 5 Hz. At each step, V T was adjusted to allow partial pressure of arterial carbon dioxide (PaCO2) to stabilize between 57 and 63 mmHg. Data are shown as median [P25th,P75th]. After lung injury, the PaO2/FiO2 (P/F) ratio was 92 [63,118] mmHg, pulmonary shunt 26 [17,31]%, and static compliance 11 [8,14] mL/cmH2O. Positive end-expiratory pressure (PEEP) was 14 [10,17] cmH2O. At 30 breaths/min, V T was higher than 6 (7.5 [6.8,10.2]) mL/kg, but at all higher frequencies, V T could be reduced and PaCO2 maintained, leading to reductions in plateau pressures and driving pressures. For frequencies of 60 to 150/min, V T progressively fell from 5.2 [5.1,5.9] to 3.8 [3.7,4.2] mL/kg (p < 0.001). There were no detrimental effects in terms of lung mechanics, auto-PEEP generation, hemodynamics, or gas exchange. Mean airway pressure was maintained constant and was increased only during HFOV. During protective mechanical ventilation, HFPPV delivered by a conventional ventilator in a severe ARDS swine model safely allows further tidal volume reductions. This strategy also allowed decreasing airway pressures while maintaining stable PaCO2 levels.

Insulin and glucose responses during bed rest with isotonic and isometric exercise

NASA Technical Reports Server (NTRS)

Dolkas, C. B.; Greenleaf, J. E.

1977-01-01

The effects of daily intensive isotonic (68% maximum oxygen uptake) and isometric (21% maximum extension force) leg exercise on plasma insulin and glucose responses to an oral glucose tolerance test (OGTT) during 14-day bed-rest (BR) periods were investigated in seven young healthy men. The OGTT was given during ambulatory control and on day 10 of the no-exercise, isotonic, and isometric exercise BR periods during the 15-wk study. The subjects were placed on a controlled diet starting 10 days before each BR period. During BR, basal plasma glucose concentration remained unchanged with no exercise, but increased (P less 0.05) to 87-89 mg/100 ml with both exercise regimens on day 2, and then fell slightly below control levels on day 13. The fall in glucose content during BR was independent of the exercise regimen and was an adjustment for the loss of plasma volume. The intensity of the responses of insulin and glucose to the OGTT was inversely proportional to the total daily energy expenditure during BR. It was estimated that at least 1020 kcal/day must be provided by supplemental exercise to restore the hyperinsulinemia to control levels.

Learning curve with minimally invasive unicompartmental knee arthroplasty.

PubMed

Hamilton, William G; Ammeen, Deborah; Engh, C Anderson; Engh, Gerard A

2010-08-01

This study examined 445 consecutive minimally invasive unicompartmental knee arthroplasties (UKAs) from one institution to determine whether revision and reoperation rates would decrease as the number of cases performed increased, indicating the presence of a learning curve with this procedure. At a mean of 3.25 years, 26 knees required revision yielding an overall revision rate of 5.8%; survivorship at 2 years with revision as an end point was 96% +/- 1.7%. Both revisions and reoperations decreased over time but not significantly. For the first half of UKA cases performed vs the second half, revision rates fell from 5.0% to 2.5%, and reoperation rates fell from 8.1% to 5.4%. These data demonstrate that despite modifications made to improve surgical technique across time, a substantial complication rate with this procedure persists. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Urban Sprawl as a Risk Factor in Motor Vehicle Occupant and Pedestrian Fatalities

PubMed Central

Ewing, Reid; Schieber, Richard A.; Zegeer, Charles V.

2003-01-01

Objectives. We sought to determine the association between urban sprawl and traffic fatalities. Methods. We created a sprawl index by applying principal components analysis to data for 448 US counties in the largest 101 metropolitan areas. Regression analysis was used to determine associations between the index and traffic fatalities. Results. For every 1% increase in the index (i.e., more compact, less sprawl), all-mode traffic fatality rates fell by 1.49% (P < .001) and pedestrian fatality rates fell by 1.47% to 3.56%, after adjustment for pedestrian exposure (P < .001). Conclusions. Urban sprawl was directly related to traffic fatalities and pedestrian fatalities. Subsequent studies should investigate relationships at a finer geographic scale and should strive to improve on the measure of exposure used to adjust pedestrian fatality rates. PMID:12948977

Analysis of phases in the structure determination of an icosahedral virus

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

Plevka, Pavel; Kaufmann, Bärbel; Rossmann, Michael G.

2012-03-15

The constraints imposed on structure-factor phases by noncrystallographic symmetry (NCS) allow phase improvement, phase extension to higher resolution and hence ab initio phase determination. The more numerous the NCS redundancy and the greater the volume used for solvent flattening, the greater the power for phase determination. In a case analyzed here the icosahedral NCS phasing appeared to have broken down, although later successful phase extension was possible when the envelope around the NCS region was tightened. The phases from the failed phase-determination attempt fell into four classes, all of which satisfied the NCS constraints. These four classes corresponded to themore » correct solution, opposite enantiomorph, Babinet inversion and opposite enantiomorph with Babinet inversion. These incorrect solutions can be seeded from structure factors belonging to reciprocal-space volumes that lie close to icosahedral NCS axes where the structure amplitudes tend to be large and the phases tend to be 0 or {pi}. Furthermore, the false solutions can spread more easily if there are large errors in defining the envelope designating the region in which NCS averaging is performed.« less

Analysis of phases in the structure determination of an icosahedral virus.

PubMed

Plevka, Pavel; Kaufmann, Bärbel; Rossmann, Michael G

2011-06-01

The constraints imposed on structure-factor phases by noncrystallographic symmetry (NCS) allow phase improvement, phase extension to higher resolution and hence ab initio phase determination. The more numerous the NCS redundancy and the greater the volume used for solvent flattening, the greater the power for phase determination. In a case analyzed here the icosahedral NCS phasing appeared to have broken down, although later successful phase extension was possible when the envelope around the NCS region was tightened. The phases from the failed phase-determination attempt fell into four classes, all of which satisfied the NCS constraints. These four classes corresponded to the correct solution, opposite enantiomorph, Babinet inversion and opposite enantiomorph with Babinet inversion. These incorrect solutions can be seeded from structure factors belonging to reciprocal-space volumes that lie close to icosahedral NCS axes where the structure amplitudes tend to be large and the phases tend to be 0 or π. Furthermore, the false solutions can spread more easily if there are large errors in defining the envelope designating the region in which NCS averaging is performed. © 2011 International Union of Crystallography

Analysis of phases in the structure determination of an icosahedral virus

PubMed Central

Plevka, Pavel; Kaufmann, Bärbel; Rossmann, Michael G.

2011-01-01

The constraints imposed on structure-factor phases by non­crystallographic symmetry (NCS) allow phase improvement, phase extension to higher resolution and hence ab initio phase determination. The more numerous the NCS redundancy and the greater the volume used for solvent flattening, the greater the power for phase determination. In a case analyzed here the icosahedral NCS phasing appeared to have broken down, although later successful phase extension was possible when the envelope around the NCS region was tightened. The phases from the failed phase-determination attempt fell into four classes, all of which satisfied the NCS constraints. These four classes corresponded to the correct solution, opposite enantiomorph, Babinet inversion and opposite enantiomorph with Babinet inversion. These incorrect solutions can be seeded from structure factors belonging to reciprocal-space volumes that lie close to icosahedral NCS axes where the structure amplitudes tend to be large and the phases tend to be 0 or π. Furthermore, the false solutions can spread more easily if there are large errors in defining the envelope designating the region in which NCS averaging is performed. PMID:21636897

Ventilation by high-frequency chest wall compression in dogs with normal lungs.

PubMed

Zidulka, A; Gross, D; Minami, H; Vartian, V; Chang, H K

1983-06-01

In 6 anesthetized and paralyzed supine dogs, ventilation by high-frequency chest wall compression (HFCWC) was accomplished by a piston pump rapidly oscillating the pressure in a modified double blood pressure cuff wrapped around the lower thorax. Testing applied frequencies at 3, 5, 8, and 11 Hz, applied peak cuff pressures ranged from 30 to 230 cmH2O. This produced swings of esophageal pressure as high as 18 cmH2O and peak oscillatory air flow ranging from 0.7 to 1.6 L/s. Oscillatory tidal volume declined with increasing frequency and ranged from a mean of 61 to 45 ml. After 30 min of applied HFCWC, arterial blood gas determinations revealed a mean PaCO2 of 29.3 mmHg at 5 Hz, 35 mmHg at 3 Hz, 36 mmHg at 8 Hz, and 51 mmHg at 11 Hz. Mean PaO2 improved from ventilator control values at 3 Hz, remained unchanged at 5 and 8 Hz, and declined at 11 Hz. In 2 dogs breathing spontaneously, HFCWC applied at 5 and 11 Hz resulted in a reduction in spontaneous minute ventilation, mainly by a reduction in spontaneous tidal volume, whereas arterial blood gas values changed slightly. One dog ceased to breath spontaneously within 5 min of application of HFCWC as the PaCO2 fell below control values. We conclude that in dogs with normal lungs, HFCWC may assist spontaneous ventilation. In paralyzed dogs, HFCWC may be of sufficient magnitude to cause hyperventilation.

19th century pioneering of intensive therapy in North America. Part 3: the Fell-O'Dwyer apparatus and William P Northrup.

PubMed

Trubuhovich, Ronald V

2009-03-01

Two previous articles in this series have described the reintroduction of forced respiration for ventilatory difficulties, particularly in opiate poisoning (by George Fell), and successful use of intralaryngeal tubes designed for treating airway obstruction in diphtheritic acute laryngitis (by Joseph O'Dwyer). In 1891, O'Dwyer extended the applications of Fell's system, introducing a longer orolaryngeal tube, replacing Fell's methods of inflating the lungs, which had been with a somewhat unsatisfactory facemask or through a tracheotomy tube. The combined system became known as the "Fell-O'Dwyer apparatus". Use of the apparatus widened, to include treating apnoea from intracranial disasters (by William P Northrup, especially) and, on the initiative of Rudolph Matas, in delivering anaesthesia and maintaining lung inflation to enable intrathoracic surgery (by FW Parham). Although the apparatus was used beyond New York (eg, in New Orleans by J D Bloom, especially for neonatal apnoea), it is difficult to find other than nonspecific references. Matas and Bloom improved O'Dwyer's original system, but after the clinical success of Charles Elsberg's continuous insufflation anaesthesia for thoracic surgery, 1909, American anaesthetists came to prefer that.

JPRS Report, Latin America.

DTIC Science & Technology

1987-06-29

finances. The tourism Industry bettered Its 1985 performance. The apprecia- tion of European currencies against the U.S dollar since the second...ing Industry , the output of which fell by 19.6 per cent during 1986. : Consumers benflted from the drop In crude oil prices and the Barbados...corresponding period in 1985. Price increases were mainly associated with an 8.8 per cent increase in the price of food and non-alcoholic beverage . With a

Determining the effects of felling method and season of year on the regeneration of short rotation coppice

Treesearch

Daniel P.L. de Souza; Tom Gallagher; Dana Mitchell; Tim McDonald; Mathew Smidt

2016-01-01

There is increasing interest in plantations with the objective of producing biomass for energy and fuel. These types of plantations are called Short Rotation Woody Crops (SRWC). Popular SRWC species are Eucalypt (Eucalyptus spp.), Cottonwood (Populus deltoides) and Willow (Salix spp.). These species have in...

Southern pulpwood production, 1991

Treesearch

Michael Howell

1993-01-01

In 1991, Southern pulpwood production climbed 1 percent, to 65.08 million cords. Roundwood production increased 2 percent to 46.6 million cords, and wood residue production fell 5 percent to 18.4 million cords. One new pulpmill began operating in the region. Pulping capacity of the 104 southern pulpmill was 133.331 tons per day.

Drought effects on leaf abscission and leaf production in Populus clones

Treesearch

Stephen G. Pallardy; Julie L. Rhoads

1997-01-01

Leaf abscission and foliation responses to water stress were studied in potted plants of five Populus clones grown in a greenhouse. As predawn leaf water potential (Ψ1) fell to -3 MPa, drought-induced leaf abscission increased progressively to 30% for data pooled across clones. As predawn Ψ1...

Metabolic Effects of Nicotine Gum and Cigarette Smoking: Potential Implications for Postcessation Weight Gain?

ERIC Educational Resources Information Center

Klesges, Robert C.; And Others

1991-01-01

Twenty smoking women participated in nicotine gum and smoking administration, after which resting energy expenditures (REEs) were measured. Results indicated acute increase in REE for both nicotine gum and cigarettes. Metabolic rates for nicotine gum slowly returned to baseline; rates for cigarettes quickly fell significantly below baseline.…

28 CFR 104.2 - Eligibility definitions and requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Special Master determines was sufficiently close to the site that there was a demonstrable risk of... fell, or debris fell upon and injured persons). [66 FR 66282, Dec. 21, 2001, as amended at 67 FR 11245...

Sound-level-dependent representation of frequency modulations in human auditory cortex: a low-noise fMRI study.

PubMed

Brechmann, André; Baumgart, Frank; Scheich, Henning

2002-01-01

Recognition of sound patterns must be largely independent of level and of masking or jamming background sounds. Auditory patterns of relevance in numerous environmental sounds, species-specific vocalizations and speech are frequency modulations (FM). Level-dependent activation of the human auditory cortex (AC) in response to a large set of upward and downward FM tones was studied with low-noise (48 dB) functional magnetic resonance imaging at 3 Tesla. Separate analysis in four territories of AC was performed in each individual brain using a combination of anatomical landmarks and spatial activation criteria for their distinction. Activation of territory T1b (including primary AC) showed the most robust level dependence over the large range of 48-102 dB in terms of activated volume and blood oxygen level dependent contrast (BOLD) signal intensity. The left nonprimary territory T2 also showed a good correlation of level with activated volume but, in contrast to T1b, not with BOLD signal intensity. These findings are compatible with level coding mechanisms observed in animal AC. A systematic increase of activation with level was not observed for T1a (anterior of Heschl's gyrus) and T3 (on the planum temporale). Thus these areas might not be specifically involved in processing of the overall intensity of FM. The rostral territory T1a of the left hemisphere exhibited highest activation when the FM sound level fell 12 dB below scanner noise. This supports the previously suggested special involvement of this territory in foreground-background decomposition tasks. Overall, AC of the left hemisphere showed a stronger level-dependence of signal intensity and activated volume than the right hemisphere. But any side differences of signal intensity at given levels were lateralized to right AC. This might point to an involvement of the right hemisphere in more specific aspects of FM processing than level coding.

Fluid extravasation during cardiopulmonary bypass in piglets--effects of hypothermia and different cooling protocols.

PubMed

Farstad, M; Heltne, J K; Rynning, S E; Lund, T; Mongstad, A; Eliassen, F; Husby, P

2003-04-01

Hypothermic cardiopulmonary bypass (CPB) is associated with capillary fluid leak and edema generation which may be secondary to hemodilution, inflammation and hypothermia. We evaluated how hypothermia and different cooling strategies influenced the fluid extravasation rate during CPB. Fourteen piglets were given 60 min normothermic CPB, followed by randomization to two groups: 1: rapid cooling (RC-group) ( approximately 15 min to 28 degrees C); 2: slow cooling (SC-group) ( approximately 60 min to 28 degrees C). Ringer's solution was used as CPB prime and for fluid supplementation. Fluid input/losses, plasma volume, colloid osmotic pressures (plasma, interstitial fluid), hematocrit, serum-proteins and total tissue water (TTW) were measured and fluid extravasation rates calculated. Start of normothermic CPB resulted in a 25% hemodilution. During the first 5-10 min the fluid level of the reservoir fell markedly due to an intravascular volume loss necessitating fluid supplementation. Thereafter a steady state was reached with a constant fluid need of 0.14 +/- 0.04 ml kg-1 min-1. After start of cooling the fluid needs increased in the following 30 min to 0.91 +/- 0.11 ml kg-1 min-1 in the RC group (P < 0.001) and 0.63 +/- 0.10 ml kg-1 min-1 in the SC-group (P < 0.001) with no statistical between-group differences. Fluid extravasation rates after start of hypothermic CPB increased from 0.20 +/- 0.08 ml kg-1 min-1 to 0.71 +/- 0.13 (P < 0.01) and 0.62 +/- 0.13 ml kg-1 min-1 (P < 0.05) in the RC- and SC-groups, respectively, without any changes in degree of hemodilution. TTW increased in most tissues, whereas the intravascular albumin and protein masses remained constant with no between group differences. Hypothermia increased fluid extravasation during CPB independent of cooling strategy. Intravascular albumin and protein masses remained constant. Since inflammatory fluid leakage usually results in protein rich exudates, our data with no net protein leakage may indicate that mechanisms other than inflammation could contribute to fluid extravasation during hypothermic CPB.

Immediate central and peripheral haemodynamic effects of a new vasodilating agent Pinacidil (P1134) in hypertensive man.

PubMed

Carlsen, J E; Kardel, T; Hilden, T; Tangø, M; Trap-Jensen, J

1981-08-01

The purpose of this study was to evaluate the immediate central and peripheral haemodynamic effects of a new vasodilating agent P 1134, in hypertensive man. After oral administration of 25 mg P 1134, the maximal haemodynamic changes were (mean +/- 1 SEM): mean blood pressure fell from 121.8 +/- 6.5 to 80.5 +/- 7.8 mmHg, heart rate increased 24.2 +/- 4.5 beats/min, cardiac output rose 2.9 +/- 0.3 1/min and forearm blood flow increased 1.0 +/- 0.1 ml/100 ml tissue/min. Stroke volume increased 17.0 +/- 2.1 ml and the inotropic state of the heart as judged from systolic time intervals increased. Total peripheral resistance and forearm vascular resistance were both reduced by approx. 50%. Linear correlations were found between the serum concentration of P 1134 and the change in mean blood pressure and total peripheral resistance. Changes in the other parameters mentioned above occurred progressively with changes in mean blood pressure and total peripheral resistance. It can be concluded that P 1134 is a very potent hypotensive agent with a haemodynamic profile identical to that seen with vasodilators with preferably act on precapillary resistance vessels. Potency and maximal efficacy exceeds that of hydralazine and seems like that of minoxidil. P 1134 is remarkably free from side-effects apart from causing water retention as all other vasodilators. It can be administered orally as well as intravenously. This makes P 1134 a very interesting compound in the treatment of moderate to severe hypertension, and further studies are well-founded.

IgE Immunoadsorption Knocks Down the Risk of Food-Related Anaphylaxis.

PubMed

Dahdah, Lamia; Ceccarelli, Stefano; Amendola, Silvia; Campagnano, Pietro; Cancrini, Caterina; Mazzina, Oscar; Fiocchi, Alessandro

2015-12-01

The effects of an immunoadsorption procedure, specifically designed to remove immunoglobulin E (IgE), on food-induced anaphylaxis have never been evaluated. We evaluate the effects of IgE removal on the allergic thresholds to foods. A 6-year-old boy with anaphylaxis to multiple foods and steroid-resistant unstable allergic asthma displayed serum IgE levels of 2800 to 3500 kU/L. To lower IgE serum concentrations, which could be overridden by a high dose of omalizumab, 1.5 plasma volumes were exchanged in 8 apheresis sessions. During the procedure, serum IgE levels fell to 309 kU/L. After the procedure, the threshold of reactivity to baked milk increased from 0.125 to 5 g of milk protein (full tolerance) after the first session, and the threshold of reactivity to hazelnut increased from 0.037 to 0.142 g of protein after the first session, 0.377 g after the eighth, and 1.067 g (full tolerance) after the first administration of omalizumab. Immediately after the sixth IgE immunoadsorption, we started omalizumab therapy. In the next 40 days, the threshold of reactivity to hazelnut increased to 7.730 (full tolerance). Asthma control was obtained, treatment with montelukast was stopped, and fluticasone was tapered from 500 to 175 μg/day. The boy became partially or fully tolerant to all the tested foods, and quality of life was improved. IgE immunoadsorption, used to establish the starting basis for omalizumab administration, is able to increase the tolerance threshold to foods. Copyright © 2015 by the American Academy of Pediatrics.

Psychiatric in-patient care and suicide in England, 1997 to 2008: a longitudinal study.

PubMed

Kapur, N; Hunt, I M; Windfuhr, K; Rodway, C; Webb, R; Rahman, M S; Shaw, J; Appleby, L

2013-01-01

Psychiatric in-patients are at high risk of suicide. Recent reductions in bed numbers in many countries may have affected this risk but few studies have specifically investigated temporal trends. We aimed to explore trends in psychiatric in-patient suicide over time. A prospective study of all patients admitted to National Health Service (NHS) in-patient psychiatric care in England (1997-2008). Suicide rates were determined using National Confidential Inquiry and Hospital Episode Statistics (HES) data. Over the study period there were 1942 psychiatric in-patient suicides. Between the first 2 years of the study (1997, 1998) and the last 2 years (2007, 2008) the rate of in-patient suicide fell by nearly one-third from 2.45 to 1.68 per 100,000 bed days. This fall in rate was observed for males and females, across ethnicities and diagnoses. It was most marked for patients aged 15-44 years. Rates also fell for the most common suicide methods, particularly suicide by hanging on the ward (a 59% reduction). Although the number of post-discharge suicides fell, the rate of post-discharge suicide may have increased by 19%. The number of suicide deaths in those under the care of crisis resolution/home treatment teams has increased in recent years to approximately 160 annually. The rate of suicide among psychiatric in-patients in England has fallen considerably. Possible explanations include falling general population rates, changes in the at-risk population or improved in-patient safety. However, a transfer of risk to the period after discharge or other clinical settings such as crisis resolution teams cannot be ruled out.

National and state patterns of teen births in the United States, 1940-2013.

PubMed

Ventura, Stephanie J; Hamilton, Brady E; Matthews, T J

2014-08-20

This report presents trends from 1940 through 2013 in national birth rates for teenagers, with particular focus on the period since 1991. The percent changes in rates for 1991-2012 and for 2007-2012 are presented for the United States and for states. Preliminary data for 2013 are shown where available. Tabular and graphical descriptions of the trends in teen birth rates for the United States and each state, by age group, race, and Hispanic origin, are presented and discussed. Data are shown for the U.S. territories. Birth rates for U.S. teenagers have generally fallen in the United States since peaking in 1957. The rate fell 57% between 1991 and 2013. The 2013 preliminary rate (26.6 per 1,000 aged 15-19) is less than one-third of the historically highest rate (96.3 in 1957). During 1991-2012, rates fell for all race and Hispanic ethnicity groups, with the largest declines measured for non-Hispanic black teenagers. In the more recent period, 2007-2012, the declines have been steepest for Hispanic teenagers. Birth rates declined significantly for teenagers in all states during 1991-2012; during 2007-2012, rates fell for all but two states. The drop in teen birth rates translates into an estimated 4 million fewer births to teenagers from 1992 through 2012. The declines in teen birth rates reflect a number of behavioral changes, including decreased sexual activity, increases in the use of contraception at first sex and at most recent sex, and the adoption and increased use of hormonal contraception, injectables, and intrauterine devices. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

Time from HIV infection to virological suppression: dramatic fall from 2007 to 2016.

PubMed

Medland, Nicholas A; Nicholson, Suellen; Chow, Eric P F; Read, Timothy R H; Bradshaw, Catriona S; Denham, Ian; Fairley, Christopher K

2017-11-13

Time from HIV infection to virological suppression: dramatic fall from 2007 to 2016. We examined the time from HIV infection to virological suppression in MSM who were first diagnosed at Melbourne Sexual Health Centre between 2007 and 2016. Retrospective cohort. Date of infection was imputed from the testing history or serological evidence of recent infection (negative or indeterminate western blot) or baseline CD4 cell count. Date of virological suppression was determined using clinical viral load data. We analysed predictors of diagnosis with serological evidence of recent infection (logistic regression) and time from diagnosis to suppression and from infection to suppression (Cox regression) using demographic, clinical, and behavioral covariates. Between 2007 and 2016, the median time from HIV infection to diagnosis fell from 6.8 to 4.3 months (P = 0.001), from diagnosis to suppression fell from 22.7 to 3.2 months (P < 0.0001), and from infection to suppression fell from 49.0 to 9.6 months (P < 0.0001). Serological evidence of recent infection increased from 15.6 to 34.3% (P < 0.0001) of diagnoses. In the multivariate analyses, age, being recently arrived from a non-English speaking country, history of IDU, other sexually transmitted infections, and sexual risk were not associated with any of these measures. The duration of infectiousness in MSM diagnosed with HIV infection at Melbourne Sexual Health Centre in Victoria has fallen dramatically between 2007 and 2016 and the proportion diagnosed with serological evidence of recent infection has increased. This effect is observed across all population subgroups and marks a positive milestone for the treatment as prevention paradigm.

Neurological deaths of American adults (55-74) and the over 75's by sex compared with 20 Western countries 1989-2010: Cause for concern.

PubMed

Pritchard, Colin; Rosenorn-Lanng, Emily

2015-01-01

Have USA total neurological deaths (TNDs) of adults (55-74) and the over 75's risen more than in twenty Western Countries? World Health Organization TND data are compared with control mortalities cancer mortality rates (CMRs) and circulatory disease deaths (CDDs) between 1989-1991 and 2008-2010 and odds ratios (ORs) and confidence intervals calculated. Neurological Deaths - Twenty country (TC) average 55-74 male rates per million (pm) rose 2% to 503 pm, USA increased by 82% to 627 pm. TC average females rose 1% to 390 pm, USA rising 48% to 560 pm. TC average over 75's male and female increased 117% and 143%; USA rising 368% and 663%, significantly more than 16 countries. Cancer mortality - Average 55-74 male and female fell 20% and 12%, USA down 36% and 18%. TC average over 75's male and female fell 13% and 15%, the USA 29% and 2%. Circulatory deaths - TC average 55-74 rates fell 60% and 46% the USA down 54% and 53%. Over 75's average down 46% and 39%, USA falling 40% and 33%. ORs for rose substantially in every country. TC average 75's ORs for CMR: TND male and females were 1:2.83 and 1:3.04 but the USA 1:5.18 and 1:6.50. The ORs for CDD: TND male and females TC average was 1:3.42 and 1:3.62 but the USA 1:6.13 and 1:9.89. Every country's neurological deaths rose relative to the controls, especially in the USA, which is a cause for concern and suggests possible environmental influences.

Bans of WHO Class I Pesticides in Bangladesh—suicide prevention without hampering agricultural output

PubMed Central

Chowdhury, Fazle Rabbi; Dewan, Gourab; Verma, Vasundhara R; Knipe, Duleeka W; Isha, Ishrat Tahsin; Faiz, M Abul; Gunnell, David J; Eddleston, Michael

2018-01-01

Abstract Background Pesticide self-poisoning is a major problem in Bangladesh. Over the past 20-years, the Bangladesh government has introduced pesticide legislation and banned highly hazardous pesticides (HHPs) from agricultural use. We aimed to assess the impacts of pesticide bans on suicide and on agricultural production. Methods We obtained data on unnatural deaths from the Statistics Division of Bangladesh Police, and used negative binomial regression to quantify changes in pesticide suicides and unnatural deaths following removal of WHO Class I toxicity HHPs from agriculture in 2000. We assessed contemporaneous trends in other risk factors, pesticide usage and agricultural production in Bangladesh from 1996 to 2014. Results Mortality in hospital from pesticide poisoning fell after the 2000 ban: 15.1% vs 9.5%, relative reduction 37.1% [95% confidence interval (CI) 35.4 to 38.8%]. The pesticide poisoning suicide rate fell from 6.3/100 000 in 1996 to 2.2/100 000 in 2014, a 65.1% (52.0 to 76.7%) decline. There was a modest simultaneous increase in hanging suicides [20.0% (8.4 to 36.9%) increase] but the overall incidence of unnatural deaths fell from 14.0/100 000 to 10.5/100 000 [25.0% (18.1 to 33.0%) decline]. There were 35 071 (95% CI 25 959 to 45 666) fewer pesticide suicides in 2001 to 2014 compared with the number predicted based on trends between 1996 to 2000. This reduction in rate of pesticide suicides occurred despite increased pesticide use and no change in admissions for pesticide poisoning, with no apparent influence on agricultural output. Conclusions Strengthening pesticide regulation and banning WHO Class I toxicity HHPs in Bangladesh were associated with major reductions in deaths and hospital mortality, without any apparent effect on agricultural output. Our data indicate that removing HHPs from agriculture can rapidly reduce suicides without imposing substantial agricultural costs. PMID:29024951

[Changes in the monoamine content in different parts of hypothalamus depending on the stages of the estrous cycle].

PubMed

Babichev, V N; Adamskaia, E I

1976-01-01

Fluorimetric determination of monoamines in various regions of the hypothalamus and at different stages of the estral cycle in rats showed that the serotonin, noradrenaline, and particularly dophamine content changed both in the course of the cycle and at different time (10, 15 and 18 hours) of the same stage of the cycle. Dophamine concentration in the arcuate area--the centre of the tonic activity--reached its maximum at 18 hours of the diestrus-2 (D2) and fell to the minimum at 10 hours of the proestrus (P). Noradrenaline level in the preoptic area increased at 18 hours of the D2 and fell at 10 hours of the P. It is supposed that in the hypothalamic regulation of the estral cycle at least two monoamines (dopamine and noradrenaline) took part; the trigger role belongs to noradrenaline of the preoptic area (the cyclic centre).

Elimination of scattered residual saplings left after clearcut harvesting of Appalachian hardwoods

Treesearch

G. R., Jr. Trimble; R. L. Rosier

1972-01-01

Basal-spraying and power-saw felling were compared as methods for eliminating the 1- to 5-inch d.b.h. understory stems left after clearcutting. Felling leaves the area more esthetically acceptable, and costs are lower.

Decrease in Statewide Antipsychotic Prescribing after Implementation of Child and Adolescent Psychiatry Consultation Services.

PubMed

Barclay, Rebecca P; Penfold, Robert B; Sullivan, Donna; Boydston, Lauren; Wignall, Julia; Hilt, Robert J

2017-04-01

To learn if a quality of care Medicaid child psychiatric consultation service implemented in three different steps was linked to changes in statewide child antipsychotic utilization. Washington State child psychiatry consultation program primary data and Medicaid pharmacy division antipsychotic utilization secondary data from July 1, 2006, through December 31, 2013. Observational study in which consult program data were analyzed with a time series analysis of statewide antipsychotic utilization. All consultation program database information involving antipsychotics was compared to Medicaid pharmacy division database information involving antipsychotic utilization. Washington State's total child Medicaid antipsychotic utilization fell from 0.51 to 0.25 percent. The monthly prevalence of use fell by a mean of 0.022 per thousand per month following the initiation of elective consults (p = .004), by 0.065 following the initiation of age/dose triggered mandatory reviews (p < .001), then by another 0.022 following the initiation of two or more concurrent antipsychotic mandatory reviews (p = .001). High-dose antipsychotic use fell by 57.8 percent in children 6- to 12-year old and fell by 52.1 percent in teens. Statewide antipsychotic prescribing for Medicaid clients fell significantly at different rates following each implementation step of a multilevel consultation and best-practice education service. © Health Research and Educational Trust.

SU-E-T-546: Use of Implant Volume for Quality Assurance of Low Dose Rate Brachytherapy Treatment Plans

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

Wilkinson, D; Kolar, M

Purpose: To analyze the application of volume implant (V100) data as a method for a global check of low dose rate (LDR) brachytherapy plans. Methods: Treatment plans for 335 consecutive patients undergoing permanent seed implants for prostate cancer and for 113 patients treated with plaque therapy for ocular melanoma were analyzed. Plaques used were 54 COMS (10 to 20 mm, notched and regular) and 59 Eye Physics EP917s with variable loading. Plots of treatment time x implanted activity per unit dose versus v100 ^.667 were made. V100 values were obtained using dose volume histograms calculated by the treatment planning systemsmore » (Variseed 8.02 and Plaque Simulator 5.4). Four different physicists were involved in planning the prostate seed cases; two physicists for the eye plaques. Results: Since the time and dose for the prostate cases did not vary, a plot of implanted activity vs V100 ^.667 was made. A linear fit with no intercept had an r{sup 2} = 0.978; more than 94% of the actual activities fell within 5% of the activities calculated from the linear fit. The greatest deviations were in cases where the implant volumes were large (> 100 cc). Both COMS and EP917 plaque linear fits were good (r{sup 2} = .967 and .957); the largest deviations were seen for large volumes. Conclusions: The method outlined here is effective for checking planning consistency and quality assurance of two types of LDR brachytherapy treatment plans (temporary and permanent). A spreadsheet for the calculations enables a quick check of the plan in situations were time is short (e.g. OR-based prostate planning)« less

Static lung volumes in healthy subjects assessed by helium dilution during occlusion of one mainstem bronchus.

PubMed

Johansen, B; Bjørtuft, O; Boe, J

1993-04-01

Single lung function is usually assessed by radioisotopes or, more rarely, by bronchospirometry in which a double lumen catheter is used to separate ventilation of the two lungs. The latter is more precise but less comfortable. An alternative bronchoscopic method is described for determining the volume of a single lung. One mainstem bronchus was temporarily occluded with an inflatable balloon during fibreoptic bronchoscopy in 12 healthy volunteers aged 18-29 years. The functional residual capacities (FRC) of the right, left, and both lungs were measured in duplicate by closed circuit helium dilution. Supplementary vital capacity (VC) manoeuvres permitted calculation of single lung capacities (TLC) and residual volumes (RV). The standard deviation of a single determination of capacities of the right, left, and both lungs were: TLC, 80, 96, and 308 ml; VC, 56, 139, 171 ml; FRC, 131, 74, and 287 ml; RV, 112, 185, and 303 ml, respectively. The sum of the right and left unilateral TLC was not different from bilateral TLC (6.12 v 5.95 l) and the sum of the unilateral FRC was not different from the bilateral FRC (2.60 v 2.78 l). The sum of the unilateral VC was lower than bilateral VC (4.52 v 4.80 l), that of the unilateral RV was higher than bilateral RV (1.60 v 1.16 l). For all subdivisions of lung volume, the right lung was larger than the left. The most common complaint was substernal discomfort during complete exhalation. Oxygen saturation rarely fell below 90%. Temporary occlusion of a mainstem bronchus in normal subjects is safe, relatively simple, and allows fairly precise and accurate measurements of unilateral static lung volumes. Occlusion at TLC, however, probably prevents proper emptying of the non-occluded lung.

Health savings accounts and health reimbursement arrangements: assets, account balances, and rollovers, 2006-2010.

PubMed

Fronstin, Paul

2011-01-01

ASSET LEVELS GROWING: In 2010, there was $7.7 billion in health savings accounts (HSAs) and health reimbursement arrangements (HRAs), spread across 5.7 million accounts. This is up from 2006, when there were 1.2 million accounts with $835.4 million in assets, and 2009, when 5 million accounts held $7.1 billion in assets. AFTER LEVELING OFF, AVERAGE ACCOUNT BALANCE DROPS SLIGHTLY: Increases in average account balances leveled off in 2008 and 2009, and fell slightly in 2010. In 2006, account balances averaged $696. They increased to $1,320 in 2007, a 90 percent increase. Account balances averaged $1,356 in 2008 and $1,419 in 2009, 3 percent and 5 percent increases, respectively. In 2010, average account balances fell to $1,355, down 4.5 percent from the previous year. AVERAGE ROLLOVER DECLINES, WHILE TOTAL ROLLOVERS INCREASE: Despite a decline in the average rollover amount in 2010, total assets being rolled over have been increasing. $4.2 billion was rolled over in 2010, up from $4 billion in 2009. The average rollover increased from $592 in 2006 to $1,295 in 2009, and fell to $1,029 in 2010. The percentage of individuals without a rollover decreased from 23 percent in 2006 to 10 percent in 2009 and increased slightly to 13 percent in 2010. HEALTHY BEHAVIOR MEANS HIGHER ACCOUNT BALANCES AND HIGHER ROLLOVERS: Individuals who exercised, those who did not smoke, and those who were not obese had higher account balances and higher rollovers than those with less healthy behaviors. It was also found that individuals who used cost or quality information had higher account balances and higher rollovers compared with those who did not use such information. However, no relationship was found between either account balance or rollover amounts and various cost-conscious behaviors such as checking pricing before getting services or asking for generic drugs instead of brand names, among other things. DIFFERENCES IN ACCOUNT BALANCES: Men have higher account balances than women, older individuals have higher account balances than younger ones, account balances increase with household income, and education has a significant impact on account balances independent of income and other variables. DIFFERENCES IN ROLLOVER AMOUNTS: Men rolled over more money than women, and older individuals had higher rollover amounts than younger individuals. Rollover amounts increase with household income and education, and individuals with single coverage rolled over a higher amount than those with family coverage.

Felling and bunching small timber on steep slopes.

Treesearch

Rodger A. Arola; Edwin S. Miyata; John A. Sturos; Helmuth M. Steinhilb

1981-01-01

Discusses the results of a field test of the unique Menzi Muck machine for felling and bunching small trees on steep slopes. Includes the analysis of a detailed time study to determine the productivity, costs, and economic feasibility of this unusual machine.

Diesel fuel oil for increasing mountain pine beetle mortality in felled logs

Treesearch

S. A. Mata; J. M. Schmid; D. A. Leatherman

2002-01-01

Diesel fuel oil was applied to mountain pine beetle (Dendroctonus ponderosae Hopkins) infested bolts of ponderosa pine (Pinus ponderosa Lawson) in early June. Just prior to the fuel oil application and 6 weeks later, 0.5 ft2 bark samples were removed from each bolt and the numbers of live beetles counted....

Guatemala social marketing program.

PubMed

1987-01-01

The Guatemala Social Marketing Program reported 1986 increases after social marketing promotion in the sales of Panther and Scudo condoms, Perla oral contraceptives, and Lirio vaginal foaming tablets. Sale of Panther condoms was highest in February; all the other products peaked in June and July. Sales fell in December due to Christmas holidays. Sale patterns are illustrated graphically for all 4 products.

The effect of timber harvesting guidelines on felling and skidding productivity in northern Minnesota

Treesearch

Denys Goychuk; Michael A. Kilgore; Charles R. Blinn; Jay Coggins; Randall K. Kolka

2011-01-01

Substantial investment has been made in the development and application of scientifically based best management practices (i.e., guidelines) intended to protect and enhance the ecological, environmental, and aesthetic attributes of forest resources. When correctly applied, guidelines can increase environmental benefits on site and to adjacent resources, as well as...

Comparative Haematological Screening of Urban and Rural Pregnant Women Attending Antenatal Clinics in Lagos and Its Environs.

ERIC Educational Resources Information Center

Abidoye, R. O.; Olukoya, A. A.

1993-01-01

Compared blood screening data for 200 urban and rural pregnant women in Nigeria. Found that rural subjects had a greater incidence of moderate anemia than did urban subjects, and corpuscular hemoglobin concentrations fell with increased gestational age. No relationship was found between hemoglobin counts and nutrition habits. (HTH)

Assessment Instruments Used in the Education and Treatment of Persons with Autism: Brief Report of a Survey of National Service Centers.

ERIC Educational Resources Information Center

Luiselli, James K.; Campbell, Susan; Cannon, Barbara; DiPietro, Ellette; Ellis, James T.; Taras, Marie; Lifter, Karin

2001-01-01

Data from 30 national service centers found the number of assessment instruments endorsed increased as centers adopted a multidisciplinary approach to education and treatment, the largest proportion of instruments fell within intellectual, motor, and language/communication domains, and instruments were used most frequently for diagnostic and…

China's Demographic Dilemmas.

ERIC Educational Resources Information Center

Tien, H. Yuan; And Others

1992-01-01

China's herculean efforts to slow the increase of its giant population appear to have worked: the annual birth rate fell from about 35 births per 1,000 in the 1950s to 20 per 1,000 in the 1990s. This bulletin examines the development and consequences of the strict population planning control measures introduced in the 1970s, and strengthened in…

Dry Weight of Several Piedmont Hardwoods

Treesearch

Bobby G. Blackmon; Charles W. Ralston

1968-01-01

Forty-four sample hardwood trees felled on 24 plots were separated into three above-ground components- stem, branches, and leaves--and weighed for dry matter content. Tree, stand, and site variables were tested for significant relationships with dry weight of tree parts. Weight increase of stems was a logarithmic function ,of both stem diameter and height, whereas for...

Exploring the Borderlands: Elementary School Teachers' Navigation of Immigration Practices in a New Latino Diaspora Community

ERIC Educational Resources Information Center

Gallo, Sarah; Link, Holly

2016-01-01

Drawing primarily on interview data from a 5-year ethnography on the school experiences of Mexican immigrant children in a New Latino Diaspora community, we explore how their teachers understood and responded to increasing deportation-based immigration practices affecting children's lives. We illustrate how teachers fell along a continuum…

Cold related mortalities and protection against cold in Yakutsk, eastern Siberia: observation and interview study

PubMed Central

Donaldson, G C; Ermakov, S P; Komarov, Y M; McDonald, C P; Keatinge, W R

1998-01-01

Objective To assess how effectively measures adopted in extreme cold in Yakutsk control winter mortality. Design Interviews to assess outdoor clothing and measure indoor temperatures; regressions of these and of delayed cause-specific mortalities on temperature. Setting Yakutsk, east Siberia, Russia. Subjects: All people aged 50-59 and 65-74 years living within 400 km of Yakutsk during 1989-95 and sample of 1002 men and women who agreed to be interviewed. Main outcome measures Daily mortality from all causes and from ischaemic heart, cerebrovascular, and respiratory disease. Results Mean temperature for October-March 1989-95 was −26.6°C. At 10.2°C people wore 3.30 (95% confidence interval 3.08 to 3.53) layers of clothing outdoors, increasing to 4.39 (4.13 to 4.66; P<0.0001) layers at −20°C. Thick coats, often of fur, replaced anoraks as temperature fell to −48.2°C. 82% of people went out each day when temperatures were 10.2°C to −20°C, but below −20°C the proportion fell steadily to 44% (35% to 53%) at −48.2°C (P<0.001), and overall shivering outdoors did not increase. Living room temperature was 17.9 (17.2 to 18.5)°C at 10.2°C outdoors, 19.6 (18.8 to 20.4)°C at −20°C, and 19.1 (18.6 to 19.6)°C at −48.2°C. Mortality from all causes and from ischaemic heart and respiratory disease was unaffected by the fall in temperature. Mortality from respiratory disease (daily deaths per million) rose from 4.7 (4.3 to 5.1) to 5.1 (4.4 to 5.7) (P=0.03), but this was offset by a fall in deaths from injury. Conclusions People in Yakutsk wore very warm clothing, and in extremely cold weather stayed indoors in warm housing, preventing the increases in mortality seen in winter in milder regions of the world. Only respiratory mortality rose, perhaps because of breathing cold air. Key messagesDeath rates from ischaemic heart, cerebrovascular, and respiratory disease and all causes have been shown to increase as air temperature fallsIn Yakutsk, Russia, mortality from cerebrovascular and ischaemic heart disease and all causes among people aged 50-59 and 65-74 was unchanged as temperature fell to −48.2°CMortality from respiratory disease increased as temperatures fell below −20°C but this was more than offset by a decrease in deaths from accidentsExceptionally warm clothing, with reduction of outdoor excursions at temperatures below −20°C, prevented overall outdoor cold stress PMID:9765165

Biphasic changes in fetal heart rate variability in preterm fetal sheep developing hypotension after acute on chronic lipopolysaccharide exposure.

PubMed

Lear, Christopher A; Davidson, Joanne O; Booth, Lindsea C; Wassink, Guido; Galinsky, Robert; Drury, Paul P; Fraser, Mhoyra; Bennet, Laura; Gunn, Alistair J

2014-08-15

Perinatal exposure to infection is highly associated with adverse outcomes. Experimentally, acute, severe exposure to gram-negative bacterial lipopolysaccharide (LPS) is associated with increased fetal heart rate variability (FHRV). It is unknown whether FHRV is affected by subclinical infection with or without acute exacerbations. We therefore tested the hypothesis that FHRV would be associated with hypotension after acute on chronic exposure to LPS. Chronically instrumented fetal sheep at 0.7 gestation were exposed to a continuous low-dose LPS infusion (n = 12, 100 ng/kg over 24 h, followed by 250 ng·kg(-1)·24 h(-1) for a further 96 h) or the same volume of saline (n = 10). Boluses of either 1 μg LPS or saline were given at 48, 72, and 96 h. Low-dose infusion was not associated with hemodynamic or FHRV changes. The first LPS bolus was associated with tachycardia and suppression of nuchal electromyographic activity in all fetuses. Seven of twelve fetuses developed hypotension (a fall in mean arterial blood pressure ≥5 mmHg). FHRV was transiently increased only at the onset of hypotension, in association with increased cytokine induction and electroencephalogram suppression. FHRV then fell before the nadir of hypotension, with transient suppression of short-term FHRV. After the second LPS bolus, the hypotension group showed a biphasic pattern of a transient increase in FHRV followed by more prolonged suppression. These findings suggest that infection-related hypotension in the preterm fetus mediates the transient increase in FHRV and that repeated exposure to LPS leads to progressive loss of FHRV. Copyright © 2014 the American Physiological Society.

12. THE DIVISION OF STOCKHAM'S WORKFORCE FELL MOSTLY ALONG RACIAL ...

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

12. THE DIVISION OF STOCKHAM'S WORKFORCE FELL MOSTLY ALONG RACIAL BOUNDARIES. THESE WHITE COLLAR WORKERS TYPIFIED THE MAKEUP OF ENGINEERING, ACCOUNTING, SALES, AND SUPERVISORY STAFFS OF THE FIRM CA. 1950. - Stockham Pipe & Fittings Company, 4000 Tenth Avenue North, Birmingham, Jefferson County, AL

FY2011 Budget Proposals and Projections

DTIC Science & Technology

2010-09-01

Total federal revenues fell 17% between FY2007 and FY2009, and corporate income tax receipts fell even more sharply. CBO estimated in August 2010 that... corporate income tax and capital gains revenues—typically recover more quickly after economic downturns than lagging indicators such as unemployment

Changes in the contractile state, fine structure and metabolism of cardiac muscle cells during the development of rigor mortis.

PubMed

Vanderwee, M A; Humphrey, S M; Gavin, J B; Armiger, L C

1981-01-01

Transmural slices from the left anterior papillary muscle of dog hearts were maintained for 120 min in a moist atmosphere at 37 degrees C. At 15-min intervals tissue samples were taken for estimation of adenosine triphosphate (ATP) and glucose-6-phosphate (G6P) and for electron microscopic examination. At the same time the deformability under standard load of comparable regions of an adjacent slice of tissue was measured. ATP levels fell rapidly during the first 45 to 75 min after excision of the heart. During a subsequent further decline in ATP, the mean deformability of myocardium fell from 30 to 12% indicating the development of rigor mortis. Conversely, G6P levels increased during the first decline in adenosine triphosphate but remained relatively steady thereafter. Whereas many of the myocardial cells fixed after 5 min contracted on contact with glutaraldehyde, all cells examined after 15 to 40 min were relaxed. A progressive increase in the proportion of contracted cells was observed during the rapid increase in myocardial rigidity. During this late contraction the cells showed morphological evidence of irreversible injury. These findings suggest that ischaemic myocytes contract just before actin and myosin become strongly linked to maintain the state of rigor mortis.

Mechanized thinning of northern hardwood pole stands: methods and economics.

Treesearch

Frank E. Biltonen; Wiliam A. Hillstrom; Helmuth M. Steinhilb; Richard M. Godman

1976-01-01

Describes a study of various thinning treatments in northern hardwood pole stands, using mechanized felling, skidding, and field chipping, as well as chain saw felling. Cost analyses showed that a profit can be made although it is less than can be made with clearcutting.

Analysis of Geomorphic and Hydrologic Characteristics of Mount Jefferson Debris Flow, Oregon, November 6, 2006

USGS Publications Warehouse

Sobieszczyk, Steven; Uhrich, Mark A.; Piatt, David R.; Bragg, Heather M.

2008-01-01

On November 6, 2006, a rocky debris flow surged off the western slopes of Mount Jefferson into the drainage basins of Milk and Pamelia Creeks in Oregon. This debris flow was not a singular event, but rather a series of surges of both debris and flooding throughout the day. The event began during a severe storm that brought warm temperatures and heavy rainfall to the Pacific Northwest. Precipitation measurements near Mount Jefferson at Marion Forks and Santiam Junction showed that more than 16.1 centimeters of precipitation fell the week leading up to the event, including an additional 20.1 centimeters falling during the 2 days afterward. The flooding associated with the debris flow sent an estimated 15,500 to 21,000 metric tons, or 9,800 to 13,000 cubic meters, of suspended sediment downstream, increasing turbidity in the North Santiam River above Detroit Lake to an estimated 35,000 to 55,000 Formazin Nephelometric Units. The debris flow started small as rock and ice calved off an upper valley snowfield, but added volume as it eroded weakly consolidated deposits from previous debris flows, pyroclastic flows, and glacial moraines. Mud run-up markings on trees indicated that the flood stage of this event reached depths of at least 2.4 meters. Velocity calculations indicate that different surges of debris flow and flooding reached 3.9 meters per second. The debris flow reworked and deposited material ranging in size from sand to coarse boulders over a 0.1 square kilometer area, while flooding and scouring as much as 0.45 square kilometer. Based on cross-sectional transect measurements recreating pre-event topography and other field measurements, the total volume of the deposit ranged from 100,000 to 240,000 cubic meters.

Implementation of a new 'community' laboratory CD4 service in a rural health district in South Africa extends laboratory services and substantially improves local reporting turnaround time.

PubMed

Coetzee, L M; Cassim, N; Glencross, D K

2015-12-16

The CD4 integrated service delivery model (ITSDM) provides for reasonable access to pathology services across South Africa (SA) by offering three new service tiers that extend services into remote, under-serviced areas. ITSDM identified Pixley ka Seme as such an under-serviced district. To address the poor service delivery in this area, a new ITSDM community (tier 3) laboratory was established in De Aar, SA. Laboratory performance and turnaround time (TAT) were monitored post implementation to assess the impact on local service delivery. Using the National Health Laboratory Service Corporate Data Warehouse, CD4 data were extracted for the period April 2012-July 2013 (n=11,964). Total mean TAT (in hours) was calculated and pre-analytical and analytical components assessed. Ongoing testing volumes, as well as external quality assessment performance across ten trials, were used to indicate post-implementation success. Data were analysed using Stata 12. Prior to the implementation of CD4 testing at De Aar, the total mean TAT was 20.5 hours. This fell to 8.2 hours post implementation, predominantly as a result of a lower pre-analytical mean TAT reducing from a mean of 18.9 to 1.8 hours. The analytical testing TAT remained unchanged after implementation and monthly test volumes increased by up to 20%. External quality assessment indicated adequate performance. Although subjective, questionnaires sent to facilities reported improved service delivery. Establishing CD4 testing in a remote community laboratory substantially reduces overall TAT. Additional community CD4 laboratories should be established in under-serviced areas, especially where laboratory infrastructure is already in place.

Leisure-time physical activity dose-response effects on obesity among US adults: results from the 1999-2006 National Health and Nutrition Examination Survey.

PubMed

Seo, Dong-Chul; Li, Kaigang

2010-05-01

It is not well established whether total volume of leisure-time physical activity (LTPA) has dose-response effects on obesity. The dose-response relationship was examined using 12 227 non-institutionalised individuals, aged 20-64 years, drawn from the 8 years (1999-2006) of the continuous National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the US population. The age-adjusted prevalence of women's obesity was 41.4% for those with no LTPA in the past month; 39.1% for those who engaged in LTPA but fell short of the recommended minimum amount of LTPA (ie, <450 metabolic equivalent minutes per week (MET min/week)); 31.0% for those who met the recommended minimum guideline (ie, 450 to < 750); 28.0% for those whose LTPA exceeded the minimum guideline but less than the first quartile among the overachievers (ie, 750 to <1260); 23.4% for the overachievers between the first and third quartile (ie, 1260 to <3556); and 19.5% for the overachievers at or above the third quartile (ie, 3556 MET min/week or above). This association was maintained even after occupational physical activity (OPA) was controlled. However, this pattern was not observed for Mexican and black adults and showed a floor effect as LTPA increased. There is a crude graded inverse dose-response relationship between total volume of LTPA and obesity in US adult women, but not in men. Gender and racial/ethnic differences exist in the relationship of accumulated LTPA with obesity due, in part, to differential ratios of LTPA to OPA.

Prevention of bedrest-induced physical deconditioning by daily dobutamine infusions. Implications for drug-induced physical conditioning.

PubMed Central

Sullivan, M J; Binkley, P F; Unverferth, D V; Ren, J H; Boudoulas, H; Bashore, T M; Merola, A J; Leier, C V

1985-01-01

The effects of intermittent infusions of dobutamine were studied in young normal male subjects during a period of bedrest deconditioning to determine whether this synthetic catechol affects physical conditioning processes in humans. 24 volunteers were placed at bedrest and randomized to daily 2-h treatments of saline infusions (control), dobutamine infusions, or maintenance exercise (control). Exercise, hemodynamic, and metabolic studies were performed at base line and at the termination of the 3-wk treatment period. Maximal exercise (duration, oxygen consumption, and workload) fell for the saline group and remained unchanged for the dobutamine and exercise groups. Hemodynamics during exercise were maintained the same as pretreatment base line for the dobutamine and exercise groups, whereas stroke volume and cardiac output dropped and heart rate rose for the saline group. The metabolic profile showed an increased blood lactate response at rest and during submaximal exercise after 3 wk of bedrest for the saline group, and essentially no change for the exercise and the dobutamine groups. Extraction of oxygen across the exercising lower limb rose for the dobutamine group, as did the activity of the skeletal muscle oxidative enzymes, citrate synthetase, and succinate dehydrogenase. In contrast to the exercise control group, the saline and dobutamine groups developed orthostatic hypotension, tachycardia, and accentuation of the renin-aldosterone response over the 3-wk treatment period; for the saline group, this is best explained by the observed fall in blood volume and for the dobutamine group, by the blunting of vascular vasoconstrictive responses. During a period of bedrest deconditioning in humans, infusions of dobutamine maintain many of the physiologic expressions of physical conditioning. PMID:3932470

Hydration status affects urea transport across rat urothelia.

PubMed

Spector, David A; Deng, Jie; Stewart, Kerry J

2011-12-01

Although mammalian urinary tract epithelium (urothelium) is generally considered impermeable to water and solutes, recent data suggest that urine constituents may be reabsorbed during urinary tract transit and storage. To study water and solute transport across the urothelium in an in vivo rat model, we instilled urine (obtained during various rat hydration conditions) into isolated in situ rat bladders and, after a 1-h dwell, retrieved the urine and measured the differences in urine volume and concentration and total quantity of urine urea nitrogen and creatinine between instilled and retrieved urine in rat groups differing by hydration status. Although urine volume did not change >1.9% in any group, concentration (and quantity) of urine urea nitrogen in retrieved urine fell significantly (indicating reabsorption of urea across bladder urothelia), by a mean of 18% (489 mg/dl, from an instilled 2,658 mg/dl) in rats receiving ad libitum water and by a mean of 39% (2,544 mg/dl, from an instilled 6,204 mg/dl) in water-deprived rats, but did not change (an increase of 15 mg/dl, P = not significant, from an instilled 300 mg/dl) in a water-loaded rat group. Two separate factors affected urea nitrogen reabsorption rates, a urinary factor related to hydration status, likely the concentration of urea nitrogen in the instilled urine, and a bladder factor(s), also dependent on the animal's state of hydration. Urine creatinine was also absorbed during the bladder dwell, and hydration group effects on the concentration and quantity of creatinine reabsorbed were qualitatively similar to the hydration group effect on urea transport. These findings support the notion(s) that urinary constituents may undergo transport across urinary tract epithelia, that such transport may be physiologically regulated, and that urine is modified during transit and storage through the urinary tract.

Orthostatic effects on echocardiographic measures of ventricular function.

PubMed

Rowland, Thomas; Unnithan, Viswanath; Barker, Piers; Guerra, Miriam; Roche, Denise; Lindley, Martin

2012-05-01

Orthostatic-induced alterations in Doppler echocardiographic measures of ventricular function have not been well-defined. Identifying such changes may provide useful insights regarding the responses of these measures to variations in ventricular loading conditions. Standard assessment of mitral inflow velocity and tissue Doppler imaging (TDI) of left ventricular longitudinal myocardial velocities was performed on 14 young males (mean age 17.9 ± 0.7 years) in the supine position and then 5 minutes after assuming a sitting position with legs dependent. Upon sitting, average values of stroke volume and cardiac output fell by 28% and 18%, respectively, while heart rate increased from 64 ± 10 to 73 ± 12 beats/min (+14%) and calculated systemic vascular resistance rose from 12.9 ± 2.2 to 16.4 ± 3.1 units (+27%). Mitral E peak velocity declined from 87 ± 16 to 64 ± 16 cm/sec, and average TDI-E' and TDI-S both decreased (by -44% and -20%, respectively). When adjusted for orthostatic decreases in left ventricular end-diastolic volume, the mean decrease in TDI-E' was reduced to -29 (P < 0.01), but no significant decline was observed in adjusted TDI-S. Average E/E' rose with sitting by 40% (P = 0.02). These findings suggest that (a) decreases in TDI measures when assuming the upright position reflect the reduction of left ventricular size; (b) orthostatic fall in TDI-E' is also related to smaller ventricular size but, in addition, to a nonspecified reduction in ventricular relaxation; and (c) values of E/E' do not reflect alterations in ventricular preload, which occur during an orthostatic challenge. © 2012, Wiley Periodicals, Inc.

Prevalence of chronic obstructive pulmonary disease in independent community-dwelling older adults: The Fujiwara-kyo study.

PubMed

Yoshikawa, Masanori; Yamamoto, Yoshifumi; Tomoda, Koichi; Fujita, Yukio; Yamauchi, Motoo; Osa, Takao; Uyama, Hiroki; Okamoto, Nozomi; Kurumatani, Norio; Kimura, Hiroshi

2017-12-01

As the Japanese population ages, the number of older patients with chronic obstructive pulmonary disease (COPD) is expected to increase, but the prevalence of COPD in patients aged ≥80 years remains unclear. The purpose of the present study was to determine the prevalence of COPD in independent community-dwelling older adults aged ≥80 years. We investigated the prevalence of COPD in 2862 independent community-dwelling older adults (1504 men, 1358 women, mean age 77.7 ± 7.0 years) who underwent spirometry in the Fujiwara-kyo study, a study of successful aging in older adults. Those participants with airflow limitation (forced expiratory volume in 1 s/forced vital capacity <0.7) who indicated on a self-administered questionnaire that they had a history of smoking and did not have bronchial asthma were considered to have COPD. The prevalence of COPD was 16.9% among all participants and 37.4% among smokers. The prevalence among individuals aged ≥80 years (19.7%) was significantly higher than that among those aged <80 years (16.0%; P < 0.05). When forced expiratory volume in 1 s/forced vital capacity lower limit of normal was used as the criterion for airflow limitation, the prevalence fell to 11.0%. Patients with mild-to-moderate airflow limitation (stage I/stage II) accounted for the great majority (91.2%) of COPD patients aged ≥80 years. A high prevalence of mild-to-moderate COPD was observed even in the independent community-dwelling older adults aged ≥80 years. However, the benefits of the spirometric screening and treatment for these patients needs to be determined. Geriatr Gerontol Int 2017; 17: 2421-2426. © 2017 Japan Geriatrics Society.

Pharmacokinetic analysis of cloxacillin loss in children undergoing major surgery with massive bleeding.

PubMed Central

Levy, M; Egersegi, P; Strong, A; Tessoro, A; Spino, M; Bannatyne, R; Fear, D; Posnick, J C; Koren, G

1990-01-01

To determine the magnitude of cloxacillin loss during surgical procedures involving significant blood loss and high fluid replacement, we compared the pharmacokinetics of cloxacillin in children during craniomaxillofacial surgery with the disposition of the drug in healthy young adult volunteers with intact circulation. Blood loss during craniofacial operations may exceed blood volume, in some cases by as much as three times. Hemodynamic replacement with electrolyte solutions and blood products, which do not contain the drug, further dilute cloxacillin concentrations. In the patients that we studied, mean drug loss was estimated at 71%. Cloxacillin concentrations in serum fell below the lower range of the MIC for Staphylococcus aureus during significant portions of the surgical procedures. Thus, the traditional dosing of cloxacillin during prolonged operations with massive blood loss is inadequate. A more frequent dosing interval or priming of all replacement fluids with the drug may be required to maintain therapeutic levels. Our findings suggest that massive blood loss is likely to have a dramatic effect on the level of any drug with a small distribution volume. If such a drug is essential to the patient's well-being (e.g., antibiotics, antiarrhythmics, and anticonvulsants), it must be replaced promptly. PMID:2393274

Ash generation and distribution from the April-May 2010 eruption of Eyjafjallajökull, Iceland

PubMed Central

Gudmundsson, Magnús T.; Thordarson, Thorvaldur; Höskuldsson, Ármann; Larsen, Gudrún; Björnsson, Halldór; Prata, Fred J.; Oddsson, Björn; Magnússon, Eyjólfur; Högnadóttir, Thórdís; Petersen, Guðrún Nína; Hayward, Chris L.; Stevenson, John A.; Jónsdóttir, Ingibjörg

2012-01-01

The 39-day long eruption at the summit of Eyjafjallajökull volcano in April–May 2010 was of modest size but ash was widely dispersed. By combining data from ground surveys and remote sensing we show that the erupted material was 4.8±1.2·1011 kg (benmoreite and trachyte, dense rock equivalent volume 0.18±0.05 km3). About 20% was lava and water-transported tephra, 80% was airborne tephra (bulk volume 0.27 km3) transported by 3–10 km high plumes. The airborne tephra was mostly fine ash (diameter <1000 µm). At least 7·1010 kg (70 Tg) was very fine ash (<28 µm), several times more than previously estimated via satellite retrievals. About 50% of the tephra fell in Iceland with the remainder carried towards south and east, detected over ~7 million km2 in Europe and the North Atlantic. Of order 1010 kg (2%) are considered to have been transported longer than 600–700 km with <108 kg (<0.02%) reaching mainland Europe. PMID:22893851

Study and design of cryogenic propellant acquisition systems. Volume 2: Supporting experimental program

NASA Technical Reports Server (NTRS)

Burge, G. W.; Blackmon, J. B.

1973-01-01

Areas of cryogenic fuel systems were identified where critical experimental information was needed either to define a design criteria or to establish the feasibility of a design concept or a critical aspect of a particular design. Such data requirements fell into three broad categories: (1) basic surface tension screen characteristics; (2) screen acquisition device fabrication problems; and (3) screen surface tension device operational failure modes. To explore these problems and to establish design criteria where possible, extensive laboratory or bench test scale experiments were conducted. In general, these proved to be quite successful and, in many instances, the test results were directly used in the system design analyses and development. In some cases, particularly those relating to operational-type problems, areas requiring future research were identified, especially screen heat transfer and vibrational effects.

SU-G-TeP1-01: A Simulation Study to Investigate Maximum Allowable Deformations of Implant Geometry Before Plan Objectives Are Violated in Prostate HDR Brachytherapy

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

Babier, A; Joshi, C; Cancer Center of Southeastern Ontario, Kingston General Hospital, Kingston, Ontario

Purpose: In prostate HDR brachytherapy dose distributions are highly sensitive to changes in prostate volume and catheter displacements. We investigate the maximum deformations in implant geometry before planning objectives are violated. Methods: A typical prostate Ir-192 HDR brachytherapy reference plan was calculated on the Oncentra planning system, which used CT images from a tissue equivalent prostate phantom (CIRS Model 053S) embedded inside a pelvis wax phantom. The prostate was deformed and catheters were displaced in simulations using a code written in MATLAB. For each deformation dose distributions were calculated, based on TG43 methods, using the MATLAB code. The calculations weremore » validated through comparison with Oncentra calculations for the reference plan, and agreed within 0.12%SD and 0.3%SD for dose and volume, respectively. Isotropic prostate volume deformations of up to +34% to −27% relative to its original volume, and longitudinal catheter displacements of 7.5 mm in superior and inferior directions were simulated. Planning objectives were based on American Brachytherapy Society guidelines for prostate and urethra volumes. A plan violated the planning objectives when less than 90% of the prostate volume received the prescribed dose or higher (V{sub 100}), or the urethral volume receiving 125% of prescribed dose or higher was more than 1 cc (U{sub 125}). Lastly, the dose homogeneity index (DHI=1-V{sub 150}/V{sub 100}) was evaluated; a plan was considered sub-optimal when the DHI fell below 0.62. Results and Conclusion: Planning objectives were violated when the prostate expanded by 10.7±0.5% or contracted by 11.0±0.2%; objectives were also violated when catheters were displaced by 4.15±0.15 mm and 3.70±0.15 mm in the superior and inferior directions, respectively. The DHI changes did not affect the plan optimality, except in the case of prostate compression. In general, catheter displacements have a significantly larger impact on plan optimality than prostate volume changes.« less

Removing an exotic shrub from riparian forests increases butterfly abundance and diversity

Treesearch

James Hanula; Scott Horn

2011-01-01

Invasive plants are one of the greatest threats to endangered insect species and a major threat to Lepidoptera in eastern North America. We investigated the effects of the invasive shrub Chinese privet (Ligustrum sinense) and two methods (mulching or hand-felling) of removing it from riparian forests on butterfly communities and compared them to untreated, heavily...

Determining the impact of felling method and season of year on coppice regeneration

Treesearch

Daniel de Souza; Tom Gallagher; Dana Mitchell; Matthew Smidt; Tim McDonald; Jeff Wright

2014-01-01

There is an increasing interest in the establishment of plantations in the Southeast region with the objective of producing biomass for energy and fuel. Establishment of these plantations will require the development of a feasible way to harvest them. These types of plantations are called Short Rotation Woody Crops (SRWC). Popular SRWC species are Eucalypt (...

1964 Oregon log production.

Treesearch

Brian R. Wall

1965-01-01

The production of logs in Oregon in 1964 was 9.4 billion board feet, or nearly 9 percent above 1963. This year, 1964, had the third highest level of log production in history, exceeded only in 1955 and in 1952. The proportion of total cut from private lands fell to 43 percent, even though the total private cut increased 6 percent over that in 1963. Forest industry,...

Annual Earnings of Household Heads in Production Jobs, 1973. Summary: Special Labor Force Report.

ERIC Educational Resources Information Center

Department of Labor, Washington, DC.

The statistics are based on a household survey, collected annually, and are related to one year's earnings experience of family heads and unrelated individuals. Data show that after-tax earnings for the 30 million persons surveyed rose in 1973 by 5.8 percent but fell 0.4 percent after adjustment for consumer price increases (real after-tax…

Kids' Share 2010: Report on Federal Expenditures on Children through 2009

ERIC Educational Resources Information Center

Isaacs, Julia; Steuerle, C. Eugene; Rennane, Stephanie; Macomber, Jennifer

2010-01-01

Federal budget outlays totaled $3.5 trillion in 2009, of which somewhat less than 10 percent ($334 billion) was devoted to children. Despite increased spending on children under the American Recovery and Reinvestment Act of 2009 (ARRA), the kids' share of total outlays actually fell modestly to 9.5 percent in 2009, down from 9.8 percent the…

Oxygen and carbon dioxide in the marine intertidal environment: diurnal and tidal changes in rockpools.

PubMed

Truchot, J P; Duhamel-Jouve, A

1980-03-01

Water oxygen partial pressure (PO2), pH, titration alkalinity (TA), temperature and salinity were measured hourly in rockpools during emersion periods occuring at various times of the diurnal cycle. Measurements allowed calculation of oxygen concentration (CO2), CO2 partial pressure (PCO2) and concentrations of bicarbonate, carbonate and total CO2 (CCO2). During night emersion periods, water PO2 decreased to almost zero in a few hours, pH fell, TA rose and PCO2 increased up to 1-3 Torr. During day emersion periods, water PO2 rose to 400-600 Torr, pH increased to more than 10, TA decreased substantially and PCO2 fell as low as 10(-4) Torr. The direction of the observed changes depended essentially on the illumination, indicating that respiratory and photosynthetic activities were the main processes involved. The large variations of the components of the carbonate system imply considerable changes of the CO2 capacitance coefficient in water, mainly during the day-time emersion. These changes are discussed in relation to the respiratory and acid-base physiology of the animals living in these biotopes.

Cigarette advertising in magazines: the tobacco industry response to the Master Settlement Agreement and to public pressure

PubMed Central

Hamilton, W; Turner-Bowker, D; Celebucki, C; Connolly, G

2002-01-01

Design: Expenditures on cigarette advertisements in national magazines in the USA are compared for three periods: January to November 1998, December 1998 to June 2000, and July 2000 to November 2001. Magazines in which at least 15% of readers are youth under age 18 are focused upon. Regression models test for the significance of period differences after controlling for seasonal and long term patterns. Data sources: Commercially maintained data on advertising in US magazines and on magazine readership by age. Key measures: Monthly cigarette ad expenditures in magazines with 15%+ youth readership, and monthly proportion of ad expenditures in 15%+ youth magazines. Results: Cigarette advertising expenditures in magazines with 15%+ youth readership increased dramatically after MSA implementation and fell dramatically after public pressure. The percentage allocation of expenditures to 15%+ magazines fell significantly in both periods. Results differ somewhat by company. Conclusions: The tobacco industry response to the MSA was at best modest, reducing proportional allocations of advertising to youth magazines but increasing the absolute amount of such advertising. The value of public pressure was seen in substantial reductions in both absolute and proportional spending on youth magazines, although not by all companies. PMID:12034983

[Clinical and socio-medical factors related to anemia in pregnant women: prevalence study in Mara Township, Venezuela, 2013].

PubMed

Avila, Ayari Guadalupe; García, Lenis; Gómez, María; Villanueva, Nixon; Benítez, Betty; Fuentes, Belkis

2014-07-11

Anemia during pregnancy is a frequent finding and can increase morbidity and mortality in both mother and child. This paper aims to identify clinical, social and healthcare-related factors that affect the incidence of anemia in pregnant patients in a primary care prenatal clinic in Mara municipality. This is a descriptive field study that took place between November and December, 2013. Sixty-two patients were selected through non-probability sampling among four primary care clinics in the municipality of Mara. A high prevalence of anemia (76%) was found, with normal MCV (mean corpuscular volume), normal MCH (mean corpuscular hemoglobin), and normal MCHC (mean corpuscular hemoglobin concentration). In only 36% of cases serum iron levels fell below 50 ug/dl. Some clinical factors found to be related to anemia in pregnancy are multiparity (69.9%), infections before or during pregnancy (77.5%), low protein intake (91.8%), less than a year birth interval (63.3%), and gestational age (89.8%). The main socioeconomic factor related to anemia is poverty (89.8%). Prenatal checkup schedule needs to be adjusted in primary care clinics in the municipality of Mara taking into consideration clinical and socioeconomic factors in order to lower the prevalence of anemia during pregnancy in this population.

Development of LiDAR aware allometrics for Abies grandis: A Case Study

NASA Astrophysics Data System (ADS)

Stone, G. A.; Tinkham, W. T.; Smith, A. M.; Hudak, A. T.; Falkowski, M. J.; Keefe, R.

2012-12-01

Forest managers rely increasingly on accurate allometric relationships to inform decisions regarding stand rotations, silvilcultural treatments, timber harvesting, and biometric modeling. At the same time, advances in remote sensing techniques like LiDAR (light detection and ranging) have brought about opportunities to advance how we assess forest growth, and thus are contributing to the need for more accurate allometries. Past studies have attempted to relate LiDAR data to both plot and individual tree measures of forest biomass. However, many of these studies have been limited by the accuracy of their coincident observations. In this study, 24 Abies grandis were measured, felled, and dissected for the explicit objective of developing LiDAR aware allometrics. The analysis predicts spatial variables of competition, growth potential (e.g, trees per acre, aspect, elevation, etc.) and common statistical distributional metrics (e.g., mean, mode, percentiles, variance, skewness, kurtosis, etc.) derived from LiDAR point cloud returns to coincident in situ measures of Abies grandis stem biomass. The resulting allometries exemplify a new approach for predicting structural attributes of interest (biomass, basal area, volume, etc.) directly from LiDAR point cloud data, precluding the measurement errors that are propogated by indirectly predicting these structure attributes of interest from LiDAR data using traditional plot-based measurements.

Results of the Alternative Water Processor Test, A Novel Technology for Exploration Wastewater Remediation

NASA Technical Reports Server (NTRS)

Vega, Leticia; Meyer, Caitlin

2016-01-01

Biologically-based water recovery systems are a regenerative, low energy alternative to physiochemical processes to reclaim water from wastewater. This paper summarizes the results of the Alternative Water Processor (AWP) test conducted over one year. The AWP recovered 90% of water from four crewmembers using (4) membrane aerated bioreactors (MABRs) to remove carbon and nitrogen from an exploration mission wastewater, including urine, hygiene, laundry and humidity condensate. Downstream, a coupled forward and reverse osmosis system removed large organics and inorganic salts from the biological system effluent. The system exceeded the overall objectives of the test by recovering 90% of the influent wastewater processed and a 29% reduction of consumables from the current state of the art water recovery system on the International Space Station (ISS). However the biological system fell short of its test goals, failing to remove 75% and 90% of the influent ammonium and organic carbon, respectively. Despite not meeting its test goals, the BWP demonstrated the feasibility of an attached-growth biological system for simultaneous nitrification and denitrification, an innovative, volume and consumable-saving design that doesn't require toxic pretreatment. This paper will explain the reasons for this and will discuss steps to optimize each subsystem to increase effluent quality from the MABRs and the FOST to advance the system.

Results of the Alternative Water Processor Test, A Novel Technology for Exploration Wastewater Remediation

NASA Technical Reports Server (NTRS)

Vega, Leticia; Meyer, Caitlin

2015-01-01

Biologically-based water recovery systems are a regenerative, low energy alternative to physiochemical processes to reclaim water from wastewater. This paper summarizes the results of the Alternative Water Processor (AWP) test conducted over one year. The AWP recovered 90% of water from four crewmembers using (4) membrane aerated bioreactors (MABRs) to remove carbon and nitrogen from an exploration mission wastewater, including urine, hygiene, laundry and humidity condensate. Downstream, a coupled forward and reverse osmosis system removed large organics and inorganic salts from the biological system effluent. The system exceeded the overall objectives of the test by recovering 90% of the influent wastewater processed and a 29% reduction of consumables from the current state of the art water recovery system on the International Space Station (ISS). However the biological system fell short of its test goals, failing to remove 75% and 90% of the influent ammonium and organic carbon, respectively. Despite not meeting its test goals, the BWP demonstrated the feasibility of an attachedgrowth biological system for simultaneous nitrification and denitrification, an innovative, volume and consumable-saving design that doesn't require toxic pretreatment. This paper will explain the reasons for this and will discuss steps to optimize each subsystem to increase effluent quality from the MABRs and the FOST to advance the system.

The inflammatory response to ruptured abdominal aortic aneurysm is altered by endovascular repair.

PubMed

Makar, R R; Badger, S A; O'Donnell, M E; Soong, C V; Lau, L L; Young, I S; Hannon, R J; Lee, B

2013-01-01

Introduction. Ruptured abdominal aortic aneurysm (rAAA) causes a significant inflammatory response. The study aims to investigate this response following endovascular and open repair of ruptured AAA. Patients and Methods. Consecutive rAAA patients had either endovascular aneurysm repair (EVAR) or open repair (OR). Blood samples were taken for cytokines, lipid hydroperoxides (LOOH), antioxidants, and neutrophil elastase/ α 1-anti-trypsin complexes (NE/AAT) before surgery, 6 hours after clamp release and 1, 3, 5 days postoperatively. Results. 30 patients were included in the study, with 14 undergoing eEVAR and 16 eOR, with comparable baseline comorbidities, age, and parameters. IL-6 peaked higher in eOR patients (P = 0.04), while p75TNFr was similar between groups except at day 5 (P = 0.04). The NE/AAT concentrations were higher in eOR patients (P = 0.01), particularly in the first postoperative day, and correlated with blood (r = 0.398, P = 0.029) and platelet (r = 0.424, P = 0.020) volume transfused. C-reactive protein rose and lipid hydroperoxide fell in both groups without significant intergroup difference. Vitamins C and E, lycopene, and β -carotene levels were similar between groups. Conclusion. EVAR is associated with lower systemic inflammatory response compared to OR. Its increased future use may thereby improve outcomes for patients.

The Inflammatory Response to Ruptured Abdominal Aortic Aneurysm Is Altered by Endovascular Repair

PubMed Central

Makar, R. R.; Badger, S. A.; O'Donnell, M. E.; Soong, C. V.; Lau, L. L.; Young, I. S.; Hannon, R. J.; Lee, B.

2013-01-01

Introduction. Ruptured abdominal aortic aneurysm (rAAA) causes a significant inflammatory response. The study aims to investigate this response following endovascular and open repair of ruptured AAA. Patients and Methods. Consecutive rAAA patients had either endovascular aneurysm repair (EVAR) or open repair (OR). Blood samples were taken for cytokines, lipid hydroperoxides (LOOH), antioxidants, and neutrophil elastase/α1-anti-trypsin complexes (NE/AAT) before surgery, 6 hours after clamp release and 1, 3, 5 days postoperatively. Results. 30 patients were included in the study, with 14 undergoing eEVAR and 16 eOR, with comparable baseline comorbidities, age, and parameters. IL-6 peaked higher in eOR patients (P = 0.04), while p75TNFr was similar between groups except at day 5 (P = 0.04). The NE/AAT concentrations were higher in eOR patients (P = 0.01), particularly in the first postoperative day, and correlated with blood (r = 0.398, P = 0.029) and platelet (r = 0.424, P = 0.020) volume transfused. C-reactive protein rose and lipid hydroperoxide fell in both groups without significant intergroup difference. Vitamins C and E, lycopene, and β-carotene levels were similar between groups. Conclusion. EVAR is associated with lower systemic inflammatory response compared to OR. Its increased future use may thereby improve outcomes for patients. PMID:24363936

Adequacy and pattern of blood donations in north-eastern Nigeria: the implications for blood safety.

PubMed

Ahmed, S G; Ibrahim, U A; Hassan, A W

2007-12-01

In a retrospective analysis, the quantities, patterns and adequacy of blood donations made, between 1984 and 2006, at the University of Maiduguri Teaching Hospital in north-eastern Nigeria were explored and related to blood safety in the study area. The types of blood donor were reviewed and the annual increments in the number of donations made were estimated and compared with the annual increments in the numbers of in-patients managed at the study hospital. The mean annual increment in the number of blood donations (4%) fell well below the mean annual increment in in-patient numbers (11%). The blood donations received at the hospital fell into four types: voluntary, family-replacement, commercial and pre-deposit autologous donations. Over the study period, the percentage of donations falling into the voluntary and family-replacement categories fell from 31% to 5% and from 49% to 23%, respectively. These falls were matched by increases in the percentages of donations categorised as commercial and autologous, which rose from 20% to 63%, and from 1% to 9%, respectively. By the end of the study period, the quantity of blood being donated at the hospital was grossly inadequate and predominantly derived from family and commercial donors, who were found to be generally inferior, in terms of blood safety, to voluntary donors. There is an urgent need to rectify this situation by setting up a functional and national blood-transfusion service in Nigeria.

Benthic invertebrates in the headwaters of the Wye and Severn: effects of forestry and clear-felling

NASA Astrophysics Data System (ADS)

Gee, J. H. R.; Smith, B. D.

Invertebrate communities were recorded in three surveys between 1974 and 1994 of headwaters of the Wye and Severn at Plynlimon: the Afon Gwy (unforested), the Afon Hore (initially forested) and the Afon Hafren (forested throughout). The data cover periods before and after the clear-felling of a large area of coniferous forest in the catchment of the Hore. All three streams contained invertebrates characteristic of acidic, upland conditions and had similar species richness. Differences in assemblage composition within streams between surveys could be related to differences in method or timing of sampling. All assemblages were dominated by Insecta, particularly Plecoptera and Diptera, whereas Ephemeroptera, Moilusca, Crustacca and some families of Trichoptera (notably Hydropsychidae and Philopotamidae) were poorly represented. The forested streams (Hafren and Hore) contained similar assemblages which differed from those in the unforested stream (Gwy) in containing lower densities of Ephemeroptera and Oligochacta and much higher densities of nemourid and leuctrid Plecoptera. Clear-felling of the Hore catchment resulted in changes in physical and chemical conditions (including a reduction of stream pH, and increases in dissolved aluminium concentration and summer water temperature) but no related change in the invertebrate assemblage. The apparent failure of invertebrates to respond as expected to substantial changes in local environmental conditions may reflect either a lack of understanding of causal links between invertebrates and environmental factors, or the over-riding influence of the dynamics of recruitment to populations.

Strontium

USGS Publications Warehouse

Ober, J.A.

1996-01-01

Part of the Annual Commodities Review 1995. In 1995, U.S. strontium imports and consumption increased nearly 30 percent due to increased domestic production of color television picture tube glass. However, strontium compound exports fell during 1995. Strontium is also used in the production of permanent ceramic ferrite magnets. Strontium nitrate, strontium chromate, and strontium chloride are also commonly used materials. Although the development of an affordable flatscreen display could eliminate the need for strontium in television production, this technology is not expected to be perfected in the immediate future.

Cystone® for 1 year did not change urine chemistry or decrease stone burden in cystine stone formers.

PubMed

Erickson, Stephen B; Vrtiska, Terri J; Canzanello, Vincent J; Lieske, John C

2011-06-01

Cystine kidney stones frequently recur because inadequate prevention exists. We recruited documented recurrent cystine kidney stone formers (6 men, 4 women, 44 ± 17 years) into a 2-phased study to assess safety and effectiveness of Cystone®, a herbal treatment used to prevent and facilitate passage of cystine kidney stones. The first phase was a randomized double-blinded 12 weeks crossover study assessing the effect of Cystone® versus placebo (2 tablets BID) on urinary chemistries. The second phase was an open label 1 year study of Cystone® to determine if renal stone burden decreased, as assessed by quantitative and subjective assessment of CT. There was no statistically significant change of urinary composition from baseline short (6 weeks) or long (52 weeks) term on Cystone®, including volume (2525, 2611, 2730 ml), pH (6.7, 6.7, 7.05), and cystine excretion (2770, 2889, 4025 μmol). Pre and post-CT was available in nine patients. Although seven kidneys lost stones spontaneously or surgically, overall stone burden increased in seven kidneys, was unchanged in nine, and fell in only two. Quantitative scoring increased in both the left and right kidneys (1602-1667 and 301-2064 volumetric units, respectively). Therefore, this study does not suggest that Cystone® has a favorable effect on urinary chemistries that could decrease cystine stone formation, nor does it appear to prevent stone growth or promote stone passage over a 1-year period.

Mindfulness and meditation: treating cognitive impairment and reducing stress in dementia.

PubMed

Russell-Williams, Jesse; Jaroudi, Wafa; Perich, Tania; Hoscheidt, Siobhan; El Haj, Mohamad; Moustafa, Ahmed A

2018-02-21

This study investigates the relationship between mindfulness, meditation, cognition and stress in people with Alzheimer's disease (AD), dementia, mild cognitive impairment and subjective cognitive decline. Accordingly, we explore how the use of meditation as a behavioural intervention can reduce stress and enhance cognition, which in turn ameliorates some dementia symptoms. A narrative review of the literature was conducted with any studies using meditation as an intervention for dementia or dementia-related memory conditions meeting inclusion criteria. Studies where moving meditation was the main intervention were excluded due to the possible confounding of exercise. Ten papers were identified and reviewed. There was a broad use of measures across all studies, with cognitive assessment, quality of life and perceived stress being the most common. Three studies used functional magnetic resonance imaging to measure functional changes to brain regions during meditation. The interventions fell into the following three categories: mindfulness, most commonly mindfulness-based stress reduction (six studies); Kirtan Kriya meditation (three studies); and mindfulness-based Alzheimer's stimulation (one study). Three of these studies were randomised controlled trials. All studies reported significant findings or trends towards significance in a broad range of measures, including a reduction of cognitive decline, reduction in perceived stress, increase in quality of life, as well as increases in functional connectivity, percent volume brain change and cerebral blood flow in areas of the cortex. Limitations and directions for future studies on meditation-based treatment for AD and stress management are suggested.

Presence in the media of the topic "donation and transplantation of organs and tissues" during the 2005 to 2007 period in Venezuela as a strategy to improve its perception in Venezuelan society.

PubMed

Pacheco, Z; Alonzo, E; Venegas, I; Armas, S; Hernández, E; Milanés, C L; Rivas Vetencour, P

2009-10-01

Media are main allies to encourage donation and transplantation. We sought to quantify the presence in the media of the topic "Donation and transplantation (D/Tx)" during the period 2005 to 2007 and to determine the relationship between the volume of information issued by the media and indexes related to the topic. We conducted a systematic recording of the news on the topic of D/Tx in print, radio, and television during 2005 to 2007. There was an increased presence in the media by 100% in 2005 and 2006, and by 200% in 2007. The presence in print media was greater than radio (249 +/- 31.5 vs 131 +/- 5.49; P = .05) or television (249 +/- 31.5 vs 92 +/- 7.12; P = .01). We observed a positive correlation between the total number of contacts versus the number of registered volunteer donors (R(2) = 0.9713) and number of contacts versus total number of transplants from cadaveric donors (CTX; R(2) = 0905). The index CTX per million population increased by 30% (2006 vs 2005) and 100% (2007 vs 2005). The percent of family refusals fell from 41% in 2005 to 34% in 2006 and to 31% in 2007. The rate of donors per million population grew steadily from 1.8 in 2005 to 2.3 in 2006, and to 3.6 in 2007. The sustained increase in D/Tx briefing as a strategy of Sistema de Procura de Organos y Tejidos has helped to foster a positive perception that is reflected in the increased rate of donation and transplantation in Venezuela.

An Interactive Simulation System for Modeling Stands, Harvests, and Machines

Treesearch

Jingxin Wang; W. Dale Greene

1999-01-01

A interactive computer simulation program models stands, harvest, and machine factors and evaluates their interatcitons while performing felling, skidding, or fowarding activities. A stand generator allows the user to generate either natural or planted stands. Fellings with chainsaw, drive-to-tree feller-bunchers, or harvesters and extraction with grapple skidders or...

The Decline of Private-Sector Unionism and the Gender Wage Gap.

ERIC Educational Resources Information Center

Even, William E.; Macpherson, David A.

1993-01-01

Between 1973 and 1988, private sector union membership fell by 9.5 percentage points more for men than women; the gender wage gap decreased by 0.09. Unionism fell more slowly for women. Greater decline in male unionism is responsible for one-seventh of the decline in the wage gap. (SK)

Music Enhances Sleep in Preschool Children.

ERIC Educational Resources Information Center

Field, Tiffany

1999-01-01

Examined the effect of playing background classical guitar music at nap time on alternate days to toddlers and preschool children attending a model preschool. Specifically assessed music's effect on nap-time sleep onset. Found that children fell asleep faster on the music days than on the nonmusic days. Toddlers fell asleep faster than did the…

Effect of temperature on postillumination isoprene emission in oak and poplar.

PubMed

Li, Ziru; Ratliff, Ellen A; Sharkey, Thomas D

2011-02-01

Isoprene emission from broadleaf trees is highly temperature dependent, accounts for much of the hydrocarbon emission from plants, and has a profound effect on atmospheric chemistry. We studied the temperature response of postillumination isoprene emission in oak (Quercus robur) and poplar (Populus deltoides) leaves in order to understand the regulation of isoprene emission. Upon darkening a leaf, isoprene emission fell nearly to zero but then increased for several minutes before falling back to nearly zero. Time of appearance of this burst of isoprene was highly temperature dependent, occurring sooner at higher temperatures. We hypothesize that this burst represents an intermediate pool of metabolites, probably early metabolites in the methylerythritol 4-phosphate pathway, accumulated upstream of dimethylallyl diphosphate (DMADP). The amount of this early metabolite(s) averaged 2.9 times the amount of plastidic DMADP. DMADP increased with temperature up to 35°C before starting to decrease; in contrast, the isoprene synthase rate constant increased up to 40°C, the highest temperature at which it could be assessed. During a rapid temperature switch from 30°C to 40°C, isoprene emission increased transiently. It was found that an increase in isoprene synthase activity is primarily responsible for this transient increase in emission levels, while DMADP level stayed constant during the switch. One hour after switching to 40°C, the amount of DMADP fell but the rate constant for isoprene synthase remained constant, indicating that the high temperature falloff in isoprene emission results from a reduction in the supply of DMADP rather than from changes in isoprene synthase activity.

Renal ischemia induces an increase in nitric oxide levels from tissue stores.

PubMed

Salom, Miguel G; Arregui, Begoña; Carbonell, Luis F; Ruiz, Fernando; González-Mora, José Luis; Fenoy, Francisco J

2005-11-01

Tissue nitric oxide (NO) levels increase dramatically during ischemia, an effect that has been shown to be partially independent from NO synthases. Because NO is stored in tissues as S-nitrosothiols and because these compounds could release NO during ischemia, we evaluated the effects of buthionine sulfoximine (BSO; an intracellular glutathione depletor), light stimulation (which releases NO, decomposing S-nitrosothiols), and N-acetyl-L-cysteine (a sulfhydryl group donor that repletes S-nitrosothiols stores) on the changes in outer medullary NO concentration produced during 45 min of renal artery occlusion in anesthetized rats. Renal ischemia increased renal tissue NO concentration (+223%), and this effect was maintained along 45 min of renal arterial blockade. After reperfusion, NO concentration fell below preischemic values and remained stable for the remainder of the experiment. Pretreatment with 10 mg/kg nitro-L-arginine methyl ester (L-NAME) decreased significantly basal NO concentration before ischemia, but it did not modify the rise in NO levels observed during ischemia. In rats pretreated with 4 mmol/kg BSO and L-NAME, ischemia was followed by a transient increase in renal NO concentration that fell to preischemic values 20 min before reperfusion. A similar response was observed when the kidney was illuminated 40 min before the ischemia. The coadministration of 10 mg/kg iv N-acetyl-L-cysteine with BSO + L-NAME restored the increase in NO levels observed during renal ischemia and prevented the depletion of renal thiol groups. These results demonstrate that the increase in renal NO concentration observed during ischemia originates from thiol-dependent tissue stores.

California energy flow in 1989

NASA Astrophysics Data System (ADS)

Borg, I. Y.; Briggs, C. K.

1991-02-01

California's energy use showed a modest increase (2.2 percent) in 1989 over 1988 which was in keeping with the steady increase in population that the state has experienced annually during the decade. All end-use sectors (residential, commercial, industrial, transportation, etc.) contributed to the growth. The larger demand was met by increased imports of all major fuels. Only electrical imports remained close to 1988 levels, in part due to increased output from Diablo Canyon nuclear plant whose performance exceeded expectations. California's per capita energy consumption has traditionally been below the national average due to the relatively benign climate associated with its centers of population. The largest single use for energy in the state was for transportation, which overtook industrial usage in the 60's. Use of highway fuels continued to grow and reached all time highs in 1989. Highway congestion, a major problem and concern in the state, is anticipated to grow as the number of licensed drivers increases; in 1989 the increase was 3.4 percent. Output from the The Geysers Geothermal fields, the largest in the world, continued to falter as the steam output fell. Nonetheless new resources at the Coso Geothermal Resource Area and at the Wendel Geothermal field came on line during the year, and other geothermal areas were under active development. Novel sources of renewable energy (solar, wind, etc.) grew; however, collectively they made only a small contribution to the overall energy supply. Cogenerated electricity sold to the utilities by small power producers inexplicably fell in 1989 although estimates of the total capacity available rose. Energy flow diagrams illustrate energy sources and energy consumption.

Diurnal blood pressure variation in quadriplegic chronic spinal cord injury patients.

PubMed

Krum, H; Louis, W J; Brown, D J; Jackman, G P; Howes, L G

1991-03-01

1. Measurement of blood pressure and heart rate over a 24 h period was performed in 10 quadriplegic spinal cord injury patients and 10 immobilized, neurologically intact orthopaedic subjects by using the Spacelabs 90207 automated ambulatory monitoring system. 2. Systolic and diastolic blood pressure fell significantly at night in orthopaedic subjects but not in quadriplegic patients, and night-time blood pressures were similar in both groups. 3. Cumulative summation of differences from a reference value (cusum analysis) confirmed a markedly diminished diurnal blood pressure variation in the quadriplegic patients. 4. These findings could not be accounted for on the basis of blood pressure variations during chronic postural change. 5. Heart rate fell significantly at night in both groups. 6. The findings suggest that the increase in blood pressure during waking hours in neurologically intact subjects is a consequence of a diurnal variation in sympathetic activity (absent in quadriplegic patients with sympathetic decentralization) which is independent of changes in physical activity.

The plinian eruptions of 1912 at Novarupta, Katmai National Park, Alaska

USGS Publications Warehouse

Fierstein, J.; Hildreth, W.

1992-01-01

The three-day eruption at Novarupta in 1912 consisted of three discrete episodes. Episode I began with plinian dispersal of rhyolitic fallout (Layer A) and contemporaneous emplacement of rhyolitic ignimbrites and associated proximal veneers. The plinian column was sustained throughout most of the interval of ash flow generation, in spite of progressive increases in the proportions of dacitic and andesitic ejecta at the expense of rhyolite. Accordingly, plinian Layer B, which fell in unbroken continuity with purely rhyolitic Layer A, is zoned from >99% to ???15% rhyolite and accumulated synchronously with emplacement of the correspondingly zoned ash flow sequence in Mageik Creek and the Valley of Ten Thousand Smokes (VTTS). Only the andesiterichest flow units that cap the flow sequence lack a widespread fallout equivalent, indicating that ignimbrite emplacement barely outlasted the plinian phase. On near-vent ridges, the passing ash flows left proximal ignimbrite veneers that share the compositional zonation of their valley-filling equivalents but exhibit evidence for turbulent deposition and recurrent scour. Episode II began after a break of a few hours and was dominated by plinian dispersal of dacitic Layers C and D, punctuated by minor proximal intraplinian flows and surges. After another break, dacitic Layers F and G resulted from a third plinian episode (III); intercalated with these proximally are thin intraplinian ignimbrites and several andesite-rich fall/flow layers. Both CD and FG were ejected from an inner vent <400 m wide (nested within that of Episode I), into which the rhyolitic lava dome (Novarupta) was still later extruded. Two finer-grained ash layers settled from composite regional dust clouds: Layer E, which accumulated during the D-F hiatus, includes a contribution from small contemporaneous ash flows; and Layer H settled after the main eruption was over. Both are distinct layers in and near the VTTS, but distally they merge with CD and FG, respectively; they are largely dacitic but include rhyolitic shards that erupted during Episode I and were kept aloft by atmospheric turbulence. Published models yield column heights of 23-26 km for A, 22-25 km for CD, and 17-23 km for FG; and peak mass eruption rates of 0.7-1x108, 0.6-2x108, and 0.2-0.4x108 kg s-1, respectively. Fallout volumes, adjusted to reflect calculated redistribution of rhyolitic glass shards, are 8.8 km3, 4.8 km3, and 3.4 km3 for Episodes I, II, and III. Microprobe analyses of glass show that as much as 0.4 km3 of rhyolitic glass shards from eruptive Episode I fell with CDE and 1.1 km3 with FGH. Most of the rhyolitic ash in the dacitic fallout layers fell far downwind (SE of the vent); near the rhyolite-dominated ignimbrite, however, nearly all of Layers E and H are dacitic, showing that the downwind rhyolitic ash is of 'co-plinian' rather than co-ignimbrite origin. ?? 1992 Springer-Verlag.

Welfare to Work Policy. Getting a Job is a First Step: What Should Follow?

ERIC Educational Resources Information Center

Stevens, David W.

Policy options for increasing the earnings of the young welfare recipients were explored by analyzing the incomes of nearly 12,000 young women in Baltimore, Maryland, whose 19th birthday fell between April 1, 1985, and March 31, 1989, and who had at least one spell of welfare dependency between their 19th and 29th birthdays. An analysis of the…

JPRS Report: East Europe.

DTIC Science & Technology

1991-07-26

of our behaviour as an unques- tioning satellite over decades. But the same politicians, looking for political dividends from this theme, fell into...slowdown in price increases in the producer as well as consumer markets which was recorded statistically also during May makes it possible to carry out...justified losses in a secondary distribution system. The present billing method charged all losses in these distribution systems to the consumers

Bans of WHO Class I Pesticides in Bangladesh-suicide prevention without hampering agricultural output.

PubMed

Chowdhury, Fazle Rabbi; Dewan, Gourab; Verma, Vasundhara R; Knipe, Duleeka W; Isha, Ishrat Tahsin; Faiz, M Abul; Gunnell, David J; Eddleston, Michael

2018-02-01

Pesticide self-poisoning is a major problem in Bangladesh. Over the past 20-years, the Bangladesh government has introduced pesticide legislation and banned highly hazardous pesticides (HHPs) from agricultural use. We aimed to assess the impacts of pesticide bans on suicide and on agricultural production. We obtained data on unnatural deaths from the Statistics Division of Bangladesh Police, and used negative binomial regression to quantify changes in pesticide suicides and unnatural deaths following removal of WHO Class I toxicity HHPs from agriculture in 2000. We assessed contemporaneous trends in other risk factors, pesticide usage and agricultural production in Bangladesh from 1996 to 2014. Mortality in hospital from pesticide poisoning fell after the 2000 ban: 15.1% vs 9.5%, relative reduction 37.1% [95% confidence interval (CI) 35.4 to 38.8%]. The pesticide poisoning suicide rate fell from 6.3/100 000 in 1996 to 2.2/100 000 in 2014, a 65.1% (52.0 to 76.7%) decline. There was a modest simultaneous increase in hanging suicides [20.0% (8.4 to 36.9%) increase] but the overall incidence of unnatural deaths fell from 14.0/100 000 to 10.5/100 000 [25.0% (18.1 to 33.0%) decline]. There were 35 071 (95% CI 25 959 to 45 666) fewer pesticide suicides in 2001 to 2014 compared with the number predicted based on trends between 1996 to 2000. This reduction in rate of pesticide suicides occurred despite increased pesticide use and no change in admissions for pesticide poisoning, with no apparent influence on agricultural output. Strengthening pesticide regulation and banning WHO Class I toxicity HHPs in Bangladesh were associated with major reductions in deaths and hospital mortality, without any apparent effect on agricultural output. Our data indicate that removing HHPs from agriculture can rapidly reduce suicides without imposing substantial agricultural costs. © The Author 2017. Published by Oxford University Press on behalf of the International Epidemiological Association

Response of white-footed mice (Peromyscus leucopus) to fire and fire surrogate fuel reduction treatments in a southern Appalachian hardwood forest

USGS Publications Warehouse

Greenberg, C.H.; Otis, D.L.; Waldrop, T.A.

2006-01-01

An experiment conducted as part of the multidisciplinary National Fire and Fire Surrogate Study was designed to determine effects of three fuel reduction techniques on small mammals and habitat structure in the southern Appalachian mountains. Four experimental units, each >14-ha were contained within each of three replicate blocks at the Green River Game Land, Polk County, NC. Treatments were (1) prescribed burning (B); (2) mechanical felling of shrubs and small trees (M); (3) mechanical felling + burning (MB); (4) controls (C). Mechanical understory felling treatments were conducted in winter 2001-2002, and prescribed burning was conducted in March 2003. After treatment, there were fewer live trees, more snags, and greater canopy openness in MB than in other treatments. Leaf litter depth was reduced by burning in both B and MB treatments, and tall shrub cover was reduced in all fuel reduction treatments compared to C. Coarse woody debris pieces and percent cover were similar among treatments and controls. We captured 990 individuals of eight rodent species a total of 2823 times. Because white-footed mice composed >79% of all captures, we focused on this species. Populations in experimental units increased 228% on average between 2001 and 2002, but there was no evidence of an effect of the mechanical treatment. From 2002 to 2003, all units again showed an average increase in relative population size, but increases were greater in MB than in the other treatments. Age structure and male to female ratio were not affected by the fuel reduction treatment. Average adult body weight declined from 2001 to 2002, but less so in M than in units that remained C in both years. The proportion of mice captured near coarse woody debris was similar to the proportion captured in open areas for all treatments, indicating that white-footed mice did not use coarse woody debris preferentially or change their use patterns in response to fuel reduction treatments. Land managers should understand possible effects of different fuel reduction treatments on white-footed mouse populations, as they are an important component of the fauna and food chain of deciduous southern Appalachian forests.

What did the public think of health services reform in Bangladesh? Three national community-based surveys 1999–2003

PubMed Central

Cockcroft, Anne; Andersson, Neil; Milne, Deborah; Hossain, Md Zakir; Karim, Enamul

2007-01-01

Background Supported by development partners, the Government of Bangladesh carried out a comprehensive reform of health services in Bangladesh between 1998 and 2003, intended to make services more responsive to public needs: the Health and Population Sector Programme (HPSP). They commissioned a series of surveys of the public, as part of evaluation of the HPSP. This article uses the survey findings to examine the changes in public opinions, use and experience of health services in the period of the HPSP. Methods We carried out three household surveys (1999, 2000 and 2003) of a stratified random sample of 217 rural sites and 30 urban sites. Each site comprised 100–120 contiguous households. Each survey included interviews with 25,000 household respondents and managers of health facilities serving the sites, and gender-stratified focus groups in each site. We measured: household ratings of government health services; reported use of services in the preceding month; unmet need for health care; user reports of waiting times, payments, explanations of condition, availability of prescribed medicines, and satisfaction with service providers. Results Public rating of government health services as "good" fell from 37% to 10% and the proportion using government treatment services fell from 13% to 10%. Unmet need increased from 3% to 9% of households. The proportion of visits to government facilities fell from 17% to 13%, while the proportion to unqualified practitioners rose from 52% to 60%. Satisfaction with service providers' behaviour dropped from 66% to 56%. Users were more satisfied when waiting time was shorter, prescribed medicines were available, and they received explanations of their condition. Conclusion Services have retracted despite increased investment and the public now prefer unqualified practitioners over government services. Public opinion of government health services has deteriorated and the reforms have not specifically helped the poorest people. User satisfaction could be increased if government doctors improved their interaction with patients and if waiting times were reduced by better management of facilities. PMID:17324263

Virginia pine seed viable two months before natural cone opening

Treesearch

Thomas W., Jr. Church; Edward I. Sucoff

1960-01-01

Virginia pine (Pinus virginiana Mill.) seed used in nurseries and for forest seeding ordinarily is collected from standing or felled trees in autumn. Some questions that concern the seed collector are: How early in the season does Virginia pine seed ripen? How does seed viability change if the cones are left on the felled trees?

Silvicultural treatments and logging costs for minimizing gypsy moth impacts

Treesearch

Michael D. Erickson; Curt C. Hassler; Chris B. LeDoux

1991-01-01

Gypsy moth defoliation is a serious threat to eastern hardwood forests. Felling and skidding costs for harvesting timber in silvicultural thinnings designed to reduce the impacts of the moth were evaluated. Cost of felling the nonmerchantable component of the thinnings to achieve treatment objectives are reported, along with a discussion of the economic feasibility of...

Timber marking guidelines to minimize chainsaw felling accidents

Treesearch

Penn A. Peters; Michael D. Erickson; Curt D. Hassler

1995-01-01

Trees are marked by foresters for retention or harvest to satisfy landowner objectives for timber sale revenues, stand improvement, wildlife habitat, water quality, and aesthetics. Another consideration when marking trees is the safety of the chainsaw feller. Can the tree that has been marked for harvest be felled safely? Will the feller be able to select and control a...

--No Title--

Science.gov Websites

Driving Family drowned after high waters swept their car off the road, flipped it over, and carried the Monroe 24 F Creek Driving Driver attempted to drive through high water on an infrequently travelled road fell in. Dad was in jail. 5/28/2014 LA Duplessis Ascension 56 M Parking Lot Fell in Business let people

Hierarchical models for informing general biomass equations with felled tree data

Treesearch

Brian J. Clough; Matthew B. Russell; Christopher W. Woodall; Grant M. Domke; Philip J. Radtke

2015-01-01

We present a hierarchical framework that uses a large multispecies felled tree database to inform a set of general models for predicting tree foliage biomass, with accompanying uncertainty, within the FIA database. Results suggest significant prediction uncertainty for individual trees and reveal higher errors when predicting foliage biomass for larger trees and for...

Felling and skidding productivity and harvesting cost in southern pine forests

Treesearch

R.A. Kluender; B.J. Stokes

1996-01-01

Sixteen stands were harvested at various levels of basal area removed (intensity). Chainsaw felling productivity was more sensitive to stem diameter than harvest intensity. Skidding productivity was highest when removing large trees at high intensity. Harvesting cost was more sensitive to stem size than harvest intensity, although harvest intensity was a very important...

Education Looks at Poverty: Conceptions and Misconceptions.

ERIC Educational Resources Information Center

Levin, Benjamin

Poverty is one of the most important influences on educational attainment in Canada. Using Statistics Canada definitions, the overall poverty rate in Canada in 1991 was 16 percent; 4.2 million people fell below low income thresholds, and most poor families fell well below the cutoff ($21,000 for an urban family of four). The most notable change in…

Neurological injuries from car surfing.

PubMed

Wang, Arthur; Cohen, Alan R; Robinson, Shenandoah

2009-11-01

Trauma secondary to car surfing is a unique mechanism of head and spinal injury in children and adolescents. In this study, the authors present their experience with neurological injuries resulting from car surfing and describe the growing national trend of car-surfing injuries and the increasing portrayal of this activity in the media. A retrospective study of the Rainbow Babies and Children's Hospital trauma database was conducted to identify all cases of neurological injuries secondary to car surfing. Between January 1995 and December 2008, 7 patients

The changing epidemiology of open fractures in vehicle occupants, pedestrians, motorcyclists and cyclists.

PubMed

Winkler, Dennis; Goudie, Stuart T; Court-Brown, Charles M

2018-02-01

To investigate the changing epidemiology of open fractures in vehicle occupants, pedestrians, motorcyclists and cyclists. Data on all non-spinal open fractures admitted to the Royal Infirmary of Edinburgh after a road traffic accident between 1988 and 2010 were collected and analysed to provide information about the changing epidemiology in different patient groups. Demographic information was collected on all patients with the severity of injury being analysed with the Injury Severity Score (ISS), Musculoskeletal Index (MSI) and the number of open fractures. The severity of the open fractures was analysed using the Gustilo classification. The 23-year study period was divided into four shorter periods and the results were compared. There were 696 patients treated in 23 years. Analysis showed that the incidence of RTA open fractures initially fell in both males and females and continued to fall in females during the 23 years. In males it levelled off about 2000. The age of the female patients also fell during the study period but it did not change in males. The only patient group to show an increased incidence of open fractures were cyclists. In vehicle occupants the incidence fell throughout the study period but it levelled off in pedestrians and motorcyclists. There was no difference in the severity of injury in any group during the study period. The most severe open fractures were those of the distal femur and femoral diaphysis although open tibial diaphyseal fractures were the most common fracture in all patient groups. Improved car design and road safety legislation has resulted in a reduction in the incidence of open fractures in vehicle occupants, pedestrians and motorcyclists. The most obvious group to have benefitted from this are older female pedestrians. The only group to show an increase in age during the study period were male motorcyclists. Copyright © 2017 Elsevier Ltd. All rights reserved.

The effects of household wealth on HIV prevalence in Manicaland, Zimbabwe – a prospective household census and population-based open cohort study

PubMed Central

Schur, Nadine; Mylne, Adrian; Mushati, Phyllis; Takaruza, Albert; Ward, Helen; Nyamukapa, Constance; Gregson, Simon

2015-01-01

Introduction Intensified poverty arising from economic decline and crisis may have contributed to reductions in HIV prevalence in Zimbabwe. Objectives To assess the impact of the economic decline on household wealth and prevalent HIV infection using data from a population-based open cohort. Methods Household wealth was estimated using data from a prospective household census in Manicaland Province (1998 to 2011). Temporal trends in summed asset ownership indices for sellable, non-sellable and all assets combined were compared for households in four socio-economic strata (small towns, agricultural estates, roadside settlements and subsistence farming areas). Multivariate logistic random-effects models were used to measure differences in individual-level associations between prevalent HIV infection and place of residence, absolute wealth group and occupation. Results Household mean asset scores remained similar at around 0.37 (on a scale of 0 to 1) up to 2007 but decreased to below 0.35 thereafter. Sellable assets fell substantially from 2004 while non-sellable assets continued increasing until 2008. Small-town households had the highest wealth scores but the gap to other locations decreased over time, especially for sellable assets. Concurrently, adult HIV prevalence fell from 22.3 to 14.3%. HIV prevalence was highest in better-off locations (small towns) but differed little by household wealth or occupation. Initially, HIV prevalence was elevated in women from poorer households and lower in men in professional occupations. However, most recently (2009 to 2011), men and women in the poorest households had lower HIV prevalence and men in professional occupations had similar prevalence to unemployed men. Conclusions The economic crisis drove more households into extreme poverty. However, HIV prevalence fell in all socio-economic locations and sub-groups, and there was limited evidence that increased poverty contributed to HIV prevalence decline. PMID:26593453

Reduction of diuretics and analysis of water and muscle volumes to prevent falls and fall-related fractures in older adults.

PubMed

Okada, Kosuke; Okada, Masahiro; Kamada, Nanao; Yamaguchi, Yumiko; Kakehashi, Masayuki; Sasaki, Hidemi; Katoh, Shigeko; Morita, Katsuya

2017-02-01

In an attempt to decrease the incidence of falls and fall-related fractures at a special geriatric nursing home, we endeavored to reduce diuretic doses, and examined the relationship between the effectiveness of this approach with the body compositions and activities of daily living of the study cohort. We enrolled 93 participants living in the community, 60 residents of an intermediate geriatric nursing home and 50 residents of the 100-bed Kandayama Yasuragien special geriatric nursing home. We recorded body composition using a multifrequency bioelectrical impedance analyzer. Daily loop diuretic and other diuretic regimens of those in the special geriatric nursing home were reduced or replaced with "NY-mode" diuretic therapy, namely, spironolactone 12.5 mg orally once on alternate days. The incidence of falls fell from 53 in 2011 to 29 in 2012, and there were no fall-related proximal femoral fractures for 3 years after the introduction of NY-mode diuretic therapy. We also found statistically significant differences in muscle and intracellular water volumes in our elderly participants: those with higher care requirements or lower levels of independence had lower muscle or water volumes. We found that reducing or replacing daily diuretics with NY-mode therapy appeared to reduce the incidence of falls and fall-related proximal femoral fracture, likely by preserving intracellular and extracellular body water volumes. Low-dose spironolactone (12.5 mg on alternate days) appears to be an effective means of treating elderly individuals with chronic heart failure or other edematous states, while preventing falls and fall-related fractures. Geriatr Gerontol Int 2017; 17: 262-269. © 2016 The Authors. Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

SU-F-J-223: Patterns of Failure for Laryngeal Cancer Patients Treated with Definitive IMRT: Comparing Two Different Methods for Determining the Origin of Recurrence From Follow-Up PET/CT Scans

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

Brodin, P; Guha, C; Tome, W

Purpose: To determine patterns of failure in laryngeal cancer treated with definitive IMRT by comparing two different methods for identifying the recurrence epicenter on follow-up PET/CT. Methods: We identified 20 patients treated for laryngeal squamous cell carcinoma with definitive IMRT who had loco-regional recurrence diagnosed on PET/CT. Recurrence PET/CT scans were co-registered with the original treatment planning CT using deformable image registration with the VoxAlign deformation engine in MIM Software. Recurrence volumes were delineated on co-registered follow-up scans using a semi-automatic PETedge tool and two separate methods were used to identify the recurrence point of origin: a) Finding the pointmore » within the recurrence volume for which the maximum distance to the surface of the surrounding recurrence volume is smaller than for any other point. b) Finding the point within the recurrence volume with the maximum standardized uptake value (SUVmax), without geometric restrictions.For each method the failure pattern was determined as whether the recurrence origin fell within the original high-dose target volumes GTV70, CTV70, PTV70 (receiving 70Gy), intermediate-risk PTV59 (receiving 59.4Gy) or low-risk PTV54 (receiving 54.1Gy), in the original treatment planning CT. Results: 23 primary/nodal recurrences from the 20 patients were analyzed. The three-dimensional distance between the two different origins was on average 10.5mm (std.dev. 10mm). Most recurrences originated in the high-dose target volumes for both methods with 13 (57%) and 11 (48%) in the GTV70 and 20 (87%) and 20 (87%) in the PTV70 for method a) and b), respectively. There was good agreement between the two methods in classifying the origin target volumes with 69% concordance for GTV70, 89% for CTV70 and 100% for PTV70. Conclusion: With strong agreement in patterns of failure between two separate methods for determining recurrence origin, we conclude that most recurrences occurred within the high-dose treatment region, which influences potential risk-adaptive treatment strategies.« less

Hyperthyroidism affects lipid metabolism in lactating and suckling rats.

PubMed

Varas, S M; Jahn, G A; Giménez, M S

2001-08-01

Two per thousand pregnant women have hyperthyroidism (HT), and although the symptoms are attenuated during pregnancy, they rebound after delivery, affecting infant development. To examine the effects of hyperthyroidism on lactation, we studied lipid metabolism in maternal mammary glands and livers of hyperthyroid rats and their pups. Thyroxine (10 microg/100 g body weight/d) or vehicle-treated rats were made pregnant 2 wk after commencement of treatment and sacrificed on days 7, 14, and 21 of lactation with the litters. Circulating triiodothyronine and tetraiodothyronine concentrations in the HT mothers were increased on all days. Hepatic esterified cholesterol (EC) and free cholesterol (FC) and triglyceride (TG) concentrations were diminished on days 14 and 21. Lipid synthesis, measured by incorporation of [3H]H2O into EC, FC, and TG, fatty acid synthase, and acetyl CoA carboxylase activities increased at day 14, while incorporation into FC and EC decreased at days 7 and 21, respectively. Mammary FC and TG concentrations were diminished at day 14; incorporation of [3H]H2O into TG decreased at days 7 and 21, and incorporation of [3H]H2O into FC increased at day 14. In the HT pups, growth rate was diminished, tetraiodothyronine concentration rose at days 7 and 14 of lactation, and triiodothyronine increased only at day 14. Liver TG concentrations increased at day 7 and fell at day 14, while FC increased at day 14 and only acetyl CoA carboxylase activity fell at day 14. Thus, hyperthyroidism changed maternal liver and mammary lipid metabolism, with decreased lipid concentration in spite of increased liver rate of synthesis and decreases in mammary synthesis. These changes, along with the mild hyperthyroidism of the litters, may have contributed to their reduced growth rate.

Floods of April-June 1957 in Oklahoma and western Arkansas

USGS Publications Warehouse

Weiss, D.L.; Sullivan, C.W.

1957-01-01

Floods of unusual magnitude in volume for the three-month period in Oklahoma and western Arkansas resulted from several heavy rains. In one storm period 20 inches of precipitation fell within 24 hours, on May 15, 16, near Hennessey, Okla., according to information obtained by a 'bucket survey.' Total precipitation for the three-month period at many points of observation equaled the normal yearly totals. Ten lives are known to have been lost. Hundreds of families were evacuated from lowlands where homes were inundated for many days. The Arkansas River at Van Buren, Ark., was above flood stage for 74 days. This report contains tabulation of peak stages and discharges for 96 gaging stations, 9 sites other than gaging stations, maximum contents of 11 reservoirs, isohyetal maps showing total precipitation by months and for the three-month period, and other data related to the floods. (available as photostat copy only)

Gender differences in blood pressure regulation following artificial gravity exposure

NASA Astrophysics Data System (ADS)

Evans, Joyce; Goswami, Nandu; Kostas, Vladimir; Zhang, Qingguang; Ferguson, Connor; Moore, Fritz; Stenger, Michael, , Dr; Serrador, Jorge; W, Siqi

Introduction. Before countermeasures to space flight cardiovascular deconditioning are established, gender differences in cardiovascular responses to orthostatic stress, in general, and to orthostatic stress following exposure to artificial gravity (AG), in particular, need to be determined. Our recent determination that a short exposure to AG improved the orthostatic tolerance limit (OTL) of cardiovascularly deconditioned subjects drives the current effort to determine mechanisms of that improvement in men and in women. Methods. We determined the OTL of 9 men and 8 women following a 90 min exposure to AG compared to that following 90 min of head down bed rest (HDBR). On both days (21 days apart), subjects were made hypovolemic (low salt diet plus 20 mg intravenous furosemide) and orthostatic tolerance was determined from a combination of head up tilt and increasing lower body negative pressure until presyncope. Mean values and correlations with OTL were determined for heart rate, blood pressure, stroke volume, cardiac output, total peripheral resistance (Finometer), middle cerebral artery flow velocity (DWL), partial pressure of carbon dioxide (Novametrics) and body segmental impedance (UFI THRIM) at supine baseline, during orthostatic stress to presyncope and at supine recovery. Results. Orthostatic tolerance of these hypovolemic subjects was significantly greater following AG than following HDBR. Exposure to AG increased cardiac output in both men and women and increased stroke volume in women. In addition, AG decreased systolic blood pressure in men, but not women, and increased cerebral flow in women, but not men. In both men and women, AG exposure decreased peripheral resistance and decreased cerebrovascular resistance in women. Men’s heart rate rose more at the end of OTL on their AG, compared to their HDBR, day but women’s fell. Presyncopal stroke volume reached the same level on each day of study for both men and women. Conclusions. In the present study, men and women demonstrated significantly different strategies for regulating blood pressure and cerebral flow both at rest and during orthostatic stress on the day in which they had undergone exposure to AG. Since, in both men and women, a single, acute bout of AG exposure improved orthostatic tolerance, the feasibility of short exposures to AG during longer spaceflights or prior to entry into a gravitational (Earth or Mars) environment, should be explored. Given the known beneficial effects of AG on other organ systems, the present study indicates that the positive effect of artificial gravity on cardiac output make AG a likely candidate for sustaining cardiovascular conditioning upon return to gravity. Supported by KY NASA EPSCoR Grant #NNX07AT58A, KY State Matching Grants, NASA JSC Human Research Program and NASA Ames Research Center.

Lower serum oestrogen concentrations associated with faster intestinal transit.

PubMed Central

Lewis, S. J.; Heaton, K. W.; Oakey, R. E.; McGarrigle, H. H.

1997-01-01

Increased fibre intake has been shown to reduce serum oestrogen concentrations. We hypothesized that fibre exerts this effect by decreasing the time available for reabsorption of oestrogens in the colon. We tested this in volunteers by measuring changes in serum oestrogen levels in response to manipulation of intestinal transit times with senna and loperamide, then comparing the results with changes caused by wheat bran. Forty healthy premenopausal volunteers were placed at random into one of three groups. The first group took senna for two menstrual cycles then, after a washout period, took wheat bran, again for two menstrual cycles. The second group did the reverse. The third group took loperamide for two menstrual cycles. At the beginning and end of each intervention a 4-day dietary record was kept and whole-gut transit time was measured; stools were taken for measurement of pH and beta-glucuronidase activity and blood for measurement of oestrone and oestradiol and their non-protein-bound fractions and of oestrone sulphate. Senna and loperamide caused the intended alterations in intestinal transit, whereas on wheat bran supplements there was a trend towards faster transit. Serum oestrone sulphate fell with wheat bran (mean intake 19.8 g day(-1)) and with senna; total- and non-protein-bound oestrone fell with senna. No significant changes in serum oestrogens were seen with loperamide. No significant changes were seen in faecal beta-glucuronidase activity. Stool pH changed only with senna, in which case it fell. In conclusion, speeding up intestinal transit can lower serum oestrogen concentrations. PMID:9252210

Impact of Scottish Smoke-Free Legislation on Smoking Quit Attempts and Prevalence

PubMed Central

Mackay, Daniel F.; Haw, Sally; Pell, Jill P.

2011-01-01

Objectives In Scotland, legislation was implemented in March 2006 prohibiting smoking in all wholly or partially enclosed public spaces. We investigated the impact on attempts to quit smoking and smoking prevalence. Methods We performed time series models using Box-Jenkins autoregressive integrated moving averages (ARIMA) on monthly data on the gross ingredient cost of all nicotine replacement therapy (NRT) prescribed in Scotland in 2003–2009, and quarterly data on self-reported smoking prevalence between January 1999 and September 2010 from the Scottish Household Survey. Results NRT prescription costs were significantly higher than expected over the three months prior to implementation of the legislation. Prescription costs peaked at £1.3 million in March 2006; £292,005.9 (95% CI £260,402.3, £323,609, p<0.001) higher than the monthly norm. Following implementation of the legislation, costs fell exponentially by around 26% per month (95% CI 17%, 35%, p<0.001). Twelve months following implementation, the costs were not significantly different to monthly norms. Smoking prevalence fell by 8.0% overall, from 31.3% in January 1999 to 23.7% in July–September 2010. In the quarter prior to implementation of the legislation, smoking prevalence fell by 1.7% (95% CI 2.4%, 1.0%, p<0.001) more than expected from the underlying trend. Conclusions Quit attempts increased in the three months leading up to Scotland's smoke-free legislation, resulting in a fall in smoking prevalence. However, neither has been sustained suggesting the need for additional tobacco control measures and ongoing support. PMID:22110585

Onchocerciasis control in the Democratic Republic of Congo (DRC): challenges in a post-war environment.

PubMed

Makenga Bof, J-C; Maketa, V; Bakajika, D K; Ntumba, F; Mpunga, D; Murdoch, M E; Hopkins, A; Noma, M M; Zouré, H; Tekle, A H; Katabarwa, M N; Lutumba, P

2015-01-01

To evaluate onchocerciasis control activities in the Democratic Republic of Congo (DRC) in the first 12 years of community-directed treatment with ivermectin (CDTI). Data from the National Programme for Onchocerciasis (NPO) provided by the National Onchocerciasis Task Force (NOTF) through the annual reports of the 21 CDTI projects for the years 2001-2012 were reviewed retrospectively. A hypothetical-inputs-process-outputs-outcomes table was constructed. Community-directed treatment with ivermectin expanded from 1968 communities in 2001 to 39 100 communities by 2012 while the number of community-directed distributors (CDD) and health workers (HW) multiplied. By 2012, there were ratios of 1 CDD per 262 persons and 1 HW per 2318 persons at risk. More than 80% of the funding came from the fiduciary funds of the African Programme for Onchocerciasis Control. The cost of treatment per person treated fell from US$ 1.1 in 2001 to US$ 0.1 in 2012. The therapeutic coverage increased from 2.7% (2001) to 74.2% (2012); the geographical coverage, from 4.7% (2001) to 93.9% (2012). Geographical coverage fell in 2005 due to deaths in loiasis co-endemic areas, and the therapeutic coverage fell in 2008 due to insecurity. Challenges to CDTI in DRC have been serious adverse reactions to ivermectin in loiasis co-endemic areas and political conflict. Targets for personnel or therapeutic and geographical coverages were not met. Longer term funding and renewed efforts are required to achieve control and elimination of onchocerciasis in DRC. © 2014 John Wiley & Sons Ltd.

Anthropometric changes during pregnancy of urban Indian women related to birthweight.

PubMed

Lakhani, S A; Sequeira, E; Thiuri, B; Mannetje, W; Jansen, A A

1982-06-01

Vegetarian and nonvegetarian women of Asian Indian origin living in Nairobi, Kenya, and attending the antenatal clinic at the Aga Khan Hospital were followed up from 26 weeks of pregnancy to term. The objective was to observe these pregnant women in relation to pregnancy performance and outcome. The mean gestational age for both groups was 39.0 weeks. There is a progressive increase in weight from the 26th week of pregnancy up to the time of delivery among both groups. 65.4% of the women gained between 90 and 150% of the expected value. Women who gained less than 90% of the expected value (34.6%) did not produce smaller babies. The mean birth weight of the newborns was 2,869 gms in the vegetarian group and 3,026 gms in the nonvegetarian group. There was no significant difference in the outcome of pregnancy between the 2 groups. Mean birth weight, mean length and mean head circumference of the babies in both the groups fell within the 10th and 25th percentiles of the Harvard standards. The mean chest circumference of the babies in the vegetarian group fell within the 25th and 50th percentiles, while that of the babies in the nonvegetarian group fell between 50th and 75th percentiles. The pattern of weight gain in the study population corresponds favorably with that observed among British women . Other anthropometric parameters studied were height, mid-upper arm circumference and 4 skinfold thickness. Changes in muscle mass and fat area were also calculated. Tables show quantitative data.

Felling and skidding cost estimates for thinnings to reduce gypsy moth impacts

Treesearch

Michael D. Erickson; Curt C. Hassler; Chris B. LeDoux

1991-01-01

The gypsy moth is a serious threat to the hardwood forests of the eastern United States. Although chemical treatments currently exist which can be used to help control the impacts of the moth, silvicultural control measures are just now being proposed and tested. Felling and skidding cost estimates for harvesting merchantable timber under two such proposed...

Fire, herbicide, and chainsaw felling effects on arthropods in fire-suppressed longleaf pine sandhills at Eglin Air Force Base, Florida

Treesearch

Louis Provencher; Krista E. M. Galley; Andrea R. Litt; Doria R. Gordon; Leonard A. Brennan; George W. Tanner; Jeffrey L. Hardesty

2002-01-01

Experimentally evaluating the success of hardwood reduction techniques against a "model" reference condition of longleaf pine sandhill communities is not directly possible because reference sites are not randomized or replicated. We addressed this issue by measuring the similarity of arthropods in treatment (fire, herbicide, felling/girdling, and control) and...

Lake States Pulpwood Production Plummets 413,000 Cords, 1968

Treesearch

James E. Blyth

1969-01-01

This twenty-third annual report shows that the 1968 Lake States pulpwood output dropped to about 3 1/2 million cords from about 4 million cords in 1967. Michigan's roundwood harvest dropped 198,000 cords in 1968, while the Wisconsin and Minnesota harvests each fell more than 125,000 cords. Pulpwood receipts fell 1/2 million cords below the 1967 level in...

Logging costs and cutting methods in young-growth ponderosa pine in California

Treesearch

Philip M. McDonald; William A. Atkinson; Dale O. Hall

1969-01-01

Mixed-conifer stands at the Challenge Experimental Forest, Calif., were cut to four specifications: seed-tree, group selection, single tree selection, and clearcut. Logging costs and production rates were compared and evaluated. Cutting method had little effect on felling or skidding production; felling ranged from 1,802 to 2,019 bd ft per hour, and skidding from 3,138...

Development of the swathe-felling mobile chipper

Treesearch

P. Koch; T.E. Savage

1980-01-01

A harvesting machine and auxilary equipment are being developed to recover logging residues us chips for fuel and fiber, and to deliver these chips to mills at ubout $18 per green ton including 30 percent pre-tax profit on the equipment investment. The harvester, a 575 horsepower trucked mobile chipper equipped with a front-mounted felling bar, wus field-tested on red...

Vegetation composition five years after silvicultural treatments to control competition in a natural stand of loblolly-shortleaf pines

Treesearch

M.D. Cain

2000-01-01

Woody nonpine vegetation, averaging over 6,000 rootstocksiac, was controlled by chain-saw felling, chain-saw felling plus prescribed burning,orby a broadcast herbicide spray to release even-aged loblolly and shortleafpine (Pinus taeda L. and P. echinata Mill.) saplings that became established from natural seedfall on a cutover area...

That’s Not What I Joined to Do, Sir -- Understanding Military Culture and Ethos is Critical for the Correct Use of the Military Instrument of Power

DTIC Science & Technology

2012-05-21

Defense. This paper is entirely my own work except as documented in footnotes. Thesis Adviser: Approved by: ~ Signature: ----------- 21 May 2012...the Berlin Wall fell, the U.S. increasingly saw itself as the global policemen and counselor. To retain this role in today‘s world of globalised ...Supplies,‖ CEPS Working Document – Thinking Ahead for Europe, No 352, (June 2011). 17 Ibid. 16 increasingly multi-polar, globalized and resource

Experimental Septic Shock: Models and Mechanisms

DTIC Science & Technology

1976-06-14

the renal, hepatic, and pulmonary systems with severe pathophysiological effects on the liver circulation and metabolism (7,9,11,17,18,20). The...was sustained at values between 40 and 60 nmHg. Mean plasm glucose increased for the first several hours, then progressively fell to hypoglycemic...when the state of shock is severe and when death is imminent. On the other hand, hyperglycemia con- comitantly occurring with hypoinsulinemia, termed

Removing an invasive shrub (Chinese privet) increases native bee diversity and abundance in riparian forests of the southeastern United States

Treesearch

James L. Hanula; Scott Horn

2011-01-01

1. Chinese privet (Ligustrum sinense Lour.) was removed from riparian forests in the Piedmont of Georgia in November 2005 by mulching with a track-mounted mulching machine or by chainsaw felling. The remaining privet in the herbaceous layer was killed with herbicide in December 2006. 2. Bee (Hymentoptera: Apoidea) abundance, diversity and community similarity in the...

Brief Report: Autistic Features in Children and Adolescents with Gender Dysphoria.

PubMed

Skagerberg, Elin; Di Ceglie, Domenico; Carmichael, Polly

2015-08-01

This paper looks at the association between gender dysphoria (GD), scores on the Social Responsiveness Scale (SRS), and reported diagnoses of autism spectrum disorder (ASD). Parents of 166 young people presenting with GD (Mean age = 14.26, SD = 2.68) completed the SRS. Information concerning an ASD diagnosis was also extracted from the patient files. 45.8% fell within the normal range on the SRS and of those 2.8% had an ASD diagnosis. 27.1% fell within the mild/moderate range and of those 15.6% had an ASD diagnosis and 6.7% an ASD query. 27.1% fell within the severe range and of those 24.4% had an ASD diagnosis and 26.7% an ASD query. No difference was found in autistic features between the natal females and males.

Effect of an Internet-Based System for Doctor-Patient Communication on Health Care Spending

PubMed Central

Baker, Laurence; Rideout, Jeffrey; Gertler, Paul; Raube, Kristiana

2005-01-01

We studied the effect of a structured electronic communication service on health care spending, comparing doctor office and laboratory spending for a group of patients before and after the service became available to them relative to changes in a control group. In the treatment group, doctor office spending and laboratory spending fell in the period after the service became available, relative to the control group (p < 0.05). A rough estimate is that average doctor office spending per treatment group member per month fell $1.71 after availability of the service, and laboratory spending fell roughly $0.12. Spending associated with use of the electronic service was $0.29 per member per month. We conclude that use of structured electronic visits can reduce health care spending. PMID:15905484

[Change of endogenous hormone around sprout tumble of Pinellia ternata under high temperature stress].

PubMed

Xue, Jian-Ping; Zhang, Ai-Min; Yang, Jian; Chang, Li; Huang, Yue-Qin

2007-12-01

To study the change of endogenous hormone (ABA, IAA, JA, GA3, ZR) in the leaves, petioles, tubers of Pinellia ternate around sprout tumble. It also provided some valuable information to prevent sprout tumble and increase production. Tubers of P. ternata were cultured firstly at (23 +/- 1) degree C for certain days, and then they were coerced under (30 +/- 1 ) degree C stress in the same artificial climate boxes. The endogenous hormones in leaves, petioles and tubers during different stages of high temperature stress were determined with Enzyme-linked Immunosorbent Assays (ELISA). After under high temperature stress, ABA content in leaves, petioles and tubers increased obviously. Similarly, JA content rose all in the leaves, petioles and tubers. But in the same conditions IAA content declined significantly in the leaves and petioles. In the tubers, IAA content also decreased, but not quickly. With the extension of high temperature coercion, the leaves, petioles, tubers, ZR content were gradually falling off. In the leaves of GA3 content rose markedly at the third day, fell down at the sixth day, but remained higher than before treatment. With the extension of the processing time, GA3 content fell off in the petioles and tubers. ABA, JA, ZT and GA3 played an important role in controlling sprout tumble of P. ternata.

Changes in Thai sexual behavior lower HIV spread.

PubMed

1997-06-02

More than 700,000 people are thought to be HIV positive in Thailand. A booming sex industry and social attitudes which support the male patronage of prostitutes are major factors in the spread of disease in the country. A 4-day workshop on sexual behavior and AIDS in Thailand was attended by representatives from Burma, Cambodia, China, Indonesia, Malaysia, the Philippines, Thailand, and Vietnam. According to the Joint UN Program on HIV/AIDS (UNAIDS), the percentage of military conscripts in northern Thailand who visited a brothel in the past year fell from 58% in 1991 to 23% in 1995, while the percentage of recruits using condoms during their most recent brothel visits increased from 60% to 90% over the same period. Statistics from the Thai Public Health Ministry indicate that the percentage of men in the general population who used condoms when visiting a brothel increased from 40% in 1990 to 90% in 1994. Furthermore, a nationwide survey among military conscripts found the prevalence of HIV infection fell from 3.7% in 1993 to 2.5% in 1995, with the downward trend continuing in 1996. This success in reducing the level of sexual risk behavior and the incidence of HIV infection in Thailand lends hope for the possibility of changing the course of the HIV/AIDS epidemic elsewhere.

Oral theophylline in chronic heart failure

PubMed Central

Al-Damluji, S.; Johnston, A.; Spurrell, R. A. J.; Nathan, A. W.; Banim, S. O.; Camm, A. J.

1982-01-01

Theophylline choline 600 mg was given as a single oral dose to nine patients in chronic left ventricular failure due to myocardial dysfunction. Cardiac output, left ventricular filling pressure (LVFP) and right atrial pressure (RAP) were measured with a pulmonary artery thermodilution catheter for the following 3 hr. Continuous recordings of cardiac rhythm were made throughout the study. Mean cardiac index increased from 1·75 (±0·14 s.e. mean) to 2·04 (±0·11) 1/min/m2 (P<0·02), mean LVFP fell from 27 (±2·4) to 22 (±1·5) mmHg (P<0·01), mean RAP fell from 5 (±1·3) to 3 (±2·0) mmHg (P<0·05) and mean systemic arterial pressure rose from 80 (±3) to 86 (±3·5) mmHg (P<0·05). There were no significant changes in heart rate or systemic vascular resistance; thus the increase in cardiac output was probably due to a positive inotropic effect. Side effects were seen in two patients, both of whom proved to have toxic plasma theophylline concentrations. This study demonstrated a beneficial acute haemodynamic effect of oral theophylline in chronic cardiac failure. PMID:7111101

In vivo sup 31 P-NMR spectroscopy of chronically stimulated canine skeletal muscle

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

Clark, B.J. III; McCully, A.K.; Subramanian, H.V.

1988-02-01

Chronic stimulation converts skeletal muscle of mixed fiber type to a uniform muscle made up of type I, fatigue-resistant fibers. Here, the bioenergetic correlates of fatigue resistance in conditioned canine latissimus dorsi are assessed with in vivo phosphorus-31 nuclear magnetic resonance ({sup 31}P-NMR) spectroscopy. After chronic electrical stimulation, five dogs underwent {sup 31}P-NMR spectroscopic and isometric tension measurements on conditioned and contralateral control muscle during stimulation for 200, 300, 500, and 800 ms of an 1,100-ms duty cycle. With stimulation, phosphocreatine (PCr) fell proportional to the degree of stimulation in both conditioned and control muscle but fell significantly less inmore » conditioned muscle at all the least intense stimulation period (200 ms). Isometric tension, expressed as a tension time index per gram muscle, was significantly greater in the conditioned muscle at the two longest stimulation periods. The overall small change in PCr and the lack of a plateau in tension observed in the conditioned muscle are similar to that seen in cardiac muscle during increased energy demand. This study indicates that the conditioned muscle's markedly enhanced resistance to fatigue is in part the result of its increased capacity for oxidative phosphorylation.« less

Using 'nudge' principles for order set design: a before and after evaluation of an electronic prescribing template in critical care.

PubMed

Bourdeaux, Christopher P; Davies, Keith J; Thomas, Matthew J C; Bewley, Jeremy S; Gould, Timothy H

2014-05-01

Computerised order sets have the potential to reduce clinical variation and improve patient safety but the effect is variable. We sought to evaluate the impact of changes to the design of an order set on the delivery of chlorhexidine mouthwash and hydroxyethyl starch (HES) to patients in the intensive care unit. The study was conducted at University Hospitals Bristol NHS Foundation Trust, UK. Our intensive care unit uses a clinical information system (CIS). All drugs and fluids are prescribed with the CIS and drug and fluid charts are stored within a database. Chlorhexidine mouthwash was added as a default prescription to the prescribing template in January 2010. HES was removed from the prescribing template in April 2009. Both interventions were available to prescribe manually throughout the study period. We conducted a database review of all patients eligible for each intervention before and after changes to the configuration of choices within the prescribing system. 2231 ventilated patients were identified as appropriate for treatment with chlorhexidine, 591 before the intervention and 1640 after. 55.3% were prescribed chlorhexidine before the change and 90.4% after (p<0.001). 6199 patients were considered in the HES intervention, 2177 before the intervention and 4022 after. The mean volume of HES infused per patient fell from 630 mL to 20 mL after the change (p<0.001) and the percentage of patients receiving HES fell from 54.1% to 3.1% (p<0.001). These results were well sustained with time. The presentation of choices within an electronic prescribing system influenced the delivery of evidence-based interventions in a predictable way and the effect was well sustained. This approach has the potential to enhance the effectiveness of computerised order sets.

Conditioning out-of-date bank-stored red blood cells using a cell-saver auto-transfusion device: effects on numbers of red cells and quality of suspension fluid.

PubMed

Read, M S; Coles, P; Pomeroy, M; Anderson, E; Aziz, M I

2014-11-01

We investigated the utility of a cell-saver device for processing out-of-date red blood cells, by washing twenty bags of red blood cells that had been stored for between 36 and 55 days. The volume of recovered cells, and the characteristics of the suspension fluid, were measured before and after treatment. The ratio of free haemoglobin to total haemoglobin was up to 0.02 before processing, and up to 0.011 afterwards, changing by between -0.013 and +0.003. This ratio met the current standard for free haemoglobin (less than 0.008 in more than 75% of samples), both before and after processing. Ninety-three percent of red blood cells survived the process. Potassium ion concentration fell from above 15 mmol.l(-1) in all cases, to a mean of 6.4 mmol.l(-1) (p < 0.001). The pH rose to a mean value of 6.44 (p = 0.001). Lactate ion concentration fell to a mean value of 14 mmol.l(-1) (p < 0.001). Sodium ion concentration rose from a mean value of 93 mmol.l(-1) to a mean value of 140 mmol.l(-1) (p < 0.001). A useful proportion of out-of-date red blood cells remained intact after conditioning using a cell-saver, and the process lowered concentrations of potentially toxic solutes in the fluid in which they were suspended. © 2014 The Association of Anaesthetists of Great Britain and Ireland.

Reforming primary health care: is New Zealand's primary health care strategy achieving its early goals?

PubMed

Cumming, Jacqueline; Mays, Nicholas; Gribben, Barry

2008-11-06

In 2001, the New Zealand government introduced its Primary Health Care Strategy (PHCS), aimed at strengthening the role of primary health care, in order to improve health and to reduce inequalities in health. As part of the Strategy, new funding was provided to reduce the fees that patients pay when they use primary health care services in New Zealand, to improve access to services and to increase service use. In this article, we estimate the impact of the new funding on general practitioner and practice nurse visit fees paid by patients and on consultation rates. The analyses involved before-and-after monitoring of fees and consultation rates in a random sample of 99 general practices and covered the period from June 2001 (pre-Strategy) to mid-2005. Fees fell particularly in Access (higher need, higher per capita funded) practices over time for doctor and nurse visits. Fees increased over time for many in Interim (lower need, lower per capita funded) practices, but they fell for patients aged 65 years and over as new funding was provided for this age group. There were increases in consultation rates across almost all age, funding model (Access or Interim), socio-demographic and ethnic groups. Increases were particularly high in Access practices. The Strategy has resulted in lower fees for primary health care for many New Zealanders, and consultation rates have also increased over the past few years. However, fees have not fallen by as much as expected in government policy given the amount of extra public money spent since there are limited requirements for practices to reduce patients' fees in line with increases in public funding for primary care.

Trends in funding for research on pain: a report on the National Institutes Of Health grant awards over the years 2003 to 2007.

PubMed

Bradshaw, David H; Empy, Court; Davis, Phillip; Lipschitz, David; Dalton, Peter; Nakamura, Yoshio; Chapman, C Richard

2008-12-01

In recent years, the National Institutes of Health (NIH) has experienced unprecedented reductions in its customary annual budget increases. Consequently, researchers, health care policy planners and others have a pressing need for accurate information on NIH funding patterns. We created a unique and objective system for compiling, classifying, and analyzing data on NIH grant awards and funding for research on pain, nausea, and dyspnea using naïve observers, cross-validation by multiple raters, and face validation by experts. We present results of our method and analyses for the period from 2003 to 2007. Following a 12% increase from 2003 to 2004, funding for pain research fell by 9.4% per year on average over the next 3 years. The percent of the total NIH budget going to support pain research increased to 0.78% in 2004 but fell to 0.61% in 2007. A piecewise regression model confirmed the declining trend represented a significant fit to the data (R(2)=0.98, p=0.024). Separate breakdowns by Institutes showed similar patterns. Analyses of nausea and dyspnea research support revealed small but steady increases over the same period. Declining support for pain research disproportionate to decreases in the NIH budget signals a need for measures to promote funding for meritorious applications. Results of 5 year trends in numbers of grants and funding for research in pain, nausea, and dyspnea by the NIH show overall declines for pain but slight increases for nausea and dyspnea. Declining support for pain research that exceeds the reductions in the total NIH budget signals a need for measures to increase pain research funding.

Reforming primary health care: is New Zealand's primary health care strategy achieving its early goals?

PubMed Central

Cumming, Jacqueline; Mays, Nicholas; Gribben, Barry

2008-01-01

Background In 2001, the New Zealand government introduced its Primary Health Care Strategy (PHCS), aimed at strengthening the role of primary health care, in order to improve health and to reduce inequalities in health. As part of the Strategy, new funding was provided to reduce the fees that patients pay when they use primary health care services in New Zealand, to improve access to services and to increase service use. In this article, we estimate the impact of the new funding on general practitioner and practice nurse visit fees paid by patients and on consultation rates. The analyses involved before-and-after monitoring of fees and consultation rates in a random sample of 99 general practices and covered the period from June 2001 (pre-Strategy) to mid-2005. Results Fees fell particularly in Access (higher need, higher per capita funded) practices over time for doctor and nurse visits. Fees increased over time for many in Interim (lower need, lower per capita funded) practices, but they fell for patients aged 65 years and over as new funding was provided for this age group. There were increases in consultation rates across almost all age, funding model (Access or Interim), socio-demographic and ethnic groups. Increases were particularly high in Access practices. Conclusion The Strategy has resulted in lower fees for primary health care for many New Zealanders, and consultation rates have also increased over the past few years. However, fees have not fallen by as much as expected in government policy given the amount of extra public money spent since there are limited requirements for practices to reduce patients' fees in line with increases in public funding for primary care. PMID:18990236

Sustained reduction in antibiotic consumption in a South African public sector hospital; Four year outcomes from the Groote Schuur Hospital antibiotic stewardship program.

PubMed

Boyles, T H; Naicker, V; Rawoot, N; Raubenheimer, P J; Eick, B; Mendelson, M

2017-01-30

Overuse of antibiotics has driven global bacterial resistance to the extent that we have entered a post-antibiotic era, where infections that were once easily treatable are now becoming untreatable. Efforts to control consumption have focused on antibiotic stewardship programmes (ASPs), aimed at optimising use. To report antibiotic consumption and cost over 4 years from a public hospital ASP in South Africa (SA). A comprehensive ASP comprising online education, a dedicated antibiotic prescription chart and weekly dedicated ward rounds was introduced at Groote Schuur Hospital, Cape Town, in 2012. Electronic records were used to collect data on volume and cost of antibiotics and related laboratory tests, and to determine inpatient mortality and 30-day readmission rates. These data were compared with a control period before the intervention. Total antibiotic consumption fell from 1 046 defined daily doses/1 000 patient days in 2011 (control period) to 868 by 2013 and remained at similar levels for the next 2 years. This was driven by reductions in intravenous antibiotic use, particularly ceftriaxone. Inflation-adjusted cost savings on antibiotics were ZAR3.2 million over 4 years. Laboratory tests increased over the same period with a total increased cost of ZAR0.4 million. There was no significant change in mortality or 30-day readmission rates. The effects of a comprehensive ASP on medical inpatients at a public sector hospital in SA were durable over 4 years, leading to a reduction in total antibiotic consumption without adverse effect. When increased laboratory costs were offset there was a net cost saving of ZAR2.8 million.

A review of the response to HIV/AIDS in Trinidad and Tobago: 1983–2010

PubMed Central

Laptiste, Christine; Beharry, Vyjanti; Edwards-Wescott, Patricia

2014-01-01

This paper examines the character of the response to HIV/AIDS in Trinidad and Tobago and assesses the impact of the response on reducing the spread of the epidemic. The launch of the National HIV/AIDS Strategic Plan in 2004 signalled the intent of the government to take the response to HIV/AIDS to a different level. This is seen by the sheer increase in the volume of resources allocated to the response from the levels of the 1980s and 1990s. The expectation was that there would be increased cohesiveness, which would allow for targeted interventions to be more effective. Though in 2009, there was a slight increase in the HIV prevalence rate to 1.5%, this was due mainly to improvements in access to antiretrovirals and same-day testing as well as improvements in data collection and analysis. The annual number of new infections fell from a high of 1709 in 2003 to 1154 in 2010. Additionally, great strides have been made in the prevention of mother-to-child transmission programme with some regions reporting 100% coverage of antenatal attendees. The study indicates that the country has responded relatively well in the areas of Strategic Planning, Care and Support, and Prevention and there has been involvement by both the public and private sector (NGOs in particular), in the response. However, there are gaps in the provision of social services and the implementing legislation to protect the rights of persons living with HIV/AIDS. Of note is the fact that a successful response to the HIV/AIDS epidemic is one that embraces all social groups, all spheres of activity and all areas of the country. PMID:24405282

Comparing tree foliage biomass models fitted to a multispecies, felled-tree biomass dataset for the United States

Treesearch

Brian J. Clough; Matthew B. Russell; Grant M. Domke; Christopher W. Woodall; Philip J. Radtke

2016-01-01

tEstimation of live tree biomass is an important task for both forest carbon accounting and studies of nutri-ent dynamics in forest ecosystems. In this study, we took advantage of an extensive felled-tree database(with 2885 foliage biomass observations) to compare different models and grouping schemes based onphylogenetic and geographic variation for predicting foliage...

Midsouth Pulpwood Prices, 1986

Treesearch

Dennis M. May

1988-01-01

In 1986, the average price for a cord of Midsouth roundwood was $47.20, a decrease of 6 percent from the 1985 price. The average price for a green ton of chipped residues also decreased, down 1 percent to $21.77. The average price for a green ton of sawdust fell to $10.25, 3 percent below the 1985 price. Between 1977 and 1986, real prices for roundwood fell, but real...

Fluvial dissolved organic carbon composition varies spatially and seasonally in a small catchment draining a wind farm and felled forestry.

PubMed

Zheng, Ying; Waldron, Susan; Flowers, Hugh

2018-06-01

Assessing whether land use, from activities such as wind farm construction and tree-felling, impacts on terrestrial C delivery to rivers has focused on quantifying the loss of dissolved organic carbon (DOC), and not the composition changes. Here we explore how land use influences DOC composition by considering fluvial DOC concentration, [DOC], and spectrophotometric composition of a river draining a peat-rich catchment. We find that in this 5.7km 2 catchment differences occur in both the concentration and composition of the DOC in its sub-catchments. This is attributed to differences in how land was used: one tributary (D-WF) drains an area with wind farm construction and forestry in the headwaters, and one tributary (D-FF) drains an area with felled plantation trees. Generally, [DOC] in both streams showed similar seasonal variation, and autumn maxima. However, the felled catchment had greater mean [DOC] than the wind farm catchment. The SUVA 254 and E 4 /E 6 indicated DOC in both streams had similar aromaticity and fulvic:humic acid for most of the time, but SUVA 410 and E 2 /E 4 indicated less DOC humification in the felled catchment. This may be due to young DOC from the breakdown of residual branches and roots, or more humification in soils in the wind farm area. During the dry months, DOC composition showed more spatial variation: the D-WF DOC had smaller SUVA 254 (less total aromatic material) and SUVA 410 (fewer humic substances). The decreased E 2 /E 4 in both streams indicated the total aromatic carbon decreased more than humic substances content. Moreover, the larger E 4 /E 6 for D-WF in summer indicated that the humic substances were richer in fulvic acids than humic acids. Soil disturbance associated with forestry-felling likely contributed to the higher [DOC] and release of less-humified material in D-FF. This research indicates drivers of different DOC concentration and composition can exist even in small catchments. Copyright © 2018 Elsevier B.V. All rights reserved.

Respiratory parameters at varied altitudes in intermittent mining work.

PubMed

Bacaloni, Alessandro; Zamora Saà, Margarita Cecilia; Sinibaldi, Federica; Steffanina, Alessia; Insogna, Susanna

2018-01-07

Workers in the mining industry in altitude are subjected to several risk factors, e.g., airborne silica and low barometric pressure. The aim of this study has been to assess the risks for this work category, evaluating single risk factors as airborne silica, altitude and work shift, and relating them with cardiovascular and ventilatory parameters. Healthy miners employed in a mining company, Chile, working at varied altitudes, and subjected to unusual work shifts, were evaluated. Cardiovascular and respiratory parameters were investigated. Exposure to airborne silica was evaluated and compared to currently binding exposure limits. At varied altitudes and work shifts, alterations emerged in haemoglobin, ventilation and respiratory parameters, related to employment duration, due to compensatory mechanisms for hypoxia. Haemoglobin increased with altitude, saturation fell down under 90% in the highest mines. The multiple linear regression analysis showed a direct relationship, in the higher mine, between years of exposure to altitude and increased forced vital capacity percent (FVC%), and forced expiratory volume in 1 s (FEV1). An inverse relationship emerged between forced vital capacity (FVC) and years of exposure to airborne silica. In the workplace Mina Subterrànea (MT-3600), statistically significant inverse relationship emerged between the Tiffeneau index and body weight. The working conditions in the mining industry in altitude appeared to be potentially pathogenic; further investigations should be realized integrating risk assessment protocols even in consideration of their undeniable unconventionality. Int J Occup Med Environ Health 2018;31(2):129-138. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Baclofen Solution for Low-Volume Therapeutic Delivery.

PubMed

Meythaler, Jay M; Peduzzi, Jean D

2017-06-01

Baclofen is a zwitterion molecule where increased ions in the excipient increase the solubility. We developed baclofen in a stable solution similar to cerebrospinal fluid (CSF) without bicarbonate and proteins to improve the solubility of the baclofen and to reduce the potential toxicity to the central nervous system (CNS) and subarachnoid space. The objective is to develop a solution of baclofen wherein baclofen is solubilized in a multivalent physiological ion solution such as artificial cerebrospinal fluid (aCSF) at a concentration from 2 mg/cc to 10 mg/cc. First, to determine the solubility of Baclofen in aCSF, solubility was determined at six different pH levels at 37°C, by the addition of aCSF to a known amount of Baclofen. The final concentrations were confirmed by high performance liquid chromatography (HPLC) analysis. Second, the stability of Baclofen at 4 mg/cc investigated in a test manufacturing batch utilizing standard methods of production of 1500 20 cc vials inverted for 18 months at 25°C at 60% humidity. The stability and purity of the baclofen was verified at 18 months by HPLC analysis. Baclofen was initially soluble between pH of 6-8 above 7 mg/cc but fell back to 6.3-5.8 mg/cc level with time. Baclofen produced in vials with inversion were noted to be stable at 4 mg/cc at 18 months with less than 2% breakdown of the baclofen in solution. Baclofen is much more soluble in artificial CSF than normal saline. The artificial CSF may also be less toxic to the subarachnoid space than saline. © 2016 International Neuromodulation Society.

Decentralised black water treatment by combined auto-thermal aerobic digestion and ammonia - A pilot study optimising treatment capacity.

PubMed

Nordin, A; Göttert, D; Vinnerås, B

2018-02-01

Partial heating of black water by auto-thermal aerobic digestion was combined with the addition of 1% w/w urea and monitoring of pathogens and indicator organisms over a 21-day period. After initial mixing, the 160 m 3 black water (60 m 3 heated and 100 m 3 non-heated) was left undisturbed. The urea was confirmed to be fully degraded into ammonia (5.1 g N L -1 ) first after 14 days, while the pH stabilised at around 9.2 after one week. The initial temperature of 17 °C fell by 6 °C during the study. E. coli and Salmonella spp., which are sensitive to ammonia, were inactivated during the first few days of the study, despite the urea only being partly hydrolysed. At day 14, f-RNA bacteriophages could also no longer be detected. The more persistent somatic coliphages, Enterococcus spp. and Ascaris eggs, showed significant but slow inactivation. The treatment proved to be efficient with regards to salmonella, which is a target pathogen in the Swedish context, but for parasite egg inactivation a higher temperature was required. The treatment would benefit from more frequent stirring to speed up the hydrolysis of urea and thus improve treatment efficiency. The alternative treatment scheme could increase capacity by 2.4 times, albeit with a 40% higher cost per volume due to the increased use of urea. Copyright © 2017 Elsevier Ltd. All rights reserved.

Symptoms, airway responsiveness, and exposure to dust in beech and oak wood workers

PubMed Central

Bohadana, A.; Massin, N.; Wild, P.; Toamain, J.; Engel, S.; Goutet, P.

2000-01-01

OBJECTIVES—To investigate the relation between levels of cumulative exposure to wood dust and respiratory symptoms and the occurrence of bronchial hyperresponsiveness among beech and oak workers.
METHODS—114 Male woodworkers from five furniture factories and 13 male unexposed controls were examined. The unexposed control group was supplemented by 200 male historical controls. Statistical analyses were performed excluding and including the historical controls. Dust concentration was measured by personal sampling methods. Cumulative exposure to dust was calculated for each woodworker by multiplying the duration of the work by the intensity of exposure (years.mg/m3). Bronchial hyperresponsiveness was assessed by the methacholine bronchial challenge test. Subjects were labelled methacholine bronchial challenge positive if forced expiratory volume in 1 second (FEV1) fell by ⩾20%. The linear dose-response slope was calculated as the last dose divided by the total dose given.
RESULTS—443 Dust samples were collected. The median cumulative exposure to dust was 110 years.mg/m3 with lower and upper quartiles at 70 and 160 years.mg/m3 Overall, no declines in FEV1 and forced vital capacity (FVC) were found with increasing exposures. A dose-response relation was found between intensity of exposure on the one hand, and sore throat, increased prevalence of positive methacholine bronchial challenge tests, and steeper dose-response slope, on the other.
CONCLUSION—Exposure to oak and beech dust may lead to the development of sore throat and bronchial hyperresponsiveness.


Keywords: bronchial hyperresponsiveness; wood dust; beech; oak PMID:10810114

Treatment of hepatorenal syndrome as defined by the international ascites club by albumin and furosemide infusion according to the central venous pressure: a prospective pilot study.

PubMed

Péron, Jean-Marie; Bureau, Christophe; Gonzalez, Laurent; Garcia-Ricard, Franck; de Soyres, Olivier; Dupuis, Emmanuel; Alric, Laurent; Pourrat, Jacques; Vinel, Jean-Pierre

2005-12-01

Hepatorenal syndrome (HRS) is a functional renal failure that occurs late during cirrhosis. The prognosis is extremely poor with a mean survival of 1.7 wks from the time of diagnosis. The aim of the present study was to examine the effects of albumin and furosemide administration tailored to central venous pressure (CVP) on renal function and clinical outcome. We treated 20 consecutive patients with HRS. Albumin was given to increase and/or maintain CVP above 3 cm H(2)O. If diuresis remained below 50 mL/h despite effective volume expansion, furosemide was administrated. Patients were considered responders and treatment was discontinued when creatinine clearance rose above 40 mL/min or serum creatinine fell under 132 mumol/L. The need for albumin varied from patient to patient (extremes 40-600 g) and in the same patient from day to day. All but one needed furosemide. Eleven patients (55%) responded to treatment. In this population, diuresis, serum creatinine, and creatinine clearance were all significantly improved. Creatinine clearance at baseline was predictive of treatment efficacy. Survival increased in these patients compared to nonresponders defined as patients with no improvement in renal function (259 days +/- 113 compared to 14 days +/- 3, p < 0.0005). Response to treatment and the type of HRS were the only variables with an independent prognostic value. This study shows that HRS as defined by the International Ascites Club can be treated by albumin administration alone or with furosemide given according to the patient's specific need using CVP.

Is ultraviolet radiation on haemodialysis RO water beneficial?

PubMed

Stragier, A

2005-01-01

The quality of dialysis fluids has become increasingly important in the treatment of HD patients. Purified water represents over 95% of its volume. Bacterial and endotoxin content of Reverse Osmosis (RO) water is usually kept under control by bacterial filters, inserted in the distribution departure loop, and by monthly disinfection of the distribution circuit; the simpler the circuit, the better. This paper reports 12 years experience during which Ultraviolet Irradiation (UV) has replaced bacterial filters. To keep the bacterial growth under control in a complex RO water circuit (including a tank and multiple loops) a simple UV lamp was inserted in the departure line. It proved sufficient to keep bacterial count within AAMI norms. Failure of the UV lamp was associated with a rise of up to 500 cfu/ml in the last (fourth week) before routine disinfection. Normal levels were again obtained after replacement of the UV lamp. Six years later, a second UV lamp was added on the return loop. Bacterial counts and endotoxin levels in RO water promptly fell to <1 cfu/ml and <0.125 EU, till today. It is concluded that UV lamps should be favoured over bacterial filters in systems that are not disinfected daily, such as the RO water circuit. The principle of UV irradiation is explained and its advantage over bacterial filters is discussed. Future possible applications of UV are presented.

The Operative Burden of General Surgical Disease and Non-Battle Injury in a Deployed Military Treatment Facility in Afghanistan.

PubMed

Hollingsworth, Andrew C; Bowley, Douglas M; Lundy, Jonathan B

2016-09-01

Contemporary medical operations support a mobile, nonconventional force involved in nation building, counterinsurgency, and humanitarian operations. Prior reports have described surgical care for disease and nonbattle injuries (DNBI). The purpose of this report is to describe the prevalence and scope of DNBI managed by general surgeons in a contemporary, deployed medical facility. A 2-year retrospective review of the operative logbook from the U.K. Role 3 Multinational Hospital, Camp Bastion, Afghanistan, was performed to determine the prevalence and makeup of procedures performed for DNBI by general surgeons. Nontrauma general surgical procedures accounted for 7.7% (n = 279 of 3,607 cases) of cases; appendectomy (n = 146) was the most common, followed by drainage of soft tissue (n = 55) and oral abscesses (n = 5), scrotal exploration (n = 12), and hernia repair (n = 7). A total of 7.2% (n = 20 of 279) of cases fell outside the standard scope of practice of an urban, civilian general surgeon. Although the prevalence of operative procedures for DNBI was low, the spectrum of cases included those not typically managed in the civilian setting of the United Kingdom. With an evolving decline in case volume performed in multiple anatomic locations due to subspecialization during surgical training, this gap in expertise is likely to increase. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Effects of thiopentone sodium, methoxyflurane and halothane on haematological parameters in sheep during prolonged anaesthesia.

PubMed

Edjtehadi, M

1978-01-01

1. Satisfactory surgical anaesthesia in sheep was achieved by i.v. injection of thiopentone sodium per se (20 mg/kg); and also with thiopentone/methoxyflurane and thiopentone/halothane anaesthetics (2--3% and 1.5--2%, respectively). 2. Cardiac arrhythmias were not observed during thiopentone sodium, thiopentone/methoxyflurane and thiopentone/halothane anaesthesia. However, during thiopentone anaesthesia, one sheep displayed a high degree of sinus tachycardia followed with ventricular tachycardia. 3. Pneumograms recorded during thiopentone sodium and thiopentone/methoxyflurane anaesthesia showed no irregularity, but in thiopentone/halothane anaesthesia, 30% of the sheep developed Cheyne-Stokes periodic respiration. 4. Packed cell volume (PCV) and haemoglobin (Hb) were significantly decreased in thiopentone/methoxyflurane and thiopentone anaesthetized sheep, but not in animals anaesthetized by thiopentone/halothane. 5. White blood cell count (WBC) was significantly decreased only in thiopentone/methoxyflurane anaesthetized sheep, but was not remarkable in thiopentone and thiopentone/halothane anaesthetized animals. 6. A significant lymphocytopenia occurred in thiopentone/methoxyflurane and in thiopentone/halothane anaesthetized sheep, but not in the thiopentone anaesthetized animals. This was accompanied with an increase in neutrophils. 7. Clotting time fell, but the extent and time course was different in thiopentone, thiopentone/methoxyflurane and thiopentone/halothane anaesthesia. 8. From these data, it is suggested that thiopentone sodium, thiopentone/methoxyflurane and thiopentone/halothane have different effects on different blood parameters during prolonged anaesthesia, and may be clinically significant.

Systematic kidney disease management in a population with diabetes mellitus: turning the tide of kidney failure.

PubMed

Rayner, Hugh C; Hollingworth, Lee; Higgins, Robert; Dodds, Simon

2011-10-01

A significant proportion of patients with diabetes mellitus do not get the benefit of treatment that would reduce their risk of progressive kidney disease and reach a nephrologist once significant loss of kidney function has already occurred. Systematic disease management of patients with diabetes and kidney disease. Diverse population (approximately 800,000) in and around Birmingham, West Midlands, UK. Number of outpatient appointments, estimated glomerular filtration rate (eGFR) at first contact with nephrologist, number of patients starting kidney replacement therapy (KRT) and mode of KRT at start. Identification of patients with low or deteriorating trend in eGFR from weekly database review, specialist diabetes-kidney clinic, self-management of blood pressure and transfer to multidisciplinary clinic >12 months before end-stage kidney disease. New patients increased from 62 in 2003 to 132 in 2010; follow-ups fell from 251 to 174. Median eGFR at first clinic visit increased from 28.8 ml/min/1.73 m(2) (range 6.1-67.0) in 2000/2001 to 35.0 (11.1-147.5) in 2010 (p<0.006). In 2010, the number of patients starting KRT fell 30% below the projected activity using 1993-2003 data as baseline (p<0.003). The proportion starting KRT with either a kidney transplant, peritoneal dialysis or haemodialysis via an arteriovenous fistula increased from 26% in 2000 to 55% in 2010. Systematic disease management across a large population significantly improves patient outcomes, increases the productivity of a specialist service and could reduce healthcare costs compared with the current model of care.

Storm Effects on Net Ecosystem Productivity in Boreal Forests

NASA Astrophysics Data System (ADS)

Vestin, Patrik; Grelle, Achim; Lagergren, Fredrik; Hellström, Margareta; Langvall, Ola; Lindroth, Anders

2010-05-01

Regional carbon budgets are to some extent determined by disturbance in ecosystems. Disturbance is believed to be partly responsible for the large inter-annual variability of the terrestrial carbon balance. When neglecting anthropogenic disturbance, forest fires have been considered the most important kind of disturbance. However, also insect outbreaks and wind-throw may be major factors in regional carbon budgets. The effects of wind-throw on CO2 fluxes in boreal forests are not well known due to lack of data. Principally, the reduced carbon sequestration capacity, increased substrate availability and severe soil perturbation following wind-throw are expected to result in increased CO2 fluxes from the forest to the atmosphere. In January 2005, the storm Gudrun hit Sweden, which resulted in approx. 66 × 106m3storm-felled stem wood distributed over an area of approx. 272 000 ha. Eddy covariance flux measurements started at storm-felled areas in Asa and Toftaholm in central Sweden during summer 2005. Data from the first months suggests increased CO2 fluxes by a factor of 2.5-10, as compared to normal silviculture (clear-cutting). An important question is how long such enhanced CO2 fluxes persist. The BIOME-BGC model will be calibrated against measured CO2 fluxes from both sites for 2005 through 2009. Modeled data will be used to fill gaps in the data sets and annual carbon balances will be calculated. Data from Asa and Toftaholm will be presented at the conference.

Patterns of Chemotherapy Use in a U.S.-Based Cohort of Patients with Metastatic Pancreatic Cancer.

PubMed

Abrams, Thomas A; Meyer, Gary; Meyerhardt, Jeffrey A; Wolpin, Brian M; Schrag, Deborah; Fuchs, Charles S

2017-08-01

Few population studies have examined patterns of systemic therapy administration in metastatic pancreatic cancer (MPC) or the predictors associated with specific treatment choices. We assessed 4,011 consecutive MPC patients who received chemotherapy between January 2005 and December 2015 at academic, private, and community-based oncology practices subscribing to a U.S.-wide chemotherapy order entry system capturing disease, patient, provider, and treatment data. Multivariate analyses of these prospectively recorded characteristics identified significant predictors of specific therapeutic choices. Overall, 100 different regimens were used in first-line treatment of MPC. First-line gemcitabine monotherapy usage fell steadily from 72% in 2006 to 16% in 2015. This steep decline mirrored increases in first-line usage of both 5 fluorouracil, leucovorin, irinotecan and oxaliplatin (FOLFIRINOX) and gemcitabine + nab-paclitaxel. Younger male patients were more likely to receive FOLFIRINOX as first-line treatment, whereas patients treated at community practices and by oncologists with lower MPC patient volume were more likely to receive gemcitabine plus nab-paclitaxel (all p  ≤ .05). Among all patients receiving first-line chemotherapy for MPC, 49% went on to receive second-line therapy and 19% received third-line therapy; administration of second- and third-line therapies increased steadily over the time course of follow-up. Younger patients and those treated by oncologists with higher MPC patient volume were more likely to receive second- and third-line therapies. This population-based study provides insight into treatment patterns of MPC in the U.S. Usage patterns varied greatly according to patient and provider characteristics. This study examined real world metastatic pancreatic cancer treatment patterns in the United States with the goals of understanding changes in chemotherapy treatment frequencies over time and determining the individual predictors that underlie the chemotherapy choices oncologists make for their patients. Our data set is unique in that it captured not only patient-level data, but also oncologist-level data. It also captured data from private and community practices as well as academic centers. To our knowledge, this is the only data set that can give this degree of insight into oncologist decision making practices. © AlphaMed Press 2017.

The Maharashtra Felling of Trees (Regulation) (Amendment) Act, 1988 (No. 26 of 1989), 5 August 1989.

PubMed

1989-01-01

Among other things, this Act amends the Maharashtra (India) Felling of Trees (Regulation) Act, 1964, to authorize the Tree Officer to order the planting of trees in any land (other than government-designated drought land) that he thinks does not contain an adequate number of trees. Owners and occupiers of the land must comply with the order, after being given a reasonable opportunity to be heard. If they do not comply, they can be charged for expenses incurred in having the trees planted. In 1989 the government of West Bengal enacted The Indian Forest (West Bengal Amendment) Act, 1989 (No. 22 of 1988) (Calcutta Gazette, Extraordinary, Part III, 3 February 1989). This Act increases the punishment for various infractions of the Indian Forest Act, 1927, as applied to West Bengal and inserts new language relating to the power of officers to stop and search vehicles; the ability of the state government to seize contraband and related tools, vehicles, boats, and cattle; and punishment for abetting offenses delineated by the Act.

Vibration sensory thresholds depend on pressure of applied stimulus.

PubMed

Lowenthal, L M; Hockaday, T D

1987-01-01

Vibration sensory thresholds (VSTs) were estimated in 40 healthy subjects and 8 with diabetic peripheral neuropathy. A vibrameter and a biothesiometer were used at four sites and at differing pressures. In normal subjects, with the vibrameter at 200 g, mean VST +/- SE for all sites was 1.87 micron +/- 0.22 and at 400 g dropped to 1.08 micron +/- 0.15 (P less than .0001). In 20 of these subjects with a biothesiometer at 200 and 400 g, mean VST fell from 12.8 +/- 1.5 to 11.1 +/- 1.1 (arbitrary units) (P = .01) when the greater pressure was applied. In the 8 subjects with peripheral neuropathy, with the vibrameter at 200 and 400 g, respectively, mean VST fell from 70.7 +/- 26 to 7.2 +/- 1.8. VST in these subjects was estimated again after 1 mo and showed strong correlations with the previous values. Biothesiometer results correlated with vibrameter results at all sites. Thus, VST decreases as the pressure of the applied stimulus is increased and this effect appears to be more marked in peripheral neuropathy. This has important consequences in monitoring this condition.

a Study of the Reconstruction of Accidents and Crime Scenes Through Computational Experiments

NASA Astrophysics Data System (ADS)

Park, S. J.; Chae, S. W.; Kim, S. H.; Yang, K. M.; Chung, H. S.

Recently, with an increase in the number of studies of the safety of both pedestrians and passengers, computer software, such as MADYMO, Pam-crash, and LS-dyna, has been providing human models for computer simulation. Although such programs have been applied to make machines beneficial for humans, studies that analyze the reconstruction of accidents or crime scenes are rare. Therefore, through computational experiments, the present study presents reconstructions of two questionable accidents. In the first case, a car fell off the road and the driver was separated from it. The accident investigator was very confused because some circumstantial evidence suggested the possibility that the driver was murdered. In the second case, a woman died in her house and the police suspected foul play with her boyfriend as a suspect. These two cases were reconstructed using the human model in MADYMO software. The first case was eventually confirmed as a traffic accident in which the driver bounced out of the car when the car fell off, and the second case was proved to be suicide rather than homicide.

Economic Shocks and Public Health Protections in US Metropolitan Areas

PubMed Central

Hogg, Rachel A.

2015-01-01

Objectives. We examined public health system responses to economic shocks using longitudinal observations of public health activities implemented in US metropolitan areas from 1998 to 2012. Methods. The National Longitudinal Survey of Public Health Systems collected data on the implementation of 20 core public health activities in a nationally representative cohort of 280 metropolitan areas in 1998, 2006, and 2012. We used generalized estimating equations to estimate how local economic shocks relate to the scope of activities implemented in communities, the mix of organizations performing them, and perceptions of the effectiveness of activities. Results. Public health activities fell by nearly 5% in the average community between 2006 and 2012, with the bottom quintile of communities losing nearly 25% of their activities. Local public health delivery fell most sharply among communities experiencing the largest increases in unemployment and the largest reductions in governmental public health spending. Conclusions. Federal resources and private sector contributions failed to avert reductions in local public health protections during the recession. New financing mechanisms may be necessary to ensure equitable public health protections during economic downturns. PMID:25689201

"More Shortfalls than Ever"--Growing Evidence That the Funding Formula Does Not Cover the Costs of Public Education. BCTF Research Report. Section V. 2009-EF-01

ERIC Educational Resources Information Center

White, Margaret

2009-01-01

A new report by the Centre for Civic Governance of the Columbia Institute sheds light on why districts are struggling to balance their budgets while the Minister of Education claims they received the "highest funding ever." The $122 million increase in the current 2008-09 operating grant fell $15 million short of the $137 million…

Strategic Dissonance: British Middle East Command in World War II

DTIC Science & Technology

2014-05-22

shipping in the Atlantic Ocean, slowing American replacement of the equipment lost at Dunkirk .4 In the overseas empire, nationalist movements in the...British soldiers were rescued from Greece, they were forced to abandon their equipment just as they had at Dunkirk less than a year earlier.19 Crete fell...at Dunkirk only 10 months earlier, the hasty withdrawl required abandoning aircraft, tanks, trucks, and artillery that were increasingly scarce.62

Redwoods sawed and saved: What happened to the redwoods of Humboldt County?

Treesearch

Jerry Rohde

2017-01-01

The early day logging of coast redwood in Humboldt County was destructive, dramatic, and dangerous. Giant old-growth redwoods were felled by pairs of “choppers” using double-bitted axes and long crosscut saws. Felling a single tree could take a week. After bucking, logs were initially moved by water to mills on the shores of Humboldt Bay. Logging railroads gradually...

Southern Pine Beetle Survival In Trees Felled By the Cut and Top-Cut and Leave Method

Treesearch

J.D. Hodges; R.C. Thatcher

1976-01-01

When the cut & top-cut & leave method was used for control of the southern pine beetle in Central Louisiana, trees were felled into the open or into shade in September, June, July, December, and January. Survival was greatest in September, moderate in July, and relatively low in June, December, and January. The cut and top treatment resulted in lower beetle...

Productivity and cost of manual felling and cable skidding in central Appalachian hardwood forests

Treesearch

Jingxin Wang; Charlie Long; Joe McNeel; John Baumgras; John Baumgras

2004-01-01

A field production study was conducted for a manual harvesting system using a chainsaw and cable skidder in a central Appalachian hardwood forest site. A partial cut was performed on a 50-acre tract with an average slope of 25 percent. Felling time pre tree was most affected by diameter at breast height and the distance between harvested trees while skidding cycle time...

Use of the Fakopp TreeSonic acoustic device to estimate wood quality characteristics in loblolly pine trees planted at different densities

Treesearch

Ralph L. Amateis; Harold E. Burkhart

2015-01-01

A Fakopp TreeSonic acoustic device was used to measure time of flight (TOF) impulses through sample trees prior to felling from 27-year-old loblolly pine (Pinus taeda L.) plantations established at different planting densities. After felling, the sample trees were sawn into lumber and the boards subjected to edgewise bending under 2-point loading. Bending properties...

JPRS Report, Epidemiology

DTIC Science & Technology

1989-02-21

type 4 since the poisoning scare. "Figures since Dec 9, when egg consumption fell by half, show that cases of salmonella enteritidis type 4 fell from...Epidemics Reported in Wales [Michael Fleet; THE DAILY TELEGRAPH, 10 Dec 88] • ••••• - 23 Government Gives Statistics on Salmonella Deaths [David...difficult to estimate the size of an outbreak. Government Gives Statistics on Salmonella Deaths 54500048 London THE DAILY TELEGRAPH in English 20 Dec

Fluid inclusion gas studies, carrock fell tungsten deposit, england: implications for regional exploration

NASA Astrophysics Data System (ADS)

Shepherd, T. J.; Waters, P.

1984-10-01

A fluid inclusion investigation of the Carrock Fell tungsten deposit, Northern England, confirms that the quartz-wolframite-scheelite veins associated with the Caledonian Skiddaw Granite are almost exclusively related to an exocontact hydrothermal system developed at the margin of a local cupola. Fluid circulation, as defined by the spatial variation in temperature and H2O/CO2 ratios for inclusions in vein quartz, reveals a strong structural control. The zone of maximum flow, which extends 0 400 m out from the granite contact, is characterised by high H2O/CO2 ratios and corresponds closely with the known distribution of high-grade oreshoots. Based on the fluid inclusion “gas” signature for the Carrock Fell deposit, a distinction can be made between potentially tungstaniferous quartz veins and those related to Cu-Pb-Zn deposits in the absence of diagnostic ore minerals. Also, a regional survey of quartz veins in the Lake District suggests that at several localities the fluids have a close affinity with those at Carrock Fell. This is interpreted as the high-level, distal expression of tungsten mineralisation at depth. Evidence for similar mineralisation elsewhere in the British Caledonides favours those granites in the paratectonic zones of Ireland and southern Scotland.

Daily activity during stability and exacerbation of chronic obstructive pulmonary disease.

PubMed

Alahmari, Ayedh D; Patel, Anant R C; Kowlessar, Beverly S; Mackay, Alex J; Singh, Richa; Wedzicha, Jadwiga A; Donaldson, Gavin C

2014-06-02

During most COPD exacerbations, patients continue to live in the community but there is little information on changes in activity during exacerbations due to the difficulties of obtaining recent, prospective baseline data. Patients recorded on daily diary cards any worsening in respiratory symptoms, peak expiratory flow (PEF) and the number of steps taken per day measured with a Yamax Digi-walker pedometer. Exacerbations were defined by increased respiratory symptoms and the number of exacerbations experienced in the 12 months preceding the recording of daily step count used to divide patients into frequent (> = 2/year) or infrequent exacerbators. The 73 COPD patients (88% male) had a mean (±SD) age 71(±8) years and FEV1 53(±16)% predicted. They recorded pedometer data on a median 198 days (IQR 134-353). At exacerbation onset, symptom count rose by 1.9(±1.3) and PEF fell by 7(±13) l/min. Mean daily step count fell from 4154(±2586) steps/day during a preceding baseline week to 3673(±2258) step/day during the initial 7 days of exacerbation (p = 0.045). Patients with larger falls in activity at exacerbation took longer to recover to stable level (rho = -0.56; p < 0.001). Recovery in daily step count was faster (median 3.5 days) than for exacerbation symptoms (median 11 days; p < 0.001). Recovery in step count was also faster in untreated compared to treated exacerbation (p = 0.030).Daily step count fell faster over time in the 40 frequent exacerbators, by 708 steps/year, compared to 338 steps/year in 33 infrequent exacerbators (p = 0.002). COPD exacerbations reduced physical activity and frequent exacerbations accelerate decline in activity over time.

Horizontal schools-based health programme in rural Kenya.

PubMed

Bogie, James; Eder, Ben; Magnus, Dan; Amonje, Onguko David; Gant, Martina

2017-09-01

Primary school children in low-income countries are at risk of many diseases and poor health affects attendance, cognition and ability to learn. Developing school health and nutrition strategies has been extensively highlighted as a global priority, with a particular focus on complex programme design. However, such programmes are relatively untested in low-income settings. We implemented a complex school health and nutrition programme in two schools in Western Kenya over 3 years. There were numerous elements covering health policy, skills-based health education, infrastructure and disease prevention. A local non-governmental organisation, with involvement from local government and the community, performed programme implementation. Height-for-age, weight-for-age,height-for-weight, anaemia prevalence, academic performance and school attendance were the primary outcome measures. The programme improved nutrition, academic performance and anaemia prevalence. The number of underweight children fell from 20% to 11% (OR 0.51 95% CI 0.39 to 0.68 p=<0.01) and stunting prevalence fell from 29.9% to 20% (OR 0.59 95% CI 0.50 to 0.68 p=<0.01). Academic performance improved with a 74% reduction in odds of failing assessments (OR 0.26 95% CI 0.22 to 0.29 p=<0.01). Anaemia prevalence fell from 17.2% to 11%. The programme showed an increase in low body mass index prevalence and no effect on school attendance, the reasons for which are unclear. These results are encouraging and demonstrate that complex schools health programmes can lead to positive gains in health, nutrition and importantly academic performance. There is a need for further evaluation of comprehensive school health interventions in poor communities. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Community-based asthma care: trial of a "credit card" asthma self-management plan.

PubMed

D'Souza, W; Crane, J; Burgess, C; Te Karu, H; Fox, C; Harper, M; Robson, B; Howden-Chapman, P; Crossland, L; Woodman, K

1994-07-01

Although asthma self-management plans are widely recommended as essential in the long-term treatment of adult asthma, there have been few studies examining their use. Our objective was to assess the effect of a "credit card" adult asthma self-management plan in a community experiencing major health problems from asthma, by means of a before and after intervention trial of the efficacy of the "credit card" plan, when introduced through community-based asthma clinics. The participants were 69 Maori people with asthma. The "credit card" plan consisted of written guidelines for the self-management of asthma, based on self-assessment of asthma severity, printed on a plastic card. On one side, management guidelines were based on the interpretation of peak expiratory flow rate (PEFR) recordings, whilst the reverse side was based on symptoms. The outcome measures used were before and after comparison of markers of asthma morbidity and requirement for acute medical treatment; and a structured questionnaire assessing the acceptability and use of the credit card plan. Following the introduction of the plan, the mean PEFR increased from 347 to 389 l.min-1, the percentage of nights woken fell from 30.4 to 16.9%, and the number of days "out of action" fell from 3.8 to 1.7%. The requirements for acute medical treatment also fell during the intervention period. Most participants commented favourably on the content and usefulness of the plan. In the situation of worsening asthma, 28% of subjects found the peak flow side of the card most helpful, 7% the symptoms side, and 48% found both sides equally helpful.(ABSTRACT TRUNCATED AT 250 WORDS)

Further Progress in Noise Source Identification in High Speed Jets via Causality Principle

NASA Technical Reports Server (NTRS)

Panda, J.; Seasholtz, R. G.; Elam, K. A.

2004-01-01

To locate noise sources in high-speed jets, the sound pressure fluctuations p/, measured at far field locations, were correlated with each of density p, axial velocity u, radial velocity v, puu and pvv fluctuations measured from various points in fully expanded, unheated plumes of Mach number 0.95, 1.4 and 1.8. The velocity and density fluctuations were measured simultaneously using a recently developed, non-intrusive, point measurement technique based on molecular Rayleigh scattering (Seasholtz, Panda, and Elam, AIAA Paper 2002-0827). The technique uses a continuous wave, narrow line-width laser, Fabry-Perot interferometer and photon counting electronics. The far field sound pressure fluctuations at 30 to the jet axis provided the highest correlation coefficients with all flow variables. The correlation coefficients decreased sharply with increased microphone polar angle, and beyond about 60 all correlation mostly fell below the experimental noise floor. Among all correlations < puu; p/> showed the highest values. Interestingly, , in all respects, were very similar to . The and correlations with 90deg microphone fell below the noise floor. By moving the laser probe at various locations in the jet it was found that the strongest noise source lies downstream of the end of the potential core and extends many diameters beyond. Correlation measurement from the lip shear layer showed a Mach number dependency. While significant correlations were measured in Mach 1.8 jet, values were mostly below the noise floor for subsonic Mach 0.95 jet. Various additional analyses showed that fluctuations from large organized structures mostly contributed to the measured correlation, while that from small scale structures fell below the noise floor.

Cardiac, skeletal, and smooth muscle mitochondrial respiration: are all mitochondria created equal?

PubMed

Park, Song-Young; Gifford, Jayson R; Andtbacka, Robert H I; Trinity, Joel D; Hyngstrom, John R; Garten, Ryan S; Diakos, Nikolaos A; Ives, Stephen J; Dela, Flemming; Larsen, Steen; Drakos, Stavros; Richardson, Russell S

2014-08-01

Unlike cardiac and skeletal muscle, little is known about vascular smooth muscle mitochondrial respiration. Therefore, the present study examined mitochondrial respiratory rates in smooth muscle of healthy human feed arteries and compared with that of healthy cardiac and skeletal muscles. Cardiac, skeletal, and smooth muscles were harvested from a total of 22 subjects (53 ± 6 yr), and mitochondrial respiration was assessed in permeabilized fibers. Complex I + II, state 3 respiration, an index of oxidative phosphorylation capacity, fell progressively from cardiac to skeletal to smooth muscles (54 ± 1, 39 ± 4, and 15 ± 1 pmol·s(-1)·mg(-1), P < 0.05, respectively). Citrate synthase (CS) activity, an index of mitochondrial density, also fell progressively from cardiac to skeletal to smooth muscles (222 ± 13, 115 ± 2, and 48 ± 2 μmol·g(-1)·min(-1), P < 0.05, respectively). Thus, when respiration rates were normalized by CS (respiration per mitochondrial content), oxidative phosphorylation capacity was no longer different between the three muscle types. Interestingly, complex I state 2 normalized for CS activity, an index of nonphosphorylating respiration per mitochondrial content, increased progressively from cardiac to skeletal to smooth muscles, such that the respiratory control ratio, state 3/state 2 respiration, fell progressively from cardiac to skeletal to smooth muscles (5.3 ± 0.7, 3.2 ± 0.4, and 1.6 ± 0.3 pmol·s(-1)·mg(-1), P < 0.05, respectively). Thus, although oxidative phosphorylation capacity per mitochondrial content in cardiac, skeletal, and smooth muscles suggest all mitochondria are created equal, the contrasting respiratory control ratio and nonphosphorylating respiration highlight the existence of intrinsic functional differences between these muscle mitochondria. This likely influences the efficiency of oxidative phosphorylation and could potentially alter ROS production.

Fenoterol increases erythropoietin concentrations during tocolysis

PubMed Central

Gleiter, C H; Schreeb, K H; Goldbach, S; Herzog, S; Cunze, T; Kuhn, W

1998-01-01

Aims The present study was carried out to assess the effect of the selective β2- adrenoceptor agonists on erythropoietin (EPO) production. Methods Routine tocolysis with fenoterol (using the regular rate of 2 μg min−1) was used as a clinically easily accessible model. Results EPO concentrations had doubled 24 h after the start of tocolysis (P < 0.001). This increase lasted over the entire observation period of 48 h. Potassium concentrations fell significantly during the first hours of fenoterol infusion. There was no increase of human placenta lactogen during the period of EPO increase. Conclusions The data confirm our earlier results that fenoterol increases EPO concentrations following haemorrhage. In this model it was not necessary to stimulate EPO production prior to pharmacological treatment. PMID:9491829

Distribution of Mature Cones, Conelets, and Old Cones in Shortleaf Pine-Oak Stands an Uneven-Aged Regeneration Cut

Treesearch

Kenneth J. Grayson; Robert F. Wittwer; Michael G. Shelton

2004-01-01

Sixteen shortleaf pine trees were felled in a stand 10 years after an uneven-aged regeneration cut reduced pine basal area to 60 square feet per acre and hardwoods were controlled. Sixteen unreleased trees in an adjacent uncut pine-hardwood stand (120 square feet per acre) were felled for comparison. Sample trees were selected from four 2-inch d.b.h. classes (11, 13,...

The national fire and fire surrogate study: vegetation changes over 11 years of fuel reduction treatments in the southern Appalachian Mountains

Treesearch

Thomas A. Waldrop; Helen H. Mohr; Ross J. Phillips; Dean M. Simon

2014-01-01

At the Appalachian site of the National Fire and Fire Surrogate Study, prescribed burning was repeated three times and chainsaw felling of shrubs was done twice between 2002 and 2012. Goals were to reduce fuel loading and to promote restoration of an open woodland community. Chainsaw felling created a vertical fuel break, but the effect was temporary, and no...

Funding Instability Reduces the Impact of the Federal Teaching Health Center Graduate Medical Education Program.

PubMed

Kurz, Troy; Liaw, Winston; Wingrove, Peter; Petterson, Stephen; Bazemore, Andrew

2017-01-01

The Teaching Health Center Graduate Medical Education (THCGME) program is a decentralized residency training component of the Affordable Care Act, created to combat critical shortages and maldistribution of primary care physicians. The Accreditation Council of Graduate Medical Education and federal data reveal that the THCGME program accounted for 33% of the net increase in family medicine residency positions between 2011 and 2015. However, amid concerns about the program's stability, the contribution of the THCGME program to the net increase fell to 7% after 2015. © Copyright 2017 by the American Board of Family Medicine.

Estimating Water Storage Capacity of Existing and Potentially Restorable Wetland Depressions in a Subbasin of the Red River of the North

USGS Publications Warehouse

Gleason, Robert A.; Tangen, Brian A.; Laubhan, Murray K.; Kermes, Kevin E.; Euliss, Ned H.

2007-01-01

Executive Summary Concern over flooding along rivers in the Prairie Pothole Region has stimulated interest in developing spatially distributed hydrologic models to simulate the effects of wetland water storage on peak river flows. Such models require spatial data on the storage volume and interception area of existing and restorable wetlands in the watershed of interest. In most cases, information on these model inputs is lacking because resolution of existing topographic maps is inadequate to estimate volume and areas of existing and restorable wetlands. Consequently, most studies have relied on wetland area to volume or interception area relationships to estimate wetland basin storage characteristics by using available surface area data obtained as a product from remotely sensed data (e.g., National Wetlands Inventory). Though application of areal input data to estimate volume and interception areas is widely used, a drawback is that there is little information available to provide guidance regarding the application, limitations, and biases associated with such approaches. Another limitation of previous modeling efforts is that water stored by wetlands within a watershed is treated as a simple lump storage component that is filled prior to routing overflow to a pour point or gaging station. This approach does not account for dynamic wetland processes that influence water stored in prairie wetlands. Further, most models have not considered the influence of human-induced hydrologic changes, such as land use, that greatly influence quantity of surface water inputs and, ultimately, the rate that a wetland basin fills and spills. The goals of this study were to (1) develop and improve methodologies for estimating and spatially depicting wetland storage volumes and interceptions areas and (2) develop models and approaches for estimating/simulating the water storage capacity of potentially restorable and existing wetlands under various restoration, land use, and climatic scenarios. To address these goals, we developed models and approaches to spatially represent storage volumes and interception areas of existing and potentially restorable wetlands in the upper Mustinka subbasin within Grant County, Minn. We then developed and applied a model to simulate wetland water storage increases that would result from restoring 25 and 50 percent of the farmed and drained wetlands in the upper Mustinka subbasin. The model simulations were performed during the growing season (May-October) for relatively wet (1993; 0.79 m of precipitation) and dry (1987; 0.40 m of precipitation) years. Results from the simulations indicated that the 25 percent restoration scenario would increase water storage by 21-24 percent and that a 50 percent scenario would increase storage by 34-38 percent. Additionally, we estimated that wetlands in the subbasin have potential to store 11.57-20.98 percent of the total precipitation that fell over the entire subbasin area (52,758 ha). Our simulation results indicated that there is considerable potential to enhance water storage in the subbasin; however, evaluation and calibration of the model is necessary before simulation results can be applied to management and planning decisions. In this report we present guidance for the development and application of models (e.g., surface area-volume predictive models, hydrology simulation model) to simulate wetland water storage to provide a basis from which to understand and predict the effects of natural or human-induced hydrologic alterations. In developing these approaches, we tried to use simple and widely available input data to simulate wetland hydrology and predict wetland water storage for a specific precipitation event or a series of events. Further, the hydrology simulation model accounted for land use and soil type, which influence surface water inputs to wetlands. Although information presented in this report is specific to the Mustinka subbasin, the approaches

Variability in Treatment for Patients with Cervical Spine Fracture and Dislocation: An Analysis of 107,152 Patients.

PubMed

Wang, Jing; Eltorai, Adam E M; DePasse, J Mason; Durand, Wesley; Reid, Daniel; Daniels, Alan H

2018-06-01

Cervical spine injuries are a common cause of morbidity and mortality; however, the optimal treatment of many of these injuries is debated, and previous studies have shown substantial variation in treatment. We sought to examined treatment variation in arthrodesis and halo/tong placement in cervical spine injury patients over a 12-year period. Data from the Healthcare Cost and Utilization Project National Inpatient Sample, from 2000 to 2011, were used for this study. Patients were identified with a cervical vertebral facture or dislocation based on the International Classification of Diseases, 9th Revision codes. Using χ 2 analysis, spinal arthrodesis rates and halo/tong placement rates were compared between hospitals based on teaching status for patients with and without spinal cord injury (SCI). The records of 107,152 patients with cervical fractures were examined. From 2000 to 2011, the overall arthrodesis rates fell from 25.2% to 20.6% (P < 0.001), and halo/tong placement rates fell from 13.2% to 3.6% (P < 0.001). In patients with cervical fracture without SCI, arthrodesis rates fell from 17.6% to 13.9% (P < 0.001), in cervical fracture patients with SCI, arthrodesis rates rose from 50.0% to 58.9% (P < 0.001), and in cervical dislocation patients, arthrodesis rates rose from 47.6% to 57.5% (P < 0.001). During the 12-year period, teaching hospitals had higher arthrodesis rates compared with nonteaching hospitals for patients with cervical fractures with SCI (57.3% vs. 53.4%, P = 0.001) and higher halo/tong placement rates for patients with cervical dislocations (2.7% vs. 1.7%, P = 0.004). Individual hospital variation showed a 3.5-fold variation in arthrodesis rates in 2000 to 2002, which fell to 3.0-fold by 2009 to 2011. Arthrodesis rates for cervical fracture patients significantly decreased, and arthrodesis rates for cervical dislocation and SCI patients increased from 2000 to 2011, with variability in treatment based on hospital teaching status. Rates of halo/tong placement rapidly decreased for cervical spine trauma at both teaching and nonteaching hospitals. Individual hospital treatment variation also decreased over the study period. Further clinical studies examining the optimal treatment for spine trauma may lead to continued decreases in treatment variability. Copyright © 2018 Elsevier Inc. All rights reserved.

Shortleaf pine and mixed hardwood stands: thirty-four years after regeneration with the fell-and-burn technique in the Southern Appalachian Mountains

Treesearch

Lauren S. Pile; Tom Waldrop

2016-01-01

There has been considerable interest in developing management techniques for creating mixed shortleaf pine (Pinus echinata)–hardwood forests in the Southern Appalachian Mountains. This interest has increased in recent years due to the need to manage for more diverse and resilient forests, and to reestablish shortleaf pine as a dominant species throughout its native...

Impacts of harvesting and postharvest treatments on soil bulk density, soil strength, and ealry growth of Pinus taeda in the Gulf Coastal Plain: a long-term soil productivity affiliated study

Treesearch

Mason C. Carter; Thomas J. Dean; Ziyin Wang; Ray A. Newbold

2006-01-01

At four sites in the Gulf Coastal Plain, mechanical whole-tree harvesting (MWT) removed from biomass and nutrients than hand-fell bole-only harvesting (HFBO). Soil compaction and loblolly pine (Pinus taeda L.) regeneration growth varied among sites. At one location, MWT increased soil bulk density by 0.1 Mgm-3, from 1.14 to 1....

Share of Energy Used by Appliances and Consumer Electronics Increases in U.S. Homes

EIA Publications

2011-01-01

Over the past three decades, the share of residential electricity used by appliances and electronics in U.S. homes has nearly doubled from 17% to 3% , growing from 1.77 quadrillion Btu (quads) to 3.25 quads. This rise has occurred while federal energy efficiency standards were enacted on every major appliance, overall household energy consumption actually decreased from 10.58 quads to 10.55 quads, and energy use per household fell 31%.

Yeast succession in the Amazon fruit Parahancornia amapa as resource partitioning among Drosophila spp.

PubMed Central

Morais, P B; Martins, M B; Klaczko, L B; Mendonça-Hagler, L C; Hagler, A N

1995-01-01

The succession of yeasts colonizing the fallen ripe amapa fruit, from Parahancornia amapa, was examined. The occupation of the substrate depended on both the competitive interactions of yeast species, such as the production of killer toxins, and the selective dispersion by the drosophilid guild of the amapa fruit. The yeast community associated with this Amazon fruit differed from those isolated from other fruits in the same forest. The physiological profile of these yeasts was mostly restricted to the assimilation of a few simple carbon sources, mainly L-sorbose, D-glycerol, DL-lactate, cellobiose, and salicin. Common fruit-associated yeasts of the genera Kloeckera and Hanseniaspora, Candida guilliermondii, and Candida krusei colonized fruits during the first three days after the fruit fell. These yeasts were dispersed and served as food for the invader Drosophila malerkotliana. The resident flies of the Drosophila willistoni group fed selectively on patches of yeasts colonizing fruits 3 to 10 days after the fruit fell. The killer toxin-producing yeasts Pichia kluyveri var. kluyveri and Candida fructus were probably involved in the exclusion of some species during the intermediate stages of fruit deterioration. An increase in pH, inhibiting toxin activity and the depletion of simple sugars, may have promoted an increase in yeast diversity in the later stages of decomposition. The yeast succession provided a patchy environment for the drosophilids sharing this ephemeral substrate. PMID:8534092

Intracellular pH in early Xenopus embryos: its effect on current flow between blastomeres.

PubMed Central

Turin, L; Warner, A E

1980-01-01

1. Electrophysiological techniques were used to monitor the flow of electric current from one cell to the next in Xenopus laevis embryos between the 4-cell and early blastula stages of development. Intracellular pH and blastocoel pH were determined using pH-sensitive micro-electrodes. 2. The resting intracellular pH was 7.74+/-0.02 (S.E. of mean, n = 29); there were no systematic differences between developmental stages. Blastocoel cavity pH was 8.4+/-0.06 (S.E. of mean, n = 10). The intracellular buffer value was 18 m-equiv. H+/pH unit per litre. 3. In embryos treated with bicarbonate buffered Holtfreter solution equilibrated with 100% CO2 the intracellular pH fell to 6.3+/-0.17 (S.D., n = 8). The membrane potential fell and the input resistance increased. The size of the effect on membrane potential and input resistance varied. 4. From the 32-cell stage onwards current flow from one cell to the next was abolished when the intracellular pH fell to below 6.5; the effect was rapid in onset and completely reversible. At cleavage stages of development lowering intracellular pH with CO2 had no effect on current flow from cell to cell. 5. The relationship between intracellular pH and current flow from cell to cell was sigmoid and covered between 0.2 and 0.4 pH units. The pH at which current flow was completely abolished ranged from 6.85 to 6.4. 6. Alterations in extraembryonic pH over the range 5.8-7.5 had no effect on any parameter measured. 7. We conclude that lowering the intracellular pH increases the resistance of both non-junctional junctional membranes. The data do not allow us to extract the pH junctional conductance relationship. 8. Variations in intracellular pH may provide a useful tool for the study of the functional role of direct cell to cell communication in both adult organs and early embryos. PMID:6770084

Increasing compliance with low tidal volume ventilation in the ICU with two nudge-based interventions: evaluation through intervention time-series analyses

PubMed Central

Bourdeaux, Christopher P; Thomas, Matthew JC; Gould, Timothy H; Malhotra, Gaurav; Jarvstad, Andreas; Jones, Timothy; Gilchrist, Iain D

2016-01-01

Objectives Low tidal volume (TVe) ventilation improves outcomes for ventilated patients, and the majority of clinicians state they implement it. Unfortunately, most patients never receive low TVes. ‘Nudges’ influence decision-making with subtle cognitive mechanisms and are effective in many contexts. There have been few studies examining their impact on clinical decision-making. We investigated the impact of 2 interventions designed using principles from behavioural science on the deployment of low TVe ventilation in the intensive care unit (ICU). Setting University Hospitals Bristol, a tertiary, mixed medical and surgical ICU with 20 beds, admitting over 1300 patients per year. Participants Data were collected from 2144 consecutive patients receiving controlled mechanical ventilation for more than 1 hour between October 2010 and September 2014. Patients on controlled mechanical ventilation for more than 20 hours were included in the final analysis. Interventions (1) Default ventilator settings were adjusted to comply with low TVe targets from the initiation of ventilation unless actively changed by a clinician. (2) A large dashboard was deployed displaying TVes in the format mL/kg ideal body weight (IBW) with alerts when TVes were excessive. Primary outcome measure TVe in mL/kg IBW. Findings TVe was significantly lower in the defaults group. In the dashboard intervention, TVe fell more quickly and by a greater amount after a TVe of 8 mL/kg IBW was breached when compared with controls. This effect improved in each subsequent year for 3 years. Conclusions This study has demonstrated that adjustment of default ventilator settings and a dashboard with alerts for excessive TVe can significantly influence clinical decision-making. This offers a promising strategy to improve compliance with low TVe ventilation, and suggests that using insights from behavioural science has potential to improve the translation of evidence into practice. PMID:27230998

Effects of inspiratory pause on CO2 elimination and arterial PCO2 in acute lung injury

PubMed Central

Devaquet, Jérôme; Jonson, Björn; Niklason, Lisbet; Si Larbi, Anne-Gaëlle; Uttman, Leif; Aboab, Jérôme; Brochard, Laurent

2008-01-01

A high respiratory rate associated with the use of small tidal volumes, recommended for acute lung injury (ALI), shortens time for gas diffusion in the alveoli. This may decrease CO2 elimination. We hypothesized that a post-inspiratory pause could enhance CO2 elimination and reduce PaCO2 by reducing dead space in ALI. In 15 mechanically ventilated patients with ALI and hypercapnia, a 20% post-inspiratory pause (Tp20) was applied during a period of 30 min between two ventilation periods without post-inspiratory pause (Tp0). Other parameters were kept unchanged. The single breath test for CO2 was recorded every 5 minutes to measure tidal CO2 elimination (VtCO2), airway dead space (VDaw) and slope of the alveolar plateau. PaO2, PaCO2, physiological and alveolar dead space (VDphys, VDalv) were determined at the end of each 30 minute period. The post-inspiratory pause, 0.7±0.2 s, induced on average less than 0.5 cm H2O of intrinsic PEEP. During Tp20, VtCO2 increased immediately by 28±10% (14±5 ml per breath compared to 11±4 for Tp0) and then decreased without reaching the initial value within 30 minutes. The addition of a post-inspiratory pause decreased significantly VDaw by 14% and VDphys by 11% with no change in VDalv. During Tp20, the slope of alveolar plateau initially fell to 65±10 % of baseline value and continued to decrease. Tp20 induced a 10±3% decrease in PaCO2 at 30 minutes (from 55±10 to 49±9 mmHg, p<0.001) with no significant variation in PaO2. Post-inspiratory pause has a significant influence on CO2 elimination when small tidal volumes are used during mechanical ventilation for ALI. PMID:18801962

High-volume plasma exchange in patients with acute liver failure: An open randomised controlled trial.

PubMed

Larsen, Fin Stolze; Schmidt, Lars Ebbe; Bernsmeier, Christine; Rasmussen, Allan; Isoniemi, Helena; Patel, Vishal C; Triantafyllou, Evangelos; Bernal, William; Auzinger, Georg; Shawcross, Debbie; Eefsen, Martin; Bjerring, Peter Nissen; Clemmesen, Jens Otto; Hockerstedt, Krister; Frederiksen, Hans-Jørgen; Hansen, Bent Adel; Antoniades, Charalambos G; Wendon, Julia

2016-01-01

Acute liver failure (ALF) often results in cardiovascular instability, renal failure, brain oedema and death either due to irreversible shock, cerebral herniation or development of multiple organ failure. High-volume plasma exchange (HVP), defined as exchange of 8-12 or 15% of ideal body weight with fresh frozen plasma in case series improves systemic, cerebral and splanchnic parameters. In this prospective, randomised, controlled, multicentre trial we randomly assigned 182 patients with ALF to receive either standard medical therapy (SMT; 90 patients) or SMT plus HVP for three days (92 patients). The baseline characteristics of the groups were similar. The primary endpoint was liver transplantation-free survival during hospital stay. Secondary-endpoints included survival after liver transplantation with or without HVP with intention-to-treat analysis. A proof-of-principle study evaluating the effect of HVP on the immune cell function was also undertaken. For the entire patient population, overall hospital survival was 58.7% for patients treated with HVP vs. 47.8% for the control group (hazard ratio (HR), with stratification for liver transplantation: 0.56; 95% confidence interval (CI), 0.36-0.86; p=0.0083). HVP prior to transplantation did not improve survival compared with patients who received SMT alone (CI 0.37 to 3.98; p=0.75). The incidence of severe adverse events was similar in the two groups. Systemic inflammatory response syndrome (SIRS) and sequential organ failure assessment (SOFA) scores fell in the treated group compared to control group, over the study period (p<0.001). Treatment with HVP improves outcome in patients with ALF by increasing liver transplant-free survival. This is attributable to attenuation of innate immune activation and amelioration of multi-organ dysfunction. Copyright © 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Changes of cerebral blood flow during the secondary expansion of a cortical contusion assessed by 14C-iodoantipyrine autoradiography in mice using a non-invasive protocol.

PubMed

Engel, Doortje C; Mies, Günter; Terpolilli, Nicole A; Trabold, Raimund; Loch, Alexander; De Zeeuw, Chris I; Weber, John T; Maas, Andrew I R; Plesnila, Nikolaus

2008-07-01

Although changes of cerebral blood flow (CBF) in and around traumatic contusions are well documented, the role of CBF for the delayed death of neuronal cells in the traumatic penumbra ultimately resulting in secondary contusion expansion remains unclear. The aim of the current study was therefore to investigate the relationship between changes of CBF and progressive peri-contusional cell death following traumatic brain injury (TBI). CBF and contusion size were measured in C57Bl6 mice under continuous on-line monitoring of (ETp)CO2 before, and at 15 min and 24 h following controlled cortical impact by 14C-iodoantipyrine autoradiography (IAP-AR; n = 5-6 per group) and by Nissl staining, respectively. Contused and ischemic (CBF < 10%) tissue volumes were calculated and compared over time. Cortical CBF in not injured mice varied between 69 and 93 mL/100mg/min depending on the anatomical location. Fifteen minutes after trauma, CBF decreased in the whole brain by approximately 50% (39 +/- 18 mL/100mg/min; p < 0.05), except in contused tissue where it fell by more than 90% (3 +/- 2 mL/100mg/min; p < 0.001). Within 24 h after TBI, CBF recovered to normal values in all brain areas except the contusion where it remained reduced by more than 90% (p < 0.001). Contusion volume expanded from 24.9 to 35.5 mm3 (p < 0.01) from 15 min to 24 h after trauma (+43%), whereas the area of severe ischemia (CBF < 10%) showed only a minimal (+13%) and not significant increase (22.3 to 25.1 mm3). The current data therefore suggest that the delayed secondary expansion of a cortical contusion following traumatic brain injury may not be caused by a reduction of CBF alone.

Neuromuscular responses differ between slip-induced falls and recoveries in older adults

PubMed Central

Pai, Yi-Chung (Clive); Bhatt, Tanvi; Ting, Lena H.

2016-01-01

How does the robust control of walking and balance break down during a fall? Here, as a first step in identifying the neuromuscular determinants of falls, we tested the hypothesis that falls and recoveries are characterized by differences in neuromuscular responses. Using muscle synergy analysis, conventional onset latencies, and peak activity, we identified differences in muscle coordination between older adults who fell and those who recovered from a laboratory-induced slip. We found that subjects who fell recruited fewer muscle synergies than those who recovered, suggesting a smaller motor repertoire. During slip trials, compared with subjects who recovered, subjects who fell had delayed knee flexor and extensor onset times in the leading/slip leg, as well as different muscle synergy structure involving those muscles. Therefore, the ability to coordinate muscle activity around the knee in a timely manner may be critical to avoiding falls from slips. Unique to subjects who fell during slip trials were greater bilateral (interlimb) muscle activation and the recruitment of a muscle synergy with excessive coactivation. These differences in muscle coordination between subjects who fell and those who recovered could not be explained by differences in gait-related variables at slip onset (i.e., initial motion state) or variations in slip difficulty, suggesting that differences in muscle coordination may reflect differences in neural control of movement rather than biomechanical constraints imposed by perturbation or initial walking mechanics. These results are the first step in determining the causation of falls from the perspective of muscle coordination. They suggest that there may be a neuromuscular basis for falls that could provide new insights into treatment and prevention. Further research comparing the muscle coordination and mechanics of falls and recoveries within subjects is necessary to establish the neuromuscular causation of falls. NEW & NOTEWORTHY A central question relevant to the prevention of falls is: How does the robust control of walking and balance break down during a fall? Previous work has focused on muscle coordination during successful balance recoveries or the kinematics and kinetics of falls. Here, for the first time, we identified differences in the spatial and temporal coordination of muscles among older adults who fell and those who recovered from an unexpected slip. PMID:27832608

Neuromuscular responses differ between slip-induced falls and recoveries in older adults.

PubMed

Sawers, Andrew; Pai, Yi-Chung Clive; Bhatt, Tanvi; Ting, Lena H

2017-02-01

How does the robust control of walking and balance break down during a fall? Here, as a first step in identifying the neuromuscular determinants of falls, we tested the hypothesis that falls and recoveries are characterized by differences in neuromuscular responses. Using muscle synergy analysis, conventional onset latencies, and peak activity, we identified differences in muscle coordination between older adults who fell and those who recovered from a laboratory-induced slip. We found that subjects who fell recruited fewer muscle synergies than those who recovered, suggesting a smaller motor repertoire. During slip trials, compared with subjects who recovered, subjects who fell had delayed knee flexor and extensor onset times in the leading/slip leg, as well as different muscle synergy structure involving those muscles. Therefore, the ability to coordinate muscle activity around the knee in a timely manner may be critical to avoiding falls from slips. Unique to subjects who fell during slip trials were greater bilateral (interlimb) muscle activation and the recruitment of a muscle synergy with excessive coactivation. These differences in muscle coordination between subjects who fell and those who recovered could not be explained by differences in gait-related variables at slip onset (i.e., initial motion state) or variations in slip difficulty, suggesting that differences in muscle coordination may reflect differences in neural control of movement rather than biomechanical constraints imposed by perturbation or initial walking mechanics. These results are the first step in determining the causation of falls from the perspective of muscle coordination. They suggest that there may be a neuromuscular basis for falls that could provide new insights into treatment and prevention. Further research comparing the muscle coordination and mechanics of falls and recoveries within subjects is necessary to establish the neuromuscular causation of falls. A central question relevant to the prevention of falls is: How does the robust control of walking and balance break down during a fall? Previous work has focused on muscle coordination during successful balance recoveries or the kinematics and kinetics of falls. Here, for the first time, we identified differences in the spatial and temporal coordination of muscles among older adults who fell and those who recovered from an unexpected slip. Copyright © 2017 the American Physiological Society.

Inception and variability of the Antarctic ice sheet across the Eocene-Oligocene transition

NASA Astrophysics Data System (ADS)

Stocchi, Paolo; Galeotti, Simone; Ladant, Jan-Baptiste; DeConto, Robert; Vermeersen, Bert; Rugenstein, Maria

2014-05-01

Climate cooling throughout middle to late Eocene (~48 - 34 Million years ago, Ma) triggered the transition from hot-house to ice-house conditions. Based on deep-sea marine δ18O values, a continental-scale Antarctic Ice Sheet (AIS) rapidly developed across the Eocene-Oligocene transition (EOT) in two ~200 kyr-spaced phases between 34.0 - 33.5 Ma. Regardless of the geographical configuration of southern ocean gateways, geochemical data and ice-sheet modelling show that AIS glaciation initiated as atmospheric CO2 fell below ~2.5 times pre-industrial values. AIS likely reached or even exceeded present-day dimensions. Quantifying the magnitude and timing of AIS volume variations by means of δ18O records is hampered by the fact that the latter reflect a coupled signal of temperature and ice-sheet volume. Besides, bathymetric variations based on marine geologic sections are affected by large uncertainties and, most importantly, reflect the local response of relative sea level (rsl) to ice volume fluctuations rather than the global eustatic signal. AIS proximal and Northern Hemisphere (NH) marine settings show an opposite trend of rsl change across the EOT. In fact, consistently with central values based on δ18O records, an 60 ± 20m rsl drop is estimated from NH low-latitude shallow marine sequences. Conversely, sedimentary facies from shallow shelfal areas in the proximity of the AIS witness an 50 - 150m rsl rise across the EOT. Accounting for ice-load-induced crustal and geoidal deformations and for the mutual gravitational attraction between the growing AIS and the ocean water is a necessary requirement to reconcile near- and far-field rsl sites, regardless of tectonics and of any other possible local contamination. In this work we investigate the AIS inception and variability across the EOT by combining the observed rsl changes with predictions based on numerical modeling of Glacial Isostatic Adjustment (GIA). We solve the gravitationally self-consistent Sea Level Equation for two different and independent AIS models both driven by atmospheric CO2 variations and evolving on different Antarctic topographies. In particular, minimum and maximum AIS volumes, respectively of ~55m and ~70m equivalent sea level (esl), stem from a smaller and a larger Antarctic topography. Minimum and maximum GIA predictions at the NH rsl sites respectively correspond to the lower limit and central value of the EOT rsl drop inferred from geological data. For both GIA models, the departures from the eustatic trend significantly increase southward toward Antarctica, where the AIS growth is accompanied by a rsl rise. Accordingly, the cyclochronological record of sedimentary cycles retrieved from Cape Roberts Project Drillcore CRP-3 (Victoria Land Basin) witness a deepening across the EOT. Most importantly, CRP-3 record shows that full glacial conditions consistent with the maximum AIS model dimensions were reached only at ~32.8 Ma, while ice-sheet volumes fluctuations around the minimum AIS model volume persisted during the first million years of glaciation.

Alterations in adenosine triphosphate and energy charge in cultured endothelial and P388D1 cells after oxidant injury.

PubMed Central

Spragg, R G; Hinshaw, D B; Hyslop, P A; Schraufstätter, I U; Cochrane, C G

1985-01-01

To investigate mechanisms whereby oxidant injury of cells results in cell dysfunction and death, cultured endothelial cells or P388D1 murine macrophage-like cells were exposed to oxidants including H2O2, O2-. (generated by the enzymatic oxidation of xanthine), or to stimulated polymorphonuclear leukocytes (PMN). Although Trypan Blue exclusion was not diminished before 30 min, cellular ATP was found to fall to less than 30% of control values within 3 min of exposure to 5 mM H2O2. Stimulated PMN plus P388D1 caused a 50% fall in cellular ATP levels. During the first minutes of oxidant injury, total adenylate content of cells fell by 85%. Cellular ADP increased 170%, AMP increased 900%, and an 83% loss of ATP was accompanied by a stoichiometric increase in IMP and inosine. Calculated energy charge [(ATP + 1/2 AMP)/(ATP + ADP + AMP)] fell from 0.95 to 0.66. Exposure of P388D1 to oligomycin plus 2-deoxyglucose (which inhibit oxidative and glycolytic generation of ATP, respectively) resulted in a rate of ATP fall similar to that induced by H2O2. In addition, nucleotide alterations induced by exposure to oligomycin plus 2-deoxyglucose were qualitatively similar to those induced by the oxidant. Loss of cell adenylates could not be explained by arrest of de novo purine synthesis or increased ATP consumption by the Na+-K+ ATPase or the mitochondrial F0-ATPase. These results indicate that H2O2 causes a rapid and profound fall in cellular ATP levels similar to that seen when ATP production is arrested by metabolic inhibitors. PMID:2997279

Effect of Sirolimus on Disease Progression in Patients with Autosomal Dominant Polycystic Kidney Disease and CKD Stages 3b-4.

PubMed

Ruggenenti, Piero; Gentile, Giorgio; Perico, Norberto; Perna, Annalisa; Barcella, Luca; Trillini, Matias; Cortinovis, Monica; Ferrer Siles, Claudia Patricia; Reyes Loaeza, Jorge Arturo; Aparicio, Maria Carolina; Fasolini, Giorgio; Gaspari, Flavio; Martinetti, Davide; Carrara, Fabiola; Rubis, Nadia; Prandini, Silvia; Caroli, Anna; Sharma, Kanishka; Antiga, Luca; Remuzzi, Andrea; Remuzzi, Giuseppe

2016-05-06

The effect of mammalian target of rapamycin (mTOR) inhibitors has never been tested in patients with autosomal dominant polycystic kidney disease (ADPKD) and severe renal insufficiency. In this academic, prospective, randomized, open label, blinded end point, parallel group trial (ClinicalTrials.gov no. NCT01223755), 41 adults with ADPKD, CKD stage 3b or 4, and proteinuria ≤0.5 g/24 h were randomized between September of 2010 and March of 2012 to sirolimus (3 mg/d; serum target levels of 5-10 ng/ml) added on to conventional therapy (n=21) or conventional treatment alone (n=20). Primary outcome was GFR (iohexol plasma clearance) change at 1 and 3 years versus baseline. At the 1-year preplanned interim analysis, GFR fell from 26.7±5.8 to 21.3±6.3 ml/min per 1.73 m(2) (P<0.001) and from 29.6±5.6 to 24.9±6.2 ml/min per 1.73 m(2) (P<0.001) in the sirolimus and conventional treatment groups, respectively. Albuminuria (73.8±81.8 versus 154.9±152.9 μg/min; P=0.02) and proteinuria (0.3±0.2 versus 06±0.4 g/24 h; P<0.01) increased with sirolimus. Seven patients on sirolimus versus one control had de novo proteinuria (P=0.04), ten versus three patients doubled proteinuria (P=0.02), 18 versus 11 patients had peripheral edema (P=0.04), and 14 versus six patients had upper respiratory tract infections (P=0.03). Three patients on sirolimus had angioedema, 14 patients had aphthous stomatitis, and seven patients had acne (P<0.01 for both versus controls). Two patients progressed to ESRD, and two patients withdrew because of worsening of proteinuria. These events were not observed in controls. Thus, the independent data and safety monitoring board recommend early trial termination for safety reasons. At 1 year, total kidney volume (assessed by contrast-enhanced computed tomography imaging) increased by 9.0% from 2857.7±1447.3 to 3094.6±1519.5 ml on sirolimus and 4.3% from 3123.4±1695.3 to 3222.6±1651.4 ml on conventional therapy (P=0.12). On follow-up, 37% and 7% of serum sirolimus levels fell below or exceeded the therapeutic range, respectively. Finding that sirolimus was unsafe and ineffective in patients with ADPKD and renal insufficiency suggests that mTOR inhibitor therapy may be contraindicated in this context. Copyright © 2016 by the American Society of Nephrology.

Effect of Sirolimus on Disease Progression in Patients with Autosomal Dominant Polycystic Kidney Disease and CKD Stages 3b-4

PubMed Central

Ruggenenti, Piero; Gentile, Giorgio; Perico, Norberto; Perna, Annalisa; Barcella, Luca; Trillini, Matias; Cortinovis, Monica; Ferrer Siles, Claudia Patricia; Reyes Loaeza, Jorge Arturo; Aparicio, Maria Carolina; Fasolini, Giorgio; Gaspari, Flavio; Martinetti, Davide; Carrara, Fabiola; Rubis, Nadia; Prandini, Silvia; Caroli, Anna; Sharma, Kanishka; Antiga, Luca; Remuzzi, Andrea

2016-01-01

Background and objectives The effect of mammalian target of rapamycin (mTOR) inhibitors has never been tested in patients with autosomal dominant polycystic kidney disease (ADPKD) and severe renal insufficiency. Design, setting, participants, & measurements In this academic, prospective, randomized, open label, blinded end point, parallel group trial (ClinicalTrials.gov no. NCT01223755), 41 adults with ADPKD, CKD stage 3b or 4, and proteinuria ≤0.5 g/24 h were randomized between September of 2010 and March of 2012 to sirolimus (3 mg/d; serum target levels of 5–10 ng/ml) added on to conventional therapy (n=21) or conventional treatment alone (n=20). Primary outcome was GFR (iohexol plasma clearance) change at 1 and 3 years versus baseline. Results At the 1-year preplanned interim analysis, GFR fell from 26.7±5.8 to 21.3±6.3 ml/min per 1.73 m2 (P<0.001) and from 29.6±5.6 to 24.9±6.2 ml/min per 1.73 m2 (P<0.001) in the sirolimus and conventional treatment groups, respectively. Albuminuria (73.8±81.8 versus 154.9±152.9 μg/min; P=0.02) and proteinuria (0.3±0.2 versus 06±0.4 g/24 h; P<0.01) increased with sirolimus. Seven patients on sirolimus versus one control had de novo proteinuria (P=0.04), ten versus three patients doubled proteinuria (P=0.02), 18 versus 11 patients had peripheral edema (P=0.04), and 14 versus six patients had upper respiratory tract infections (P=0.03). Three patients on sirolimus had angioedema, 14 patients had aphthous stomatitis, and seven patients had acne (P<0.01 for both versus controls). Two patients progressed to ESRD, and two patients withdrew because of worsening of proteinuria. These events were not observed in controls. Thus, the independent data and safety monitoring board recommend early trial termination for safety reasons. At 1 year, total kidney volume (assessed by contrast–enhanced computed tomography imaging) increased by 9.0% from 2857.7±1447.3 to 3094.6±1519.5 ml on sirolimus and 4.3% from 3123.4±1695.3 to 3222.6±1651.4 ml on conventional therapy (P=0.12). On follow-up, 37% and 7% of serum sirolimus levels fell below or exceeded the therapeutic range, respectively. Conclusions Finding that sirolimus was unsafe and ineffective in patients with ADPKD and renal insufficiency suggests that mTOR inhibitor therapy may be contraindicated in this context. PMID:26912555

Actor-specific contributions to the deforestation slowdown in the Brazilian Amazon.

PubMed

Godar, Javier; Gardner, Toby A; Tizado, E Jorge; Pacheco, Pablo

2014-10-28

Annual deforestation rates in the Brazilian Amazon fell by 77% between 2004 and 2011, yet have stabilized since 2009 at 5,000-7,000 km(2). We provide the first submunicipality assessment, to our knowledge, of actor-specific contributions to the deforestation slowdown by linking agricultural census and remote-sensing data on deforestation and forest degradation. Almost half (36,158 km(2)) of the deforestation between 2004 and 2011 occurred in areas dominated by larger properties (>500 ha), whereas only 12% (9,720 km(2)) occurred in areas dominated by smallholder properties (<100 ha). In addition, forests in areas dominated by smallholders tend to be less fragmented and less degraded. However, although annual deforestation rates fell during this period by 68-85% for all actors, the contribution of the largest landholders (>2,500 ha) to annual deforestation decreased over time (63% decrease between 2005 and 2011), whereas that of smallholders went up by a similar amount (69%) during the same period. In addition, the deforestation share attributable to remote areas increased by 88% between 2009 and 2011. These observations are consistent across the Brazilian Amazon, regardless of geographical differences in actor dominance or socioenvironmental context. Our findings suggest that deforestation policies to date, which have been particularly focused on command and control measures on larger properties in deforestation hotspots, may be increasingly limited in their effectiveness and fail to address all actors equally. Further reductions in deforestation are likely to be increasingly costly and require actor-tailored approaches, including better monitoring to detect small-scale deforestation and a shift toward more incentive-based conservation policies.

Effects of licence change on prescribing and poisons enquiries for antipsychotic agents in England and Scotland

PubMed Central

Bateman, D N; Good, A M; Afshari, R; Kelly, C A

2003-01-01

Aims To examine the effect of licence change for thioridazine at the end of 2000 on the prescription of antipsychotic drugs in England and Scotland, and investigate changes in poisons information inquiries and, for Edinburgh, poisons admissions. Methods Prescription data for antipsychotic drugs were obtained for England and Scotland and quarterly trends examined for 2000 and 2001. Accesses to the UK National Poisons Information Service website TOXBASE for antipsychotic products were examined for the same period. For Scotland telephone enquiry data, and admission data to the Edinburgh Poisons Unit were also evaluated. Trends in poisonings were compared with prescribing change. Results In England prescriptions for thioridazine fell rapidly in 2001 from approximately 35% of market share to less than 5%, and were replaced by risperidone, chlorpromazine and olanzapine. TOXBASE accesses fell from 39.3% of antipsychotics to 4.4%. Accesses for chlorpromazine, olanzapine and risperidone increased. In Scotland prescribing of thioridazine was similar to changes in England, but it was principally replaced by chlorpromazine. These changes were mirrored by TOXBASE accesses, telephone enquiries and in-patient admissions. The ratio of TOXBASE accesses for thioridazine to prescription numbers for the drug increased after the licence change. Conclusions Licence change produced rapid change in prescribing behaviour within 3 months. Prescribing behaviour in England and Scotland was different. Changes in prescribing were mirrored by changes in accesses for poisons information in both England and Scotland, and in Edinburgh by hospital admissions. The increase in the ratio of TOXBASE accesses to prescriptions for thioridazine suggests doctors may have become more aware of its potential toxicity. PMID:12814455

Veterans' Health Insurance Coverage Under the Affordable Care Act and Implications of Repeal for the Department of Veterans Affairs

PubMed Central

Dworsky, Michael; Farmer, Carrie M.; Shen, Mimi

2018-01-01

Abstract This article describes the Affordable Care Act's (ACA's) effects on nonelderly veterans' insurance coverage and demand for Department of Veterans Affairs (VA) health care and assesses the coverage and VA utilization changes that could result from repealing the ACA. Although prior research has shown that the number of uninsured veterans fell after the ACA took effect, the implications of ACA repeal for veterans and, especially, for VA have received less attention. Besides providing a new coverage option to veterans who are not enrolled in VA, the ACA also had the potential to affect health care use among VA patients. Findings include the following: In 2013, prior to the major coverage expansions under the ACA, nearly one in ten nonelderly veterans were uninsured, lacking access to both VA coverage and non-VA health insurance. Uninsurance among nonelderly veterans fell by an adjusted 36 percent (3.3 percentage points) after implementation of the ACA, from 9.1 percent in 2013 to 5.8 percent in 2015. By increasing non-VA health insurance coverage for VA patients, the ACA likely reduced demand for VA care; the authors estimate that, if the gains in insurance coverage that occurred between 2013 and 2015 had not occurred, nonelderly veterans would have used about 1 percent more VA health care in 2015: 125,000 more office visits, 1,500 more inpatient surgeries, and 375,000 more prescriptions. Recent congressional proposals to repeal and replace the ACA would increase the number of uninsured nonelderly veterans and further increase demand for VA health care. PMID:29607249

Trends in exposure to television food advertisements in South Korea.

PubMed

Han, Euna; Powell, Lisa M; Kim, Tae Hyun

2013-03-01

Given the increased concern about the impact of TV food advertisements (ads) on individual food choices, we provide important evidence on TV food ad exposure between 2004 and 2009 in South Korea. We used monthly targeted ratings data by age group as the number of ads seen daily from Korean Nielsen Media Research. We generated six food groups: beverages (milk, soda, fruit drinks, sports/energy drinks, water, coffee/tea products, and other); snacks/sweets (cookies/chips, candy, and chewing gum); fast food (Domino's pizza, Lotteria, McDonald's, Mr. Pizza, Pizza Hut, local chicken and pizza franchises, and other); instant noodle; full-service restaurants; and other. From 2004 to 2009, overall exposure to television food ads fell by 19.0% (from 6.8 to 5.5 ads daily), although exposure to full-service restaurant ads increased over that time period by 45.7%. While fast-food ad exposure fell overall, exposure to ads for local fried chicken franchises nearly doubled, making them the most commonly seen fast-food ads by 2009. Fast-food and instant noodle ads made up larger proportions of total ad exposure in 2009 than in 2004 in all age groups, with the largest increase among adolescents. Beverage ads continue to be the most prevalent food ads seen in South Korea. Differential trends found in exposure across and within food product categories and differences by age groups highlight the need for continued monitoring to help inform the regulatory policy debate on food advertising, particularly with regards to ads directed at children and adolescents. Copyright © 2012 Elsevier Ltd. All rights reserved.

Reduced Effectiveness of Interruptive Drug-Drug Interaction Alerts after Conversion to a Commercial Electronic Health Record.

PubMed

Wright, Adam; Aaron, Skye; Seger, Diane L; Samal, Lipika; Schiff, Gordon D; Bates, David W

2018-05-15

Drug-drug interaction (DDI) alerts in electronic health records (EHRs) can help prevent adverse drug events, but such alerts are frequently overridden, raising concerns about their clinical usefulness and contribution to alert fatigue. To study the effect of conversion to a commercial EHR on DDI alert and acceptance rates. Two before-and-after studies. 3277 clinicians who received a DDI alert in the outpatient setting. Introduction of a new, commercial EHR and subsequent adjustment of DDI alerting criteria. Alert burden and proportion of alerts accepted. Overall interruptive DDI alert burden increased by a factor of 6 from the legacy EHR to the commercial EHR. The acceptance rate for the most severe alerts fell from 100 to 8.4%, and from 29.3 to 7.5% for medium severity alerts (P < 0.001). After disabling the least severe alerts, total DDI alert burden fell by 50.5%, and acceptance of Tier 1 alerts rose from 9.1 to 12.7% (P < 0.01). Changing from a highly tailored DDI alerting system to a more general one as part of an EHR conversion decreased acceptance of DDI alerts and increased alert burden on users. The decrease in acceptance rates cannot be fully explained by differences in the clinical knowledge base, nor can it be fully explained by alert fatigue associated with increased alert burden. Instead, workflow factors probably predominate, including timing of alerts in the prescribing process, lack of differentiation of more and less severe alerts, and features of how users interact with alerts.

The effect of partial acclimatization to high altitude on loop gain and central sleep apnoea severity.

PubMed

Andrews, Gareth; Ainslie, Philip N; Shepherd, Kelly; Dawson, Andrew; Swart, Marianne; Lucas, Samuel; Burgess, Keith R

2012-07-01

Loop gain is an engineering term that predicts the stability of a feedback control system, such as the control of breathing. Based on earlier studies at lower altitudes, it was hypothesized that acclimatization to high altitude would lead to a reduction in loop gain and thus central sleep apnoea (CSA) severity. This study used exposure to very high altitude to induce CSA in healthy subjects to investigate the effect of partial acclimatization on loop gain and CSA severity. Measurements were made on 12 subjects (age 30 ± 10 years, body mass index 22.8 ± 1.9, eight males, four females) at an altitude of 5050 m over a 2-week period upon initial arrival (days 2-4) and following partial acclimatization (days 12-14). Sleep was studied by full polysomnography, and resting arterial blood gases were measured. Loop gain was measured by the 'duty cycle' method (duration of hyperpnoea/cycle length). Partial acclimatization to high-altitude exposure was associated with both an increase in loop gain (duty cycle fell from 0.60 ± 0.05 to 0.55 ± 0.06 (P = 0.03)) and severity of CSA (apnoea-hypopnoea index increased from 76.8 ± 48.8 to 115.9 ± 20.2 (P = 0.01)), while partial arterial carbon dioxide concentration fell from 29 ± 3 to 26 ± 2 (P = 0.01). Contrary to the results at lower altitudes, at high-altitude loop gain and severity of CSA increased. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.

Voxel-Based Approach for Estimating Urban Tree Volume from Terrestrial Laser Scanning Data

NASA Astrophysics Data System (ADS)

Vonderach, C.; Voegtle, T.; Adler, P.

2012-07-01

The importance of single trees and the determination of related parameters has been recognized in recent years, e.g. for forest inventories or management. For urban areas an increasing interest in the data acquisition of trees can be observed concerning aspects like urban climate, CO2 balance, and environmental protection. Urban trees differ significantly from natural systems with regard to the site conditions (e.g. technogenic soils, contaminants, lower groundwater level, regular disturbance), climate (increased temperature, reduced humidity) and species composition and arrangement (habitus and health status) and therefore allometric relations cannot be transferred from natural sites to urban areas. To overcome this problem an extended approach was developed for a fast and non-destructive extraction of branch volume, DBH (diameter at breast height) and height of single trees from point clouds of terrestrial laser scanning (TLS). For data acquisition, the trees were scanned with highest scan resolution from several (up to five) positions located around the tree. The resulting point clouds (20 to 60 million points) are analysed with an algorithm based on voxel (volume elements) structure, leading to an appropriate data reduction. In a first step, two kinds of noise reduction are carried out: the elimination of isolated voxels as well as voxels with marginal point density. To obtain correct volume estimates, the voxels inside the stem and branches (interior voxels) where voxels contain no laser points must be regarded. For this filling process, an easy and robust approach was developed based on a layer-wise (horizontal layers of the voxel structure) intersection of four orthogonal viewing directions. However, this procedure also generates several erroneous "phantom" voxels, which have to be eliminated. For this purpose the previous approach was extended by a special region growing algorithm. In a final step the volume is determined layer-wise based on the extracted branch areas Ai of this horizontal cross-section multiplied by the thickness of the voxel layer. A significant improvement of this method could be obtained by a reasonable determination of the threshold for excluding sparsely filled voxels for noise reduction which can be defined based on the function change of filled voxels. Field measurements were used to validate this method. For a quality assessment nine deciduous trees were selected for control and were scanned before felling and weighing. The results are in good accordance to the control trees within a range of only -5.1% to +14.3%. The determined DBH values show only minor deviations, while the heights of trees are systematically underestimated, mainly due to field measurements. Possible error sources including gaps in surface voxels, influence of thin twigs and others are discussed in detail and several improvements of this approach are suggested. The advantages of the algorithm are the robustness and simple structure as well as the quality of the results obtained. The drawbacks are the high effort both in data acquisition and analysis, even if a remarkable data reduction can be obtained by the voxel structure.

Application of a surfactant-assisted dispersive liquid-liquid microextraction method along with central composite design for micro-volume based spectrophotometric determination of low level of Cr(VI) ions in aquatic samples.

PubMed

Sobhi, Hamid Reza; Azadikhah, Efat; Behbahani, Mohammad; Esrafili, Ali; Ghambarian, Mahnaz

2018-05-09

A fast, simple, low cost surfactant-assisted dispersive liquid-liquid microextraction method along with central composite design for the determination of low level of Cr(VI) ions in several aquatic samples has been developed. Initially, Cr(VI) ions present in the aqueous sample were readily reacted with 1,5‑diphenylcarbazide (DPC) in acidic medium through complexation. Sodium dodecyl sulfate (SDS), as an anionic surfactant, was then employed as an ion-pair agent to convert the cationic complex into the neutral one. Following on, the whole aqueous phase underwent a dispersive liquid-liquid microextraction (DLLME) leading to the transfer of the neutral complex into the fine droplet of organic extraction phase. A micro-volume spectrophotometer was used to determine Cr(VI) concentrations. Under the optimized conditions predicted by the statistical design, the limit of quantification (LOQ) obtained was reported to be 5.0 μg/L, and the calibration curve was linear over the concentration range of 5-100 μg/L. Finally, the method was successfully implemented for the determination of low levels of Cr(VI) ions in various real aquatic samples and the accuracies fell within the range of 83-102%, while the precision varied in the span of 1.7-5.2%. Copyright © 2018. Published by Elsevier B.V.

The preanalytical optimization of blood cultures: a review and the clinical importance of benchmarking in 5 Belgian hospitals.

PubMed

Willems, Elise; Smismans, Annick; Cartuyvels, Reinoud; Coppens, Guy; Van Vaerenbergh, Kristien; Van den Abeele, Anne-Marie; Frans, Johan

2012-05-01

Bloodstream infections remain a major challenge in medicine. Optimal detection of pathogens is only possible if the quality of preanalytical factors is thoroughly controlled. Since the laboratory is responsible for this preanalytical phase, the quality control of critical factors should be integrated in its quality control program. The numerous recommendations regarding blood culture collection contain controversies. Only an unambiguous guideline permits standardization and interlaboratory quality control. We present an evidence-based concise guideline of critical preanalytical determinants for blood culture collection and summarize key performance indicators with their concomitant target values. In an attempt to benchmark, we compared the true-positive rate, contamination rate, and collected blood volume of blood culture bottles in 5 Belgian hospital laboratories. The true-positive blood culture rate fell within previously defined acceptation criteria by Baron et al. (2005) in all 5 hospitals, whereas the contamination rate exceeded the target value in 4 locations. Most unexpected, in each of the 5 laboratories, more than one third of the blood culture bottles were incorrectly filled, irrespective of the manufacturer of the blood culture vials. As a consequence of this shortcoming, one manufacturer recently developed an automatic blood volume monitoring system. In conclusion, clear recommendations for standardized blood culture collection combined with quality control of critical factors of the preanalytical phase are essential for diagnostic blood culture improvement. Copyright © 2012 Elsevier Inc. All rights reserved.

Assessing bone volume for orthodontic miniplate fixation below the maxillary frontal process.

PubMed

Präger, T M; Brochhagen, H G; Mischkowski, R; Jost-Brinkmann, P-G; Müller-Hartwich, R

2014-09-01

The maxillary bone below the frontal process is used for orthodontic anchorage; indications have included skeletally anchored protraction of the maxilla for treating Class III malocclusions or the intrusion of teeth in patients with a deep bite. This study was conducted to assess the condition of bone before cortically implanting miniplates in that area of the maxilla. A total of 51 thin-sliced computed tomography scans of 51 fully-dentate adult patients (mean age 24.0 ± 8.1 years; 27 men and 24 women) obtained prior to third-molar osteotomy were evaluated. Study parameters included total bone thickness, thickness of the facial cortical plate, and width of the nasal maxillary buttress. All these parameters were measured at different vertical levels. The bone volume adjacent to the piriform aperture was most pronounced at the basal level and decreased progressively toward more cranial levels. The basal bone structure had a mean total thickness of 7.8 mm, facial cortical plate thickness of 1.9 mm, and nasal maxillary buttress width of 9.2 mm. At 16 mm cranial to the aperture base, these values fell to 5.6 mm, 1.3 mm, and 5.8 mm, respectively. These bone measurements suggest that screws 7 mm in length can be inserted at the base level of the piriform aperture and screws 5 mm long at the cranial end of the bone.

Particle size effects on viscosity of silver pastes: A manufacturer's view

NASA Technical Reports Server (NTRS)

Provance, J.; Allison, K.

1983-01-01

Particles from a variety of silver powders were investigated by scanning electron microscopy and particle size analyses. Particle size distribution curves and volume population graphs were prepared for these silver powders and for glass powders with optimum, extra fine and coarse particle sizes. The viscosity at a given shear rate and slope of viscosity over a range of shear rates were determined for thick film pastes made with these powders. Because of particle anomalies and variations, the need for flexibility to achieve the best printing qualities for silver pastes was evident. It was established that print quality, dried and fired film density and optimum contact of silver particles with silicon, important for cell electrical output, could be achieved by adjusting the slope of viscosity that fell outside of the range, -0.550 to -0.650. This was accomplished through organic vehicle technology that permitted a change in the slope of viscosity, up or down, while maintaining a constant silver and total solids content.

The study of the physics of cometary nuclei

NASA Technical Reports Server (NTRS)

Whipple, F. L.

1984-01-01

The observations of comet P/Holmes 1892III, exhibiting two 8 to 10 magnitude bursts, were carefully analyzed. The phenomena are consistent with the grazing encounter of a small satellite with the nucleus. The grazing encounter produced, besides the first great burst, an active area on the nucleus, which was rotating retrograde with a period of 16.3 hr and inclination nearly 180 deg. After the final encounter, the spin period was essentially unchanged, but two areas became active, separated some 164 deg in longitude on the nucleus. After the first burst the total magnitude fell less than two magnitudes, while the nuclear region remained diffuse or complex, rarely if ever showing a stellar appearance. The fading was much more rapid after the second burst (barely naked eye at maximum) while the nucleus frequently stellar after the first day. It seems reasonable to conclude that the grazing encounter distributed a volume of large chunks in the neighborhood of the nucleus, maintaining activity for weeks.

Effect of hydration on some orthostatic and haematological responses to head-up tilt

NASA Technical Reports Server (NTRS)

Harrison, M. H.; Hill, L. C.; Spaul, W. A.; Greenleaf, J. E.

1986-01-01

Experiments were undertaken to determine the effects of hydration status on: (1) orthostatic responses, and on (2) relative changes in intravascular volume and protein content, during 70 deg head-up tilt (HUT). Six men underwent 45 min of HUT, preceded by 45 min supine, first dehydrated, and again 105 min later after rehydration with water. Heart rate was consistently lower following rehydration (p less than 0.01), while supine diastolic pressure was higher (p less than 0.02). Systolic pressure fell during dehydrated HUT (p less than 0.01), but not during rehydrated HUT. Postural haemoconcentration, which was reduced after rehydration (p less than 0.001), was accompanied by a decrease in intravascular albumin content (p less than 0.05). Two subjects experienced severe presyncopal symptoms during dehydrated HUT, but not during rehydrated HUT. Thus, it appears that rehydration after fluid restriction improves orthostatic tolerance. Furthermore, extravascular hydration status may be more important than intravascular hydration status in determining orthostatic tolerance.

RIKEN BNL RESEARCH CENTER WORKSHOP ON GAUGE-INVARIANT VARIABLES IN GAUGE THEORIES, VOLUME 20

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

VAN BAAL,P.; ORLAND,P.; PISARSKI,R.

2000-06-01

This four-day workshop focused on the wide variety of approaches to the non-perturbative physics of QCD. The main topic was the formulation of non-Abelian gauge theory in orbit space, but some other ideas were discussed, in particular the possible extension of the Maldacena conjecture to nonsupersymmetric gauge theories. The idea was to involve most of the participants in general discussions on the problem. Panel discussions were organized to further encourage debate and understanding. Most of the talks roughly fell into three categories: (1) Variational methods in field theory; (2) Anti-de Sitter space ideas; (3) The fundamental domain, gauge fixing, Gribovmore » copies and topological objects (both in the continuum and on a lattice). In particular some remarkable progress in three-dimensional gauge theories was presented, from the analytic side by V.P. Nair and mostly from the numerical side by O. Philipsen. This work may ultimately have important implications for RHIC experiments on the high-temperature quark-gluon plasma.« less

Amino and fatty acids in carbonaceous meteorites

NASA Technical Reports Server (NTRS)

Kvenvolden, K. A.

1974-01-01

Analyses of two carbonaceous meteorites have provided much of the latest evidence which seems to support Oparin's theory on the origin of life. The meteorites involved are the Murray meteorite, which fell in 1950, and the Murchison meteorite, which fell in 1969. The amino acids in the two meteorites are similar in composition. Eight of the twenty amino acids found belong to amino acids present in proteins. A number of monocarboxylic and dicarboxylic fatty acids were also found in the meteorites.

Manual harvesting of high population Leucaena stands

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

Pecson, R.D.; Van Den Beldt, R.J.

1983-01-01

Five-year-old giant Leucaena leucocephala, planted at spacing 1x0.5 m, were harvested using bolos (Filipino machetes) and chainsaws. For felling alone, chainsaws took 35% less time than bolos. For the total harvest including delimbing and hauling an average 20 m to the edge of the stand, chainsaws took 20% less time than bolos. Assuming chainsaws are economically viable, it may be advisable to fell with chainsaws in advance of bolo teams that buck and haul. 2 references.

Using wood-based structural products as forest management tools to improve forest health, sustainability and reduce forest fuels : a research program of the USDA Forest Service under the National Fire Plan

Treesearch

John F. Hunt; Jerrold E. Winandy

2002-01-01

Currently, after logging or thinning operations much of the low value timber is either left standing or is felled and left on the ground, chipped, or burned because most North American mills are not equipped to handle this material. In many areas of Western U.S., this forest residue does not decompose if felled and it soon becomes susceptible to forest insect or...

A Study of Black Officer Candidate Attrition in the United States Air Force

DTIC Science & Technology

1993-09-01

concern among Air Force accession policy officials (Travers, 1992). Prior to 1973 the Air Force, as well as all other services, was under -represented in...Although the Air Force did not exist in 1940, its predecessor, the Army Air Corps, fell under this new policy. Thus, by the time the Air Force was made a...participation increased from 0.6 percent in 1942 to approximately 2 percent by 1973. However, blacks were 3till vastly under -represented in relation to both the

The Impact of Military Training on Veterans’ Earnings in the Private Sector: Is there Complimentarity Between Military and Private Training for Veterans

DTIC Science & Technology

1994-03-01

thesis analyzed the complimentarity between military and post-military private sector training and the effect of military training on private sector wages...of data. The results of the thesis indicate that military training increases post-military private sector earnings of Veterans by 0.18 percent per...between military and post-service private sector training. When type of occupation is included in the models, the wage effect of military training fell to

Heart Rate Variability Responses of a Preterm Infant to Kangaroo Care

PubMed Central

McCain, Gail C.; Ludington-Hoe, Susan M.; Swinth, Joan Y.; Hadeed, Anthony J.

2006-01-01

A 35-week old preterm infant's behavior was fussy and restless in the open crib, but he calmed and fell asleep immediately on being placed skin-to-skin on his mother's chest. Heart rate variability (HRV), a noninvasive method to assess the autonomic nervous system's influence on heart rate, was increased with fussy behavior in the open crib and decreased with sleep during kangaroo care (KC). KC produced changes in behavior and HRV that are illustrative of decreasing stress. PMID:16282226

Myxomatosis. The effect of age upon survival of wild and domestic rabbits (Oryctolagus cuniculus) with a degree of genetic resistance and unselected domestic rabbits infected with myxoma virus.

PubMed

Sobey, W R; Conolly, D; Haycockp; Edmonds, J W

1970-03-01

The response of wild and domestic rabbits with a degree of genetic resistance to myxomatosis has been shown to be markedly affected by the age at which they were infected with a virulent strain of the virus. The response, in terms of mean survival time and percentage survival, fell with increasing age from 10 to 30 weeks with little change thereafter.

Myxomatosis. The effect of age upon survival of wild and domestic rabbits (Oryctolagus cuniculus) with a degree of genetic resistance and unselected domestic rabbits infected with myxoma virus

PubMed Central

Sobey, W. R.; Conolly, Dorothy; Haycock, P.; Edmonds, J. W.

1970-01-01

The response of wild and domestic rabbits with a degree of genetic resistance to myxomatosis has been shown to be markedly affected by the age at which they were infected with a virulent strain of the virus. The response, in terms of mean survival time and percentage survival, fell with increasing age from 10 to 30 weeks with little change thereafter. PMID:5267123

Cerebral metabolic studies in vivo by 31P NMR.

PubMed

Prichard, J W; Alger, J R; Behar, K L; Petroff, O A; Shulman, R G

1983-05-01

31P NMR studies on the brains of living rabbits were carried out at 32 MHz in a spectrometer having a 200-mm clear bore. Paralyzed pump-ventilated animals under nitrous oxide analgesia were inserted into the 1.89-T field and signals were focused in the brain by using a 4-cm surface coil. Several conventional physiological variables were monitored together with 31P spectra during induction and reversal of insulin shock and hypoxic hypoxia sufficient to abolish the electroencephalogram and during status epilepticus. A reversible decrease in phosphocreatine stores accompanied by an increase in Pi was detected during hypoglycemia and hypoxia. Similar changes were observed in prolonged status epilepticus but were not reversed. ATP levels fell about 50% in hypoglycemia but only slightly in the other two metabolic stresses. Intracellular pH rose in hypoglycemia; in status epilepticus and hypoxia it fell, but only when cardiovascular function was severely impaired. From the measured NMR parameters and the assumptions (i) that creatine kinase was at equilibrium and (ii) that the creatine/phosphocreatine pool was constant, it was possible to calculate the relative changes in cytoplasmic ADP levels associated with these metabolic disturbances.

Variations in teenage birth rates, 1991-98: national and state trends.

PubMed

Ventura, S J; Curtin, S C; Mathews, T J

2000-04-24

This report presents national birth rates for teenagers for 1991-98 and the percent change, 1991-98. State-specific teenage birth rates by age, race, and Hispanic origin for 1991 and 1998 and the percent change, 1991 to 1998, are also presented. Tabular and graphical descriptions of the trends in teenage birth rates for the Nation and each State, by age group, race, and Hispanic origin of the mother, are discussed. Birth rates for teenagers 15-19 years declined nationally between 1991 and 1998 for all age and race and Hispanic origin populations, with the steepest declines recorded for black teenagers. State-specific rates fell significantly in all States for ages 15-19 years; declines ranged from 10 to 38 percent. In general, rates by State fell more for younger than for older teenagers, ranging by State from 10 to 46 percent for ages 15-17 years. Statistically significant reductions for older teenagers ranged from 3 to 39 percent. Reductions by State were largest for black teenagers 15-19 years, with rates falling 30 percent or more in 15 States. Among the factors accounting for these declines are decreased sexual activity, increases in condom use, and the adoption of the implant and injectable contraceptives.

Outcomes associated with a structured prenatal counseling program for shoulder dystocia with brachial plexus injury.

PubMed

Daly, Mary Veronica; Bender, Christina; Townsend, Kathryn E; Hamilton, Emily F

2012-08-01

We examined outcomes that were associated with a novel program to identify patients who are at high risk for shoulder dystocia with brachial plexus injury. The program included a checklist of key risk factors and a multifactorial algorithm to estimate risk of shoulder dystocia with brachial plexus injury. We examined rates of cesarean delivery and shoulder dystocia in 8767 deliveries by clinicians who were enrolled in the program and in 11,958 patients of clinicians with no access to the program. Key risk factors were identified in 1071 of 8767 mothers (12.2%), of whom 40 of 8767 women (0.46%) had results in the high-risk category. The rate of primary cesarean delivery rate was stable (21.2-20.8%; P = .57). Shoulder dystocia rates fell by 56.8% (1.74-0.75%; P = .002). The rates of shoulder dystocia and cesarean birth showed no changes in the group with no access to the program. With the introduction of this program, overall shoulder dystocia rates fell by more than one-half with no increase in the primary cesarean delivery rate. Copyright © 2012 Mosby, Inc. All rights reserved.

Doctor Shopping Behavior and the Diversion of Prescription Opioids.

PubMed

Simeone, Ronald

2017-01-01

"Doctor shopping" as a means of prescription opioid diversion is examined. The number and percentage of prescriptions and morphine-equivalent milligrams diverted in this manner are estimated by state and molecule for the period 2008-2012. Eleven billion prescriptions with unique patient, doctor, and pharmacy identifiers were used to construct diversion "events" that involved between 1 and 6 unique doctors and between 1 and 6 unique pharmacies. Diversion thresholds were established based on the probability of each contingency. A geographically widespread decline occurred between 2008 and 2012. The number of prescriptions diverted fell from approximately 4.30 million (1.75% of all prescriptions) in 2008 to approximately 3.37 million (1.27% of all prescriptions) in 2012, and the number of morphine-equivalent milligrams fell from approximately 6.55 metric tons (2.95% of total metric tons) in 2008 to approximately 4.87 metric tons (2.19% of total metric tons) in 2012. Diversion control efforts have likely been effective. But given increases in opioid-related deaths, opioid-related drug treatment admissions, and the more specific resurgence of heroin-related events, it is clear that additional public health measures are required.

Association of Nurse Engagement and Nurse Staffing on Patient Safety.

PubMed

Brooks Carthon, J Margo; Hatfield, Linda; Plover, Colin; Dierkes, Andrew; Davis, Lawrence; Hedgeland, Taylor; Sanders, Anne Marie; Visco, Frank; Holland, Sara; Ballinghoff, Jim; Del Guidice, Mary; Aiken, Linda H

2018-06-08

Nurse engagement is a modifiable element of the work environment and has shown promise as a potential safety intervention. Our study examined the relationship between the level of engagement, staffing, and assessments of patient safety among nurses working in hospital settings. A secondary analysis of linked cross-sectional data was conducted using survey data of 26 960 nurses across 599 hospitals in 4 states. Logistic regression models were used to examine the association between nurse engagement, staffing, and nurse assessments of patient safety. Thirty-two percent of nurses gave their hospital a poor or failing patient safety grade. In 25% of hospitals, nurses fell in the least or only somewhat engaged categories. A 1-unit increase in engagement lowered the odds of an unfavorable safety grade by 29% (P < .001). Hospitals where nurses reported higher levels of engagement were 19% (P < .001) less likely to report that mistakes were held against them. Nurses in poorly staffed hospitals were 6% more likely to report that important information about patients "fell through the cracks" when transferring patients across units (P < .001). Interventions to improve nurse engagement and adequate staffing serve as strategies to improve patient safety.

Endo-exuberance and abdominal aortic aneurysm management: have we gone too far?

PubMed

Sternbergh, W Charles

2003-11-01

new technology, such as endovascular abdominal aortic aneurysm repair (EVAR) may promote an 'irrational exuberance' for its application. nonsuprarenal AAA repairs performed at a single institution over a 7 year period were retrospectively studied. Method of repair, 30-day mortality and EVAR aortic neck anatomy were assessed. 431 AAA repairs were performed between January 1996 and June 2002, 238 (55%) open and 193 (45%) EVAR. The percentage of EVAR increased steadily from approximately 20% in 1996 and 1997 to a peak of 69.5% in 2000. However, in 2001-2002 the percentage of EVAR fell to approximately 40% of total repairs. In this time period our selection criteria for EVAR became more conservative, with treatment of fewer patients with short aortic necks (12.8 vs. 28.9% with neck length < or = 20 mm, p = 0.05; 3.8 vs. 10.8% with neck length < or = 15 mm, p = 0.1) or highly angulated necks (3.8 vs. 28.9% with neck angulation > or = 40 degrees, p = 0.04) in 2001-2002 versus 1999-2000, respectively. Institutional volume of AAA repairs doubled over the study period (p = 0.001). 30-day mortality over the study period for nonruptured EVAR and open AAA repair was 2.6 and 3.3%, respectively (p = NS). The complexity of open repairs increased significantly during the final 3 years of the review. the application of EVAR has fallen from a high of 69.5% of our AAA repairs in 2000 to approximately 40% in 2001-2002. More prudent patient selection in recent years regarding unfavorable aortic neck anatomy was felt to be a primary etiology of changes in overall EVAR utilization. The anticipated improvement in long-term results from EVAR await multi-year follow-up.

Eight-Year Experience with Nocturnal, Every-Other-Day, Online Haemodiafiltration.

PubMed

Maduell, Francisco; Ojeda, Raquel; Arias-Guillen, Marta; Rossi, Florencia; Fontseré, Néstor; Vera, Manel; Rico, Nayra; Gonzalez, Leonardo Nicolás; Piñeiro, Gastón; Jiménez-Hernández, Mario; Rodas, Lida; Bedini, José Luis

2016-01-01

New haemodialysis therapeutic regimens are required to improve patient survival. Longer and more frequent dialysis sessions have produced excellent survival and clinical advantages, while online haemodiafiltration (OL-HDF) provides the most efficient form of dialysis treatment. In this single-centre observational study, 57 patients on 4-5-hour thrice-weekly OL-HDF were switched to nocturnal every-other-day OL-HDF. Inclusion criteria consisted of stable patients with good prospects for improved occupational, psychological and social rehabilitation. The aim of this study was to report our 8-year experience with this schedule and to evaluate analytical and clinical outcomes. Nocturnal, every-other-day OL-HDF was well tolerated and 56% of patients were working. The convective volume increased from 26.7 ± 2 litres at baseline to 46.6 ± 6.5 litres at 24 months (p < 0.01). Increasing the dialysis dose significantly decreased bicarbonate, blood-urea-nitrogen and creatinine values. Predialysis phosphate levels fell markedly with complete suspension of phosphate binders from the second year of follow-up. Although haemoglobin was unchanged, there was a 50.4% reduction in darbepoetin dose at 24 months and a significant decrease in the erythropoietin resistance index. Blood pressure significantly decreased in a few months. Antihypertensive medication requirements were decreased by 60% after 3 months and by 73% after 1 year and this difference was maintained thereafter. Nocturnal, every-other-day OL-HDF could be an excellent therapeutic alternative since it is well tolerated and leads to clinical and social-occupational rehabilitation with satisfactory morbidity and mortality. These encouraging results strengthen us to continue and invite other clinicians to join this initiative. © 2016 S. Karger AG, Basel.

Has payment by results affected the way that English hospitals provide care? Difference-in-differences analysis

PubMed Central

Yi, Deokhee; Sutton, Matt; Chalkley, Martin; Sussex, Jon; Scott, Anthony

2009-01-01

Objective To examine whether the introduction of payment by results (a fixed tariff case mix based payment system) was associated with changes in key outcome variables measuring volume, cost, and quality of care between 2003/4 and 2005/6. Setting Acute care hospitals in England. Design Difference-in-differences analysis (using a control group created from trusts in England and providers in Scotland not implementing payment by results in the relevant years); retrospective analysis of patient level secondary data with fixed effects models. Data sources English hospital episode statistics and Scottish morbidity records for 2002/3 to 2005/6. Main outcome measures Changes in length of stay and proportion of day case admissions as a proxy for unit cost; growth in number of spells to measure increases in output; and changes in in-hospital mortality, 30 day post-surgical mortality, and emergency readmission after treatment for hip fracture as measures of impact on quality of care. Results Length of stay fell more quickly and the proportion of day cases increased more quickly where payment by results was implemented, suggesting a reduction in the unit costs of care associated with payment by results. Some evidence of an association between the introduction of payment by results and growth in acute hospital activity was found. Little measurable change occurred in the quality of care indicators used in this study that can be attributed to the introduction of payment by results. Conclusion Reductions in unit costs may have been achieved without detrimental impact on the quality of care, at least in as far as these are measured by the proxy variables used in this study. PMID:19713233

Regional cell density distribution and oxygen consumption rates in porcine TMJ discs: an explant study.

PubMed

Kuo, J; Shi, C; Cisewski, S; Zhang, L; Kern, M J; Yao, H

2011-07-01

To determine the regional cell density distribution and basal oxygen consumption rates (based on tissue volume and cell number) of temporomandibular joint (TMJ) discs and further examine the impact of oxygen tension on these rates. TMJ discs from pigs aged 6-8 months were divided into five regions: anterior, intermediate, posterior, lateral and medial. The cell density was determined using confocal laser scanning microscopy. The change in oxygen tension was recorded while TMJ disc explants were cultured in sealed metabolism chambers. The volume based oxygen consumption rate of explants was determined by theoretical curve-fitting of the recorded oxygen tension data with the Michaelis-Menten equation. The rate on a per-cell basis was calculated based on the cell density measurements and volume based rate measured in another group of discs. The overall cell density [mean, 95% confidence interval (CI)] was 51.3 (21.3-81.3) × 10(6) cells/mL wet tissue. Along the anteroposterior axis, the anterior band had 25.5% higher cell density than the intermediate zone (P<0.02) and 29.1% higher than the posterior band (P<0.008). Along the mediolateral axes, the medial region had 26.2% higher cell density than the intermediate zone (P<0.04) and 25.4% higher than the lateral region (P<0.045). The overall volume and cell based maximum oxygen consumption rates were 1.44 (0.44-2.44) μmol/mL wet tissue/h and 28.7 (12.2-45.2)nmol/10(6)cells/h, respectively. The central regions (intermediate, lateral, and medial) had significantly higher volume based (P<0.02) and cell based (P<0.005) oxygen consumption rates than the anterior and posterior bands. At high oxygen tension, the oxygen consumption rate remained constant, but dropped as oxygen tension fell below 5%. The TMJ disc had higher cell density and oxygen consumption rates than articular cartilage reported in the literature. These results suggest that a steeper oxygen gradient may exist in the TMJ disc and may be vulnerable to pathological events that impede nutrient supply. Copyright © 2011 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Regional Cell Density Distribution and Oxygen Consumption Rates in Porcine TMJ Discs: An Explant Study

PubMed Central

Kuo, Jonathan; Shi, Changcheng; Cisewski, Sarah; Zhang, Lixia; Kern, Michael J.; Yao, Hai

2011-01-01

Objective To determine the regional cell density distribution and basal oxygen consumption rates (based on tissue volume and cell number) of temporomandibular joint (TMJ) discs and further examine the impact of oxygen tension on these rates. Design TMJ discs from pigs aged 6–8 months were divided into five regions: anterior, intermediate, posterior, lateral and medial. The cell density was determined using confocal laser scanning microscopy. The change in oxygen tension was recorded while TMJ disc explants were cultured in sealed metabolism chambers. The volume based oxygen consumption rate of explants was determined by theoretical curve fitting of the recoded oxygen tension data with the Michaelis-Menten equation. The rate on a per-cell basis was calculated based on the cell density measurements and volume based rate measured in another group of discs. Results The overall cell density (mean, 95% CI) was 51.3(21.3–81.3)×106cells/mL wet tissue. Along the anteroposterior axis, the anterior band had 25.5% higher cell density than the intermediate zone (p<0.02) and 29.1% higher than the posterior band (p<0.008). Along the mediolateral axes, the medial region had 26.2% higher cell density than the intermediate zone (p<0.04) and 25.4% higher than the lateral region (p<0.045). The overall volume and cell based maximum oxygen consumption rates were 1.44(0.44–2.44) μmol/mL wet tissue/hr and 28.7(12.2–45.2) nmol/106 cells/hr, respectively. The central regions (intermediate, lateral, and medial) had significantly higher volume based (p<0.02) and cell based (p<0.005) oxygen consumption rates than the anterior and posterior bands. At high oxygen tension, the oxygen consumption rate remained constant, but dropped as oxygen tension fell below 5%. Conclusions The TMJ disc had higher cell density and oxygen consumption rates than articular cartilage reported in the literature. These results suggest that a steeper oxygen gradient may exist in the TMJ disc and may be vulnerable to pathological events that impede nutrient supply. PMID:21397032

Computer-aided design of customized foot orthoses: reproducibility and effect of method used to obtain foot shape.

PubMed

Telfer, Scott; Gibson, Kellie S; Hennessy, Kym; Steultjens, Martijn P; Woodburn, Jim

2012-05-01

To determine, for a number of techniques used to obtain foot shape based around plaster casting, foam box impressions, and 3-dimensional scanning, (1) the effect the technique has on the overall reproducibility of custom foot orthoses (FOs) in terms of inter- and intracaster reliability and (2) the reproducibility of FO design by using computer-aided design (CAD) software in terms of inter- and intra-CAD operator reliability for all these techniques. Cross-sectional study. University laboratory. Convenience sample of individuals (N=22) with noncavus foot types. Not applicable. Parameters of the FO design (length, width at forefoot, width at rearfoot, and peak medial arch height), the forefoot to rearfoot angle of the foot shape, and overall volume match between device designs. For intra- and intercaster reliability of the different methods of obtaining the foot shape, all methods fell below the reproducibility quality threshold for the medial arch height of the device, and volume matching was <80% for all methods. The more experienced CAD operator was able to achieve excellent reliability (intraclass correlation coefficients >0.75) for all variables with the exception of forefoot to rearfoot angle, with overall volume matches of >87% of the devices. None of the techniques for obtaining foot shape met all the criteria for excellent reproducibility, with the peak arch height being particularly variable. Additional variability is added at the CAD stage of the FO design process, although with adequate operator experience good to excellent reproducibility may be achieved at this stage. Taking only basic linear or angular measurement parameters from the device may fail to fully capture the variability in FO design. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Integration of remote sensing and GIS for studying a short-term flashflood in the El Arish Catchment (Egypt)

NASA Astrophysics Data System (ADS)

Badawy, M.

2012-04-01

Wadi El Arish is the largest drainage system in Sinai Peninsula, Egypt. The Wadi was subject to severe thunderstorms on 17 and 18 January 2010 followed by an extreme and violent flood that had not been known in Sinai since 1980. The flood claimed six victims, injured tens of people, and devastated vital infrastructure and hundreds of houses. Hydrologic characteristics of the Wadi are not fully understood due to substantial lack of the detailed hydro-meteorological information. Hence, remote sensing and GIS techniques were used to provide better spatial understanding of rainfall characteristics and drainage basin response. The study was based on the analysis of the TRMM images and 6 hourly average HYDIS data of rainfall analyses. A hydrological model was constructed using ASTER DEMs. The empirical black box model was used depending on the curve number approach to predict stream runoff. Landcover and hydrological soil groups were identified from the Landsat ETM+ mosaic using multispectral supervised classification. The curve numbers were adjusted to ARC I (dry condition) as the total rain in a 5-day period preceding the storm were very low (≤5 mm). We found, that the Wadi received a total rain volume of 665.4 x 106 m3. Most of it fell on 17 January, when the rain intensity ranged between 4-8 mm/hr. The estimated total surface runoff Q was 123.3 x 103 mm and the total runoff volume was 124 x 106 m3 that constitutes 18.8 % of the total rain volume. The results are in agreement with the observed values in the Wadi and highly required for many applications related to water harvesting and flood protection studies.

Renal function and plasma volume following ultramarathon cycling.

PubMed

Neumayr, G; Pfister, R; Hoertnagl, H; Mitterbauer, G; Prokop, W; Joannidis, M

2005-01-01

In recreational cyclists marathon cycling influences renal function only on a minimal scale. Respective information on extreme ultramarathon cycling in better trained athletes is not available. The objective was to evaluate the renal and haematological effects of ultraendurance cycling in the world's best ultramarathon cyclists. Creatinine (CR), urea, haemoglobin (Hb), haematocrit (Hct) and plasma volume (PV) were investigated in 16 male ultramarathon cyclists during the 1st Race Across the Alps in 2001 (distance: 525 km; cumulative altitude difference: 12,600 m). All renal functional parameters were normal pre-exercise. During the race serum CR, urea and uric acid rose significantly by 33, 97 % and 18 % (p <0.001 respectively) and nearly normalised again on the following day. The decline in calculated CR clearance was 25 %. There was a negative correlation (r=- 0.575, p=0.02) between the rise in serum CR and the athlete's training kilometers. The serum urea/CR ratio rose above 40 in 12 athletes (75 %). Mean fractional sodium excretion and fractional uric acid excretion fell below 0.5 % (p <0.001) and 7 %, indicating reduced renal perfusion. The deflection of the renal functional parameters was temporary and nearly gone after 24 hours of recovery. Hct declined during the race from 0.44 to 0.42, and continued falling on the next day (0.42 --> 0.40; p <0.001). The corresponding rises in calculated PV were + 8 % and + 22 %. The study affirms that in world class cyclists the enormous strains of ultramarathon cycling influence renal function only on a minimal scale. The impact on the PV, however, is pronounced leading to marked haemodilution post-exercise. This very temporary "impairment of renal function" seems to be the physiological response to ultramarathon cycling and may be attenuated to some extent by preceding high-volume training.

Sci—Fri AM: Mountain — 06: Optimizing planning target volume in lung radiotherapy using deformable registration

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

Hoang, P; Wierzbicki, M; Juravinski Cancer Centre, Medical Physics Department, Hamilton, Ontario

A four dimensional computed tomography (4DCT) image is acquired for all radically treated, lung cancer patients to define the internal target volume (ITV), which encompasses tumour motion due to breathing and subclinical disease. Patient set-up error and anatomical motion that is not due to breathing is addressed through an additional 1 cm margin around the ITV to obtain the planning target volume (PTV). The objective of this retrospective study is to find the minimum PTV margin that provides an acceptable probability of delivering the prescribed dose to the ITV. Acquisition of a kV cone beam computed tomography (CBCT) image atmore » each fraction was used to shift the treatment couch to accurately align the spinal cord and carina. Our method utilized deformable image registration to automatically position the planning ITV on each CBCT. We evaluated the percentage of the ITV surface that fell within various PTVs for 79 fractions across 18 patients. Treatment success was defined as a situation where at least 99% of the ITV is covered by the PTV. Overall, this is to be achieved in at least 90% of the treatment fractions. The current approach with a 1cm PTV margin was successful ∼96% of the time. This analysis revealed that the current margin can be reduced to 0.8cm isotropic or 0.6×0.6×1 cm{sup 3} non-isotropic, which were successful 92 and 91 percent of the time respectively. Moreover, we have shown that these margins maintain accuracy, despite intrafractional variation, and maximize CBCT image guidance capabilities.« less

The Influence of Landslides on Channel Flood Response: A Case Study from the Colorado Front Range

NASA Astrophysics Data System (ADS)

Bennett, G. L.; Ryan, S. E.; Sholtes, J.; Rathburn, S. L.

2016-12-01

Studies have identified the role of thresholds and gradients in stream power in inducing geomorphic change during floods. At much longer time scales, empirical and modeling studies suggest the role of landslides in modifying channel response to external forcing (e.g. tectonic uplift); landslide-delivered sediment may behave as a tool, enhancing channel incision, or as cover, reducing channel incision. However, the influence of landslides on channel response to an individual flood event remains to be elucidated. Here we explore the influence of landslides on channel response to a 200-yr flood in Colorado, USA. From 9 - 15th September 2013 up to 450 mm of rain fell across a 100 km-wide swath of the Colorado Front Range, triggering >1000 landslides and inducing major flooding in several catchments. The flood caused extensive channel erosion, deposition and planform change, resulting in significant damage to property and infrastructure and even loss of life. We use a combination of pre and post flood LiDAR and field mapping to quantify geomorphic change in several catchments spanning the flooded region. We make a reach-by-reach analysis of channel geomorphic change metrics (e.g. volume of erosion) in relation to landslide sediment input and total stream power as calculated from radar-based rainfall measurements. Preliminary results suggest that landslide-sediment input may complicate the predictive relationship between channel erosion and stream power. Low volumes of landslide sediment input appear to enhance channel erosion (a tools effect), whilst very large volumes appear to reduce channel erosion (a cover effect). These results have implications for predicting channel response to floods and for flood planning and mitigation.

Effects of body size and gender on the population pharmacokinetics of artesunate and its active metabolite dihydroartemisinin in pediatric malaria patients.

PubMed

Morris, Carrie A; Tan, Beesan; Duparc, Stephan; Borghini-Fuhrer, Isabelle; Jung, Donald; Shin, Chang-Sik; Fleckenstein, Lawrence

2013-12-01

Despite the important role of the antimalarial artesunate and its active metabolite dihydroartemisinin (DHA) in malaria treatment efforts, there are limited data on the pharmacokinetics of these agents in pediatric patients. This study evaluated the effects of body size and gender on the pharmacokinetics of artesunate-DHA using data from pediatric and adult malaria patients. Nonlinear mixed-effects modeling was used to obtain a base model consisting of first-order artesunate absorption and one-compartment models for artesunate and for DHA. Various methods of incorporating effects of body size descriptors on clearance and volume parameters were tested. An allometric scaling model for weight and a linear body surface area (BSA) model were deemed optimal. The apparent clearance and volume of distribution of DHA obtained with the allometric scaling model, normalized to a 38-kg patient, were 63.5 liters/h and 65.1 liters, respectively. Estimates for the linear BSA model were similar. The 95% confidence intervals for the estimated gender effects on clearance and volume parameters for artesunate fell outside the predefined no-relevant-clinical-effect interval of 0.75 to 1.25. However, the effect of gender on apparent DHA clearance was almost entirely contained within this interval, suggesting a lack of an influence of gender on this parameter. Overall, the pharmacokinetics of artesunate and DHA following oral artesunate administration can be described for pediatric patients using either an allometric scaling or linear BSA model. Both models predict that, for a given artesunate dose in mg/kg of body weight, younger children are expected to have lower DHA exposure than older children or adults.

Lessons from 150 years of UK maternal hemorrhage deaths.

PubMed

Kerr, Robert Stuart; Weeks, Andrew David

2015-06-01

We have reviewed maternal hemorrhage death rates in the UK over the past 150 years in order to draw lessons from this material for current attempts to reduce global maternal mortality. Mortality rates from data in the UK Annual Reports from the Registrar General were entered into a database. Charts were created to display trends in hemorrhage mortality, allowing comparison with historical medical advances. Hemorrhage death rates fell steadily before the 1930s; between 1874 and 1926 they fell by 56%. In contrast, there was no consistent reduction in overall maternal mortality rates until the 1930s; from 1932 to 1952 they fell by 85%, primarily due to a reduction in sepsis deaths. In conclusion the majority of maternal hemorrhage mortality reductions in the UK occurred prior to the availability of effective oxytocics, antibiotics, and blood transfusion. Improving access to and standards of maternal care is key to addressing global maternal mortality today. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

EFFECT OF ROENTGEN RADIATION ON $beta$-GLUCURONIDASE IN RAT TESTIS

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

Arata, L.; Santoro, R.; Severi, M.A.

1962-04-30

The testes were irradiated with a single 600-r dose and enzyme activity was determined in homogenates of testis, at 10-day intervals, up to the 50th postirradiation day. In comparison with the control value of 47.9 (units/mg fresh tissue), BETA -glucuronidase activity fell to 30.5 by the 10th day, then progressively rose to 78.4, 126.0, 242.0, and 275.0 in the subsequent 10-day periods. A parallel drop, followed by a rise, occurred in total activity of testis. Testicular weight fell, and seminal vesicular weight fell and then rose, during the 50-day period. Thus, the transient sterility and destruction of germinal epithelium inducedmore » by irradiation were reflected by a decrease in BETA - glucuronidase activity, whereas regeneration of this epithelium followed the rise in enzyme activity. Such parallel changes in epithelial function and enzyme activity were previously noted in vitamin E-deficient rats. (H.H.D.)« less

Health benefits in 2005: premium increases slow down, coverage continues to erode.

PubMed

Gabel, Jon; Claxton, Gary; Gil, Isadora; Pickreign, Jeremy; Whitmore, Heidi; Finder, Benjamin; Hawkins, Samantha; Rowland, Diane

2005-01-01

This paper reports findings on the state of job-based health insurance in spring 2005 and how it has changed during recent years. Premiums rose 9.2 percent, the first year of single-digit increases since 2000. The percentage of firms offering health benefits has fallen from 69 percent in 2000 to 60 percent in 2005. Cost sharing did not grow appreciably in the past year. Enrollment in preferred provider organizations (PPOs) grew from 55 percent in 2004 to 61 percent in 2005, while enrollment in health maintenance organizations (HMOs) fell from 25 percent to 21 percent of the total.

Epistemic Beliefs about Justification Employed by Physics Students and Faculty in Two Different Problem Contexts

NASA Astrophysics Data System (ADS)

Çağlayan Mercan, Fatih

2012-06-01

This study examines the epistemic beliefs about justification employed by physics undergraduate and graduate students and faculty in the context of solving a standard classical physics problem and a frontier physics problem. Data were collected by a think-aloud problem solving session followed by a semi-structured interview conducted with 50 participants, 10 participants at freshmen, seniors, masters, PhD, and faculty levels. Seven modes of justification were identified and used for exploring the relationships between each justification mode and problem context, and expertise level. The data showed that justification modes were not mutually exclusive and many respondents combined different modes in their responses in both problem contexts. Success on solving the standard classical physics problem was not related to any of the justification modes and was independent of expertise level. The strength of the association across the problem contexts for the authoritative, rational, and empirical justification modes fell in the medium range and for the modeling justification mode fell in the large range of practical significance. Expertise level was not related with the empirical and religious justification modes. The strength of the association between the expertise level and the authoritative, rational, experiential, and relativistic justification modes fell in the medium range, and the modeling justification mode fell in the large range of practical significance. The results provide support for the importance of context for the epistemic beliefs about justification and are discussed in terms of the implications for teaching and learning science.

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

Glauber, H.; Wallace, P.; Brechtel, G.

We studied the measurement of hepatic glucose output (HGO) with prolonged (3-/sup 3/H)glucose infusion in 14 patients with non-insulin-dependent diabetes mellitus (NIDDM). Over the course of 10.5 h, plasma glucose concentration fell with fasting by one-third, from 234 +/- 21 to 152 +/- 12 mg/dl, and HGO fell from 2.35 +/- 0.18 to 1.36 +/- 0.07 mg . kg-1 . min-1 (P less than .001). In the basal state, HGO and glucose were significantly correlated (r = 0.68, P = .03), and in individual patients, HGO and glucose were closely correlated as both fell with fasting (mean r = 0.79,more » P less than .01). Plasma (3-/sup 3/H)glucose radioactivity approached a steady state only 5-6 h after initiation of the primed continuous infusion, and a 20% overestimate of HGO was demonstrated by not allowing sufficient time for tracer labeling of the glucose pool. Assumption of steady-state instead of non-steady-state kinetics in using Steele's equations to calculate glucose turnover resulted in a 9-24% overestimate of HGO. Stimulation of glycogenolysis by glucagon injection demonstrated no incorporation of (3-/sup 3/H)glucose in hepatic glycogen during the prolonged tracer infusion. In a separate study, plasma glucose was maintained at fasting levels (207 +/- 17 mg/dl) for 8 h with the glucose-clamp technique. Total glucose turnover rates remained constant during this prolonged tracer infusion. However, HGO fell to 30% of the basal value simply by maintaining fasting hyperglycemia in the presence of basal insulin levels.« less

Creation of inpatient capacity during a major hospital relocation: lessons for disaster planning.

PubMed

Jen, Howard C; Shew, Stephen B; Atkinson, James B; Rosenthal, J Thomas; Hiatt, Jonathan R

2009-09-01

To identify tools to aid the creation of disaster surge capacity using a model of planned inpatient census reduction prior to relocation of a university hospital. Prospective analysis of hospital operations for 1-week periods beginning 2 weeks (baseline) and 1 week (transition) prior to move day; analysis of regional hospital and emergency department capacity. Large metropolitan university teaching hospital. Hospital census figures and patient outcomes. Census was reduced by 36% from 537 at baseline to 345 on move day, a rate of 18 patients/d (P < .005). Census reduction was greater for surgical services than nonsurgical services (46% vs 30%; P = .02). Daily volume of elective operations also decreased significantly, while the number of emergency operations was unchanged. Hospital admissions were decreased by 42%, and the adjusted discharges per occupied bed were increased by 8% (both P < .05). Inpatient mortality was not affected. Regional capacity to absorb new patients was limited. During a period in which southern California population grew by 8.5%, acute care beds fell by 3.3%, while Los Angeles County emergency departments experienced a 13% diversion rate due to overcrowding. Local or regional disasters of any size can overwhelm the system's ability to respond. Our strategy produced a surge capacity of 36% without interruption of emergency department and trauma services but required 3 to 4 days for implementation, making it applicable to disasters and mass casualty events with longer lead times. These principles may aid in disaster preparedness and planning.

A Plant-Based Dietary Intervention Improves Beta-Cell Function and Insulin Resistance in Overweight Adults: A 16-Week Randomized Clinical Trial.

PubMed

Kahleova, Hana; Tura, Andrea; Hill, Martin; Holubkov, Richard; Barnard, Neal D

2018-02-09

The aim of this study was to test the effect of a plant-based dietary intervention on beta-cell function in overweight adults with no history of diabetes. Participants ( n = 75) were randomized to follow a low-fat plant-based diet ( n = 38) or to make no diet changes ( n = 37) for 16 weeks. At baseline and 16 weeks, beta-cell function was quantified with a mathematical model. Using a standard meal test, insulin secretory rate was calculated by C-peptide deconvolution. The Homeostasis Model Assessment (HOMA-IR) index was used to assess insulin resistance while fasting. A marked increase in meal-stimulated insulin secretion was observed in the intervention group compared with controls (interaction between group and time, Gxt, p < 0.001). HOMA-IR index fell significantly ( p < 0.001) in the intervention group (treatment effect -1.0 (95% CI, -1.2 to -0.8); Gxt, p = 0.004). Changes in HOMA-IR correlated positively with changes in body mass index (BMI) and visceral fat volume ( r = 0.34; p = 0.009 and r = 0.42; p = 0.001, respectively). The latter remained significant after adjustment for changes in BMI ( r = 0.41; p = 0.002). Changes in glucose-induced insulin secretion correlated negatively with BMI changes ( r = -0.25; p = 0.04), but not with changes in visceral fat. Beta-cell function and insulin sensitivity were significantly improved through a low-fat plant-based diet in overweight adults.

Alterations in body fluid content can be detected by bioelectrical impedance analysis.

PubMed

Scheltinga, M R; Jacobs, D O; Kimbrough, T D; Wilmore, D W

1991-05-01

The electrical resistance across the whole body and its segments to the conduction of a weak alternating current was determined in human subjects under three different conditions: (1) during bed rest, (2) during infusion of 1 liter of saline, and (3) during donation of 1 unit of blood. During bed rest, extracellular and total body water were measured by dilution of bromide and heavy water, respectively. Electrical resistance obtained from electrodes placed on proximal portions of extremities ("proximal resistance") accounted for less than 50% of that determined by electrodes positioned on routinely used portions of a hand and foot ("whole body resistance"). Following saline infusion, resistance determined from the whole body and all its segments fell (P less than 0.001); the magnitude of the drop in both proximal and whole body resistance was inversely related to the volume of total body water (TBW) (r = -0.82, P less than 0.002, and r = -0.73, P less than 0.01, respectively). In contrast, blood donation was associated with significantly increased resistance at both measurement sites. TBW predicted from anthropometrics was inversely related to both proximal (r = -0.90, P less than 0.001) and whole body resistance (r = -0.75, P less than 0.001). Bioelectrical impedance analysis is a simple technique which may be useful in monitoring minimal alterations in TBW. Furthermore, altered fluid status may be predicted more accurately by changes in proximal resistance compared to changes in traditionally used whole body resistance.

Natural history and outcome of aortic stenosis diagnosed prenatally.

PubMed Central

Simpson, J. M.; Sharland, G. K.

1997-01-01

OBJECTIVE: To document the growth of the left heart structures and outcome of fetuses with aortic stenosis. DESIGN: Retrospective echocardiographic and clinical study. SETTING: Tertiary centre for fetal cardiology. PATIENTS: 27 consecutive fetuses with aortic stenosis. MAIN OUTCOME MEASURES: Survival of affected fetuses. Measurement of left ventricular end diastolic volume (LVEDV), aortic root diameter, and ejection fraction. RESULTS: Before 25 weeks' gestation, the LVEDV was normal or increased in all cases. In six of eight fetuses studied sequentially, the LVEDV fell across normal centiles. Initial ejection fraction was reduced in 23 fetuses (88%). Before 28 weeks' gestation, the aortic root was normal in all but one case, but after 29 weeks, 11 of 13 fetuses had values below the 50th centile. In two fetuses prenatal aortic valvoplasty was attempted, 10 babies had postnatal interventions, and there were six survivors. Biventricular repair was attempted in eight cases, of whom five survived. A first stage Norwood operation was performed in three babies, of whom one survived. The four fetuses with the highest aortic root z scores had successful biventricular repair. The two fetuses with initially normal ejection fractions survived. Successful biventricular repair was achieved even where the LVEDV was below the 5th centile. CONCLUSIONS: In aortic stenosis diagnosed prenatally, failure of growth of the left ventricle and aortic root often occurs. The outcome of affected fetuses is better than previously reported. Prenatal echocardiography may assist selection of suitable candidates for biventricular versus Norwood repair. Images PMID:9093035

Temporal patterns, sources, and sinks of C8-C16 hydrocarbons in the atmosphere of Mace Head, Ireland

NASA Astrophysics Data System (ADS)

Sartin, , J. H.; Halsall, , C. J.; Robertson, , L. A.; Gonard, , R. G.; MacKenzie, , A. R.; Berresheim, , H.; Hewitt, C. N.

2002-10-01

During the 1999 New Particle Formation and Fate in the Coastal Environment (PARFORCE) field campaign, 16 C8-C16 volatile organic compounds (VOCs) were identified in the coastal atmosphere of Mace Head, Ireland. Sampling took place over 24 days, with 12 VOCs routinely quantified. Concentrations were observed in the low <10-150 parts per trillion by volume range, with levels typically in the order of aldehydes > ketones ≥ n-alkanes. Concentrations of these compounds were also measured in shoreline surface seawater. No relationship was observed between atmospheric concentrations and high/low tide events. Many VOCs revealed a temporal pattern in the atmosphere, with highest concentrations measured during the early morning and lowest concentrations in the afternoon. The strongest pattern was observed for the n-alkanes. However, this was dependent on the prevailing air mass direction and the local meteorology. A Lagrangian box model was applied to assess this diurnal cycle, using seawater emissions as a source (based on the seawater concentrations and observed wind speeds), and depletion via OH radicals and dilution by entrainment as sinks (using measured [OH] and boundary layer height data). The model gave good agreement to the observed concentrations for selected air mass types, predicting the daytime decrease in VOC concentrations due to OH radical chemistry and boundary layer growth, and the subsequent increase in VOC concentrations toward evening as both oxidation chemistry diminished and the mixing layer height fell.

Effects of anti-glare particles on sedation in mice

NASA Astrophysics Data System (ADS)

Wang, Hongyu; Hao, Shaojun; Liu, Xiaobin; Kong, Xuejun; Wang, Xidong; Li, Wenjun; Zhang, Zhengchen

2018-04-01

To investigate the effect of anti-glare particles on sedation of mice, 60 mice were randomly divided into 5 groups, were fed by Ant-dizzy Granule Suspension, saline, Yang Xue Qing Nao Granule suspension and the same volume of saline, and administered 1 times daily, for 7 days. The mice in the wilderness box, hang - 150W light bulbs in the box above, the light recording activities within 2 minutes. The wilderness box into the box after the number of mice, mice with limbs went to the 1 squares is around 1 in the same case, mouse location and method of wilderness case; each group was placed in the turn/bar with rotating speed of 40RPM, each time 5 Parallel experiment recorded the mouse stay time on the rotating rod, if the mouse fell within 2 minutes, immediately put it on the rotating rod to continue the experiment, recorded the mouse on the rotating rod accumulated stay time. If 10 minutes did not drop, press 10 minutes; eighty mice were divided into 5 groups. The number of each rat injected subthreshold dose of pentobarbital sodium in mice. The sleep recording liquid were recorded sleep latency and sleep time. The anti-vertigo granule can obviously reduce the spontaneous activity of mice (P<0.05), can significantly increase the residence time of mice on the rotating rod (P<0.05) have obvious synergistic effect (P<0.05). Anti-glare particles have good sedative effect.

Influence of drought acclimation and CO sub 2 enrichment on osmotic adjustment and chlorophyll a fluorescence of sunflower during drought. [Helianthus annuus var Hyson 30

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

Conroy, J.P.; Virgona, J.M.; Smillie, R.M.

1988-04-01

Osmotic adjustment occurred during drought in expanded leaves of sunflowers (Helianthus annuus var Hysun 30) which had been continuously exposed to 660 microliters CO{sub 2} per liter or had been previously acclimated to drought. The effect was greatest when the treatments were combined and was negligible in nonacclimated plants grown at 340 microliters CO{sub 2} per liter. The concentrations of ethanol soluble sugars and potassium increased during drought but they did not account for the osmotic adjustment. The delay in the decline in conductance and relative water content and in the loss of structural integrity with increasing drought was dependentmore » on the degree of osmotic adjustment. The relative water content remained constant at 85% for three days and fell to 36% on the sixth day. There was no evidence of leaf desiccation even on the eighth day. In contrast, the conductance of leaves showing minimal adjustment fell rapidly after the first day of drought and was negligible after the fourth, at which time the relative water content was 36%. By the sixth day of drought, areas near the margins of the leaves were desiccating and the plants did not recover upon rewatering. Despite the differences in the rate of change of conductance and relative water content during drought, photosynthetic electron transport activity, remained functional until desiccation occurred.« less

Trends in exposure to television food advertisements among children and adolescents in the United States.

PubMed

Powell, Lisa M; Szczypka, Glen; Chaloupka, Frank J

2010-09-01

To examine the trends in food advertising seen by American children and adolescents. Trend analysis of children's and adolescents' exposure to food advertising in 2003, 2005, and 2007, including separate analyses by race. Children aged 2 to 5 years and 6 to 11 years and adolescents aged 12 to 17 years. Television ratings. Exposure to total food advertising and advertising by food category. Between 2003 and 2007 daily average exposure to food ads fell by 13.7% and 3.7% among young children aged 2 to 5 and 6 to 11 years, respectively, but increased by 3.7% among adolescents aged 12 to 17 years. Exposure to sweets ads fell 41%, 29.3%, and 12.1%, respectively, for 2- to 5-, 6- to 11-, and 12- to 17-year-olds and beverage ads were down by about 27% to 30% across these age groups, with substantial decreases in exposure to ads for the most heavily advertised sugar-sweetened beverages-fruit drinks and regular soft drinks. Exposure to fast food ads increased by 4.7%, 12.2%, and 20.4% among children aged 2 to 5, 6 to 11, and 12 to 17 years, respectively, between 2003 and 2007. The racial gap in exposure to food advertising grew between 2003 and 2007, particularly for fast food ads. A number of positive changes have occurred in children's exposure to food advertising. Continued monitoring of food advertising exposure along with nutritional analyses is needed to further assess self-regulatory pledges.

Drugs and other chemicals involved in fatal poisoning in England and Wales during 2000 – 2011.

PubMed

Handley, S A; Flanagan, R J

2014-01-01

Fatal poisoning data can reveal trends in the poisons encountered, which can help guide prescribing practices and product safety and other legislation, and more recently has helped to monitor the use of emerging drugs of abuse ( ‘ legal highs ’ ). We searched Mortality Statistics – Injury and poisoning, Series DH4 (2000 – 2005), Mortality Statistics – Deaths registered in England and Wales, Series DR (2006 – 2011), and the Office for National Statistics drug poisoning database for information on fatal poisoning during 2000 – 2011. We also searched the Pubmed database for ‘ fatal ’ and ‘ poisoning ’ and ‘ England ’ and ‘ Wales ’ : this search yielded seven papers that gave relevant information on deaths reported during 2000 – 2011 that were not superseded by later publications. DEATHS FROM POISONING: The annual number of deaths from poisoning fell from 2000 (3092) to 2010 (2749), before increasing to 3341 in 2011. This increase was due in part to a change in the ICD coding relating to alcohol poisoning, suggesting that such deaths had been under-recorded previously. Although fatalities from dextropropoxyphene declined (287 in 2004 and 18 in 2011) following the withdrawal of co-proxamol (paracetamol [acetaminophen] and dextropropoxyphene [propoxyphene] mixture) during 2005 – 2007, deaths involving codeine and most notably tramadol (836 deaths during 2000 – 2011) increased. Deaths from paracetamol poisoning either alone, or with alcohol reached 89 in 2011, the lowest annual figure since 1974. However, in reality there has been no marked downward trend since 1999 despite reductions in pack size, continued publicity as to the dangers of paracetamol overdose, and improved liver failure treatment, including transplantation. The annual number of deaths from antidepressants remained relatively stable (median: 397, range: 335 – 469). Although the number of deaths from dosulepin [dothiepin] decreased (186 in 2000 and 49 in 2011), the number of deaths involving selective serotonin reuptake inhibitors increased (50 in 2000 and 127 in 2011). Although annual numbers of deaths involving diamorphine/morphine (88% unintentional) declined, deaths involving methadone (89% unintentional) increased and the total annual number of deaths from these drugs showed little change (2000: 1061, 2011: 995). Deaths involving amfetamine/metamfetamine remained relatively constant at about 50 annually, and whilst cocaine-related deaths fell by 48% during 2008 – 2011, and deaths involving MDMA and related compounds fell by 69% over this same period, deaths involving ‘ legal highs ’ , notably γ -hydroxybutrate/ γ -butyrolactone and ketamine, increased. Alterations in the availability of paracetamol and of prescription drugs such as dextropropoxyphene and dosulepin have not been accompanied by decreases in the number of deaths from poisoning. Despite intense media and other interest, the annual number of deaths (250 – 300) involving ‘ recreational ’ drugs remains small in relation to the 1000 or so deaths a year from diamorphine and/or methadone.

Has modern perinatal practice caused the fall in perinatal mortality? The experience of a district maternity hospital.

PubMed

Shepherd, R C; Ridley, W; Struthers, J O

1983-07-01

During the first 12 years of operation the perinatal mortality rate in Paisley Maternity Hospital fell steadily from 27 per 1,000 in 1970 to 10 per 1,000 in 1981. During this period the nulliparous birth rate remained constant, but the parous birth rate fell. Improved survival of premature babies, falling numbers of babies with neural tube defects and reduction in intrapartum asphyxia are identified as responsible for this fall. Unexplained intra-uterine death remains an unsolved problem.

Evaluation of manual and automatic manually triggered ventilation performance and ergonomics using a simulation model.

PubMed

Marjanovic, Nicolas; Le Floch, Soizig; Jaffrelot, Morgan; L'Her, Erwan

2014-05-01

In the absence of endotracheal intubation, the manual bag-valve-mask (BVM) is the most frequently used ventilation technique during resuscitation. The efficiency of other devices has been poorly studied. The bench-test study described here was designed to evaluate the effectiveness of an automatic, manually triggered system, and to compare it with manual BVM ventilation. A respiratory system bench model was assembled using a lung simulator connected to a manikin to simulate a patient with unprotected airways. Fifty health-care providers from different professional groups (emergency physicians, residents, advanced paramedics, nurses, and paramedics; n = 10 per group) evaluated manual BVM ventilation, and compared it with an automatic manually triggered device (EasyCPR). Three pathological situations were simulated (restrictive, obstructive, normal). Standard ventilation parameters were recorded; the ergonomics of the system were assessed by the health-care professionals using a standard numerical scale once the recordings were completed. The tidal volume fell within the standard range (400-600 mL) for 25.6% of breaths (0.6-45 breaths) using manual BVM ventilation, and for 28.6% of breaths (0.3-80 breaths) using the automatic manually triggered device (EasyCPR) (P < .0002). Peak inspiratory airway pressure was lower using the automatic manually triggered device (EasyCPR) (10.6 ± 5 vs 15.9 ± 10 cm H2O, P < .001). The ventilation rate fell consistently within the guidelines, in the case of the automatic manually triggered device (EasyCPR) only (10.3 ± 2 vs 17.6 ± 6, P < .001). Significant pulmonary overdistention was observed when using the manual BVM device during the normal and obstructive sequences. The nurses and paramedics considered the ergonomics of the automatic manually triggered device (EasyCPR) to be better than those of the manual device. The use of an automatic manually triggered device may improve ventilation efficiency and decrease the risk of pulmonary overdistention, while decreasing the ventilation rate.

The Cardiovascular Effects of Morphine THE PERIPHERAL CAPACITANCE AND RESISTANCE VESSELS IN HUMAN SUBJECTS

PubMed Central

Zelis, Robert; Mansour, Edward J.; Capone, Robert J.; Mason, Dean T.

1974-01-01

To evaluate the effects of morphine on the peripheral venous and arterial beds, 69 normal subjects were evaluated before and after the intravenous administration of 15 mg morphine. Venous tone was determined by three independent techniques in 22 subjects. The venous pressure measured in a hand vein during temporary circulatory arrest (isolated hand vein technique) fell from 20.2±1.4 to 13.4±0.9 mm Hg (P < 0.01) 10 min after morphine, indicating that a significant venodilation had occurred. With the acute occlusion technique, morphine induced a reduction in forearm venous tone from 12.8±1.1 to 7.9±2.3 mm Hg/ml/100 ml (P < 0.01). Although forearm venous volume at a pressure of 30 mm Hg (VV[30]) was increased from 2.26±0.17 to 2.55±0.26 ml/100 ml, measured by the equilibration technique, the change was not significant (P > 0.1). Of note is that the initial reaction to morphine was a pronounced venoconstriction, demonstrated during the first 1-2 min after the drug. (Isolated hand vein pressure increased to 37.2±5.4 mm Hg, P < 0.01). This rapidly subsided, and by 5 min a venodilation was evident. Morphine did not attenuate the venoconstrictor response to a single deep breath, mental arithmetic, or the application of ice to the forehead when measured by either the isolated hand vein technique or the equilibration technique. To evaluate the effects of morphine on the peripheral resistance vessels in 47 normal subjects, forearm blood flow was measured plethysmographically before and 10-15 min after the intravenous administration of 15 mg of morphine. Although mean systemic arterial pressure was unchanged, forearm blood flow increased from 2.92±0.28 to 3.96±0.46 ml/min/100 ml (P < 0.01), and calculated vascular resistance fell from 42.4±5.2 to 31.6±3.2 mm Hg/ml/min/100 ml (P < 0.01). When subjects were tilted to the 45° head-up position, morphine did not block the increase in total peripheral vascular resistance that occurs; however, it did significantly attenuate the forearm arteriolar constrictor response (before morphine, + 25.7±5.4; after morphine, + 13.7±5.3 mm Hg/ml/min/100 ml, P < 0.05). However, morphine did not block the post-Valsalva overshoot of blood pressure, nor did it block the increase in forearm vascular resistance produced by the application of ice to the forehead. Similarly, morphine did not block the arteriolar or venoconstrictor effects of intra-arterially administered norepinephrine. Morphine infused into the brachial artery in doses up to 200 μg/min produced no changes in ipsilateral forearm VV[30], forearm blood flow, or calculated forearm resistance. Intra-arterial promethazine, atropine, and propranolol did not block the forearm arteriolar dilator response to intravenous morphine; however, intra-arterial phentolamine abolished the response. These data suggest that in human subjects, morphine induces a peripheral venous and arteriolar dilation by a reflex reduction in sympathetic alpha adrenergic tone. Morphine does not appear to act as a peripheral alpha adrenergic blocking agent but seems to attenuate the sympathetic efferent discharge at a central nervous system level. Images PMID:4612057

Inner Core Structure of Hurricane Alicia from Airborne Doppler Radar Observations.

NASA Astrophysics Data System (ADS)

Marks, Frank D., Jr.; Houze, Robert A., Jr.

1987-05-01

Airborne Doppler radar measurements are used to determine the horizontal winds, vertical air motions, radar reflectivity and hydrometer fallspeeds over much of the inner-core region (within 40 km of the eye) of Hurricane Alicia (1983). The reconstructed flow field is more complete and detailed than any obtained previously. The data show both the primary (azimuthal) and secondary (radial-height) circulations. The primary circulation was characterized by an outward sloping maximum of tangential wind. The secondary circulation was characterized by a deep layer of radial inflow in the lower troposphere and a layer of intense outflow above 10 km altitude. The rising branch of the secondary circulation was located in the eyewall and sloped radially outward. Discrete convective-scale bubbles of more intense upward motion were superimposed on this mean rising current, and convective-scale downdrafts were located throughout and below the core of maximum precipitation in the eyewall.Precipitation particles in the eyewall rainshaft circulated 18-20 km downwind as they fell, consistent with the typical upwind slope with increasing altitude of eyewall precipitation cores Outside the eyewall, the precipitation was predominantly stratiform. A radar bright band was evident at the melting level. Above the melting level, ice particles were advected into the stratiform region from the upper levels of the eyewall and drifted downward through a mesoscale region of ascent. Hypothetical precipitation particle trajectories showed that as these particles fell slowly through the mesoscale updraft toward the melting level, they were carried azimuthally as many as 1 1/2 times around the storm. During this spiraling descent, the particles evidently grew vigorously. The amount of water condensed by the ambient mesoscale ascent exceeded that transported into the stratiform region by the eyewall outflow by a factor of 3. As the particles fell into the lower troposphere, they entered a mesoscale region of subsidence, the top of which coincided with the radar bright band.

Daily activity during stability and exacerbation of chronic obstructive pulmonary disease

PubMed Central

2014-01-01

Background During most COPD exacerbations, patients continue to live in the community but there is little information on changes in activity during exacerbations due to the difficulties of obtaining recent, prospective baseline data. Methods Patients recorded on daily diary cards any worsening in respiratory symptoms, peak expiratory flow (PEF) and the number of steps taken per day measured with a Yamax Digi-walker pedometer. Exacerbations were defined by increased respiratory symptoms and the number of exacerbations experienced in the 12 months preceding the recording of daily step count used to divide patients into frequent (> = 2/year) or infrequent exacerbators. Results The 73 COPD patients (88% male) had a mean (±SD) age 71(±8) years and FEV1 53(±16)% predicted. They recorded pedometer data on a median 198 days (IQR 134–353). At exacerbation onset, symptom count rose by 1.9(±1.3) and PEF fell by 7(±13) l/min. Mean daily step count fell from 4154(±2586) steps/day during a preceding baseline week to 3673(±2258) step/day during the initial 7 days of exacerbation (p = 0.045). Patients with larger falls in activity at exacerbation took longer to recover to stable level (rho = −0.56; p < 0.001). Recovery in daily step count was faster (median 3.5 days) than for exacerbation symptoms (median 11 days; p < 0.001). Recovery in step count was also faster in untreated compared to treated exacerbation (p = 0.030). Daily step count fell faster over time in the 40 frequent exacerbators, by 708 steps/year, compared to 338 steps/year in 33 infrequent exacerbators (p = 0.002). Conclusions COPD exacerbations reduced physical activity and frequent exacerbations accelerate decline in activity over time. PMID:24885188

Trends in 30-day mortality rate and case mix for paediatric cardiac surgery in the UK between 2000 and 2010.

PubMed

Brown, Katherine L; Crowe, Sonya; Franklin, Rodney; McLean, Andrew; Cunningham, David; Barron, David; Tsang, Victor; Pagel, Christina; Utley, Martin

2015-01-01

To explore changes over time in the 30-day mortality rate for paediatric cardiac surgery and to understand the role of attendant changes in the case mix. Included were: all mandatory submissions to the National Institute of Cardiovascular Outcomes Research (NICOR) relating to UK cardiac surgery in patients aged <16 years. The χ(2) test for trend was used to retrospectively analyse the proportion of surgical episodes ending in 30-day mortality and with various case mix indicators, in 10 consecutive time periods, from 2000 to 2010. Comparisons were made between two 5-year eras of: 30-day mortality, period prevalence and mean age for 30 groups of specific operations. 30-day mortality for an episode of surgical management. Our analysis includes 36 641 surgical episodes with an increase from 2283 episodes in 2000 to 3939 in 2009 (p<0.01). The raw national 30-day mortality rate fell over the period of review from 4.3% (95% CI 3.5% to 5.1%) in 2000 to 2.6% (95% CI 2.2% to 3.0%) in 2009/2010 (p<0.01). The case mix became more complex in terms of the percentage of patients <2.5 kg (p=0.05), with functionally univentricular hearts (p<0.01) and higher risk diagnoses (p<0.01). In the later time era, there was significant improvement in 30-day mortality for arterial switch with ventricular septal defect (VSD) repair, patent ductus arteriosus ligation, Fontan-type operation, tetralogy of Fallot and VSD repair, and the mean age of patients fell for a range of operations performed in infancy. The raw 30-day mortality rate for paediatric cardiac surgery fell over a decade despite a rise in the national case mix complexity, and compares well with international benchmarks. Definitive repair is now more likely at a younger age for selected infants with congenital heart defects.

Did the formation of D″ cause the Archaean-Proterozoic transition?

NASA Astrophysics Data System (ADS)

Campbell, Ian H.; Griffiths, Ross W.

2014-02-01

The MgO content of the highest MgO plume-related komatiites and picrites remained constant at 32±2.5% between 3.5 and 2.7 Ga, then fell to 21±3% by ca. 2.0 Ga, a value similar to the present day value. Because there is a linear relationship between the liquidus temperature of dry magmas and their MgO content this observation implies that the temperature of mantle plumes changed little between 3.5 and 2.7 Ga, and then fell by 200-250 °C between 2.7 and 2.0 Ga to a temperature similar to that of present plumes. We suggest that Archaean plumes originate from the core-mantle boundary and that their temperature remained constant because the temperature of the outer core was buffered by solidification of the Fe-Ni inner core. At about 2.7 Ga dense former basaltic crust began to accumulate at the core and eventually covered it to produce an insulating layer that reduced the heat flux out of the core and lowered the temperature of mantle plumes. The temperature of mantle plumes fell as the dense layer above the core thickened until it exceeded the critical thickness required for convection. Because heat is transferred rapidly across the convecting part of the insulating layer, any further increase in its thickness by the addition more basaltic material has no influence on the temperature at the top of the layer, which is the source of Post-Archaean mantle plumes. We equate the dense layer above the core with the seismically identified layer D″. Our analyses suggest the drop in plume temperatures produced by a dense insulating layer above the core will be about 40% once it starts to convect, which is consistent with the observed drop inferred from the decrease in the MgO content of komatiites and picrites at that time.

Cardiac, skeletal, and smooth muscle mitochondrial respiration: are all mitochondria created equal?

PubMed Central

Park, Song-Young; Gifford, Jayson R.; Andtbacka, Robert H. I.; Trinity, Joel D.; Hyngstrom, John R.; Garten, Ryan S.; Diakos, Nikolaos A.; Ives, Stephen J.; Dela, Flemming; Larsen, Steen; Drakos, Stavros

2014-01-01

Unlike cardiac and skeletal muscle, little is known about vascular smooth muscle mitochondrial respiration. Therefore, the present study examined mitochondrial respiratory rates in smooth muscle of healthy human feed arteries and compared with that of healthy cardiac and skeletal muscles. Cardiac, skeletal, and smooth muscles were harvested from a total of 22 subjects (53 ± 6 yr), and mitochondrial respiration was assessed in permeabilized fibers. Complex I + II, state 3 respiration, an index of oxidative phosphorylation capacity, fell progressively from cardiac to skeletal to smooth muscles (54 ± 1, 39 ± 4, and 15 ± 1 pmol·s−1·mg−1, P < 0.05, respectively). Citrate synthase (CS) activity, an index of mitochondrial density, also fell progressively from cardiac to skeletal to smooth muscles (222 ± 13, 115 ± 2, and 48 ± 2 μmol·g−1·min−1, P < 0.05, respectively). Thus, when respiration rates were normalized by CS (respiration per mitochondrial content), oxidative phosphorylation capacity was no longer different between the three muscle types. Interestingly, complex I state 2 normalized for CS activity, an index of nonphosphorylating respiration per mitochondrial content, increased progressively from cardiac to skeletal to smooth muscles, such that the respiratory control ratio, state 3/state 2 respiration, fell progressively from cardiac to skeletal to smooth muscles (5.3 ± 0.7, 3.2 ± 0.4, and 1.6 ± 0.3 pmol·s−1·mg−1, P < 0.05, respectively). Thus, although oxidative phosphorylation capacity per mitochondrial content in cardiac, skeletal, and smooth muscles suggest all mitochondria are created equal, the contrasting respiratory control ratio and nonphosphorylating respiration highlight the existence of intrinsic functional differences between these muscle mitochondria. This likely influences the efficiency of oxidative phosphorylation and could potentially alter ROS production. PMID:24906913

Are adults with intellectual disabilities socially excluded? An exploratory study in Taiwan.

PubMed

Wang, Y T

2013-10-01

The aim of this exploratory study is to examine to what extent adults with intellectual disabilities (ID) in Taiwan are socially excluded and to identify the factors that are potentially associated with such social exclusion. The research method of this study is secondary data analysis, using descriptive and χ2 statistical analysis. Two data sets, from the 2003 and 2006 surveys entitled 'Survey of Living Situation for People with Disabilities in Taiwan', were used (n = 572; n = 618). In addition, 'independent living/living within the community' (as opposed to residing in an institution), 'employment' and 'household economic situation/residing in a low-income household' were social exclusion indicators in this study. The results revealed that in the 2003 (2006) survey, 81.9% (79.6%) of the subjects fell into at least one category of social exclusion, 11.3% (12.3%) fell into two or more categories and 0.2% (1.1%) fell into all three categories. Moreover, older women with ID, with no spouse or partner, lower educational levels and greater severity of the disability had a significantly greater likelihood of being subjected to more categories of social exclusion. The finding that the proportion of adults with ID and no social exclusion has risen from 18.1% in 2003 to 20.4% in 2006 represents an encouraging trend. However, there has been a marked increase in the proportion of the subjects with more categories of social exclusion, particularly with regard to those who have to endure all three categories, from 0.2% in 2003, to 1.1% in 2006. This implies that, at the time of the last survey, there was still considerable room for improvement in the social inclusion of adults with ID in Taiwan. © 2012 The Author. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

Actor-specific contributions to the deforestation slowdown in the Brazilian Amazon

PubMed Central

Godar, Javier; Gardner, Toby A.; Tizado, E. Jorge

2014-01-01

Annual deforestation rates in the Brazilian Amazon fell by 77% between 2004 and 2011, yet have stabilized since 2009 at 5,000–7,000 km2. We provide the first submunicipality assessment, to our knowledge, of actor-specific contributions to the deforestation slowdown by linking agricultural census and remote-sensing data on deforestation and forest degradation. Almost half (36,158 km2) of the deforestation between 2004 and 2011 occurred in areas dominated by larger properties (>500 ha), whereas only 12% (9,720 km2) occurred in areas dominated by smallholder properties (<100 ha). In addition, forests in areas dominated by smallholders tend to be less fragmented and less degraded. However, although annual deforestation rates fell during this period by 68–85% for all actors, the contribution of the largest landholders (>2,500 ha) to annual deforestation decreased over time (63% decrease between 2005 and 2011), whereas that of smallholders went up by a similar amount (69%) during the same period. In addition, the deforestation share attributable to remote areas increased by 88% between 2009 and 2011. These observations are consistent across the Brazilian Amazon, regardless of geographical differences in actor dominance or socioenvironmental context. Our findings suggest that deforestation policies to date, which have been particularly focused on command and control measures on larger properties in deforestation hotspots, may be increasingly limited in their effectiveness and fail to address all actors equally. Further reductions in deforestation are likely to be increasingly costly and require actor-tailored approaches, including better monitoring to detect small-scale deforestation and a shift toward more incentive-based conservation policies. PMID:25313087

Comparison of the compressive strengths for stitched and toughened composite systems

NASA Technical Reports Server (NTRS)

Reeder, James R.

1994-01-01

The compression strength of a stitched and a toughened matrix graphite/epoxy composite was determined and compared to a baseline unstitched untoughened composite. Two different layups with a variety of test lengths were tested under both ambient and hot/wet conditions. No significant difference in strength was seen for the different materials when the gage lengths of the specimens were long enough to lead to a buckling failure. For shorter specimens, a 30 percent reduction in strength from the baseline was seen due to stitching for both a 48-ply quasi-isotropic and a (0/45/0/-45/90/-45/0/45/0)s laminate. Analysis of the results suggested that the decrease in strength was due to increased fiber misalignment due to the stitches. An observed increasing strength with decreasing gage length, which was seen for all materials, was explained with a size effect model. The model assumed a random distribution of flaws (misaligned fibers). The toughened materials showed a small increase in strength over the baseline material for both laminates presumably due to the compensating effects of a more compliant matrix and straighter fibers in the toughened material. The hot/wet strength of the stitched and baseline material fell 30 percent below their ambient strengths for shorter, nonbuckling specimen, while the strength of the toughened matrix material only fell 20 percent. Video images of the failing specimen were recorded and showed local failures prior to global collapse of the specimen. These images support the theory of a random distribution of flaws controlling composite failure. Failed specimen appearance, however, seems to be a misleading indication of the cause of failure.

Brain oxygen utilization is unchanged by hypoglycemia in normal humans: lactate, alanine, and leucine uptake are not sufficient to offset energy deficit.

PubMed

Lubow, Jeffrey M; Piñón, Ivan G; Avogaro, Angelo; Cobelli, Claudio; Treeson, David M; Mandeville, Katherine A; Toffolo, Gianna; Boyle, Patrick J

2006-01-01

During hypoglycemia, substrates other than glucose have been suggested to serve as alternate neural fuels. We evaluated brain uptake of endogenously produced lactate, alanine, and leucine at euglycemia and during insulin-induced hypoglycemia in 17 normal subjects. Cross-brain arteriovenous differences for plasma glucose, lactate, alanine, leucine, and oxygen content were quantitated. Cerebral blood flow (CBF) was measured by Fick methodology using N(2)O as the dilution indicator gas. Substrate uptake was measured as the product of CBF and the arteriovenous concentration difference. As arterial glucose concentration fell, cerebral oxygen utilization and CBF remained unchanged. Brain glucose uptake (BGU) decreased from 36.3+/-2.6 to 26.6+/-2.1 micromol.100 g of brain(-1).min(-1) (P<0.001), equivalent to a drop in ATP of 291 micromol.100 g(-1).min(-1). Arterial lactate rose (P<0.001), whereas arterial alanine and leucine fell (P<0.009 and P<0.001, respectively). Brain lactate uptake (BLU) increased from a net release of -1.8+/- 0.6 to a net uptake of 2.5+/-1.2 micromol.100 g(-1).min(-1) (P<0.001), equivalent to an increase in ATP of 74 micromol.100 g(-1).min(-1). Brain leucine uptake decreased from 7.1+/-1.2 to 2.5 +/- 0.5 micromol.100 g(-1).min(-1) (P<0.001), and brain alanine uptake trended downward (P<0.08). We conclude that the ATP generated from the physiological increase in BLU during hypoglycemia accounts for no more than 25% of the brain glucose energy deficit.

Secular trends and risk factors of overweight and obesity among Kuwaiti adults: National Nutrition Surveillance System data from 1998 to 2009.

PubMed

Ahmed, Faruk; Waslien, Carol; Al-Sumaie, Mona A; Prakash, Prasanna

2012-11-01

To determine trends in prevalence of overweight and obesity in Kuwaiti adults, and to examine their association with selected sociodemographic and lifestyle factors. Analysis of cross-sectional population survey data from the Kuwait National Nutrition Surveillance System. Social and health facilities in Kuwait. Males (n 17 491) and females (n 21 120) aged 20-69 years attending registration for employment or pensions, or Hajj Pilgrimage health check-ups, or parents accompanying their children for immunization 1998 through 2009. Sociodemographic, lifestyle and anthropometric data were collected. Prevalence of BMI ≥ 25 kg/m2 rose from 61·8 % and 59·3 % in females and males respectively, peaked in 2004-2005 (81·4 % and 79·2 %) and fell slightly in 2008-2009 (77·3 % and 77·4 %). Obesity prevalence in females exceeded males for all years and age groups; by 2009, it had increased by 11·3 % in males and 14·6 % in females. Overweight and obesity prevalences in both genders increased until 2004-2005 but fell thereafter, with significant falls for females in 2008-2009. Logistic and linear regression analyses confirmed these temporal changes for both prevalence and BMI in both genders. The odds of obesity increased with age until the fifth decade for both genders and then declined significantly for males. Education level was negatively associated with obesity prevalence in females, while participation in leisure-time exercise was negatively associated with obesity prevalence in males. Although the combined prevalence of overweight and obesity (BMI ≥ 25 kg/m2) seemed to decrease from 2005 to 2009 among Kuwaiti adults, further research to clarify the identified confounders and continued monitoring are needed to confirm the decrease observed.

A long-duration (118-day) backpacking trip (2669 km) normalizes lipids without medication: a case study.

PubMed

Devoe, Dale; Israel, Richard Gay; Lipsey, Tiffany; Voyles, Wyatt

2009-01-01

To evaluate the effects of a long-distance backpacking trip on body composition, weight, blood lipids, and lipoproteins. Single-subject (male, aged 49 years) study of an experienced backpacker who hiked 118 days on the Appalachian Trail. Outcome measures that were assessed pre-hike and post-hike included body fat (%) by hydrostatic weighing and skinfold assessment, height and weight, body mass index (BMI), circumference measurements (umbilicus, anterior suprailiac, maximum hip, greater trochanter, minimum waist, umbilicus/anterior suprailiac ratio), and blood pressure (systolic and diastolic at rest and peak). Dietary analyses (total kilocalories, protein, carbohydrate, fat, cholesterol, saturated fat, monounsaturated fat, polyunsaturated fat, dietary fiber) were conducted pre-hike, on days 54 through 56, and on days 98 through 100. Blood lipids and lipoproteins (triglycerides, high-density lipoprotein, low-density lipoprotein) were measured pre-hike, on day 89, and post-hike. Pre-post differences showed decreases in body weight, from 85.3 kg to 73.9 kg (-11.4 [-13.4%]); percent body fat, hydrostatic weighing, from 25.18 to 14.31 (-10.87 [-43.2%]); percent body fat, skinfolds (7-site), from 23.79 to 11.61 (12.18 [-51.2%]); and BMI, from 29.37 to 25.46 (-3.91 [-13.3%]). Pre-post differences in blood lipid changes over the course of 118 days were as follows: triglycerides (mg x dL(-1)) fell from 319 to 79 (-240 [-75%]); total cholesterol (mg x dL(-1)) fell from 276 to 196 (-80 [-29%]); high-density lipoprotein (HDL) (mg x dL(-1)) rose from 46 to 63 (+17 [+37%]); low-density lipoprotein (LDL) (mg.dL(-1)) fell from 167 to 118 (-49 [-29%]); LDL/HDL ratio fell from 3.63 to 1.87 (-1.76 [-48%]); and total cholesterol/HDL ratio fell from 6.00 to 3.11 (-2.89 [-48%]). The physical activity and diet associated with an extended backpacking adventure can considerably reduce and clinically normalize blood lipids and lipoproteins without medication and can very positively affect body composition and weight.

Transient cutaneous vasodilatation and hypotension after drinking in dehydrated and exercising men

PubMed Central

Kamijo, Yoshi-Ichiro; Okumoto, Tadashi; Takeno, Yoshiaki; Okazaki, Kazunobu; Inaki, Mitsuharu; Masuki, Shizue; Nose, Hiroshi

2005-01-01

We examined whether oropharyngeal stimulation by drinking released the dehydration-induced suppression of cutaneous vasodilatation and decreased mean arterial pressure (MAP) in exercising subjects, and assessed the effects of hypovolaemia or hyperosmolality alone on these responses. Seven young males underwent four hydration conditions. These were two normal plasma volume (PV) trials: normal plasma osmolality (Posmol, control trial) and hyperosmolality (ΔPosmol = +11 mosmol (kg H2O)−1); and two low PV trials: isosmolality (ΔPV = −310 ml) and hyperosmolality (ΔPV = −345 ml; ΔPosmol = +9 mosmol (kg H2O)−1), attained by combined treatment with furosemide (frusemide), hypertonic saline and/or 24 h water restriction. In each trial, the subjects exercised at 60% peak aerobic power for ∼50 min at 30°C atmospheric temperature and 50% relative humidity. When oesophageal temperature (Toes) reached a plateau after ∼30 min of exercise, the subjects drank 200 ml water at 37.5°C within a minute. Before drinking, forearm vascular conductance (FVC), calculated as forearm blood flow divided by MAP, was lowered by 20–40% in hypovolaemia, hyperosmolality, or both, compared with that in the control trial, despite increased Toes. After drinking, FVC increased by ∼20% compared with that before drinking (P < 0.05) in both hyperosmotic trials, but it was greater in normovolaemia than in hypovolaemia (P < 0.05). However, no increases occurred in either isosmotic trial. MAP fell by 4–8 mmHg in both hyperosmotic trials (P < 0.05) after drinking, but more rapidly in normovolaemia than in hypovolaemia. PV and Posmol did not change during this period. Thus, oropharyngeal stimulation by drinking released the dehydration-induced suppression of cutaneous vasodilatation and reduced MAP during exercise, and this was accelerated when PV was restored. PMID:16123108

Risk factors for severe injury following indoor and outdoor falls in geriatric patients.

PubMed

Kim, Sun Hyu

2016-01-01

This study was performed to examine the characteristics of indoor and outdoor falls in older patients and the factors related to severe injury in the emergency department (ED). In total, 26,515 patients fell indoors and 19,581 outdoors. The general and clinical characteristics were compared between the two groups and factors associated with severe injury following the falls were evaluated. Younger males fell more frequently outdoors than indoors. The common activities during outdoor falls were sports and leisure activities. Environmental hazards lead to more outdoor falls than indoor falls. Factors associated with severe injury after indoor falls were transport to the ED by public ambulance or from another medical facility rather than individual transportation, fall from stairs rather than fell over, and a head and neck injury rather than a lower extremity injury. Factors related to severe injury after outdoor falls were male sex, transport to the ED by public ambulance or from another medical facility or by another method rather than individual transportation, state employed, fall from stairs rather than fell over, head and neck or thorax or abdomen injury rather than a lower extremity injury. Transport to the ED by public ambulance or from another medical facility, and head and neck injury were risks for severe injury following indoor and outdoor falls in elderly subjects. Efforts to identify the risk factors for severe injury and for falling itself are important to prevent and reduce fall injuries in elderly subjects. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Insights for Setting of Nutrient Requirements, Gleaned by Comparison of Selenium Status Biomarkers in Turkeys and Chickens versus Rats, Mice, and Lambs12

PubMed Central

Sunde, Roger A; Li, Jin-Long; Taylor, Rachel M

2016-01-01

To gain insights into nutrient biomarkers and setting of dietary nutrient requirements, selenium biomarker levels and requirements in response to multiple graded levels of dietary selenium were compared between day-old turkeys and chickens versus weanling rats and mice and 2-d-old lambs supplemented with sodium selenite. In rodents, there was no significant effect of dietary selenium on growth, indicating that the minimum selenium requirement was <0.007 μg Se/g diet. In contrast, there was a significant effect in turkeys, chicks, and lambs, which showed selenium requirements for growth of 0.05, 0.025, and 0.05 μg Se/g diet, respectively. Liver glutathione peroxidase (GPX) 1 activity fell in all species to <4% of selenium-adequate levels, plasma GPX3 activity fell to <3% in all species except for mice, and liver GPX4 activity fell to <10% in avians but only to ∼50% of selenium-adequate levels in rodents. Selenium-response curves for these biomarkers reached well-defined plateaus with increasing selenium supplementation in all species, collectively indicating minimum selenium requirements of 0.06–0.10 μg Se/g for rats, mice, and lambs but 0.10–0.13 μg Se/g for chicks and 0.23–0.33 μg Se/g for turkeys. In contrast, increasing dietary selenium did not result in well-defined plateaus for erythrocyte GPX1 activity and liver selenium in most species. Selenium-response curves for GPX1 mRNA for rodents and avians had well-defined plateaus and similar breakpoints. GPX4 mRNA was not significantly regulated by dietary selenium in rodents, but GPX4 mRNA in avians decreased in selenium deficiency to ∼35% of selenium-adequate plateau levels. Notably, no selenoprotein activities or mRNA were effective biomarkers for supernutritional selenium status. Robust biomarkers, such as liver GPX1 and plasma GPX3 activity for selenium, should be specific for the nutrient, fall dramatically in deficiency, and reach well-defined plateaus. Differences in biomarker-response curves may help researchers better understand nutrient metabolism and targeting of tissues in deficiency, thus to better characterize requirements. PMID:28140330

Insights for Setting of Nutrient Requirements, Gleaned by Comparison of Selenium Status Biomarkers in Turkeys and Chickens versus Rats, Mice, and Lambs.

PubMed

Sunde, Roger A; Li, Jin-Long; Taylor, Rachel M

2016-11-01

To gain insights into nutrient biomarkers and setting of dietary nutrient requirements, selenium biomarker levels and requirements in response to multiple graded levels of dietary selenium were compared between day-old turkeys and chickens versus weanling rats and mice and 2-d-old lambs supplemented with sodium selenite. In rodents, there was no significant effect of dietary selenium on growth, indicating that the minimum selenium requirement was <0.007 μg Se/g diet. In contrast, there was a significant effect in turkeys, chicks, and lambs, which showed selenium requirements for growth of 0.05, 0.025, and 0.05 μg Se/g diet, respectively. Liver glutathione peroxidase (GPX) 1 activity fell in all species to <4% of selenium-adequate levels, plasma GPX3 activity fell to <3% in all species except for mice, and liver GPX4 activity fell to <10% in avians but only to ∼50% of selenium-adequate levels in rodents. Selenium-response curves for these biomarkers reached well-defined plateaus with increasing selenium supplementation in all species, collectively indicating minimum selenium requirements of 0.06-0.10 μg Se/g for rats, mice, and lambs but 0.10-0.13 μg Se/g for chicks and 0.23-0.33 μg Se/g for turkeys. In contrast, increasing dietary selenium did not result in well-defined plateaus for erythrocyte GPX1 activity and liver selenium in most species. Selenium-response curves for GPX1 mRNA for rodents and avians had well-defined plateaus and similar breakpoints. GPX4 mRNA was not significantly regulated by dietary selenium in rodents, but GPX4 mRNA in avians decreased in selenium deficiency to ∼35% of selenium-adequate plateau levels. Notably, no selenoprotein activities or mRNA were effective biomarkers for supernutritional selenium status. Robust biomarkers, such as liver GPX1 and plasma GPX3 activity for selenium, should be specific for the nutrient, fall dramatically in deficiency, and reach well-defined plateaus. Differences in biomarker-response curves may help researchers better understand nutrient metabolism and targeting of tissues in deficiency, thus to better characterize requirements. © 2016 American Society for Nutrition.

Maternal mortality in Bangladesh: a Countdown to 2015 country case study.

PubMed

El Arifeen, Shams; Hill, Kenneth; Ahsan, Karar Zunaid; Jamil, Kanta; Nahar, Quamrun; Streatfield, Peter Kim

2014-10-11

Bangladesh is one of the only nine Countdown countries that are on track to achieve the primary target of Millennium Development Goal (MDG) 5 by 2015. It is also the only low-income or middle-income country with two large, nationally-representative, high-quality household surveys focused on the measurement of maternal mortality and service use. We use data from the 2001 and 2010 Bangladesh Maternal Mortality Surveys to measure change in the maternal mortality ratio (MMR) and from these and six Bangladesh Demographic and Health Surveys to measure changes in factors potentially related to such change. We estimate the changes in risk of maternal death between the two surveys using Poisson regression. The MMR fell from 322 deaths per 100,000 livebirths (95% CI 253-391) in 1998-2001 to 194 deaths per 100,000 livebirths (149-238) in 2007-10, an annual rate of decrease of 5·6%. This decrease rate is slightly higher than that required (5·5%) to achieve the MDG target between 1990 and 2015. The key contribution to this decrease was a drop in mortality risk mainly due to improved access to and use of health facilities. Additionally, a number of favourable changes occurred during this period: fertility decreased and the proportion of births associated with high risk to the mother fell; income per head increased sharply and the poverty rate fell; and the education levels of women of reproductive age improved substantially. We estimate that 52% of maternal deaths that would have occurred in 2010 in view of 2001 rates were averted because of decreases in fertility and risk of maternal death. The decrease in MMR in Bangladesh seems to have been the result of factors both within and outside the health sector. This finding holds important lessons for other countries as the world discusses and decides on the post-MDG goals and strategies. For Bangladesh, this case study provides a strong rationale for the pursuit of a broader developmental agenda alongside increased and accelerated investments in improving access to and quality of public and private health-care facilities providing maternal health in Bangladesh. United States Agency for International Development, UK Department for International Development, Bill & Melinda Gates Foundation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Physician staffed helicopter emergency medical service case identification - a before and after study in children.

PubMed

Garner, Alan A; Lee, Anna; Weatherall, Andrew; Langcake, Mary; Balogh, Zsolt J

2016-07-12

Severely injured children may have better outcomes when transported directly to a Paediatric Trauma Centre (PTC). A case identification system using the crew of a physician staffed helicopter emergency medical service (P-HEMS) that identified severely injured children for P-HEMS dispatch was previously associated with high rates of direct transfer. It was theorised that discontinuation of this system may have resulted in deterioration of system performance. Severe paediatric trauma cases were identified from a state based trauma registry over two time periods. In Period A the P-HEMS case identification system operated in parallel with a paramedic dispatcher (Rapid Launch Trauma Co-ordinator-RLTC) operating from a central control room (n = 71). In Period B the paramedic dispatcher operated in isolation (n = 126). Case identification and direct transfer rates were compared as was time to arrival at the PTC. After cessation of the P-HEMS system the rate of case identification fell from 62 to 31 % (P < 0.001), identification of fatal cases fell from 100 to 47 % (P < 0.001), the rate of direct transfer to a PTC fell from 66 to 53 % (P = 0.076) and the time to arrival in a PTC increased from a median 69 (interquartile range 52 - 104) mins to 97 (interquartile range 56 - 305) mins (P = 0.003). When analysing the rate of direct transfer to a PTC as a function of team composition, after adjusting for age and injury severity scores, there was no change in the rate between the physician and paramedic groups across the two time periods (relative risk 0.92, 95 % CI: 0.44 to 1.41). The parallel identification system improves case identification rates and decreases time to arrival at the PTC, whilst requiring RLTC authorisation preserves the safety and efficiency benefits of centralised dispatch. The model could be extended to adult patients with similar benefits. A case identification system relying solely on RLTC paramedics resulted in a significantly lower case identification rate and increased prehospital time with a non-significant fall in direct transfer rate to the PTC. The elimination of the P-HEMS input from the tasking system resulted in worse performance indicators and has the potential for poorer outcomes.

An evaluation of the effects of acid rain on low conductivity headwater streams in Pennsylvania

USGS Publications Warehouse

Ritter, John R.; Brown, Ann E.

1981-01-01

Analyses of water collected at 32 sites on headwater streams in Pennsylvania during low-flow conditions in 1970-80 were compared to pre-1971 data to evaluate whether acid rain had changed the chemistry of the streams in the previous decade. Most pH, alkalinity, and sulfate values of the samples collected in 1970-80 fell within the ranges of values for samples collected before 1971. The limited data indicate, however, that pH may have increased and alkalinity and sulfate may have decreased with time.

Investigations of modifications to improve the spin resistance of a high-wing, single-engine, light airplane

NASA Technical Reports Server (NTRS)

Manuel, G. S.; Dicarlo, D. J.; Stough, H. P., III; Brown, P. W.; Stuever, R. A.

1989-01-01

A general aviation aircraft with drooped leading edge modifications for improvement of lateral stability at high angles of attack has been flight tested in combination with a ventral fin which improves directional stability. The two modifications were assessed in light of spin-resistance criteria proposed for incorporation into FAA certification regulations. The configuration combining outboard wing leading-edge droop and a ventral fin yielded a substantial increase in spin resistance, but fell short of all requirements encompassed by the proposed spin-resistance criteria.

The effect of a single sauna exposure on spermatozoa.

PubMed

Brown-Woodman, P D; Post, E J; Gass, G C; White, I G

1984-01-01

Semen was collected at weekly intervals for 3 wk before and 10 wk after the sauna exposure at 85 degrees C for 20 minutes. The numbers, morphology, ultrastructure, motility, viability and metabolism of the sperm was assessed. Sperm numbers fell within one wk and slowly returned to normal in 5 wk. The earliest ultrastructural change was swelling of the plasma membrane, followed by an increase in the number of immature forms and disorganization of the arrangement of the mitochondria. Motility, glucose utilization and lactic acid accumulation of the sperm rose temporarily immediately after sauna.

Pyroclastic density currents associated with the 2008-2009 eruption of Chaitén Volcano (Chile): forest disturbances, deposits, and dynamics

USGS Publications Warehouse

Major, Jon J.; Pierson, Thomas C.; Hoblitt, Richard P.; Moreno, Hugo

2013-01-01

Explosive activity at Chaitén Volcano in May 2008 and subsequent dome collapses over the following nine months triggered multiple, small-volume pyroclastic density currents (PDCs). The explosive activity triggered PDCs to the north and northeast, which felled modest patches of forest as far as 2 km from the caldera rim. Felled trees pointing in the down-current direction dominate the disturbance zones. The PDC on the north flank of Chaitén left a decimeters-thick, bipartite deposit having a basal layer of poorly sorted, fines-depleted pumice-and-lithic coarse ash and lapilli, which transitions abruptly to fines-enriched pumice-and-lithic coarse ash. The deposit contains fragments of mostly uncharred organics near its base; vegetation protruding above the deposit is uncharred. The nature of the forest disturbance and deposit characteristics suggest the PDC was dilute, of relatively low temperature (-1. It was formed by directionally focused explosions throughout the volcano's prehistoric, intracaldera lava dome. Dilute, low-temperature PDCs that exited the caldera over a low point on the east-southeast caldera rim deposited meters-thick fill of stratified beds of pumice-and-lithic coarse ash and lapilli. They did not fell large trees more than a few hundred of meters from the caldera rim and were thus less energetic than those on the north and northeast flanks. They likely formed by partial collapses of the margins of vertical eruption columns. In the Chaitén River valley south of the volcano, several-meter-thick deposits of two block-and-ash flow (BAF) PDCs are preserved. Both have a coarse ash matrix that supports blocks and lapilli predominantly of lithic rhyolite dome rock, minor obsidian, and local bedrock. One deposit was emplaced by a BAF that traveled an undetermined distance downvalley between June and November 2008, apparently triggered by partial collapse of a newly effused lava dome on that started growing on 12 May. A second, and larger, BAF related to another collapse of the new lava dome on 19 February 2009 traveled to within 3 km of the village of Chaitén, 10 km downstream of the volcano. It deposited as much as 8-10 m of diamict having sedimentary characteristics very similar to the previous BAF deposit. Charred trees locally encased within the BAD deposits suggest that the flows were of moderate temperature, perhaps as much as 300°C. Erosion of the BAD deposits filling the Chaitén River channel has delivered substantial sediment loads downstream, contributing to channel instability and challenged river management.

Barriers to and facilitators of walking and bicycling to school: formative results from the non-motorized travel study.

PubMed

Ahlport, Kathryn N; Linnan, Laura; Vaughn, Amber; Evenson, Kelly R; Ward, Dianne S

2008-04-01

Barriers to and facilitators of walking and bicycling to school were explored through 12 focus groups made up of fourth- and fifth-grade students and their parents who lived near their respective schools. The barriers and facilitators reported by parents and children generally fell into one of three categories: intrapersonal and interpersonal characteristics of parents and children, environmental characteristics of the neighborhood, and environmental and policy characteristics of the school. Findings indicate that a supportive environment is a necessary but insufficient condition to increase walking and biking to school. Initiatives to increase active school travel may need to include multiple levels of intervention to be effective.

Regulation of transepithelial ion transport by intracellular calcium ions.

PubMed

Cuthbert, A W

1985-01-01

A photodynamic effect of erythrosine B on the basolateral surface of rat colon epithelium under short circuit conditions is described. The resulting irreversible increase in short circuit current was the result of electrogenic chloride secretion. The effect was dependent upon oxygen and calcium ions, and is probably due to the generation of singlet oxygen which then permeabilises the membranes to calcium. Half maximal activation of secretion in permeabilised preparations occurred at an external calcium concentration of 1 microM. In tight sodium transporting epithelia increased Cai reduces SCC, possibly by a direct effect on apical sodium permeability. In toad urinary bladder SCC fell in response to conditions outlined above for rat colon.

Safe and rapid resolution of severe hypertriglyceridaemia in two patients with intravenous insulin.

PubMed

Triay, J M; Day, A; Singhal, P

2010-09-01

To rapidly reduce serum triglyceride to a safe serum level. Severe hypertriglyceridaemia is associated with uncontrolled diabetes, obesity and poor physical activity. Even moderate increases in triglyceride levels (> 5mmol/L) confer an increased risk of pancreatitis and coronary artery disease. We present two patients with diabetes and serum triglyceride levels of greater than 85mmol/L despite polypharmacy intervention. 72-hour intravenous insulin infusion was administered. Serum triglyceride levels fell to 9.4 and 4.6 mmol/L respectively, without adverse events and sustained effect over several months. We suggest the use of intravenous insulin infusion where lifestyle and oral drug therapies have failed can impact on severe hypertriglyceridaemia.

Prediction in Ungauged Basins (PUB) for estimating water availability during water scarcity conditions: rainfall-runoff modelling of the ungauged diversion inflows to the Ridracoli water supply reservoir

NASA Astrophysics Data System (ADS)

Toth, Elena

2013-04-01

The Ridracoli reservoir is the main drinking water supply reservoir serving the whole Romagna region, in Northern Italy. Such water supply system has a crucial role in an area where the different characteristics of the communities to be served, their size, the mass tourism and the presence of food industries highlight strong differences in drinking water needs. Its operation allows high quality drinking water supply to a million resident customers, plus a few millions of tourists during the summer of people and it reduces the need for water pumping from underground sources, and this is particularly important since the coastal area is subject also to subsidence and saline ingression into aquifers. The system experienced water shortage conditions thrice in the last decade, in 2002, in 2007 and in autumn-winter 2011-2012, when the reservoir water storage fell below the attention and the pre-emergency thresholds, thus prompting the implementation of a set of mitigation measures, including limitations to the population's water consumption. The reservoir receives water not only from the headwater catchment, closed at the dam, but also from four diversion watersheds, linked to the reservoir through an underground water channel. Such withdrawals are currently undersized, abstracting only a part of the streamflow exceeding the established minimum flows, due to the design of the water intake structures; it is therefore crucial understanding how the reservoir water availability might be increased through a fuller exploitation of the existing diversion catchment area. Since one of the four diversion catchment is currently ungauged (at least at the fine temporal scale needed for keeping into account the minimum flow requirements downstream of the intakes), the study first presents the set up and parameterisation of a continuous rainfall-runoff model at hourly time-step for the three gauged diversion watersheds and for the headwater catchment: a regional parameterisation approach is then applied for modelling the streamflow originated in the fourth, ungauged, diversion watershed. Finally, the potential reservoir water availability is estimated, hypothesising to take from the diversion catchments all the streamflow exceeding the minimum flow requirements. The results indicate that modifying the water intake structures might allow a consistent increase in the storage volumes in the reservoir during the water scarcity periods: the water available to the reservoir would in fact - on average - increase of around the 13% of the abstracted annual volume.

Calculating the refractive index for pediatric parenteral nutrient solutions.

PubMed

Nelson, Scott; Barrows, Jason; Haftmann, Richard; Helm, Michael; MacKay, Mark

2013-02-15

The utility of refractometric analysis for calculating the refractive index (RI) of compounded parenteral nutrient solutions for pediatric patients was examined. An equation for calculating the RI of parenteral nutrient solutions was developed by chemical and linear regression analysis of 154 pediatric parenteral nutrient solutions. This equation was then validated by analyzing 1057 pediatric parenteral nutrition samples. The RI for the parenteral nutrient solutions could be calculated by summing the RI contribution for each ingredient and then adding the RI of water. The RI contribution for each ingredient was determined by multiplying the RI of the manufacturer's concentrate by the volume of the manufacturer's concentrate mixed into the parenteral nutrient solution divided by the total volume of the parenteral nutrient solution. The calculated RI was highly correlated with the measured RI (R(2) = 0.94, p < 0.0001). Using a range of two standard deviations (±0.0045), 99.8% of the samples fell into the comparative range. RIs of electrolytes, vitamins, and trace elements in the concentrations used did not affect the RI, similar to the findings of other studies. There was no statistical difference between the calculated RI and the measured RI in the final product of a pediatric parenteral nutrient solution. This method of quality control can be used by personnel compounding parenteral nutrient solutions to confirm the compounding accuracy of dextrose and amino acid concentrations in the final product, and a sample can be sent to the hospital laboratory for electrolyte verification.

An evaluation of the impact of social interaction skills training for facially disfigured people.

PubMed

Robinson, E; Rumsey, N; Partridge, J

1996-07-01

Facially disfigured people can experience significant psychological problems, commonly relating to difficulties in social interaction. The effect of social interaction skills workshops on the psychological well-being of 64 facially disfigured participants is described. Participants completed the Hospital Anxiety and Depression Scale (HAD), the Social Avoidance and Distress Scale (SAD) and an open-ended questionnaire, before a workshop and at 6 weeks and 6 months follow-up. The high levels of anxiety evident prior to the workshop fell significantly 6 weeks post-workshop (HSD = 1.297, P < 0.01) and remained significantly lower at 6 month follow-up (HSD = 1.563, P < 0.01). Similarly, SAD scores fell significantly at 6 weeks (HSD = 1.89, P < 0.05) and again at 6 month follow-up (HSD = 2.26, P < 0.01). 6 weeks post-workshop, participants reported feeling more confident in the company of strangers (HSD = -1.266, P < 0.01) and about meeting new people (HSD = -1.159, P < 0.01). This increase in confidence was maintained at 6 months (HSD = -1.068 and -1.042 respectively, P < 0.01 for both). 61% of those who experienced problems before the workshop reported a positive change in these situations. The potential of these workshops as an addition to surgical intervention is discussed.

The major epidemic infections: a gift from the Old World to the New?

PubMed

Sessa, R; Palagiano, C; Scifoni, M G; di Pietro, M; Del Piano, M

1999-03-01

With the discovery of the New World, the Europeans flocked to America and with them spread infectious diseases. During long sea voyages the agents of these diseases increased their diffusion capacity in a suitable environment. Lack of hygiene, fatigue and privations, a diet without vitamins and many persons kept in confined spaces were the essential features of this environment. Sick persons, whose health conditions worsened during the journey to the New World, carried the germs of infectious diseases. The first disease to appear in the New World was smallpox described in 1518 in Hispaniola. From there the disease moved rapidly to Mexico in 1520, exterminating most of the Aztecs, Guatemala and to the territories of Incas from 1525-26, killing most of them and the King himself. The second disease, influenza, appeared in La Isabela, a few years later, causing a heavy epidemic between 1558 and 1559. Other diseases followed such as yellow fever and malaria. So Europeans and these invisible and mortal agents caused enormous destruction of American populations. In fact historians have estimated that beginning from early 1500, in only 50 years the population of Peru and Mexico fell from 60 to 10 million; in the latter country, in one century, the populations fell from an initial 10 million to only 2 million.

Do targets matter? A comparison of English and Welsh National Health priorities.

PubMed

Hauck, Katharina; Street, Andrew

2007-03-01

National priorities and performance management regimes in the National Health Services of England and Wales diverged following devolution, most notably with respect to the use of waiting time targets, which have been progressively strengthened in England but were abandoned in Wales in the immediate post-devolution period. We analyse routine data collected over a six-year period from three English and one Welsh hospital trust close to the English-Welsh border to ascertain whether: (a) there is evidence of differential performance over time that relates to the country where the hospital is located; (b) within each hospital, there is evidence that English and Welsh patients faced different waiting times. Over the period the English hospitals recorded increased levels of activity, undertook proportionately more day case activity, and mortality rates fell. Activity levels remained constant in Wales, the proportion of day case activity fell, proportionately more non-elective patients were admitted, and mortality rates rose. There is partial evidence that English patients faced lower waiting times than their Welsh counterparts and were more likely to be admitted within a target waiting period. The stronger performance management regime operating in England appears to have contributed to higher levels of performance in the English hospitals over the period. Copyright (c) 2006 John Wiley & Sons, Ltd.

Hospital Utilization and Universal Health Insurance Coverage: Evidence from the Massachusetts Health Care Reform Act.

PubMed

Cseh, Attila; Koford, Brandon C; Phelps, Ryan T

2015-12-01

The Affordable Care Act is currently in the roll-out phase. To gauge the likely implications of the national policy we analyze how the Massachusetts Health Care Reform Act impacted various hospitalization outcomes in each of the 25 major diagnostic categories (MDC). We utilize a difference-in-difference approach to identify the impact of the Massachusetts reform on insurance coverage and patient outcomes. This identification is achieved using six years of data from the Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project. We report MDC-specific estimates of the impact of the reform on insurance coverage and type as well as length of stay, number of diagnoses, and number of procedures. The requirement of universal insurance coverage increased the probability of being covered by insurance. This increase was in part a result of an increase in the probability of being covered by Medicaid. The percentage of admissions covered by private insurance fell. The number of diagnoses rose as a result of the law in the vast majority of diagnostic categories. Our results related to length of stay suggest that looking at aggregate results hides a wealth of information. The most disparate outcomes were pregnancy related. The length of stay for new-born babies and neonates rose dramatically. In aggregate, this increase serves to mute decreases across other diagnoses. Also, the number of procedures fell within the MDCs for pregnancy and child birth and that for new-born babies and neonates. The Massachusetts Health Care Reform appears to have been effective at increasing insurance take-up rates. These increases may have come at the cost of lower private insurance coverage. The number of diagnoses per admission was increased by the policy across nearly all MDCs. Understanding the changes in length of stay as a result of the Massachusetts reform, and perhaps the Affordable Care Act, requires MDC-specific analysis. It appears that the most important distinction to make is to differentiate care related to new-born babies and neonates from that related to other diagnostic categories.

A five-city trial of a behavioural intervention to reduce sexually transmitted disease/HIV risk among sex workers in China.

PubMed

Rou, Keming; Wu, Zunyou; Sullivan, Sheena G; Li, Fan; Guan, Jihui; Xu, Chen; Liu, Wei; Liu, Dahua; Yin, Yueping

2007-12-01

To explore and evaluate a sexually transmitted disease (STD)/HIV intervention program targeting female sex workers working in entertainment establishments in five different settings in China. A prospective, community-based, pre/post, intervention trial set in entertainment establishments (karaoke bars, massage parlours, dance halls, beauty parlours) where sex workers operate at sites in five provinces of China: Anhui, Beijing, Fujian, Guangxi and Xinjiang. The participants were all sex workers working in targeted entertainment establishments. A Women's Health Clinic was set up near participants' places of work at each site. Clinic-based outreach activities, including awareness-raising, condom promotion, and sexual health care, were developed and delivered to sex workers. Cross-sectional surveys at baseline and post-intervention were used to evaluate changes in condom use with the last three clients, and the prevalence of chlamydia and gonorrhoea. In total, 907 sex workers were surveyed at baseline and 782 at 12 months post-intervention. Outreach teams made 2552 visits to the target entertainment establishments, approached 13,785 female sex workers, and distributed 33,575 copies of education material and 5102 packets of condoms. The rate of condom use with the most recent three clients increased from 55.2% at baseline to 67.5% at 12 months evaluation. The prevalence of gonorrhoea fell from 26% at baseline to 4% after intervention, and that of chlamydia fell from about 41 to 26%. The intervention was effective for increasing condom use and reducing STD among sex workers. The results were used to develop national guidelines on sex worker interventions for nationwide scale up.

Trends in upper gastrointestinal diagnosis over four decades in Lusaka, Zambia: a retrospective analysis of endoscopic findings.

PubMed

Kayamba, Violet; Sinkala, Edford; Mwanamakondo, Stayner; Soko, Rose; Kawimbe, Boniface; Amadi, Beatrice; Zulu, Isaac; Nzaisenga, Jean-Baptiste; Banda, Themba; Mumbwe, Chipasha; Phiri, Evans; Munkonge, Philip; Kelly, Paul

2015-10-06

There a shortage of robust information about profiles of gastrointestinal disease in sub-Saharan Africa. The endoscopy unit of the University Teaching Hospital in Lusaka has been running without interruption since 1977 and this 38-year record is largely intact. We report an analysis of endoscopic findings over this period. Written endoscopy records from 29th September 1977 to 16th December 2014 were recovered, computerised, coded by two experienced endoscopists and analysed. Temporal trends were analysed using tables, graphs, and unconditional logistic regression, with age, sex of patient, decade, and endoscopist as independent variables to adjust for inter-observer variation. Sixteen thousand nine hundred fifty-three records were identified and analysed. Diagnosis of gastric ulcer rose by 22 %, and that of duodenal ulcer fell by 14 % per decade. Endoscopically diagnosed oesophageal cancer increased by 32 % per decade, but gastric cancer rose only in patients under 60 years of age (21 % per decade). Oesophageal varices were the commonest finding in patients presenting with haematemesis, increasing by 14 % per decade in that patient group. Two HIV-related diagnoses, oesophageal candidiasis and Kaposi's sarcoma, rose from almost zero to very high levels in the 1990s but fell substantially after 2005 when anti-retroviral therapy became widely available. This useful dataset suggests that there are important trends in some endoscopic findings over four decades. These trends are not explained by inter-observer variation. Reasons for the divergent trends in incidence of peptic ulceration and apparent trends in diagnosis of upper gastrointestinal cancers merit further exploration.

Quantitative analysis of wet-heat inactivation in bovine spongiform encephalopathy

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

Matsuura, Yuichi; Ishikawa, Yukiko; Bo, Xiao

2013-03-01

Highlights: ► We quantitatively analyzed wet-heat inactivation of the BSE agent. ► Infectivity of the BSE macerate did not survive 155 °C wet-heat treatment. ► Once the sample was dehydrated, infectivity was observed even at 170 °C. ► A quantitative PMCA assay was used to evaluate the degree of BSE inactivation. - Abstract: The bovine spongiform encephalopathy (BSE) agent is resistant to conventional microbial inactivation procedures and thus threatens the safety of cattle products and by-products. To obtain information necessary to assess BSE inactivation, we performed quantitative analysis of wet-heat inactivation of infectivity in BSE-infected cattle spinal cords. Using amore » highly sensitive bioassay, we found that infectivity in BSE cattle macerates fell with increase in temperatures from 133 °C to 150 °C and was not detected in the samples subjected to temperatures above 155 °C. In dry cattle tissues, infectivity was detected even at 170 °C. Thus, BSE infectivity reduces with increase in wet-heat temperatures but is less affected when tissues are dehydrated prior to the wet-heat treatment. The results of the quantitative protein misfolding cyclic amplification assay also demonstrated that the level of the protease-resistant prion protein fell below the bioassay detection limit by wet-heat at 155 °C and higher and could help assess BSE inactivation. Our results show that BSE infectivity is strongly resistant to wet-heat inactivation and that it is necessary to pay attention to BSE decontamination in recycled cattle by-products.« less

Control of sodium excretion in patients with cranial diabetes insipidus maintained on desamino-[8-D-arginine]vasopressin.

PubMed

Sutters, M; Brace, C; Hatfield, E; Whitehurst, A; Lightman, S L; Peart, W S

1993-11-01

1. We have studied the response of six patients with cranial diabetes insipidus and six age-matched control subjects to dietary sodium restriction during constant administration of the synthetic vasopressin analogue desamino-[8-D-arginine]vasopressin. 2. Urine flow increased on the first low salt day in the normal control subjects but not in the patients with cranial diabetes insipidus. Body weight fell 1.35 kg in the control subjects but was constant in the patients with cranial diabetes insipidus. 3. Urinary sodium excretion fell at the same rate in both groups. Diurnal variation of urinary sodium excretion and creatinine clearance was present in the control subjects but not in the patients with cranial diabetes insipidus. 4. Changes in plasma sodium concentration and osmolality were similar. Plasma protein concentration increased more in the control subjects (from 69.1 +/- 1.5 to 73 +/- 1.2 versus from 71.7 +/- 1 to 73.2 +/- 1.1 milligrams). The responses of plasma atrial natriuretic peptide, plasma renin activity and salivary aldosterone concentration were similar between the two groups. Salivary aldosterone concentration levels were consistently higher in the patients with cranial diabetes insipidus. 5. We confirm that the low salt diuresis is triggered by release from the antidiuretic activity of arginine vasopressin. In the patients with cranial diabetes insipidus extracellular fluid osmoregulation appeared to be achieved by the movement of water out of and sodium into the extracellular fluid. 6. Absent posterior pituitary function and hypothalamic disturbances did not alter renal sodium conservation.(ABSTRACT TRUNCATED AT 250 WORDS)

Changing clinical patterns in rheumatoid arthritis management over two decades: sequential observational studies.

PubMed

Mian, Aneela N; Ibrahim, Fowzia; Scott, Ian C; Bahadur, Sardar; Filkova, Maria; Pollard, Louise; Steer, Sophia; Kingsley, Gabrielle H; Scott, David L; Galloway, James

2016-01-27

Rheumatoid arthritis (RA) treatment paradigms have shifted over the last two decades. There has been increasing emphasis on combination disease modifying anti-rheumatic drug (DMARD) therapy, newer biologic therapies have become available and there is a greater focus on achieving remission. We have evaluated the impact of treatment changes on disease activity scores for 28 joints (DAS28) and disability measured by the health assessment questionnaire scores (HAQ). Four cross-sectional surveys between 1996 and 2014 in two adjacent secondary care rheumatology departments in London evaluated changes in drug therapy, DAS28 and its component parts and HAQ scores (in three surveys). Descriptive statistics used means and standard deviations (SD) or medians and interquartile ranges (IQR) to summarise changes. Spearman's correlations assessed relationships between assessments. 1324 patients were studied. Gender ratios, age and mean disease duration were similar across all cohorts. There were temporal increases in the use of any DMARDs (rising from 61% to 87% of patients from 1996-2014), combination DMARDs (1% to 41%) and biologic (0 to 32%). Mean DAS28 fell (5.2 to 3.7), active disease (DAS28 > 5.1) declined (50% to 18%) and DAS28 remission (DAS28 < 2.6) increased (8% to 28%). In contrast HAQ scores were unchanged (1.30 to 1.32) and correlations between DAS28 and HAQ weakened (Spearman's rho fell from 0.56 to 0.44). Treatment intensity has increased over time, disease activity has fallen and there are more remissions. However, these improvements in controlling synovitis have not resulted in comparable reductions in disability measured by HAQ. As a consequence the relationship between DAS28 and HAQ has become weaker over time. Although the reasons for this divergence between disease activity and disability are uncertain, focussing treatment entirely in suppressing synovitis may be insufficient.

Increasing butyrate concentration in the distal colon by accelerating intestinal transit

PubMed Central

Lewis, S; Heaton, K

1997-01-01

Background—Populations at low risk of colonic cancer consume large amounts of fibre and starch and pass acid, bulky stools. One short chain fatty acid (SCFA), butyrate, is the colon's main energy source and inhibits malignant transformation in vitro. 
Aim—To test the hypothesis that altering colonic transit rate alters colonic pH and the SCFA content of the stools. 
Patients—Thirteen healthy adults recruited by advertisement. 
Methods—Volunteers consumed, in turn, wheat bran, senna and loperamide, each for nine days with a two week washout period between study periods, dietary intake being unchanged. Before, and in the last four days of each intervention, whole gut transit time (WGTT), defaecation frequency, stool form, stool β-glucuronidase activity, stool pH, stool SCFA concentrations and intracolonic pH (using a radiotelemetry capsule for continuous monitoring) were assessed. 
Results—WGTT decreased, stool output and frequency increased with wheat bran and senna, vice versa with loperamide. The pH was similar in the distal colon and stool. Distal colonic pH fell with wheat bran and senna and tended to increase with loperamide. Faecal SCFA concentrations, including butyrate, increased with senna and fell with loperamide. With wheat bran the changes were non-significant, possibly because of the short duration of the study. Baseline WGTT correlated with faecal SCFA concentration (r=−0.511, p=0.001), with faecal butyrate (r=−0.577, p<0.001) and with distal colonic pH (r=0.359, p=0.029). 
Conclusion—Bowel transit rate is a determinant of stool SCFA concentration including butyrate and distal colonic pH. This may explain the inter-relations between colonic cancer, dietary fibre intake, stool output, and stool pH. 

 Keywords: bowel cancer; colonic pH; fibre; intestinal transit; pH; short chain fatty acids PMID:9301506

Vascular capacitance and cardiac output in pacing-induced canine models of acute and chronic heart failure.

PubMed

Ogilvie, R I; Zborowska-Sluis, D

1995-11-01

The relationship between stressed and total blood volume, total vascular capacitance, central blood volume, cardiac output (CO), and pulmonary capillary wedge pressure (Ppcw) was investigated in pacing-induced acute and chronic heart failure. Acute heart failure was induced in anesthetized splenectomized dogs by a volume load (20 mL/kg over 10 min) during rapid right ventricular pacing at 250 beats/min (RRVP) for 60 min. Chronic heart failure was induced by continuous RRVP for 2-6 weeks (average 24 +/- 2 days). Total vascular compliance and capacitance were calculated from the mean circulatory filling pressure (Pmcf) during transient circulatory arrest after acetylcholine at three different circulating volumes. Stressed blood volume was calculated as a product of compliance and Pmcf, with the total blood volume measured by a dye dilution. Central blood volume (CBV) and CO were measured by thermodilution. Central (heart and lung) vascular capacitance was estimated from the plot of Ppcw against CBV. Acute volume loading without RRVP increased capacitance and CO, whereas after volume loading with RRVP, capacitance and CO were unaltered from baseline. Chronic RRVP reduced capacitance and CO. All interventions, volume +/- RRVP or chronic RRVP, increased stressed and central blood volumes and Ppcw. Acute or chronic RRVP reduced central vascular capacitance. Cardiac output was increased when stressed and unstressed blood volumes increased proportionately as during volume loading alone. When CO was reduced and Ppcw increased, as during chronic RRVP or acute RRVP plus a volume load, stressed blood volume was increased and unstressed blood volume was decreased. Thus, interventions that reduced CO and increased Ppcw also increased stressed and reduced unstressed blood volume and total vascular capacitance.

The Middlesex Fells Volcanic Complex: A Revised Tectonic Model based on Geochronology, Geochemistry, and Field Data

NASA Astrophysics Data System (ADS)

Hampton, R.

2017-12-01

The Boston Bay area is composed of several terranes originating on the paleocontinent of Avalonia, an arc terrane that accreted onto the continent of Laurentia during the Devonian. Included in these terranes is the Middlesex Fells Volcanic Complex, a bimodal complex composed of both intrusive and extrusive igneous rocks. Initial studies suggested that this volcanic complex formed during a rift event as the Avalonian continent separated from its parent continent 700-900 Ma. New geochemical and geochronological data and field relationships observed in this study establishes a new tectonic model. U-Pb laser ablation zircon data on four samples from different units within the complex reveal that the complex erupted 600 Ma. ICP-MS geochemical analysis of the metabasalt member of the complex yield a trace element signature enriched in Rb, Pb, and Sr and depleted in Th, indicating a subduction component to the melt and interpreted as an eruption into a back-arc basin. The felsic units similarly have an arc related signature when plotted on trace element spider diagrams and tectonic discrimination diagrams. Combined with the field relationships, including an erosional unconformity, stratigraphic and intrusional relationships and large faults from episodic extension events, this data suggests that the Middlesex Fells Volcanic Complex was erupted as part of the arc-sequence of Avalonia and as part of the formation of a back-arc basin well after Avalonia separated from its parent continent. This model presents a significantly younger eruption scenario for the Middlesex Fells Volcanics than previously hypothesized and may be used to study and compare to other volcanics from Avalon terranes in localities such as Newfoundland and the greater Boston area.

Expansion of a regional ST-segment-elevation myocardial infarction system to an entire state.

PubMed

Jollis, James G; Al-Khalidi, Hussein R; Monk, Lisa; Roettig, Mayme L; Garvey, J Lee; Aluko, Akinyele O; Wilson, B Hadley; Applegate, Robert J; Mears, Greg; Corbett, Claire C; Granger, Christopher B

2012-07-10

Despite national guidelines calling for timely coronary artery reperfusion, treatment is often delayed, particularly for patients requiring interhospital transfer. One hundred nineteen North Carolina hospitals developed coordinated plans to rapidly treat patients with ST-segment-elevation myocardial infarction according to presentation: walk-in, ambulance, or hospital transfer. A total of 6841 patients with ST-segment-elevation myocardial infarction (3907 directly presenting to 21 percutaneous coronary intervention hospitals, 2933 transferred from 98 non-percutaneous coronary intervention hospitals) were treated between July 2008 and December 2009 (age, 59 years; 30% women; 19% uninsured; chest pain duration, 91 minutes; shock, 9.2%). The rate of patients not receiving reperfusion fell from 5.4% to 4.0% (P=0.04). Treatment times for hospital transfer patients substantially improved. First-hospital-door-to-device time for hospitals that adopted a "transfer for percutaneous coronary intervention" reperfusion strategy fell from 117 to 103 minutes (P=0.0008), whereas times at hospitals with a mixed strategy of transfer or fibrinolysis fell from 195 to 138 minutes (P=0.002). Median door-to-device times for patients presenting directly to PCI hospitals fell from 64 to 59 minutes (P<0.001). Emergency medical services-transported patients were most likely to reach door-to-device goals, with 91% treated within 90 minutes and 52% being treated with 60 minutes. Patients treated within guideline goals had a mortality of 2.2% compared with 5.7% for those exceeding guideline recommendations (P<0.001). Through extension of regional coordination to an entire state, rapid diagnosis and treatment of ST-segment-elevation myocardial infarction has become an established standard of care independently of healthcare setting or geographic location.

Seasons, Searches, and Intentions: What The Internet Can Tell Us About The Bed Bug (Hemiptera: Cimicidae) Epidemic.

PubMed

Sentana-Lledo, Daniel; Barbu, Corentin M; Ngo, Michelle N; Wu, Yage; Sethuraman, Karthik; Levy, Michael Z

2016-01-01

The common bed bug (Cimex lectularius L.) is once again prevalent in the United States. We investigated temporal patterns in Google search queries for bed bugs and co-occurring terms, and conducted in-person surveys to explore the intentions behind searches that included those terms. Searches for "bed bugs" rose steadily through 2011 and then plateaued, suggesting that the epidemic has reached an equilibrium in the United States. However, queries including terms that survey respondents associated strongly with having bed bugs (e.g., "exterminator," "remedies") continued to climb, while terms more closely associated with informational searches (e.g., "hotels," "about") fell. Respondents' rankings of terms and nonseasonal trends in Google search volume as assessed by a cosinor model were significantly correlated (Kendall's Tau-b P = 0.015). We find no evidence from Google Trends that the bed bug epidemic in the United States has reached equilibrium. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Rockfalls and Avalanches from Little Tahoma Peak on Mount Rainier, Washington

USGS Publications Warehouse

Crandell, Dwight Raymond; Fahnestock, Robert K.

1965-01-01

In December 1963 rockfalls from Little Tahoma Peak on the east side of Mount Rainier volcano fell onto Emmons Glacier and formed avalanches of rock debris that traveled about 4 miles down the glacier and the White River valley. In this distance, the rock debris descended as much as 6,200 feet in altitude. Minor lithologic differences and crosscutting relations indicate that the rockfalls caused at least seven separate avalanches, having an estimated total volume of 14 million cubic yards. The initial rockfall may have been caused by a small steam explosion near the base of Little Tahoma Peak. During movement, some of the avalanches were deflected from one side of the valley to the other. Calculations based on the height to which the avalanches rose on the valley walls suggest that their velocity reached at least 80 or 90 miles per hour. The unusually long distance some of the avalanches were transported is attributed to a cushion of trapped and compressed air at their base, which buoyed them up amid reduced friction.

A comparative analysis of marine mammal tracheas.

PubMed

Moore, Colby; Moore, Michael; Trumble, Stephen; Niemeyer, Misty; Lentell, Betty; McLellan, William; Costidis, Alexander; Fahlman, Andreas

2014-04-01

In 1940, Scholander suggested that stiffened upper airways remained open and received air from highly compressible alveoli during marine mammal diving. There are few data available on the structural and functional adaptations of the marine mammal respiratory system. The aim of this research was to investigate the anatomical (gross) and structural (compliance) characteristics of excised marine mammal tracheas. Here, we defined different types of tracheal structures, categorizing pinniped tracheas by varying degrees of continuity of cartilage (categories 1-4) and cetacean tracheas by varying compliance values (categories 5A and 5B). Some tracheas fell into more than one category along their length; for example, the harbor seal (Phoca vitulina) demonstrated complete rings cranially, and as the trachea progressed caudally, tracheal rings changed morphology. Dolphins and porpoises had less stiff, more compliant spiraling rings while beaked whales had very stiff, less compliant spiraling rings. The pressure-volume (P-V) relationships of isolated tracheas from different species were measured to assess structural differences between species. These findings lend evidence for pressure-induced collapse and re-inflation of lungs, perhaps influencing variability in dive depth or ventilation rates of the species investigated.

Aging and the discrimination of 3-D shape from motion and binocular disparity.

PubMed

Norman, J Farley; Holmin, Jessica S; Beers, Amanda M; Cheeseman, Jacob R; Ronning, Cecilia; Stethen, Angela G; Frost, Adam L

2012-10-01

Two experiments evaluated the ability of younger and older adults to visually discriminate 3-D shape as a function of surface coherence. The coherence was manipulated by embedding the 3-D surfaces in volumetric noise (e.g., for a 55 % coherent surface, 55 % of the stimulus points fell on a 3-D surface, while 45 % of the points occupied random locations within the same volume of space). The 3-D surfaces were defined by static binocular disparity, dynamic binocular disparity, and motion. The results of both experiments demonstrated significant effects of age: Older adults required more coherence (tolerated volumetric noise less) for reliable shape discrimination than did younger adults. Motion-defined and static-binocular-disparity-defined surfaces resulted in similar coherence thresholds. However, performance for dynamic-binocular-disparity-defined surfaces was superior (i.e., the observers' surface coherence thresholds were lowest for these stimuli). The results of both experiments showed that younger and older adults possess considerable tolerance to the disrupting effects of volumetric noise; the observers could reliably discriminate 3-D surface shape even when 45 % of the stimulus points (or more) constituted noise.

Disease progression model in subjects with mild cognitive impairment from the Alzheimer's disease neuroimaging initiative: CSF biomarkers predict population subtypes

PubMed Central

Samtani, Mahesh N; Raghavan, Nandini; Shi, Yingqi; Novak, Gerald; Farnum, Michael; Lobanov, Victor; Schultz, Tim; Yang, Eric; DiBernardo, Allitia; Narayan, Vaibhav A

2013-01-01

AIM The objective is to develop a semi-mechanistic disease progression model for mild cognitive impairment (MCI) subjects. The model aims to describe the longitudinal progression of ADAS-cog scores from the Alzheimer's disease neuroimaging initiative trial that had data from 198 MCI subjects with cerebrospinal fluid (CSF) information who were followed for 3 years. METHOD Various covariates were tested on disease progression parameters and these variables fell into six categories: imaging volumetrics, biochemical, genetic, demographic, cognitive tests and CSF biomarkers. RESULTS CSF biomarkers were associated with both baseline disease score and disease progression rate in subjects with MCI. Baseline disease score was also correlated with atrophy measured using hippocampal volume. Progression rate was also predicted by executive functioning as measured by the Trail B-test. CONCLUSION CSF biomarkers have the ability to discriminate MCI subjects into sub-populations that exhibit markedly different rates of disease progression on the ADAS-cog scale. These biomarkers can therefore be utilized for designing clinical trials enriched with subjects that carry the underlying disease pathology. PMID:22534009

Results of the Alternative Water Processor Test, A Novel Technology for Exploration Wastewater Remediation

NASA Technical Reports Server (NTRS)

Meyer, Caitlin E.; Pensinger, Stuart; Adam, Niklas; Pickering, Karen D.; Barta, Daniel; Shull, Sarah A.; Vega, Leticia M.; Lange, Kevin; Christenson, Dylan; Jackson, W. Andrew

2016-01-01

Biologically-based water recovery systems are a regenerative, low energy alternative to physiochemical processes to reclaim water from wastewater. This report summarizes the results of the Alternative Water Processor (AWP) Integrated Test, conducted from June 2013 until April 2014. The system was comprised of four (4) membrane aerated bioreactors (MABRs) to remove carbon and nitrogen from an exploration mission wastewater and a coupled forward and reverse osmosis system to remove large organic and inorganic salts from the biological system effluent. The system exceeded the overall objectives of the test by recovering 90% of the influent wastewater processed into a near potable state and a 64% reduction of consumables from the current state of the art water recovery system on the International Space Station (ISS). However, the biological system fell short of its test goals, failing to remove 75% and 90% of the influent ammonium and organic carbon, respectively. Despite not meeting its test goals, the BWP demonstrated the feasibility of an attached-growth biological system for simultaneous nitrification and denitrification, an innovative, volume- and consumable-saving design that does not require toxic pretreatment.

HIV enteropathy: crypt stem and transit cell hyperproliferation induces villous atrophy in HIV/Microsporidia-infected jejunal mucosa.

PubMed

Batman, Philip A; Kotler, Donald P; Kapembwa, Moses S; Booth, Dawn; Potten, Christopher S; Orenstein, Jan M; Scally, Andrew J; Griffin, George E

2007-02-19

The study aim was to analyse the kinetics of stem and transit cells in the crypts of jejunal mucosa infected with HIV and Microsporidia. The size of villi, depth of crypts and proliferative activity of transit and stem cells in jejunal mucosa were measured using morphometric techniques. The surface area/volume ratio (S/V) of jejunal biopsies was estimated under light microscopy using a Weibel graticule. Crypt length was measured by counting enterocytes along the crypt side from the base to the villus junction, and the mean crypt length was calculated. The S/V and crypt lengths of the jejunal mucosa of 21 HIV and Microsporidia-infected test cases were compared with 14 control cases. The labelling index in relation to the crypt cell position of 10 of the test cases was analysed compared with 13 control cases. Differences were found in the S/V and crypt length, and there was a negative correlation between S/V and crypt length in test and control cases combined. Cell labelling indices fell into low and high proliferation groups. There were significant differences in labelling indices between low proliferation test cases and controls, between high proliferation test cases and controls, and between high and low proliferation test cases. Villous atrophy induced by HIV and Microsporidia is attributed to crypt cell hyperplasia and the encroachment of crypt cells onto villi. These infections induce crypt hypertrophy by stimulating cell mitosis predominantly in transit cells but also in stem cells. Increased stem cell proliferation occurs only in high proliferation cases.

Influence of Microgravity on Arterial Baroreflex Responses Triggered by Valsalva's Maneuver

NASA Technical Reports Server (NTRS)

Eckberg, Dwain L.; Cox, James F.; Tahvanainen, Kari U. O.; Kuusela, Tom A.; Cooke, William H.; Ames, Jimey E.

2003-01-01

When astronauts return to Earth and stand upright, their heart rates may speed inordinately, their blood pressures may fall, and some returning astronauts may even faint. Since physiological adjustments to standing are mediated importantly by pressure-regulating reflexes (baroreflexes), we studied involuntary (or autonomic) nerve and blood pressure responses of astronauts to four, 15-second periods of 15- and 30-mmHg straining (Valsalva'. maneuver). We measured the electrocardiogram, finger blood pressure, respiration, and muscle sympathetic nerve activity in four healthy male astronauts before and during the 16-day Neurolab Space Shuttle mission. We found that although microgravity provoked major autonomic changes, no astronaut experienced fainting symptoms after the mission. Blood pressure fell more during straining in space than on Earth (the average reduction of systolic pressure with 30-mmHg straining was 49 mmHg during and 27 mmHg before the mission). However, the increases of muscle sympathetic nerve activity that were triggered by straining were also larger in space than on Earth. As a result, the gain of the sympathetic baroreflex, taken as the total sympathetic nerve response divided by the maximum pressure reduction during straining, was the same in space as on Earth. In contrast, heart rate changes, which are mediated by changes of vagus nerve activity, were smaller in space. This and earlier research suggest that exposure to microgravity augments blood pressure and sympathetic adjustments to Valsalva straining and differentially reduces vagal, but not sympathetic baroreflex responsiveness. The changes that we documented can be explained economically as a consequence of the blood volume reduction that occurs in space.

Increasing compliance with low tidal volume ventilation in the ICU with two nudge-based interventions: evaluation through intervention time-series analyses.

PubMed

Bourdeaux, Christopher P; Thomas, Matthew Jc; Gould, Timothy H; Malhotra, Gaurav; Jarvstad, Andreas; Jones, Timothy; Gilchrist, Iain D

2016-05-26

Low tidal volume (TVe) ventilation improves outcomes for ventilated patients, and the majority of clinicians state they implement it. Unfortunately, most patients never receive low TVes. 'Nudges' influence decision-making with subtle cognitive mechanisms and are effective in many contexts. There have been few studies examining their impact on clinical decision-making. We investigated the impact of 2 interventions designed using principles from behavioural science on the deployment of low TVe ventilation in the intensive care unit (ICU). University Hospitals Bristol, a tertiary, mixed medical and surgical ICU with 20 beds, admitting over 1300 patients per year. Data were collected from 2144 consecutive patients receiving controlled mechanical ventilation for more than 1 hour between October 2010 and September 2014. Patients on controlled mechanical ventilation for more than 20 hours were included in the final analysis. (1) Default ventilator settings were adjusted to comply with low TVe targets from the initiation of ventilation unless actively changed by a clinician. (2) A large dashboard was deployed displaying TVes in the format mL/kg ideal body weight (IBW) with alerts when TVes were excessive. TVe in mL/kg IBW. TVe was significantly lower in the defaults group. In the dashboard intervention, TVe fell more quickly and by a greater amount after a TVe of 8 mL/kg IBW was breached when compared with controls. This effect improved in each subsequent year for 3 years. This study has demonstrated that adjustment of default ventilator settings and a dashboard with alerts for excessive TVe can significantly influence clinical decision-making. This offers a promising strategy to improve compliance with low TVe ventilation, and suggests that using insights from behavioural science has potential to improve the translation of evidence into practice. 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/

HCO3(-) secretion by murine nasal submucosal gland serous acinar cells during Ca2+-stimulated fluid secretion.

PubMed

Lee, Robert J; Harlow, Janice M; Limberis, Maria P; Wilson, James M; Foskett, J Kevin

2008-07-01

Airway submucosal glands contribute to airway surface liquid (ASL) composition and volume, both important for lung mucociliary clearance. Serous acini generate most of the fluid secreted by glands, but the molecular mechanisms remain poorly characterized. We previously described cholinergic-regulated fluid secretion driven by Ca(2+)-activated Cl(-) secretion in primary murine serous acinar cells revealed by simultaneous differential interference contrast (DIC) and fluorescence microscopy. Here, we evaluated whether Ca(2+)-activated Cl(-) secretion was accompanied by secretion of HCO(3)(-), possibly a critical ASL component, by simultaneous measurements of intracellular pH (pH(i)) and cell volume. Resting pH(i) was 7.17 +/- 0.01 in physiological medium (5% CO(2)-25 mM HCO(3)(-)). During carbachol (CCh) stimulation, pH(i) fell transiently by 0.08 +/- 0.01 U concomitantly with a fall in Cl(-) content revealed by cell shrinkage, reflecting Cl(-) secretion. A subsequent alkalinization elevated pH(i) to above resting levels until agonist removal, whereupon it returned to prestimulation values. In nominally CO(2)-HCO(3)(-)-free media, the CCh-induced acidification was reduced, whereas the alkalinization remained intact. Elimination of driving forces for conductive HCO(3)(-) efflux by ion substitution or exposure to the Cl(-) channel inhibitor niflumic acid (100 microM) strongly inhibited agonist-induced acidification by >80% and >70%, respectively. The Na(+)/H(+) exchanger (NHE) inhibitor dimethylamiloride (DMA) increased the magnitude (greater than twofold) and duration of the CCh-induced acidification. Gene expression profiling suggested that serous cells express NHE isoforms 1-4 and 6-9, but pharmacological sensitivities demonstrated that alkalinization observed during both CCh stimulation and pH(i) recovery from agonist-induced acidification was primarily due to NHE1, localized to the basolateral membrane. These results suggest that serous acinar cells secrete HCO(3)(-) during Ca(2+)-evoked fluid secretion by a mechanism that involves the apical membrane secretory Cl(-) channel, with HCO(3)(-) secretion sustained by activation of NHE1 in the basolateral membrane. In addition, other Na(+)-dependent pH(i) regulatory mechanisms exist, as evidenced by stronger inhibition of alkalinization in Na(+)-free media.