Defining worthwhile and desired responses to treatment of chronic low back pain.

PubMed

Yelland, Michael J; Schluter, Philip J

2006-01-01

To describe patients' perceptions of minimum worthwhile and desired reductions in pain and disability upon commencing treatment for chronic low back pain. Descriptive study nested within a community-based randomized controlled trial on prolotherapy injections and exercises. A total of 110 participants with chronic low back pain. Interventions. Prior to treatment, participants were asked what minimum percentage reductions in pain and disability would make treatment worthwhile and what percentage reductions in pain and disability they desired with treatment. Minimum worthwhile reductions and desired reductions in pain and disability. Median (inter-quartile range) minimum worthwhile reductions were 25% (20%, 50%) for pain and 35% (20%, 50%) for disability. This compared with desired reductions of 80% (60%, 100%) for pain and 80% (50%, 100%) for disability. The internal consistency between pain and disability responses was high (Spearman's coefficient of association of 0.81 and 0.87, respectively). A significant association existed between minimum worthwhile reductions and desired reductions, but no association was found between these two factors and patient age, gender, pain severity or duration, disability, anxiety, depression, response to treatment, or treatment satisfaction. Inquiring directly about patients' expectations of reductions in pain and in disability is important in establishing realistic treatment goals and setting benchmarks for success. There is a wide disparity between the reductions that they regard as minimum worthwhile and reductions that they hope to achieve. However, there is a high internal consistency between reductions in pain and disability that they expect.

Comparisons of external fixator combined with limited internal fixation and open reduction and internal fixation for Sanders type 2 calcaneal fractures: Finite element analysis and clinical outcome.

PubMed

Pan, M; Chai, L; Xue, F; Ding, L; Tang, G; Lv, B

2017-07-01

The aim of this study was to compare the biomechanical stability and clinical outcome of external fixator combined with limited internal fixation (EFLIF) and open reduction and internal fixation (ORIF) in treating Sanders type 2 calcaneal fractures. Two types of fixation systems were selected for finite element analysis and a dual cohort study. Two fixation systems were simulated to fix the fracture in a finite element model. The relative displacement and stress distribution were analysed and compared. A total of 71 consecutive patients with closed Sanders type 2 calcaneal fractures were enrolled and divided into two groups according to the treatment to which they chose: the EFLIF group and the ORIF group. The radiological and clinical outcomes were evaluated and compared. The relative displacement of the EFLIF was less than that of the plate (0.1363 mm to 0.1808 mm). The highest von Mises stress value on the plate was 33% higher than that on the EFLIF. A normal restoration of the Böhler angle was achieved in both groups. No significant difference was found in the clinical outcome on the American Orthopedic Foot and Ankle Society Ankle Hindfoot Scale, or on the Visual Analogue Scale between the two groups (p > 0.05). Wound complications were more common in those who were treated with ORIF (p = 0.028). Both EFLIF and ORIF systems were tested to 160 N without failure, showing the new construct to be mechanically safe to use. Both EFLIF and ORIF could be effective in treating Sanders type 2 calcaneal fractures. The EFLIF may be superior to ORIF in achieving biomechanical stability and less blood loss, shorter surgical time and hospital stay, and fewer wound complications. Cite this article : M. Pan, L. Chai, F. Xue, L. Ding, G. Tang, B. Lv. Comparisons of external fixator combined with limited internal fixation and open reduction and internal fixation for Sanders type 2 calcaneal fractures: Finite element analysis and clinical outcome. Bone Joint Res 2017;6:433-438. DOI: 10.1302/2046-3758.67.2000640. © 2017 Xue et al.

Displaced intra-articular calcaneal fractures.

PubMed

Bajammal, Sohail; Tornetta, Paul; Sanders, David; Bhandari, Mohit

2005-01-01

Calcaneal fractures comprise 1 to 2 percent of all fractures. Approximately 75% of calcaneal fractures are intra-articular. The management of intra-articular calcaneal fractures remains controversial. Nonoperative treatment options include elevation, ice, early mobilization, and cyclic compression of the plantar arch. Operative treatment options include closed reduction and percutaneous pin fixation, open reduction and internal fixation, and arthrodesis. The effect of operative versus nonoperative treatment has been the focus of several comparative studies. This study was designed to determine the effect of operative treatment compared with nonoperative treatment on the rate of union, complications, and functional outcome after intra-articular calcaneal fracture in adults.

Noise transmission and reduction in turboprop aircraft

NASA Astrophysics Data System (ADS)

MacMartin, Douglas G.; Basso, Gordon L.; Leigh, Barry

1994-09-01

There is considerable interest in reducing the cabin noise environment in turboprop aircraft. Various approaches have been considered at deHaviland Inc., including passive tuned-vibration absorbers, speaker-based noise cancellation, and structural vibration control of the fuselage. These approaches will be discussed briefly. In addition to controlling the noise, a method of predicting the internal noise is required both to evaluate potential noise reduction approaches, and to validate analytical design models. Instead of costly flight tests, or carrying out a ground simulation of the propeller pressure field, a much simpler reciprocal technique can be used. A capacitive scanner is used to measure the fuselage vibration response on a deHaviland Dash-8 fuselage, due to an internal noise source. The approach is validated by comparing this reciprocal noise transmission measurement with the direct measurement. The fuselage noise transmission information is then combined with computer predictions of the propeller pressure field data to predict the internal noise at two points.

SU-E-J-218: Evaluation of CT Images Created Using a New Metal Artifact Reduction Reconstruction Algorithm for Radiation Therapy Treatment Planning

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

Niemkiewicz, J; Palmiotti, A; Miner, M

2014-06-01

Purpose: Metal in patients creates streak artifacts in CT images. When used for radiation treatment planning, these artifacts make it difficult to identify internal structures and affects radiation dose calculations, which depend on HU numbers for inhomogeneity correction. This work quantitatively evaluates a new metal artifact reduction (MAR) CT image reconstruction algorithm (GE Healthcare CT-0521-04.13-EN-US DOC1381483) when metal is present. Methods: A Gammex Model 467 Tissue Characterization phantom was used. CT images were taken of this phantom on a GE Optima580RT CT scanner with and without steel and titanium plugs using both the standard and MAR reconstruction algorithms. HU valuesmore » were compared pixel by pixel to determine if the MAR algorithm altered the HUs of normal tissues when no metal is present, and to evaluate the effect of using the MAR algorithm when metal is present. Also, CT images of patients with internal metal objects using standard and MAR reconstruction algorithms were compared. Results: Comparing the standard and MAR reconstructed images of the phantom without metal, 95.0% of pixels were within ±35 HU and 98.0% of pixels were within ±85 HU. Also, the MAR reconstruction algorithm showed significant improvement in maintaining HUs of non-metallic regions in the images taken of the phantom with metal. HU Gamma analysis (2%, 2mm) of metal vs. non-metal phantom imaging using standard reconstruction resulted in an 84.8% pass rate compared to 96.6% for the MAR reconstructed images. CT images of patients with metal show significant artifact reduction when reconstructed with the MAR algorithm. Conclusion: CT imaging using the MAR reconstruction algorithm provides improved visualization of internal anatomy and more accurate HUs when metal is present compared to the standard reconstruction algorithm. MAR reconstructed CT images provide qualitative and quantitative improvements over current reconstruction algorithms, thus improving radiation treatment planning accuracy.« less

Reductive capacity measurement of waste forms for secondary radioactive wastes

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

Um, Wooyong; Yang, Jung-Seok; Serne, R. Jeffrey

2015-12-01

The reductive capacities of dry ingredients and final solid waste forms were measured using both the Cr(VI) and Ce(IV) methods and the results were compared. Blast furnace slag (BFS), sodium sulfide, SnF2, and SnCl2 used as dry ingredients to make various waste forms showed significantly higher reductive capacities compared to other ingredients regardless of which method was used. Although the BFS exhibits appreciable reductive capacity, it requires greater amounts of time to fully react. In almost all cases, the Ce(IV) method yielded larger reductive capacity values than those from the Cr(VI) method and can be used as an upper boundmore » for the reductive capacity of the dry ingredients and waste forms, because the Ce(IV) method subjects the solids to a strong acid (low pH) condition that dissolves much more of the solids. Because the Cr(VI) method relies on a neutral pH condition, the Cr(VI) method can be used to estimate primarily the waste form surface-related and readily dissolvable reductive capacity. However, the Cr(VI) method does not measure the total reductive capacity of the waste form, the long-term reductive capacity afforded by very slowly dissolving solids, or the reductive capacity present in the interior pores and internal locations of the solids.« less

Variation in the Use of Therapy following Distal Radius Fractures in the United States

PubMed Central

Waljee, Jennifer F.; Zhong, Lin; Shauver, Melissa

2014-01-01

Background: Distal radius fractures (DRFs) are one of the most common injuries among the elderly, resulting in significant expense and disability. The specific aims of this study are (1) to examine rates of therapy following DRFs and (2) to identify those factors that influence utilization of therapy and time span between DRF treatment and therapy among a national cohort of elderly patients. Methods: We examined national use of physical and occupational therapy among all Medicare beneficiaries who suffered DRFs between January 1, 2007, and October 1, 2007, and assessed the effect of treatment, patient-related, and surgeon-related factors on utilization of therapy. Results: Overall, 20.6% of patients received either physical or occupational therapy following DRF. Use of therapy varied by DRF treatment, and patients who underwent open reduction and internal fixation were more likely to receive therapy compared with patients who received closed reduction. Patients who received open reduction and internal fixation were also referred to therapy earlier compared with patients who received external fixation, percutaneous pinning, and closed reduction. Surgeon specialization is associated with greater use of postoperative therapy. Patient predictors of therapy use include younger age, female sex, higher socioeconomic status, and fewer comorbidity conditions. Conclusion: Use of therapy following DRF varies significantly by both patient- and surgeon-related factors. Identifying patients who benefit from postinjury therapy can allow for better resource utilization following these common injuries. PMID:25289323

Assessment of Soft Vane and Metal Foam Engine Noise Reduction Concepts

NASA Technical Reports Server (NTRS)

Jones, Michael G.; Parrott, Tony L.; Sutliff, Daniel L.; Hughes, Chris

2009-01-01

Two innovative fan-noise reduction concepts developed by NASA are presented - soft vanes and over-the-rotor metal foam liners. Design methodologies are described for each concept. Soft vanes are outlet guide vanes with internal, resonant chambers that communicate with the exterior aeroacoustic environment via a porous surface. They provide acoustic absorption via viscous losses generated by interaction of unsteady flows with the internal solid structure. Over-the-rotor metal foam liners installed at or near the fan rotor axial plane provide rotor noise absorption. Both concepts also provide pressure-release surfaces that potentially inhibit noise generation. Several configurations for both concepts are evaluated with a normal incidence tube, and the results are used to guide designs for implementation in two NASA fan rigs. For soft vanes, approximately 1 to 2 dB of broadband inlet and aft-radiated fan noise reduction is achieved. For over-the-rotor metal foam liners, up to 3 dB of fan noise reduction is measured in the low-speed fan rig, but minimal reduction is measured in the high-speed fan rig. These metal foam liner results are compared with a static engine test, in which inlet sound power level reductions up to 5 dB were measured. Brief plans for further development are also provided.

X-ray tomography studies on porosity and particle size distribution in cast in-situ Al-Cu-TiB{sub 2} semi-solid forged composites

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

Mathew, James; Mandal, Animesh

X-ray computed tomography (XCT) was used to characterise the internal microstructure and clustering behaviour of TiB{sub 2} particles in in-situ processed Al-Cu metal matrix composites prepared by casting method. Forging was used in semi-solid state to reduce the porosity and to uniformly disperse TiB{sub 2} particles in the composite. Quantification of porosity and clustering of TiB{sub 2} particles was evaluated for different forging reductions (30% and 50% reductions) and compared with an as-cast sample using XCT. Results show that the porosity content was decreased by about 40% due to semi-solid forging as compared to the as-cast condition. Further, XCT resultsmore » show that the 30% forging reduction resulted in greater uniformity in distribution of TiB{sub 2} particles within the composite compared to as-cast and the 50% forge reduction in semi-solid state. These results show that the application of forging in semi-solid state enhances particle distribution and reduces porosity formation in cast in-situ Al-Cu-TiB{sub 2} metal matrix composites. - Highlights: •XCT was used to visualise 3D internal structure of Al-Cu-TiB{sub 2} MMCs. •Al-Cu-TiB{sub 2} MMC was prepared by casting using flux assisted synthesis method. •TiB{sub 2} particles and porosity size distribution were evaluated. •Results show that forging in semi-solid condition decreases the porosity content and improve the particle dispersion in MMCs.« less

SU-C-BRF-01: Correlation of DIBH Breath Hold Amplitude with Dosimetric Sparing of Heart and Left Anterior Descending Artery in Left Breast Radiotherapy

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

Kim, Taeho; Reardon, Kelli; Sukovich, Kaitlyn

Purpose: A 7.4% increase in major coronary events per 1 Gy increase in mean heart dose has been reported from the population-based analysis of radiation-induced cardiac toxicity following treatment of left sided breast cancer. Deep inhalation breath-hold (DIBH) is clinically utilized to reduce radiation dose to heart and left anterior descending artery (LAD). We investigated the correlation of dose sparing in heart and LAD with internal DIBH amplitude to develop a quantitative predictive model for expected dose to heart and LAD based on internal breath hold amplitude. Methods: A treatment planning study (Prescription Dose = 50 Gy) was performed onmore » 50 left breast cancer patients underwent DIBH whole breast radiotherapy. Two CT datasets, free breathing (FB) and DIBH, were utilized for treatment planning and for determination of the internal anatomy DIBH amplitude (difference between sternum position at FB and DIBH). The heart and LAD dose between FB and DIBH plans was compared and dose to the heart and LAD as a function of breath hold amplitude was determined. Results: Average DIBH amplitude using internal anatomy was 13.9±4.2 mm. The DIBH amplitude-mean dose reduction correlation is 20%/5mm (0.3 Gy/5mm) for the heart and 18%/5mm (1.1 Gy/5mm) for LAD. The correlation with max dose reduction is 12%/5mm (3.8 Gy/5mm) for the heart and 16%/5mm (3.2 Gy/5mm) for LAD. We found that average dose reductions to LAD from 6.0±6.5 Gy to 2.0±1.6 Gy with DIBH (4.0 Gy reduction: -67%, p < 0.001) and average dose reduction to the heart from 1.3±0.7 Gy to 0.7±0.2 Gy with DIBH (0.6 Gy reduction: -46%, p < 0.001). That suggests using DIBH may reduce the risk of the major coronary event for left sided breast cancer patients. Conclusion: The correlation between breath hold amplitude and dosimetric sparing suggests that dose sparing linearly increases with internal DIBH amplitude.« less

Reduction of carbamylated albumin by extended hemodialysis.

PubMed

Perl, Jeffrey; Kalim, Sahir; Wald, Ron; Goldstein, Marc B; Yan, Andrew T; Noori, Nazanin; Kiaii, Mercedeh; Wenger, Julia; Chan, Christopher; Thadhani, Ravi I; Karumanchi, S Ananth; Berg, Anders H

2016-10-01

Introduction Among conventional hemodialysis (CHD) patients, carbamylated serum albumin (C-Alb) correlates with urea and amino acid deficiencies and is associated with mortality. We postulated that reduction of C-Alb by intensive HD may correlate with improvements in protein metabolism and cardiac function. Methods One-year observational study of in-center nocturnal extended hemodialysis (EHD) patients and CHD control subjects. Thirty-three patients receiving 4-hour CHD who converted to 8-hour EHD were enrolled, along with 20 controls on CHD. Serum C-Alb, biochemistries, and cardiac MRI parameters were measured before and after 12 months of EHD. Findings EHD was associated with reduction of C-Alb (average EHD change -3.20 mmol/mol [95% CI -4.23, -2.17] compared to +0.21 [95% CI -1.11, 1.54] change in CHD controls, P < 0.001). EHD was also associated with increases in average essential amino acids (in standardized units) compared to CHD (+0.38 [0.08, 0.68 95%CI]) vs. -0.12 [-0.50, 0.27, 95% CI], P = 0.047). Subjects who reduced C-Alb more than 25% were found to have reduced left ventricular mass, increased urea reduction ratio, and increased serum albumin compared to nonresponders, and % change in C-Alb significantly correlated with % change in left ventricular mass. Discussion EHD was associated with reduction of C-Alb as compared to CHD, and reduction of C-Alb by EHD correlates with reduction of urea. Additional studies are needed to test whether reduction of C-Alb by EHD also correlates with improved clinical outcomes. © 2016 International Society for Hemodialysis.

Internal jugular vein blood flow in multiple sclerosis patients and matched controls.

PubMed

Mancini, Marcello; Lanzillo, Roberta; Liuzzi, Raffaele; Di Donato, Orlando; Ragucci, Monica; Monti, Serena; Salvatore, Elena; Morra, Vincenzo Brescia; Salvatore, Marco

2014-01-01

The aim of the study was to investigate the Internal Jugular Veins dynamics using contrast enhanced ultrasonography in Multiple Sclerosis patients, clinically isolated syndrome patients and healthy controls. Contrast enhanced ultrasonography imaging of the Internal Jugular Vein was performed in fifty-eight patients with Multiple Sclerosis, seven clinically isolated syndrome patients and in thirteen healthy controls. Time-intensity curves were quantified using a semi-automated method and compared with clinical disease outcomes. Wash-out parameters were calculated and six Time-intensity curves shapes were created. Significantly reduction of wash-out rate in Internal Jugular Veins was detected in Multiple Sclerosis patients compared to healthy controls [22.2% (2.7%-65.9%) vs. 33.4% (16.2%-76.8%); P<0.005]. Internal Jugular Vein enhancement was heterogeneous in patients with Multiple Sclerosis and consisted of slow wash-out Time-intensity curves shapes, compared with almost only one type of Time-intensity curves shape in control subjects that correspond to fast enhancement and fast wash-out. The vein wash-in parameters were similar in Multiple Sclerosis group compared with controls. A significant correlation was found between Internal Jugular Vein wash-out and level of disability (R =  -0.402, p<0.05). Contrast enhanced ultrasonography of the Internal Jugular Vein with time intensity curve analysis revealed alterations of cerebral venous outflow in Multiple Sclerosis patients, however mechanisms that determine this condition remains unclear.

Simulation-Based Educational Module Improves Intern and Medical Student Performance of Closed Reduction and Percutaneous Pinning of Pediatric Supracondylar Humeral Fractures.

PubMed

Butler, Bennet A; Lawton, Cort D; Burgess, Jamie; Balderama, Earvin S; Barsness, Katherine A; Sarwark, John F

2017-12-06

Simulation-based education has been integrated into many orthopaedic residency programs to augment traditional teaching models. Here we describe the development and implementation of a combined didactic and simulation-based course for teaching medical students and interns how to properly perform a closed reduction and percutaneous pinning of a pediatric supracondylar humeral fracture. Subjects included in the study were either orthopaedic surgery interns or subinterns at our institution. Subjects all completed a combined didactic and simulation-based course on pediatric supracondylar humeral fractures. The first part of this course was an electronic (e)-learning module that the subjects could complete at home in approximately 40 minutes. The second part of the course was a 20-minute simulation-based skills learning session completed in the simulation center. Subject knowledge of closed reduction and percutaneous pinning of supracondylar humeral fractures was tested using a 30-question, multiple-choice, written test. Surgical skills were tested in the operating room or in a simulated operating room. Subject pre-intervention and post-intervention scores were compared to determine if and how much they had improved. A total of 21 subjects were tested. These subjects significantly improved their scores on both the written, multiple-choice test and skills test after completing the combined didactic and simulation module. Prior to the module, intern and subintern multiple-choice test scores were significantly worse than postgraduate year (PGY)-2 to PGY-5 resident scores (p < 0.01); after completion of the module, there was no significant difference in the multiple-choice test scores. After completing the module, there was no significant difference in skills test scores between interns and PGY-2 to PGY-5 residents. Both tests were validated using the scores obtained from PGY-2 to PGY-5 residents. Our combined didactic and simulation course significantly improved intern and subintern understanding of supracondylar humeral fractures and their ability to perform a closed reduction and percutaneous pinning of these fractures.

Microdensitometer errors: Their effect on photometric data reduction

NASA Technical Reports Server (NTRS)

Bozyan, E. P.; Opal, C. B.

1984-01-01

The performance of densitometers used for photometric data reduction of high dynamic range electrographic plate material is analyzed. Densitometer repeatability is tested by comparing two scans of one plate. Internal densitometer errors are examined by constructing histograms of digitized densities and finding inoperative bits and differential nonlinearity in the analog to digital converter. Such problems appear common to the four densitometers used in this investigation and introduce systematic algorithm dependent errors in the results. Strategies to improve densitometer performance are suggested.

Analysis and Design of International Emission Trading Markets Applying System Dynamics Techniques

NASA Astrophysics Data System (ADS)

Hu, Bo; Pickl, Stefan

2010-11-01

The design and analysis of international emission trading markets is an important actual challenge. Time-discrete models are needed to understand and optimize these procedures. We give an introduction into this scientific area and present actual modeling approaches. Furthermore, we develop a model which is embedded in a holistic problem solution. Measures for energy efficiency are characterized. The economic time-discrete "cap-and-trade" mechanism is influenced by various underlying anticipatory effects. With a systematic dynamic approach the effects can be examined. First numerical results show that fair international emissions trading can only be conducted with the use of protective export duties. Furthermore a comparatively high price which evokes emission reduction inevitably has an inhibiting effect on economic growth according to our model. As it always has been expected it is not without difficulty to find a balance between economic growth and emission reduction. It can be anticipated using our System Dynamics model simulation that substantial changes must be taken place before international emissions trading markets can contribute to global GHG emissions mitigation.

Kinematics of ACL and anterolateral ligament. Part II: anterolateral and anterior cruciate ligament reconstruction.

PubMed

Bonanzinga, T; Signorelli, C; Grassi, A; Lopomo, N; Jain, M; Mosca, M; Iacono, F; Marcacci, M; Zaffagnini, S

2017-04-01

To quantify the influence of Single-Bundle with Lateral Plasty and Double-Bundle reconstruction on static and dynamic laxity in combined ACL- and ALL-deficient knees. The study included 10 fresh-frozen human knees. The joints were analyzed in the following conditions: ACL + ALL resection, Single-Bundle with Lateral Plasty (SBLP) reconstruction, Double-Bundle (DB) reconstruction. Testing parameters were: anterior displacement at 30° and 90° of flexion (AP30, AP90) applying a manual maximum load; internal rotation at 30° and 90° of flexion (INT30, INT90) applying a 5 Nm torque and acceleration and internal rotation Pivot-Shift (PS) test. Kinematics was acquired by a navigation system. Paired Student's t test was conducted to assess statistical difference (P < 0.05). At both 30° and 90° of knee flexion, both SBLP and DB surgical techniques showed a significant reduction (P < 0.01) of anterior-posterior tibial displacement compared to the resection of ACL + ALL. At 30° on knee flexion it is the SBLP that allows the greatest reduction of internal rotational laxity when compared to DB reconstruction. Concerning the PS test, only SBPL procedure had a significant laxity decrease considering the acceleration reached by the joint when compared with the ACL + ALL state (P < 0.01). Clinical relevance of this study is that the internal rotation and PS test were more efficiently controlled by the SBLP technique than by the DB one at both 30° and 90° of flexion in case of ACL + ALL lesions.

Internal Fixation of Complicated Acetabular Fractures Directed by Preoperative Surgery with 3D Printing Models.

PubMed

Liu, Zhao-Jie; Jia, Jian; Zhang, Yin-Guang; Tian, Wei; Jin, Xin; Hu, Yong-Cheng

2017-05-01

The purpose of this article is to evaluate the efficacy and feasibility of preoperative surgery with 3D printing-assisted internal fixation of complicated acetabular fractures. A retrospective case review was performed for the above surgical procedure. A 23-year-old man was confirmed by radiological examination to have fractures of multiple ribs, with hemopneumothorax and communicated fractures of the left acetabulum. According to the Letounel and Judet classification, T-shaped fracture involving posterior wall was diagnosed. A 3D printing pelvic model was established using CT digital imaging and communications in medicine (DICOM) data preoperatively, with which surgical procedures were simulated in preoperative surgery to confirm the sequence of the reduction and fixation as well as the position and length of the implants. Open reduction with internal fixation (ORIF) of the acetabular fracture using modified ilioinguinal and Kocher-Langenbeck approaches was performed 25 days after injury. Plates that had been pre-bent in the preoperative surgery were positioned and screws were tightened in the directions determined in the preoperative planning following satisfactory reduction. The duration of the operation was 170 min and blood loss was 900 mL. Postoperative X-rays showed that anatomical reduction of the acetabulum was achieved and the hip joint was congruous. The position and length of the implants were not different when compared with those in preoperative surgery on 3D printing models. We believe that preoperative surgery using 3D printing models is beneficial for confirming the reduction and fixation sequence, determining the reduction quality, shortening the operative time, minimizing preoperative difficulties, and predicting the prognosis for complicated fractures of acetabulam. © 2017 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

Status of the internal orbit after reduction of zygomaticomaxillary complex fractures.

PubMed

Ellis, Edward; Reddy, Likith

2004-03-01

We sought to determine the status of the internal orbit before and after reduction of zygomaticomaxillary complex (ZMC) fractures when treated without internal orbital reconstruction. We conducted a retrospective study of preoperative and postoperative computed tomography (CT) scans in 65 patients with unilateral ZMC fractures who were treated by reduction of the ZMC complex without internal orbital reconstruction. The size and location of the internal orbital defects, orbital soft tissue displacement, and orbital volume were assessed in the preoperative and postoperative CT scans. Reduction in the ZMC fractures was considered ideal in 58 of the 65 patients. Only minor malpositions occurred in the remaining 7 patients. The size of the internal orbital defects increased slightly with ZMC reduction but the internal orbital fractures were realigned, and few had increases in orbital volume or soft tissue sagging into the sinuses. Examination of follow-up CT scans in several patients taken weeks to months later showed that the residual defects became smaller and that none of these patients had an increase in orbital volume or soft tissue sagging. The preoperative CT scan can be used to assess the amount of internal orbital disruption for purposes of developing a treatment plan in patients with ZMC fractures. When there is minimal or no soft tissue herniation and minimal disruption of the internal orbit, ZMC reduction is adequate treatment.

A novel reductive amination method with isotopic formaldehydes for the preparation of internal standard and standards for determining organosulfur compounds in garlic.

PubMed

Tsai, De-Cheng; Liu, Meng-Chieh; Lin, Yi-Reng; Huang, Mei-Fang; Liang, Shih-Shin

2016-04-15

Garlic (Allium sativum) is a long-cultivated plant that is widely utilized in cooking and has been employed as a medicine for over 4000 years. In this study, we fabricated standards and internal standards (ISs) for absolute quantification via reductive amination with isotopic formaldehydes. Garlic has four abundant organosulfur compounds (OSCs): S-allylcysteine, S-allylcysteinine sulfoxide, S-methylcysteine, and S-ethylcysteine are abundant in garlic. OSCs with primary amine groups were reacted with isotopic formaldehydes to synthesize ISs and standards. Cooked and uncooked garlic samples were compared, and we utilized tandem mass spectrometry equipped with a selective reaction monitoring technique to absolutely quantify the four organosulfur compounds. Copyright © 2015 Elsevier Ltd. All rights reserved.

Fracture of mandibular condyle—to open or not to open: an attempt to settle the controversy.

PubMed

Rastogi, Sanjay; Sharma, Siddharth; Kumar, Sanjeev; Reddy, Mahendra P; Niranjanaprasad Indra, B

2015-06-01

To compare the outcome of the open method versus the closed method of treatment for mandibular condylar fracture. Fifty patients with fractures of the mandibular condylar processes were evaluated. All fractures were displaced, with a degree of deviation between the condylar fragment and the ascending ramus of 10 to 45 degrees (mediolaterally). The patients were randomly divided into two groups, with group 1 receiving open reduction internal fixation and group 2 receiving closed reduction. The follow-up was done over the period of 6 months. Statistically significant improvement was seen in group 1 compared with group 2 in terms of anatomic reduction of the condyle, shortening of the ascending ramus, occlusal status, and deviation on mouth opening. A statistically significant difference was seen in the patients treated with the open method, with improved temporomandibular joint functions and fewer short- and long-term complications compared with those treated with the closed method. Copyright © 2015 Elsevier Inc. All rights reserved.

Low-background gamma-ray spectrometry for the international monitoring system

DOE PAGES

Greenwood, L. R.; Cantaloub, M. G.; Burnett, J. L.; ...

2016-12-28

PNNL has developed two low-background gamma-ray spectrometers in a new shallow underground laboratory, thereby significantly improving its ability to detect low levels of gamma-ray emitting fission or activation products in airborne particulate in samples from the IMS (International Monitoring System). Furthermore, the combination of cosmic veto panels, dry nitrogen gas to reduce radon and low background shielding results in a reduction of the background count rate by about a factor of 100 compared to detectors operating above ground at our laboratory.

Angular-contact ball-bearing internal load estimation algorithm using runtime adaptive relaxation

NASA Astrophysics Data System (ADS)

Medina, H.; Mutu, R.

2017-07-01

An algorithm to estimate internal loads for single-row angular contact ball bearings due to externally applied thrust loads and high-operating speeds is presented. A new runtime adaptive relaxation procedure and blending function is proposed which ensures algorithm stability whilst also reducing the number of iterations needed to reach convergence, leading to an average reduction in computation time in excess of approximately 80%. The model is validated based on a 218 angular contact bearing and shows excellent agreement compared to published results.

Participant Characteristics and the Effects of Two Types of Meditation versus Quiet Sitting.

ERIC Educational Resources Information Center

Fling, Sheila; And Others

1981-01-01

Compared restricted and expanded awareness types of meditation with quiet sitting, and controls. All groups except controls became less anxious, more intuitive, and more internal on locus of control. Found little evidence of differential change across groups. Those practicing more showed more anxiety reduction. (JAC)

Low-dose CT of postoperative pelvic fractures: a comparison with radiography.

PubMed

Eriksson, Thomas; Berg, Per; Olerud, Claes; Shalabi, Adel; Hänni, Mari

2018-01-01

Background Computed tomography (CT) is superior to conventional radiography (CR) for assessing internal fixation of pelvic fractures, but with a higher radiation exposure. Low-dose CT (LDCT) could possibly have a sufficient diagnostic accuracy but with a lower radiation dose. Purpose To compare postoperative diagnostic accuracy of LDCT and CR after open reduction and internal fixation of pelvic fracture. Material and Methods Twenty-one patients were examined with LDCT and CR 0-9 days after surgery. The examinations were reviewed by two musculoskeletal radiologists. Hardware, degree of fracture reduction, image quality, and reviewing time were assessed, and effective radiation dose was calculated. Inter-reader agreement was calculated. Results LDCT was significantly better than CR in determining whether hardware positioning was assessable ( P < 0.001). Acetabular congruence was assessable in all fractured patients with LDCT. In 12 of the 32 assessments with CR of patients with an acetabular fracture, joint congruence was not assessable due to overlapping hardware ( P = 0.001). Image quality was significantly higher for LDCT. Median time to review was 240 s for LDCT compared to 180 s for CR. Effective dose was 0.79 mSv for LDCT compared to 0.32 mSv for CR ( P < 0.001). Conclusion LDCT is more reliable than CR in assessing hardware position and fracture reduction. Joint congruency is sometimes not possible to assess with CR, due to overlapping hardware. The image quality is higher, but also the effective dose, with LDCT than with CR.

Performances of Kevlar and Polyethylene as radiation shielding on-board the International Space Station in high latitude radiation environment.

PubMed

Narici, Livio; Casolino, Marco; Di Fino, Luca; Larosa, Marianna; Picozza, Piergiorgio; Rizzo, Alessandro; Zaconte, Veronica

2017-05-10

Passive radiation shielding is a mandatory element in the design of an integrated solution to mitigate the effects of radiation during long deep space voyages for human exploration. Understanding and exploiting the characteristics of materials suitable for radiation shielding in space flights is, therefore, of primary importance. We present here the results of the first space-test on Kevlar and Polyethylene radiation shielding capabilities including direct measurements of the background baseline (no shield). Measurements are performed on-board of the International Space Station (Columbus modulus) during the ALTEA-shield ESA sponsored program. For the first time the shielding capability of such materials has been tested in a radiation environment similar to the deep-space one, thanks to the feature of the ALTEA system, which allows to select only high latitude orbital tracts of the International Space Station. Polyethylene is widely used for radiation shielding in space and therefore it is an excellent benchmark material to be used in comparative investigations. In this work we show that Kevlar has radiation shielding performances comparable to the Polyethylene ones, reaching a dose rate reduction of 32 ± 2% and a dose equivalent rate reduction of 55 ± 4% (for a shield of 10 g/cm 2 ).

Reduction of secondhand tobacco smoke in public places following national smoke-free legislation in Uruguay.

PubMed

Blanco-Marquizo, Adriana; Goja, Beatriz; Peruga, Armando; Jones, Miranda R; Yuan, Jie; Samet, Jonathan M; Breysse, Patrick N; Navas-Acien, Ana

2010-06-01

Smoke-free legislation eliminating tobacco smoke in all indoor public places and workplaces is the international standard to protect all people from exposure to secondhand smoke. Uruguay was the first country in the Americas and the first middle-income country in the world to enact a comprehensive smoke-free national legislation in March 2006. To compare air nicotine concentrations measured in indoor public places and workplaces in Montevideo, Uruguay before (November 2002) and after (July 2007) the implementation of the national legislation. Air nicotine concentrations were measured for 7-14 days using the same protocol in schools, a hospital, a local government building, an airport and restaurants and bars. A total of 100 and 103 nicotine samples were available in 2002 and 2007, respectively. Median (IQR) air nicotine concentrations in the study samples were 0.75 (0.2-1.54) microg/m(3) in 2002 compared to 0.07 (0.0-0.20) microg/m(3) in 2007. The overall nicotine reduction comparing locations sampled in 2007 to those sampled in 2002 was 91% (95% CI 85% to 94%) after adjustment for differences in room volume and ventilation. The greatest nicotine reduction was observed in schools (97% reduction), followed by the airport (94% reduction), the hospital (89% reduction), the local government building (86% reduction) and restaurants/bars (81% reduction). Exposure to secondhand smoke has decreased greatly in indoor public places and workplaces in Montevideo, Uruguay, after the implementation of a comprehensive national smoke-free legislation. These findings suggest that it is possible to successfully implement smoke-free legislations in low and middle-income countries.

Clinical value of pointwise encoding time reduction with radial acquisition (PETRA) MR sequence in assessing internal derangement of knee.

PubMed

Kim, Sung Kwan; Kim, Donghyun; Lee, Sun Joo; Choo, Hye Jung; Oh, Minkyung; Son, Yohan; Paek, MunYoung

2018-06-01

The purpose was to evaluate the clinical value of PETRA sequence for the diagnosis of internal derangement of the knee. The major structures of the knee in 34 patients were evaluated and compared among conventional MRI findings, PETRA images, and arthroscopic findings. The specificities of PETRA with 2D FSE sequence were higher for meniscal lesions than those obtained when using 2D FSE alone. Using PETRA images along with conventional 2D FSE images can increase the accuracy of assessing internal derangements of the knee and, specifically, meniscal lesions. Copyright © 2018 Elsevier Inc. All rights reserved.

An international comparative family medicine study of the Transition Project data from the Netherlands, Malta and Serbia. Is family medicine an international discipline? Comparing incidence and prevalence rates of reasons for encounter and diagnostic titles of episodes of care across populations.

PubMed

Soler, Jean K; Okkes, Inge; Oskam, Sibo; van Boven, Kees; Zivotic, Predrag; Jevtic, Milan; Dobbs, Frank; Lamberts, Henk

2012-06-01

This is a study of the epidemiology of family medicine (FM) in three practice populations from the Netherlands, Malta and Serbia. Incidence and prevalence rates, especially of reasons for encounter (RfEs) and episode labels, are compared. Participating family doctors (FDs) recorded details of all their patient contacts in an episode of care (EoC) structure using electronic patient records based on the International Classification of Primary Care (ICPC), collecting data on all elements of the doctor-patient encounter. RfEs presented by the patient, all FD interventions and the diagnostic labels (EoCs labels) recorded for each encounter were classified with ICPC (ICPC-2-E in Malta and Serbia and ICPC-1 in the Netherlands). The content of family practice in the three population databases, incidence and prevalence rates of the common top 20 RfEs and EoCs in the three databases are given. Data that are collected with an episode-based model define incidence and prevalence rates much more precisely. Incidence and prevalence rates reflect the content of the doctor-patient encounter in FM but only from a superficial perspective. However, we found evidence of an international FM core content and a local FM content reflected by important similarities in such distributions. FM is a complex discipline, and the reduction of the content of a consultation into one or more medical diagnoses, ignoring the patient's RfE, is a coarse reduction, which lacks power to fully characterize a population's health care needs. In fact, RfE distributions seem to be more consistent between populations than distributions of EoCs are, in many respects.

The international generalisability of evidence for health policy: A cross country comparison of medication adherence following policy change.

PubMed

Sinnott, Sarah-Jo; Whelton, Helen; Franklin, Jessica Myers; Polinski, Jennifer Milan

2017-01-01

Copayments for prescriptions may increase morbidity and mortality via reductions in adherence to medications. Relevant data can inform policy to minimise such unintended effects. We explored the generalisability of evidence for copayments by comparing two international copayment polices, one in Massachusetts and one in Ireland, to assess whether effects on medication adherence were comparable. We used national prescription data for public health insurance programmes in Ireland and Medicaid data in the U.S. New users of oral anti-hypertensive, anti-hyperlipidaemic and diabetic drugs were included (total n=14,259 in U.S. and n=43,843 in Ireland). We examined changes in adherence in intervention and comparator groups in each setting using segmented linear regression with generalised estimating equations. In Massachusetts, a gradual decrease in adherence to anti-hypertensive medications of -1% per month following the policy occurred. In contrast, the response in Ireland was confined to a -2.9% decrease in adherence immediately following the policy, with no further decrease over the 8 month follow-up. Reductions in adherence to oral diabetes drugs were larger in the U.S. group in comparison to the Irish group. No difference in adherence changes between the two settings for anti-hyperlipidaemic drugs occurred. Evidence on cost-sharing for prescription medicines is not 'one size fits all'. Time since policy implementation and structural differences between health systems may influence the differential impact of copayment policies in international settings. Copyright © 2016. Published by Elsevier Ireland Ltd.

Process for Making Carbon-Carbon Turbocharger Housing Unit for Intermittent Combustion Engines

NASA Technical Reports Server (NTRS)

Northam, G. Burton (Inventor); Ransone, Philip O. (Inventor); Rivers, H. Kevin (Inventor)

1999-01-01

An improved. lightweight, turbine housing unit for an intermittent combustion reciprocating internal combustion engine turbocharger is prepared from a lay-up or molding of carbon-carbon composite materials in a single-piece or two-piece process. When compared to conventional steel or cast iron, the use of carbon-carbon composite materials in a turbine housing unit reduces the overall weight of the engine and reduces the heat energy loss used in the turbo-charging process. This reduction in heat energy loss and weight reduction provides for more efficient engine operation.

Carbon-Carbon Turbocharger Housing Unit for Intermittent Combustion Engines

NASA Technical Reports Server (NTRS)

Northam, G. Burton (Inventor); Ransone, Philip O. (Inventor); Rivers, H. Kevin (Inventor)

1998-01-01

An improved, lightweight, turbine housing unit for an intermittent combustion reciprocating internal combustion engine turbocharger is prepared from a lay-up or molding of carbon-carbon composite materials in a single-piece or two-piece process. When compared to conventional steel or cast iron, the use of carbon-carbon composite materials in a turbine housing unit reduces the overall weight of the engine and reduces the heat energy loss used in the turbocharging process. This reduction in heat energy loss and weight reduction provides for more efficient engine operation.

An indigenous method for closed reduction of pediatric mandibular parasymphysis fracture.

PubMed

Kumar, Naresh; Singh, Akhilesh Kumar; Pandey, Arun; Verma, Vishal

2015-01-01

Mandibular fractures in children are very rare as compared to adults due to protected anatomic features of child and less exposure to road traffic accidents. Management becomes complicated due to inherent dynamic nature, instability of mixed dentition and fear of surgery. Conservative management can be done with the help of acrylic cap splints along with circum-mandibular wiring, intermaxillary fixation with eyelet wires, arch wires or open reduction and internal fixation with bio-resorbable plates. Different methods have various pros and cons. The choice of anesthesia is also very crucial sometimes. This case report describes a new method of closed reduction with 18 gauge needle simulated as an arch bar performed under local anaesthesia.

An indigenous method for closed reduction of pediatric mandibular parasymphysis fracture

PubMed Central

Kumar, Naresh; Singh, Akhilesh Kumar; Pandey, Arun; Verma, Vishal

2015-01-01

Mandibular fractures in children are very rare as compared to adults due to protected anatomic features of child and less exposure to road traffic accidents. Management becomes complicated due to inherent dynamic nature, instability of mixed dentition and fear of surgery. Conservative management can be done with the help of acrylic cap splints along with circum-mandibular wiring, intermaxillary fixation with eyelet wires, arch wires or open reduction and internal fixation with bio-resorbable plates. Different methods have various pros and cons. The choice of anesthesia is also very crucial sometimes. This case report describes a new method of closed reduction with 18 gauge needle simulated as an arch bar performed under local anaesthesia. PMID:27390498

Evaluation of Freehand B-Mode and Power-Mode 3D Ultrasound for Visualisation and Grading of Internal Carotid Artery Stenosis.

PubMed

Pelz, Johann Otto; Weinreich, Anna; Karlas, Thomas; Saur, Dorothee

2017-01-01

Currently, colour-coded duplex sonography (2D-CDS) is clinical standard for detection and grading of internal carotid artery stenosis (ICAS). However, unlike angiographic imaging modalities, 2D-CDS assesses ICAS by its hemodynamic effects rather than luminal changes. Aim of this study was to evaluate freehand 3D ultrasound (3DUS) for direct visualisation and quantification of ICAS. Thirty-seven patients with 43 ICAS were examined with 2D-CDS as reference standard and with freehand B-mode respectively power-mode 3DUS. Stenotic value of 3D reconstructed ICAS was calculated as distal diameter respectively distal cross-sectional area (CSA) reduction percentage and compared with 2D-CDS. There was a trend but no significant difference in successful 3D reconstruction of ICAS between B-mode and power mode (examiner 1 {Ex1} 81% versus 93%, examiner 2 {Ex2} 84% versus 88%). Inter-rater agreement was best for power-mode 3DUS and assessment of stenotic value as distal CSA reduction percentage (intraclass correlation coefficient {ICC} 0.90) followed by power-mode 3DUS and distal diameter reduction percentage (ICC 0.81). Inter-rater agreement was poor for B-mode 3DUS (ICC, distal CSA reduction 0.36, distal diameter reduction 0.51). Intra-rater agreement for power-mode 3DUS was good for both measuring methods (ICC, distal CSA reduction 0.88 {Ex1} and 0.78 {Ex2}; ICC, distal diameter reduction 0.83 {Ex1} and 0.76 {Ex2}). In comparison to 2D-CDS inter-method agreement was good and clearly better for power-mode 3DUS (ICC, distal diameter reduction percentage: Ex1 0.85, Ex2 0.78; distal CSA reduction percentage: Ex1 0.63, Ex2 0.57) than for B-mode 3DUS (ICC, distal diameter reduction percentage: Ex1 0.40, Ex2 0.52; distal CSA reduction percentage: Ex1 0.15, Ex2 0.51). Non-invasive power-mode 3DUS is superior to B-mode 3DUS for imaging and quantification of ICAS. Thereby, further studies are warranted which should now compare power-mode 3DUS with the angiographic gold standard imaging modalities for quantification of ICAS, i.e. with CTA or CE-MRA.

78 FR 23738 - Monsanto Company and Forage Genetics International (FGI); Availability of Petition for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-22

... pathway. Suppression of the CCOMT gene expression leads to lower CCOMT protein expression resulting in reduced synthesis of G lignin subunit compared to conventional alfalfa at the same stage of growth. The reduction in G lignin subunit synthesis leads to reduced accumulation of total lignin, measured as acid...

Internal fixators: a safe option for managing distal femur fractures?

PubMed Central

Batista, Bruno Bellaguarda; Salim, Rodrigo; Paccola, Cleber Antonio Jansen; Kfuri, Mauricio

2014-01-01

OBJECTIVE: Evaluate safety and reliability of internal fixator for the treatment of intra-articular and periarticular distal femur fractures. METHODS: Retrospective data evaluation of 28 patients with 29 fractures fixed with internal fixator was performed. There was a predominance of male patients (53.5%), with 52% of open wound fractures, 76% of AO33C type fractures, and a mean follow up of 21.3 months. Time of fracture healing, mechanical axis deviation, rate of infection and postoperative complications were registered. RESULTS: Healing rate was 93% in this sample, with an average time of 5.5 months. Twenty-seven percent of patients ended up with mechanical axis deviation, mostly resulting from poor primary intra-operative reduction. There were two cases of implant loosening; two implant breakage, and three patients presented stiff knee. No case of infection was observed. Healing rate in this study was comparable with current literature; there was a high degree of angular deviation, especially in the coronal plane. CONCLUSION: Internal fixators are a breakthrough in the treatment of knee fractures, but its use does not preclude application of principles of anatomical articular reduction and mechanical axis restoration. Level of Evidence II, Retrospective Study. PMID:25061424

Open reduction and internal fixation versus casting for highly comminuted and intra-articular fractures of the distal radius (ORCHID): protocol for a randomized clinical multi-center trial.

PubMed

Bartl, Christoph; Stengel, Dirk; Bruckner, Thomas; Rossion, Inga; Luntz, Steffen; Seiler, Christoph; Gebhard, Florian

2011-03-22

Fractures of the distal radius represent the most common fracture in elderly patients, and often indicate the onset of symptomatic osteoporosis. A variety of treatment options is available, including closed reduction and plaster casting, K-wire-stabilization, external fixation and open reduction and internal fixation (ORIF) with volar locked plating. The latter is widely promoted by clinicians and hardware manufacturers. Closed reduction and cast stabilization for six weeks is a simple, convenient, and ubiquitously available intervention. In contrast, ORIF requires hospitalization, but allows for functional rehabilitation.Given the lack of randomized controlled trials, it remains unclear whether ORIF leads to better functional outcomes one year after injury than closed reduction and casting. ORCHID (Open reduction and internal fixation versus casting for highly comminuted intra-articular fractures of the distal radius) is a pragmatic, randomized, multi-center, clinical trial with two parallel treatment arms. It is planned to include 504 patients in 15 participating centers throughout Germany over a three-year period. Patients are allocated by a central web-based randomization tool.The primary objective is to determine differences in the Short Form 36 (SF-36) Physical Component Score (PCS) between volar locked plating and closed reduction and casting of intraarticular, comminuted distal radius fractures in patients > 65 years of age one year after the fracture. Secondary outcomes include differences in other SF-36 dimensions, the EuroQol-5D questionnaire, the Disability of the Arm, Shoulder, and Hand (DASH) instrument. Also, the range of motion in the affected wrist, activities of daily living, complications (including secondary ORIF and revision surgery), as well as serious adverse events will be assessed. Data obtained during the trial will be used for later health-economic evaluations. The trial architecture involves a central statistical unit, an independent monitoring institute, and a data safety monitoring board. Following approval by the institutional review boards of all participating centers, conduct and reporting will strictly adhere to national and international rules, regulations, and recommendations (e.g., Good Clinical Practice, data safety laws, and EQUATOR/CONSORT proposals). To our knowledge, ORCHID is the first multicenter RCT designed to assess quality of life and functional outcomes following operative treatment compared to conservative treatment of complex, intra-articular fractures of the distal radius in elderly patients. The results are expected to influence future treatment recommendations and policies on an international level. ISRCTN: ISRCTN76120052 Registration date: 31.07.2008; Randomization of first patient: 15.09.2008.

Performance analysis of a SOFC under direct internal reforming conditions

NASA Astrophysics Data System (ADS)

Janardhanan, Vinod M.; Heuveline, Vincent; Deutschmann, Olaf

This paper presents the performance analysis of a planar solid-oxide fuel cell (SOFC) under direct internal reforming conditions. A detailed solid-oxide fuel cell model is used to study the influences of various operating parameters on cell performance. Significant differences in efficiency and power density are observed for isothermal and adiabatic operational regimes. The influence of air number, specific catalyst area, anode thickness, steam to carbon (s/c) ratio of the inlet fuel, and extend of pre-reforming on cell performance is analyzed. In all cases except for the case of pre-reformed fuel, adiabatic operation results in lower performance compared to isothermal operation. It is further discussed that, though direct internal reforming may lead to cost reduction and increased efficiency by effective utilization of waste heat, the efficiency of the fuel cell itself is higher for pre-reformed fuel compared to non-reformed fuel. Furthermore, criteria for the choice of optimal operating conditions for cell stacks operating under direct internal reforming conditions are discussed.

Computational and human observer image quality evaluation of low dose, knowledge-based CT iterative reconstruction

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

Eck, Brendan L.; Fahmi, Rachid; Miao, Jun

2015-10-15

Purpose: Aims in this study are to (1) develop a computational model observer which reliably tracks the detectability of human observers in low dose computed tomography (CT) images reconstructed with knowledge-based iterative reconstruction (IMR™, Philips Healthcare) and filtered back projection (FBP) across a range of independent variables, (2) use the model to evaluate detectability trends across reconstructions and make predictions of human observer detectability, and (3) perform human observer studies based on model predictions to demonstrate applications of the model in CT imaging. Methods: Detectability (d′) was evaluated in phantom studies across a range of conditions. Images were generated usingmore » a numerical CT simulator. Trained observers performed 4-alternative forced choice (4-AFC) experiments across dose (1.3, 2.7, 4.0 mGy), pin size (4, 6, 8 mm), contrast (0.3%, 0.5%, 1.0%), and reconstruction (FBP, IMR), at fixed display window. A five-channel Laguerre–Gauss channelized Hotelling observer (CHO) was developed with internal noise added to the decision variable and/or to channel outputs, creating six different internal noise models. Semianalytic internal noise computation was tested against Monte Carlo and used to accelerate internal noise parameter optimization. Model parameters were estimated from all experiments at once using maximum likelihood on the probability correct, P{sub C}. Akaike information criterion (AIC) was used to compare models of different orders. The best model was selected according to AIC and used to predict detectability in blended FBP-IMR images, analyze trends in IMR detectability improvements, and predict dose savings with IMR. Predicted dose savings were compared against 4-AFC study results using physical CT phantom images. Results: Detection in IMR was greater than FBP in all tested conditions. The CHO with internal noise proportional to channel output standard deviations, Model-k4, showed the best trade-off between fit and model complexity according to AIC{sub c}. With parameters fixed, the model reasonably predicted detectability of human observers in blended FBP-IMR images. Semianalytic internal noise computation gave results equivalent to Monte Carlo, greatly speeding parameter estimation. Using Model-k4, the authors found an average detectability improvement of 2.7 ± 0.4 times that of FBP. IMR showed greater improvements in detectability with larger signals and relatively consistent improvements across signal contrast and x-ray dose. In the phantom tested, Model-k4 predicted an 82% dose reduction compared to FBP, verified with physical CT scans at 80% reduced dose. Conclusions: IMR improves detectability over FBP and may enable significant dose reductions. A channelized Hotelling observer with internal noise proportional to channel output standard deviation agreed well with human observers across a wide range of variables, even across reconstructions with drastically different image characteristics. Utility of the model observer was demonstrated by predicting the effect of image processing (blending), analyzing detectability improvements with IMR across dose, size, and contrast, and in guiding real CT scan dose reduction experiments. Such a model observer can be applied in optimizing parameters in advanced iterative reconstruction algorithms as well as guiding dose reduction protocols in physical CT experiments.« less

Comparison of muzzle suppression and ear-level hearing protection in firearm use.

PubMed

Branch, Matthew Parker

2011-06-01

To compare noise reduction of commercially available ear-level hearing protection (muffs/inserts) to that of firearm muzzle suppressors. Experimental sound measurements under consistent environmental conditions. None. Muzzle suppressors for 2 pistol and 2 rifle calibers were tested using the Bruel & Kjaer 2209 sound meter and Bruel & Kjaer 4136 microphone calibrated with the Bruel & Kjaer Pistonphone using Military-Standard 1474D placement protocol. Five shots were recorded unsuppressed and 10 shots suppressed under consistent environmental conditions. Sound reduction was then compared with the real-world noise reduction rate of the best available ear-level protectors. All suppressors offered significantly greater noise reduction than ear-level protection, usually greater than 50% better. Noise reduction of all ear-level protectors is unable to reduce the impulse pressure below 140 dB for certain common firearms, an international standard for prevention of sensorineural hearing loss. Modern muzzle-level suppression is vastly superior to ear-level protection and the only available form of suppression capable of making certain sporting arms safe for hearing. The inadequacy of standard hearing protectors with certain common firearms is not recognized by most hearing professionals or their patients and should affect the way hearing professionals counsel patients and the public.

Reduction in Total Cardiovascular Events With Ezetimibe/Simvastatin Post-Acute Coronary Syndrome: The IMPROVE-IT Trial.

PubMed

Murphy, Sabina A; Cannon, Christopher P; Blazing, Michael A; Giugliano, Robert P; White, Jennifer A; Lokhnygina, Yuliya; Reist, Craig; Im, KyungAh; Bohula, Erin A; Isaza, Daniel; Lopez-Sendon, Jose; Dellborg, Mikael; Kher, Uma; Tershakovec, Andrew M; Braunwald, Eugene

2016-02-02

Intensive low-density lipoprotein cholesterol therapy with ezetimibe/simvastatin in IMPROVE-IT (IMProved Reduction of Outcomes: Vytorin Efficacy International Trial) significantly reduced the first primary endpoint (PEP) in patients post-acute coronary syndrome (ACS) compared to placebo/simvastatin. This analysis tested the hypothesis that total events, including those beyond the first event, would also be reduced with ezetimibe/simvastatin therapy. All PEP events (cardiovascular [CV] death, myocardial infarction [MI], stroke, unstable angina [UA] leading to hospitalization, coronary revascularization ≥30 days post-randomization) during a median 6-year follow-up were analyzed in patients randomized to receive ezetimibe/simvastatin or placebo/simvastatin in IMPROVE-IT. Negative binomial regression was used for the primary analysis. Among 18,144 patients, there were 9,545 total PEP events (56% were first events and 44% subsequent events). Total PEP events were significantly reduced by 9% with ezetimibe/simvastatin vs placebo/simvastatin (incidence-rate ratio [RR]: 0.91; 95% confidence interval [CI]: 0.85 to 0.97; p = 0.007), as were the 3 pre-specified secondary composite endpoints and the exploratory composite endpoint of CV death, MI, or stroke (RR: 0.88; 95% CI: 0.81 to 0.96; p = 0.002). The reduction in total events was driven by decreases in total nonfatal MI (RR: 0.87; 95% CI: 0.79 to 0.96; p = 0.004) and total NF stroke (RR: 0.77; 95% CI: 0.65 to 0.93; p = 0.005). Lipid-lowering therapy with ezetimibe plus simvastatin improved clinical outcomes. Reductions in total PEP events, driven by reductions in MI and stroke, more than doubled the number of events prevented compared with examining only the first event. These data support continuation of intensive combination lipid-lowering therapy after an initial CV event. (IMProved Reduction of Outcomes: Vytorin Efficacy International Trial [IMPROVE-IT]; NCT00202878). Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Evaluation of computed tomography post-processing images in postoperative assessment of Lisfranc injuries compared with plain radiographs.

PubMed

Li, Haobo; Chen, Yanxi; Qiang, Minfei; Zhang, Kun; Jiang, Yuchen; Zhang, Yijie; Jia, Xiaoyang

2017-06-14

The objective of this study is to evaluate the value of computed tomography (CT) post-processing images in postoperative assessment of Lisfranc injuries compared with plain radiographs. A total of 79 cases with closed Lisfranc injuries that were treated with conventional open reduction and internal fixation from January 2010 to June 2016 were analyzed. Postoperative assessment was performed by two independent orthopedic surgeons with both plain radiographs and CT post-processing images. Inter- and intra-observer agreement were analyzed by kappa statistics while the differences between the two postoperative imaging assessments were assessed using the χ 2 test (McNemar's test). Significance was assumed when p < 0.05. Inter- and intra-observer agreement of CT post-processing images was much higher than that of plain radiographs. Non-anatomic reduction was more easily identified in patients with injuries of Myerson classifications A, B1, B2, and C1 using CT post-processing images with overall groups (p < 0.05), and poor internal fixation was also more easily detected in patients with injuries of Myerson classifications A, B1, B2, and C2 using CT post-processing images with overall groups (p < 0.05). CT post-processing images can be more reliable than plain radiographs in the postoperative assessment of reduction and implant placement for Lisfranc injuries.

Evaluation of radio-frequency heating in controlling Salmonella enterica in raw shelled almonds.

PubMed

Jeong, Seul-Gi; Baik, Oon-Doo; Kang, Dong-Hyun

2017-08-02

This study was conducted to investigate the efficacy of radio-frequency (RF) heating to reduce Salmonella enterica serovars Enteritidis, Typhimurium, and Senftenberg in raw shelled almonds compared to conventional convective heating, and the effect of RF heating on quality by measuring changes in the color and degree of lipid oxidation. Agar-grown cells of three pathogens were inoculated onto the surface or inside of raw shelled almonds using surface inoculation or the vacuum perfusion method, respectively, and subjected to RF or conventional heating. RF heating for 40s achieved 3.7-, 6.0-, and 5.6-log reductions in surface-inoculated S. Enteritidis, S. Typhimurium, and S. Senftenberg, respectively, whereas the reduction of these pathogens following convective heating for 600s was 1.7, 2.5, and 3.7 log, respectively. RF heating reduced internally inoculated pathogens to below the detection limit (0.7 logCFU/g) after 30s. However, conventional convective heating did not attain comparable reductions even at the end of treatment (600s). Color values, peroxide values, and acid values of RF-treated (40-s treatment) almonds were not significantly (P>0.05) different from those of nontreated samples. These results suggest that RF heating can be applied to control internalized pathogens as well as surface-adhering pathogens in raw almonds without affecting product quality. Copyright © 2017. Published by Elsevier B.V.

Impacts of drug reimbursement reductions on utilization and expenditures of oral antidiabetic medications in Taiwan: an interrupted time series study.

PubMed

Hsu, Jason C; Lu, Christine Y; Wagner, Anita K; Chan, K Arnold; Lai, Mei-Shu; Ross-Degnan, Dennis

2014-06-01

To control increasing pharmaceutical expenditures, Taiwan's National Health Insurance has implemented a series of drug reimbursement price reductions since 2000. This study examined changes in use and expenditures of oral antidiabetic medications following the price regulation in November 2006. We obtained claims data between January 2006 and August 2007 from Taiwan's National Health Insurance Research Database. We categorized oral antidiabetic products as affected by the reimbursement reduction ("targeted") or not ("non-targeted"), by level of relative price reduction, and by manufacturer type (international vs. local manufacturers). We used an interrupted time series design and segmented regression models to estimate changes in monthly per capita prescribing rate, volume, and insurance reimbursement expenditures following the policy. The majority (129/178; 72.5%) of oral antidiabetic products were targeted by this round of price reductions. There was a relative reduction of 9.5% [95%CI: -12.68, -6.32] in total expenditures at ten months post-policy compared to expected rates. For targeted products, there were 2.04% [95%CI: -4.15, 0.07] and 13.26% [95%CI: -16.64, -9.87] relative reductions in prescribing rate and expenditures, respectively, at ten months post-policy. Non-targeted products increased significantly (22% [95%CI: 10.49, 33.51] and 22.85% [95%CI: 11.69, 34.01] relative increases in prescribing rate and expenditures respectively). Larger reimbursement cuts led to greater reductions in prescribing rate, volume, and insurance reimbursement expenditures of targeted products. Prescribing rates of both targeted and non-targeted products by international manufacturers declined after the policy while rates of prescribing non-targeted products by local manufacturers increased. While total government expenditures for oral antidiabetic medications were contained by the policy, our results indicate that prescribing shifted at the margin from targeted to non-targeted products and from international to local products. Further research is warranted to understand how changes in medication use due to price regulation policies affect medication adherence and patient health outcomes. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Overview of harm reduction in prisons in seven European countries.

PubMed

Sander, Gen; Scandurra, Alessio; Kamenska, Anhelita; MacNamara, Catherine; Kalpaki, Christina; Bessa, Cristina Fernandez; Laso, Gemma Nicolás; Parisi, Grazia; Varley, Lorraine; Wolny, Marcin; Moudatsou, Maria; Pontes, Nuno Henrique; Mannix-McNamara, Patricia; Libianchi, Sandro; Antypas, Tzanetos

2016-10-07

While the last decade has seen a growth of support for harm reduction around the world, the availability and accessibility of quality harm reduction services in prison settings is uneven and continues to be inadequate compared to the progress achieved in the broader community. This article provides a brief overview of harm reduction in prisons in Catalonia (Spain), Greece, Ireland, Italy, Latvia, Poland, and Portugal. While each country provides a wide range of harm reduction services in the broader community, the majority fail to provide these same services or the same quality of these services, in prison settings, in clear violation of international human rights law and minimum standards on the treatment of prisoners. Where harm reduction services have been available and easily accessible in prison settings for some time, better health outcomes have been observed, including significantly reduced rates of HIV and HCV incidence. While the provision of harm reduction in each of these countries' prisons varies considerably, certain key themes and lessons can be distilled, including around features of an enabling environment for harm reduction, resource allocation, collection of disaggregated data, and accessibility of services.

Evaluation of possible reasons for the low phenylalanine ammonia lyase activity in cellulose nitrate membrane microcapsules.

PubMed

Habibi-Moini, S; D'mello, A P

2001-03-14

Microencapsulated phenylalanine ammonia lyase (PAL) exhibits a marked reduction in activity compared to the activity of the free enzyme in pH 8.5 Tris buffer. The purpose of this investigation was to evaluate the contribution of incomplete entrapment, the internal environment of cellulose nitrate membrane microcapsules, the diffusional barrier of the membrane and the microcapsulation process to the low activity of encapsulated PAL. A solution of PAL and 10% w/v hemoglobin was incorporated into cellulose nitrate membrane microcapsules. Hemoglobin incorporation was used as a surrogate marker of PAL entrapment. Using 14C hemoglobin, the encapsulation efficiency was determined to be 70% and suggested that incomplete entrapment might partially account for the low activity of encapsulated PAL. The effect of the internal environment of the microcapsule (10% hemoglobin solution) on PAL activity was evaluated by comparing enzyme activity in 10% w/v hemoglobin solution and pH 8.5 Tris buffer. Similar K(M) and V(max) values of PAL in the two media indicated that the internal environment of the microcapsule did not contribute to the reduction in activity of the encapsulated enzyme. The contribution of a membrane diffusional barrier was determined by breaking the putative barrier and measuring PAL activity in intact and broken microcapsules. Similar activity of PAL in these two conditions is evidence for the lack of a diffusional barrier. The effect of the microencapsulation process on PAL activity was evaluated by comparing K(M) and V(max) of free and encapsulated PAL. Similar K(M) values in these two media suggested that the process did not affect the conformation of PAL. However, encapsulated PAL had a 50% lower V(max) value compared to free PAL, which showed that the microencapsulation process deactivated a substantial proportion of the enzyme.

Reducing emissions by using special air filters for internal combustion engines

NASA Astrophysics Data System (ADS)

Birtok-Băneasă, C.; Raţiu, S. A.; Alexa, V.; Crăciun, A. L.; Josan, A.; Budiul-Berghian, A.

2017-05-01

This paper presents the experimental methodology to carry out functional performance tests for an air filter with a particular design of its housing, generically named Super absorbing YXV „Air by Corneliu”, patented and homologated by the Romanian Automotive Registry, to which numerous prizes and medals were awarded at national and international innovations salons. The tests were carried out in the Internal Combustion Engines Laboratory, within the specialization “Road vehicles” belonging to the Faculty of Engineering Hunedoara, component of Politehnica University of Timisoara. The scope of the study is to optimise the air intake into the engine cylinders by reducing the gas-dynamic resistances caused by the air filter and, therefore, to achieve higher energy efficiency, i.e. fuel consumption reduction and engine performance increase. We present some comparative values of various operating parameters of the engine fitted, in the first measuring session, with the original filter, and then with the studied filter. The data collected shows a reduction in fuel consumption by using this type of filter, which leads to lower emissions.

[Isolated Displaced Fracture of the Acromion - Case Report].

PubMed

Krtička, M; Ira, D

2016-01-01

Displaced fractures of the acromion are rare injuries. A 45-year-old lady presented with an isolated acromion fracture (type III, Kuhn classification) resulting from a direct blow to the top of her right shoulder in a fall while skiing. After standard clinical and radiological examination of the shoulder, an open reduction and internal plate fixation using a postero-superior approach to the scapula was performed. Early rehabilitation of the arm and shoulder was initiated. At 50 days after surgery the patient achieved a full range of motion in her right shoulder and muscle strength equal to that of the contralateral extremity. By 12 weeks radiographic union of the fracture was recorded. The final functional outcome after open reduction and internal plate fixation of the fracture was comparable with results reported in the literature and, in comparison with conservative treatment, the risk of non-union was significantly reduced. acromion fracture, scapula, osteosynthesis.

Hierarchy of evidence: differences in results between non-randomized studies and randomized trials in patients with femoral neck fractures.

PubMed

Bhandari, Mohit; Tornetta, Paul; Ellis, Thomas; Audige, Laurent; Sprague, Sheila; Kuo, Jonathann C; Swiontkowski, Marc F

2004-01-01

There have been a number of non-randomized studies comparing arthroplasty with internal fixation in patients with femoral neck fractures. However, there remains considerable debate about whether the results of non-randomized studies are consistent with the results of randomized, controlled trials. Given the economic burden of hip fractures, it remains essential to identify therapies to improve outcomes; however, whether data from non-randomized studies of an intervention should be used to guide patient care remains unclear. We aimed to determine whether the pooled results of mortality and revision surgery among non-randomized studies were similar to those of randomized trials in studies comparing arthroplasty with internal fixation in patients with femoral neck fractures. We conducted a Medline search from 1969 to June 2002, identifying both randomized and non-randomized studies comparing internal fixation with arthroplasty in patients with femoral neck fractures. Additional strategies to identify relevant articles included Cochrane database, SCISEARCH, textbooks, annual meeting programs, and content experts. We abstracted information on mortality and revision rates in each study and compared the pooled results between non-randomized and randomized studies. In addition, we explored potential reasons for dissimilar results between the two study designs. We identified 140 citations that addressed the general topic of comparison of arthroplasty and internal fixation for hip fracture. Of these, 27 studies met the eligibility criteria, 13 of which were non-randomized studies and 14 of which were randomized trials. Mortality data was available in all 13 non-randomized studies ( n=3108 patients) and in 12 randomized studies ( n=1767 patients). Non-randomized studies overestimated the risk of mortality by 40% when compared with the results of randomized trials (relative risk 1.44 vs 1.04, respectively). Information on revision risk was available in 9 non-randomized studies ( n=2764 patients) and all 14 randomized studies ( n=1901 patients). Both estimates from non-randomized and randomized studies revealed a significant reduction in the risk of revision surgery with arthroplasty compared with internal fixation (relative risk 0.38 vs 0.23, respectively). The reduction in the risk of revision surgery with arthroplasty compared with internal fixation was 62% for non-randomized studies and 77% for randomized trials. Thus, non-randomized studies underestimated the relative benefit of arthroplasty by 19.5%. Non-randomized studies with point estimates of relative risk similar to the pooled estimate for randomized trials all controlled for patient age, gender, and fracture displacement in their comparisons of mortality. We were unable to identify reasons for differences in the revision rate results between the study designs. Similar to other reports in medical subspecialties, non-randomized studies provided results dissimilar to randomized trials of arthroplasty vs internal fixation for mortality and revision rates in patients with femoral neck fractures. Investigators should be aware of these discrepancies when evaluating the merits of alternative surgical interventions, especially when both randomized trials and non-randomized comparative studies are available.

Sanders II type calcaneal fractures: a retrospective trial of percutaneous versus operative treatment.

PubMed

Wang, Ye-ming; Wei, Wan-fu

2015-02-01

The purpose of this study was to compare the clinical results of percutaneous reduction and Steinman pin fixation for Sanders II calcaneal fractures with those of operative management through an extensile lateral approach. Fifty-three patients treated with standard open reduction and internal fixation (ORIF group) and 54 patients who had undergone percutaneous reduction and Steinman pin fixation (CRIF group) were retrospectively reviewed. There were no differences between the groups regarding sex, age or fracture classification. Pain and functional outcome were evaluated with a visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) scores. Wound complications and radiological results were compared. At a mean follow-up of 40.4 months (24 to 56 months), there were no differences between the two groups in mean AOFAS score, VAS score or radiologically determined variables. Two cases of deep infection and six of poor wound healing occurred in the ORIF group and none in the CRIF group. Subtalar and ankle motion was found to be better in the CRIF group. Percutaneous reduction and Steinman pin fixation minimizes complications and achieves functional outcomes comparable to those of the open techniques in patients with Sanders II calcaneal fractures. © 2015 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

Internal Structural Design of the Common Research Model Wing Box for Aeroelastic Tailoring

NASA Technical Reports Server (NTRS)

Jutte, Christine V.; Stanford, Bret K.; Wieseman, Carol D.

2015-01-01

This work explores the use of alternative internal structural designs within a full-scale wing box structure for aeroelastic tailoring, with a focus on curvilinear spars, ribs, and stringers. The baseline wing model is a fully-populated, cantilevered wing box structure of the Common Research Model (CRM). Metrics of interest include the wing weight, the onset of dynamic flutter, and the static aeroelastic stresses. Twelve parametric studies alter the number of internal structural members along with their location, orientation, and curvature. Additional evaluation metrics are considered to identify design trends that lead to lighter-weight, aeroelastically stable wing designs. The best designs of the individual studies are compared and discussed, with a focus on weight reduction and flutter resistance. The largest weight reductions were obtained by removing the inner spar, and performance was maintained by shifting stringers forward and/or using curvilinear ribs: 5.6% weight reduction, a 13.9% improvement in flutter speed, but a 3.0% increase in stress levels. Flutter resistance was also maintained using straight-rotated ribs although the design had a 4.2% lower flutter speed than the curved ribs of similar weight and stress levels were higher. For some configurations, the differences between curved and straight ribs were smaller, which provides motivation for future optimization-based studies to fully exploit the trade-offs.

Assessment of energy density usage during 180W lithium triborate laser photoselective vaporization of the prostate for benign prostatic hyperplasia. Is there an optimum amount of kilo-Joules per gram of prostate?

PubMed

Valdivieso, Roger; Meyer, Christian P; Hueber, Pierre-Alain; Meskawi, Malek; Alenizi, Abdullah M; Azizi, Mounsif; Trinh, Quoc-Dien; Misrai, Vincent; Rutman, Matthew; Te, Alexis E; Chughtai, Bilal; Barber, Neil J; Emara, Amr M; Munver, Ravi; Zorn, Kevin C

2016-10-01

To assess the effect of energy density (kJ/mL) applied on adenoma during photoselective vaporization of the prostate (PVP) treatment for benign prostate hyperplasia (BPH) on functional outcomes, prostate-specific antigen (PSA) reduction and complications. After exclusions, a total of 440 patients who underwent GreenLight (tm) laser XPS-180W lithium triborate PVP for the treatment of BPH were retrospectively reviewed. Data were collected from seven different international centres (Canada, USA, UK and France). Patients were stratified into four energy density groups (kJ/mL) according to intra-operative energy delivered and prostate volume as determined by preoperative transrectal ultrasonography (TRUS): group 1: <3 kJ/mL; group 2: 3-5 kJ/mL; group 3: 5-7 kJ/mL; and group 4: ≥7 kJ/mL. Energy density groups were chosen arbitrarily. PSA reduction and functional outcomes (International Prostate Symptom Score, quality of life, post-void residual urine volume, maximum urinary flow rate) were compared at 6, 12 and 24 months. Peri-operative complications and retreatment rates were also compared among the groups. The PSA reduction rates at 24 months after the procedure were 51, 61, 79 and 83% for the energy density groups <3, 3-5, 5-7 and ≥7 kJ/mL, respectively (P ≤ 0.01). This held true after accounting for baseline confounders. Energy density was not associated with higher complication rates, including haematuria, stricture formation, incontinence, refractory urinary retention, urinary tract infection and conversion to transurethral resection of the prostate. Functional outcomes at 2 years of follow-up were equivalent among the groups (P > 0.05 for all) and similar retreatment rates were observed (P = 0.36). Higher energy usage per cc of prostate was associated with a more significant reduction in PSA level (>50%) at 6, 12 and 24 months, suggesting increased vaporization of adenoma tissue; however, this did not translate into differences in functional outcomes at 2-year follow-up. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

Reducing GHG emissions in the United States' transportation sector

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

Das, Sujit; Andress, David A; Nguyen, Tien

Reducing GHG emissions in the U.S. transportation sector requires both the use of highly efficient propulsion systems and low carbon fuels. This study compares reduction potentials that might be achieved in 2060 for several advanced options including biofuels, hybrid electric vehicles (HEV), plug-in hybrid electric vehicles (PHEV), and fuel cell electric vehicles (FCEV), assuming that technical and cost reduction targets are met and necessary fueling infrastructures are built. The study quantifies the extent of the reductions that can be achieved through increasing engine efficiency and transitioning to low-carbon fuels separately. Decarbonizing the fuels is essential for achieving large reductions inmore » GHG emissions, and the study quantifies the reductions that can be achieved over a range of fuel carbon intensities. Although renewables will play a vital role, some combination of coal gasification with carbon capture and sequestration, and/or nuclear energy will likely be needed to enable very large reductions in carbon intensities for hydrogen and electricity. Biomass supply constraints do not allow major carbon emission reductions from biofuels alone; the value of biomass is that it can be combined with other solutions to help achieve significant results. Compared with gasoline, natural gas provides 20% reduction in GHG emissions in internal combustion engines and up to 50% reduction when used as a feedstock for producing hydrogen or electricity, making it a good transition fuel for electric propulsion drive trains. The material in this paper can be useful information to many other countries, including developing countries because of a common factor: the difficulty of finding sustainable, low-carbon, cost-competitive substitutes for petroleum fuels.« less

Increased Retinal Thinning after Combination of Internal Limiting Membrane Peeling and Silicone Oil Endotamponade in Proliferative Diabetic Retinopathy.

PubMed

Kaneko, Hiroki; Matsuura, Toshiyuki; Takayama, Kei; Ito, Yasuki; Iwase, Takeshi; Ueno, Shinji; Nonobe, Norie; Yasuda, Shunsuke; Kataoka, Keiko; Terasaki, Hiroko

2017-01-01

The aim of this study was to examine the change in retinal thickness after vitrectomy with internal limiting membrane (ILM) peeling and/or silicone oil (SO) endotamponade in proliferative diabetic retinopathy (PDR). The actual amount and ratio of changes in the retinal thickness were calculated. Compared to control eyes in the ILM peeling (-)/SO (-) group, the central, superior inner, and temporal inner retina in the ILM peeling (+)/SO (-) group, the central and superior inner retina in the ILM peeling (-)/SO (+) group, and the central, inferior inner, temporal inner, and nasal inner retina in the ILM peeling (+)/SO (+) group showed a significant reduction of the retinal thickness. The central, superior inner, and temporal inner retina in the ILM peeling (+)/SO (-) group, the central and superior inner retina in the ILM peeling (-)/SO (+) group, and the central, superior inner, inferior inner, and temporal inner retina in the ILM peeling (+)/SO (+) group showed a significantly increased reduction rate of the retinal thickness compared to the control group. Macular retinal thinning in PDR was observed after ILM peeling and SO endotamponade, and it was increased by the combination of these 2 factors. © 2017 S. Karger AG, Basel.

Clinical comparison between the retromandibular approach for reduction and fixation and endoscope-assisted open reduction and internal fixation for mandibular condyle fractures.

PubMed

Nogami, Shinnosuke; Takahashi, Tetsu; Yamauchi, Kensuke; Miyamoto, Ikuya; Kaneuji, Takeshi; Yamamoto, Noriaki; Yoshiga, Daigo; Yamashita, Yoshihiro

2012-11-01

Endoscope-assisted transoral open reduction and internal fixation (EAORIF) for mandibular condyle fractures has recently become popular because it is minimally invasive, provides excellent visibility without a large incision, and reduces surgical scarring and the risk of facial nerve injury. This report describes a retrospective clinical study that compared certain clinical parameters, including postoperative function, between the retromandibular (RM) approach and EAORIF. Fifteen patients were treated by the RM approach, whereas 15 underwent EAORIF between July 2006 and September 2011 at Kyushu Dental College, Japan. Clinical indices comprised fracture line, fracture type, number of plates used, surgical duration, bleeding amount, and functional items, including maximum interincisal opening, mandibular deviation on the opening pathway, malocclusion, facial paresthesia, and temporomandibular joint pain and clicking. The areas subjected to either approach included lower neck and subcondyle. The RM approach was used for mandibular condyle fractures with dislocation of a small bone segment. Both groups used 2 plates in all cases. Surgical duration, maximum interincisal opening, mandibular deviation, occlusion, and temporomandibular joint function at 6 months after surgery were comparable between groups. The average bleeding amount in the EAORIF group was greater than in the RM group. One patient from the RM group developed facial paresthesia that persisted for 6 months after surgery. It was concluded that surgical treatment was suitable for fractures of the lower neck and subcondylar. Both procedures showed good results in the functional items of this study.

Effects of a Group Psychoeducation Program on Self-Stigma, Empowerment and Perceived Discrimination of Persons with Schizophrenia.

PubMed

Ivezić, Slađana Štrkalj; Sesar, Marijan Alfonso; Mužinić, Lana

2017-03-01

Self-stigma adversely affects recovery from schizophrenia. Analyses of self stigma reduction programs discovered that few studies have investigated the impact of education about the illness on self-stigma reduction. The objective of this study was to determine whether psychoeducation based on the principles of recovery and empowerment using therapeutic group factors assists in reduction of self-stigma, increased empowerment and reduced perception of discrimination in patients with schizophrenia. 40 patients participated in psychoeducation group program and were compared with a control group of 40 patients placed on the waiting list for the same program. A Solomon four group design was used to control the influence of the pretest. Rating scales were used to measure internalized stigma, empowerment and perception of discrimination. Two-way analysis of variance was used to determine the main effects and interaction between the treatment and pretest. Simple analysis of variance with repeated measures was used to additionally test effect of treatment onself-stigma, empowerment and perceived discrimination. The participants in the psychoeducation group had lower scores on internalized stigma (F(1,76)=8.18; p<0.01) than the patients treated as usual. Analysis also confirmed the same effect with comparing experimental group before and after psychoeducation (F(1,19)=5.52; p<0.05). All participants showed a positive trend for empowerment. Psychoeducation did not influence perception of discrimination. Group psychoeducation decreased the level of self stigma. This intervention can assist in recovery from schizophrenia.

Evaluation of near-infrared pasteurization in controlling Escherichia coli O157:H7, Salmonella enterica serovar typhimurium, and Listeria monocytogenes in ready-to-eat sliced ham.

PubMed

Ha, Jae-Won; Ryu, Sang-Ryeol; Kang, Dong-Hyun

2012-09-01

This study was conducted to investigate the efficacy of near-infrared (NIR) heating to reduce Salmonella enterica serovar Typhimurium, Escherichia coli O157:H7, and Listeria monocytogenes in ready-to-eat (RTE) sliced ham compared to conventional convective heating, and the effect of NIR heating on quality was determined by measuring the color and texture change. A cocktail of three pathogens was inoculated on the exposed or protected surfaces of ham slices, followed by NIR or conventional heating at 1.8 kW. NIR heating for 50 s achieved 4.1-, 4.19-, and 3.38-log reductions in surface-inoculated S. Typhimurium, E. coli O157:H7, and L. monocytogenes, respectively, whereas convective heating needed 180 s to attain comparable reductions for each pathogen. There were no statistically significant (P > 0.05) differences in reduction between surface- and internally inoculated pathogens at the end of NIR treatment (50 s). However, when treated with conventional convective heating, significant (P < 0.05) differences were observed at the final stages of the treatment (150 and 180 s). Color values and texture parameters of NIR-treated (50-s treatment) ham slices were not significantly (P > 0.05) different from those of nontreated samples. These results suggest that NIR heating can be applied to control internalized pathogens as well as surface-adhering pathogens in RTE sliced meats without affecting product quality.

Evaluation of Near-Infrared Pasteurization in Controlling Escherichia coli O157:H7, Salmonella enterica Serovar Typhimurium, and Listeria monocytogenes in Ready-To-Eat Sliced Ham

PubMed Central

Ha, Jae-Won; Ryu, Sang-Ryeol

2012-01-01

This study was conducted to investigate the efficacy of near-infrared (NIR) heating to reduce Salmonella enterica serovar Typhimurium, Escherichia coli O157:H7, and Listeria monocytogenes in ready-to-eat (RTE) sliced ham compared to conventional convective heating, and the effect of NIR heating on quality was determined by measuring the color and texture change. A cocktail of three pathogens was inoculated on the exposed or protected surfaces of ham slices, followed by NIR or conventional heating at 1.8 kW. NIR heating for 50 s achieved 4.1-, 4.19-, and 3.38-log reductions in surface-inoculated S. Typhimurium, E. coli O157:H7, and L. monocytogenes, respectively, whereas convective heating needed 180 s to attain comparable reductions for each pathogen. There were no statistically significant (P > 0.05) differences in reduction between surface- and internally inoculated pathogens at the end of NIR treatment (50 s). However, when treated with conventional convective heating, significant (P < 0.05) differences were observed at the final stages of the treatment (150 and 180 s). Color values and texture parameters of NIR-treated (50-s treatment) ham slices were not significantly (P > 0.05) different from those of nontreated samples. These results suggest that NIR heating can be applied to control internalized pathogens as well as surface-adhering pathogens in RTE sliced meats without affecting product quality. PMID:22773635

Phosphate-binding efficacy of crushed vs. chewed lanthanum carbonate in hemodialysis patients.

PubMed

How, Priscilla P; Anattiwong, Prathana; Mason, Darius L; Arruda, Jose A; Lau, Alan H

2011-01-01

Lanthanum carbonate, a chewable noncalcium-containing phosphorus (P) binder, is useful for treating secondary hyperparathyroidism in patients who have hypercalcemia and cannot swallow whole tablets. However, some patients cannot chew tablets or prefer to crush and mix them with food. This study was conducted to determine the P-binding efficacy of crushed lanthanum and compare it with chewed lanthanum in hemodialysis (HD) patients. After a 1-week washout period, 11 hemodialysis patients (7 men, 4 women) were randomized to receive, in a crossover fashion, lanthanum 1000 mg 3 times daily chewed with meals and lanthanum 1000 mg 3 times daily crushed into a fine powder, mixed with applesauce and taken with meals, for 4 weeks each. Serum P was measured at the end of each washout (baseline) and weekly during treatment. Changes in serum P from baseline for crushed lanthanum were compared with chewed lanthanum using paired sample t test. Administration of crushed lanthanum resulted in a significant reduction in serum P from baseline (P reduction [mg/dL] for crushed lanthanum in week 1: 2.1 ± 0.4, week 2: 1.7 ± 0.5, week 3: 1.7 ± 0.5, week 4: 1.7 ± 0.4, P<0.05). No statistically significant differences were observed in serum P reduction from baseline and serum P attained during treatment with crushed when compared with chewed lanthanum. Crushed lanthanum is effective in reducing serum P and have similar P-binding efficacy to chewed lanthanum. Crushing lanthanum and mixing it with food can thus be an option for patients who are unable to chew or swallow whole tablets. © 2010 The Authors. Hemodialysis International © 2010 International Society for Hemodialysis.

Posterior internal fixation plus vertebral bone implantation under navigational aid for thoracolumbar fracture treatment

PubMed Central

ZHOU, WEI; KONG, WEIQING; ZHAO, BIZHEN; FU, YISHAN; ZHANG, TAO; XU, JIANGUANG

2013-01-01

The aim of this study was to investigate the method of posterior thoracolumbar vertebral pedicle screw reduction and fixation combined with vertebral bone implantation via the affected vertebral body under navigational aid for the treatment of thoracolumbar fractures. The efficacy of the procedure was also measured. Between June 2005 and March 2011, posterior thoracolumbar vertebral pedicle screw reduction and fixation plus artificial bone implantation via the affected vertebral pedicle under navigational aid was used to treat 30 patients with thoracolumbar fractures, including 18 males and 12 females, ranging in age from 21 to 57 years. Compared with the values prior to surgery, intraspinal occupation, vertebral height ratio and Cobb angle at the follow-up were significantly improved. At the long-term follow-up, the postoperative Cobb angle loss was <1° and the anterior vertebral body height loss was <2 mm. Posterior thoracolumbar vertebral pedicle screw reduction and fixation combined with vertebral bone implantation via the affected vertebral body under navigational aid may increase the accuracy and safety of surgery, and it is an ideal method of internal implantation. Bone implantation via the affected vertebral body may increase vertebral stability. PMID:23935737

Beating the Standard Sensitivity-Bandwidth Limit of Cavity-Enhanced Interferometers with Internal Squeezed-Light Generation

NASA Astrophysics Data System (ADS)

Korobko, M.; Kleybolte, L.; Ast, S.; Miao, H.; Chen, Y.; Schnabel, R.

2017-04-01

The shot-noise limited peak sensitivity of cavity-enhanced interferometric measurement devices, such as gravitational-wave detectors, can be improved by increasing the cavity finesse, even when comparing fixed intracavity light powers. For a fixed light power inside the detector, this comes at the price of a proportional reduction in the detection bandwidth. High sensitivity over a large span of signal frequencies, however, is essential for astronomical observations. It is possible to overcome this standard sensitivity-bandwidth limit using nonclassical correlations in the light field. Here, we investigate the internal squeezing approach, where the parametric amplification process creates a nonclassical correlation directly inside the interferometer cavity. We theoretically analyze the limits of the approach and measure 36% increase in the sensitivity-bandwidth product compared to the classical case. To our knowledge, this is the first experimental demonstration of an improvement in the sensitivity-bandwidth product using internal squeezing, opening the way for a new class of optomechanical force sensing devices.

Filipin-dependent Inhibition of Cholera Toxin: Evidence for Toxin Internalization and Activation through Caveolae-like Domains

PubMed Central

Orlandi, Palmer A.; Fishman, Peter H.

1998-01-01

The mechanism by which cholera toxin (CT) is internalized from the plasma membrane before its intracellular reduction and subsequent activation of adenylyl cyclase is not well understood. Ganglioside GM1, the receptor for CT, is predominantly clustered in detergent-insoluble glycolipid rafts and in caveolae, noncoated, cholesterol-rich invaginations on the plasma membrane. In this study, we used filipin, a sterol-binding agent that disrupts caveolae and caveolae-like structures, to explore their role in the internalization and activation of CT in CaCo-2 human intestinal epithelial cells. When toxin internalization was quantified, only 33% of surface-bound toxin was internalized by filipin-treated cells within 1 h compared with 79% in untreated cells. However, CT activation as determined by its reduction to form the A1 peptide and CT activity as measured by cyclic AMP accumulation were inhibited in filipin-treated cells. Another sterol-binding agent, 2-hydroxy-β-cyclodextrin, gave comparable results. The cationic amphiphilic drug chlorpromazine, an inhibitor of clathrin-dependent, receptor-mediated endocytosis, however, affected neither CT internalization, activation, nor activity in contrast to its inhibitory effects on diphtheria toxin cytotoxicity. As filipin did not inhibit the latter, the two drugs appeared to distinguish between caveolae- and coated pit–mediated processes. In addition to its effects in CaCo-2 cells that express low levels of caveolin, filipin also inhibited CT activity in human epidermoid carcinoma A431 and Jurkat T lymphoma cells that are, respectively, rich in or lack caveolin. Thus, filipin inhibition correlated more closely with alterations in the biochemical characteristics of CT-bound membranes due to the interactions of filipin with cholesterol rather than with the expressed levels of caveolin and caveolar structure. Our results indicated that the internalization and activation of CT was dependent on and mediated through cholesterol- and glycolipid-rich microdomains at the plasma membrane rather than through a specific morphological structure and that these glycolipid microdomains have the necessary components required to mediate endocytosis. PMID:9585410

Our hearts and minds--what would it take for Australia to become the healthiest country in the world?

PubMed

Ring, Ian T; O'Brien, John F

2007-10-15

To highlight recent reductions in mortality rates in Australia and identify conditions and population groups with the greatest potential for further reduction in mortality rates. International benchmarking and intranational comparisons of mortality rates were used to identify areas with the greatest potential for improvement. Latest data from Organisation for Economic Cooperation and Development (OECD) countries confirm that, while Japan's death rates remain the lowest in the world, Australia's are decreasing rapidly and we now rival Switzerland for second overall ranking. When the contributions of specific conditions are compared, the areas with the greatest potential for reductions are circulatory diseases (especially ischaemic heart disease); suicide; injury and violence; smoking-related conditions; and cancers amenable to prevention/early detection. Intranational comparisons show considerable scope for reduction in inequalities, especially those between Aboriginal and Torres Strait Islander peoples and other Australians, between males and females, and between low and high socioeconomic groups. These conditions and inequalities are highly interrelated, as differentials in health status are often mediated through broader societal inequalities. Australia should aim to become the country with the lowest mortality rate in the world. This could realistically be achieved by benchmarking performance nationally and internationally, applying current knowledge and available interventions, matching policies with funding, and implementing systemic national programs and activities to promote health and prevent "illth".

Physical Covering for Control of Escherichia coli O157:H7 and Salmonella spp. in Static and Windrow Composting Processes

PubMed Central

Yossa, Irene; Macarisin, Dumitru; Millner, Patricia

2015-01-01

This study investigated the effect of a 30-cm covering of finished compost (FC) on survival of Escherichia coli O157:H7 and Salmonella spp. in active static and windrow composting systems. Feedstocks inoculated with E. coli O157:H7 (7.41 log CFU/g) and Salmonella (6.46 log CFU/g) were placed in biosentry tubes (7.5-cm diameter, 30-cm height) at three locations: (i and ii) two opposing sides at the interface between the FC cover layer (where present) and the feedstock material (each positioned approximately 10 cm below the pile's surface) and (iii) an internal location (top) (approximately 30 cm below the surface). On specific sampling days, surviving populations of inoculated E. coli O157:H7 and Salmonella, generic E. coli, and coliforms in compost samples were determined. Salmonella spp. were reduced significantly within 24 h in windrow piles and were below the detection limit after 3 and 7 days at internal locations of windrow and static piles containing FC covering, respectively. Likewise, E. coli O157:H7 was undetectable after 1 day in windrow piles covered with finished compost. Use of FC as a covering layer significantly increased the number of days that temperatures in the windrows remained ≥55°C at all locations and in static piles at internal locations. These time-temperature exposures resulted in rapid reduction of inoculated pathogens, and the rate of bacterial reduction was rapid in windrow piles. The sample location significantly influenced the survival of these pathogens at internal locations compared to that at interface locations of piles. Finished compost covering of compost piles aids in the reduction of pathogens during the composting process. PMID:25576620

Primary Retrograde Tibiotalocalcaneal Nailing For Fragility Ankle Fractures.

PubMed

Taylor, Benjamin C; Hansen, Dane C; Harrison, Ryan; Lucas, Douglas E; Degenova, Daniel

2016-01-01

Ankle fragility fractures are difficult to treat due to poor bone quality and soft tissues as well as the near ubiquitous presence of comorbidities including diabetes mellitus and peripheral neuropathy. Conventional open reduction and internal fixation in this population has been shown to lead to a significant rate of complications. Given the high rate of complications with contemporary fixation methods, the present study aims to critically evaluate the use of acute hindfoot nailing as a percutaneous fixation technique for high-risk ankle fragility fractures. In this study, we retrospectively evaluated 31 patients treated with primary retrograde tibiotalocalcaneal nail without joint preparation for a mean of 13.6 months postoperatively from an urban Level I trauma center during the years 2006-2012. Overall, there were two superficial infections (6.5%) and three deep infections (9.7%) in the series. There were 28 (90.3%) patients that went on to radiographic union at a mean of 22.2 weeks with maintenance of foot and ankle alignment. There were three cases of asymptomatic screw breakage observed at a mean of 18.3 months postoperatively, which were all treated conservatively.. This study shows that retrograde hindfoot nailing is an acceptable treatment option for treatment of ankle fragility fractures. Hindfoot nailing allows early weightbearing, limited soft tissue injury, and a relatively low rate of complications, all of which are advantages to conventional open reduction internal fixation techniques. Given these findings, larger prospective randomized trials comparing this treatment with conventional open reduction internal fixation techniques are warranted.

Clinical study on the unloading effect of hip bracing on gait in patients with hip osteoarthritis.

PubMed

Nérot, Agathe; Nicholls, Micah

2017-04-01

Internal hip abduction moment is a major indicator for hip loading. A new hip bracing concept was designed to unload the cartilaginous area in hip osteoarthritis via an abduction and external rotation force intended to alter the weight bearing area and reduce compression through the joint. To assess the effect of a novel brace on hip rotation in the transverse and coronal planes and on the hip abduction moment. Repeated measures. Gait analysis was performed on 14 subjects with unilateral symptomatic hip osteoarthritis. Pain, joint motion, moments and vertical ground reaction force were compared between the braced and the unbraced (control), randomly assigned, conditions. Nine participants felt an immediate reduction in pain while walking with the hip brace. Peak hip abduction moment significantly decreased on the osteoarthritis side ( p = 0.017). Peak hip adduction ( p = 0.004) and internal rotation ( p = 0.0007) angles significantly decreased at stance with the brace. Wearing the brace would appear to reduce the compressive joint reaction force at the femuroacetabular interface as indicated by a reduction in internal hip abduction moment along with immediate pain reduction in nine participants. Further long-term studies are warranted. Clinical relevance The brace rotates the hip in the transverse and coronal planes, possibly resulting in a decrease in load through the diseased area of cartilage. In some patients, an immediate decrease in pain was experienced. The brace offers an alternative solution for hip osteoarthritis patients not ready for a hip replacement.

Internal ecosystem feedbacks enhance nitrogen-fixing cyanobacteria blooms and complicate management in the Baltic Sea.

PubMed

Vahtera, Emil; Conley, Daniel J; Gustafsson, Bo G; Kuosa, Harri; Pitkänen, Heikki; Savchuk, Oleg P; Tamminen, Timo; Viitasalo, Markku; Voss, Maren; Wasmund, Norbert; Wulff, Fredrik

2007-04-01

Eutrophication of the Baltic Sea has potentially increased the frequency and magnitude of cyanobacteria blooms. Eutrophication leads to increased sedimentation of organic material, increasing the extent of anoxic bottoms and subsequently increasing the internal phosphorus loading. In addition, the hypoxic water volume displays a negative relationship with the total dissolved inorganic nitrogen pool, suggesting greater overall nitrogen removal with increased hypoxia. Enhanced internal loading of phosphorus and the removal of dissolved inorganic nitrogen leads to lower nitrogen to phosphorus ratios, which are one of the main factors promoting nitrogenfixing cyanobacteria blooms. Because cyanobacteria blooms in the open waters of the Baltic Sea seem to be strongly regulated by internal processes, the effects of external nutrient reductions are scale-dependent. During longer time scales, reductions in external phosphorus load may reduce cyanobacteria blooms; however, on shorter time scales the internal phosphorus loading can counteract external phosphorus reductions. The coupled processes inducing internal loading, nitrogen removal, and the prevalence of nitrogen-fixing cyanobacteria can qualitatively be described as a potentially self-sustaining "vicious circle." To effectively reduce cyanobacteria blooms and overall signs of eutrophication, reductions in both nitrogen and phosphorus external loads appear essential.

Internal combustion engine run on biogas is a potential solution to meet Indonesia emission target

NASA Astrophysics Data System (ADS)

Ambarita, Himsar

2017-09-01

Indonesia has released two different Greenhouse Gas (GHG) emissions reduction targets. The first target, released in 2009, is reduction GHG emissions 26% from Business-as-Usual (BAU) level using own budget and up 41% if supported international aids by 2020. The second target is reduction 29% and 41% from BAU by 2030 using own budget and with international support, respectively. In this paper, the BAU emissions and emissions reduction target of these two targets are elaborated. In addition, the characteristics of emissions from transportation sector are discussed. One of the potential mitigation actions is switching fuel in transportation sector. The results the most promising mitigation action in the transportation is switching oil fuel with biofuel. The Government of Indonesia (GoI) focuses on using biodiesel and bioethanol to run internal combustion engine in transportation sector and biogas is aimed to fuel power plant unit. However, there is very limited of success stories on using biogas in the power plant. The barriers and challenges will be discussed here. It is suggested to run internal combustion engine with biogas.

Evaluation of the Efficacy of Disinfectant Footmats for the Reduction of Bacterial Contamination on Footwear in a Large Animal Veterinary Hospital.

PubMed

Hornig, K J; Burgess, B A; Saklou, N T; Johnson, V; Malmlov, A; Van Metre, D C; Morley, P S; Byers, S R

2016-11-01

Infection control is critical to providing high-quality patient care. Many veterinary teaching hospitals (VTHs) utilize footbaths or footmats at entrances and key control points throughout the facility to decrease trafficking of pathogenic microorganism on contaminated footwear. To compare efficacy of 4 disinfectants used in footmats for decreasing bacterial contamination of footwear in a large animal hospital. A single adult dairy cow was housed in a stall for 4 days to facilitate stall contamination with fecal material. Overboots were experimentally contaminated with organic material in a standardized manner. Each boot was randomly assigned to 1 of 5 treatments (no treatment, or exposure to 1 of 4 disinfectants: an accelerated peroxygen [AHP], a peroxygen [VIRKON], a quaternary ammonium [QUAT], and a phenolic disinfectant [PHENOLIC]) by stepping on a soaked footmat and collecting samples from boot soles. Generalized linear modeling was used to analyze differences in bacterial counts. Reductions in colony-forming units (CFUs) on treated boots ranged from no detectable reduction to 0.45 log 10 and varied by disinfectant. Percentage reductions in total bacterial counts generally were larger (albeit still modest) for AHP and QUAT disinfectants (range 37-45%) and smallest for the PHENOLIC (no detectable reduction). In general, use of disinfectant footmats was associated with significant reductions in viable bacteria on overboots-albeit with variable efficacy. Footmats may be useful adjuncts to cleaning and disinfection programs for decreasing trafficking of microorganisms throughout VTHs but should not be considered as a sole prevention method. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

A retrospective analysis of laparoscopic partial nephrectomy with segmental renal artery clamping and factors that predict postoperative renal function.

PubMed

Li, Pu; Qin, Chao; Cao, Qiang; Li, Jie; Lv, Qiang; Meng, Xiaoxin; Ju, Xiaobing; Tang, Lijun; Shao, Pengfei

2016-10-01

To evaluate the feasibility and efficiency of laparoscopic partial nephrectomy (LPN) with segmental renal artery clamping, and to analyse the factors affecting postoperative renal function. We conducted a retrospective analysis of 466 consecutive patients undergoing LPN using main renal artery clamping (group A, n = 152) or segmental artery clamping (group B, n = 314) between September 2007 and July 2015 in our department. Blood loss, operating time, warm ischaemia time (WIT) and renal function were compared between groups. Univariable and multivariable linear regression analyses were applied to assess the correlations of selected variables with postoperative glomerular filtration rate (GFR) reduction. Volumetric data and estimated GFR of a subset of 60 patients in group B were compared with GFR to evaluate the correlation between these functional variables and preserved renal function after LPN. The novel technique slightly increased operating time, WIT and intra-operative blood loss (P < 0.001), while it provided better postoperative renal function (P < 0.001) compared with the conventional technique. The blocking method and tumour characteristics were independent factors affecting GFR reduction, while WIT was not an independent factor. Correlation analysis showed that estimated GFR presented better correlation with GFR compared with kidney volume (R(2) = 0.794 cf. R(2) = 0.199) in predicting renal function after LPN. LPN with segmental artery clamping minimizes warm ischaemia injury and provides better early postoperative renal function compared with clamping the main renal artery. Kidney volume has a significantly inferior role compared with eGFR in predicting preserved renal function. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

“What Motivates Her”: Motivations for Considering Labial Reduction Surgery as Recounted on Women's Online Communities and Surgeons' Websites

PubMed Central

Zwier, Sandra

2014-01-01

Introduction Increasing numbers of women are seeking labial reduction surgery. We studied the motivations for considering labial reduction surgery as recounted on women's online communities and surgery provider's websites. Aims The study analyzed motivations for considering labial reduction surgery expressed by women on online communities, looked at the role of the women's age and nationality, compared findings with motivations indicated on the websites of an international sample of surgery providers, and identified similarities to and differences from what is known from extant studies. Methods Quantitative content analysis of the posts of 78 American, British, and Dutch women on online communities, and 40 international surgery providers' websites about labial reduction surgery was conducted. Main Outcome Measures Main outcome measures concerned the incidence and prominence of different motivational categories (functional/emotional and discomfort/enhancement related). Differences in motivations as a function of age, national background, and women's vs. surgeons' stated motivations were tested. Results Emotional discomfort regarding self-appearance and social and sexual relationships was found to be the most frequent and most prominent motivation for considering labial reduction surgery on women's online communities, regardless of age and national background. Functional discomfort and desired emotional enhancement ranked second. Very few age or national differences were found. The surgeons' websites recognized functional discomfort more and elaborated upon emotional issues in sexual relationships less than members of the online communities. Conclusions Feelings of emotional and psychosexual distress in addition to functional distress are a highly prevalent motivation among women considering labial reduction surgery. Emotional distress appears to be greater and more freely emphasized when women communicate on online communities, while functional issues appear to receive greater notice on surgery provider's websites. Zwier S. “What motivates her”: Motivations for considering labial reduction surgery as recounted on women's online communities and surgeons' websites. Sex Med 2014;2:16–23. PMID:25356297

26 CFR 1.420-1 - Significant reduction in retiree health coverage during the cost maintenance period.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Significant reduction in retiree health coverage during the cost maintenance period. 1.420-1 Section 1.420-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.420-1 Significant...

Small Engine Technology (SET) Task 24 Business and Regional Aircraft System Studies

NASA Technical Reports Server (NTRS)

Lieber, Lysbeth

2003-01-01

This final report has been prepared by Honeywell Engines & Systems, Phoenix, Arizona, a unit of Honeywell International Inc., documenting work performed during the period June 1999 through December 1999 for the National Aeronautics and Space Administration (NASA) Glenn Research Center, Cleveland, Ohio, under the Small Engine Technology (SET) Program, Contract No. NAS3-27483, Task Order 24, Business and Regional Aircraft System Studies. The work performed under SET Task 24 consisted of evaluating the noise reduction benefits compared to the baseline noise levels of representative 1992 technology aircraft, obtained by applying different combinations of noise reduction technologies to five business and regional aircraft configurations. This report focuses on the selection of the aircraft configurations and noise reduction technologies, the prediction of noise levels for those aircraft, and the comparison of the noise levels with those of the baseline aircraft.

Bendable solid-state supercapacitors with Au nanoparticle-embedded graphene hydrogel films

PubMed Central

Yang, Kyungwhan; Cho, Kyoungah; Yoon, Dae Sung; Kim, Sangsig

2017-01-01

In this study, we fabricate bendable solid-state supercapacitors with Au nanoparticle (NP)-embedded graphene hydrogel (GH) electrodes and investigate the influence of the Au NP embedment on the internal resistance and capacitive performance. Embedding the Au NPs into the GH electrodes results in a decrease of the internal resistance from 35 to 21 Ω, and a threefold reduction of the IR drop at a current density of 5 A/g when compared with GH electrodes without Au NPs. The Au NP-embedded GH supercapacitors (NP-GH SCs) exhibit excellent capacitive performances, with large specific capacitance (135 F/g) and high energy density (15.2 W·h/kg). Moreover, the NP-GH SCs exhibit comparable areal capacitance (168 mF/cm2) and operate under tensile/compressive bending. PMID:28074865

Incidence and risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture: A systematic review and meta-analysis.

PubMed

Shao, Jiashen; Chang, Hengrui; Zhu, Yanbin; Chen, Wei; Zheng, Zhanle; Zhang, Huixin; Zhang, Yingze

2017-05-01

This study aimed to quantitatively summarize the risk factors associated with surgical site infection after open reduction and internal fixation of tibial plateau fracture. Medline, Embase, CNKI, Wanfang database and Cochrane central database were searched for relevant original studies from database inception to October 2016. Eligible studies had to meet quality assessment criteria according to the Newcastle-Ottawa Scale, and had to evaluate the risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture. Stata 11.0 software was used for this meta-analysis. Eight studies involving 2214 cases of tibial plateau fracture treated by open reduction and internal fixation and 219 cases of surgical site infection were included in this meta-analysis. The following parameters were identified as significant risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture (p < 0.05): open fracture (OR 3.78; 95% CI 2.71-5.27), compartment syndrome (OR 3.53; 95% CI 2.13-5.86), operative time (OR 2.15; 95% CI 1.53-3.02), tobacco use (OR 2.13; 95% CI 1.13-3.99), and external fixation (OR 2.07; 95% CI 1.05-4.09). Other factors, including male sex, were not identified as risk factors for surgical site infection. Patients with the abovementioned medical conditions are at risk of surgical site infection after open reduction and internal fixation of tibial plateau fracture. Surgeons should be cognizant of these risks and give relevant preoperative advice. Copyright © 2017. Published by Elsevier Ltd.

Clinically relevant reductions in HbA1c without hypoglycaemia: results across four studies of saxagliptin.

PubMed

Karyekar, C S; Frederich, R; Ravichandran, S

2013-08-01

In four 24-week controlled studies, the antihyperglycaemic efficacy of saxagliptin was demonstrated in patients with type 2 diabetes mellitus as add-on therapy to glyburide, a thiazolidinedione, or metformin, and when used in initial combination with metformin vs. metformin monotherapy in drug-naive patients. Data from these studies were analysed to compare the proportions of patients who achieved specific reductions from baseline in glycated haemoglobin [HbA(1c); reductions of ≥ 0.5% and ≥ 0.7% in all studies (prespecified); reductions ≥ 1.0% in the add-on studies and ≥ 1.0% to ≥ 2.5% in the initial combination study (post hoc)] for saxagliptin vs. comparator at week 24. We report overall rates of glycaemic response defined by these reductions in HbA(1c) and rates of response without experiencing hypoglycaemia. Large glycaemic response rates were higher with saxagliptin 2.5 and 5 mg/day than with comparator (HbA(1c) ≥ 1.0%, 31.7-50.3% vs. 10.3-20.0%) as add-on therapy and higher with saxagliptin 5 mg/day as initial combination with metformin than with metformin monotherapy (HbA(1c) ≥ 2.0%, 68.3% vs. 49.8%) in drug-naive patients. Addition of saxagliptin was associated with a low incidence of hypoglycaemia; overall response rates and response rates excluding patients who experienced hypoglycaemia were similar. Analysis of several demographic and baseline clinical variables revealed no consistent correlations with response to saxagliptin. Whether receiving saxagliptin as an add-on therapy to glyburide, a thiazolidinedione, or metformin or in initial combination with metformin, a greater percentage of patients achieve clinically relevant large reductions in HbA(1c) vs. comparator, with a low incidence of hypoglycaemia. © 2013 Bristol-Myers Squibb Co. International Journal of Clinical Practice published by John Wiley & Sons Ltd.

Intraoperative CT in the assessment of posterior wall acetabular fracture stability.

PubMed

Cunningham, Brian; Jackson, Kelly; Ortega, Gil

2014-04-01

Posterior wall acetabular fractures that involve 10% to 40% of the posterior wall may or may not require an open reduction and internal fixation. Dynamic stress examination of the acetabular fracture under fluoroscopy has been used as an intraoperative method to assess joint stability. The aim of this study was to demonstrate the value of intraoperative ISO computed tomography (CT) examination using the Siemens ISO-C imaging system (Siemens Corp, Malvern, Pennsylvania) in the assessment of posterior wall acetabular fracture stability during stress examination under anesthesia. In 5 posterior wall acetabular fractures, standard fluoroscopic images (including anteroposterior pelvis and Judet radiographs) with dynamic stress examinations were compared with the ISO-C CT imaging system to assess posterior wall fracture stability during stress examination. After review of standard intraoperative fluoroscopic images under dynamic stress examination, all 5 cases appeared to demonstrate posterior wall stability; however, when the intraoperative images from the ISO-C CT imaging system demonstrated that 1 case showed fracture instability of the posterior wall segment during stress examination, open reduction and internal fixation was performed. The use of intraoperative ISO CT imaging has shown an initial improvement in the surgeon's ability to assess the intraoperative stability of posterior wall acetabular fractures during stress examination when compared with standard fluoroscopic images. Copyright 2014, SLACK Incorporated.

To Legislate or Not to Legislate? A Comparison of the UK and South African Approaches to the Development and Implementation of Salt Reduction Programs

PubMed Central

Charlton, Karen; Webster, Jacqui; Kowal, Paul

2014-01-01

The World Health Organization promotes salt reduction as a best-buy strategy to reduce chronic diseases, and Member States have agreed to a 30% reduction target in mean population salt intake by 2025. Whilst the UK has made the most progress on salt reduction, South Africa was the first country to pass legislation for salt levels in a range of processed foods. This paper compares the process of developing salt reduction strategies in both countries and highlights lessons for other countries. Like the UK, the benefits of salt reduction were being debated in South Africa long before it became a policy priority. Whilst salt reduction was gaining a higher profile internationally, undoubtedly, local research to produce context-specific, domestic costs and outcome indicators for South Africa was crucial in influencing the decision to legislate. In the UK, strong government leadership and extensive advocacy activities initiated in the early 2000s have helped drive the voluntary uptake of salt targets by the food industry. It is too early to say which strategy will be most effective regarding reductions in population-level blood pressure. Robust monitoring and transparent mechanisms for holding the industry accountable will be key to continued progress in each of the countries. PMID:25230210

An international systematic review and meta-analysis of multisession psychosocial interventions compared with educational or minimal interventions on the HIV sex risk behaviors of people who use drugs.

PubMed

Meader, Nicholas; Semaan, Salaam; Halton, Marie; Bhatti, Henna; Chan, Melissa; Llewellyn, Alexis; Des Jarlais, Don C

2013-07-01

This systematic review and meta-analysis examines the effectiveness of multisession psychosocial interventions compared with educational interventions and minimal interventions in reducing sexual risk in people who use drugs (51 studies; 19,209 participants). We conducted comprehensive searches (MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials and PsychINFO 1998-2012). Outcomes (unprotected sex, condom use, or a composite outcome) were extracted by two authors and synthesised using meta-analysis. Subgroup analyses and meta-regression were conducted to explore heterogeneity. Multisession psychosocial interventions had modest additional benefits compared to educational interventions (K = 46; OR 0.86; 95% CI 0.77, 0.96), and large positive effects compared to minimal interventions (K = 7; OR 0.60; 95% CI 0.46, 0.78). Comparison with previous meta-analyses suggested limited progress in recent years in developing more effective interventions. Multisession psychosocial and educational interventions provided similar modest sexual risk reduction justifying offering educational interventions in settings with limited exposure to sexual risk reduction interventions, messages, and resources.

Tumour regression of uveal melanoma after ruthenium-106 brachytherapy or stereotactic radiotherapy with gamma knife or linear accelerator.

PubMed

Georgopoulos, Michael; Zehetmayer, Martin; Ruhswurm, Irene; Toma-Bstaendig, Sabine; Ségur-Eltz, Nikolaus; Sacu, Stefan; Menapace, Rupert

2003-01-01

This study assesses differences in relative tumour regression and internal acoustic reflectivity after 3 methods of radiotherapy for uveal melanoma: (1) brachytherapy with ruthenium-106 radioactive plaques (RU), (2) fractionated high-dose gamma knife stereotactic irradiation in 2-3 fractions (GK) or (3) fractionated linear-accelerator-based stereotactic teletherapy in 5 fractions (Linac). Ultrasound measurements of tumour thickness and internal reflectivity were performed with standardised A scan pre-operatively and 3, 6, 9, 12, 18, 24 and 36 months postoperatively. Of 211 patients included in the study, 111 had a complete 3-year follow-up (RU: 41, GK: 37, Linac: 33). Differences in tumour thickness and internal reflectivity were assessed with analysis of variance, and post hoc multiple comparisons were calculated with Tukey's honestly significant difference test. Local tumour control was excellent with all 3 methods (>93%). At 36 months, relative tumour height reduction was 69, 50 and 30% after RU, GK and Linac, respectively. In all 3 treatment groups, internal reflectivity increased from about 30% initially to 60-70% 3 years after treatment. Brachytherapy with ruthenium-106 plaques results in a faster tumour regression as compared to teletherapy with gamma knife or Linac. Internal reflectivity increases comparably in all 3 groups. Besides tumour growth arrest, increasing internal reflectivity is considered as an important factor indicating successful treatment. Copyright 2003 S. Karger AG, Basel

Clinical efficacy of open reduction and semirigid internal fixation in management of displaced pediatric mandibular fractures: a series of 10 cases and surgical guidelines.

PubMed

Joshi, Samir; Kshirsagar, Rajesh; Mishra, Akshay; Shah, Rahul

2015-01-01

To evaluate the efficacy of open reduction and semirigid internal fixation in the management of displaced pediatric mandibular fractures. Ten patients with displaced mandibular fractures treated with 1.5 mm four holed titanium mini-plate and 4 mm screws which were removed within four month after surgery. All cases showed satisfactory bone healing without any growth disturbance. Open reduction and rigid internal fixation (ORIF) with 1.5 mm titanium mini- plates and 4 mm screws is a reliable and safe method in treatment of displaced paediatric mandibular fractures.

Design of aircraft turbine fan drive gear transmission system

NASA Technical Reports Server (NTRS)

Dent, E.; Hirsch, R. A.; Peterson, V. W.

1970-01-01

The following basic types of gear reduction concepts were studied as being feasible power train systems for a low-bypass-ratio, single-spool, geared turbofan engine for general aircraft use: (1) single-stage external-internal reduction, (2) gears (offset shafting), (3) multiple compound idler gear system (concentric shafting), and (4) star gear planetary system with internal ring gear final output member (concentric shafting-counterrotation). In addition, studies were made of taking the accessories drive power off both the high-speed and low-speed shafting, using either face gears or spiral bevel gears. Both antifriction and sleeve-type bearings were considered for the external-internal and star-planet reduction concepts.

The effect of the Tscherne injury pattern on the outcome of operatively treated Lisfranc fracture dislocations.

PubMed

Demirkale, Ismail; Tecimel, Osman; Celik, Ismail; Kilicarslan, Kasim; Ocguder, Ali; Dogan, Metin

2013-09-01

Lisfranc fracture dislocations cause severe tarso-metatarsal malalignment. The research question of this study was to evaluate the severity of the soft tissue injury on the final clinical outcome and compare that with the effect of various determinants on the disability in daily living activities after open reduction and internal fixation of a Lisfranc injury. This study consisted of a retrospective analysis of patients with Lisfranc fracture dislocations who were treated by open reduction and internal fixation beween 2004 and 2009. Evaluation focused mainly on the severity of the soft tissue injury, age, fracture classification, time to operation, posttraumatic osteoarthritis, and the results were compared with American Foot and Ankle Society (AOFAS) scores, and Foot and Ankle Disability Index (FADI). Eight patients had Tscherne Grade 1, 13 had Grade 2, and 11 had Grade 3 soft tissue injuries. Myerson classification revealed 11 type A, 8 type B and 13 type C fractures. Six patients' operations were delayed beyond 8h. Of the 38 patients treated in the study period, 32 patients (11 female, 21 male; <30 y-old: 14, >30 y-old: 18) were available for complete follow-up (average, 55.5 months). The comparison of treatment results revealed that those patients with high grade soft tissue injuries had lower AOFAS and FADI scores (43.8±15.9, 53.7±9.4, respectively) when compared to Tscherne Grade 1 injuries (82.8±6.1, 109±13.9, respectively) (p<0.001). The overall negative impact of the severity of soft tissue injury on functional outcomes had similar significance with regard to post-traumatic osteoarthritis, and fracture type. There was also a statistically significant difference between outcome measures and post-reduction quality (p=0.002). Patient age (p=0.9) and delayed surgery (p=0.5) had no statistically significant effect on the final outcome. Satisfactory results can be achieved with open reduction for Lisfranc injuries. However, despite this treatment, both the severity of the soft tissue injury and non-anatomic reduction are negative prognostic factors in the treatment of Lisfranc fracture dislocations. Copyright © 2013 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Reducing air pollutant emissions at airports by controlling aircraft ground operations

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

Gelinas, C.G.; Fan, H.S.L.

1979-02-01

Average-day carbon monoxide, total hydrocarbon, and NO/sub x/ aircraft emissions and fuel use estimates (apportioned to takeoff, taxi, idle, and landing) for departure and arrival at Los Angeles and San Francisco International Airports were compared with emissions level and fuel use estimates for four emission reduction strategies (tow aircraft between runways and gates, shutdown one engine during taxiing, control departure time, and assign runways to minimize taxiing distance). The best strategy, the shutdown of one engine while taxiing, produces substantial emission reductions, cost benefits owing to fuel savings, and no apparent safety problems; aircraft towing reduced emissions significantly, but introducedmore » a number of safety problems.« less

Development of a ruthenium/phosphite catalyst system for domino hydroformylation-reduction of olefins with carbon dioxide.

PubMed

Liu, Qiang; Wu, Lipeng; Fleischer, Ivana; Selent, Detlef; Franke, Robert; Jackstell, Ralf; Beller, Matthias

2014-06-02

An efficient domino ruthenium-catalyzed reverse water-gas-shift (RWGS)-hydroformylation-reduction reaction of olefins to alcohols is reported. Key to success is the use of specific bulky phosphite ligands and triruthenium dodecacarbonyl as the catalyst. Compared to the known ruthenium/chloride system, the new catalyst allows for a more efficient hydrohydroxymethylation of terminal and internal olefins with carbon dioxide at lower temperature. Unwanted hydrogenation of the substrate is prevented. Preliminary mechanism investigations uncovered the homogeneous nature of the active catalyst and the influence of the ligand and additive in individual steps of the reaction sequence. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Primary Arthrodesis versus Open Reduction and Internal Fixation for Low-Energy Lisfranc Injuries in a Young Athletic Population.

PubMed

Cochran, Grant; Renninger, Christopher; Tompane, Trevor; Bellamy, Joseph; Kuhn, Kevin

2017-09-01

There are 2 Level I studies comparing open reduction and internal fixation (ORIF) and primary arthrodesis (PA) in high-energy Lisfranc injuries. There are no studies comparing ORIF and PA in young athletic patients with low-energy injuries. All operatively managed low-energy Lisfranc injuries sustained by active duty military personnel at a single institution were identified from 2010 to 2015. The injury pattern, method of treatment, and complications were reviewed. Implant removal rates, fitness test scores, return to military duty rates, and Foot and Ankle Ability Measure (FAAM) scores were compared. Thirty-two patients were identified with the average age of 28 years. PA was performed in 14 patients with ORIF in 18. The PA group returned to full duty at an average of 4.5 months whereas the ORIF group returned at an average of 6.7 months ( P = .0066). The PA group ran their fitness test an average of 9 seconds per mile slower than their preoperative average whereas the ORIF group ran it an average of 39 seconds slower per mile ( P = .032). There were no differences between the 2 groups in the FAAM scores at an average of 35 months. Implant removal was performed in 15 (83%) in the ORIF group and 2 (14%) in the PA group ( P = .005). Low-energy Lisfranc injuries treated with primary arthrodesis had a lower implant removal rate, an earlier return to full military activity, and better fitness test scores after 1 year, but there was no difference in FAAM scores after 3 years. Level III, comparative cohort study.

Evaluation of emission control strategies for airfield operations at the Los Angeles and San Francisco International Airports. Final report

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

Gelinas, C.G.

1978-08-01

This report reviews potential air pollutant emission reductions which could be achieved by various strategies to control airfield operations at Los Angeles and San Francisco International Airports, and examines safety problems, cost impacts, potential fuel savings, time frame for strategy implementation, and potential regulatory and jurisdictional conflicts associated with each strategy. Airfield emission sources studied included aircraft operation in the idle, taxi, takeoff, and landing modes; ground service vehicles; fuel handling and storage; and aircraft engine maintenance. Nineteen potential strategies were identified, and seven strategies were selected for detailed analysis and examination after a preliminary evaluation. Two strategies, aircraft towingmore » and reducing the number of operating engines on the ground, appear to provide the most significant emission reduction. Both of these strategies offer potential reductions in the range of 20 to 40 percent of the carbon monoxide and nitrogen oxides which are currently emitted by ground operations. The aircraft towing strategy also offers a comparable improvement in suspended particulate matter emissions. When the overall feasibility of each strategy is evaluated, the strategy to reduce the number of operating engines appears to be the most viable since its implementation would result in fuel savings, no apparent safety problems, and it can be implemented immediately.« less

Combined circular external fixation and open reduction internal fixation with pro-syndesmotic screws for repair of a diabetic ankle fracture

PubMed Central

Facaros, Zacharia; Ramanujam, Crystal L.; Stapleton, John J.

2010-01-01

The surgical management of ankle fractures among the diabetic population is associated with higher complication rates compared to the general population. Efforts toward development of better methods in prevention and treatment are continuously evolving for these injuries. The presence of peripheral neuropathy and the possible development of Charcot neuroarthropathy in this high risk patient population have stimulated much surgical interest to create more stable osseous constructs when open reduction of an ankle fracture/dislocation is required. The utilization of multiple syndesmotic screws (pro-syndesmotic screws) to further stabilize the ankle mortise has been reported by many foot and ankle surgeons. In addition, transarticular Steinmann pins have been described as an adjunct to traditional open reduction with internal fixation (ORIF) of the ankle to better stabilize the talus, thus minimizing risk of further displacement, malunion, and Charcot neuroarthropathy. The authors present a unique technique of ORIF with pro-syndesmotic screws and the application of a multi-plane circular external fixator for management of a neglected diabetic ankle fracture that prevented further deformity while allowing a weight-bearing status. This techniqu may be utilized for the management of complex diabetic ankle fractures that are prone to future complications and possible limb loss. PMID:22396812

Externally calibrated parallel imaging for 3D multispectral imaging near metallic implants using broadband ultrashort echo time imaging.

PubMed

Wiens, Curtis N; Artz, Nathan S; Jang, Hyungseok; McMillan, Alan B; Reeder, Scott B

2017-06-01

To develop an externally calibrated parallel imaging technique for three-dimensional multispectral imaging (3D-MSI) in the presence of metallic implants. A fast, ultrashort echo time (UTE) calibration acquisition is proposed to enable externally calibrated parallel imaging techniques near metallic implants. The proposed calibration acquisition uses a broadband radiofrequency (RF) pulse to excite the off-resonance induced by the metallic implant, fully phase-encoded imaging to prevent in-plane distortions, and UTE to capture rapidly decaying signal. The performance of the externally calibrated parallel imaging reconstructions was assessed using phantoms and in vivo examples. Phantom and in vivo comparisons to self-calibrated parallel imaging acquisitions show that significant reductions in acquisition times can be achieved using externally calibrated parallel imaging with comparable image quality. Acquisition time reductions are particularly large for fully phase-encoded methods such as spectrally resolved fully phase-encoded three-dimensional (3D) fast spin-echo (SR-FPE), in which scan time reductions of up to 8 min were obtained. A fully phase-encoded acquisition with broadband excitation and UTE enabled externally calibrated parallel imaging for 3D-MSI, eliminating the need for repeated calibration regions at each frequency offset. Significant reductions in acquisition time can be achieved, particularly for fully phase-encoded methods like SR-FPE. Magn Reson Med 77:2303-2309, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

Modification of Aortic Cannula With an Inlet Chamber to Induce Spiral Flow and Improve Outlet Flow.

PubMed

Darlis, Nofrizalidris; Osman, Kahar; Padzillah, Muhamad Hasbullah; Dillon, Jeswant; Md Khudzari, Ahmad Zahran

2018-05-01

Physiologically, blood ejected from the left ventricle in systole exhibited spiral flow characteristics. This spiral flow has been proven to have several advantages such as lateral reduction of directed forces and thrombus formation, while it also appears to be clinically beneficial in suppressing neurological complications. In order to deliver spiral flow characteristics during cardiopulmonary bypass operation, several modifications have been made on an aortic cannula either at the internal or at the outflow tip; these modifications have proven to yield better hemodynamic performances compared to standard cannula. However, there is no modification done at the inlet part of the aortic cannula for inducing spiral flow so far. This study was carried out by attaching a spiral inducer at the inlet of an aortic cannula. Then, the hemodynamic performances of the new cannula were compared with the standard straight tip end-hole cannula. This is achieved by modeling the cannula and attaching the cannula at a patient-specific aorta model. Numerical approach was utilized to evaluate the hemodynamic performance, and a water jet impact experiment was used to demonstrate the jet force generated by the cannula. The new spiral flow aortic cannula has shown some improvements by reducing approximately 21% of impinging velocity near to the aortic wall, and more than 58% reduction on total force generated as compared to standard cannula. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Young adult gay and bisexual men's stigma experiences and mental health: An 8-year longitudinal study.

PubMed

Pachankis, John E; Sullivan, Timothy J; Feinstein, Brian A; Newcomb, Michael E

2018-04-05

This study investigated longitudinal trajectories of stigma (i.e., enacted, anticipated, internalized, concealed); stress-sensitive mental health disorder symptoms (i.e., depression, social anxiety); and their associations across 8 annual assessments in a sample of 128 young gay and bisexual U.S. university students. All forms of stigma significantly decreased over time, while depressive symptoms remained stable and social anxiety symptoms significantly increased. Men from higher socioeconomic backgrounds experienced quicker reductions in anticipated stigma, compared to men from lower socioeconomic backgrounds. More self-described feminine men experienced quicker reductions in concealment, compared to more self-described masculine men. Enacted stigma demonstrated contemporaneous associations with depression and social anxiety across 8 years; and anticipated stigma and internalized stigma demonstrated contemporaneous associations with social anxiety across 8 years. Enacted stigma was more strongly associated with depressive symptoms among men who reported greater masculinity compared to those who reported greater femininity. Findings are discussed in terms of common developmental influences across early sexual orientation identity formation, including gay and bisexual young men's resilience to stigma-based stress; the transition from college; and the rapidly changing social climate surrounding sexual minority individuals. Findings suggest the need for future longitudinal examinations of stigma and mental health among sexual minorities that utilize multiple age cohorts to determine the relative contribution of cohort-specific versus common maturational factors influencing the mental health of this population. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

SITE PROGRAM DEMONSTRATION ECO LOGIC INTERNATIONAL GAS-PHASE CHEMICAL REDUCTION PROCESS, BAY CITY, MICHIGAN TECHNOLOGY EVALUATION REPORT

EPA Science Inventory

The SITE Program funded a field demonstration to evaluate the Eco Logic Gas-Phase Chemical Reduction Process developed by ELI Eco Logic International Inc. (ELI), Ontario, Canada. The Demonstration took place at the Middleground Landfill in Bay City, Michigan using landfill wa...

ECO LOGIC INTERNATIONAL GAS-PHASE CHEMICAL REDUCTION PROCESS - THE THERMAL DESORPTION UNIT - APPLICATIONS ANALYSIS REPORT

EPA Science Inventory

ELI ECO Logic International, Inc.'s Thermal Desorption Unit (TDU) is specifically designed for use with Eco Logic's Gas Phase Chemical Reduction Process. The technology uses an externally heated bath of molten tin in a hydrogen atmosphere to desorb hazardous organic compounds fro...

Primary Retrograde Tibiotalocalcaneal Nailing For Fragility Ankle Fractures

PubMed Central

Taylor, Benjamin C.; Hansen, Dane C.; Harrison, Ryan; Lucas, Douglas E; Degenova, Daniel

2016-01-01

Background Ankle fragility fractures are difficult to treat due to poor bone quality and soft tissues as well as the near ubiquitous presence of comorbidities including diabetes mellitus and peripheral neuropathy. Conventional open reduction and internal fixation in this population has been shown to lead to a significant rate of complications. Given the high rate of complications with contemporary fixation methods, the present study aims to critically evaluate the use of acute hindfoot nailing as a percutaneous fixation technique for high-risk ankle fragility fractures. Methods In this study, we retrospectively evaluated 31 patients treated with primary retrograde tibiotalocalcaneal nail without joint preparation for a mean of 13.6 months postoperatively from an urban Level I trauma center during the years 2006-2012. Results Overall, there were two superficial infections (6.5%) and three deep infections (9.7%) in the series. There were 28 (90.3%) patients that went on to radiographic union at a mean of 22.2 weeks with maintenance of foot and ankle alignment. There were three cases of asymptomatic screw breakage observed at a mean of 18.3 months postoperatively, which were all treated conservatively.. Conclusions This study shows that retrograde hindfoot nailing is an acceptable treatment option for treatment of ankle fragility fractures. Hindfoot nailing allows early weightbearing, limited soft tissue injury, and a relatively low rate of complications, all of which are advantages to conventional open reduction internal fixation techniques. Given these findings, larger prospective randomized trials comparing this treatment with conventional open reduction internal fixation techniques are warranted. PMID:27528840

A comparative study of coagulation, granular- and powdered-activated carbon for the removal of perfluorooctane sulfonate and perfluorooctanoate in drinking water treatment.

PubMed

Pramanik, Biplob Kumar; Pramanik, Sagor Kumar; Suja, Fatihah

2015-01-01

Perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA) are persistent organic pollutants in the environment and their occurrence causes toxicological effects on humans. We examined different conventional coagulant treatments such as alum, ferric chloride and polyaluminium chloride in removing these compounds. These were then compared with a natural coagulant (Moringa oleifera). We also investigated the powdered-activated carbon (PAC) and granular-activated carbon (GAC) for removing these compounds. At an initial dose of 5 mg/L, polyaluminium chloride led to a higher reduction of PFOS/PFOA compared with alum which in turn was higher than ferric. The removal efficiency increased with the increase in coagulant dose and decrease in pH. M. oleifera was very effective in reducing PFOS and PFOA than conventional coagulants, with a reduction efficiencies of 65% and 72%, respectively, at a dose of 30 mg/L. Both PAC and GAC were very effective in reducing these compounds than coagulations. PAC led to a higher reduction in PFOS and PFOA than GAC due to its greater surface area and shorter internal diffusion distances. The addition of PAC (10 min contact time) with coagulation (at 5 mg/L dosage) significantly increased the removal efficiency, and the maximum removal efficiency was for M. oleifera with 98% and 94% for PFOS and PFOA, respectively. The reduction efficiency of PFOS/PFOA was reduced with the increase in dissolved organic concentration due to the adsorption competition between organic molecules and PFOS/PFOA.

[Manipulative reduction and percutaneous Kirschner wire internal fixation for grade IV supination-external rotation ankle fractures].

PubMed

Li, Jia; Sun, Jin-Ke; Wang, Chen-Lin

2017-06-25

To investigate surgical skills and clinical effects of manipulative reduction and percutaneous Kirschner wire internal fixation in treating grade IV supination-external rotation ankle fractures. From May 2013 to October 2016, 35 patients with grade IV supination-external rotation ankle fractures were treated with percutaneous Kirschner wire internal fixation, involving 22 males and 13 females with an average age of 38.2 years ranged from 18 to 65 years old. The time from injury to operation ranged from 2 h to 10 d with an average of 5 d. Reduction quality was assessed by Burwell-Charnley radiological criteria. Baird-Jackson ankle scoring system was used to assess clinical effects. Thirty-three patients were followed up from 10 to 28 months with an average of 14 months. Fracture healing time ranged from 10 to 18 weeks with an average of 12 weeks. According to Burwell-Charnley radiological criteria, 30 cases were obtained anatomic reduction, 3 cases moderate. According to Baird-Jackson ankle scoring system, total score was 93.8±5.4, 17 cases got excellent result, 12 good, 2 fair and 2 poor. Manipulative reduction and percutaneous Kirschner wire internal fixation in treating grade IV supination-external rotation ankle fractures has advantages of reliable efficacy, less complications. But higher require techniques were required for closed reduction. It is not suitable for severe crushed fracture and compressive articular surface fracture.

A comparative evaluation on the emission characteristics of ceramic and metallic catalytic converter in internal combustion engine

NASA Astrophysics Data System (ADS)

Leman, A. M.; Jajuli, Afiqah; Rahman, Fakhrurrazi; Feriyanto, Dafit; Zakaria, Supaat

2017-09-01

Enforcement of a stricter regulation on exhaust emission by many countries has led to utilization of catalytic converter to reduce the harmful pollutant emission. Ceramic and metallic catalytic converters are the most common type of catalytic converter used. The purpose of this study is to evaluate the performance of the ceramic and metallic catalytic converter on its conversion efficiency using experimental measurement. Both catalysts were placed on a modified exhaust system equipped with a Mitshubishi 4G93 single cylinder petrol engine that was tested on an eddy current dynamometer under steady state conditions for several engine speeds. The experimental results show that the metallic catalytic converter reduced a higher percentage of CO up to 98.6% reduction emissions while ceramic catalytic converter had a better reduction efficiency of HC up to 85.4% and 87.2% reduction of NOx.

On the Theory of Oxidation-Reduction Reactions Involving Electron Transfer. V. Comparison and Properties of Electrochemical and Chemical Rate Constants

DOE R&D Accomplishments Database

Marcus, R. A.

1962-01-01

Using a theory of electron transfers which takes cognizance of reorganization of the medium outside the inner coordination shell and of changes of bond lengths inside it, relations between electrochemical and related chemical rate constants are deduced and compared with the experimental data. A correlation is found, without the use of arbitrary parameters. Effects of weak complexes with added electrolytes are included under specified conditions. The deductions offer a way of coordinating a variety of data in the two fields, internally as well as with each those in another. For example, the rate of oxidation or reduction of a series of related reactants by one reagent is correlated with that of another and with that of the corresponding electrochemical oxidation-reduction reaction, under certain specified conditions. These correlations may also provide a test for distinguishing an electron from an atom transfer mechanism. (auth)

Designed Proteins as Optimized Oxygen Carriers for Artificial Blood

DTIC Science & Technology

2013-02-01

to the lower energy for electron transfer when coupled to a proton transfer from water (3). Thus we set out to compare the rate of solvent...binding affinities and reduction potentials are the sole result of differences in internal electric fields in these proteins wrought by the surface...serving as the source of potential energy for the hexa- to penta-coordinate conformational change, and one in which the b-position glutamates from

Adenomatous-Dominant Benign Prostatic Hyperplasia (AdBPH) as a Predictor for Clinical Success Following Prostate Artery Embolization: An Age-Matched Case–Control Study

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

Little, M. W., E-mail: m.little@doctors.org.uk; Boardman, P.; Macdonald, A. C.

PurposeTo investigate the clinical impact of performing prostate artery embolization (PAE) on patients with adenomatous-dominant benign prostatic hyperplasia (AdBPH).Materials and MethodsTwelve patients from the ongoing proSTatic aRtery EmbolizAtion for the treatMent of benign prostatic hyperplasia (STREAM) trial were identified as having AdBPH; defined as two or more adenomas within the central gland of ≥1 cm diameter on multi-parametric MRI (MP-MRI). These patients were age-matched with patients from the STREAM cohort, without AdBPH. Patients were followed up with repeat MP-MRI at 3 months and 1 year. International prostate symptom score (IPSS), international index for erectile function (IIEF), and quality of life assessment from themore » IPSS and EQ-5D-5S questionnaires were recorded pre-PAE and at 6 weeks, 3 months, and 1 year.ResultsThe mean age of patients was 68 (61–76). All patients had PAE as a day-case procedure. The technical success in the cohort was 23/24 (96%). There was a significant reduction in prostate volume following embolization with a median reduction of 34% (30–55) in the AdBPH group, compared to a mean volume reduction of 22% (9–44) in the non-AdBPH group (p = 0.04). There was a significant reduction in IPSS in the AdBPH group following PAE when compared with the control group [AdBPH median IPSS 8 (3–15) vs. non-AdBPH median IPSS 13 (8–18), p = 0.01]. IPSS QOL scores significantly improved in the AdBPH group (p = 0.007). There was no deterioration in sexual function in either group post-PAE.ConclusionsThis is the first time that AdBPH has been identified as being a predictor of clinical success following PAE.« less

Strategies for price reduction of HIV medicines under a monopoly situation in Brazil

PubMed Central

Chaves, Gabriela Costa; Hasenclever, Lia; Osorio-de-Castro, Claudia Garcia Serpa; Oliveira, Maria Auxiliadora

2016-01-01

ABSTRACT OBJECTIVE To analyze Government strategies for reducing prices of antiretroviral medicines for HIV in Brazil. METHODS Analysis of Ministry of Health purchases of antiretroviral medicines, from 2005 to 2013. Expenditures and costs of the treatment per year were analyzed and compared to international prices of atazanavir. Price reductions were estimated based on the terms of a voluntary license of patent rights and technology transfer in the Partnership for Productive Development Agreement for atazanavir. RESULTS Atazanavir, a patented medicine, represented a significant share of the expenditures on antiretrovirals purchased from the private sector. Prices in Brazil were higher than international references, and no evidence was found of a relationship between purchase volume and price paid by the Ministry of Health. Concerning the latest strategy to reduce prices, involving local production of the 200 mg capsule, the price reduction was greater than the estimated reduction. As for the 300 mg capsule, the amounts paid in the first two years after the Partnership for Productive Development Agreement were close to the estimated values. Prices in nominal values for both dosage forms remained virtually constant between 2011 (the signature of the Partnership for Productive Development Agreement), 2012 and 2013 (after the establishment of the Partnership). CONCLUSIONS Price reduction of medicines is complex in limited-competition environments. The use of a Partnership for Productive Development Agreement as a strategy to increase the capacity of local production and to reduce prices raises issues regarding its effectiveness in reducing prices and to overcome patent barriers. Investments in research and development that can stimulate technological accumulation should be considered by the Government to strengthen its bargaining power to negotiate medicines prices under a monopoly situation. PMID:26759969

The Challenge of Universal Primary Education: Strategies for Achieving the International Development Targets.

ERIC Educational Resources Information Center

Department for International Development, London (England).

The Department for International Development (DFID) is the British government department responsible for promoting development and the reduction of poverty in sites in developing and transition countries around the world. This paper focuses on the education dimension of poverty reduction, and specifically the attainment of the International…

76 FR 27609 - Reduction of Foreign Tax Credit Limitation Categories Under Section 904(d); Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-12

... Reduction of Foreign Tax Credit Limitation Categories Under Section 904(d); Correction AGENCY: Internal... foreign tax credit limitation categories under section 904(d) of the Internal Revenue Code. DATES: This... in and Losses With Respect to the Pre-2007 Separate Category for High Withholding Tax Interest...

Teaching the Basics: Development and Validation of a Distal Radius Reduction and Casting Model.

PubMed

Seeley, Mark A; Fabricant, Peter D; Lawrence, J Todd R

2017-09-01

Approximately one-third of reduced pediatric distal radius fractures redisplace, resulting in further treatment. Two major modifiable risk factors for loss of reduction are reduction adequacy and cast quality. Closed reduction and immobilization of distal radius fractures is an Accreditation Council for Graduate Medical Education residency milestone. Teaching and assessing competency could be improved with a life-like simulation training tool. Our goal was to develop and validate a realistic distal radius fracture reduction and casting simulator as determined by (1) a questionnaire regarding the "realism" of the model and (2) the quantitative assessments of reduction time, residual angulation, and displacement. A distal radius fracture model was created with radiopaque bony segments and articulating elbows and shoulders. Simulated periosteum and internal deforming forces required proper reduction and casting techniques to achieve and maintain reduction. The forces required were estimated through an iterative process through feedback from experienced clinicians. Embedded monofilaments allowed for quantitative assessment of residual displacement and angulation through the use of fluoroscopy. Subjects were asked to perform closed reduction and apply a long arm fiberglass cast. Primary performance variables assessed included reduction time, residual angulation, and displacement. Secondary performance variables consisted of number of fluoroscopic images, casting time, and cast index (defined as the ratio of the internal width of the forearm cast in the sagittal plane to the internal width in the coronal plane at the fracture site). Subject grading was performed by two blinded reviewers. Interrater reliability was nearly perfect across all measurements (intraclass correlation coefficient range, 0.94-0.99), thus disagreements in measurements were handled by averaging the assessed values. After completion the participants answered a Likert-based questionnaire regarding the realism of simulation. Eighteen participants consented to participate in the study (eight attending pediatric orthopaedic surgeons, six junior residents, four senior residents). The performances of junior residents (Postgraduate Year [PGY] 1-2), senior residents (PGY 3-5), and attending surgeons were compared using one-way ANOVA with Tukey's-adjusted pairwise comparisons. The majority of participants (15 of 18) felt that the model looked, felt, and moved like a human forearm. All participants strongly agreed that the model taught the basic steps of fracture reduction and should be implemented in orthopaedic training. Attending surgeons reduced fractures in less time than junior residents (60 ± 27 seconds versus 460 ± 62 seconds; mean difference, 400 seconds; 95% CI, 335-465 seconds; p < 0.001). Residual angulation was greater for junior residents when compared with attending surgeons on AP (7° ± 5° versus 0.7° ± 0.9°; mean difference, 6.3°; 95% CI, 3°-11°; p = 0.003) and lateral (27° ± 7° versus 7° ± 5°; mean difference, 20°; 95% CI, 13°-27°; p = 0.001) radiographs. Similarly, residual displacement was greater for junior residents than either senior residents (mean difference, 16 mm; 95% CI, 2-34 mm; p = 0.05) or attending surgeons (mean difference, 15 mm; 95% CI, 3-27 mm; p = 0.02) on lateral images. There were no differences identified in secondary performance variables (number of fluoroscopic images, casting time, and cast index) between groups. This is the first distal radius fracture reduction model to incorporate an elbow and shoulder and allow quantitative assessment of the fracture reduction. This simulator may be useful in an orthopaedic resident training program to help them reach a defined minimum level of competency. This simulator also could easily be integrated in other accreditation and training programs, including emergency medicine. Level II, therapeutic study.

Self-desiccation mechanism of high-performance concrete.

PubMed

Yang, Quan-Bing; Zhang, Shu-Qing

2004-12-01

Investigations on the effects of W/C ratio and silica fume on the autogenous shrinkage and internal relative humidity of high performance concrete (HPC), and analysis of the self-desiccation mechanisms of HPC showed that the autogenous shrinkage and internal relative humidity of HPC increases and decreases with the reduction of W/C respectively; and that these phenomena were amplified by the addition of silica fume. Theoretical analyses indicated that the reduction of RH in HPC was not due to shortage of water, but due to the fact that the evaporable water in HPC was not evaporated freely. The reduction of internal relative humidity or the so-called self-desiccation of HPC was chiefly caused by the increase in mole concentration of soluble ions in HPC and the reduction of pore size or the increase in the fraction of micro-pore water in the total evaporable water (T(r)/T(te) ratio).

Outcomes Related to the Use of Frozen Plasma or Pooled Solvent/Detergent-Treated Plasma in Critically Ill Children.

PubMed

Camazine, Maraya N; Karam, Oliver; Colvin, Ryan; Leteurtre, Stephane; Demaret, Pierre; Tucci, Marisa; Muszynski, Jennifer A; Stanworth, Simon; Spinella, Philip C

2017-05-01

To determine if the use of fresh frozen plasma/frozen plasma 24 hours compared to solvent detergent plasma is associated with international normalized ratio reduction or ICU mortality in critically ill children. This is an a priori secondary analysis of a prospective, observational study. Study groups were defined as those transfused with either fresh frozen plasma/frozen plasma 24 hours or solvent detergent plasma. Outcomes were international normalized ratio reduction and ICU mortality. Multivariable logistic regression was used to determine independent associations. One hundred one PICUs in 21 countries. All critically ill children admitted to a participating unit were included if they received at least one plasma unit during six predefined 1-week (Monday to Friday) periods. All children were exclusively transfused with either fresh frozen plasma/frozen plasma 24 hours or solvent detergent plasma. None. There were 443 patients enrolled in the study. Twenty-four patients (5%) were excluded because no plasma type was recorded; the remaining 419 patients were analyzed. Fresh frozen plasma/frozen plasma 24 hours group included 357 patients, and the solvent detergent plasma group included 62 patients. The median (interquartile range) age and weight were 1 year (0.2-6.4) and 9.4 kg (4.0-21.1), respectively. There was no difference in reason for admission, severity of illness score, pretransfusion international normalized ratio, or lactate values; however, there was a difference in primary indication for plasma transfusion (p < 0.001). There was no difference in median (interquartile range) international normalized ratio reduction, between fresh frozen plasma/frozen plasma 24 hours and solvent detergent plasma study groups, -0.2 (-0.4 to 0) and -0.2 (-0.3 to 0), respectively (p = 0.80). ICU mortality was lower in the solvent detergent plasma versus fresh frozen plasma/frozen plasma 24 hours groups, 14.5% versus 29.1%%, respectively (p = 0.02). Upon adjusted analysis, solvent detergent plasma transfusion was independently associated with reduced ICU mortality (odds ratio, 0.40; 95% CI, 0.16-0.99; p = 0.05). Solvent detergent plasma use in critically ill children may be associated with improved survival. This hypothesis-generating data support a randomized controlled trial comparing solvent detergent plasma to fresh frozen plasma/frozen plasma 24 hours.

Effects of glucosamine-chondroitin combination on synovial fluid IL-1β, IL-6, TNF-α and PGE2 levels in internal derangements of temporomandibular joint

PubMed Central

Esen, Emin; Tatli, Ufuk

2015-01-01

Background The aim of the present study was to evaluate the effects of glucosamine-chondroitin sulphate combination on internal derangements of temporomandibular joint in clinical and biochemical manners. Material and Methods This randomized clinical study included 31 cases reporting joint tenderness, in which disc displacement was detected on MR imaging. In all patients, synovial fluid sampling was performed under local anesthesia. In the study group, the patients were prescribed a combination of 1500 mg glucosamine and 1200 mg chondroitin sulphate, while patients in the control group were only prescribed 50 mg tramadol HCl (twice daily) for pain control. After 8 weeks, synovial fluid sampling was repeated in the same manner. The levels of pain, maximum mouth opening (MMO), synovial fluid IL-1ß, IL-6, TNF-α and PGE2 measured before and after pharmacological intervention were compared. Results The reduction in pain levels was significant in both groups. There was no significant difference between two groups in terms of pain reduction. The improvement in MMO was significant in the study group but it was not in the control group. The MMO improvement was significantly higher in the study group compared to the control group. In the study group, significant decrease was observed in PGE2 level, while the decreases in IL-1β, IL-6 and TNF-α levels were not significant. In the control group, no significant decrease was observed in any of the inflammatory cytokines after 8 weeks, moreover IL-1ß and IL-6 levels were increased. Alterations of IL-1ß and IL-6 levels were significant in study group while TNF-α and PGE2 levels were not, compared to control group. Conclusions In conclusion, these results might suggest that glucosamine-chondroitin combination significantly increases the MMO and decreases the synovial fluid IL1β and IL6 levels in internal derangements of TMJ compared to tramadol. The modifications of synovial fluid TNF-α and PGE2 levels do not reach statistical significance. This combination also provides efficient pain relief in similar level with tramadol, a narcotic analgesic. Key words: Chondroitin sulphate, glucosamine, internal derangement, TMJ, tramadol. PMID:25662545

Dissonance and Healthy Weight Eating Disorder Prevention Programs: Long-Term Effects from a Randomized Efficacy Trial

PubMed Central

Stice, Eric; Marti, C. Nathan; Spoor, Sonja; Presnell, Katherine; Shaw, Heather

2009-01-01

Adolescent girls with body dissatisfaction (N=481; SD=1.4) were randomized to a dissonance-based thin-ideal internalization reduction program, healthy weight control program, expressive-writing control condition, or assessment-only control condition. Dissonance participants showed significantly greater decreases in thin-ideal internalization, body dissatisfaction, negative affect, eating disorder symptoms, and psychosocial impairment, and lower risk for eating pathology onset through 2–3 year follow-up than assessment-only controls. Dissonance participants showed greater decreases in thin-ideal internalization, body dissatisfaction, and psychosocial impairment than expressive-writing controls. Healthy weight participants showed greater decreases in thin-ideal internalization, body dissatisfaction, negative affect, eating disorder symptoms, and psychosocial impairment, less increases in weight, and lower risk for eating pathology and obesity onset through 2–3 year follow-up than assessment-only controls. Healthy weight participants showed greater decreases in thin-ideal internalization and weight than expressive writing controls. Dissonance participants showed a 60% reduction in risk for eating pathology onset and healthy weight participants showed a 61% reduction in risk for eating pathology onset and a 55% reduction in risk for obesity onset relative to assessment-only controls through 3-year follow-up, implying that the effects are clinically important and enduring. PMID:18377128

Dosimetric Advantages of Midventilation Compared With Internal Target Volume for Radiation Therapy of Pancreatic Cancer

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

Lens, Eelco, E-mail: e.lens@amc.uva.nl; Horst, Astrid van der; Versteijne, Eva

2015-07-01

Purpose: The midventilation (midV) approach can be used to take respiratory-induced pancreatic tumor motion into account during radiation therapy. In this study, the dosimetric consequences for organs at risk and tumor coverage of using a midV approach compared with using an internal target volume (ITV) were investigated. Methods and Materials: For each of the 18 patients, 2 treatment plans (25 × 2.0 Gy) were created, 1 using an ITV and 1 using a midV approach. The midV dose distribution was blurred using the respiratory-induced motion from 4-dimensional computed tomography. The resulting planning target volume (PTV) coverage for this blurred dosemore » distribution was analyzed; PTV coverage was required to be at least V{sub 95%} >98%. In addition, the change in PTV size and the changes in V{sub 10Gy}, V{sub 20Gy}, V{sub 30Gy}, V{sub 40Gy}, D{sub mean} and D{sub 2cc} for the stomach and for the duodenum were analyzed; differences were tested for significance using the Wilcoxon signed-rank test. Results: Using a midV approach resulted in sufficient target coverage. A highly significant PTV size reduction of 13.9% (P<.001) was observed. Also, all dose parameters for the stomach and duodenum, except the D{sub 2cc} of the duodenum, improved significantly (P≤.002). Conclusions: By using the midV approach to account for respiratory-induced tumor motion, a significant PTV reduction and significant dose reductions to the stomach and to the duodenum can be achieved when irradiating pancreatic tumors.« less

Comparative induction of nitrate reductase by nitrate and nitrite in barley leaves

NASA Technical Reports Server (NTRS)

Aslam, M.; Rosichan, J. L.; Huffaker, R. C.

1987-01-01

The comparative induction of nitrate reductase (NR) by ambient NO3- and NO2- as a function of influx, reduction (as NR was induced) and accumulation in detached leaves of 8-day-old barley (Hordeum vulgare L.) seedlings was determined. The dynamic interaction of NO3- influx, reduction and accumulation on NR induction was shown. The activity of NR, as it was induced, influenced its further induction by affecting the internal concentration of NO3-. As the ambient concentration of NO3- increased, the relative influences imposed by influx and reduction on NO3- accumulation changed with influx becoming a more predominant regulant. Significant levels of NO3- accumulated in NO2(-)-fed leaves. When the leaves were supplied cycloheximide or tungstate along with NO2-, about 60% more NO3- accumulated in the leaves than in the absence of the inhibitors. In NO3(-)-supplied leaves NR induction was observed at an ambient concentration of as low as 0.02 mM. No NR induction occurred in leaves supplied with NO2- until the ambient NO2- concentration was 0.5 mM. In fact, NR induction from NO2- solutions was not seen until NO3- was detected in the leaves. The amount of NO3- accumulating in NO2(-)-fed leaves induced similar levels of NR as did equivalent amounts of NO3- accumulating from NO3(-)-fed leaves. In all cases the internal concentration of NO3-, but not NO2-, was highly correlated with the amount of NR induced. The evidence indicated that NO3- was a more likely inducer of NR than was NO2-.

Reduction of metal artifacts due to dental hardware in computed tomography angiography: assessment of the utility of model-based iterative reconstruction.

PubMed

Kuya, Keita; Shinohara, Yuki; Kato, Ayumi; Sakamoto, Makoto; Kurosaki, Masamichi; Ogawa, Toshihide

2017-03-01

The aim of this study is to assess the value of adaptive statistical iterative reconstruction (ASIR) and model-based iterative reconstruction (MBIR) for reduction of metal artifacts due to dental hardware in carotid CT angiography (CTA). Thirty-seven patients with dental hardware who underwent carotid CTA were included. CTA was performed with a GE Discovery CT750 HD scanner and reconstructed with filtered back projection (FBP), ASIR, and MBIR. We measured the standard deviation at the cervical segment of the internal carotid artery that was affected most by dental metal artifacts (SD 1 ) and the standard deviation at the common carotid artery that was not affected by the artifact (SD 2 ). We calculated the artifact index (AI) as follows: AI = [(SD 1 )2 - (SD 2 )2]1/2 and compared each AI for FBP, ASIR, and MBIR. Visual assessment of the internal carotid artery was also performed by two neuroradiologists using a five-point scale for each axial and reconstructed sagittal image. The inter-observer agreement was analyzed using weighted kappa analysis. MBIR significantly improved AI compared with FBP and ASIR (p < 0.001, each). We found no significant difference in AI between FBP and ASIR (p = 0.502). The visual score of MBIR was significantly better than those of FBP and ASIR (p < 0.001, each), whereas the scores of ASIR were the same as those of FBP. Kappa values indicated good inter-observer agreements in all reconstructed images (0.747-0.778). MBIR resulted in a significant reduction in artifact from dental hardware in carotid CTA.

Open Reduction and Internal Fixation versus Non-Surgical Treatment in Displaced Midshaft Clavicle Fractures: A Meta-Analysis.

PubMed

Ahmed, Abdulaziz F; Salameh, Motasem; AlKhatib, Nidal; Elmhiregh, Aissam; Ahmed, Ghalib O

2018-04-17

To compare open reduction and internal fixation (ORIF) and non-surgical treatment outcomes in displaced midshaft clavicle fractures. PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Library, and ClinicalTrials.gov were searched in September 2017. Inclusion criteria were randomized controlled trials reporting nonunion, shoulder functional outcomes, and subsequent surgery rates or pain scores. We excluded studies with patients younger than 16 years, maximum follow-up less than nine months, and inaccessible full text. Extracted data included the first author, publication year, number of patients, number of nonunions, Constant scores, disabilities of the arm, shoulder and hand (DASH) scores, number of subsequent surgeries, and pain measured using the visual analogue analog scale. The risk ratio (RR) of nonunion was 0.15 (95% confidence interval [CI], 0.08, 0.31) in ORIF compared with that of non-surgical treatment. Constant and DASH scores were significantly better in ORIF up to 6 months. The mean difference (MD) in DASH scores at 12 months was statistically insignificant in both treatments (MD, -4.19; 95% CI, -9.34, 0.96). Constant scores remained significant in ORIF (MD, 4.39; 95% CI, 1.03, 7.75). Subsequent surgeries and pain scores were similar in both treatments. Significant reduction in nonunions and favorable early functional outcomes are associated with ORIF. Nevertheless, late functional outcomes, subsequent surgeries, and pain scores are similar to those of non-surgical treatment. Although patients treated with ORIF mainly had subsequent elective plate removals; non-surgically treated patients had more surgical fixations for nonunions. As a result, there remains inconsistent evidence regarding the best treatment for displaced midshaft clavicle fractures. Therapeutic Level I.

Part II: arthroscopic treatment of tibial plateau fractures: intercondylar eminence avulsion fractures.

PubMed

Lubowitz, James H; Elson, Wylie S; Guttmann, Dan

2005-01-01

Arthroscopic reduction and internal fixation (ARIF) of tibial intercondylar eminence fractures is the emerging state-of-the-art. ARIF is recommended for displaced type III fractures and should be considered for all cases of displaced type II fractures. Fractures without displacement after closed reduction require careful evaluation to rule out meniscal entrapment. Subjective results of ARIF are uniformly excellent, despite reports of objective anteroposterior laxity. Early range-of-motion exercises are essential to prevent loss of extension. Repair using nonabsorbable suture fixation, when of adequate strength to allow early range-of-motion, has the advantages of eliminating the risks of comminution of the fracture fragment, posterior neurovascular injury, and need for hardware removal, compared with ARIF using screws.

Comparison of Lives Saved Tool model child mortality estimates against measured data from vector control studies in sub-Saharan Africa

PubMed Central

2011-01-01

Background Insecticide-treated mosquito nets (ITNs) and indoor-residual spraying have been scaled-up across sub-Saharan Africa as part of international efforts to control malaria. These interventions have the potential to significantly impact child survival. The Lives Saved Tool (LiST) was developed to provide national and regional estimates of cause-specific mortality based on the extent of intervention coverage scale-up. We compared the percent reduction in all-cause child mortality estimated by LiST against measured reductions in all-cause child mortality from studies assessing the impact of vector control interventions in Africa. Methods We performed a literature search for appropriate studies and compared reductions in all-cause child mortality estimated by LiST to 4 studies that estimated changes in all-cause child mortality following the scale-up of vector control interventions. The following key parameters measured by each study were applied to available country projections: baseline all-cause child mortality rate, proportion of mortality due to malaria, and population coverage of vector control interventions at baseline and follow-up years. Results The percent reduction in all-cause child mortality estimated by the LiST model fell within the confidence intervals around the measured mortality reductions for all 4 studies. Two of the LiST estimates overestimated the mortality reductions by 6.1 and 4.2 percentage points (33% and 35% relative to the measured estimates), while two underestimated the mortality reductions by 4.7 and 6.2 percentage points (22% and 25% relative to the measured estimates). Conclusions The LiST model did not systematically under- or overestimate the impact of ITNs on all-cause child mortality. These results show the LiST model to perform reasonably well at estimating the effect of vector control scale-up on child mortality when compared against measured data from studies across a range of malaria transmission settings. The LiST model appears to be a useful tool in estimating the potential mortality reduction achieved from scaling-up malaria control interventions. PMID:21501453

Targeting Interventions: Moderators of the Effects of Expressive Writing and Assertiveness Training on the Adjustment of International University Students

PubMed Central

Hijazi, Alaa M.; Tavakoli, Shedeh; Slavin-Spenny, Olga M.; Lumley, Mark A.

2011-01-01

Acculturative stress is a common experience for international students and is associated with psychological and physical problems. In a previous study, the authors reported that two stress reduction interventions—expressive writing (EW) and assertiveness training (AT)—had limited overall benefits among international students at an American University. The current analyses of data from that study investigated whether individual differences moderated the effects of EW and AT. Results indicate that greater acculturative stress at baseline predicted greater improvement from both interventions, compared with control. Women benefited more from AT than EW, except that EW improved women’s physical symptoms. Men benefited more from EW than AT. Students with limited emotional awareness and expression tended to benefit from both interventions, relative to control. Finally, nation of origin cultural differences generally did not predict outcomes. It is concluded that the benefits of EW and AT and can be enhanced by targeting these interventions to specific subgroups of international students. PMID:21660220

Pediatric mandibular fractures: a free hand technique.

PubMed

Davison, S P; Clifton, M S; Davison, M N; Hedrick, M; Sotereanos, G

2001-01-01

The treatment of pediatric mandibular fractures is rare, controversial, and complicated by mixed dentition. To determine if open mandibular fracture repair with intraoral and extraoral rigid plate placement, after free hand occlusal and bone reduction, without intermaxillary fixation (IMF), is appropriate and to discuss postoperative advantages, namely, maximal early return of function and minimal oral hygiene issues. A group of 29 pediatric patients with a mandibular fracture were examined. Twenty pediatric patients (13 males and 7 females) with a mean age of 9 years (age range, 1-17 years) were treated using IMF. All patients were treated by the same surgeon (G.S.). Surgical time for plating was reduced by 1 hour, the average time to place patients in IMF. The patients who underwent open reduction internal fixation without IMF ate a soft mechanical diet by postoperative day 3 compared with postoperative day 16 for those who underwent IMF. Complication rates related to fixation technique were comparable at 20% for those who did not undergo IMF and 33% for those who did. We believe that free hand reduction is a valuable technique to reduce operative time for pediatric mandibular fractures. It maximizes return to function while minimizing the oral hygiene issues and hardware removal of intermaxillary function.

[Hospitalisation Rates and Duration of Hospital Stays of Patients from an Ambulatory Health Centre Compared to Traditional General Practices - A Practical Example].

PubMed

Woebkenberg, J; Schneider, N

2015-06-01

The reduction of treatment costs in the health-care system is a great challenge for all participating persons and institutions in Germany. In particular, we notice an evident increase in the costs of hospitalisation treatment in the last 20 years. The reduction of a further increase in stationary treatment costs by reducing the hospitalisation rate and the duration of stationary treatment as managed by cooperation of general practitioners and medical specialists could be an important possibility. Is it possible to reduce the hospitalisation rate and the duration of the hospital treatment by cooperation of general practitioners and internal specialists in an ambulatory health centre? The hospitalisation rate and the average duration of the stationary treatment of the "Praxisgemeinschaft" (PG) of the "Gesundheitscentrum Damme" (GCD) at the local hospital were retrospectively analysed for the years 2002 up to 2011 and compared with the data of the remaining general practitioner offices and the data of the "Deutsche Krankenhausstatistik" (German Hospital statistics). We did indeed find a slight increase for the hospitalisation rate from 0.012 to 0.019% of all the ambulant treated patient cases of the PG; but this increase was statistically significantly lower compared with the results of the remaining practitioner offices of the local area as well the data of the "Deutsche Krankenhausstatistik". Similarly, the duration of hospital treatment for the patients of the PG could be significantly more reduced from 10.80 to 6.49 days compared to the results of the 2 other above-mentioned groups. Both the hospitalisation rate as well as the duration of hospital treatment can significantly reduced by cooperation of general practitioner and internal specialist in an ambulatory health centre. © Georg Thieme Verlag KG Stuttgart · New York.

Neuroprotection after a first episode of mania: a randomized controlled maintenance trial comparing the effects of lithium and quetiapine on grey and white matter volume

PubMed Central

Berk, M; Dandash, O; Daglas, R; Cotton, S M; Allott, K; Fornito, A; Suo, C; Klauser, P; Liberg, B; Henry, L; Macneil, C; Hasty, M; McGorry, P; Pantelis, Cs; Yücel, M

2017-01-01

Lithium and quetiapine are effective treatments for bipolar disorder, but their potential neuroprotective effects in humans remain unclear. A single blinded equivalence randomized controlled maintenance trial was conducted in a prospective cohort of first-episode mania (FEM) patients (n=26) to longitudinally compare the putative protective effects of lithium and quetapine on grey and white matter volume. A healthy control sample was also collected (n=20). Using structural MRI scans, voxel-wise grey and white matter volumes at baseline and changes over time in response to treatment were investigated. Patients were assessed at three time points (baseline, 3 and 12-month follow-up), whereas healthy controls were assessed at two time points (baseline and 12-month follow-up). Patients were randomized to lithium (serum level 0.6 mmol l−1, n=20) or quetiapine (flexibly dosed up to 800 mg per day, n=19) monotherapy. At baseline, compared with healthy control subjects, patients with FEM showed reduced grey matter in the orbitofrontal cortex, anterior cingulate, inferior frontal gyrus and cerebellum. In addition, patients had reduced internal capsule white matter volume bilaterally (t1,66>3.20, P<0.01). Longitudinally, there was a significant treatment × time effect only in the white matter of the left internal capsule (F2,112=8.54, P<0.01). Post hoc testing showed that, compared with baseline, lithium was more effective than quetiapine in slowing the progression of white matter volume reduction after 12 months (t1,24=3.76, P<0.01). Our data support the role of lithium but not quetiapine therapy in limiting white matter reduction early in the illness course after FEM. PMID:28117843

Research in Biological and Medical Sciences Including Biochemistry, Communicable Disease and Immunology, Internal Medicine, Physiology, Psychiatry, Surgery, and Veterinary Medicine. Volume 1

DTIC Science & Technology

1979-09-01

and R.P. MacDermott. Antibody-dependent cell-mediated antibacterial activity of human mononuclear cells. I. K-lymphocytes and monocytes are effective...malaria research. During the reporting period, research activities have included analyses of: 1) a hemagglutination inhibition test for early detection of...radioiodination or sodium borohydride reduction. Evaluate the potential roles of activity for each protein isolated. Compare the composition of isolated

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

Greenwood, L. R.; Cantaloub, M. G.; Burnett, J. L.

PNNL has developed two low-background gamma-ray spectrometers in a new shallow underground laboratory, thereby significantly improving its ability to detect low levels of gamma-ray emitting fission or activation products in airborne particulate in samples from the IMS (International Monitoring System). Furthermore, the combination of cosmic veto panels, dry nitrogen gas to reduce radon and low background shielding results in a reduction of the background count rate by about a factor of 100 compared to detectors operating above ground at our laboratory.

WFPC2 Stellar Photometry with HSTphot

NASA Technical Reports Server (NTRS)

Dolphin, Andrew E.

2000-01-01

HSTphot, a photometry package designed to handle the undersampled PSFs found in WFPC2 images, is introduced and described, as well as some of the considerations that have to be made in order to obtain accurate PSF-fitting stellar photometry with WFPC2 data. Tests of HSTphot's internal reliability are made using multiple observations of the same field, and tests of external reliability are made by comparing with DoPHOT reductions of the same data. Subject headz'ngs: techniques: photometric

The effects of brief individual cognitive behavioural therapy for depression and homesickness among international students in Malaysia.

PubMed

Saravanan, Coumaravelou; Alias, Alizi; Mohamad, Mardiana

2017-10-01

Students who go to other countries for higher education face various psychological problems, particularly homesickness and depression. The objectives of this study were to: (a) identify differences between students who did and did not receive brief individual cognitive behavioural therapy (CBT) for depression to reduce homesickness; (b) identify whether brief individual CBT for depression reduces the level of homesickness in students between pre-, post- and follow-up assessment; and (c) compare the scores of students experiencing only homesickness and those experiencing both homesickness and depression. The sample consisted of 520 first-year undergraduate international students. The experimental group contained students who were diagnosed with depression and homesickness and received seven sessions of brief individual CBT for depression to reduce homesickness. The control group contained students who were diagnosed with depression and homesickness and received one session of advice and suggestions. The comparison group contained students who experienced only homesickness and did not receive any interventions. The study used the comparison group to determine if an interaction effect existed between students experiencing only homesickness and students experiencing both homesickness and depression. Students who received brief individual CBT displayed a significant reduction in their homesickness and depression scores compared to the scores of students in the control group. Students who experienced only homesickness exhibited a significant reduction in the scores on homesickness in the post-assessment compared to the control group's post-assessment homesickness scores. The results of this study cannot be generalized as data were collected from three universities in Malaysia. The follow-up assessment was conducted six months after the post-assessment, which also limits generalizability beyond six months. Overall, homesickness is considered a normal reaction. Brief individual CBT for depression is effective in reducing homesickness and depression among international students. Copyright © 2017 Elsevier B.V. All rights reserved.

Methyl Group Internal Rotation in the Pure Rotational Spectrum of 1,1-DIFLUOROACETONE

NASA Astrophysics Data System (ADS)

Grubbs, G. S. Grubbs, II; Cooke, S. A.; Groner, P.

2011-06-01

We have used chirped pulse Fourier transform microwave spectroscopy to record the pure rotational spectrum of the title molecule. The spectrum was doubled owing to the internal rotation of the methyl group. The spectrum has been assigned and two approaches to the spectral analysis have been performed. In the first case, the A and E components were fit separately using a principal axis method with the SPFIT code of Pickett. In the second case, the A and E states were fit simultaneously using the ERHAM code. For a satisfactory analysis of the spectral data it has been found that the choice of Hamiltonian reduction, i.e. Watson A or S, is very important. The barrier to the internal rotation has been determined to be 261.1(8) Cm-1 and it will be compared to that of acetone and other halogenated acetone species recently studied in our laboratory.

Climate impact of biofuels in shipping: global model studies of the aerosol indirect effect.

PubMed

Righi, Mattia; Klinger, Carolin; Eyring, Veronika; Hendricks, Johannes; Lauer, Axel; Petzold, Andreas

2011-04-15

Aerosol emissions from international shipping are recognized to have a large impact on the Earth's radiation budget, directly by scattering and absorbing solar radiation and indirectly by altering cloud properties. New regulations have recently been approved by the International Maritime Organization (IMO) aiming at progressive reductions of the maximum sulfur content allowed in marine fuels from current 4.5% by mass down to 0.5% in 2020, with more restrictive limits already applied in some coastal regions. In this context, we use a global bottom-up algorithm to calculate geographically resolved emission inventories of gaseous (NO(x), CO, SO(2)) and aerosol (black carbon, organic matter, sulfate) species for different kinds of low-sulfur fuels in shipping. We apply these inventories to study the resulting changes in radiative forcing, attributed to particles from shipping, with the global aerosol-climate model EMAC-MADE. The emission factors for the different fuels are based on measurements at a test bed of a large diesel engine. We consider both fossil fuel (marine gas oil) and biofuels (palm and soy bean oil) as a substitute for heavy fuel oil in the current (2006) fleet and compare their climate impact to that resulting from heavy fuel oil use. Our simulations suggest that ship-induced surface level concentrations of sulfate aerosol are strongly reduced, up to about 40-60% in the high-traffic regions. This clearly has positive consequences for pollution reduction in the vicinity of major harbors. Additionally, such reductions in the aerosol loading lead to a decrease of a factor of 3-4 in the indirect global aerosol effect induced by emissions from international shipping.

[Medial versus lateral plating in distal tibial fractures: a prospective study of 40 fractures].

PubMed

Encinas-Ullán, C A; Fernandez-Fernandez, R; Rubio-Suárez, J C; Gil-Garay, E

2013-01-01

Tibial plafond fractures are one of the most challenging injuries in orthopaedic surgery. Their results could be improved by following the new guidelines for the management, and modern plating techniques. The results and complication rate between anteromedial and anterolateral approach for open reduction and internal fixation of these fractures were compared. A study was conducted on 40 patients treated by open reduction an internal fixation between 2007 and 2008. The surgical approach was selected by the surgeon in charge, depending on fracture pattern and skin situation. Patients were evaluated clinically and radiographically by an independent orthopaedic surgeon, not involved in the surgical procedure, using clinical (American Orthopaedic Foot and Ankle Society score) and radiological criteria at a minimum of two years. The appearance of complications after both approaches was recorded. Forty patients were included. The mean age was 53 years, with 24 males and 16 females. Seventeen of the injuries were of high energy, and there were 8 open fractures (3 of type i, 4 type ii and one type iii), and 12 of the closed injuries were grade ii or iii in the Tscherne classification. Six patients (15%) had associated injuries. At final follow-up there were 33 (82%) excellent or good results. No statistical differences were found between either surgical approach regarding time to bone union, rate of delayed union and infection rate. Three plates of the anteromedial group and none of the anterolateral group needed to be removed. Open reduction and internal fixation of distal tibia fractures produced reliable results, with no statistical differences found between anteromedial and anterolateral surgical approaches. Clinical and radiological results and complication rate were mainly related to the fracture type. Copyright © 2012 SECOT. Published by Elsevier Espana. All rights reserved.

Oral-motor and electromyographic characterization of patients submitted to open a nd closed reductions of mandibular condyle fracture.

PubMed

Silva, Amanda Pagliotto da; Sassi, Fernanda Chiarion; Andrade, Claudia Regina Furquim de

To characterize the oral-motor system of adults with mandibular condyle facture comparing the performance of individuals submitted to open reduction with internal fixation (ORIF) and closed reduction with mandibulomaxillary fixation (CRMMF). Study participants were 26 adults divided into three groups: G1 - eight individuals submitted to ORIF for correction of condyle fracture; G2 - nine individuals submitted to CRMMF for correction of condyle fracture; CG - nine healthy volunteers with no alterations of the orofacial myofunctional system. All participants underwent the same clinical protocol: assessment of the orofacial myofunctional system; evaluation of the mandibular range of motion; and surface electromyography (sEMG) of the masticatory muscles. Results indicated that patients with condyle fractures from both groups presented significant differences compared with those from the control group in terms of mobility of the oral-motor organs, mastication, and deglutition. Regarding the measures obtained for mandibular movements, participants with facial fractures from both groups showed significant differences compared with those from the control group, indicating greater restrictions in mandibular motion. As for the analysis of sEMG results, G1 patients presented more symmetrical masseter activation during the task of maximal voluntary teeth clenching. Patients with mandibular condyle fractures present significant deficits in posture, mobility, and function of the oral-motor system. The type of medical treatment does not influence the results of muscle function during the first six months after fracture reduction. Individuals submitted to ORIF of the condyle fracture present more symmetrical activation of the masseter muscle.

Reduction of Cr(6+) to Cr(3+) in a packed-bed bioreactor

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

Turick, C.E.; Apel, W.A.; Camp, C.E.

1997-12-31

Hexavalent chromium, Cr(6{sup +}), is a common and toxic pollutant in soils and waters. Reduction of the mobile Cr(6{sup +}) to the less mobile and less toxic trivalent chromium, Cr(3{sup +}), can be achieved with conventional chemical reduction technologies. Alternatively, Cr(6{sup +}) can be biochemically reduced to Cr(3{sup +}) by anaerobic microbial consortia which appear to use Cr(6{sup +}) as a terminal electron acceptor. A bioprocess for Cr(6{sup +}) reduction has been demonstrated using a packed-bed bioreactor containing ceramic packing, and then compared to a similar bioreactor containing DuPont Bio-Sep beads. An increase in volumetric productivity from 4 mg Cr(6{supmore » +})/L/h to 260 mg Cr(6{sup +})/L/h, probably due to an increase in biomass density, was obtained using Bio-Sep beads. The beads contain internal macropores which were shown by scanning electron microscopy to house dense concentrations of bacteria. Comparisons to conventional Cr(6{sup +}) treatment technologies indicate that a bioprocess has several economic and operational advantages. 7 refs., 4 figs.« less

Management of complications of open reduction and internal fixation of ankle fractures.

PubMed

Ng, Alan; Barnes, Esther S

2009-01-01

The management of complications resulting from the open reduction and internal fixation of ankle fractures is discussed in detail. The initial radiographic findings of the most common postsurgical complications of ankle fracture reduction are briefly discussed, namely lateral, medial, and posterior malleolar malunion or nonunion, syndesmotic widening, degenerative changes, and septic arthritis with or without concomitant osteomyelitis. Emphasis is placed on the management of these complications, with a review of the treatment options proposed in the literature, a detailed discussion of the authors' recommendations, and an inclusion of different case presentations.

Internal performance characteristics of short convergent-divergent exhaust nozzles designed by the method of characteristics

NASA Technical Reports Server (NTRS)

Krull, H George; Beale, William T

1956-01-01

Internal performance data on a short exhaust nozzle designed by the method of characteristics were obtained over a range of pressure ratios from 1.5 to 22. The peak thrust coefficient was not affected by a shortened divergent section, but it occurred at lower pressure ratios due to reduction in expansion ratio. This nozzle contour based on characteristics solution gave higher thrust coefficients than a conical convergent-divergent nozzle of equivalent length. Abrupt-inlet sections permitted a reduction in nozzle length without a thrust-coefficient reduction.

Reduction of High Levels of Internal Radio-Contamination by Dietary Intervention in Residents of Areas Affected by the Fukushima Daiichi Nuclear Plant Disaster: A Case Series

PubMed Central

Tsubokura, Masaharu; Kato, Shigeaki; Nomura, Shuhei; Gilmour, Stuart; Nihei, Masahiko; Sakuma, Yu; Oikawa, Tomoyoshi; Kanazawa, Yukio; Kami, Masahiro; Hayano, Ryugo

2014-01-01

Maintaining low levels of chronic internal contamination among residents in radiation-contaminated areas after a nuclear disaster is a great public health concern. However, the efficacy of reduction measures for individual internal contamination remains unknown. To reduce high levels of internal radiation exposure in a group of individuals exposed through environmental sources, we performed careful dietary intervention with identification of suspected contaminated foods, as part of mass voluntary radiation contamination screenings and counseling program in Minamisoma Municipal General Hospital and Hirata Central Hospital. From a total of 30,622 study participants, only 9 residents displayed internal cesium-137 (Cs-137) levels of more than 50 Bq/kg. The median level of internal Cs-137 contamination in these residents at the initial screening was 4,830 Bq/body (range: 2,130–15,918 Bq/body) and 69.6 Bq/kg (range: 50.7–216.3 Bq/kg). All these residents with high levels of internal contamination consumed homegrown produce without radiation inspection, and often collected mushrooms in the wild or cultivated them on bed-logs in their homes. They were advised to consume distributed food mainly and to refrain from consuming potentially contaminated foods without radiation inspection and local produces under shipment restrictions such as mushrooms, mountain vegetables, and meat of wild life. A few months after the intervention, re-examination of Cs levels revealed remarkable reduction of internal contamination in all residents. Although the levels of internal radiation exposure appear to be minimal amongst most residents in Fukushima, a subset of the population, who unknowingly consumed highly contaminated foodstuffs, experienced high levels of internal contamination. There seem to be similarities in dietary preferences amongst residents with high internal contamination levels, and intervention based on pre- and post-test counseling and dietary advice from medical care providers about risky food intake appears to be a feasible option for changing residents' dietary practices, subsequently resulting in a reduction in Cs internal contamination levels. PMID:24932486

The large-scale placebo-controlled beta-blocker studies in systolic heart failure revisited: results from CIBIS-II, COPERNICUS and SENIORS-SHF compared with stratified subsets from MERIT-HF.

PubMed

Wikstrand, J; Wedel, H; Castagno, D; McMurray, J J V

2014-02-01

The four pivotal beta-blocker trials in heart failure (HF) had different inclusion criteria, making comparison difficult without patient stratifying. The aim of this study was to compare, in similar patients, the effects of bisoprolol, metoprolol controlled release/extended release (CR/XL), carvedilol and nebivolol on (i) total mortality, (ii) all-cause mortality or hospitalization due to cardiovascular causes (time to first event), (iii) all-cause mortality or hospitalization because of HF and (iv) tolerability, defined as discontinuation of randomized treatment. We compared stratified (s ) subsets in MERIT-HF with patients in CIBIS-II [New York Heart Association (NYHA) class III/IV and ejection fraction (EF) ≤ 35%] and COPERNICUS (NYHA III/IV and EF <25%) and in patients with systolic HF in SENIORS-SHF (age ≥ 70 years and EF ≤ 35%). The annual mortality rates in the placebo and beta-blocker arms were: (i) CIBIS-II (n = 2647), 13.2% vs. 8.8% (relative risk reduction 34%, 95% CI: 19-46, P < 0.0001) and MERIT-HFs (n = 2002), 14.8% vs. 8.6% (relative risk reduction 42%, 95% CI: 24-56, P < 0.0001); (ii) COPERNICUS (n = 2289), 19.7% vs. 12.8% (relative risk reduction 35%, 95% CI: 19-48, P = 0.0014) and MERIT-HFs (n = 795), 19.1% vs. 11.7% (relative risk reduction 39%; 95% CI: 11-58, P = 0.0086); (iii) SENIORS-SHF (n = 1359), 11.3% vs. 9.7% (relative risk reduction 16%, NS) and MERIT-HFs (n = 985), 14.8% vs. 10.1% (relative risk reduction 32%, 95% CI: 2-53, P = 0.038). The effects on the other outcomes assessed were similar. Analyses indicated fewer discontinuations from randomized treatment on beta-blockers compared with placebo in COPERNICUS and the MERIT-HFs subsets. The efficacy and tolerability of bisoprolol, carvedilol and metoprolol CR/XL are similar in patients with systolic HF, irrespective of NYHA class or ejection fraction. Nebivolol is less effective and not better tolerated. © 2013 The Association for the Publication of the Journal of Internal Medicine.

7-year follow-up after open reduction and internal screw fixation in Bennett fractures.

PubMed

Leclère, Franck Marie Patrick; Jenzer, Achat; Hüsler, Rolf; Kiermeir, David; Bignion, Dietmar; Unglaub, Frank; Vögelin, Esther

2012-07-01

Bennett fractures are unstable, and, with inadequate treatment, lead to osteoarthritis, weakness and loss of function of the first carpometacarpal joint. This study focuses on long-term functional and radiological outcomes after open reduction and internal fixation. Between June 1997 and December 2005, 24 patients with Bennett fractures were treated with open reduction and internal fixation with screws at our center. Radiological and functional assessments including range of motion of the thumb and pinch and grip strength were performed 4 months post-procedure and at the long-term follow-up, on average 83 months after surgery. Reduction of the Bennett fracture was maintained as it was at the time of the procedure in 96 % of the cases when fixation with two lag screws was performed. At the 4-month follow-up, mean pinch and grip strength reached 92 ± 3 and 89 ± 4 % of the contralateral side, respectively. Long-term follow-up demonstrated no correlation between the accuracy of the fracture reduction and the development of post-traumatic arthritis. Good clinical results could be observed, if successful reduction of the fracture was achieved and maintained. However, there was no correlation between the accuracy of the fracture reduction considering a gap and step <2 mm and the development of arthritis.

Research on Soft Reduction Amount Distribution to Eliminate Typical Inter-dendritic Crack in Continuous Casting Slab of X70 Pipeline Steel by Numerical Model

NASA Astrophysics Data System (ADS)

Liu, Ke; Wang, Chang; Liu, Guo-liang; Ding, Ning; Sun, Qi-song; Tian, Zhi-hong

2017-04-01

To investigate the formation of one kind of typical inter-dendritic crack around triple point region in continuous casting(CC) slab during the operation of soft reduction, fully coupled 3D thermo-mechanical finite element models was developed, also plant trials were carried out in a domestic continuous casting machine. Three possible types of soft reduction amount distribution (SRAD) in the soft reduction region were analyzed. The relationship between the typical inter-dendritic cracks and soft reduction conditions is presented and demonstrated in production practice. Considering the critical strain of internal crack formation, a critical tolerance for the soft reduction amount distribution and related casing parameters have been proposed for better contribution of soft reduction to the internal quality of slabs. The typical inter-dendritic crack around the triple point region had been eliminated effectively through the application of proposed suggestions for continuous casting of X70 pipeline steel in industrial practice.

Global and local scale flood discharge simulations in the Rhine River basin for flood risk reduction benchmarking in the Flagship Project

NASA Astrophysics Data System (ADS)

Gädeke, Anne; Gusyev, Maksym; Magome, Jun; Sugiura, Ai; Cullmann, Johannes; Takeuchi, Kuniyoshi

2015-04-01

The global flood risk assessment is prerequisite to set global measurable targets of post-Hyogo Framework for Action (HFA) that mobilize international cooperation and national coordination towards disaster risk reduction (DRR) and requires the establishment of a uniform flood risk assessment methodology on various scales. To address these issues, the International Flood Initiative (IFI) has initiated a Flagship Project, which was launched in year 2013, to support flood risk reduction benchmarking at global, national and local levels. In the Flagship Project road map, it is planned to identify the original risk (1), to identify the reduced risk (2), and to facilitate the risk reduction actions (3). In order to achieve this goal at global, regional and local scales, international research collaboration is absolutely necessary involving domestic and international institutes, academia and research networks such as UNESCO International Centres. The joint collaboration by ICHARM and BfG was the first attempt that produced the first step (1a) results on the flood discharge estimates with inundation maps under way. As a result of this collaboration, we demonstrate the outcomes of the first step of the IFI Flagship Project to identify flood hazard in the Rhine river basin on the global and local scale. In our assessment, we utilized a distributed hydrological Block-wise TOP (BTOP) model on 20-km and 0.5-km scales with local precipitation and temperature input data between 1980 and 2004. We utilized existing 20-km BTOP model, which is applied globally, and constructed the local scale 0.5-km BTOP model for the Rhine River basin. For the BTOP model results, both calibrated 20-km and 0.5-km BTOP models had similar statistical performance and represented observed flood river discharges, epecially for 1993 and 1995 floods. From 20-km and 0.5-km BTOP simulation, the flood discharges of the selected return period were estimated using flood frequency analysis and were comparable to the the river gauging station data at the German part of the Rhine river basin. This is an important finding that both 0.5-km and 20-km BTOP models produce similar flood peak discharges although the 0.5-km BTOP model results indicate the importance of scale in the local flood hazard assessment. In summary, we highlight that this study serves as a demonstrative example of institutional collaboration and is stepping stone for the next step implementation of the IFI Flagship Project.

Foreign body impaction in the esophagus: are there underlying motor disorders?

PubMed

Mazzadi, S; Salis, G B; García, A; Iannicillo, H; Fucile, V; Chiocca, J C

2017-11-01

Compared with the control group, the impacted subjects presented marked reduction in amplitude and duration of esophageal contraction in the proximal esophagus. These motor disorders could be responsible for the foreign body impaction in the esophagus. However, we believe this patient group should be further studied by 24-hour esophageal manometry to reach a more accurate diagnosis by studying each patient's entire circadian cycle. © 1998 International Society for Diseases of the Esophagus/Harcourt Brace & Co. Ltd

USSR Report, International Affairs, Peoples of Asia and Africa,No 6, November-December 1986.

DTIC Science & Technology

1987-05-05

own laws, and it would be incorrect from a scientific point of view and dangerous from a political one to approach them with criteria that reflect...reduction, a halt in the development of capitalism, and its gradual removal from the commanding heights and its placement under the control of the...development, which in practice signified rapid growth in the sectors of the 2nd subdivision. Over a comparatively short period of time, the production of

IEEE International Symposium on Information Theory (ISIT): Abstracts of Papers, Held in Ann Arbor, Michigan on 6-9 October 1986.

DTIC Science & Technology

1986-10-01

BUZO, and FEDERICO KUHLMANN, Universidad Nacional Autdnoma de Mixico, Facultad de Ingenieria , Divisidn Estudios de Posgrado, P.O. Box 70-256, 04510...unsuccess- ful in this area for a long time. It was felt, e.g., in the voiceband modem industry , that the coding gains achievable by error-correction coding...without bandwidth expansion or data rate reduction, when compared to uncoded modulation. The concept was quickly adopted by industry , and is now becoming

Infrasonic wind-noise reduction by barriers and spatial filters.

PubMed

Hedlin, Michael A H; Raspet, Richard

2003-09-01

This paper reports experimental observations of wind speed and infrasonic noise reduction inside a wind barrier. The barrier is compared with "rosette" spatial filters and with a reference site that uses no noise reduction system. The barrier is investigated for use at International Monitoring System (IMS) infrasound array sites where spatially extensive noise-reducing systems cannot be used because of a shortage of suitable land. Wind speed inside a 2-m-high 50%-porous hexagonal barrier coated with a fine wire mesh is reduced from ambient levels by 90%. If the infrasound wind-noise level reductions are all plotted versus the reduced frequency given by f*L/v, where L is the characteristic size of the array or barrier, f is the frequency, and v is the wind speed, the reductions at different wind speeds are observed to collapse into a single curve for each wind-noise reduction method. The reductions are minimal below a reduced frequency of 0.3 to 1, depending on the device, then spatial averaging over the turbulence structure leads to increased reduction. Above the reduced corner frequency, the barrier reduces infrasonic noise by up to 20 to 25 dB. Below the corner frequency the barrier displays a small reduction of about 4 dB. The rosettes display no reduction below the corner frequency. One other advantage of the wind barrier over rosette spatial filters is that the signal recorded inside the barrier enters the microbarometer from free air and is not integrated, possibly out of phase, after propagation through a system of narrow pipes.

External versus internal fixation for bicondylar tibial plateau fractures: systematic review and meta-analysis.

PubMed

Metcalfe, David; Hickson, Craig J; McKee, Lesley; Griffin, Xavier L

2015-12-01

It is uncertain whether external fixation or open reduction internal fixation (ORIF) is optimal for patients with bicondylar tibial plateau fractures. A systematic review using Ovid MEDLINE, Embase Classic, Embase, AMED, the Cochrane Library, Open Grey, Orthopaedic Proceedings, WHO International Clinical Trials Registry Platform, Current Controlled Trials, US National Institute for Health Trials Registry, and the Cochrane Central Register of Controlled Trials. The search was conducted on 3rd October 2014 and no language limits were applied. Inclusion criteria were all clinical study designs comparing external fixation with open reduction internal fixation of bicondylar tibial plateau fractures. Studies of only one treatment modality were excluded, as were those that included unicondylar tibial plateau fractures. Treatment effects from studies reporting dichotomous outcomes were summarised using odds ratios. Continuous outcomes were converted to standardized mean differences to assess the treatment effect, and inverse variance methods used to combine data. A fixed effect model was used for meta-analyses. Patients undergoing external fixation were more likely to have returned to preinjury activities by six and twelve months (P = 0.030) but not at 24 months follow-up. However, external fixation was complicated by a greater number of infections (OR 2.59, 95 % CI 1.25-5.36, P = 0.01). There were no statistically significant differences in the rates of deep infection, venous thromboembolism, compartment syndrome, or need for re-operation between the two groups. Although external fixation and ORIF are associated with different complication profiles, both are acceptable strategies for managing bicondylar tibial plateau fractures.

Immobilization of Acetobacter sp. CCTCC M209061 for efficient asymmetric reduction of ketones and biocatalyst recycling

PubMed Central

2012-01-01

Background The bacterium Acetobacter sp. CCTCC M209061 is a promising whole-cell biocatalyst with exclusive anti-Prelog stereoselectivity for the reduction of prochiral ketones that can be used to make valuable chiral alcohols such as (R)-4-(trimethylsilyl)-3-butyn-2-ol. Although it has promising catalytic properties, its stability and reusability are relatively poor compared to other biocatalysts. Hence, we explored various materials for immobilizing the active cells, in order to improve the operational stability of biocatalyst. Results It was found that Ca-alginate give the best immobilized biocatalyst, which was then coated with chitosan to further improve its mechanical strength and swelling-resistance properties. Conditions were optimized for formation of reusable immobilized beads which can be used for repeated batch asymmetric reduction of 4′-chloroacetophenone. The optimized immobilized biocatalyst was very promising, with a specific activity of 85% that of the free-cell biocatalyst (34.66 μmol/min/g dw of cells for immobilized catalyst vs 40.54 μmol/min/g for free cells in the asymmetric reduction of 4′-chloroacetophenone). The immobilized cells showed better thermal stability, pH stability, solvent tolerance and storability compared with free cells. After 25 cycles reaction, the immobilized beads still retained >50% catalytic activity, which was 3.5 times higher than degree of retention of activity by free cells reused in a similar way. The cells could be recultured in the beads to regain full activity and perform a further 25 cycles of the reduction reaction. The external mass transfer resistances were negligible as deduced from Damkohler modulus Da < <1, and internal mass transfer restriction affected the reduction action but was not the principal rate-controlling step according to effectiveness factors η < 1 and Thiele modulus 0.3<∅ <1. Conclusions Ca-alginate coated with chitosan is a highly effective material for immobilization of Acetobacter sp. CCTCC M209061 cells for repeated use in the asymmetric reduction of ketones. Only a small cost in terms of the slightly lower catalytic activity compared to free cells could give highly practicable immobilized biocatalyst. PMID:22947394

Immobilization of Acetobacter sp. CCTCC M209061 for efficient asymmetric reduction of ketones and biocatalyst recycling.

PubMed

Chen, Xiao-Hong; Wang, Xiao-Ting; Lou, Wen-Yong; Li, Ying; Wu, Hong; Zong, Min-Hua; Smith, Thomas J; Chen, Xin-De

2012-09-04

The bacterium Acetobacter sp. CCTCC M209061 is a promising whole-cell biocatalyst with exclusive anti-Prelog stereoselectivity for the reduction of prochiral ketones that can be used to make valuable chiral alcohols such as (R)-4-(trimethylsilyl)-3-butyn-2-ol. Although it has promising catalytic properties, its stability and reusability are relatively poor compared to other biocatalysts. Hence, we explored various materials for immobilizing the active cells, in order to improve the operational stability of biocatalyst. It was found that Ca-alginate give the best immobilized biocatalyst, which was then coated with chitosan to further improve its mechanical strength and swelling-resistance properties. Conditions were optimized for formation of reusable immobilized beads which can be used for repeated batch asymmetric reduction of 4'-chloroacetophenone. The optimized immobilized biocatalyst was very promising, with a specific activity of 85% that of the free-cell biocatalyst (34.66 μmol/min/g dw of cells for immobilized catalyst vs 40.54 μmol/min/g for free cells in the asymmetric reduction of 4'-chloroacetophenone). The immobilized cells showed better thermal stability, pH stability, solvent tolerance and storability compared with free cells. After 25 cycles reaction, the immobilized beads still retained >50% catalytic activity, which was 3.5 times higher than degree of retention of activity by free cells reused in a similar way. The cells could be recultured in the beads to regain full activity and perform a further 25 cycles of the reduction reaction. The external mass transfer resistances were negligible as deduced from Damkohler modulus Da < <1, and internal mass transfer restriction affected the reduction action but was not the principal rate-controlling step according to effectiveness factors η < 1 and Thiele modulus 0.3<∅ <1. Ca-alginate coated with chitosan is a highly effective material for immobilization of Acetobacter sp. CCTCC M209061 cells for repeated use in the asymmetric reduction of ketones. Only a small cost in terms of the slightly lower catalytic activity compared to free cells could give highly practicable immobilized biocatalyst.

A retrospective photometric study of 82 published reports of mastopexy and breast reduction.

PubMed

Swanson, Eric

2011-12-01

Numerous publications claim to improve breast projection and upper pole fullness after mastopexy or breast reduction. Fascial sutures and "autoaugmentation" with local flaps are advocated. However, there is no objective evidence that these efforts are effective. The author has proposed a measuring system to quantitate results. Not only is this system useful for assessing one's own results, but it may also be used to assess and compare results in published studies. Eighty-two international publications on mastopexies and breast reductions were analyzed. The studies were grouped by technique: inverted-T (superior/medial, central, and inferior pedicles), vertical, periareolar, inframammary, lateral, and "other." Measurements were made using the definitions and terminology reported separately and included breast projection, upper pole projection, lower pole level, nipple level, breast convexity, breast parenchymal ratio, and lower pole ratio. Areola shape was assessed. Breast projection and upper pole projection were not increased significantly by any of the mastopexy/reduction procedures or by the use of fascial sutures or autoaugmentation techniques. Nipple overelevation was common (41.9 percent). The incidence of the teardrop areola deformity (53.8 percent) was significantly higher (p < 0.001) in patients treated with the open technique of nipple placement. There was no significant difference in results when compared by follow-up times, resection weights, year of publication, or geographic region. Existing mastopexy/reduction techniques do not significantly increase breast projection or upper pole projection. Fascial sutures and autoaugmentation techniques are ineffective. Nipple overelevation and the teardrop areola deformity are common problems and should be avoided.

26 CFR 1.1017-1 - Basis reductions following a discharge of indebtedness.

Code of Federal Regulations, 2011 CFR

2011-04-01

... profits of the partnership, or if reductions to the basis of the taxpayer's depreciable property (or... 26 Internal Revenue 11 2011-04-01 2011-04-01 false Basis reductions following a discharge of... Basis reductions following a discharge of indebtedness. (a) General rule for section 108(b)(2)(E). This...

26 CFR 1.1017-1 - Basis reductions following a discharge of indebtedness.

Code of Federal Regulations, 2010 CFR

2010-04-01

... profits of the partnership, or if reductions to the basis of the taxpayer's depreciable property (or... 26 Internal Revenue 11 2010-04-01 2010-04-01 true Basis reductions following a discharge of... reductions following a discharge of indebtedness. (a) General rule for section 108(b)(2)(E). This paragraph...

Evaluation of Bite Force After Open Reduction and Internal Fixation Using Microplates

PubMed Central

Kumar, S Tharani; Saraf, Saurabh; Devi, S Prasanna

2013-01-01

The primary aim of this study is to determine maximum bite force in molar and incisor regions of healthy individuals, to evaluate the bite force after open reduction and internal fixation of mandibular fractures using micro plates, for a period of up to 6 weeks and to determine the rate of recovery of maximum bite force in an Indian population. PMID:24910656

The spectra program library: A PC based system for gamma-ray spectra analysis and INAA data reduction

USGS Publications Warehouse

Baedecker, P.A.; Grossman, J.N.

1995-01-01

A PC based system has been developed for the analysis of gamma-ray spectra and for the complete reduction of data from INAA experiments, including software to average the results from mulitple lines and multiple countings and to produce a final report of analysis. Graphics algorithms may be called for the analysis of complex spectral features, to compare the data from alternate photopeaks and to evaluate detector performance during a given counting cycle. A database of results for control samples can be used to prepare quality control charts to evaluate long term precision and to search for systemic variations in data on reference samples as a function of time. The entire software library can be accessed through a user-friendly menu interface with internal help.

Internalization and localization of basal insulin peglispro in cells.

PubMed

Moyers, Julie S; Volk, Catherine B; Cao, Julia X C; Zhang, Chen; Ding, Liyun; Kiselyov, Vladislav V; Michael, M Dodson

2017-10-15

Basal insulin peglispro (BIL) is a novel, PEGylated insulin lispro that has a large hydrodynamic size compared with insulin lispro. It has a prolonged duration of action, which is related to a delay in insulin absorption and a reduction in clearance. Given the different physical properties of BIL compared with native insulin and insulin lispro, it is important to assess the cellular internalization characteristics of the molecule. Using immunofluorescent confocal imaging, we compared the cellular internalization and localization patterns of BIL, biosynthetic human insulin, and insulin lispro. We assessed the effects of BIL on internalization of the insulin receptor (IR) and studied cellular clearance of BIL. Co-localization studies using antibodies to either insulin or PEG, and the early endosomal marker EEA1 showed that the overall internalization and subcellular localization pattern of BIL was similar to that of human insulin and insulin lispro; all were rapidly internalized and co-localized with EEA1. During ligand washout for 4 h, concomitant loss of insulin, PEG methoxy group, and PEG backbone immunostaining was observed for BIL, similar to the loss of insulin immunostaining observed for insulin lispro and human insulin. Co-localization studies using an antibody to the lysosomal marker LAMP1 did not reveal evidence of lysosomal localization for insulin lispro, human insulin, BIL, or PEG using either insulin or PEG immunostaining reagents. BIL and human insulin both induced rapid phosphorylation and internalization of human IR. Our findings show that treatment of cells with BIL stimulates internalization and localization of IR to early endosomes. Both the insulin and PEG moieties of BIL undergo a dynamic cellular process of rapid internalization and transport to early endosomes followed by loss of cellular immunostaining in a manner similar to that of insulin lispro and human insulin. The rate of clearance for the insulin lispro portion of BIL was slower than the rate of clearance for human insulin. In contrast, the PEG moiety of BIL can recycle out of cells. Copyright © 2017 Elsevier B.V. All rights reserved.

Fixation orientation in ankle fractures with syndesmosis injury.

PubMed

Nimick, Craig J; Collman, David R; Lagaay, Pieter

2013-01-01

Accurate reduction of the syndesmosis has been shown to be an important prognostic factor for functional outcome in ankle injuries that disrupt the syndesmosis. The purpose of the present case series was to assess the fixation orientation and the position of the fibula within the tibial incisura after open reduction and internal fixation of ankle fractures with syndesmosis injury. Computed tomography was used to assess the accuracy of the reduction. Twelve patients were included in the present case series. A ratio representing the relationship between the tibia and fibula and the orientation of the syndesmotic fixation was measured preoperatively and postoperatively and compared with the uninjured contralateral ankle, representing the patient's normal anatomy. The measurements were accomplished electronically to one tenth of 1 mm using Stentor Intelligent Informatics, I-site, version 3.3.1 (Phillips Electronics; Andover, MA). Posteriorly oriented syndesmotic fixation caused posterior translation of the fibula with respect to the tibia and anteriorly oriented syndesmotic fixation caused anterior translation. Copyright © 2013. Published by Elsevier Inc.

Open reduction internal fixation of the unstable mallet fracture.

PubMed

Phadnis, Joideep; Yousaf, Sohail; Little, Nicholas; Chidambaram, Ramiah; Mok, Daniel

2010-09-01

Unstable mallet fractures of the digit pose a challenge when treated surgically. We present the results of a technique, not earlier described, for the fixation of these uncommon injuries. The technique involves anatomical reduction and stable fixation of the distal articular fragment combined with stabilization of the distal interphalangeal joint with buried Kirschner wires allowing early mobilization of the digit. Twenty patients with an average follow-up of 12.7 months (10 mo to 21 mo) are presented. Results were good/excellent (Crawford's criteria) in 16 patients, fair in 3, and poor in 1 with those operated upon within 2 weeks postinjury achieving the best results. There were no incidences of fixation failure, loss of reduction, or posttraumatic osteoarthritis. One patient had a minor infection, but there were no cases of nail deformity or wound breakdown. There was high patient satisfaction and all patients returned to work after treatment. We conclude that this is a reliable technique with minimal complications and is comparable with other published operative and nonoperative treatment modalities.

Enhanced Airport Capacity Through Safe, Dynamic Reductions in Aircraft Separation: NASA's Aircraft VOrtex Spacing System (AVOSS)

NASA Technical Reports Server (NTRS)

OConnor, Cornelius J.; Rutishauser, David K.

2001-01-01

An aspect of airport terminal operations that holds potential for efficiency improvements is the separation criteria applied to aircraft for wake vortex avoidance. These criteria evolved to represent safe spacing under weather conditions conducive to the longest wake hazards, and are consequently overly conservative during a significant portion of operations. Under many ambient conditions, such as moderate crosswinds or turbulence, wake hazard durations are substantially reduced. To realize this reduction NASA has developed a proof-of-concept Aircraft Vortex Spacing System (AVOSS). Successfully operated in a real-time field demonstration during July 2000 at the Dallas Ft. Worth International Airport, AVOSS is a novel integration of weather sensors, wake sensors, and analytical wake prediction algorithms. Gains in airport throughput using AVOSS spacing as compared to the current criteria averaged 6%, with peak values approaching the theoretical maximum of 16%. The average throughput gain translates to 15-40% reductions in delay when applied to realistic capacity ratios at major airports.

Superoxide and nitric oxide production by Kupffer cells in rats with obstructive jaundice: effect of internal and external drainage.

PubMed

Li, Wen; Chan, Angus C W; Lau, James Y W; Lee, Danny W H; Ng, Enders K W; Sung, Joseph J Y; Chung, S C Sydney

2004-02-01

The role of Kupffer cells in obstructive jaundice (OJ) has not been fully understood. The aims of the present study were to measure superoxide and nitric oxide (NO) production by Kupffer cells in experimental OJ in rats and to investigate the response to internal and external biliary drainage. Eighty male Sprague-Dawley rats were assigned to four groups: sham operation, OJ, and internal and external biliary drainage. Kupffer cells were isolated on day 7 in the sham operation and OJ group, and on day 7 after drainage procedures. Cells were cultured with or without lipopolysaccharide (LPS). Superoxide production was quantified in cultured Kupffer cells at 2 h and 48 h, respectively, after cell isolation using the superoxide dismutase inhibitable ferricytochrome c reduction method. Nitrite production in cell culture supernatants was measured 48 h later using Greiss reagents. Without LPS stimulation, Kupffer cells produced comparable superoxide and nitrite in each group (P > 0.05). With LPS stimulation, Kupffer cells in the OJ group produced significantly higher superoxide anions than the other groups (P = 0.006). Nitrite production was significantly increased in the OJ group and external biliary drainage group compared to rats in the sham operation and internal drainage groups (P < 0.01). Kupffer cells from rats with OJ produce great amounts of endotoxin-mediated oxidants. Both internal and external biliary drainage can decrease the elevated superoxide production. Internal drainage is superior to external drainage for reversing the distortional capacity of NO production by Kupffer cells.

[Treatment of open tile type C pelvic fractures by open reduction and internal fixation through anterior and posterior approaches at early stage].

PubMed

Li, Baichuan

2014-05-01

To explore the effectiveness of open reduction and internal fixation through anterior and posterior approaches in treatment of open Tile type C pelvic fractures at early stage. Between January 2009 and April 2012, 12 patients with open Tile C pelvic fractures were treated. There were 7 males and 5 females, aged 6-53 years (median, 31 years). Of 12 cases, 4 were classified as Tile type C1, 6 as Tile type C2, and 2 as Tile type C3; 5 were rated as Gustilo type II and 7 as Gustilo type III. The injury severity score was 18-57 (mean, 37.2). The interval of injury and admission ranged from 15 minutes to 3 days (median, 50 minutes). The debridement and external fixation were performed at first stage; then open reduction and internal fixation were used through anterior approach (reconstruction plate) and posterior approach (cannulated lag screws). The vacuum sealing drainage was performed during treatment until the wounds healed. Delayed healing of incison was obtained in 12 cases because of wound infection. Anatomical reduction or approximate anatomical reduction was achieved in all 12 cases. The patients were followed up 3-39 months (median, 18 months). No loosening of internal fixation or fracture displacement was observed during follow-up. The fracture healing time was 7-13 weeks (mean, 9.7 weeks). At last follow-up, according to the Matta standard, the outcome was excellent in 10 cases and good in 2 cases; according to Majeed score, the results were excellent in 9 cases, good in 1, and poor in 2. Early internal fixation operation of open Tile type C pelvic fractures can effectively restore the pelvic anatomical structure and stability, reduce the complication, and achieve satisfactory effectiveness.

[Multi-Target Recognition of Internal and External Defects of Potato by Semi-Transmission Hyperspectral Imaging and Manifold Learning Algorithm].

PubMed

Huang, Tao; Li, Xiao-yu; Jin, Rui; Ku, Jing; Xu, Sen-miao; Xu, Meng-ling; Wu, Zhen-zhong; Kong, De-guo

2015-04-01

The present paper put forward a non-destructive detection method which combines semi-transmission hyperspectral imaging technology with manifold learning dimension reduction algorithm and least squares support vector machine (LSSVM) to recognize internal and external defects in potatoes simultaneously. Three hundred fifteen potatoes were bought in farmers market as research object, and semi-transmission hyperspectral image acquisition system was constructed to acquire the hyperspectral images of normal external defects (bud and green rind) and internal defect (hollow heart) potatoes. In order to conform to the actual production, defect part is randomly put right, side and back to the acquisition probe when the hyperspectral images of external defects potatoes are acquired. The average spectrums (390-1,040 nm) were extracted from the region of interests for spectral preprocessing. Then three kinds of manifold learning algorithm were respectively utilized to reduce the dimension of spectrum data, including supervised locally linear embedding (SLLE), locally linear embedding (LLE) and isometric mapping (ISOMAP), the low-dimensional data gotten by manifold learning algorithms is used as model input, Error Correcting Output Code (ECOC) and LSSVM were combined to develop the multi-target classification model. By comparing and analyzing results of the three models, we concluded that SLLE is the optimal manifold learning dimension reduction algorithm, and the SLLE-LSSVM model is determined to get the best recognition rate for recognizing internal and external defects potatoes. For test set data, the single recognition rate of normal, bud, green rind and hollow heart potato reached 96.83%, 86.96%, 86.96% and 95% respectively, and he hybrid recognition rate was 93.02%. The results indicate that combining the semi-transmission hyperspectral imaging technology with SLLE-LSSVM is a feasible qualitative analytical method which can simultaneously recognize the internal and external defects potatoes and also provide technical reference for rapid on-line non-destructive detecting of the internal and external defects potatoes.

Simultaneous nitrification-denitrification achieved by an innovative internal-loop airlift MBR: comparative study.

PubMed

Li, Y Z; He, Y L; Ohandja, D G; Ji, J; Li, J F; Zhou, T

2008-09-01

This study assessed the performance of different single-stage continuous aerated submerged membrane bioreactors (MBR) for nitrogen removal. Almost complete nitrification was achieved in each MBR irrespective of operating mode and biomass system. Denitrification was found to be the rate-limiting step for total nitrogen (T-N) removal. The MBR with internal-loop airlift reactor (ALR) configuration performed better as regards T-N removal compared with continuous stirred-tank reactor (CSTR). It was demonstrated that simultaneous nitrification and denitrification (SND) is the mechanism leading to nitrogen removal and the contribution of microenvironment on SND is more remarkable for the MBRs with hybrid biomass. Macroenvironment analyses showed that gradient distribution of dissolved oxygen (DO) level in airlift MBRs imposed a significant effect on SND. Higher mixed liquor suspended solid (MLSS) concentration led to the improvement in T-N removal by enhancing anoxic microenvironment. Apparent nitrite accumulation coupled with higher nitrogen reduction was accomplished at MLSS concentration exceeded 12.6 g/L.

Attentional focus and performance anxiety: effects on simulated race-driving performance and heart rate variability.

PubMed

Mullen, Richard; Faull, Andrea; Jones, Eleri S; Kingston, Kieran

2012-01-01

Previous studies have demonstrated that an external focus can enhance motor learning compared to an internal focus. The benefits of adopting an external focus are attributed to the use of less effortful automatic control processes, while an internal focus relies upon more effort-intensive consciously controlled processes. The aim of this study was to compare the effectiveness of a distal external focus with an internal focus in the acquisition of a simulated driving task and subsequent performance in a competitive condition designed to increase state anxiety. To provide further evidence for the automatic nature of externally controlled movements, the study included heart rate variability (HRV) as an index of mental effort. Sixteen participants completed eight blocks of four laps in either a distal external or internal focus condition, followed by two blocks of four laps in the competitive condition. During acquisition, the performance of both groups improved; however, the distal external focus group outperformed the internal focus group. The poorer performance of the internal focus group was accompanied by a larger reduction in HRV, indicating a greater investment of mental effort. In the competition condition, state anxiety increased, and for both groups, performance improved as a function of the increased anxiety. Increased heart rate and self-reported mental effort accompanied the performance improvement. The distal external focus group also outperformed the internal focus group across both neutral and competitive conditions and this more effective performance was again associated with lower levels of HRV. Overall, the results offer support for the suggestion that an external focus promotes a more automatic mode of functioning. In the competitive condition, both foci enhanced performance and while the improved performance may have been achieved at the expense of greater compensatory mental effort, this was not reflected in HRV scores.

Secondary harm mitigation: A more humanitarian framework for international drug law enforcement.

PubMed

Blaustein, Jarrett; McLay, Miki; McCulloch, Jude

2017-08-01

This article introduces the concept of 'secondary harm mitigation' as a framework for improving the humanitarian credentials of international drug law enforcement agencies. The concept is rooted in a critical analysis of the compatibility of the harm reduction philosophy with Australia's international drug law enforcement practices. On a utilitarian level, the net benefits of international drug law enforcement are determined to be, at best inconclusive, arguably counterproductive and in most cases, incalculable. On a humanitarian level, international drug law enforcement is also determined to be problematic from a criminological standpoint because it generates secondary harms and it is indifferent to the vulnerability of individuals who participate in illicit drug trafficking. Accordingly, the article concludes that a philosophy of harm reduction grounded in the public health perspective is inadequate for mitigating secondary harms arising from Australia's efforts to combat international illicit drug trafficking. A tentative list of secondary harm mitigation principles is presented and the article argues that secondary harm mitigation should replace supply reduction as a core tenet of Australia's National Drug Strategy. The article also concludes that secondary harm mitigation may provide a viable framework for stimulating a productive dialogue between those who advocate prohibition and those who call for decriminalisation at the global level. Copyright © 2017 Elsevier B.V. All rights reserved.

Functional outcome of displaced intra-articular calcaneal fractures: a comparison between open reduction/internal fixation and a minimally invasive approach featured an anatomical plate and compression bolts.

PubMed

Wu, Zhanpo; Su, Yanling; Chen, Wei; Zhang, Qi; Liu, Yueju; Li, Ming; Wang, Haili; Zhang, Yingze

2012-09-01

The purpose of this study is to assess the clinical results of a minimally invasive treatment featured the concept of internal compression, including an anatomic plate and multiple compression bolts compared with open reduction and internal fixation for displaced intra-articular calcaneal fractures (DIACFs). We retrospectively analyzed 329 patients (383 feet) who were identified from trauma inpatient database in our hospital for DIACFs from January 2004 to December 2009. Of them, 148 patients (170 feet) were treated with open reduction and internal fixation (OR group), which involved using a traditional L-shaped extended lateral approach, and fractures were fixed by plate and screws from January 2004 to December 2006; 181 patients (213 feet) were treated with a minimally invasive approach featured the concept of calcaneal internal compression (CIC group), which was achieved by an anatomic plate and multiple compression bolts through a small lateral incision from January 2007 to December 2009. Postoperative complications were recorded. During follow-up, pain and functional outcome were evaluated with the American Orthopaedic Foot and Ankle Society (AOFAS) scores and compared between the two groups. Subsequent subtalar arthrodesis and early implant removal were performed when indicated. Routine hardware removal was scheduled for all patients at 1-year follow-up. There were no significant differences in sex, age, and fracture classification (Sanders classification) between the two groups. Wound healing complications were 4 of 213 (1.88%) in CIC group and 20 of 170 (11.76%) in OR group. Subtalar arthrodesis had to be performed in one case in OR group. Four cases in CIC group and four cases in OR group had the hardware removed earlier due to complications. The average time after surgery to start weight-bearing exercise is 5.64 weeks in CIC group and 9.38 weeks in OR group (p < 0.001). The mean AOFAS score is higher in CIC group than in OR group, although the difference is not statistically significant (87.53 vs. 84.95; p = 0.191). The overall results according to the AOFAS scoring system were good or excellent in 185 of 213 (86.85%) in CIC group and 144 of 170 (84.71%) in OR group. The subjective portion of the AOFAS survey answered by patients showed statistically significant difference in activity limitation and walking surface score (7.31 vs. 7.02 and 3.72 vs. 3.42; p < 0.05) but not in pain and walking distance between the two groups (32.72 vs. 32.29 and 4.37 vs. 4.42; p > 0.05). The study results suggest that this minimally invasive approach featured the concept of the calcaneal internal compression can achieve functional outcome as good as, if not better than the open techniques. It is proved to be an effective alternative treatment for DIACFs. Therapeutic study, level IV.

Internal Kinematics of the Tongue Following Volume Reduction

PubMed Central

SHCHERBATYY, VOLODYMYR; PERKINS, JONATHAN A.; LIU, ZI-JUN

2008-01-01

This study was undertaken to determine the functional consequences following tongue volume reduction on tongue internal kinematics during mastication and neuromuscular stimulation in a pig model. Six ultrasonic-crystals were implanted into the tongue body in a wedge-shaped configuration which allows recording distance changes in the bilateral length (LENG) and posterior thickness (THICK), as well as anterior (AW), posterior dorsal (PDW), and ventral (PVW) widths in 12 Yucatan-minipigs. Six animals received a uniform mid-sagittal tongue volume reduction surgery (reduction), and the other six had identical incisions without tissue removal (sham). The initial-distances among each crystal-pairs were recorded before, and immediately after surgery to calculate the dimensional losses. Referring to the initial-distance there were 3−66% and 1−4% tongue dimensional losses by the reduction and sham surgeries, respectively. The largest deformation in sham animals during mastication was in AW, significantly larger than LENG, PDW, PVW, and THICK (P < 0.01−0.001). In reduction animals, however, these deformational changes significantly diminished and enhanced in the anterior and posterior tongue, respectively (P < 0.05−0.001). In both groups, neuromuscular stimulation produced deformational ranges that were 2−4 times smaller than those occurred during chewing. Furthermore, reduction animals showed significantly decreased ranges of deformation in PVW, LENG, and THICK (P < 0.05−0.01). These results indicate that tongue volume reduction alters the tongue internal kinematics, and the dimensional losses in the anterior tongue caused by volume reduction can be compensated by increased deformations in the posterior tongue during mastication. This compensatory effect, however, diminishes during stimulation of the hypoglossal nerve and individual tongue muscles. PMID:18484603

An experimental investigation of internal area ruling for transonic and supersonic channel flow

NASA Technical Reports Server (NTRS)

Roberts, W. B.; Vanrintel, H. L.; Rizvi, G.

1982-01-01

A simulated transonic rotor channel model was examined experimentally to verify the flow physics of internal area ruling. Pressure measurements were performed in the high speed wind tunnel at transonic speeds with Mach 1.5 and Mach 2 nozzle blocks to get an indication of the approximate shock losses. The results showed a reduction in losses due to internal area ruling with the Mach 1.5 nozzle blocks. The reduction in total loss coefficient was of the order of 17 percent for a high blockage model and 7 percent for a cut-down model.

Moderators of the Intervention Effects for a Dissonance-Based Eating Disorder Prevention Program; Results from an Amalgam of Three Randomized Trials

PubMed Central

Müller, Sina; Stice, Eric

2013-01-01

Objective To investigate factors hypothesized to moderate the effects of a dissonance-based eating disorder prevention program, including initial elevations in thin-ideal internalization, body dissatisfaction, eating disorder symptoms, and older participant age. Method Adolescent female high school and college students with body image concerns (N = 977; M age = 18.6) were randomized to a dissonance-based thin-ideal internalization reduction program or an assessment-only control condition in three prevention trials. Results The intervention produced (a) significantly stronger reductions in thin-ideal internalization for participants with initial elevations in thin-ideal internalization and a threshold/subthreshold DSM-5 eating disorder at baseline, (b) significantly greater reductions in eating disorder symptoms for participants with versus without a DSM-5 eating disorder at baseline, and (c) significantly stronger reductions in body dissatisfaction for late adolescence/young adulthood versus mid-adolescent participants. Baseline body dissatisfaction did not moderate the intervention effects. Conclusion Overall, intervention effects tended to be amplified for individuals with initial elevations in risk factors and a DSM-5 eating disorder at baseline. Results suggest that this prevention program is effective for a broad range of individuals, but is somewhat more beneficial for the subgroups identified in the moderation analyses. PMID:23337181

Mechanical aspects of a multidirectional, angular stable osteosynthesis system and comparison with four conventional systems.

PubMed

Gbara, Ali; Heiland, Max; Schmelzle, Rainer; Blake, Felix

2008-04-01

Following open reduction, internal fixation of fractures of the mandible is predominantly achieved using plates and screws. Today, a multitude of osteosynthesis systems are available on the market. One therapy modality, primarily developed for orthopaedic surgery, is using angular stable osteosynthesis plate systems. The dominating principle of these is the bond between screw and plate following insertion. This principle of an "internal fixateur" results in a more stable fixation of the fragments associated with less compression of the bone surfaces. A new multidirectional osteosynthesis system (TiFix=Smartlock, Hamburg - Germany) was modified to fit the maxillofacial region and compared with four other well established osteosynthesis systems developed by Mondial, Medicon, Synthes, Leibinger-Stryker, one of these (Unilock by Synthes) being also angular stable. The resistance to deformation in varying directions was investigated following fixation in four different materials. The TiFix system proved more resistant to deformation even when mounted with fewer screws than the non-angular stable systems. This system results in greater stability even when fewer screws are used. For the clinician this means smaller access incisions, less soft tissue trauma, better aesthetic results, decreased duration of operation and a reduction of costs.

System Response of Metabolic Networks in Chlamydomonas reinhardtii to Total Available Ammonium

PubMed Central

Lee, Do Yup; Park, Jeong-Jin; Barupal, Dinesh K.; Fiehn, Oliver

2012-01-01

Drastic alterations in macronutrients are known to cause large changes in biochemistry and gene expression in the photosynthetic alga Chlamydomonas reinhardtii. However, metabolomic and proteomic responses to subtle reductions in macronutrients have not yet been studied. When ammonium levels were reduced by 25–100% compared with control cultures, ammonium uptake and growth rates were not affected at 25% or 50% nitrogen-reduction for 28 h. However, primary metabolism and enzyme expression showed remarkable changes at acute conditions (4 h and 10 h after ammonium reduction) compared with chronic conditions (18 h and 28 h time points). Responses of 145 identified metabolites were quantified using gas chromatography-time of flight mass spectrometry; 495 proteins (including 187 enzymes) were monitored using liquid chromatography-ion trap mass spectrometry with label-free spectral counting. Stress response and carbon assimilation processes (Calvin cycle, acetate uptake and chlorophyll biosynthesis) were altered first, in addition to increase in enzyme contents for lipid biosynthesis and accumulation of short chain free fatty acids. Nitrogen/carbon balance metabolism was found changed only under chronic conditions, for example in the citric acid cycle and amino acid metabolism. Metabolism in Chlamydomonas readily responds to total available media nitrogen with temporal increases in short-chain free fatty acids and turnover of internal proteins, long before nitrogen resources are depleted. PMID:22787274

Implications of driving patterns on well-to-wheel performance of plug-in hybrid electric vehicles.

PubMed

Raykin, Leon; MacLean, Heather L; Roorda, Matthew J

2012-06-05

This study examines how driving patterns (distance and conditions) and the electricity generation supply interact to impact well-to-wheel (WTW) energy use and greenhouse gas (GHG) emissions of plug-in hybrid electric vehicles (PHEVs). The WTW performance of a PHEV is compared with that of a similar (nonplug-in) gasoline hybrid electric vehicle and internal combustion engine vehicle (ICEV). Driving PHEVs for short distances between recharging generally results in lower WTW total and fossil energy use and GHG emissions per kilometer compared to driving long distances, but the extent of the reductions depends on the electricity supply. For example, the shortest driving pattern in this study with hydroelectricity uses 81% less fossil energy than the longest driving pattern. However, the shortest driving pattern with coal-based electricity uses only 28% less fossil energy. Similar trends are observed in reductions relative to the nonplug-in vehicles. Irrespective of the electricity supply, PHEVs result in greater reductions in WTW energy use and GHG emissions relative to ICEVs for city than highway driving conditions. PHEVs charging from coal facilities only reduce WTW energy use and GHG emissions relative to ICEVs for certain favorable driving conditions. The study results have implications for environmentally beneficial PHEV adoption and usage patterns.

Seizure frequency reduction after posteromedial hypothalamus deep brain stimulation in drug-resistant epilepsy associated with intractable aggressive behavior.

PubMed

Benedetti-Isaac, Juan C; Torres-Zambrano, Martin; Vargas-Toscano, Andres; Perea-Castro, Esther; Alcalá-Cerra, Gabriel; Furlanetti, Luciano L; Reithmeier, Thomas; Tierney, Travis S; Anastasopoulos, Constantin; Fonoff, Erich T; Contreras Lopez, William Omar

2015-07-01

The aim of this study was to analyze the impact of deep brain stimulation (DBS) of the posteromedial hypothalamus (pHyp) on seizure frequency in patients with drug-resistant epilepsy (DRE) associated with intractable aggressive behavior (IAB). Data were collected retrospectively from nine patients, who received bilateral stereotactic pHyp-DBS for the treatment of medically intractable aggressive behavior, focusing on five patients who also had DRE. All patients were treated at the Colombian Center and Foundation of Epilepsy and Neurological Diseases-FIRE (Chapter of the International Bureau for Epilepsy), in Cartagena de Indias, Colombia from 2010 to 2014. Each case was evaluated previously by the institutional ethical committee, assessing the impact of aggressive behavior on the patient's family and social life, the humanitarian aspects of preserving the safety and physical integrity of caregivers, and the need to prevent self-harm. Epilepsy improvement was measured by a monthly seizure reduction percentage, comparing preoperative state and outcome. Additional response to epilepsy was defined by reduction of the antiepileptic drugs (AEDs). Aggressive behavior response was measured using the Overt Aggression Scale (OAS). All the patients with DRE associated with IAB presented a significant decrease of the rate of epileptic seizures after up to 4 years follow-up, achieving a general 89.6% average seizure reduction from the state before the surgery. Aggressiveness was significantly controlled, with evident improvement in the OAS, enhancing the quality of life of patients and families. In well-selected patients, DBS of the pHyp seems to be a safe and effective procedure for treatment of DRE associated with refractory aggressive behavior. Larger and prospective series are needed to define the pHyp as a target for DRE in different contexts. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

Optimal Post-Operative Immobilisation for Supracondylar Humeral Fractures.

PubMed

Azzolin, Lucas; Angelliaume, Audrey; Harper, Luke; Lalioui, Abdelfettah; Delgove, Anaïs; Lefèvre, Yan

2018-05-25

Supracondylar humeral fractures (SCHFs) are very common in paediatric patients. In France, percutaneous fixation with two lateral-entry pins is widely used after successful closed reduction. Post-operative immobilisation is typically with a long arm cast combined with a tubular-bandage sling that immobilises the shoulder and holds the arm in adduction and internal rotation to prevent external rotation of the shoulder, which might cause secondary displacement. The objective of this study was to compare this standard immobilisation technique to a posterior plaster splint with a simple sling. Secondary displacement is not more common with a posterior plaster splint and sling than with a long arm cast. 100 patients with extension Gartland type III SCHFs managed by closed reduction and percutaneous fixation with two lateral-entry pins between December 2011 and December 2015 were assessed retrospectively. Post-operative immobilisation was with a posterior plaster splint and a simple sling worn for 4 weeks. Radiographs were obtained on days 1, 45, and 90. Secondary displacement occurred in 8% of patients. No patient required revision surgery. The secondary displacement rate was comparable to earlier reports. Of the 8 secondary displacements, 5 were ascribable to technical errors. The remaining 3 were not caused by rotation of the arm and would probably not have been prevented by using the tubular-bandage sling. A posterior plaster splint combined with a simple sling is a simple and effective immobilisation method for SCHFs provided internal fixation is technically optimal. IV, retrospective observational study. Copyright © 2018. Published by Elsevier Masson SAS.

Cost-Effectiveness Analysis of Primary Arthrodesis Versus Open Reduction Internal Fixation for Primarily Ligamentous Lisfranc Injuries.

PubMed

Albright, Rachel H; Haller, Sarah; Klein, Erin; Baker, Jeffrey R; Weil, Lowell; Weil, Lowell S; Fleischer, Adam E

The purpose of the present study was to determine whether surgical intervention with open reduction internal fixation (ORIF) or primary arthrodesis (PA) for Lisfranc injuries is more cost effective. We conducted a formal cost-effectiveness analysis using a Markov model and decision tree to explore the healthcare costs and health outcomes associated with a scenario of ORIF versus PA for 45 years postoperatively. The outcomes assessed included long-term costs, quality-adjusted life-years (QALYs), and incremental cost per QALY gained. The costs were evaluated from the healthcare system perspective and are expressed in U.S. dollars at a 2017 price base. ORIF was always associated with greater costs compared with PA and was less effective in the long term. When calculating the cost required to gain 1 additional QALY, the PA group cost $1429/QALY and the ORIF group cost $3958/QALY. The group undergoing PA overall spent, on average, $43,192 less than the ORIF group, and PA was overall a more effective technique. Strong dominance compared with ORIF was demonstrated in multiple scenarios, and the model's conclusions were unchanged in the sensitivity analysis even after varying the key assumptions. ORIF failed to show functional or financial benefits. In conclusion, from a healthcare system's standpoint, PA would clearly be the preferred treatment strategy for predominantly ligamentous Lisfranc injuries and dislocations. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Fabrication and Characteristics of Sintered Cutting Stainless Steel Fiber Felt with Internal Channels and an Al₂O₃ Coating.

PubMed

Huang, Shufeng; Wan, Zhenping; Zou, Shuiping

2018-03-20

A novel sintered cutting stainless steel fiber felt with internal channels (SCSSFFC) composed of a stainless-steel fiber skeleton, three-dimensional interconnected porous structure and multiple circular microchannels is developed. SCSSFFC has a jagged and rough surface morphology and possesses a high specific surface area, which is approximately 2.4 times larger than that of the sintered bundle-drawing stainless steel fiber felt with internal channels (SBDSSFFC) and is expected to enhance adhesive strength. The sol-gel and wet impregnation methods are adopted to prepare SCSSFFC with an Al₂O₃ coating (SCSSFFC/Al₂O₃). The adhesive strength of SCSSFFC/Al₂O₃ is investigated using ultrasonic vibration and thermal shock tests. The experimental results indicate that the weight loss rate of the Al₂O₃ coating has a 4.2% and 8.42% reduction compared with those of SBDSSFFCs based on ultrasonic vibration and thermal shock tests. In addition, the permeability of SCSSFFC/Al₂O₃ is investigated based on forced liquid flow tests. The experimental results show that the permeability and inertial coefficients of SCSSFFC/Al₂O₃ are mainly affected by the coating rate, porosity and open ratio; however, the internal microchannel diameter has little influence. It is also found that SCSSFFC/Al₂O₃ yields superior permeability, as well as inertial coefficients compared with those of other porous materials reported in the literature.

Bacteriophage removal efficiency as a validation and operational monitoring tool for virus reduction in wastewater reclamation: Review.

PubMed

Amarasiri, Mohan; Kitajima, Masaaki; Nguyen, Thanh H; Okabe, Satoshi; Sano, Daisuke

2017-09-15

The multiple-barrier concept is widely employed in international and domestic guidelines for wastewater reclamation and reuse for microbiological risk management, in which a wastewater reclamation system is designed to achieve guideline values of the performance target of microbe reduction. Enteric viruses are one of the pathogens for which the target reduction values are stipulated in guidelines, but frequent monitoring to validate human virus removal efficacy is challenging in a daily operation due to the cumbersome procedures for virus quantification in wastewater. Bacteriophages have been the first choice surrogate for this task, because of the well-characterized nature of strains and the presence of established protocols for quantification. Here, we performed a meta-analysis to calculate the average log 10 reduction values (LRVs) of somatic coliphages, F-specific phages, MS2 coliphage and T4 phage by membrane bioreactor, activated sludge, constructed wetlands, pond systems, microfiltration and ultrafiltration. The calculated LRVs of bacteriophages were then compared with reported human enteric virus LRVs. MS2 coliphage LRVs in MBR processes were shown to be lower than those of norovirus GII and enterovirus, suggesting it as a possible validation and operational monitoring tool. The other bacteriophages provided higher LRVs compared to human viruses. The data sets on LRVs of human viruses and bacteriophages are scarce except for MBR and conventional activated sludge processes, which highlights the necessity of investigating LRVs of human viruses and bacteriophages in multiple treatment unit processes. Copyright © 2017 Elsevier Ltd. All rights reserved.

A case-controlled, retrospective, comparative study on the use of biodegradable synthetic polyurethane foam versus polyvinyl acetate sponge after nasal fracture reduction.

PubMed

Jeong, H-S; Lee, H-K; Kim, H-S; Moon, M-S; Tark, K-C

2014-06-01

One of the most frequently used packing materials in closed reduction of a nasal bone fracture is the hydroxylated polyvinyl acetate sponge (PVAS; Merocel(®)); however this may cause synechia, epistaxis, and pain. Synthetic polyurethane foam (SPF; Nasopore(®) Forte) has recently been used in septoplasty to prevent synechia or restenosis and haematoma formation. The purpose of this study was to compare the effects of PVAS and SPF on postoperative appearance and discomfort following the reduction of nasal bone fractures. We retrospectively reviewed all patient questionnaires and medical histories, and clinical photographs and computed tomography scans obtained before and after surgery. Outcomes were assessed using the Global Aesthetic Improvement Scale (GAIS) score and visual analogue scale (VAS) scores, which were used to assess discomfort during the 6-month follow-up period. Postoperatively, there was no statistically significant difference in the GAIS for the two packing materials (P > 0.05). Postoperative epistaxis was observed at a significantly lower rate in the SPF group than in the PVAS group, whereas anterior rhinorrhea and posterior nasal drip occurred at significantly higher rates following removal of packing in the SPF group (P < 0.05). The results of this study suggest that synthetic dissolvable polyurethane may be a reliable alternative material for nasal packing and postoperative management following the reduction of nasal bone fractures. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Using a centrifuge for quality control of pre-wetted lightweight aggregate in internally cured concrete

NASA Astrophysics Data System (ADS)

Miller, Albert E.

Early age shrinkage of cementitious systems can result in an increased potential for cracking which can lead to a reduction in service life. Early age shrinkage cracking can be particularly problematic for high strength concretes, which are often specified due to their high strength and low permeability. However, these high strength concretes frequently exhibit a reduction in the internal relative humidity (RH) due to the hydration reaction (chemical shrinkage) and self-desiccation which results in a bulk shrinkage, termed autogenous shrinkage, which is substantial at early ages. Due to the low permeability of these concretes, standard external curing is not always efficient in addressing this reduction in internal RH since the penetration of water can be limited. Internal curing has been developed to reduce autogenous shrinkage. Internally cured mixtures use internal reservoirs filled with fluid (generally water) that release this fluid at appropriate times to counteract the effects of self-desiccation thereby maintaining a high internal RH. Internally cured concrete is frequently produced in North America using pre-wetted lightweight aggregate. One important aspect associated with preparing quality internally cured concrete is being able to determine the absorbed moisture and surface moisture associated with the lightweight aggregate which enables aggregate moisture corrections to be made for the concrete mixture. This thesis represents work performed to develop a test method using a centrifuge to determine the moisture state of pre-wetted fine lightweight aggregate. The results of the test method are then used in a series of worksheets that were developed to assist field technicians when performing the tests and applying the results to a mixture design. Additionally, research was performed on superabsorbent polymers to assess their ability to be used as an internal curing reservoir.

Intramedullary osteosynthesis versus plate osteosynthesis in subtrochanteric fractures.

PubMed

Burnei, C; Popescu, Gh; Barbu, D; Capraru, F

2011-11-14

Due to an ever-aging population and a growing prevalence of osteoporosis and motor vehicle accidents, the number of subtrochanteric fractures is increasing worldwide. The choice of the appropriate implant continues to be critical for fixation of unstable hip fractures. The subtrochanteric region has certain anatomical and biomechanical features that can make fractures in this region difficult to treat. The preferred type of device is a matter of debate. Increased understandings of biomechanical characteristics of the hip and improvement of the implant materials have reduced the incidence of complications. The surgeons choose between the two methods according to Seinsheimer's classification and also to their personal preferences. As a general principle, the open reduction and internal fixation were performed in stable fractures, and the closed reduction and internal fixation were performed in unstable fractures. The advantages of intramedullary nailing consist in a small skin incision, lower operating times, preservation of fracture hematoma and the possibility of early weight bearing. The disadvantages consist in a difficult closed reduction due to important muscular forces, although the nail can be used as a reduction instrument, and higher implant cost. In open reduction internal fixation techniques, the advantage is represented by anatomical reduction which, in our opinion, is not necessary. The disadvantages are represented by: higher operating time, demanding surgery, large devascularization, higher infection rates, late weight bearing, medial instability, refracture after plate removal and inesthetic approach.

Intramedullary osteosynthesis versus plate osteosynthesis in subtrochanteric fractures

PubMed Central

Burnei, C; Popescu, Gh; Barbu, D; Capraru, F

2011-01-01

Due to an ever-aging population and a growing prevalence of osteoporosis and motor vehicle accidents, the number of subtrochanteric fractures is increasing worldwide. The choice of the appropriate implant continues to be critical for fixation of unstable hip fractures. The subtrochanteric region has certain anatomical and biomechanical features that can make fractures in this region difficult to treat. The preferred type of device is a matter of debate. Increased understandings of biomechanical characteristics of the hip and improvement of the implant materials have reduced the incidence of complications. The surgeons choose between the two methods according to Seinsheimer's classification and also to their personal preferences. As a general principle, the open reduction and internal fixation were performed in stable fractures, and the closed reduction and internal fixation were performed in unstable fractures. The advantages of intramedullary nailing consist in a small skin incision, lower operating times, preservation of fracture hematoma and the possibility of early weight bearing. The disadvantages consist in a difficult closed reduction due to important muscular forces, although the nail can be used as a reduction instrument, and higher implant cost. In open reduction internal fixation techniques, the advantage is represented by anatomical reduction which, in our opinion, is not necessary. The disadvantages are represented by: higher operating time, demanding surgery, large devascularization, higher infection rates, late weight bearing, medial instability, refracture after plate removal and inesthetic approach. PMID:22514563

Robotics and artificial intelligence across the Atlantic and Pacific

NASA Astrophysics Data System (ADS)

Schlussel, K.

1983-08-01

Attention is given to development efforts outside the U.S. in the fields of robotics and artificial intelligence, including international cooperative efforts, and Japanese, Western European, and Eastern European programs. It is noted that the Japan Industrial Robot Association, together with Japan's Ministry of International Trade and Industry, are promoting robotics developments through the exchange of specifications data among researchers and the arrangement of interest-free loans. Private research in Japan has concentrated on problems relating to applications, such as increased speed, miniaturization, digital control, weight reduction, and modularization. Western Europe has been comparatively slow in initiating research, but possesses an industry leader in a Swedish firm. The 25th Party Congress of the Communist Party of the Soviet Union committed itself to the mass production of industrial robots in 1976.

Bladder incarceration following anterior pelvic infix of a traumatic pubic symphysis diastasis treated with immediate open reduction and internal fixation.

PubMed

Jain, Mantu; Nanda, Saurav Narayan; Mohapatra, Soumya Shrikanta; Samal, Barada Prasanna

2017-08-01

Stabilization after a pelvic fracture can be accomplished using multiple techniques. The anterior external fixator has been traditionally used in variety of unstable pelvis either singly or in combination of posterior screws. These devices are cumbersome and restrict side turning and sitting particularly in obese patients. An alternative, anterior subcutaneous pelvic internal fixation technique (ASPIF) was developed which is well tolerated by patients for mobility and comfort and biomechanically more stable construct Complications of this construct included irritation of the lateral femoral cutaneous nerve, femoral nerve palsy &heterotypic ossification with reduced rates of infections and aseptic loosening as compared to external fixator. Bladder incarceration following treatment has never been reported and we encountered such a problem during management which we want to highlight.

Effects of Thermal Barrier Coatings on Approaches to Turbine Blade Cooling

NASA Technical Reports Server (NTRS)

Boyle, Robert J.

2007-01-01

Reliance on Thermal Barrier Coatings (TBC) to reduce the amount of air used for turbine vane cooling is beneficial both from the standpoint of reduced NOx production, and as a means of improving cycle efficiency through improved component efficiency. It is shown that reducing vane cooling from 10 to 5 percent of mainstream air can lead to NOx reductions of nearly 25 percent while maintaining the same rotor inlet temperature. An analysis is given which shows that, when a TBC is relied upon in the vane thermal design process, significantly less coolant is required using internal cooling alone compared to film cooling. This is especially true for small turbines where internal cooling without film cooling permits the surface boundary layer to remain laminar over a significant fraction of the vane surface.

Food Emulsifier Glycerin Monostearate Increases Internal Exposure Levels of Six Priority Controlled Phthalate Esters and Exacerbates Their Male Reproductive Toxicities in Rats.

PubMed

Gao, Hai-Tao; Xu, Run; Cao, Wei-Xin; Zhou, Xu; Yan, Ye-Hui-Mei; Lu, Lingeng; Xu, Qian; Shen, Yang

2016-01-01

Human beings are inevitably exposed to ubiquitous phthalate esters (PAEs). Processed, packaged foods are popular nowadays, in which emulsifiers are frequently added as food additives. It is unclear how emulsifiers affect the bioavailability of ingested PAEs contaminants and their toxicities. The purposes of our study were to explore whether food emulsifier Glycerin Monostearate (GMS) could increase the internal exposure levels of six priority controlled PAEs and affect their reproductive toxicities when male rats are exposed to PAEs mixture (MIXPs). The male rats were exposed to MIXPs by gavage for thirty days in combination with or without given GMS. Phthalate monoesters (MPAEs), primary metabolites of PAEs, in rat urine were used as biomarkers to predict the internal exposure levels of the six PAEs, and their concentrations were determined using UPLC-MS. The reproductive toxicity was evaluated using serum testosterone levels test and histopathology of testes. Results showed that compared to PAEs exposure alone, the internal exposure levels of PAEs increased by 30%-49% in the presence of GMS. PAEs exposure led to the reduction of testosterone level by 23.4%-42.1% in the presence and absence of GMS, respectively, compared to the baseline. Testosterone levels in MIXPs+GMS and DEHP+GMS group were decreased by 9.1% and 13.6%, respectively, compared with MIXPs and DEHP group. Histopathology showed that injuries of testis (deciduous spermatids) were observed, and GMS exacerbated the injuries. The results indicated food emulsifiers chronically taken up might increase safety risks of food PAEs contaminants.

Allgöwer-Donati Versus Vertical Mattress Suture Technique Impact on Perfusion in Ankle Fracture Surgery: A Randomized Clinical Trial Using Intraoperative Angiography.

PubMed

Shannon, Steven F; Houdek, Matthew T; Wyles, Cody C; Yuan, Brandon J; Cross, William W; Cass, Joseph R; Sems, Stephen A

2017-02-01

The purpose of this study was to evaluate which primary wound closure technique for ankle fractures affords the most robust perfusion as measured by laser-assisted indocyanine green angiography: Allgöwer-Donati or vertical mattress. Prospective, randomized. Level 1 Academic Trauma Center. Thirty patients undergoing open reduction internal fixation for ankle fractures were prospectively randomized to Allgöwer-Donati (n = 15) or vertical mattress (n = 15) closure. Demographics were similar for both cohorts with respect to age, sex, body mass index, surgical timing, and OTA/AO fracture classification. Skin perfusion (mean incision perfusion and mean perfusion impairment) was quantified in fluorescence units with laser-assisted indocyanine green angiography along the lateral incision as well as anterior and posterior to the incision at 30 separate locations. Minimum follow-up was 3 months with a mean follow-up 4.7 months. Allgöwer-Donati enabled superior perfusion compared with the vertical mattress suture technique. Mean incision perfusion for Allgöwer-Donati was 51 (SD = 13) and for vertical mattress was 28 (SD = 10, P < 0.0001). Mean perfusion impairment was less in the Allgöwer-Donati cohort (12.8, SD = 9) compared with that in the vertical mattress cohort (23.4, SD = 14; P = 0.03). One patient in each cohort experienced a wound complication. The Allgöwer-Donati suture technique offers improved incision perfusion compared with vertical mattress closure after open reduction internal fixation of ankle fractures. Theoretically, this may enhance soft tissue healing and decrease the risk of wound complications. Surgeons may take this into consideration when deciding closure techniques for ankle fractures. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Cost-effectiveness of a new urinary biomarker-based risk score compared to standard of care in prostate cancer diagnostics - a decision analytical model.

PubMed

Dijkstra, Siebren; Govers, Tim M; Hendriks, Rianne J; Schalken, Jack A; Van Criekinge, Wim; Van Neste, Leander; Grutters, Janneke P C; Sedelaar, John P Michiel; van Oort, Inge M

2017-11-01

To assess the cost-effectiveness of a new urinary biomarker-based risk score (SelectMDx; MDxHealth, Inc., Irvine, CA, USA) to identify patients for transrectal ultrasonography (TRUS)-guided biopsy and to compare this with the current standard of care (SOC), using only prostate-specific antigen (PSA) to select for TRUS-guided biopsy. A decision tree and Markov model were developed to evaluate the cost-effectiveness of SelectMDx as a reflex test vs SOC in men with a PSA level of >3 ng/mL. Transition probabilities, utilities and costs were derived from the literature and expert opinion. Cost-effectiveness was expressed in quality-adjusted life years (QALYs) and healthcare costs of both diagnostic strategies, simulating the course of patients over a time horizon representing 18 years. Deterministic sensitivity analyses were performed to address uncertainty in assumptions. A diagnostic strategy including SelectMDx with a cut-off chosen at a sensitivity of 95.7% for high-grade prostate cancer resulted in savings of €128 and a gain of 0.025 QALY per patient compared to the SOC strategy. The sensitivity analyses showed that the disutility assigned to active surveillance had a high impact on the QALYs gained and the disutility attributed to TRUS-guided biopsy only slightly influenced the outcome of the model. Based on the currently available evidence, the reduction of over diagnosis and overtreatment due to the use of the SelectMDx test in men with PSA levels of >3 ng/mL may lead to a reduction in total costs per patient and a gain in QALYs. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

Surgical treatment of distal tibia fractures: open versus MIPO.

PubMed

Gülabi, Deniz; Bekler, Halil İbrahim; Sağlam, Fevzi; Taşdemir, Zeki; Çeçen, Gültekin Sıtkı; Elmalı, Nurzat

2016-01-01

Treatment of the distal tibial fractures are challenging due to the limited soft tissue, subcutaneous location and poor vascularity. In this control-matched study, it was aimed to compare the traditional open reduction and internal fixation with minimal invasive plating (MIPO). We hypothesized that superior results may be achieved with MIPO technique. 22 patients treated with traditional open reduction and internal fixation were matched with 22 patients treated with closed reduction and MIPO on the basis of age (±3), gender, and fracture pattern (AO classification). Evaluation was assed according to the wound problems, the American Orthopaedic Foot and Ankle surgery (AOFAS) scoring, radiological union, malunion, delayed union, hospitalisation time, time from injury to surgery, and operation time. There was no significant difference in the distribution of AO/OTA classification, age, gender, AOFAS score, time from injury to operation, follow-up, bone union time, delayed union, malunion and infection (p>0.05). The operation time was significantly longer in the open group than in the MIPO group: 69.59±7.21 min. for the ORIF, and 61.14±5.61 for the MIPO group (p<0.01).The hospitalisation time was significantly longer in the open group than in the MIPO group: 7.64±4.71 days for the MIPO, and 10.18±4.32 days for the ORIF group (p<0.05). MIPO technique can be beneficial for the treatment of distal tibia AO/OTA A and B type fractures with reduced hospital stay, cost-effectiveness, and infection rate.

Neutron Imaging for Selective Laser Melting Inconel Hardware with Internal Passages

NASA Technical Reports Server (NTRS)

Tramel, Terri L.; Norwood, Joseph K.; Bilheux, Hassina

2014-01-01

Additive Manufacturing is showing great promise for the development of new innovative designs and large potential life cycle cost reduction for the Aerospace Industry. However, more development work is required to move this technology into space flight hardware production. With selective laser melting (SLM), hardware that once consisted of multiple, carefully machined and inspected pieces, joined together can be made in one part. However standard inspection techniques cannot be used to verify that the internal passages are within dimensional tolerances or surface finish requirements. NASA/MSFC traveled to Oak Ridge National Lab's (ORNL) Spallation Neutron Source to perform some non-destructive, proof of concept imaging measurements to assess the capabilities to understand internal dimensional tolerances and internal passages surface roughness. This presentation will describe 1) the goals of this proof of concept testing, 2) the lessons learned when designing and building these Inconel 718 test specimens to minimize beam time, 3) the neutron imaging test setup and test procedure to get the images, 4) the initial results in images, volume and a video, 4) the assessment of using this imaging technique to gather real data for designing internal flow passages in SLM manufacturing aerospace hardware, and lastly 5) how proper cleaning of the internal passages is critically important. In summary, the initial results are very promising and continued development of a technique to assist in SLM development for aerospace components is desired by both NASA and ORNL. A plan forward that benefits both ORNL and NASA will also be presented, based on the promising initial results. The initial images and volume reconstruction showed that clean, clear images of the internal passages geometry are obtainable. These clear images of the internal passages of simple geometries will be compared to the build model to determine any differences. One surprising result was that a new cleaning process was used on these simply geometric specimens that resulted in what appears to be very smooth internal surfaces, when compared to other aerospace hardware cleaning methods.

Single-Event Upset and Scaling Trends in New Generation of the Commercial SOI PowerPC Microprocessors

NASA Technical Reports Server (NTRS)

Irom, Farokh; Farmanesh, Farhad; Kouba, Coy K.

2006-01-01

SEU from heavy-ions is measured for SOI PowerPC microprocessors. Results for 0.13 micron PowerPC with 1.1V core voltages increases over 1.3V versions. This suggests that improvement in SEU for scaled devices may be reversed. In recent years there has been interest in the possible use of unhardened commercial microprocessors in space because of their superior performance compared to hardened processors. However, unhardened devices are susceptible to upset from radiation space. More information is needed on how they respond to radiation before they can be used in space. Only a limited number of advanced microprocessors have been subjected to radiation tests, which are designed with lower clock frequencies and higher internal core voltage voltages than recent devices [1-6]. However the trend for commercial Silicon-on-insulator (SOI) microprocessors is to reduce feature size and internal core voltage and increase the clock frequency. Commercial microprocessors with the PowerPC architecture are now available that use partially depleted SOI processes with feature size of 90 nm and internal core voltage as low as 1.0 V and clock frequency in the GHz range. Previously, we reported SEU measurements for SOI commercial PowerPCs with feature size of 0.18 and 0.13 m [7, 8]. The results showed an order of magnitude reduction in saturated cross section compared to CMOS bulk counterparts. This paper examines SEUs in advanced commercial SOI microprocessors, focusing on SEU sensitivity of D-Cache and hangs with feature size and internal core voltage. Results are presented for the Motorola SOI processor with feature sizes of 0.13 microns and internal core voltages of 1.3 and 1.1 V. These results are compared with results for the Motorola SOI processors with feature size of 0.18 microns and internal core voltage of 1.6 and 1.3 V.

[Secondhand smoke in hospitality venues. Exposure, body burden, economic and health aspects in conjunction with smoking bans].

PubMed

Fromme, H; Kuhn, J; Bolte, G

2009-04-01

Secondhand smoke was classified by national and international organisations as a known cause of cancer in humans and has many adverse health effects, especially cardiovascular diseases and lung tumours. Global studies have clearly shown that hospitality venues have the highest levels of indoor air pollution containing different substances that are clearly carcinogenic--such as tobacco-related chemicals--compared with other, smoke-free indoor spaces. Data from the human biomonitoring of non-smoking employees in the food service industry confirm this high exposure level. Non-smokers exposed to secondhand smoke in these environments are at increased risk for adverse health effects. The consistent protection of non-smokers in public places such as restaurants and bars through a smoking ban results in a significant reduction of the pollutants in the air (mostly > 90%) and clearly reduces the internal body burden for users and employees. Furthermore, health complaints by non-smoking employees are reduced and the higher risk for lung tumours of employees in the food service industry compared with the general population can be effectively reduced as well. According to current standards of knowledge, other measures such as spatial separation of smoking areas or the use of mechanical venting systems do not achieve a comparably high and effective pollutant reduction under field conditions. Studies concerning the economic effects of prohibiting smoking in public places conducted in various countries have shown that beverage-focused gastronomic enterprises experience a short-term down trend but that food-focused gastronomic enterprises do not experience any negative or even positive effects. The positive effects of a ban on smoking in public places on the general population are a decline in cigarette consumption and the reduction of secondhand smoke exposure by non-smokers. Smoking bans in hospitality venues are not necessarily linked with a shift of the tobacco consumption to private rooms and an associated increase of secondhand smoke exposure. A comprehensive smoking ban in public spaces without exemption is therefore an easy and targeted measure for gastronomic enterprises from a health perspective.

Mechanical Systems Versus Smoking Bans for Secondhand Smoke Control

PubMed Central

Barrientos-Gutierrez, Tonatiuh; Amick, Benjamin C.; Gimeno, David; Reynales-Shigematsu, Luz M.; Delclos, George L.; Harrist, Ronald B.; Kelder, Steven H.; Lazcano-Ponce, Eduardo; Hernandez-Ávila, Mauricio

2012-01-01

Introduction: Despite international efforts to implement smoking bans, several national legislations still allow smoking and recommend mechanical systems, such as ventilation and air extraction, to eliminate secondhand smoke (SHS) health-related risks. We aimed to quantify the relative contribution of mechanical systems and smoking bans to SHS elimination. Methods: A cross-sectional study was conducted in randomly selected establishments from 4 Mexican cities (3 with no ban). SHS exposure was assessed using nicotine passive monitors. Establishment characteristics, presence of mechanical systems, and enforcement of smoking policies were obtained through direct observation and self-report. Multilevel models were used to assess relative contributions to SHS reduction. Results: Compared with Mexico City, nicotine concentrations were 3.8 times higher in Colima, 5.4 in Cuernavaca, and 6.4 in Toluca. Mechanical systems were not associated with reduced nicotine concentrations. Concentration differences between cities were largely explained by the presence of smoking bans (69.1% difference reduction) but not by mechanical systems (−5.7% difference reduction). Conclusions: Smoking bans represent the only effective approach to reduce SHS. Tobacco control regulations should stop considering mechanical systems as advisable means for SHS reduction and opt for complete smoking bans in public places. PMID:21994338

Reductive amination derivatization for the quantification of garlic components by isotope dilution analysis.

PubMed

Lin, Yi-Reng; Huang, Mei-Fang; Wu, You-Ying; Liu, Meng-Chieh; Huang, Jing-Heng; Chen, Ziyu; Shiue, Yow-Ling; Wu, Chia-En; Liang, Shih-Shin

2017-09-01

In this work, we synthesized internal standards for four garlic organosulfur compounds (OSCs) by reductive amination with 13 C, D 2 -formaldehyde, and developed an isotope dilution analysis method to quantitate these organosulfur components in garlic samples. Internal standards were synthesized for internal absolute quantification of S-allylcysteine (SAC), S-allylcysteine sulfoxide (alliin), S-methylcysteine (SMC), and S-ethylcysteine (SEC). We used a multiple reaction monitoring (MRM) to detect 13 C, D 2 -formaldehyde-modified OSCs by ultrahigh-performance liquid phase chromatography coupled with tandem mass spectrometry (UHPLC-MS/MS) and obtained MS spectra showing different ratios of 13 C, D 2 -formaldehyde-modified and H 2 -formaldehyde-modified compounds. The resulting labeled and unlabeled OSCs were exhibited correlation coefficient (R 2 ) ranged from 0.9989 to 0.9994, respectively. The average recoveries for four OSCs at three concentration levels ranged from 89% to 105%. By 13 C, D 2 -formaldehyde and sodium cyanoborohydride, the reductive amination-based method can be utilized to generate novel internal standard for isotope dilution and to extend the quantitative application. Copyright © 2017 Elsevier Ltd. All rights reserved.

Critical Propulsion and Noise reduction Technologies for Future Commercial Subsonic Engines. Area of Interest 14.3: Separate Flow Exhaust System Noise

NASA Technical Reports Server (NTRS)

Janardan, B. A.; Hoff, G. E.; Barter, J. W.; Brausch, J. F.; Gliebe, P. R.; Coffin, R. S.; Martens, S.; Delaney, B. R.; Dalton, W. N.; Mengle, V. G.

2000-01-01

This presentation discusses: Project Objectives, Approach and Goal; Baseline Nozzles and Test Cycle Definition; Repeatability and Baseline Nozzle Results; Noise Reduction Concepts; Noise Reduction Tests Configurations of BPR=5 Internal Plug Nozzle adn Acoustic Results; Noise Reduction Test Configurations of BPR=5 External Plug Nozzle and Acoustic Results; and Noise Reduction Tests Configurations of BPR=8 External Plug Nozzle and Acoustic Results.

Survival of Bacillus pumilus spores for a prolonged period of time in real space conditions.

PubMed

Vaishampayan, Parag A; Rabbow, Elke; Horneck, Gerda; Venkateswaran, Kasthuri J

2012-05-01

To prevent forward contamination and maintain the scientific integrity of future life-detection missions, it is important to characterize and attempt to eliminate terrestrial microorganisms associated with exploratory spacecraft and landing vehicles. Among the organisms isolated from spacecraft-associated surfaces, spores of Bacillus pumilus SAFR-032 exhibited unusually high resistance to decontamination techniques such as UV radiation and peroxide treatment. Subsequently, B. pumilus SAFR-032 was flown to the International Space Station (ISS) and exposed to a variety of space conditions via the European Technology Exposure Facility (EuTEF). After 18 months of exposure in the EXPOSE facility of the European Space Agency (ESA) on EuTEF under dark space conditions, SAFR-032 spores showed 10-40% survivability, whereas a survival rate of 85-100% was observed when these spores were kept aboard the ISS under dark simulated martian atmospheric conditions. In contrast, when UV (>110 nm) was applied on SAFR-032 spores for the same time period and under the same conditions used in EXPOSE, a ∼7-log reduction in viability was observed. A parallel experiment was conducted on Earth with identical samples under simulated space conditions. Spores exposed to ground simulations showed less of a reduction in viability when compared with the "real space" exposed spores (∼3-log reduction in viability for "UV-Mars," and ∼4-log reduction in viability for "UV-Space"). A comparative proteomics analysis indicated that proteins conferring resistant traits (superoxide dismutase) were present in higher concentration in space-exposed spores when compared to controls. Also, the first-generation cells and spores derived from space-exposed samples exhibited elevated UVC resistance when compared with their ground control counterparts. The data generated are important for calculating the probability and mechanisms of microbial survival in space conditions and assessing microbial contaminants as risks for forward contamination and in situ life detection.

A randomized comparison of patients' understanding of number needed to treat and other common risk reduction formats.

PubMed

Sheridan, Stacey L; Pignone, Michael P; Lewis, Carmen L

2003-11-01

Commentators have suggested that patients may understand quantitative information about treatment benefits better when they are presented as numbers needed to treat (NNT) rather than as absolute or relative risk reductions. To determine whether NNT helps patients interpret treatment benefits better than absolute risk reduction (ARR), relative risk reduction (RRR), or a combination of all three of these risk reduction presentations (COMBO). Randomized cross-sectional survey. University internal medicine clinic. Three hundred fifty-seven men and women, ages 50 to 80, who presented for health care. Subjects were given written information about the baseline risk of a hypothetical "disease Y" and were asked (1) to compare the benefits of two drug treatments for disease Y, stating which provided more benefit; and (2) to calculate the effect of one of those drug treatments on a given baseline risk of disease. Risk information was presented to each subject in one of four randomly allocated risk formats: NNT, ARR, RRR, or COMBO. When asked to state which of two treatments provided more benefit, subjects who received the RRR format responded correctly most often (60% correct vs 43% for COMBO, 42% for ARR, and 30% for NNT, P =.001). Most subjects were unable to calculate the effect of drug treatment on the given baseline risk of disease, although subjects receiving the RRR and ARR formats responded correctly more often (21% and 17% compared to 7% for COMBO and 6% for NNT, P =.004). Patients are best able to interpret the benefits of treatment when they are presented in an RRR format with a given baseline risk of disease. ARR also is easily interpreted. NNT is often misinterpreted by patients and should not be used alone to communicate risk to patients.

Antibody uptake into neurons occurs primarily via clathrin-dependent Fcγ receptor endocytosis and is a prerequisite for acute tau protein clearance.

PubMed

Congdon, Erin E; Gu, Jiaping; Sait, Hameetha B R; Sigurdsson, Einar M

2013-12-06

Tau immunotherapy is effective in transgenic mice, but the mechanisms of Tau clearance are not well known. To this end, Tau antibody uptake was analyzed in brain slice cultures and primary neurons. Internalization was rapid (<1 h), saturable, and substantial compared with control mouse IgG. Furthermore, temperature reduction to 4 °C, an excess of unlabeled mouse IgG, or an excess of Tau antibodies reduced uptake in slices by 63, 41, and 62%, respectively (p = 0.002, 0.04, and 0.005). Uptake strongly correlated with total and insoluble Tau levels (r(2) = 0.77 and 0.87 and p = 0.002 and 0.0002), suggesting that Tau aggregates influence antibody internalization and/or retention within neurons. Inhibiting phagocytosis did not reduce uptake in slices or neuronal cultures, indicating limited microglial involvement. In contrast, clathrin-specific inhibitors reduced uptake in neurons (≤ 78%, p < 0.0001) and slices (≤ 35%, p = 0.03), demonstrating receptor-mediated endocytosis as the primary uptake pathway. Fluid phase endocytosis accounted for the remainder of antibody uptake in primary neurons, based on co-staining with internalized dextran. The receptor-mediated uptake is to a large extent via low affinity FcγII/III receptors and can be blocked in slices (43%, p = 0.04) and neurons (53%, p = 0.008) with an antibody against these receptors. Importantly, antibody internalization appears to be necessary for Tau reduction in primary neurons. Overall, these findings clarify that Tau antibody uptake is primarily receptor-mediated, that these antibodies are mainly found in neurons with Tau aggregates, and that their intracellular interaction leads to clearance of Tau pathology, all of which have major implications for therapeutic development of this approach.

Essays on alternative energy policies affecting the US transportation sector

NASA Astrophysics Data System (ADS)

O'Rear, Eric G.

This dissertation encompasses three essays evaluating the impacts of different policies targeting the greenhouse gas (GHG) emissions, fuel demands, etc. of the transportation sector. Though there are some similarities across the three chapters, each essay stands alone as an independent work. The 2010 US EPA MARKAL model is used in each essay to evaluate policy effects. Essay 1 focuses on the recent increases in Corporate Average Fuel Economy (CAFE) standards, and the implications of a "rebound effect." These increases are compared to a carbon tax generating similar reductions in system-wide emissions. As anticipated, the largest reductions in fuel use by light-duty vehicles (LDV) and emissions are achieved under CAFE. Consideration of the rebound effect does little to distort CAFE benefits. Our work validates many economists' belief that a carbon tax is a more efficient approach. However, because the tax takes advantage of cheaper abatement opportunities in other sectors, reductions in transportation emissions will be much lower than what we observe with CAFE. Essay 2 compares CAFE increases with what some economists suggest would be a much more "efficient" alternative -- a system-wide oil tax internalizing some environmental externalities. Because oil taxes are likely to be implemented in addition to CAFE standards, we consider a combined policy case reflecting this. Our supplementary analysis approximates the appropriate tax rates to produce similar reductions in oil demands as CAFE (CAFE-equivalent tax rates). We discover that taxes result in greater and more cost-effective reductions in system-wide emissions and net oil imports than CAFE. The current fuel tax system is compared to three versions of a national vehicle miles traveled (VMT) tax charged to all LDVs in Essay 3. VMT taxes directly charge motorists for each mile driven and help to correct the problem of eroding tax revenues given the failure of today's fuel taxes to adjust with inflation. Results suggest that VMT taxes generate more revenue than our existing fuel tax structure, but do so at the expense of the LDV fleet becoming less fuel-inefficient. If stringent enough, VMT taxes can lead to some rather noticeable reductions in miles driven, fuel use, and emissions.

Allosteric control of internal electron transfer in cytochrome cd1 nitrite reductase

PubMed Central

Farver, Ole; Kroneck, Peter M. H.; Zumft, Walter G.; Pecht, Israel

2003-01-01

Cytochrome cd1 nitrite reductase is a bifunctional multiheme enzyme catalyzing the one-electron reduction of nitrite to nitric oxide and the four-electron reduction of dioxygen to water. Kinetics and thermodynamics of the internal electron transfer process in the Pseudomonas stutzeri enzyme have been studied and found to be dominated by pronounced interactions between the c and the d1 hemes. The interactions are expressed both in dramatic changes in the internal electron-transfer rates between these sites and in marked cooperativity in their electron affinity. The results constitute a prime example of intraprotein control of the electron-transfer rates by allosteric interactions. PMID:12802018

Benefit of Adding Ezetimibe to Statin Therapy on Cardiovascular Outcomes and Safety in Patients With Versus Without Diabetes Mellitus: Results From IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial).

PubMed

Giugliano, Robert P; Cannon, Christopher P; Blazing, Michael A; Nicolau, José C; Corbalán, Ramón; Špinar, Jindřich; Park, Jeong-Gun; White, Jennifer A; Bohula, Erin A; Braunwald, Eugene

2018-04-10

Ezetimibe, when added to simvastatin, reduces cardiovascular events after acute coronary syndrome. We explored outcomes stratified by diabetes mellitus (DM). In IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial), 18 144 patients after acute coronary syndrome with low-density lipoprotein cholesterol 50 to 125 mg/dL were randomized to 40 mg ezetimibe/simvastatin (E/S) or 40 mg placebo/simvastatin. The primary composite end point was cardiovascular death, major coronary events, and stroke. DM was a prespecified subgroup. The 4933 (27%) patients with DM were more often older and female, had had a prior myocardial infarction and revascularization, and presented more frequently with non-ST segment elevation acute coronary syndrome compared with patients without DM (each P <0.001). The median admission low-density lipoprotein cholesterol was lower among patients with DM (89 versus 97 mg/dL, P <0.001). E/S achieved a significantly lower median time-weighted average low-density lipoprotein cholesterol compared with placebo/simvastatin, irrespective of DM (DM: 49 versus 67 mg/dL; no DM: 55 versus 71 mg/dL; both P <0.001). In patients with DM, E/S reduced the 7-year Kaplan-Meier primary end point event rate by 5.5% absolute (hazard ratio, 0.85; 95% confidence interval, 0.78-0.94); in patients without DM, the absolute difference was 0.7% (hazard ratio, 0.98; 95% confidence interval, 0.91-1.04; P int =0.02). The largest relative reductions in patients with DM were in myocardial infarction (24%) and ischemic stroke (39%). No differences in safety outcomes by treatment were present regardless of DM. When stratified further by age, patients ≥75 years of age had a 20% relative reduction in the primary end point regardless of DM ( P int =0.91), whereas patients <75 years of age with DM had greater benefit than those without ( P int =0.011). When stratified by the TIMI (Thrombolysis in Myocardial Infarction) Risk Score for Secondary Prevention, all patients with DM demonstrated benefit with E/S regardless of risk. In contrast, among patients without DM, those with a high risk score experienced a significant (18%) relative reduction in the composite of cardiovascular death, myocardial infarction, and ischemic stroke with E/S compared with placebo/simvastatin, whereas patients without DM at low or moderate risk demonstrated no benefit with the addition of ezetimibe to simvastatin ( P int =0.034). In IMPROVE-IT, the benefit of adding ezetimibe to statin was enhanced in patients with DM and in high-risk patients without DM. URL: https://www.clinicaltrials.gov. Unique identifier: NCT00202878. © 2017 American Heart Association, Inc.

Sharing International Culture at Kingsmont.

ERIC Educational Resources Information Center

Hyman, Kim Houston

1987-01-01

Camp Kingsmont, a weight reduction and fitness facility for boys and girls located near West Stockbridge, Massachusetts, traditionally celebrates International Day each July. Campers design costumes, prepare native dances and songs, enjoy an outdoor feast, stage an "International Beautyless Contest," and gather around a bonfire to view a…

A study on the dependence of exposure dose reduction and image evaluation on the distance from the dental periapical X-ray machine

NASA Astrophysics Data System (ADS)

Joo, Kyu-Ji; Shin, Jae-Woo; Dong, Kyung-Rae; Lim, Chang-Seon; Chung, Woon-Kwan; Kim, Young-Jae

2013-11-01

Reducing the exposure dose from a periapical X-ray machine is an important aim in dental radiography. Although the radiation exposure dose is generally low, any radiation exposure is harmful to the human body. Therefore, this study developed a method that reduces the exposure dose significantly compared to that encountered in a normal procedure, but still produces an image with a similar resolution. The correlation between the image resolution and the exposure dose of the proposed method was examined with increasing distance between the dosimeter and the X-ray tube. The results were compared with those obtained from the existing radiography method. When periapical radiography was performed once according to the recommendations of the International Commission on Radiological Protection (ICRP), the measured skin surface dose was low at 7 mGy or below. In contrast, the skin surface dose measured using the proposed method was only 1.57 mGy, showing a five-fold reduction. These results suggest that further decreases in dose might be achieved using the proposed method.

26 CFR 1.961-2 - Reduction in basis of stock in foreign corporations and of other property.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 10 2011-04-01 2011-04-01 false Reduction in basis of stock in foreign... Corporations § 1.961-2 Reduction in basis of stock in foreign corporations and of other property. (a) Reduction... excluded amount, by the sum of the amount so excluded and any income, war profits, or excess profits taxes...

Internal electron transfer between hemes and Cu(II) bound at cysteine beta93 promotes methemoglobin reduction by carbon monoxide.

PubMed

Bonaventura, C; Godette, G; Tesh, S; Holm, D E; Bonaventura, J; Crumbliss, A L; Pearce, L L; Peterson, J

1999-02-26

Previous studies showed that CO/H2O oxidation provides electrons to drive the reduction of oxidized hemoglobin (metHb). We report here that Cu(II) addition accelerates the rate of metHb beta chain reduction by CO by a factor of about 1000. A mechanism whereby electron transfer occurs via an internal pathway coupling CO/H2O oxidation to Fe(III) and Cu(II) reduction is suggested by the observation that the copper-induced rate enhancement is inhibited by blocking Cys-beta93 with N-ethylmaleimide. Furthermore, this internal electron-transfer pathway is more readily established at low Cu(II) concentrations in Hb Deer Lodge (beta2His --> Arg) and other species lacking His-beta2 than in Hb A0. This difference is consistent with preferential binding of Cu(II) in Hb A0 to a high affinity site involving His-beta2, which is ineffective in promoting electron exchange between Cu(II) and the beta heme iron. Effective electron transfer is thus affected by Hb type but is not governed by the R left arrow over right arrow T conformational equilibrium. The beta hemes in Cu(II)-metHb are reduced under CO at rates close to those observed for cytochrome c oxidase, where heme and copper are present together in the oxygen-binding site and where internal electron transfer also occurs.

Broad-band absorbers for reduction of parasitic light: two alternative solutions

NASA Astrophysics Data System (ADS)

Giovannini, Hughes; Lemarquis, F.; Akhouayri, H.; Cathelinaud, Michel; Torchio, Philippe; Amra, C.; Cousin, Bernard; Laubier, D.; Otrio, Georges

2018-04-01

This paper, "Broad-band absorbers for reduction of parasitic light: two alternative solutions," was presented as part of International Conference on Space Optics—ICSO 1997, held in Toulouse, France.

Cardiac dose reduction with deep inspiration breath hold for left-sided breast cancer radiotherapy patients with and without regional nodal irradiation.

PubMed

Yeung, Rosanna; Conroy, Leigh; Long, Karen; Walrath, Daphne; Li, Haocheng; Smith, Wendy; Hudson, Alana; Phan, Tien

2015-09-22

Deep inspiration breath hold (DIBH) reduces heart and left anterior descending artery (LAD) dose during left-sided breast radiation therapy (RT); however there is limited information about which patients derive the most benefit from DIBH. The primary objective of this study was to determine which patients benefit the most from DIBH by comparing percent reduction in mean cardiac dose conferred by DIBH for patients treated with whole breast RT ± boost (WBRT) versus those receiving breast/chest wall plus regional nodal irradiation, including internal mammary chain (IMC) nodes (B/CWRT + RNI) using a modified wide tangent technique. A secondary objective was to determine if DIBH was required to meet a proposed heart dose constraint of Dmean < 4 Gy in these two cohorts. Twenty consecutive patients underwent CT simulation both free breathing (FB) and DIBH. Patients were grouped into two cohorts: WBRT (n = 11) and B/CWRT + RNI (n = 9). 3D-conformal plans were developed and FB was compared to DIBH for each cohort using Wilcoxon signed-rank tests for continuous variables and McNemar's test for discrete variables. The percent relative reduction conferred by DIBH in mean heart and LAD dose, as well as lung V20 were compared between the two cohorts using Wilcox rank-sum testing. The significance level was set at 0.05 with Bonferroni correction for multiple testing. All patients had comparable target coverage on DIBH and FB. DIBH statistically significantly reduced mean heart and LAD dose for both cohorts. Percent reduction in mean heart and LAD dose with DIBH was significantly larger in the B/CWRT + RNI cohort compared to WBRT group (relative reduction in mean heart and LAD dose: 55.9 % and 72.1 % versus 29.2 % and 43.5 %, p < 0.02). All patients in the WBRT group and five patients (56 %) in the B/CWBRT + RNI group met heart Dmean <4 Gy with FB. All patients met this constraint with DIBH. All patients receiving WBRT met Dmean Heart < 4 Gy on FB, while only slightly over half of patients receiving B/CWRT + RNI were able to meet this constraint in FB. DIBH allowed a greater reduction in mean heart and LAD dose in patients receiving B/CWRT + RNI, including IMC nodes than patients receiving WBRT. These findings suggest greatest benefit from DIBH treatment for patients receiving regional nodal irradiation.

A drift correction optimization technique for the reduction of the inter-measurement dispersion of isotope ratios measured using a multi-collector plasma mass spectrometer

NASA Astrophysics Data System (ADS)

Doherty, W.; Lightfoot, P. C.; Ames, D. E.

2014-08-01

The effects of polynomial interpolation and internal standardization drift corrections on the inter-measurement dispersion (statistical) of isotope ratios measured with a multi-collector plasma mass spectrometer were investigated using the (analyte, internal standard) isotope systems of (Ni, Cu), (Cu, Ni), (Zn, Cu), (Zn, Ga), (Sm, Eu), (Hf, Re) and (Pb, Tl). The performance of five different correction factors was compared using a (statistical) range based merit function ωm which measures the accuracy and inter-measurement range of the instrument calibration. The frequency distribution of optimal correction factors over two hundred data sets uniformly favored three particular correction factors while the remaining two correction factors accounted for a small but still significant contribution to the reduction of the inter-measurement dispersion. Application of the merit function is demonstrated using the detection of Cu and Ni isotopic fractionation in laboratory and geologic-scale chemical reactor systems. Solvent extraction (diphenylthiocarbazone (Cu, Pb) and dimethylglyoxime (Ni) was used to either isotopically fractionate the metal during extraction using the method of competition or to isolate the Cu and Ni from the sample (sulfides and associated silicates). In the best case, differences in isotopic composition of ± 3 in the fifth significant figure could be routinely and reliably detected for Cu65/63 and Ni61/62. One of the internal standardization drift correction factors uses a least squares estimator to obtain a linear functional relationship between the measured analyte and internal standard isotope ratios. Graphical analysis demonstrates that the points on these graphs are defined by highly non-linear parametric curves and not two linearly correlated quantities which is the usual interpretation of these graphs. The success of this particular internal standardization correction factor was found in some cases to be due to a fortuitous, scale dependent, parametric curve effect.

76 FR 37953 - Standards of Performance for Stationary Compression Ignition and Spark Ignition Internal...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-28

... problems. Moreover, the use of SCR entails the supply, storage and use of a chemical reductant, usually..., storage and handling of the chemical reductant would be greater than for engines located elsewhere in the... proper availability of the chemical reductant during the harsh winter months, new heated storage vessels...

77 FR 40410 - Open Meeting of Taxpayer Advocacy Panel Taxpayer Burden Reduction Project Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-09

... Taxpayer Burden Reduction Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas and... Reduction Project Committee will be held Wednesday, August 15, 2012, at 2:30 p.m. Eastern Time via telephone...

26 CFR 25.2702-6 - Reduction in taxable gifts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Reduction in taxable gifts. 25.2702-6 Section... AND GIFT TAXES GIFT TAX; GIFTS MADE AFTER DECEMBER 31, 1954 Special Valuation Rules § 25.2702-6 Reduction in taxable gifts. (a) Transfers of retained interests in trust—(1) Inter vivos transfers. If an...

76 FR 59166 - Navistar Truck Development and Technology Center, a Subsidiary of Navistar International...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-23

... Development and Technology Center, a Subsidiary of Navistar International Corporation Truck Division, Fort... International Corporation, Truck Division, Fort Wayne, Indiana (subject firm). The negative determination was... is a headcount reduction across the nation, made possible by the Global Outsourcing. * * * '' The...

Distal radius fracture arthroscopic intraarticular displacement measurement after open reduction and internal fixation from a volar approach.

PubMed

Ono, Hiroshi; Furuta, Kazuhiko; Fujitani, Ryotaro; Katayama, Takeshi; Akahane, Manabu

2010-07-01

The purpose of this study was to assess articular surface reduction arthroscopically after volar locked-plate fixation of distal radius fractures (DRFs) via fluoroscopyguided open reduction/internal fixation. We also aimed to develop preoperative radiographic criteria to help assist in determining which DRFs may need arthroscopic evaluation. A total of 31 consecutive patients with DRF were prospectively enrolled. Posteroanterior (PA) and lateral radiographs as well as axial, coronal, and sagittal CT scans were obtained just after attempted reduction of the DRF. The widest articular displacement at the radiocarpal joint surface of the distal radius (preopD) was then measured using a digital radiography imaging system. The DRF was reduced under fluoroscopy, and a volar locked plate was applied. The degree of residual articular displacement was then measured arthroscopically, and the maximum displacement (postopD) was measured with a calibrated probe. Of the 31 patients, 7 had an arthroscopically assessed maximum postopD of > or = 2 mm after internal fixation. The correlation coefficients between each preopD and postopD of all radiographs and CTs were statistically significant. The cutoff values were 0.5 mm for PA radiographs, 2.10 mm for lateral radiographs, 2.15 mm for axial CT scans, 3.15 mm for coronal CT scans, and 1.20 mm for sagittal CT scans. All cutoff values for PA and lateral radiographs and for axial, coronal, and sagittal CT scans were unsuitable as screening criteria for arthroscopic reduction of DRF because of their low sensitivities and specificities. The cutoff value of the new preopD (the sum of the preopDs determined by lateral radiography and coronal CT scan) was 5.80 mm, and its sensitivity and specificity were 100% and 83.3%, respectively. Because a new preopD cutoff value of 5.80 mm is a good indicator for residual articular displacement after internal fixation of >2 mm, it is also a good indicator for the need for arthroscopic evaluation after internal fixation.

Proposal of Classification Method of Time Series Data in International Emissions Trading Market Using Agent-based Simulation

NASA Astrophysics Data System (ADS)

Nakada, Tomohiro; Takadama, Keiki; Watanabe, Shigeyoshi

This paper proposes the classification method using Bayesian analytical method to classify the time series data in the international emissions trading market depend on the agent-based simulation and compares the case with Discrete Fourier transform analytical method. The purpose demonstrates the analytical methods mapping time series data such as market price. These analytical methods have revealed the following results: (1) the classification methods indicate the distance of mapping from the time series data, it is easier the understanding and inference than time series data; (2) these methods can analyze the uncertain time series data using the distance via agent-based simulation including stationary process and non-stationary process; and (3) Bayesian analytical method can show the 1% difference description of the emission reduction targets of agent.

Mindfulness training for reducing anger, anxiety, and depression in fibromyalgia patients.

PubMed

Amutio, Alberto; Franco, Clemente; Pérez-Fuentes, María de Carmen; Gázquez, José J; Mercader, Isabel

2014-01-01

Fibromyalgia is a disabling syndrome. Results obtained with different therapies are very limited to date. The goal of this study was to verify whether the application of a mindfulness-based training program was effective in modifying anger, anxiety, and depression levels in a group of women diagnosed with fibromyalgia. This study is an experimental trial that employed a waiting list control group. Measures were taken at three different times: pretest, posttest, and follow-up. The statistical analyses revealed a significant reduction of anger (trait) levels, internal expression of anger, state anxiety, and depression in the experimental group as compared to the control group, as well as a significant increase in internal control of anger. It can be concluded that the mindfulness-based treatment was effective after 7 weeks. These results were maintained 3 months after the end of the intervention.

A randomized controlled trial evaluating the efficacy of a 67% sodium bicarbonate toothpaste on gingivitis.

PubMed

Lomax, A; Patel, S; Wang, N; Kakar, K; Kakar, A; Bosma, M L

2017-11-01

In previous studies, toothpastes with high levels of sodium bicarbonate (>50%) have reduced gingival inflammation and oral malodour. This study compared the effects of brushing for 6 weeks with 67% (test group) or 0% (control group) sodium bicarbonate toothpaste on gingival health. This was a single-centre, single examiner-blind, randomized, controlled, two-treatment, parallel-group study. Eligible subjects (≥18 years) had ≥20 gradable teeth, mild-to-moderate gingivitis, a positive response to bleeding on brushing and ≥20 bleeding sites. The primary objective was to compare the number of bleeding sites following twice-daily use of 67% sodium bicarbonate toothpaste or 0% sodium bicarbonate toothpaste after 6 weeks. Secondary endpoints included Modified Gingival Index (MGI), Bleeding Index (BI) and volatile sulphur compounds (VSC), assessed after 6 weeks. Safety was assessed by treatment-emergent oral soft tissue abnormalities and adverse events. Of 148 patients randomized (74 to each treatment), 66 (89.2%) completed the study in the test group, compared with 69 (93.2%) in the control group. Compared with the control group, the test group had a significant reduction in the number of bleeding sites at Week 6 (absolute difference - 11.0 [-14.0, -8.0], P < 0.0001; relative difference - 25.4%), together with significant reductions in MGI and BI (both P < 0.0001). Although the median reductions from baseline for VSC were numerically greater in the test group, the difference did not reach statistical significance (P = 0.9701). This 67% sodium bicarbonate toothpaste provided statistically significant improvements in gingival health and bleeding after 6 weeks of use. © 2016 The Authors. International Journal of Dental Hygiene Published by John Wiley & Sons Ltd.

Assessing the impact of travel restrictions on international spread of the 2014 West African Ebola epidemic

PubMed Central

Poletto, Chiara; Gomes, Marcelo F. C.; Piontti, Ana Pastore y; Rossi, Luca; Bioglio, Livio; Chao, Dennis L.; Longini, Ira M.; Halloran, M. Elizabeth; Colizza, Vittoria; Vespignani, Alessandro

2015-01-01

The quick spread of an Ebola outbreak in West Africa has led a number of countries and airline companies to issue travel bans to the affected areas. Considering data up to 31 Aug 2014, we assess the impact of the resulting traffic reductions with detailed numerical simulations of the international spread of the epidemic. Traffic reductions are shown to delay by only a few weeks the risk that the outbreak extends to new countries. PMID:25358040

26 CFR 1.907(a)-1 - Reduction in taxes paid on FOGEI (for taxable years beginning after December 31, 1982).

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 9 2011-04-01 2011-04-01 false Reduction in taxes paid on FOGEI (for taxable...) Income from Sources Without the United States § 1.907(a)-1 Reduction in taxes paid on FOGEI (for taxable years beginning after December 31, 1982). (a) Amount of reduction. FOGEI taxes are reduced by the amount...

Development and evaluation of the Marijuana Reduction Strategies Self-Efficacy Scale.

PubMed

Davis, Alan K; Osborn, Lawrence A; Leith, Jaclyn; Rosenberg, Harold; Ashrafioun, Lisham; Hawley, Anna; Bannon, Erin E; Jesse, Samantha; Kraus, Shane; Kryszak, Elizabeth; Cross, Nicole; Carhart, Victoria; Baik, Kyoung-deok

2014-06-01

To evaluate several psychometric properties of a questionnaire designed to assess college students' self-efficacy to employ 21 cognitive-behavioral strategies intended to reduce the amount and/or frequency with which they consume marijuana, we recruited 273 marijuana-using students to rate their confidence that they could employ each of the strategies. Examination of frequency counts for each item, principal components analysis, internal consistency reliability, and mean interitem correlation supported retaining all 21 items in a single scale. In support of criterion validity, marijuana use-reduction self-efficacy scores were significantly positively correlated with cross-situational confidence to abstain from marijuana, and significantly negatively correlated with quantity and frequency of marijuana use and marijuana-related problems. In addition, compared with respondents whose use of marijuana either increased or remained stable, self-efficacy was significantly higher among those who had decreased their use of marijuana over the past year. This relatively short and easily administered questionnaire could be used to identify college students who have low self-efficacy to employ specific marijuana reduction strategies and as an outcome measure to evaluate educational and skill-training interventions.

Shoulder joint luxation in large animals: 14 cases (1976-1997).

PubMed

Semevolos, S A; Nixon, A J; Goodrich, L R; Ducharme, N G

1998-12-01

To determine clinical and radiographic findings in and treatment and outcome of large animals with shoulder joint luxations. Retrospective study. 5 horses, 3 goats, 1 calf, 1 sheep, 1 Himalayan tahr, 1 pot-bellied pig, 1 reindeer, and 1 white-tailed deer. Medical records and radiographs were reviewed to determine signalment, history, physical examination findings, type of luxation, treatment, and outcome. Owners and referring veterinarians were contracted for follow-up information. Goats, sexually intact males, and animals < 1 year old were overrepresented, compared with the general hospital population during the study period. Closed reduction was attempted in 3 animals and was successful in 1. Open reduction and internal stabilization was attempted in 4 animals, including 1 in which closed reduction was unsuccessful. Long-term stabilization of the joint was achieved in 3 animals, but overall results were poor because of osteoarthritis and chronic lameness. Three animals were not treated, and 5 were euthanatized because of a poor prognosis. Large animals with shoulder joint luxation and concurrent fractures had a poorer prognosis than did those with shoulder joint luxation alone.

Use of an automated chromium reduction system for hydrogen isotope ratio analysis of physiological fluids applied to doubly labeled water analysis.

PubMed

Schoeller, D A; Colligan, A S; Shriver, T; Avak, H; Bartok-Olson, C

2000-09-01

The doubly labeled water method is commonly used to measure total energy expenditure in free-living subjects. The method, however, requires accurate and precise deuterium abundance determinations, which can be laborious. The aim of this study was to evaluate a fully automated, high-throughput, chromium reduction technique for the measurement of deuterium abundances in physiological fluids. The chromium technique was compared with an off-line zinc bomb reduction technique and also subjected to test-retest analysis. Analysis of international water standards demonstrated that the chromium technique was accurate and had a within-day precision of <1 per thousand. Addition of organic matter to water samples demonstrated that the technique was sensitive to interference at levels between 2 and 5 g l(-1). Physiological samples could be analyzed without this interference, plasma by 10000 Da exclusion filtration, saliva by sedimentation and urine by decolorizing with carbon black. Chromium reduction of urine specimens from doubly labeled water studies indicated no bias relative to zinc reduction with a mean difference in calculated energy expenditure of -0.2 +/- 3.9%. Blinded reanalysis of urine specimens from a second doubly labeled water study demonstrated a test-retest coefficient of variation of 4%. The chromium reduction method was found to be a rapid, accurate and precise method for the analysis of urine specimens from doubly labeled water. Copyright 2000 John Wiley & Sons, Ltd.

26 CFR 1.312-3 - Liabilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 4 2011-04-01 2011-04-01 false Liabilities. 1.312-3 Section 1.312-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Effects on Corporation § 1.312-3 Liabilities. The amount of any reductions in earnings and profits...

26 CFR 1.312-3 - Liabilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 4 2010-04-01 2010-04-01 false Liabilities. 1.312-3 Section 1.312-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Effects on Corporation § 1.312-3 Liabilities. The amount of any reductions in earnings and profits...

International Inequalities: Algebraic Investigations into Health and Economic Development

ERIC Educational Resources Information Center

Staats, Susan; Robertson, Douglas

2009-01-01

The Millennium Project is an international effort to improve the health, economic status, and environmental resources of the world's most vulnerable people. Using data associated with the Millennium Project, students use algebra to explore international development issues including poverty reduction and the relationship between health and economy.…

Emerging Community Noise Reduction Approaches

NASA Technical Reports Server (NTRS)

Envia, Edmane

2012-01-01

An overview of the current NASA research portfolio in the area of aircraft noise reduction is presented. The emphasis of the research described herein is on meeting the aggressive near- and mid-term national goals for reducing aircraft noise emissions, which NASA internal studies have shown to be feasible using noise reduction technologies currently being developed in-house or in partnership with NASA s industry and academic partners. While NASA has an active research effort in airframe noise reduction, this overview focuses on propulsion noise reduction only.

Apparatus and method to inject a reductant into an exhaust gas feedstream

DOEpatents

Viola, Michael B [Macomb Township, MI

2009-09-22

An exhaust aftertreatment system for an internal combustion engine is provided including an apparatus and method to inject a reductant into the exhaust gas feedstream. Included is a fuel metering device adapted to inject reductant into the exhaust gas feedstream and a controllable pressure regulating device. A control module is operatively connected to the reductant metering device and the controllable pressure regulating device, and, adapted to effect flow of reductant into the exhaust gas feedstream over a controllable flow range.

Fabrication and Characteristics of Sintered Cutting Stainless Steel Fiber Felt with Internal Channels and an Al2O3 Coating

PubMed Central

Huang, Shufeng; Wan, Zhenping; Zou, Shuiping

2018-01-01

A novel sintered cutting stainless steel fiber felt with internal channels (SCSSFFC) composed of a stainless-steel fiber skeleton, three-dimensional interconnected porous structure and multiple circular microchannels is developed. SCSSFFC has a jagged and rough surface morphology and possesses a high specific surface area, which is approximately 2.4 times larger than that of the sintered bundle-drawing stainless steel fiber felt with internal channels (SBDSSFFC) and is expected to enhance adhesive strength. The sol-gel and wet impregnation methods are adopted to prepare SCSSFFC with an Al2O3 coating (SCSSFFC/Al2O3). The adhesive strength of SCSSFFC/Al2O3 is investigated using ultrasonic vibration and thermal shock tests. The experimental results indicate that the weight loss rate of the Al2O3 coating has a 4.2% and 8.42% reduction compared with those of SBDSSFFCs based on ultrasonic vibration and thermal shock tests. In addition, the permeability of SCSSFFC/Al2O3 is investigated based on forced liquid flow tests. The experimental results show that the permeability and inertial coefficients of SCSSFFC/Al2O3 are mainly affected by the coating rate, porosity and open ratio; however, the internal microchannel diameter has little influence. It is also found that SCSSFFC/Al2O3 yields superior permeability, as well as inertial coefficients compared with those of other porous materials reported in the literature. PMID:29558438

State Capacity and Resistance in Afghanistan

DTIC Science & Technology

2009-03-01

PRGF )222 of the International Monetary Fund (IMF).223 Facing these self-imposed (internal) and international (external) constraints, budget and...Budget_Policy_Coord_Reporting/Fact _Sheet/Fact_sheet_final_1386.pdf (accessed 19 November 2008). 222 The PRGF provides aid and structural guidance in the...management. See: A Factsheet: The Poverty Reduction and Growth Facility ( PRGF ). (International Monetary Fund, October 2008). On the web: http

Impaired intracortical transmission in G2019S leucine rich-repeat kinase Parkinson patients.

PubMed

Ponzo, Viviana; Di Lorenzo, Francesco; Brusa, Livia; Schirinzi, Tommaso; Battistini, Stefania; Ricci, Claudia; Sambucci, Manolo; Caltagirone, Carlo; Koch, Giacomo

2017-05-01

A mutation in leucine-rich repeat kinase 2 is the most common cause of hereditary Parkinson's disease (PD), yet the neural mechanisms and the circuitry potentially involved are poorly understood. We used different transcranial magnetic stimulation protocols to explore in the primary motor cortex the activity of intracortical circuits and cortical plasticity (long-term potentiation) in patients with the G2019S leucine-rich repeat kinase 2 gene mutation when compared with idiopathic PD patients and age-matched healthy subjects. Paired pulse transcranial magnetic stimulation was used to investigate short intracortical inhibition and facilitation and short afferent inhibition. Intermittent theta burst stimulation, a form of repetitive transcranial magnetic stimulation, was used to test long-term potentiation-like cortical plasticity. Leucine-rich repeat kinase 2 and idiopathic PD were tested both in ON and in OFF l-dopa therapy. When compared with idiopathic PD and healthy subjects, leucine-rich repeat kinase 2 PD patients showed a remarkable reduction of short intracortical inhibition in both ON and in OFF l-dopa therapy. This reduction was paralleled by an increase of intracortical facilitation in OFF l-dopa therapy. Leucine-rich repeat kinase 2 PD showed abnormal long-term potentiation-like cortical plasticity in ON l-dopa therapy. The motor cortex in leucine-rich repeat kinase 2 mutated PD patients is strongly disinhibited and hyperexcitable. These abnormalities could be a result of an impairment of inhibitory (gamma-Aminobutyric acid) transmission eventually related to altered neurotransmitter release. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

Radiation dose management in thoracic CT: an international survey.

PubMed

Molinari, Francesco; Tack, Denis M; Boiselle, Philip; Ngo, Long; Mueller-Mang, Christina; Litmanovich, Diana; Bankier, Alexander A

2013-01-01

We aimed to examine current practice patterns of international thoracic radiologists regarding radiation dose management in adult thoracic computed tomography (CT) examinations. An electronic questionnaire was sent to 800 members of five thoracic radiology societies in North America, Europe, Asia, and Latin America addressing radiation dose training and education, standard kVp and mAs settings for thoracic CT, dose reduction practices, clinical scenarios, and demographics. Of the 800 radiologists, 146 responded to our survey. Nearly half (66/146, 45% [95% confidence interval, 37%-53%]) had no formal training in dose reduction, with "self-study of the literature" being the most common form of training (54/146, 37% [29%-45%]). One hundred and seventeen (80% [74%-87%]) had automatic exposure control, and 76 (65% [56%-74%]) used it in all patients. Notably, most respondents (89% [84%-94%]) used a 120 to 125 kVp standard setting, whereas none used 140 kVp. The most common average dose-length-product (DLP) value was 150 to 249 mGy.cm (75/146, 51% [43%-59%]), and 59% (51%-67%) delivered less than 250 mGy.cm in a 70 kg patient. There was a tendency towards higher DLP values with multidetector-row CT. Age, gender, and pregnancy were associated more with dose reduction than weight and clinical indication. Efforts for reducing patient radiation dose are highly prevalent among thoracic radiologists. Areas for improvement include reduction of default tube current settings, reduction of anatomical scan coverage, greater use of automatic exposure control, and eventually, reduction of current reference dose values. Our study emphasizes the need for international guidelines to foster greater conformity in dose reduction by thoracic radiologists.

Do Australian immunoglobulin products meet international measles antibody titer standards?

PubMed

Young, Megan K; Bertolini, Joseph; Kotharu, Pushpa; Maher, Darryl; Cripps, Allan W

2017-03-04

The effectiveness of passive immunisation post-exposure to measles appears subject to a dose-response effect. New Zealand and the United Kingdom have increased the recommended dose of polyclonal human immunoglobulin for post-exposure prophylaxis within the last decade in response to concerns about decreasing levels of measles antibodies in these products. This study used the plaque-reduction neutralization test (PRNT) to measure the titer of measles-specific antibodies in Australian immunoglobulin products for post-exposure prophylaxis and compared the utility of an enzyme-linked immunosorbent assay (ELISA) to the PRNT in available Australian and international samples: Australian intramuscular (n = 10), Australian intravenous (n = 28), New Zealand intramuscular (n = 2), Hizentra (subcutaneous)(USA) (n = 3), and Privigen (intravenous)(USA) (n = 2). Measles titres in Australian IM and IV immunoglobulins ranged from 51 to 76 IU/mL and 6 to 24 IU/mL respectively, as measured by PRNT calibrated to the WHO 3 rd international standard. ELISA titres were variable but higher than PRNT titres in all tested samples. Measles antibody titres in Australian immunoglobulin products meet consensus-prescribed international thresholds. Development of a convenient, standardized, readily accessible assay for determination of measles titres in immunoglobulin products would be useful for future studies and facilitate international comparisons.

The Validity of the Comparative Interrupted Time Series Design for Evaluating the Effect of School-Level Interventions.

PubMed

Jacob, Robin; Somers, Marie-Andree; Zhu, Pei; Bloom, Howard

2016-06-01

In this article, we examine whether a well-executed comparative interrupted time series (CITS) design can produce valid inferences about the effectiveness of a school-level intervention. This article also explores the trade-off between bias reduction and precision loss across different methods of selecting comparison groups for the CITS design and assesses whether choosing matched comparison schools based only on preintervention test scores is sufficient to produce internally valid impact estimates. We conduct a validation study of the CITS design based on the federal Reading First program as implemented in one state using results from a regression discontinuity design as a causal benchmark. Our results contribute to the growing base of evidence regarding the validity of nonexperimental designs. We demonstrate that the CITS design can, in our example, produce internally valid estimates of program impacts when multiple years of preintervention outcome data (test scores in the present case) are available and when a set of reasonable criteria are used to select comparison organizations (schools in the present case). © The Author(s) 2016.

Hard ceramic coatings: an experimental study on a novel damping treatment

NASA Astrophysics Data System (ADS)

Patsias, Sophoclis; Tassini, Nicola; Stanway, Roger

2004-07-01

This paper describes a novel damping treatment, namely hard ceramic coatings. These materials can be applied on almost any surface (internal or external) of a component. Their effect is the significant reduction of vibration levels and hence the extension of life expectancy of the component. The damping features of air-plasma-sprayed ceramic coatings (for example amplitude dependence, influence of initial amplitude) are discussed and the experimental procedure employed for testing and characterising such materials is also described. This test procedure is based around a custom-developed rig that allows one to measure the damping (internal friction) of specimens at controlled frequencies, strain amplitudes and, if required, various temperatures. A commonly used Thermal Barrier Coating, Yttria Stabilised Zirconia (8%), is used to demonstrate the above mentioned features. The damping effectiveness of this coating is then compared against two established damping treatments: polymer Free Layer Damping (FLD) and Constrained Layer Damping (CLD). The paper discusses the major issues in characterising ceramic damping coatings and their damping effectiveness when compared against the "traditional" approaches. Finally, the paper concludes with suggestions for further research.

An international comparative overview on the rehabilitation of offenders and effective measures for the prevention of recidivism.

PubMed

Someda, Kei

2009-04-01

The prevention of recidivism has long been a central issue in criminal justice policy. This is justified because an offender who repeatedly commits crime inflicts far greater damage on society than an offender who commits a crime just once in his/her lifetime. For instance, research by the Ministry of Justice of Japan (2007) reveals that only approximately 30% of repeat offenders were responsible for around 60% of the crime committed in Japan from 1948 to 2006. It has been proven that the realization of the rehabilitation of offenders contributes to the reduction of recidivism. The successful rehabilitation of offenders depends in large part upon the effectiveness of the community-based treatment given to offenders based upon an appropriate assessment of multidimensional risk factors and a multidisciplinary approach. In exploring effective community-based treatment of offenders using a multidisciplinary approach, the author touches upon several effective programs from an international comparative view, including: intensive supervision probation/parole (ISP), Drug Court, cognitive behavioral treatment programs and some recent developments related to this field in Japan.

Verification of shielding effect by the water-filled materials for space radiation in the International Space Station using passive dosimeters

NASA Astrophysics Data System (ADS)

Kodaira, S.; Tolochek, R. V.; Ambrozova, I.; Kawashima, H.; Yasuda, N.; Kurano, M.; Kitamura, H.; Uchihori, Y.; Kobayashi, I.; Hakamada, H.; Suzuki, A.; Kartsev, I. S.; Yarmanova, E. N.; Nikolaev, I. V.; Shurshakov, V. A.

2014-01-01

The dose reduction effects for space radiation by installation of water shielding material ("protective curtain") of a stack board consisting of the hygienic wipes and towels have been experimentally evaluated in the International Space Station by using passive dosimeters. The averaged water thickness of the protective curtain was 6.3 g/cm2. The passive dosimeters consisted of a combination of thermoluminescent detectors (TLDs) and plastic nuclear track detectors (PNTDs). Totally 12 passive dosimeter packages were installed in the Russian Service Module during late 2010. Half of the packages were located at the protective curtain surface and the other half were at the crew cabin wall behind or aside the protective curtain. The mean absorbed dose and dose equivalent rates are measured to be 327 μGy/day and 821 μSv/day for the unprotected packages and 224 μGy/day and 575 μSv/day for the protected packages, respectively. The observed dose reduction rate with protective curtain was found to be 37 ± 7% in dose equivalent, which was consistent with the calculation in the spherical water phantom by PHITS. The contributions due to low and high LET particles were found to be comparable in observed dose reduction rate. The protective curtain would be effective shielding material for not only trapped particles (several 10 MeV) but also for low energy galactic cosmic rays (several 100 MeV/n). The properly utilized protective curtain will effectively reduce the radiation dose for crew living in space station and prolong long-term mission in the future.

Acoustic Performance of Novel Fan Noise Reduction Technologies for a High Bypass Model Turbofan at Simulated Flights Conditions

NASA Technical Reports Server (NTRS)

Elliott, David M.; Woodward, Richard P.; Podboy, Gary G.

2010-01-01

Two novel fan noise reduction technologies, over the rotor acoustic treatment and soft stator vane technologies, were tested in an ultra-high bypass ratio turbofan model in the NASA Glenn Research Center s 9- by 15-Foot Low-Speed Wind Tunnel. The performance of these technologies was compared to that of the baseline fan configuration, which did not have these technologies. Sideline acoustic data and hot film flow data were acquired and are used to determine the effectiveness of the various treatments. The material used for the over the rotor treatment was foam metal and two different types were used. The soft stator vanes had several internal cavities tuned to target certain frequencies. In order to accommodate the cavities it was necessary to use a cut-on stator to demonstrate the soft vane concept.

Hybrid Feedforward-Feedback Noise Control Using Virtual Sensors

NASA Technical Reports Server (NTRS)

Bean, Jacob; Fuller, Chris; Schiller, Noah

2016-01-01

Several approaches to active noise control using virtual sensors are evaluated for eventual use in an active headrest. Specifically, adaptive feedforward, feedback, and hybrid control structures are compared. Each controller incorporates the traditional filtered-x least mean squares algorithm. The feedback controller is arranged in an internal model configuration to draw comparisons with standard feedforward control theory results. Simulation and experimental results are presented that illustrate each controllers ability to minimize the pressure at both physical and virtual microphone locations. The remote microphone technique is used to obtain pressure estimates at the virtual locations. It is shown that a hybrid controller offers performance benefits over the traditional feedforward and feedback controllers. Stability issues associated with feedback and hybrid controllers are also addressed. Experimental results show that 15-20 dB reduction in broadband disturbances can be achieved by minimizing the measured pressure, whereas 10-15 dB reduction is obtained when minimizing the estimated pressure at a virtual location.

Halo-substituted azobenzenes adsorbed at Ag(111) and Au(111) interfaces: Structures and optical properties

NASA Astrophysics Data System (ADS)

Hughes, Zak E.; Baev, Alexander; Prasad, Paras N.; Walsh, Tiffany R.

2017-05-01

The adsorption of azobenzene (AB), ortho fluoro-azobenzene (FAB) and ortho chlor-azobenzol (ClAB), in both the cis and trans isomers, at the Au(111) and Ag(111) surfaces is investigated using plane-wave density functional calculations with the revPBE-vdW-DF functional. The resulting adsorption energies and internal structures of AB adsorbed to both metal surfaces are in broad agreement with available experimental data. In the gas phase, FAB and ClAB feature a significant reduction in the energy difference between the two isomeric states, compared with AB. This relative reduction in the energy difference is still significant for the adsorbed form of FAB but is only weakly apparent for ClAB. The absorption spectra of the molecules have also been calculated, with the halogen substituents generating significant changes in the gas phase, but only a modest difference for the adsorbed molecules.

Is fibular fracture displacement consistent with tibiotalar displacement?

PubMed

van den Bekerom, Michel P J; van Dijk, C Niek

2010-04-01

We believed open reduction with internal fixation is required for supination-external rotation ankle fractures located at the level of the distal tibiofibular syndesmosis (Lauge-Hanssen SER II and Weber B) with 2 mm or more fibular fracture displacement. The rationale for surgery for these ankle fractures is based on the notion of elevated intraarticular contact pressures with lateral displacement. To diagnose these injuries, we presumed that in patients with a fibular fracture with at least 2 mm fracture displacement, the lateral malleolus and talus have moved at least 2 mm in a lateral direction without medial displacement of the proximal fibula. We reviewed 55 adult patients treated operatively for a supination-external rotation II ankle fracture (2 mm or more fibular fracture displacement) between 1990 and 1998. On standard radiographs, distance from the tibia to the proximal fibula, distance from the tibia to the distal fibula, and displacement at the level of the fibular fracture were measured. These distances were compared preoperatively and postoperatively. We concluded tibiotalar displacement cannot be reliably assessed at the level of the fracture. Based on this and other studies, we believe there is little evidence to perform open reduction and internal fixation of supination-external rotation II ankle fractures. Level IV, case series. See Guidelines for Authors for a complete description of levels of evidence.

Implementation of internal model based control and individual pitch control to reduce fatigue loads and tower vibrations in wind turbines

NASA Astrophysics Data System (ADS)

Mohammadi, Ebrahim; Fadaeinedjad, Roohollah; Moschopoulos, Gerry

2018-05-01

Vibration control and fatigue loads reduction are important issues in large-scale wind turbines. Identifying the vibration frequencies and tuning dampers and controllers at these frequencies are major concerns in many control methods. In this paper, an internal model control (IMC) method with an adaptive algorithm is implemented to first identify the vibration frequency of the wind turbine tower and then to cancel the vibration signal. Standard individual pitch control (IPC) is also implemented to compare the performance of the controllers in term of fatigue loads reduction. Finally, the performance of the system when both controllers are implemented together is evaluated. Simulation results demonstrate that using only IMC or IPC alone has advantages and can reduce fatigue loads on specific components. IMC can identify and suppress tower vibrations in both fore-aft and side-to-side directions, whereas, IPC can reduce fatigue loads on blades, shaft and yaw bearings. When both IMC and IPC are implemented together, the advantages of both controllers can be used. The aforementioned analysis and comparisons were not studied in literature and this study fills this gap. FAST, AreoDyn and Simulink are used to simulate the mechanical, aerodynamic and electrical aspects of wind turbine.

A monte carlo study of restricted diffusion: Implications for diffusion MRI of prostate cancer.

PubMed

Gilani, Nima; Malcolm, Paul; Johnson, Glyn

2017-04-01

Diffusion MRI is used frequently to assess prostate cancer. The prostate consists of cellular tissue surrounding fluid filled ducts. Here, the diffusion properties of the ductal fluid alone were studied. Monte Carlo simulations were used to investigate ductal residence times to determine whether ducts can be regarded as forming a separate compartment and whether ductal radius could determine the Apparent Diffusion Coefficient (ADC) of the ductal fluid. Random walks were simulated in cavities. Average residence times were estimated for permeable cavities. Signal reductions resulting from application of a Stejskal-Tanner pulse sequence were calculated in impermeable cavities. Simulations were repeated for cavities of different radii and different diffusion times. Residence times are at least comparable with diffusion times even in relatively high grade tumors. ADCs asymptotically approach theoretical limiting values. At large radii and short diffusion times, ADCs are similar to free diffusion. At small radii and long diffusion times, ADCs are reduced toward zero, and kurtosis approaches a value of -1.2. Restricted diffusion in cavities of similar sizes to prostate ducts may reduce ductal ADCs. This may contribute to reductions in total ADC seen in prostate cancer. Magn Reson Med 77:1671-1677, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

26 CFR 1.312-1 - Adjustment to earnings and profits reflecting distributions by corporations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... earnings and profits. The reduction in earnings and profits by reason of such distribution is $5,000. Such...,000. The reduction in earnings and profits is $15,000. Such is the reduction even though only the... 26 Internal Revenue 4 2011-04-01 2011-04-01 false Adjustment to earnings and profits reflecting...

Consumer preferences, internal color and reduction of shigatoxigenic Escherichia coli in cooked hamburgers.

PubMed

Røssvoll, Elin; Sørheim, Oddvin; Heir, Even; Møretrø, Trond; Olsen, Nina Veflen; Langsrud, Solveig

2014-02-01

The aim of this study was to relate consumer preferences and preparation of hamburgers to color change, internal temperature and reduction of shigatoxigenic Escherichia coli (STEC) serogroups O157 and the "Big Six" (O26, O45, O103, O111, O121, O145) under two ground beef packaging scenarios: 75% O2 MAP and vacuum. 75% O2 MAP hamburgers cooked to 60 °C core temperature appeared done and showed less internal red color (lower a*) than corresponding vacuum hamburgers. Similar STEC reduction (<4 log10) was found for both hamburgers at core temperatures ≤ 66 °C. In a representative survey (N=1046) most consumers reported to judge hamburger doneness by the color and many preferred undercooked hamburgers. Premature browning of 75% O2 MAP hamburgers represents a risk of foodborne illness, when considering consumers' food handling practices. The risk is even greater if such ground beef is prepared by consumers who prefer undercooked hamburgers and judge doneness by color. © 2013.

Effects of potential federal funding cuts on graduate medical education: results of a survey of designated institutional officials.

PubMed

Holt, Kathleen D; Miller, Rebecca S; Philibert, Ingrid; Nasca, Thomas J

2014-03-01

Proposed reductions in federal funding for physician education may affect the United States' ability to produce the number of physicians needed to provide care. Using a survey similar to that used by the ACGME in 2011, we assessed designated institutional officials' (DIOs) perceptions of the impact of potential GME funding reductions. In August 2013, we sent a survey link to all DIOs of ACGME-accredited institutions (N  =  678). A 9-item survey asked how future federal funding would affect the number of residency programs in their institutions under 4 different funding scenarios: stable funding, and reductions of 10%, 33%, and 50%. We also asked about changes in the number of residency positions during the last 2 years. The response rate was 47.9% (325 of 678 DIOs); respondents represent 58.9% of accredited institutions with more than 1 program. Most respondents reported no change or an increase under the stable funding scenario. Under a 33% funding reduction, an estimated 17 379 (14.8% of all current) positions would be lost, and a 50% reduction would result in a loss of 33 562 positions (28.6%). Primary care specialties (eg, family medicine, internal medicine) would be most affected under the greatest funding reductions. The findings of the 2013 survey are consistent with 2011 data, with DIOs projecting significant reductions in programs and positions under more severe budget cuts. DIO comments highlighted reduced optimism (compared to data obtained in 2011) about the effect of funding cuts and concerns about the impact of reductions on patient care and health care personnel at teaching institutions.

Revitalising Evidence-based Policy for the Sendai Framework for Disaster Risk Reduction 2015-2030: Lessons from Existing International Science Partnerships.

PubMed

Carabine, Elizabeth

2015-04-23

The convergence of agreements on disaster risk reduction (DRR), development finance, sustainable development and climate change in 2015 presents a unique opportunity for coherence across these inter-related policy areas. At the same time, demand is growing for a more prominent and effective role for science and technology in providing evidence for policy, with the international community recognising that successful disaster risk reduction (DRR) depends on it. Reflecting this ambition, science is included as a core aspect of the Sendai Framework for Disaster Risk Reduction 2015-2030, although the ways in which this will be implemented in practice is still unclear. This paper aims to inform the implementation of international science coordination for DRR by examining a number of existing international science partnerships used across other relevant areas of policy to understand best practice, options for coordination and lessons identified. In the field of DRR, the science-policy interface needs to be strengthened in line with the best practice described in this review. An enhanced UNISDR Scientific and Technical Advisory Group will be given the mandate for to enhance the evidence base for DRR and mobilise science and technical work in coordination with a broad range of stakeholders. The structure and function of an enhanced STAG must be as open, as inclusive and as participatory as possible in order to build trust in new and existing institutions at local, national, regional and global levels. The challenge for the international community is to facilitate evidence-based policy making by formally recognising the links between DRR, development finance, sustainable development and climate change in the upcoming post-2015 agreements.

Defensive freezing links Hypothalamic-Pituitary-Adrenal-axis activity and internalizing symptoms in humans.

PubMed

Niermann, Hannah C M; Figner, Bernd; Tyborowska, Anna; van Peer, Jacobien M; Cillessen, Antonius H N; Roelofs, Karin

2017-08-01

The Hypothalamic-Pituitary-Adrenal (HPA)-axis plays an important role in the expression of defensive freezing. Adaptive freezing reactivity, characterized by an immediate increase in acute stress and timely termination upon threat offset or need to act, is essential for adequate stress coping. Blunted HPA-axis activity in animals is associated with blunted freezing reactivity and internalizing symptoms. Despite their potential relevance, it remains unknown whether these mechanisms apply to humans and human psychopathology. Using a well-established method combining electrocardiography and posturography, we assessed freezing before, immediately after, and one hour after a stress induction in 92 human adolescents. In line with animal models, human adolescents showed stress-induced freezing, as quantified by relative reductions in heart rate and body sway after, as compared to before, stress. Moreover, relatively lower basal cortisol was associated with reduced stress-induced freezing reactivity (i.e., less immediate freezing and less recovery). Path analyses showed that decreased freezing recovery in individuals with reduced cortisol levels was associated with increased levels of internalizing symptoms. These findings suggest that reduced freezing recovery may be a promising marker for the etiology of internalizing symptoms. Copyright © 2017 Elsevier Ltd. All rights reserved.

Efficient Procedure for the Numerical Calculation of Harmonic Vibrational Frequencies Based on Internal Coordinates

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

Miliordos, Evangelos; Xantheas, Sotiris S.

We propose a general procedure for the numerical calculation of the harmonic vibrational frequencies that is based on internal coordinates and Wilson’s GF methodology via double differentiation of the energy. The internal coordinates are defined as the geometrical parameters of a Z-matrix structure, thus avoiding issues related to their redundancy. Linear arrangements of atoms are described using a dummy atom of infinite mass. The procedure has been automated in FORTRAN90 and its main advantage lies in the nontrivial reduction of the number of single-point energy calculations needed for the construction of the Hessian matrix when compared to the corresponding numbermore » using double differentiation in Cartesian coordinates. For molecules of C 1 symmetry the computational savings in the energy calculations amount to 36N – 30, where N is the number of atoms, with additional savings when symmetry is present. Typical applications for small and medium size molecules in their minimum and transition state geometries as well as hydrogen bonded clusters (water dimer and trimer) are presented. Finally, in all cases the frequencies based on internal coordinates differ on average by <1 cm –1 from those obtained from Cartesian coordinates.« less

Psychosocial Characteristics Associated with Both Antiretroviral Therapy Adherence and Risk Behaviors in Women Living with HIV

PubMed Central

Spangler, Sydney; Higgins, Melinda; Dalmida, Safiya George; Sharma, Sanjay

2015-01-01

The purpose of this study was to identify key psychosocial characteristics of HIV-infected women who exhibit different levels of both ART adherence and risk behaviors. We analyzed baseline data from 193 predominately African American HIV-infected women participating in a behavioral clinical trial. Women were categorized into high/low groups based on levels of adherence and risky behaviors. There was a significant interaction effect for internal motivation for adherence. Women at high risk for poor health and transmitting HIV (low adherence/high risk group) had the lowest levels of internal motivation and also reported more difficult life circumstances. Gender roles, caretaking and reliance on men for economic and other support may promote external versus internal motivation as well as riskier behaviors in this group. The highest levels of internal motivation were found in those with High Adherence/High Risk behaviors. This group was highly knowledgeable about HIV and had the lowest VL. Compared to others, this group seems to tolerate risky behaviors given their high level of adherence. Adherence and risk reduction behaviors are key to individual and public health. Motivation and risk compensation should be addressed when providing interventions to women living with HIV. PMID:26452670

Comparison of the effectiveness of three different treatment methods for temporomandibular joint disc displacement without reduction.

PubMed

Tatli, U; Benlidayi, M E; Ekren, O; Salimov, F

2017-05-01

The aim of this study was to compare the effectiveness of three treatment methods for unilateral temporomandibular joint (TMJ) disc displacement without reduction (DDwoR). One hundred and twenty patients with unilateral TMJ DDwoR were assigned randomly to one of three treatment groups (40 patients in each): group 1 received arthrocentesis, group 2 received stabilization splint therapy following arthrocentesis, and group 3 received splint therapy only. The groups were compared in terms of pain (visual analogue scale), joint function (maximum mouth opening and laterotrusive movements), disability and psychological status (validated questionnaire), and success rates. These were recorded before treatment and during follow-up after treatment (1, 3, and 6 months). The between-group and within-group differences in the data were analyzed statistically. The baseline characteristics were similar in all groups (P>0.05). Significant improvements were noted in all parameters compared to baseline values in all groups (all P<0.01). Groups 1 and 2 showed comparable outcomes that were superior to those of group 3. Arthrocentesis reduces pain and functional impairment more rapidly and effectively than splint therapy. Simultaneous splint application has no additional effect on the effectiveness of arthrocentesis for the treatment of unilateral DDwoR. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Evaluation of simulated dredging to control internal phosphorus release from sediments: Focused on phosphorus transfer and resupply across the sediment-water interface.

PubMed

Yu, Juhua; Ding, Shiming; Zhong, Jicheng; Fan, Chengxin; Chen, Qiuwen; Yin, Hongbin; Zhang, Lei; Zhang, Yinlong

2017-08-15

Sediment dredging is an effective restoration method to control the internal phosphorus (P) loading of eutrophic lakes. However, the core question is that the real mechanism of dredging responsible for sediment internal P release still remains unclear. In this study, we investigated the P exchange across the sediment-water interface (SWI) and the internal P resupply ability from the sediments after dredging. The study is based on a one-year field simulation study in Lake Taihu, China, using a Rhizon soil moisture sampler, high-resolution dialysis (HR-Peeper), ZrO-Chelex diffusive gradients in thin film (ZrO-Chelex DGT), and P fractionation and adsorption isotherm techniques. The results showed low concentration of labile P in the pore water with a low diffusion potential and a low resupply ability from the sediments after dredging. The calculated flux of P from the post-dredged sediments decreased by 58% compared with that of non-dredged sediments. Furthermore, the resupply in the upper 20mm of the post-dredged sediments was reduced significantly after dredging (P<0.001). Phosphorus fractionation analysis showed a reduction of 25% in the mobile P fractions in the post-dredged sediments. Further analysis demonstrated that the zero equilibrium P concentration (EPC 0 ), partitioning coefficient (K p ), and adsorption capacity (Q max ) on the surface sediments increased after dredging. Therefore, dredging could effectively reduce the internal P resupply ability of the sediments. The reasons for this reduction are probably the lower contributions of mobile P fractions, higher retention ability, and the adsorption capacity of P for post-dredged sediments. Overall, this investigation indicated that dredging was capable of effectively controlling sediment internal P release, which could be ascribed to the removal of the surface sediments enriched with total phosphorus (TP) and/or organic matter (OM), coupled with the inactivation of P to iron (Fe) (hydr)oxides in the upper 20mm active layer. Copyright © 2017 Elsevier B.V. All rights reserved.

Internal versus external fixation of the anterior component in unstable fractures of the pelvic ring: pooled results from a systematic review.

PubMed

Wardle, B; Eslick, G D; Sunner, P

2016-10-01

Improving reduction of the pelvic ring improves long-term functional outcomes for patients. It has been demonstrated that posterior internal fixation is necessary to adequately control fractures to the posterior ring and there is evidence that supplementing this with fixation of the anterior ring improves stability. It is accepted that internal fixation provides greater stability than external fixation of the anterior ring but long-term differences in radiographic and functional outcomes have not yet been quantified. A search of electronic databases, reference lists and review articles from 1989 to 2015 yielded 18 studies (n = 884) that met our inclusion criteria. We included studies that discussed pelvic ring injuries in adults, reported functional or radiological outcomes or complications by anterior ring intervention and exceeded 14 patients. We excluded biomechanical and cadaver studies. Internal fixation of the anterior pelvic ring had better functional and radiographic outcomes. Residual displacement of >10 mm was less common with internal fixation (ER 0.12, 95 % CI 0.06-0.24) than external fixation (ER 0.31, 95 % CI 0.11-0.62). Unsatisfactory outcomes also occurred at a lower rate (ER 0.09, 95 % CI 0.03-0.22) compared to external fixation (ER 0.32, 95 % CI 0.18-0.50). Losses of reduction (ER 0.02, 95 % CI 0.01-0.04 versus ER 0.07, 95 % CI 0.02-0.21), malunions (ER 0.03, 95 % CI 0.01-0.08 versus ER 0.07, 95 % CI 0.02-0.21) and delayed/non-unions (ER 0.02, 95 % CI 0.01-0.05 versus ER 0.04, 95 % CI 0.02-0.07). Internal fixation of the anterior pelvic ring as supplementary fixation for unstable injuries to the pelvic ring appears to result in better radiographic and functional outcomes as well as fewer complications. However, data that separated outcomes and complications in relation to interventions of the anterior pelvic ring were limited. More studies looking specifically at outcomes in relation to the type of anterior ring intervention are needed.

Are prices enough? The economics of material demand reduction

NASA Astrophysics Data System (ADS)

Aidt, Toke; Jia, Lili; Low, Hamish

2017-05-01

Recent policy proposals to achieve carbon targets have emphasized material demand reduction strategies aimed at achieving material efficiency. We provide a bridge between the way economists and engineers think about efficiency. We use the tools of economics to think about policies directed at material efficiency and to evaluate the role and rationale for such policies. The analysis highlights when prices (or taxes) can be used to induce changes in material use and when taxes may not work. We argue that the role of taxes is limited by concerns about their distributional consequences, by international trade and the lack of international agreement on carbon prices, and by investment failures. This article is part of the themed issue 'Material demand reduction'.

Apparatus for photocatalytic destruction of internal combustion engine emissions during cold start

DOEpatents

Janata, Jiri; McVay, Gary L.; Peden, Charles H.; Exarhos, Gregory J.

1998-01-01

A method and apparatus for the destruction of emissions from an internal combustion engine wherein a substrate coated with TiO.sub.2 is exposed to a light source in the exhaust system of an internal combustion engine thereby catalyzing oxidation/reduction reactions between gaseous hydrocarbons, carbon monoxide, nitrogen oxides and oxygen in the exhaust of the internal combustion engine.

Design and optimization of a noise reduction system for infrasonic measurements using elements with low acoustic impedance.

PubMed

Alcoverro, Benoit; Le Pichon, Alexis

2005-04-01

The implementation of the infrasound network of the International Monitoring System (IMS) for the enforcement of the Comprehensive Nuclear-Test-Ban Treaty (CTBT) increases the effort in the design of suitable noise reducer systems. In this paper we present a new design consisting of low impedance elements. The dimensioning and the optimization of this discrete mechanical system are based on numerical simulations, including a complete electroacoustical modeling and a realistic wind-noise model. The frequency response and the noise reduction obtained for a given wind speed are compared to statistical noise measurements in the [0.02-4] Hz frequency band. The effects of the constructive parameters-the length of the pipes, inner diameters, summing volume, and number of air inlets-are investigated through a parametric study. The studied system consists of 32 air inlets distributed along an overall diameter of 16 m. Its frequency response is flat up to 4 Hz. For a 2 m/s wind speed, the maximal noise reduction obtained is 15 dB between 0.5 and 4 Hz. At lower frequencies, the noise reduction is improved by the use of a system of larger diameter. The main drawback is the high-frequency limitation introduced by acoustical resonances inside the pipes.

78 FR 65219 - Defense Federal Acquisition Regulation Supplement: Approval of Rental Waiver Requests (DFARS Case...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

... reduction of charges for the use of Government property on work for foreign governments or international... rental charges for the use of Government property on work for foreign governments or international... Government property on work for foreign governments or international organizations without a separate review...

Physical Conditions and Exobiology Potential of Icy Satellites of the Giant Planets

NASA Astrophysics Data System (ADS)

Simakov, M. B.

2017-05-01

All giant planets of the Solar system have a big number of satellites. A small part of them consist very large bodies, quite comparable to planets of terrestrial type, but including very significant share of water ice. Galileo spacecraft has given indications, primarily from magnetometer and gravity data, of the possibility that three of Jupiter's four large moons, Europa, Ganymede and Callisto have internal oceans. Formation of such satellites is a natural phenomenon, and satellite systems definitely should exist at extrasolar planets. The most recent models of the icy satellites interior lead to the conclusion that a substantial liquid layer exists today under relatively thin ice cover inside. The putative internal water ocean provide some exobiological niches on these bodies. We can see all conditions needed for origin and evolution of biosphere - liquid water, complex organic chemistry and energy sources for support of biological processes - are on the moons. The existing of liquid water ocean within icy world can be consequences of the physical properties of water ice, and they neither require the addition of antifreeze substances nor any other special conditions. On Earth life exists in all niches where water exists in liquid form for at least a portion of the year. Possible metabolic processes, such as nitrate/nitrite reduction, sulfate reduction and methanogenesis could be suggested for internal oceans of Titan and Jovanian satellites. Excreted products of the primary chemoautotrophic organisms could serve as a source for other types of microorganisms (heterotrophes). Subglacial life may be widespread among such planetary bodies as satellites of extrasolar giant planets, detected in our Galaxy.

Background Oriented Schlieren (BOS) and other Flow Visualization Developments and Applications at GRC

NASA Technical Reports Server (NTRS)

Clem, Michelle; Woike, Mark

2013-01-01

This is a presentation to be given at an internal NASA Advanced Schlieren Working Group Meeting. The presentation will cover the recent developments and applications of flow visualization methods at GRC. The topics being discussed will include the use of Background Oriented Schlieren (BOS) in the study of screech and its associated shock spacing as well as in the investigation of broadband shock noise reduction in the Jet-Surface Interaction Tests. In addition, other flow visualiztion methods will be discussed in an on-going study comparing schlieren, shadowgraph, BOS, and focusing schlieren.

Understanding the emergence of the tobacco industry's use of the term tobacco harm reduction in order to inform public health policy.

PubMed

Peeters, Silvy; Gilmore, Anna B

2015-03-01

To explore the history of transnational tobacco companies' use of the term, approach to and perceived benefits of 'harm reduction'. Analysis of internal tobacco industry documents, contemporary tobacco industry literature and 6 semistructured interviews. The 2001 Institute of Medicine report on tobacco harm reduction appears to have been pivotal in shaping industry discourse. Documents suggest British American Tobacco and Philip Morris International adopted the term 'harm reduction' from Institute of Medicine, then proceeded to heavily emphasise the term in their corporate messaging. Documents and interviews suggest harm reduction offered the tobacco industry two main benefits: an opportunity to (re-) establish dialogue with and access to policy makers, scientists and public health groups and to secure reputational benefits via an emerging corporate social responsibility agenda. Transnational tobacco companies' harm reduction discourse should be seen as opportunistic tactical adaptation to policy change rather than a genuine commitment to harm reduction. Care should be taken that this does not undermine gains hitherto secured in efforts to reduce the ability of the tobacco industry to inappropriately influence policy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

26 CFR 41.4483-7 - Reduction in tax for vehicles registered in a contiguous foreign country.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 16 2010-04-01 2010-04-01 true Reduction in tax for vehicles registered in a... OF THE TREASURY (CONTINUED) MISCELLANEOUS EXCISE TAXES EXCISE TAX ON USE OF CERTAIN HIGHWAY MOTOR VEHICLES Tax on Use of Certain Highway Motor Vehicles § 41.4483-7 Reduction in tax for vehicles registered...

Symphyseal internal rod fixation versus standard plate fixation for open book pelvic ring injuries: a biomechanical study.

PubMed

Osterhoff, G; Tiziani, S; Hafner, C; Ferguson, S J; Simmen, H-P; Werner, C M L

2016-04-01

This study investigates the biomechanical stability of a novel technique for symphyseal internal rod fixation (SYMFIX) using a multiaxial spinal screw-rod implant that allows for direct reduction and can be performed percutaneously and compares it to standard internal plate fixation of the symphysis. Standard plate fixation (PLATE, n = 6) and the SYMFIX (n = 6) were tested on pelvic composite models with a simulated open book injury using a universal testing machine. On a previously described testing setup, 500 consecutive cyclic loadings were applied with sinusoidal resulting forces of 200 N. Displacement under loading was measured using an optoelectronic camera system and construct rigidity was calculated as a function of load and displacement. The rigidity of the PLATE construct was 122.8 N/mm (95 % CI: 110.7-134.8), rigidity of the SYMFIX construct 119.3 N/mm (95 % CI: 105.8-132.7). Displacement in the symphyseal area was mean 0.007 mm (95 % CI: 0.003-0.012) in the PLATE group and 0.021 mm (95 % CI: 0.011-0.031) in the SYMFIX group. Displacement in the sacroiliac joint area was mean 0.156 mm (95 % CI: 0.051-0.261) in the PLATE group and 0.120 mm (95 % CI: 0.039-0.201) in the SYMFIX group. In comparison to standard internal plate fixation for the stabilization of open book pelvic ring injuries, symphyseal internal rod fixation using a multiaxial spinal screw-rod implant in vitro shows a similar rigidity and comparable low degrees of displacement.

Pediatric mandibular fractures treated by rigid internal fixation.

PubMed

Wong, G B

1993-09-01

Mandibular fractures in the pediatric patient population are relatively uncommon. These patients present with their own unique treatment requirements. Most fractures have been treated conservatively by dental splints. Closed reduction techniques with maxillomandibular fixation (MMF) in very young children can pose several concerns, including cooperation, compliance and adequate nutritional intake. Rigid internal fixation of unstable mandibular fractures using miniplates and screws circumvents the need for MMF and allows immediate jaw mobilization. At major pediatric trauma institutions, there has been an increasing trend toward the use of this treatment when open reduction is necessary. This article presents a report of a five-year-old child who presented with bilateral mandibular fractures and was treated by rigid internal fixation and immediate mandibular mobilization.

General solution of a cosmological model induced from higher dimensions using a kinematical constraint

NASA Astrophysics Data System (ADS)

Akarsu, Özgür; Dereli, Tekin; Katırcı, Nihan; Sheftel, Mikhail B.

2015-05-01

In a recent study Akarsu and Dereli (Gen. Relativ. Gravit. 45:1211, 2013) discussed the dynamical reduction of a higher dimensional cosmological model which is augmented by a kinematical constraint characterized by a single real parameter, correlating and controlling the expansion of both the external (physical) and internal spaces. In that paper explicit solutions were found only for the case of three dimensional internal space (). Here we derive a general solution of the system using Lie group symmetry properties, in parametric form for arbitrary number of internal dimensions. We also investigate the dynamical reduction of the model as a function of cosmic time for various values of and generate parametric plots to discuss cosmologically relevant results.

Influence of an Internally-Generated QBO on Modeled Stratospheric Dynamics and Ozone

NASA Technical Reports Server (NTRS)

Hurwitz, M. M.; Newman, P. A.; Song, I. S.

2011-01-01

A GEOS V2 CCM simulation with an internally generated quasi-biennial oscillation (QBO) signal is compared to an otherwise identical simulation without a QBO. In a present-day climate, inclusion of the modeled QBO makes a significant difference to stratospheric dynamics and ozone throughout the year. The QBO enhances variability in the tropics, as expected, but also in the polar stratosphere in some seasons. The modeled QBO also affects the mean stratospheric climate. Because tropical zonal winds in the baseline simulation are generally easterly, there is a relative increase in zonal wind magnitudes in tropical lower and middle stratosphere in the QBO simulation. Extra-tropical differences between the QBO and 'no QBO' simulations thus reflect a bias toward the westerly phase of the QBO: a relative strengthening and poleward shifting the polar stratospheric jets, and a reduction in Arctic lower stratospheric ozone.

GaN-based light emitting diodes using p-type trench structure for improving internal quantum efficiency

NASA Astrophysics Data System (ADS)

Kim, Garam; Sun, Min-Chul; Kim, Jang Hyun; Park, Euyhwan; Park, Byung-Gook

2017-01-01

In order to improve the internal quantum efficiency of GaN-based LEDs, a LED structure featuring a p-type trench in the multi-quantum well (MQW) is proposed. This structure has effects on spreading holes into the MQW and reducing the quantum-confined stark effect (QCSE). In addition, two simple fabrication methods using electron-beam (e-beam) lithography or selective wet etching for manufacturing the p-type structure are also proposed. From the measurement results of the manufactured GaN-based LEDs, it is confirmed that the proposed structure using e-beam lithography or selective wet etching shows improved light output power compared to the conventional structure because of more uniform hole distribution. It is also confirmed that the proposed structure formed by e-beam lithography has a significant effect on strain relaxation and reduction in the QCSE from the electro-luminescence measurement.

Mindfulness training for reducing anger, anxiety, and depression in fibromyalgia patients

PubMed Central

Amutio, Alberto; Franco, Clemente; Pérez-Fuentes, María de Carmen; Gázquez, José J.; Mercader, Isabel

2015-01-01

Fibromyalgia is a disabling syndrome. Results obtained with different therapies are very limited to date. The goal of this study was to verify whether the application of a mindfulness-based training program was effective in modifying anger, anxiety, and depression levels in a group of women diagnosed with fibromyalgia. This study is an experimental trial that employed a waiting list control group. Measures were taken at three different times: pretest, posttest, and follow-up. The statistical analyses revealed a significant reduction of anger (trait) levels, internal expression of anger, state anxiety, and depression in the experimental group as compared to the control group, as well as a significant increase in internal control of anger. It can be concluded that the mindfulness-based treatment was effective after 7 weeks. These results were maintained 3 months after the end of the intervention. PMID:25628591

Partial De Novo Sequencing and Unusual CID Fragmentation of a 7 kDa, Disulfide-Bridged Toxin

NASA Astrophysics Data System (ADS)

Medzihradszky, Katalin F.; Bohlen, Christopher J.

2012-05-01

A 7 kDa toxin isolated from the venom of the Texas coral snake ( Micrurus tener tener) was subjected to collision-induced dissociation (CID) and electron-transfer dissociation (ETD) analyses both before and after reduction at low pH. Manual and automated approaches to de novo sequencing are compared in detail. Manual de novo sequencing utilizing the combination of high accuracy CID and ETD data and an acid-related cleavage yielded the N-terminal half of the sequence from the reduced species. The intact polypeptide, containing 3 disulfide bridges produced a series of unusual fragments in ion trap CID experiments: abundant internal amino acid losses were detected, and also one of the disulfide-linkage positions could be determined from fragments formed by the cleavage of two bonds. In addition, internal and c-type fragments were also observed.

Dorsal slab fracture of the fourth carpal bone in a racing greyhound.

PubMed

Rutherford, Scott; Ness, Malcolm G

2012-11-01

To report the diagnosis and surgical management of a dorsal slab fracture of the fourth carpal bone in a racing greyhound. Clinical report. Three-year-old, male racing Greyhound. The fracture was not visible on orthogonal radiographs and the diagnosis was made by computed tomography. Open reduction and internal fixation with 2 countersunk 2.0-mm screws inserted in lag fashion was performed via a dorsal approach. Outcome was analyzed objectively by comparing preinjury and postsurgery racing performances. Internal fixation resulted in fracture healing and the dog returned to racing recording times similar to those before injury. Fractures of the fourth carpal bone may not be visible on standard orthogonal radiographic views and cross-sectional imaging may be required for more accurate identification. Surgical management was successful with the dog returning to preinjury levels of competition. © Copyright 2012 by The American College of Veterinary Surgeons.

New, efficient and viable system for ethanol fuel utilization on combined electric/internal combustion engine vehicles

NASA Astrophysics Data System (ADS)

Sato, André G.; Silva, Gabriel C. D.; Paganin, Valdecir A.; Biancolli, Ana L. G.; Ticianelli, Edson A.

2015-10-01

Although ethanol can be directly employed as fuel on polymer-electrolyte fuel cells (PEMFC), its low oxidation kinetics in the anode and the crossover to the cathode lead to a substantial reduction of energy conversion efficiency. However, when fuel cell driven vehicles are considered, the system may include an on board steam reformer for converting ethanol into hydrogen, but the hydrogen produced contains carbon monoxide, which limits applications in PEMFCs. Here, we present a system consisting of an ethanol dehydrogenation catalytic reactor for producing hydrogen, which is supplied to a PEMFC to generate electricity for electric motors. A liquid by-product effluent from the reactor can be used as fuel for an integrated internal combustion engine, or catalytically recycled to extract more hydrogen molecules. Power densities comparable to those of a PEMFC operating with pure hydrogen are attained by using the hydrogen rich stream produced by the ethanol dehydrogenation reactor.

On-Orbit Performance Degradation of the International Space Station P6 Photovoltaic Arrays

NASA Technical Reports Server (NTRS)

Kerslake, Thomas W.; Gustafson, Eric D.

2003-01-01

This paper discusses the on-orbit performance and performance degradation of the International Space Station P6 solar array wings (SAWs) from the period of December 2000 through February 2003. Data selection considerations and data reduction methods are reviewed along with the approach for calculating array performance degradation based on measured string shunt current levels. Measured degradation rates are compared with those predicted by the computational tool SPACE and prior degradation rates measured with the same SAW technology on the Mir space station. Initial results show that the measured SAW short-circuit current is degrading 0.2 to 0.5 percent per year. This degradation rate is below the predicted rate of 0.8 percent per year and is well within the 3 percent estimated uncertainty in measured SAW current levels. General contributors to SAW degradation are briefly discussed.

[effectiveness of open reduction and internal fixation without opening joint capsule on tibial plateau fracture].

PubMed

Chen, Qi; Xu, Xiaofeng; Huang, Yonghui; Cao, Xingbing; Meng, Chen; Cao, Xueshu; Wei, Changbao

2014-12-01

To introduce the surgery method to reset and fix tibial plateau fracture without opening joint capsule, and evaluate the safety and effectiveness of this method. Between July 2011 and July 2013, 51 patients with tibial plateau fracture accorded with the inclusion criteria were included. All of 51 patients, 17 cases underwent open reduction and internal fixation without opening joint capsule in trial group, and 34 cases underwent traditional surgery method in control group. There was no significant difference in gender, age, cause of injury, time from injury to admission, side of injury, and types of fracture between 2 groups (P > 0.05). The operation time, intraoperative blood loss, incision length, incision healing, and fracture healing were compared between 2 groups. The tibial-femoral angle and collapse of joint surface were measured on X-ray film. At last follow-up, joint function was evaluated with Hospital for Special Surgery (HSS) knee function scale. The intraoperative blood loss in trial group was significantly less than that in control group (P < 0.05). The incision length in trial group was significantly shorter than that in control group (P < 0.05). Difference was not significant in operation time and the rate of incision healing between 2 groups (P > 0.05). The patients were followed up 12-30 months (mean, 20.4 months) in trial group and 12-31 months (mean, 18.2 months) in control group. X-ray films indicated that all cases in 2 groups obtained fracture healing; there was no significant difference in the fracture healing time between 2 groups (t=1.382, P=0.173). On X-ray films, difference was not significant in tibial-femoral angle and collapse of joint surface between 2 groups (P > 0.05). HSS score of the knee in trial group was significantly higher than that of control group (t=3.161, P=0.003). It can reduce the intraoperative blood loss and shorten the incision length to use open reduction and internal fixation without opening joint capsule for tibial plateau fracture. Traction of joint capsule is helpful in the reduction and good recovery of joint surface collapse. In addition, the surgery without opening joint capsule can avoid joint stiffness and obtain better joint function.

Examining the impact of case management in Vancouver's downtown community court: a quasi-experimental design.

PubMed

Somers, Julian M; Moniruzzaman, Akm; Rezansoff, Stefanie N; Patterson, Michelle

2014-01-01

Problem solving courts (PSC) have been implemented internationally, with a common objective to prevent reoffending by addressing criminogenic needs and strengthening social determinants of health. There has been no empirical research on the effectiveness of community courts, which are a form of PSC designed to harness community resources and inter-disciplinary expertise to reduce recidivism in a geographic catchment area. We used the propensity score matching method to examine the effectiveness of Vancouver's Downtown Community Court (DCC). We focused on the subset of DCC participants who were identified as having the highest criminogenic risk and were assigned to a case management team (CMT). A comparison group was derived using one-to-one matching on a large array variables including static and dynamic criminogenic factors, geography, and time. Reductions in offences (one year pre minus one year post) were compared between CMT and comparison groups. Compared to other DCC offenders, those triaged to CMT (9.5% of the DCC population) had significantly higher levels of healthcare, social service use, and justice system involvement over the ten years prior to the index offence. Compared to matched offenders who received traditional court outcomes, those assigned to CMT (n=249) exhibited significantly greater reductions in overall offending (p<0.001), primarily comprised of significant reductions in property offences (p<0.001). Our findings indicate that CMT achieved significantly greater reductions in recidivism than traditional court among offenders with complex needs and high numbers of previous offences. Limitations of this research include a non-experimental design and one year follow up. Strengths include a robust matching process and extensive client level data spanning multiple sectors. Further research is needed to replicate the observed outcomes, to investigate the extension of community courts to settings with divergent offender needs and local resources, and to estimate potential cost avoidance attributable to this intervention.

Impact of Ezetimibe on the Rate of Cardiovascular-Related Hospitalizations and Associated Costs Among Patients With a Recent Acute Coronary Syndrome: Results From the IMPROVE-IT Trial (Improved Reduction of Outcomes: Vytorin Efficacy International Trial).

PubMed

Pokharel, Yashashwi; Chinnakondepalli, Khaja; Vilain, Katherine; Wang, Kaijun; Mark, Daniel B; Davies, Glenn; Blazing, Michael A; Giugliano, Robert P; Braunwald, Eugene; Cannon, Christopher P; Cohen, David J; Magnuson, Elizabeth A

2017-05-01

Ezetimibe, when added to simvastatin therapy, reduces cardiovascular events after recent acute coronary syndrome. However, the impact of ezetimibe on cardiovascular-related hospitalizations and associated costs is unknown. We used patient-level data from the IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial) to examine the impact of simvastatin-ezetimibe versus simvastatin-placebo on cardiovascular-related hospitalizations and related costs (excluding drug costs) over 7 years follow-up. Medicare Severity-Diagnosis Related Groups were assigned to all cardiovascular hospitalizations. Hospital costs were estimated using Medicare reimbursement rates for 2013. Associated physician costs were estimated as a percentage of hospital costs. The impact of treatment assignment on hospitalization rates and costs was estimated using Poisson and linear regression, respectively. There was a significantly lower cardiovascular hospitalization rate with ezetimibe compared with placebo (risk ratio, 0.95; 95% confidence interval, 0.90-0.99; P =0.031), mainly attributable to fewer hospitalizations for percutaneous coronary intervention, angina, and stroke. Consequently, cardiovascular-related hospitalization costs over 7 years were $453 per patient lower with ezetimibe (95% confidence interval, -$38 to -$869; P =0.030). Although all prespecified subgroups had lower cost with ezetimibe therapy, patients with diabetes mellitus, patients aged ≥75 years, and patients at higher predicted risk for recurrent ischemic events had even greater cost offsets. Addition of ezetimibe to statin therapy in patients with a recent acute coronary syndrome leads to reductions in cardiovascular-related hospitalizations and associated costs, with the greatest cost offsets in high-risk patients. These cost reductions may completely offset the cost of the drug once ezetimibe becomes generic, and may lead to cost savings from the perspective of the healthcare system, if treatment with ezetimibe is targeted to high-risk patients. URL: https://www.clinicaltrials.gov. Unique Identifier: NCT00202878. © 2017 American Heart Association, Inc.

Refurbishment of a Victorian terraced house for energy efficiency

NASA Astrophysics Data System (ADS)

Dimitriou, Angeliki

The impacts of global warming are now obvious. The international community has committed itself to reduce CO2 emissions, the main contributor to the greenhouse effect, both at international and national levels. In the Kyoto Protocol signed in 1997, countries have committed to reduce their greenhouse gases emissions below their 1990 levels by the period 2008-2012. The UK specifically should reduce those emissions by 12.5%. Format reason, the UK has introduced a package of policies, which promote not only the use of renewable energy resources, but most importantly the reduction in energy use, with energy efficiency. Refurbishment of existing houses has and will contribute to the reduction of energy consumption. A Victorian mid-terraced house was studied in this report, and different refurbishment measures were tested, using two software programmes: TAS and SAP. The targets were to achieve certain levels of thermal comfort, to comply with the Building Regulation for building thermal elements and to achieve a high SAP rating. Then, the cost of each measure was calculated and its CO2 emissions were compared. Heat losses were mainly through the walls and roof. Roof and mainly wall refurbishment measures reduce the heating loads the most. Ground floor insulation does not contribute to the reduction of the heating loads, on the contrary it has detrimental effect in summer, where the cooling effect coming from the ground is being reduced. Window replacement achieves a very good performance in summer resulting in the reduction of overheating. Wall and roof insulation increase the SAP rating the most, between the building elements, but boiler replacement and upgrading of heating controls increase it more. According to the SAP rating, CO2 annual emissions are reduced the most by boiler replacement and then by wall and roof. The results given by the two softwares concerning which measure is more leads more to energy efficiency, are the same. Finally, if the measures which lead to the best energy performance are combined together, then the house could cut its energy bills by half, and could have 70% reduction in CO2 emissions.

Particulate emissions from diesel engines: correlation between engine technology and emissions.

PubMed

Fiebig, Michael; Wiartalla, Andreas; Holderbaum, Bastian; Kiesow, Sebastian

2014-03-07

In the last 30 years, diesel engines have made rapid progress to increased efficiency, environmental protection and comfort for both light- and heavy-duty applications. The technical developments include all issues from fuel to combustion process to exhaust gas aftertreatment. This paper provides a comprehensive summary of the available literature regarding technical developments and their impact on the reduction of pollutant emission. This includes emission legislation, fuel quality, diesel engine- and exhaust gas aftertreatment technologies, as well as particulate composition, with a focus on the mass-related particulate emission of on-road vehicle applications. Diesel engine technologies representative of real-world on-road applications will be highlighted.Internal engine modifications now make it possible to minimize particulate and nitrogen oxide emissions with nearly no reduction in power. Among these modifications are cooled exhaust gas recirculation, optimized injections systems, adapted charging systems and optimized combustion processes with high turbulence. With introduction and optimization of exhaust gas aftertreatment systems, such as the diesel oxidation catalyst and the diesel particulate trap, as well as NOx-reduction systems, pollutant emissions have been significantly decreased. Today, sulfur poisoning of diesel oxidation catalysts is no longer considered a problem due to the low-sulfur fuel used in Europe. In the future, there will be an increased use of bio-fuels, which generally have a positive impact on the particulate emissions and do not increase the particle number emissions.Since the introduction of the EU emissions legislation, all emission limits have been reduced by over 90%. Further steps can be expected in the future. Retrospectively, the particulate emissions of modern diesel engines with respect to quality and quantity cannot be compared with those of older engines. Internal engine modifications lead to a clear reduction of the particulate emissions without a negative impact on the particulate-size distribution towards smaller particles. The residual particles can be trapped in a diesel particulate trap independent of their size or the engine operating mode. The usage of a wall-flow diesel particulate filter leads to an extreme reduction of the emitted particulate mass and number, approaching 100%. A reduced particulate mass emission is always connected to a reduced particle number emission.

Particulate emissions from diesel engines: correlation between engine technology and emissions

PubMed Central

2014-01-01

In the last 30 years, diesel engines have made rapid progress to increased efficiency, environmental protection and comfort for both light- and heavy-duty applications. The technical developments include all issues from fuel to combustion process to exhaust gas aftertreatment. This paper provides a comprehensive summary of the available literature regarding technical developments and their impact on the reduction of pollutant emission. This includes emission legislation, fuel quality, diesel engine- and exhaust gas aftertreatment technologies, as well as particulate composition, with a focus on the mass-related particulate emission of on-road vehicle applications. Diesel engine technologies representative of real-world on-road applications will be highlighted. Internal engine modifications now make it possible to minimize particulate and nitrogen oxide emissions with nearly no reduction in power. Among these modifications are cooled exhaust gas recirculation, optimized injections systems, adapted charging systems and optimized combustion processes with high turbulence. With introduction and optimization of exhaust gas aftertreatment systems, such as the diesel oxidation catalyst and the diesel particulate trap, as well as NOx-reduction systems, pollutant emissions have been significantly decreased. Today, sulfur poisoning of diesel oxidation catalysts is no longer considered a problem due to the low-sulfur fuel used in Europe. In the future, there will be an increased use of bio-fuels, which generally have a positive impact on the particulate emissions and do not increase the particle number emissions. Since the introduction of the EU emissions legislation, all emission limits have been reduced by over 90%. Further steps can be expected in the future. Retrospectively, the particulate emissions of modern diesel engines with respect to quality and quantity cannot be compared with those of older engines. Internal engine modifications lead to a clear reduction of the particulate emissions without a negative impact on the particulate-size distribution towards smaller particles. The residual particles can be trapped in a diesel particulate trap independent of their size or the engine operating mode. The usage of a wall-flow diesel particulate filter leads to an extreme reduction of the emitted particulate mass and number, approaching 100%. A reduced particulate mass emission is always connected to a reduced particle number emission. PMID:24606725

Dosimetric comparison of deep inspiration breath hold and free breathing technique in stereotactic body radiotherapy for localized lung tumor using Flattening Filter Free beam

NASA Astrophysics Data System (ADS)

Mani, Karthick Raj; Bhuiyan, Md. Anisuzzaman; Alam, Md. Mahbub; Ahmed, Sharif; Sumon, Mostafa Aziz; Sengupta, Ashim Kumar; Rahman, Md. Shakilur; Azharul Islam, Md. S. M.

2018-03-01

Aim: To compare the dosimetric advantage of stereotactic body radiotherapy (SBRT) for localized lung tumor between deep inspiration breath hold technique and free breathing technique. Materials and methods: We retrospectively included ten previously treated lung tumor patients in this dosimetric study. All the ten patients underwent CT simulation using 4D-CT free breathing (FB) and deep inspiration breath hold (DIBH) techniques. Plans were created using three coplanar full modulated arc using 6 MV flattening filter free (FFF) bream with a dose rate of 1400 MU/min. Same dose constraints for the target and the critical structures for a particular patient were used during the plan optimization process in DIBH and FB datasets. We intend to deliver 50 Gy in 5 fractions for all the patients. For standardization, all the plans were normalized at target mean of the planning target volume (PTV). Doses to the critical structures and targets were recorded from the dose volume histogram for evaluation. Results: The mean right and left lung volumes were inflated by 1.55 and 1.60 times in DIBH scans compared to the FB scans. The mean internal target volume (ITV) increased in the FB datasets by 1.45 times compared to the DIBH data sets. The mean dose followed by standard deviation (x¯ ± σx¯) of ipsilateral lung for DIBH-SBRT and FB-SBRT plans were 7.48 ± 3.57 (Gy) and 10.23 ± 4.58 (Gy) respectively, with a mean reduction of 36.84% in DIBH-SBRT plans. Ipsilateral lung were reduced to 36.84% in DIBH plans compared to FB plans. Conclusion: Significant dose reduction in ipsilateral lung due to the lung inflation and target motion restriction in DIBH-SBRT plans were observed compare to FB-SBRT. DIBH-SBRT plans demonstrate superior dose reduction to the normal tissues and other critical structures.

Apparatus for photocatalytic destruction of internal combustion engine emissions during cold start

DOEpatents

Janata, J.; McVay, G.L.; Peden, C.H.; Exarhos, G.J.

1998-07-14

A method and apparatus are disclosed for the destruction of emissions from an internal combustion engine wherein a substrate coated with TiO{sub 2} is exposed to a light source in the exhaust system of an internal combustion engine thereby catalyzing oxidation/reduction reactions between gaseous hydrocarbons, carbon monoxide, nitrogen oxides and oxygen in the exhaust of the internal combustion engine. 4 figs.

A randomized trial of a three-hour protected nap period in a medicine training program: sleep, alertness, and patient outcomes.

PubMed

Shea, Judy A; Dinges, David F; Small, Dylan S; Basner, Mathias; Zhu, Jingsan; Norton, Laurie; Ecker, Adrian J; Novak, Cristina; Bellini, Lisa M; Dine, C Jessica; Mollicone, Daniel J; Volpp, Kevin G

2014-03-01

Protected sleep periods for internal medicine interns have previously resulted in increased amount slept and improved cognitive alertness but required supplemental personnel. The authors evaluated intern and patient outcomes associated with protected nocturnal nap periods of three hours that are personnel neutral. Randomized trial at Philadelphia Veterans Affairs Medical Center (PVAMC) Medical Service and Hospital of the University of Pennsylvania (HUP) Oncology Unit. During 2010-2011, four-week blocks were randomly assigned to a standard intern schedule (extended duty overnight shifts of up to 30 hours), or sequential protected sleep periods (phone sign-out midnight to 3:00 AM [early shift] intern 1; 3:00 to 6:00 AM [late shift] intern 2). Participants wore wrist Actiwatches, completed sleep diaries, and performed daily assessments of behavioral alertness. Between-group comparisons of means and proportions controlled for within-person correlations. HUP interns had significantly longer sleep durations during both early (2.40 hours) and late (2.44 hours) protected periods compared with controls (1.55 hours, P < .0001). At PVAMC sleep duration was longer only for the late shift group (2.40 versus 1.90 hours, P < .036). Interns assigned to either protected period were significantly less likely to have call nights with no sleep and had fewer attentional lapses on the Psychomotor Vigilance Test. Differences in patient outcomes between standard schedule months versus intervention months were not observed. Protected sleep periods of three hours resulted in more sleep during call and reductions in periods of prolonged wakefulness, providing a plausible alternative to 16-hour shifts.

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

PubMed

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

1999-01-01

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

The indirect effect of emotion dysregulation in terms of negative affect and smoking-related cognitive processes.

PubMed

Johnson, Adrienne L; McLeish, Alison C

2016-02-01

Although negative affect is associated with a number of smoking-related cognitive processes, the mechanisms underlying these associations have yet to be examined. The current study sought to examine the indirect effect of emotion regulation difficulties in terms of the association between negative affect and smoking-related cognitive processes (internal barriers to cessation, negative affect reduction smoking motives, negative affect reduction smoking outcome expectancies). Participants were 126 daily cigarette smokers (70.4% male, Mage=36.5years, SD=13.0; 69.8% Caucasian) who smoked an average of 18.5 (SD=8.7) cigarettes per day and reported moderate nicotine dependence. Formal mediation analyses were conducted using PROCESS to examine the indirect effect of negative affect on internal barriers to cessation and negative affect reduction smoking motives and outcome expectancies through emotion regulation difficulties. After accounting for the effects of gender, daily smoking rate, and anxiety sensitivity, negative affect was indirectly related to internal barriers to cessation and negative affect reduction smoking motives through emotion regulation difficulties. There was no significant indirect effect for negative affect reduction smoking outcome expectancies. These findings suggest that greater negative affect is associated with a desire to smoke to reduce this negative affect and perceptions that quitting smoking will be difficult due to negative emotions because of greater difficulties managing these negative emotions. Thus, emotion regulation difficulties may be an important target for smoking cessation interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

Open reduction and internal fixation of patellar fractures with tension band wiring through cannulated screws.

PubMed

Malik, Mudasir; Halwai, Manzoor Ahmad

2014-10-01

The purpose of this study was to evaluate effectiveness and safety of a relatively new technique of open reduction and internal fixation of displaced transverse patellar fractures with tension band wiring (TBW) through parallel cannulated compression screws. A total of 30 patients with displaced transverse patellar fracture were enrolled in this prospective study. Of the 30 patients, 20 patients had trauma due to fall, 5 due to road traffic accident, 2 due to fall of heavy object on the knee, 2 due to forced flexion of knee, and 1 had fracture due to being beaten. All 30 patients were treated with vertical skin exposure, fracture open reduction, and internal fixation by anterior TBW through 4.0 mm cannulated screws. The postoperative rehabilitation protocol was standardized. The patients were followed postsurgery to evaluate time required for radiographic bone union, knee joint range of motion (ROM), loss of fracture reduction, material failure, and the overall functional result of knee using Bostman scoring. All the fractures healed radiologically, at an average time of 10.7 weeks (range, 8-12 weeks). The average ROM arc was 129.7 degrees (range, 115-140 degrees). No patient had loss of fracture reduction, implant migration, or material failure. The average Bostman score was 28.6 out of 30. Anterior TBW through cannulated screws for displaced transverse fractures is safe and effective alternative treatment. Good functional results and recovery can be expected. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Modifying landing mat material properties may decrease peak contact forces but increase forefoot forces in gymnastics landings.

PubMed

Mills, Chris; Yeadon, Maurice R; Pain, Matthew T G

2010-09-01

This study investigated how changes in the material properties of a landing mat could minimise ground reaction forces (GRF) and internal loading on a gymnast during landing. A multi-layer model of a gymnastics competition landing mat and a subject-specific seven-link wobbling mass model of a gymnast were developed to address this aim. Landing mat properties (stiffness and damping) were optimised using a Simplex algorithm to minimise GRF and internal loading. The optimisation of the landing mat parameters was characterised by minimal changes to the mat's stiffness (<0.5%) but increased damping (272%) compared to the competition landing mat. Changes to the landing mat resulted in reduced peak vertical and horizontal GRF and reduced bone bending moments in the shank and thigh compared to a matching simulation. Peak bone bending moments within the thigh and shank were reduced by 6% from 321.5 Nm to 302.5Nm and GRF by 12% from 8626 N to 7552 N when compared to a matching simulation. The reduction in these forces may help to reduce the risk of bone fracture injury associated with a single landing and reduce the risk of a chronic injury such as a stress fracture.

Learning to not know: results of a program for ancillary cost reduction in surgical critical care.

PubMed

Barie, P S; Hydo, L J

1996-10-01

Compelling internal and external influences are stimulating global re-evaluations of care standards for efficacy and cost. Critical care uses huge amounts of resources despite widespread shortages of beds and nurses. This study tested the hypothesis that ancillary expenditures can be decreased without compromising care. Costs for laboratory tests, radiographs, blood products, nutritional supplements, and drugs were compared prospectively for all surgical intensive care unit care for two 4-month periods (January 1 to April 30, 1994 and January 1 to April 30, 1995) at a urban university center. A systematic, multidisciplinary cost-reduction program began May 1, 1994, with emphasis on laboratory and radiographic testing and procedures, and blood product, nutritional, and drug therapies. Cohorts were compared by age, Acute Physiology and Chronic Health Evaluation (APACHE) II and III admission scores, and case mix. Outcome variables were hospital mortality, days in the intensive care unit and hospital, the development of multiple organ dysfunction syndrome, and expenditures. Cost data were taken weekly from the hospital's clinical information system. No new equipment was introduced during the study period except for pumps for patient-controlled analgesia, and there were no new critical pathways or other patient care guidelines. Case mix and all noncost variables were identical. Overall costs were reduced by 29% when normalized by the number of patient-days in each period. Laboratory testing was reduced in frequency by 24 to 32%, and cost by 26 to 28%. Comparable reductions in the cost of blood products (32%) were exceeded by the reductions in expenditures for nutritional supplements (49%) and pharmaceuticals (45%) (all, p < 0.01 or less). Modestly increased (2%) x-ray charges in 1995 were owing entirely to insertion of prophylactic inferior vena cava filters (each, $2,800, n = 5) and computed tomography scans for sinusitis (each, $350, n = 5), although the 7% reduction in portable chest radiographs that was achieved did not meet expectations. Substantial reductions in physician-ordered ancillary expenditures are possible without compromising the standard of care of critically ill patients, or the support of an elaborate framework of defined care plans. With additional experience, incremental savings may accrue from refinement of successful strategies and new approaches to intractable problems.

A Biomechanical Comparison of Three 1.5-mm Plate and Screw Configurations and a Single 2.0-mm Plate for Internal Fixation of a Mandibular Condylar Fracture

PubMed Central

Aquilina, Peter; Parr, William C.H.; Chamoli, Uphar; Wroe, Stephen; Clausen, Philip

2014-01-01

The most stable pattern of internal fixation for mandibular condyle fractures is an area of ongoing discussion. This study investigates the stability of three patterns of plate fixation using readily available, commercially pure titanium implants. Finite element models of a simulated mandibular condyle fracture were constructed. The completed models were heterogeneous in bone material properties, contained approximately 1.2 million elements and incorporated simulated jaw adducting musculature. Models were run assuming linear elasticity and isotropic material properties for bone. No human subjects were involved in this investigation. The stability of the simulated condylar fracture reduced with the different implant configurations, and the von Mises stresses of a 1.5-mm X-shaped plate, a 1.5-mm rectangular plate, and a 1.5-mm square plate (all Synthes (Synthes GmbH, Zuchwil, Switzerland) were compared. The 1.5-mm X plate was the most stable of the three 1.5-mm profile plate configurations examined and had comparable mechanical performance to a single 2.0-mm straight four-hole plate. This study does not support the use of rectangular or square plate patterns in the open reduction and internal fixation of mandibular condyle fractures. It does provide some support for the use of a 1.5-mm X plate to reduce condylar fractures in selected clinical cases. PMID:25136411

DEMONSTRATION BULLETIN: GAS-PHASE CHEMICAL REDUCTION - ECO LOGIC INTERNATIONAL, INC.

EPA Science Inventory

The patented Eco Logic Process employs a gas-phase reduction reaction of hydrogen with organic and chlorinated organic compounds at elevated temperatures to convert aqueous and oily hazardous contaminants into a hydrocarbon-rich gas product. After passing through a scrubber, the ...

Harm reduction in name, but not substance: a comparative analysis of current Canadian provincial and territorial policy frameworks.

PubMed

Hyshka, Elaine; Anderson-Baron, Jalene; Karekezi, Kamagaju; Belle-Isle, Lynne; Elliott, Richard; Pauly, Bernie; Strike, Carol; Asbridge, Mark; Dell, Colleen; McBride, Keely; Hathaway, Andrew; Wild, T Cameron

2017-07-26

In Canada, funding, administration, and delivery of health services-including those targeting people who use drugs-are primarily the responsibility of the provinces and territories. Access to harm reduction services varies across jurisdictions, possibly reflecting differences in provincial and territorial policy commitments. We examined the quality of current provincial and territorial harm reduction policies in Canada, relative to how well official documents reflect internationally recognized principles and attributes of a harm reduction approach. We employed an iterative search and screening process to generate a corpus of 54 provincial and territorial harm reduction policy documents that were current to the end of 2015. Documents were content-analyzed using a deductive coding framework comprised of 17 indicators that assessed the quality of policies relative to how well they described key population and program aspects of a harm reduction approach. Only two jurisdictions had current provincial-level, stand-alone harm reduction policies; all other documents were focused on either substance use, addiction and/or mental health, or sexually transmitted and/or blood-borne infections. Policies rarely named specific harm reduction interventions and more frequently referred to generic harm reduction programs or services. Only one document met all 17 indicators. Very few documents acknowledged that stigma and discrimination are issues faced by people who use drugs, that not all substance use is problematic, or that people who use drugs are legitimate participants in policymaking. A minority of documents recognized that abstaining from substance use is not required to receive services. Just over a quarter addressed the risk of drug overdose, and even fewer acknowledged the need to apply harm reduction approaches to an array of drugs and modes of use. Current provincial and territorial policies offer few robust characterizations of harm reduction or go beyond rhetorical or generic support for the approach. By endorsing harm reduction in name, but not in substance, provincial and territorial policies may communicate to diverse stakeholders a general lack of support for key aspects of the approach, potentially challenging efforts to expand harm reduction services.

Parasitic heat loss reduction in AMTEC cells by heat shield optimization

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

Borkowski, C.A.; Svedberg, R.C.; Hendricks, T.J.

1997-12-31

Alkali metal thermal to electric conversion (AMTEC) cell performance can be increased by the proper design of thermal radiative shielding internal to the AMTEC cell. These heat shields essentially lower the radiative heat transfer between the heat input zone of the cell and the heat rejection zone of the cell. In addition to lowering the radiative heat transfer between the heat input and heat rejection surfaces of the cell, the shields raise the AMTEC cell performance by increasing the temperature of the beta alumina solid electrolyte (BASE). This increase in temperature of the BASE tube allows the evaporator temperature tomore » be increased without sodium condensing within the BASE tubes. Experimental testing and theoretical analysis have been performed to compare the relative merits of two candidate heat shield packages: (1) chevron, and (2) cylindrical heat shields. These two heat shield packages were compared to each other and a baseline cell which had no heat shields installed. For the two heat shield packages, the reduction in total heat transfer is between 17--27% for the heat input surface temperature varying from 700 C, 750 C, and 800 C with the heat rejection surface temperature kept at 300 C.« less

NASA N3-X with Turboelectric Distributed Propulsion

NASA Technical Reports Server (NTRS)

Felder, James L.

2014-01-01

Presentation summarizing the phase I study of the NASA N3-X turboelectric distributed propulsion power aircraft to the IMechE Disruptive Green Propulsion Technologies conference in London, UK November 16th and 17th, 2014. This presentation contains the results of a NASA internal study funded by the NASA Fixed Wing program to look at the application of turboelectric distributed propulsion to a long-range 300 seat aircraft. The reference aircraft is the Boeing 777-200LR. The N3-X reduced energy consumption by 70 compared to the 777-200LR, LTO NOx by 85 compared to the CAEP 6 limits, and noise by 32-64 EPNdB depending on engine placement compared to the stage 4 noise standards. This exceeded the N+3 metrics of reducing energy by 60, LTO NOx by 80, and noise by 52 EPNdB. Cruise NOx was not estimated, but likely meet the 80 reduction goal as well.

Testing mediators hypothesized to account for the effects of a dissonance-based eating disorder prevention program over longer term follow-up.

PubMed

Stice, Eric; Marti, C Nathan; Rohde, Paul; Shaw, Heather

2011-06-01

Test the hypothesis that reductions in thin-ideal internalization and body dissatisfaction mediate the effects of a dissonance-based eating disorder prevention program on reductions in eating disorder symptoms over 1-year follow-up. Data were drawn from a randomized effectiveness trial in which 306 female high school students (mean age = 15.7 years, SD = 1.1) with body image concerns were randomized to the 4-session dissonance-based prevention program or an educational brochure control condition, wherein school counselors and nurses were responsible for participant recruitment and intervention delivery. Dissonance-intervention participants showed greater reductions in thin-ideal internalization, body dissatisfaction, and eating disorder symptoms; change in thin-ideal internalization predicted change in body dissatisfaction and symptoms; change in body dissatisfaction predicted change in symptoms; and all indirect effects were significant. Change in thin-ideal internalization fully mediated the effects of intervention condition on change in body dissatisfaction and partially mediated the effects on symptoms; change in body dissatisfaction partially mediated the effect of intervention condition on change in symptoms. Findings provided support for the intervention theory of this eating disorder prevention program over longer term follow-up, extending the evidence base for this effective intervention. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

Testing Mediators Hypothesized to Account for the Effects of a Dissonance Eating Disorder Prevention Program Over Longer-Term Follow-Up

PubMed Central

Stice, Eric; Marti, C. Nathan; Rohde, Paul; Shaw, Heather

2011-01-01

Objective Test the hypothesis that reductions in thin-ideal internalization and body dissatisfaction mediate the effects of a dissonance-based eating disorder prevention program on reductions in eating disorder symptoms over 1-year follow-up. Method Data were drawn from a randomized effectiveness trial in which 306 female high school students (M age = 15.7 SD = 1.1) with body image concerns were randomized to the 4-session dissonance-based prevention program or an educational brochure control condition, wherein school counselors and nurses were responsible for participant recruitment and intervention delivery. Results Dissonance participants showed greater reductions in thin-ideal internalization, body dissatisfaction, and eating disorder symptoms; change in thin-ideal internalization predicted change in body dissatisfaction and symptoms; change in body dissatisfaction predicted change in symptoms; and all indirect effects were significant. Change in thin-ideal internalization fully mediated the effects of intervention condition on change in body dissatisfaction and partially mediated the effects on symptoms; change in body dissatisfaction partially mediated the effect of intervention condition on change in symptoms. Conclusions Findings provided support for the intervention theory of this eating disorder prevention program over longer-term follow-up, extending the evidence base for this effective intervention. PMID:21500884

Unstable metacarpal and phalangeal fractures: treatment by internal fixation using AO mini-fragment plates and screws.

PubMed

Mumtaz, Mohammad Umar; Farooq, Muneer Ahmad; Rasool, Altaf Ahmad; Kawoosa, Altaf Ahmad; Badoo, Abdul Rashid; Dhar, Shabir Ahmad

2010-07-01

Accurate open reduction and internal fixation for metacarpal and phalangeal fractures of the hand is required in less than 5% of the patients; otherwise, closed treatment techniques offer satisfactory results in most of these cases as these fractures are stable either before or after closed reduction. AO mini-fragment screws and plates, when used in properly selected cases, can provide rigid fixation, allowing early mobilization of joints and hence good functional results while avoiding problems associated with protruding K-wires and immobilization. The advantages of such internal fixation urged us to undertake such a study in our state where such hand injuries are commonly seen. Forty patients with 42 unstable metacarpal and phalangeal fractures were treated with open reduction and internal fixation using AO mini-fragment screws and plates over a period of three years in a prospective manner. The overall results were good in 78.5% of cases, fair in 19% of cases and poor in 2.5% of cases, as judged according to the criteria of the American Society for Surgery of the Hand. This technique is a reasonable option for treating unstable metacarpal and phalangeal fractures as it provides a highly rigid fixation, which is sufficient to allow early mobilization of the adjacent joints, thus helping to achieve good functional results.

26 CFR 1.907(a)-1 - Reduction in taxes paid on FOGEI (for taxable years beginning after December 31, 1982).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Reduction in taxes paid on FOGEI (for taxable... REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Income from Sources Without the United States § 1.907(a)-1 Reduction in taxes paid on FOGEI (for taxable years...

26 CFR 1.907(b)-1 - Reduction of creditable FORI taxes (for taxable years beginning after December 31, 1982).

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 9 2011-04-01 2011-04-01 false Reduction of creditable FORI taxes (for taxable...) Income from Sources Without the United States § 1.907(b)-1 Reduction of creditable FORI taxes (for..., war profits, or excess profits taxes. Section 907(b) will apply to a person regardless of whether that...

Impact of paraquat regulation on suicide in South Korea.

PubMed

Cha, Eun Shil; Chang, Shu-Sen; Gunnell, David; Eddleston, Michael; Khang, Young-Ho; Lee, Won Jin

2016-04-01

Ingestion of pesticides (mainly paraquat) accounted for one-fifth of suicides in South Korea in 2006-10. We investigated the effect on suicide mortality of regulatory action, culminating in a ban on paraquat in South Korea in 2011-12. We calculated age-standardized method-specific suicide mortality rates among people aged ≥15 in South Korea (1983-2013) using registered death data. Negative binomial regression was used to estimate changes in the rate and number of pesticide suicides in 2013, compared with those expected based on previous trends (2003-11). Pesticide suicide mortality halved from 5.26 to 2.67 per 100 000 population between 2011 and 2013. Compared with the number expected based on previous trends, the regulations were followed by an estimated 847 [95% confidence interval (CI) -1180 to -533] fewer pesticide suicides, a 37% reduction in rates (rate ratio = 0.63, 95% CI 0.55 to 0.73) in 2013. The decline in pesticide suicides after the regulations was seen in all age/sex/geographical groups. The absolute reduction in the number of suicides was greatest among men, the elderly and in rural areas. The reduction in pesticide suicides contributed to 56% of the decline in overall suicides that occurred between 2011 and 2013. There was no impact of the regulations on crop yield. The regulation of paraquat in South Korea in 2011-12 was associated with a reduction in pesticide suicide. Further legislative interventions to prevent the easy availability of highly lethal suicide methods are recommended for reducing the number of suicides worldwide. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Comparative analysis of the photocatalytic reduction of drinking water oxoanions using titanium dioxide.

PubMed

Marks, Randal; Yang, Ting; Westerhoff, Paul; Doudrick, Kyle

2016-11-01

Regulated oxidized pollutants in drinking water can have significant health effects, resulting in the need for ancillary treatment processes. Oxoanions (e.g., nitrate) are one important class of oxidized inorganic ions. Ion exchange and reverse osmosis are often used treatment processes for oxoanions, but these separation processes leave behind a concentrated waste product that still requires treatment or disposal. Photocatalysis has emerged as a sustainable treatment technology capable of catalytically reducing oxoanions directly to innocuous byproducts. Compared with the large volume of knowledge available for photocatalytic oxidation, very little knowledge exists regarding photocatalytic reduction of oxoanion pollutants. This study investigates the reduction of various oxoanions of concern in drinking water (nitrate, nitrite, bromate, perchlorate, chlorate, chlorite, chromate) using a commercial titanium dioxide photocatalyst and a polychromatic light source. Results showed that oxoanions were readily reduced under acidic conditions in the presence of formate, which served as a hole scavenger, with the first-order rate decreasing as follows: bromate > nitrite > chlorate > nitrate > dichromate > perchlorate, corresponding to rate constants of 0.33, 0.080, 0.052, 0.0074, 0.0041, and 0 cm 2 /photons × 10 18 , respectively. Only bromate and nitrite were reduced at neutral pH, with substantially lower rate constants of 0.034 and 0.0021 cm 2 /photons × 10 18 , respectively. No direct relationship between oxoanion physicochemical properties, including electronegativity of central atom, internal bond strength, and polarizability was discovered. However, observations presented herein suggest the presence of kinetic barriers unique to each oxoanion and provides a framework for investigating photocatalytic reduction mechanisms of oxoanions in order to design better photocatalysts and optimize treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

Efficacy and safety of ginger in osteoarthritis patients: a meta-analysis of randomized placebo-controlled trials.

PubMed

Bartels, E M; Folmer, V N; Bliddal, H; Altman, R D; Juhl, C; Tarp, S; Zhang, W; Christensen, R

2015-01-01

The aim of this study was to assess the clinical efficacy and safety of oral ginger for symptomatic treatment of osteoarthritis (OA) by carrying out a systematic literature search followed by meta-analyses on selected studies. Inclusion criteria were randomized controlled trials (RCTs) comparing oral ginger treatment with placebo in OA patients aged >18 years. Outcomes were reduction in pain and reduction in disability. Harm was assessed as withdrawals due to adverse events. The efficacy effect size was estimated using Hedges' standardized mean difference (SMD), and safety by risk ratio (RR). Standard random-effects meta-analysis was used, and inconsistency was evaluated by the I-squared index (I(2)). Out of 122 retrieved references, 117 were discarded, leaving five trials (593 patients) for meta-analyses. The majority reported relevant randomization procedures and blinding, but an inadequate intention-to-treat (ITT) analysis. Following ginger intake, a statistically significant pain reduction SMD = -0.30 ([95% CI: [(-0.50, -0.09)], P = 0.005]) with a low degree of inconsistency among trials (I(2) = 27%), and a statistically significant reduction in disability SMD = -0.22 ([95% CI: ([-0.39, -0.04)]; P = 0.01; I(2) = 0%]) were seen, both in favor of ginger. Patients given ginger were more than twice as likely to discontinue treatment compared to placebo ([RR = 2.33; 95% CI: (1.04, 5.22)]; P = 0.04; I(2) = 0%]). Ginger was modestly efficacious and reasonably safe for treatment of OA. We judged the evidence to be of moderate quality, based on the small number of participants and inadequate ITT populations. Prospero: CRD42011001777. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

[An improved reduction technique for depression fractures of lateral tibial plateau].

PubMed

Wang, Hongchuan; Lou, Hua; Liu, Kai; Jiang, Junwei

2013-01-01

To investigate the improved reduction technique for depression fractures of the lateral tibial plateau and its effectiveness. Between January 2008 and December 2010; 48 patients (48 knees) with depression fractures of the lateral tibial plateau (Schatzker II or III fractures) were treated. There were 32 males and 16 females with an average age of 45.8 years (range, 16-79 years). All fractures were fresh closed fractures, which were caused by traffic accident in 27 cases, by falling from height in 5 cases, by crushing in 8 cases, and by sustained falls in 8 cases. According to Schatzker classification, 29 cases were classified as type II and 19 cases as type III. The lateral cortex was cut off to expose the depression and compacted cancellous bone was elevated to reset the articular surface. After reduction, autologous iliac bone graft and locking plate internal fixation were used. Healing of incision by first intention was achieved in all patients, and no complication occurred. All patients were followed up 1.7 years on average (range, 1-3 years). At last follow-up, the knee extension was (-0.5 +/- 0.3) degrees, and the knee flexion was (136.9 +/- 8.8) degrees. X-ray films showed that the fracture healing time was 52 weeks and no breakage of internal fixation occurred. According to Rasmussen clinical score, the results were excellent in 35 cases, good in 10 cases, and fair in 3 cases. According to Rasmussen radiographical score, the results were excellent in 41 cases, good in 7 cases; there were 41 excellent scores and 7 good scores of articular reduction; all gained good recovery of coronal and sagittal alignment and condylar width. The articular surface collapse was (1.0 +/- 0.7) mm at immediate postoperatively and (1.2 +/- 0.7) mm at last follow-up, showing no significant difference (t = -1.42, P = 0.20), but significant differences were found when compared with that at preoperation [(12.2 +/- 8.0) mm, P < 0.05]. This improved technique can provide a satisfactory effectiveness of fracture reduction and can avoid loss of reduction. The short-term effectiveness is good, but futher follow-up is necessary to determine the long-term results.

[Treatment of linguiform calcaneus fracture by close nail-pry reduction and internal fixation with hollow screws].

PubMed

Tu, Shu-Qiang; Huang, Ke-Di; Shuai, Yong-Ming; Xu, Nan-Yun; Yuan, Qiu-Wen; Guo, Jian

2012-06-01

To study the curative effects of close nail-pry reduction and internal fixation with hollow screws for treatment of linguiform calcaneus fracture. From May 2006 to October 2009,32 patients (35 feet) with linguiform calcaneus fracture were treated by close nail-pry reduction and internal fixation with hollow screws, including 23 males and 9 females ranging in age from 25 to 46 years, with a mean of 37.6 years. According to Paley classification, 3 cases were Paley II a, and 29 cases were Paley II b. All cases were close fractures. The time from injury to operation was 3 to 10 days after most swelling subsided. Böhler angle and Gissane angle were measured by X-ray before and after operation. The therapeutic effect was assessed according to ZHANG Tie-liang's foot score. All the patients were followed-up for 6 to 18 months, with a mean of 12 months. All fractures gained bone healing. The time of fracture healing averaged 12 months. The fractures healed completely and no infection occurred. According to ZHANG Tie-liang's foot scale, the postoperative function was excellent in 18 feet, good in 10 feet, moderate in 5 feet and poor in 2 feet. The Böhler angle and Gissane angle were significant improved after treatment (P < 0.01). The surgical method of close nail-pry reduction and internal fixation with hollow screws for treatment of linguiform calcaneus fracture can regain the foot function, with minimal injury, fewer complications, earlier recovery and lower costs.

Intensive group-based CBT for child social phobia: a pilot study.

PubMed

Donovan, Caroline L; Cobham, Vanessa; Waters, Allison M; Occhipinti, Stefano

2015-05-01

Although CBT has proven efficacious in the treatment of child social phobia (SP), most children do not present for treatment and child SP may be less responsive to treatment than other anxiety disorders. Intensive, group-based, SP-specific CBT may improve the efficacy of, and access to, treatment for child SP. The aim of this study was to provide a preliminary examination of such a program. Forty Australian children aged 7-12 years (15 male and 25 female) were allocated into treatment and waitlist groups. Clinical interviews to determine diagnostic status were conducted prior to treatment, following treatment and at 6-month follow-up. Parent and child questionnaire measures of child anxiety symptoms, internalizing symptoms, depression, social skills, social competence, and parental social anxiety were administered at the same time points. Treatment was delivered in 4 separate 3-hour sessions conducted over 3 consecutive weekends. At postassessment, 52.4% of children in the treatment group and 15.8% of children in the waitlist group were free of their SP diagnosis. At postassessment, compared to waitlist children, treatment group children demonstrated a greater drop in clinical severity, a greater increase in overall functioning, and held fewer clinical diagnoses. Treatment group children also reported a greater reduction in SP symptoms compared to waitlist children, and treatment group parents reported a greater reduction in child internalizing and anxiety symptoms, a greater increase in child social competence, and a greater decrease in parental SP symptoms, compared to parents of children in the waitlist group. By 6-month follow-up, 76.9% of the treatment group were free of their SP diagnosis and gains on all other measures were maintained. The results of this study are encouraging, and suggest that brief, intensive, group CBT for children with social anxiety is beneficial for many youngsters. Copyright © 2014. Published by Elsevier Ltd.

Contribution of diffusion tensor imaging to delineation of gliomas and glioblastomas.

PubMed

Tropine, A; Vucurevic, G; Delani, P; Boor, S; Hopf, N; Bohl, J; Stoeter, P

2004-12-01

To determine if the diffusion tensor imaging (DTI) parameters fractional anisotropy (FA) and mean diffusivity (MD) can differentiate between accompanying edema and tumor cell infiltration of white matter (WM) beyond the tumor edge as defined from conventional MRI in low- and high-grade gliomas. We examined 12 patients with high-grade gliomas/glioblastomas and eight patients with low-grade gliomas and compared them to 10 patients with meningiomas, in which no tumor infiltration is expected. The tumor was defined as the enhancing area in glioblastomas and meningiomas and as the area of increased T2-signal in low-grade gliomas. FA and MD were measured in the center of the tumor and in the adjacent WM. The contralateral WM and internal capsule were used as an internal standard. Comparing the WM areas of increased T2-signal adjacent to meningiomas and glioblastomas, we saw a trend (without significance) towards a reduction of FA, but not of MD, in glioblastomas. We found no changes of FA and MD in the WM adjacent to low-grade gliomas (without T2-signal increase) compared to the WM of the contralateral hemisphere. In meningiomas and high-grade gliomas/glioblastomas, a narrow rim of significantly (P < 0.01) increased FA and decreased MD values around the enhancing tumor area was seen, whereas in low-grade gliomas, such a rim could not be defined. There was no contribution of FA or MD to grading of gliomas. In glioblastomas, a reduction of FA in the edematous area surrounding the tumor may indicate tumor cell infiltration, but a reliable differentiation between infiltration and vasogenic edema is not yet possible on the basis of DTI. The additional finding of a narrow rim of increased FA and decreased MD at the edge of glioblastomas (as well as in meningiomas) may be caused by com-pressed WM fibers and/or increased vascularity, but does not contribute to exclude peripheral cellular infiltration. 2004 Wiley-Liss, Inc.

Characteristics of drug demand reduction structures in Britain and Iran

PubMed Central

Narenjiha, Hooman; Noori, Roya; Ghiabi, Maziyar; Khoddami-Vishteh, Hamid-Reza

2016-01-01

Administrative structure of drug demand reduction and the way in which involved organizations interact with each other has been neglected by researchers, policy makers, and administrators at the national level and even in international institutions in this field. Studying such structures in different countries can reveal their attributes and features. In this study, key experts from the addictive behavior department of St George’s University of London and a group of Iranian specialists in the field of drug demand reduction first wrote on a sheet the name of organizations that are in charge of drug demand reduction. Then, via teamwork, they drew the connections between the organizations and compared the two charts to assess the relations between the member organizations. In total, 17 features of efficient structure were obtained as follow: multi-institutional nature, collaborative inter-institutional activities, clear and relevant inter-institutional and intra-institutional job description, the ability to share the experiences, virtual institutions activity, community-based associations activity, mutual relationships, the existence of feedback sys-tems, evaluation, changeability, the ability to collect data rapidly, being rooted in community, flexibility at the local and regional levels, connection with research centers, updated policymaking, empowering the local level, and seeking the maximum benefit and the minimum resources. Recognizing the characteristics of substance related organizations in various countries could help policy makers to improve drug demand reduction structures and to manage the wide-spread use of psychoactive substances more effectively. PMID:27853729

Comparison of environmental tobacco smoke (ETS) concentrations generated by an electrically heated cigarette smoking system and a conventional cigarette.

PubMed

Tricker, Anthony R; Schorp, Matthias K; Urban, Hans-Jörg; Leyden, Donald; Hagedorn, Heinz-Werner; Engl, Johannes; Urban, Michael; Riedel, Kirsten; Gilch, Gerhard; Janket, Dinamis; Scherer, Gerhard

2009-01-01

Smoking conventional lit-end cigarettes results in exposure of nonsmokers to potentially harmful cigarette smoke constituents present in environmental tobacco smoke (ETS) generated by sidestream smoke emissions and exhaled mainstream smoke. ETS constituent concentrations generated by a conventional lit-end cigarette and a newly developed electrically heated cigarette smoking system (EHCSS) that produces only mainstream smoke and no sidestream smoke emissions were investigated in simulated "office" and "hospitality" environments with different levels of baseline indoor air quality. Smoking the EHCSS (International Organisation for Standardization yields: 5 mg tar, 0.3 mg nicotine, and 0.6 mg carbon monoxide) in simulated indoor environments resulted in significant reductions in ETS constituent concentrations compared to when smoking a representative lit-end cigarette (Marlboro: 6 mg tar, 0.5 mg nicotine, and 7 mg carbon monoxide). In direct comparisons, 24 of 29 measured smoke constituents (83%) showed mean reductions of greater than 90%, and 5 smoke constituents (17%) showed mean reductions between 80% and 90%. Gas-vapor phase ETS markers (nicotine and 3-ethenylpyridine) were reduced by an average of 97% (range 94-99%). Total respirable suspended particles, determined by online particle measurements and as gravimetric respirable suspended particles, were reduced by 90% (range 82-100%). The mean and standard deviation of the reduction of all constituents was 94 +/- 4%, indicating that smoking the new EHCSS in simulated "office" and "hospitality" indoor environments resulted in substantial reductions of ETS constituents in indoor air.

Characteristics of drug demand reduction structures in Britain and Iran.

PubMed

Narenjiha, Hooman; Noori, Roya; Ghiabi, Maziyar; Khoddami-Vishteh, Hamid-Reza

2015-01-01

Administrative structure of drug demand reduction and the way in which involved organizations interact with each other has been neglected by researchers, policy makers, and administrators at the national level and even in international institutions in this field. Studying such structures in different countries can reveal their attributes and features. In this study, key experts from the addictive behavior department of St George's University of London and a group of Iranian specialists in the field of drug demand reduction first wrote on a sheet the name of organizations that are in charge of drug demand reduction. Then, via teamwork, they drew the connections between the organizations and compared the two charts to assess the relations between the member organizations. In total, 17 features of efficient structure were obtained as follow: multi-institutional nature, collaborative inter-institutional activities, clear and relevant inter-institutional and intra-institutional job description, the ability to share the experiences, virtual institutions activity, community-based associations activity, mutual relationships, the existence of feedback sys-tems, evaluation, changeability, the ability to collect data rapidly, being rooted in community, flexibility at the local and regional levels, connection with research centers, updated policymaking, empowering the local level, and seeking the maximum benefit and the minimum resources. Recognizing the characteristics of substance related organizations in various countries could help policy makers to improve drug demand reduction structures and to manage the wide-spread use of psychoactive substances more effectively.

Malaria control along China-Myanmar Border during 2007-2013: an integrated impact evaluation.

PubMed

Xu, Jian-Wei; Li, Yong; Yang, Heng-Lin; Zhang, Jun; Zhang, Zai-Xing; Yang, Ya-Ming; Zhou, Hong-Ning; Havumaki, Joshua; Li, Hua-Xian; Liu, Hui; Zhou, Hua; Xie, Xin-Yu; Dong, Jia-Xiang; Zhang, Yue; Sun, Xiao-Ying; Li, Bo; Li, Jia-Yin; Tian, Yang-Hui; Wang, Pi-Yu; Li, Ben-Fu

2016-08-10

Implementing effective interventions remain a lot of difficulties along all border regions. The emergence of artemisinin resistance of Plasmodium falciparum strains in the Greater Mekong Subregion is a matter of great concern. China has effectively controlled cross-border transmission of malaria and artemisinin resistance of P. falciparum along the China-Myanmar border. A combined quantitative and qualitative study was used to collect data, and then an integrated impact evaluation was conducted to malaria control along the China-Myanmar border during 2007-2013. The parasite prevalence rate (PPR) in the five special regions of Myanmar was decreased from 13.6 % in March 2008 to 1.5 % in November 2013. Compared with the baseline (PPR in March 2008), the risk ratio was only 0.11 [95 % confidence interval (CI), 0.09-0. 14) in November 2013, which is equal to an 89 % reduction in the malaria burden. Annual parasite incidence (API) across 19 Chinese border counties was reduced from 19.6 per 10 000 person-years in 2006 to 0.9 per 10 000 person-years in 2013. Compared with the baseline (API in 2006), the API rate ratio was only 0.05(95 % CI, 0.04-0.05) in 2013, which equates to a reduction of the malaria burden by 95.0 %. Meanwhile, the health service system was strengthened and health inequity of marginalized populations reduced along the international border. The effective collaboration between China, Myanmar and the international non-governmental organization promptly carried out the core interventions through simplified processes. The integrated approaches dramatically decreased malaria burden of Chinese-Myanmar border.

Reducing eating disorder risk factors: A pilot effectiveness trial of a train-the-trainer approach to dissemination and implementation.

PubMed

Greif, Rebecca; Becker, Carolyn Black; Hildebrandt, Tom

2015-12-01

Impediments limit dissemination and implementation of evidence-based interventions (EBIs), including lack of sufficient training. One strategy to increase implementation of EBIs is the train-the-trainer (TTT) model. The Body Project is a peer-led body image program that reduces eating disorder (ED) risk factors. This study examined the effectiveness of a TTT model at reducing risk factors in Body Project participants. Specifically, this study examined whether a master trainer could train a novice trainer to train undergraduate peer leaders to administer the Body Project such that individuals who received the Body Project (i.e., participants) would evidence comparable outcomes to previous trials. We hypothesized that participants would evidence reductions in ED risk factors, with effect sizes similar to previous trials. Utilizing a TTT model, a master trainer trained a novice trainer to train undergraduate peer leaders to administer the Body Project to undergraduate women. Undergraduate women aged 18 years or older who received the Body Project intervention participated in the trial and completed measures at baseline, post-treatment, and five-month follow-up. Primary outcomes included body dissatisfaction, thin ideal internalization, negative affect, and ED pathology. Participants demonstrated significant reductions in thin ideal internalization, ED pathology and body dissatisfaction at post-treatment and 5-month follow-up. At 5 months, using three different strategies for managing missing data, effect sizes were larger or comparable to earlier trials for 3 out of 4 variables. Results support a TTT model for Body Project implementation and the importance of utilizing sensitivity analyses for longitudinal datasets with missing data. © 2015 Wiley Periodicals, Inc.

Summer syncope syndrome.

PubMed

Huang, Jennifer Juxiang; Sharda, Natasha; Riaz, Irbaz Bin; Alpert, Joseph S

2014-08-01

Antihypertensive therapy is associated with significant relative risk reductions in the incidence of heart failure, myocardial infarction, and stroke. However, a common adverse reaction to antihypertensive therapy is orthostatic hypotension, dehydration, and syncope. We propose that continued use of antihypertensive medications at the same dosage during the dry summer months in patients living in the Sonoran desert leads to an increase in syncopal episodes. All hypertensive patients who were treated with medications and admitted with International Classification of Diseases, 9th Revision code diagnosis of syncope were included. They were defined as "cases" if they presented during the summer months (May to September 2012) and "controls" if they presented during the winter months (November 2012 to March 2013). The primary outcome measure was the presence of clinical dehydration. The statistical significance was determined using the 2-sided Fisher exact test. A total of 496 patients with an International Classification of Diseases, 9th Revision code diagnosis of syncope were screened, and 179 patients were included in the final analysis. In patients taking antihypertensive medications, there were a significantly higher number of cases of syncope secondary to dehydration or orthostatic hypotension during the summer months (45%) compared with the winter months (26%) (P = .01). The incidence of syncope was significantly higher in older patients (63%) compared with younger individuals (37%) during the summer months. The incidence of syncope increases during the summer months among people who reside in a dry desert climate and who are taking antihypertensive medications. On the basis of our findings, we describe an easily preventable condition that we define as the "Summer Syncope Syndrome." We recommend judicious reduction of antihypertensive therapy in patients residing in a hot and dry climate, particularly during the summer months. Copyright © 2014 Elsevier Inc. All rights reserved.

Pain as an indication for rib fixation: a bi-institutional pilot study.

PubMed

de Moya, Marc; Bramos, Thanos; Agarwal, Suresh; Fikry, Karim; Janjua, Sumbal; King, David R; Alam, Hasan B; Velmahos, George C; Burke, Peter; Tobler, William

2011-12-01

In trauma patients, open reduction and internal fixation of rib fractures remain controversial. We hypothesized that patients who have open reduction and internal fixation of rib fractures would experience less pain compared with controls and thus require fewer opiates. Further, we hypothesized that improved pain control would result in fewer pulmonary complications and decreased length of stay. This is a retrospective bi-institutional matched case-control study. Cases were matched 1:2 by age, injury severity Score, chest abbreviated injury severity score, head abbreviated injury severity score, pulmonary contusion score, and number of fractured ribs. The daily total doses of analgesic drugs were converted to equianalgesic intravenous morphine doses, and the primary outcome was inpatient narcotic administration. Sixteen patients between July 2005 and June 2009 underwent rib fixation in 5 ± 3 days after injury using an average of 3 (1-5) metallic plates. Morphine requirements decreased from 110 mg ± 98 mg preoperatively to 63 ± 57 mg postoperatively (p = 0.01). There were no significant differences between cases and controls in the mean morphine dose (79 ± 63 vs. 76 ± 55 mg, p = 0.65), hospital stay (18 ± 12 vs. 16 ± 11 days, p = 0.67), intensive care unit stay (9 ± 8 vs. 7 ± 10 days, p = 0.75), ventilation days (7 ± 8 vs. 6 ± 10, p = 0.44), and pneumonia rates (31% vs. 38%, p = 0.76). The need for analgesia was significantly reduced after rib fixation in patients with multiple rib fractures. However, no difference in outcomes was observed when these patients were compared with matched controls in this pilot study. Further study is required to investigate these preliminary findings.

Quantitative gait analysis in parkin disease: Possible role of dystonia.

PubMed

Castagna, Anna; Frittoli, Serena; Ferrarin, Maurizio; Del Sorbo, Francesca; Romito, Luigi M; Elia, Antonio E; Albanese, Alberto

2016-11-01

Parkin disease (PARK2, OMIM 602544) is an autosomal-recessive early-onset parkinsonism characterized by an early occurrence of lower limb dystonia. The aim of this study was to analyze spatiotemporal, kinematic, and kinetic gait parameters in patients with parkin disease in the OFF and ON conditions compared to healthy age-matched controls. Fifteen patients with parkin disease and 15 healthy age-matched controls were studied in a gait analysis laboratory with an integrated optoelectronic system. Spatiotemporal, kinematic, and kinetic gait parameters at a self-selected speed were recorded in the OFF and ON conditions. A jerk index was computed to quantify the possible reduction of smoothness of joint movements. Compared to controls, parkin patients had, either in the OFF or in the ON conditions, significant reduction of walking velocity, increased step width, and decreased percentage of double support. Kinematic analysis in both conditions showed: increased ankle dorsiflexion and knee flexion at the initial contact; maximal flexion and increased range of motion in mid stance; increased hip flexion and max extension in stance at pelvis; and increased mean tilt antiversion. Kinetics showed increased hip and knee power generation in stance in either condition. The jerk index was increased at all joints both in OFF and ON. There were no correlations between individual gait parameters and clinical ratings. Parkin patients have an abnormal gait pattern that does not vary between the OFF and the ON conditions. Variations recorded with instrumented analysis are more evident for kinematic than kinetic parameters at lower limbs. Severity of dystonia does not correlate with any individual kinematic parameter. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

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Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-23

... DEPARTMENT OF THE TREASURY Internal Revenue Service Agency Information Collection Activity; Proposed Collection AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice and request for... on proposed and/or continuing information collections, as required by the Paperwork Reduction Act of...

Impact of the sharp changes in the use of contraception in 2013 on the risk of pulmonary embolism in France.

PubMed

Tricotel, A; Collin, C; Zureik, M

2015-09-01

In late 2012, a national pill crisis led French women to promptly change their behavior regarding contraception, with a significant increase in the use of first-generation and second-generation combined oral contraceptives to the detriment of third-generation and fourth-generation products (C3Gs and C4Gs). To assess the impact of the sharp changes in 2013 on the rate of women hospitalized for pulmonary embolism in France. All hospitalized pulmonary embolisms in women aged 15-49 years, excluding those occurring during delivery stay, were identified from the French national hospital discharge databases from 2010 to 2013. Hospitalization rates, overall and by age group, were calculated. We compared rates in 2013 with those in 2012, and with mean rates over the preceding 3-year period (2010-2012). Two populations of non-users of contraceptives were used as control groups: men aged 15-49 years, and women aged 50-69 years. The expected reduction in pulmonary embolism incidence, estimated by modeling the number of expected cases based on modifications of combined oral contraceptive exposure, was also considered. In France, in 2013 as compared with 2012, the pulmonary embolism hospitalization incidence rate in women aged 15-49 years fell by 10.6%, corresponding to a reduction of 322 hospitalizations (95% confidence interval -468 to -156). The expected pulmonary embolism reduction is consistent with the observed reduction in hospitalization incidence rate (-10.2% and -10.6%, respectively). Such a pattern was not observed in the control groups. The sharp change in contraception methods, with decreased use of C3Gs and C4Gs, probably played a major role in the reduction in venous thromboembolism morbidity in France. © 2015 The Authors. Journal of Thrombosis and Haemostasis published by Wiley Periodicals, Inc. on behalf of International Society on Thrombosis and Haemostasis.

Preemptive warfarin dose reduction after initiation of sulfamethoxazole-trimethoprim or metronidazole.

PubMed

Powers, Anna; Loesch, Erin B; Weiland, Anthony; Fioravanti, Nicole; Lucius, David

2017-07-01

To evaluate the utility of a preemptive warfarin dose reduction at the time of initiation of either sulfamethoxazole-trimethoprim or metronidazole, a retrospective chart review of patients who received an outpatient prescription for warfarin and either sulfamethoxazole-trimethoprim and/or metronidazole from July 1, 2011 to July 1, 2015 was conducted. Clinical outcomes compared Veterans who had a warfarin dose reduction and those who did not within 120 h (5 days) of antibiotic initiation. The primary outcome compared the pre-and post-antibiotic International Normalized Ratio (INR) of patients in the intervention group (warfarin dose reduction) with those in the control group (no intervention). Secondary outcomes assessed incidence of thromboembolic and major bleeding events within 30 days of antibiotic completion. Fifty patients were assessed. Forty-nine patients had at least one follow-up appointment; 126 follow-up visits were evaluated. There was a statistically significant difference for the change in therapeutic INR at the first follow-up appointment (p = 0.029) for those patients in the control group. On average, the patients in the intervention group required fewer follow-up visits (p = 0.019). There were no statistically significant differences for the overall rate of therapeutic INR values between groups, as well as no instances of a thromboembolic or major bleeding events during the follow-up period. Clinically significant differences were observed for patients who received a preemptive warfarin dose reduction upon initiation of sulfamethoxazole-trimethoprim or metronidazole. Patients in the intervention group required fewer follow-up appointments and were more likely maintain a therapeutic INR within the 30 days following the antibiotic course. Results of this study will be presented the at Pharmacy and Therapeutics committee in an effort to seek approval for policy development to initiate a local preemptive warfarin dose adjustment as a standard of practice.

Metal artefact reduction for patients with metallic dental fillings in helical neck computed tomography: comparison of adaptive iterative dose reduction 3D (AIDR 3D), forward-projected model-based iterative reconstruction solution (FIRST) and AIDR 3D with single-energy metal artefact reduction (SEMAR).

PubMed

Yasaka, Koichiro; Kamiya, Kouhei; Irie, Ryusuke; Maeda, Eriko; Sato, Jiro; Ohtomo, Kuni

To compare the differences in metal artefact degree and the depiction of structures in helical neck CT, in patients with metallic dental fillings, among adaptive iterative dose reduction three dimensional (AIDR 3D), forward-projected model-based iterative reconstruction solution (FIRST) and AIDR 3D with single-energy metal artefact reduction (SEMAR-A). In this retrospective clinical study, 22 patients (males, 13; females, 9; mean age, 64.6 ± 12.6 years) with metallic dental fillings who underwent contrast-enhanced helical CT involving the oropharyngeal region were included. Neck axial images were reconstructed with AIDR 3D, FIRST and SEMAR-A. Metal artefact degree and depiction of structures (the apex and root of the tongue, parapharyngeal space, superior portion of the internal jugular chain and parotid gland) were evaluated on a four-point scale by two radiologists. Placing regions of interest, standard deviations of the oral cavity and nuchal muscle (at the slice where no metal exists) were measured and metal artefact indices were calculated (the square root of the difference of the squares of them). In SEMAR-A, metal artefact was significantly reduced and depictions of all structures were significantly improved compared with those in FIRST and AIDR 3D (p ≤ 0.001, sign test). Metal artefact index for the oral cavity in AIDR 3D/FIRST/SEMAR-A was 572.0/477.7/88.4, and significant differences were seen between each reconstruction algorithm (p < 0.0001, Wilcoxon signed-rank test). SEMAR-A could provide images with lesser metal artefact and better depiction of structures than AIDR 3D and FIRST.

Antiparasite treatments reduce humoral immunity and impact oxidative status in raptor nestlings

PubMed Central

Hanssen, Sveinn Are; Bustnes, Jan Ove; Schnug, Lisbeth; Bourgeon, Sophie; Johnsen, Trond Vidar; Ballesteros, Manuel; Sonne, Christian; Herzke, Dorte; Eulaers, Igor; Jaspers, Veerle L B; Covaci, Adrian; Eens, Marcel; Halley, Duncan J; Moum, Truls; Ims, Rolf Anker; Erikstad, Kjell Einar

2013-01-01

Parasites are natural stressors that may have multiple negative effects on their host as they usurp energy and nutrients and may lead to costly immune responses that may cause oxidative stress. At early stages, animals may be more sensitive to infectious organisms because of their rapid growth and partly immature immune system. The objective of this study was to explore effects of parasites by treating chicks of two raptor species (northern goshawk Accipiter gentilis and white-tailed sea eagle Haliaeetus albicilla) against both endoparasites (internal parasites) and ectoparasites (external parasites). Nests were either treated against ectoparasites by spraying with pyrethrin or left unsprayed as control nests. Within each nest, chicks were randomly orally treated with either an antihelminthic medication (fenbendazole) or sterile water as control treatment. We investigated treatment effects on plasma (1) total antioxidant capacity TAC (an index of nonenzymatic circulating antioxidant defenses), (2) total oxidant status TOS (a measure of plasmatic oxidants), and (3) immunoglobulin levels (a measure of humoral immune function). Treatment against ectoparasites led to a reduction in circulating immunoglobulin plasma levels in male chicks. TOS was higher when not receiving any parasite reduction treatment and when receiving both endo- and ectoparasitic reduction treatment compared with receiving only one treatment. TAC was higher in all treatment groups, when compared to controls. Despite the relatively low sample size, this experimental study suggests complex but similar relationships between treatment groups and oxidative status and immunoglobulin levels in two raptor species. PMID:24455145

Impact of a multidimensional infection control strategy on catheter-associated urinary tract infection rates in the adult intensive care units of 15 developing countries: findings of the International Nosocomial Infection Control Consortium (INICC).

PubMed

Rosenthal, V D; Todi, S K; Álvarez-Moreno, C; Pawar, M; Karlekar, A; Zeggwagh, A A; Mitrev, Z; Udwadia, F E; Navoa-Ng, J A; Chakravarthy, M; Salomao, R; Sahu, S; Dilek, A; Kanj, S S; Guanche-Garcell, H; Cuéllar, L E; Ersoz, G; Nevzat-Yalcin, A; Jaggi, N; Medeiros, E A; Ye, G; Akan, Ö A; Mapp, T; Castañeda-Sabogal, A; Matta-Cortés, L; Sirmatel, F; Olarte, N; Torres-Hernández, H; Barahona-Guzmán, N; Fernández-Hidalgo, R; Villamil-Gómez, W; Sztokhamer, D; Forciniti, S; Berba, R; Turgut, H; Bin, C; Yang, Y; Pérez-Serrato, I; Lastra, C E; Singh, S; Ozdemir, D; Ulusoy, S

2012-10-01

We aimed to evaluate the impact of a multidimensional infection control strategy for the reduction of the incidence of catheter-associated urinary tract infection (CAUTI) in patients hospitalized in adult intensive care units (AICUs) of hospitals which are members of the International Nosocomial Infection Control Consortium (INICC), from 40 cities of 15 developing countries: Argentina, Brazil, China, Colombia, Costa Rica, Cuba, India, Lebanon, Macedonia, Mexico, Morocco, Panama, Peru, Philippines, and Turkey. We conducted a prospective before-after surveillance study of CAUTI rates on 56,429 patients hospitalized in 57 AICUs, during 360,667 bed-days. The study was divided into the baseline period (Phase 1) and the intervention period (Phase 2). In Phase 1, active surveillance was performed. In Phase 2, we implemented a multidimensional infection control approach that included: (1) a bundle of preventive measures, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of CAUTI rates, and (6) feedback of performance. The rates of CAUTI obtained in Phase 1 were compared with the rates obtained in Phase 2, after interventions were implemented. We recorded 253,122 urinary catheter (UC)-days: 30,390 in Phase 1 and 222,732 in Phase 2. In Phase 1, before the intervention, the CAUTI rate was 7.86 per 1,000 UC-days, and in Phase 2, after intervention, the rate of CAUTI decreased to 4.95 per 1,000 UC-days [relative risk (RR) 0.63 (95% confidence interval [CI] 0.55-0.72)], showing a 37% rate reduction. Our study showed that the implementation of a multidimensional infection control strategy is associated with a significant reduction in the CAUTI rate in AICUs from developing countries.

Early Weightbearing and Range of Motion Versus Non-Weightbearing and Immobilization After Open Reduction and Internal Fixation of Unstable Ankle Fractures: A Randomized Controlled Trial.

PubMed

Dehghan, Niloofar; McKee, Michael D; Jenkinson, Richard J; Schemitsch, Emil H; Stas, Venessa; Nauth, Aaron; Hall, Jeremy A; Stephen, David J; Kreder, Hans J

2016-07-01

The aim of this study was to compare early weightbearing and range of motion (ROM) to nonweightbearing and immobilization in a cast after surgical fixation of unstable ankle fractures. Multicentre randomized controlled trial. Two-level one trauma centers. One hundred ten patients who underwent open reduction and internal fixation of an unstable ankle fracture were recruited and randomized. One of 2 rehabilitation protocols: (1) Early weightbearing (weightbearing and ROM at 2 weeks, Early WB) or (2) Late weightbearing (nonweightbearing and cast immobilization for 6 weeks, Late WB). The primary outcome measure was time to return to work (RTW). Secondary outcome measures included: ankle ROM, SF-36 heath outcome scores, Olerud/Molander ankle function score, and rates of complications. There was no difference in RTW. At 6 weeks postoperatively, patients in the Early WB group had significantly improved ankle ROM (41 vs. 29, P < 0.0001); Olerud/Molander ankle function scores (45 vs. 32, P = 0.0007), and SF-36 scores on both the physical (51 vs. 42, P = 0.008) and mental (66 vs. 54, P = 0.0008) components. There were no differences with regard to wound complications or infections and no cases of fixation failure or loss of reduction. Patients in the Late WB group had higher rates of planned/performed hardware removal due to plate irritation (19% vs. 2%, P = 0.005). Given the convenience for the patient, early improved functional outcome, and the lack of an increased complication rate, we recommend early postoperative weightbearing and ROM in patients with surgically treated ankle fractures. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Reduction of high-affinity beta2-adrenergic receptor binding by hyperforin and hyperoside on rat C6 glioblastoma cells measured by fluorescence correlation spectroscopy.

PubMed

Prenner, Lars; Sieben, Anne; Zeller, Karin; Weiser, Dieter; Häberlein, Hanns

2007-05-01

Beta-adrenergic receptors (beta-AR) are potential targets for antidepressants. Desensitization and downregulation of beta-AR are discussed as possible modes of action for antidepressants. We have investigated the effects of hyperforin and hyperoside, compounds with potentially antidepressant activity from St. John's Wort, on the binding behavior and dynamics of beta2-AR in living rat C6 glioblastoma cells, compared to desipramine (desmethylimipramine; DMI) by means of fluorescence correlation spectroscopy (FCS) and fluorescence microscopy. FCS-binding studies with the fluorescently labeled ligand Alexa532-noradrenaline (Alexa532-NA) binding to beta2-AR of C6 cells showed a significant reduction in total beta2-AR binding after preincubation with hyperforin and hyperoside for 3 days, respectively, which was also found for DMI. This was mainly observed in high-affinity receptor-ligand complexes with hindered lateral mobility (D2 = 1.1 (+/-0.4) microm2/s) in the biomembrane. However, internalization of beta2-AR was found neither in z-scans of these C6 cells nor in HEK 293 cells stably transfected with GFP-tagged beta2-adrenergic receptors (beta2AR-GFP) after incubation up to 6 days with either DMI, hyperforin, or hyperoside. Thus, under these conditions reduction of beta2-AR binding was not mediated by receptor internalization. Additionally, preincubation of C6 cells with DMI, hyperforin, and hyperoside led to a loss of second messenger cAMP after beta2-adrenergic stimulating conditions with terbutaline. Our current results indicate that hyperforin and hyperoside from St. John's Wort, as well as DMI, reduce beta2-adrenergic sensitivity in C6 cells, emphasizing the potential usefulness of St. John's Wort dry extracts in clinical treatment of depressive symptoms.

An environment-adaptive management algorithm for hearing-support devices incorporating listening situation and noise type classifiers.

PubMed

Yook, Sunhyun; Nam, Kyoung Won; Kim, Heepyung; Hong, Sung Hwa; Jang, Dong Pyo; Kim, In Young

2015-04-01

In order to provide more consistent sound intelligibility for the hearing-impaired person, regardless of environment, it is necessary to adjust the setting of the hearing-support (HS) device to accommodate various environmental circumstances. In this study, a fully automatic HS device management algorithm that can adapt to various environmental situations is proposed; it is composed of a listening-situation classifier, a noise-type classifier, an adaptive noise-reduction algorithm, and a management algorithm that can selectively turn on/off one or more of the three basic algorithms-beamforming, noise-reduction, and feedback cancellation-and can also adjust internal gains and parameters of the wide-dynamic-range compression (WDRC) and noise-reduction (NR) algorithms in accordance with variations in environmental situations. Experimental results demonstrated that the implemented algorithms can classify both listening situation and ambient noise type situations with high accuracies (92.8-96.4% and 90.9-99.4%, respectively), and the gains and parameters of the WDRC and NR algorithms were successfully adjusted according to variations in environmental situation. The average values of signal-to-noise ratio (SNR), frequency-weighted segmental SNR, Perceptual Evaluation of Speech Quality, and mean opinion test scores of 10 normal-hearing volunteers of the adaptive multiband spectral subtraction (MBSS) algorithm were improved by 1.74 dB, 2.11 dB, 0.49, and 0.68, respectively, compared to the conventional fixed-parameter MBSS algorithm. These results indicate that the proposed environment-adaptive management algorithm can be applied to HS devices to improve sound intelligibility for hearing-impaired individuals in various acoustic environments. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

The limited anterior approach of the elbow for open reduction and internal fixation of capitellum fractures. Surgical technique and clinical experience in 2 cases with more than 2 years follow-up.

PubMed

Ballesteros-Betancourt, J R; Fernández-Valencia, J A; García-Tarriño, R; Domingo-Trepat, A; Sastre-Solsona, S; Combalia-Aleu, A; Llusá-Pérez, M

Fractures involving the capitellum can be treated surgically by excision of the fragment, or by reduction and internal fixation with screws, with or without heads. The lateral Kocher approach is the most common approach for open reduction. We believe that the limited anterior approach of the elbow, could be a valid technique for treating these fractures, as it does not involve the detachment of any muscle group or ligament, facilitating the recovery process. A description is presented of the surgical technique, as well as of 2cases with a Bryan-Morrey type 1 fracture (Dubberley type 1A). Two different final quality of life evaluation questionnaires were completed by telephone: the EuroQol Five Dimensions Questionnaire (EQ-5D), and the patient part of the Liverpool Elbow Score (PAQ-LES) questionnaire. The 2patients showed favourable clinical progress at 36 and 24 months, respectively, with an extension/flexion movement arc of -5°/145° and -10°/145°, as well as a pronosupination of 85°/80° and 90°/90°. The 2patients showed radiological consolidation with no signs of osteonecrosis. The EQ-5D score was 0.857 and 0.910 (range: 0.36-1), and a PAQ-SLE of 35 and 35 (range: 17-36), respectively. We believe that the limited anterior approach of the elbow is a technical option to consider for the open surgical treatment of a capitellum fracture, although further studies are needed to demonstrate its superiority and clinical safety compared to the classical lateral Kocher approach. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Linking International Development Actors to Geophysical Infrastructure: Exploring an IRIS Community Role in Bridging a Communications Gap

NASA Astrophysics Data System (ADS)

Lerner-Lam, A.; Aster, R.; Beck, S.; Ekstrom, G.; Fisher, K.; Meltzer, A.; Nyblade, A.; Sandvol, E.; Willemann, R.

2008-12-01

Over the past quarter century, national investments in high-fidelity digital seismograph networks have resulted in a global infrastructure for real-time in situ earthquake monitoring. Many network operators adhere to community-developed standards, with the result that there are few technical impediments to data sharing and real-time information exchange. Two unanswered questions, however, are whether the existing models of international collaboration will ensure the stability and sustainability of global earthquake monitoring, and whether the participating institutions can work with international development agencies and non- governmental organizations in meeting linked development and natural hazard risk reduction goals. Since the 2004 Indian Ocean tsunami, many of these actors are enlarging their commitments to natural hazard risk reduction and building national technical capacities, among broader programs in poverty alleviation and adaptation to environmental stress. Despite this renewed commitment, international development organizations, with notable exceptions, have been relatively passive in discussions of how the existing earthquake monitoring infrastructure could be leveraged to support risk-reduction programs and meet sustainable development goals. At the same time, the international seismological community - comprising universities and government seismological surveys - has built research and education initiatives such as EarthScope, AfricaArray, and similar programs in China, Europe and South America, that use innovative instrumentation technologies and deployment strategies to enable new science and applications, and promote education and training in critical sectors. Can these developments be combined? Recognizing this communication or knowledge gap, the IRIS International Working Group (IWG) explores the link between the activities of IRIS Members using IRIS facilities and the missions of international development agencies, such as US AID, the World Bank, other international development banks, and agencies of the United Nations. Interests of US seismologists are served by encouraging development of modern seismographic systems in countries around the world to collect data that are useful in research as well as hazard mitigation and other national interests. Activities of the IWG to date include communicating the benefits of geophysical infrastructure and training to disaster risk reduction programs within the United Nations and development banks, coordinating an initiative to leverage retired PASSCAL data loggers through long-term loans to network operators in foreign countries, preparing a white paper outlining IRIS capabilities relevant to international development, and conducting a workshop, "Out of Africa", on modernizing geophysical infrastructure in the Americas and Southeast Asia through projects that are closely tied to university education and academic research.

Association between edoxaban dose, concentration, anti-Factor Xa activity, and outcomes: an analysis of data from the randomised, double-blind ENGAGE AF-TIMI 48 trial.

PubMed

Ruff, Christian T; Giugliano, Robert P; Braunwald, Eugene; Morrow, David A; Murphy, Sabina A; Kuder, Julia F; Deenadayalu, Naveen; Jarolim, Petr; Betcher, Joshua; Shi, Minggao; Brown, Karen; Patel, Indravadan; Mercuri, Michele; Antman, Elliott M

2015-06-06

New oral anticoagulants for stroke prevention in atrial fibrillation were developed to be given in fixed doses without the need for the routine monitoring that has hindered usage and acceptance of vitamin K antagonists. A concern has emerged, however, that measurement of drug concentration or anticoagulant activity might be needed to prevent excess drug concentrations, which significantly increase bleeding risk. In the ENGAGE AF-TIMI 48 trial, higher-dose and lower-dose edoxaban were compared with warfarin in patients with atrial fibrillation. Each regimen incorporated a 50% dose reduction in patients with clinical features known to increase edoxaban drug exposure. We aim to assess whether adjustment of edoxaban dose in this trial prevented excess drug concentration and the risk of bleeding events. We analysed data from the randomised, double-blind ENGAGE AF-TIMI 48 trial. We correlated edoxaban dose, plasma concentration, and anti-Factor Xa (FXa) activity and compared efficacy and safety outcomes with warfarin stratified by dose reduction status. Patients with atrial fibrillation and at moderate to high risk of stroke were randomly assigned in a 1:1:1 ratio to receive warfarin, dose adjusted to an international normalised ratio of 2·0-3·0, higher-dose edoxaban (60 mg once daily), or lower-dose edoxaban (30 mg once daily). Randomisation was done with use of a central, 24 h, interactive, computerised response system. International normalised ratio was measured using an encrypted point-of-care device. To maintain masking, sham international normalised ratio values were generated for patients assigned to edoxaban. Edoxaban (or placebo-edoxaban in warfarin group) doses were halved at randomisation or during the trial if patients had creatinine clearance 30-50 mL/min, bodyweight 60 kg or less, or concomitant medication with potent P-glycoprotein interaction. Efficacy outcomes included the primary endpoint of all-cause stroke or systemic embolism, ischaemic stroke, and all-cause mortality. Safety outcomes included the primary safety endpoint of major bleeding, fatal bleeding, intracranial haemorrhage, and gastrointestinal bleeding. This trial is registered with ClinicalTrials.gov, number NCT00781391. Between Nov 19, 2008 and Nov 22, 2010, 21 105 patients were recruited. Patients who met clinical criteria for dose reduction at randomisation (n=5356) had higher rates of stroke, bleeding, and death compared with those who did not have a dose reduction (n=15 749). Edoxaban dose ranged from 15 mg to 60 mg, resulting in a two-fold to three fold gradient of mean trough drug exposure (16·0-48·5 ng/mL in 6780 patients with data available) and mean trough anti-FXa activity (0·35-0·85 IU/mL in 2865 patients). Dose reduction decreased mean exposure by 29% (from 48·5 ng/mL [SD 45·8] to 34·6 ng/mL [30·9]) and 35% (from 24·5 ng/mL [22·7] to 16·0 ng/mL [14·5]) and mean anti-FXa activity by 25% (from 0·85 IU/mL [0·76] to 0·64 IU/mL [0·54]) and 20% (from 0·44 IU/mL [0·37] to 0·35 IU/mL [0·28]) in the higher-dose and lower-dose regimens, respectively. Despite the lower anti-FXa activity, dose reduction preserved the efficacy of edoxaban compared with warfarin (stroke or systemic embolic event: higher dose pinteraction=0·85, lower dose pinteraction=0·99) and provided even greater safety (major bleeding: higher dose pinteraction 0·02, lower dose pinteraction=0·002). These findings validate the strategy that tailoring of the dose of edoxaban on the basis of clinical factors alone achieves the dual goal of preventing excess drug concentrations and helps to optimise an individual patient's risk of ischaemic and bleeding events and show that the therapeutic window for edoxaban is narrower for major bleeding than thromboembolism. Daiichi-Sankyo Pharma Development. Copyright © 2015 Elsevier Ltd. All rights reserved.

Inverted distal clavicle anatomic locking plate for displaced medial clavicle fracture.

PubMed

Wang, Yong; Jiang, Jiannong; Dou, Bin; Zhang, Panjun

2015-09-01

Fractures of the medial clavicle are rare injuries. Recently, open reduction and internal fixation has been recommended for displaced medial clavicle fractures in order to prevent non-union and dysfunction. Because of the rarity of this injury, the optimal fixation device has not yet been established. In this report, we describe a case of a 40-year-old male patient who sustained a significantly displaced medial clavicle fracture treated by open reduction and internal fixation using an inverted distal clavicle anatomic locking plate. At the 12 months follow-up, the patient recovered well, had returned to pre-injury job, and was quite satisfied with the outcome. Internal fixation of medial clavicle fracture using an inverted distal clavicle anatomic locking plate of the ipsilateral side appears to be a good treatment option.

Effects of platelet concentrate storage time reduction in patients after blood stem cell transplantation.

PubMed

Heuft, H-G; Goudeva, L; Krauter, J; Peest, D; Buchholz, S; Tiede, A

2013-07-01

To evaluate the clinical effect of platelet concentrate (PC) transfusions after PC storage time reduction to 4 days. This was a single-centre cohort study comparing two 3-month periods of time, before and after the reduction of PC storage time from 5 to 4 days. Seventy-seven consecutive patients with PC transfusions were enrolled after blood stem cell transplantation. Corrected platelet count increment (CCI) on the morning after transfusion, time to next platelet transfusion, need for red blood cell (RBC) transfusion and clinical bleeding symptoms were compared. Platelet concentrate storage time was reduced between period 1 (storage for up to 5 days, median storage time 78 h, range 11-136 h) and period 2 (storage for up to 4 days, median storage time 53 h, range 11-112 h). Patients were comparable for age, weight, body surface area, underlying disorder, type of transplantation and transfused platelet dose. The CCI increased from a median of 4 (range 0-20) to 8 (0-68) × 10(9) /l per 10(11) platelets/m(2) (P < 0·0001). Time to next PC transfusion increased from 1·1 to 2·0 days (P < 0·0001). Any bleeding symptom was noted in 20 of 36 patients (56%) vs. 9/41 patients (22%, P < 0·01). Nose bleeds, haematuria and bleeding at more than one site were significantly reduced. Frequency of RBC transfusion within 5 days after PC transfusion was reduced from 74 to 58% (P < 0·0001). Platelet concentrate storage time shortening was associated with highly significant CCI increase, reduced RC needs and lower patient numbers with bleeding events. © 2013 International Society of Blood Transfusion.

A Systematic Review of Randomized Controlled Trials Comparing Hypertonic Sodium Solutions and Mannitol for Traumatic Brain Injury: Implications for Emergency Department Management.

PubMed

Burgess, Sarah; Abu-Laban, Riyad B; Slavik, Richard S; Vu, Erik N; Zed, Peter J

2016-04-01

To comparatively evaluate hypertonic sodium (HTS) and mannitol in patients following acute traumatic brain injury (TBI) on the outcomes of all-cause mortality, neurological disability, intracranial pressure (ICP) change from baseline, ICP treatment failure, and serious adverse events. PubMed, EMBASE, CENTRAL, Cochrane Database of Systematic Reviews, ClinicalTrials.gov, and WHO ICTRP (World Health Organization International Clinical Trials Registry Platform) were searched (inception to November 2015) using hypertonic saline solutions, sodium chloride, mannitol, osmotic diuretic, traumatic brain injury, brain injuries, and head injury. Searches were limited to humans. Clinical practice guidelines and bibliographies were reviewed. Prospective, randomized trials comparing HTS and mannitol in adults (≥16 years) with severe TBI (Glasgow Coma Scale score ≤8) and elevated ICP were included. ICP elevation, ICP reduction, and treatment failure were defined using study definitions. Of 326 articles screened, 7 trials enrolling a total of 191 patients met inclusion criteria. Studies were underpowered to detect a significant difference in mortality or neurological outcomes. Due to significant heterogeneity and differences in reporting ICP change from baseline, this outcome was not meta-analyzed. No difference between HTS and mannitol was observed for mean ICP reduction; however, risk of ICP treatment failure favored HTS (risk ratio [RR] = 0.39; 95% CI = 0.18-0.81). Serious adverse events were not reported. Based on limited data, clinically important differences in mortality, neurological outcomes, and ICP reduction were not observed between HTS or mannitol in the management of severe TBI. HTS appears to lead to fewer ICP treatment failures. © The Author(s) 2016.

Influence of internal current and pacing current on pacemaker longevity.

PubMed

Schuchert, A; Kuck, K H

1994-01-01

The effects of lower pulse amplitude on battery current and pacemaker longevity were studied comparing the new, small-sized VVI pacemaker, Minix 8341, with the former model, Pasys 8329. Battery current was telemetrically measured at 0.8, 1.6, 2.5, and 5.0 V pulse amplitude and 0.05, 0.25, 0.5, and 1.0 msec pulse duration. Internal current was assumed to be equal to the battery current at 0.8 V and 0.05 msec. Pacing current was calculated subtracting internal current from battery current. The Minix pacemaker had a significantly lower battery current because of a lower internal current (Minix: 4.1 +/- 0.1 microA; Pasys: 16.1 +/- 0.1 microA); pacing current of both units was similar. At 0.5 msec pulse duration, the programming from 5.0-2.5 V pulse amplitude resulted in a greater relative reduction of battery current in the newer pacemaker (51% vs 25%). Projected longevity of each pacemaker was 7.9 years at 5.0 V and 0.5 msec. The programming from 5.0-2.5 V extended the projected longevity by 2.3 years (Pasys) and by 7.1 years (Minix). The longevity was negligibly longer after programming to 1.6 V. extension of pacemaker longevity can be achieved with the programming to 2.5 V or less if the connected pacemakers need a low internal current for their circuitry.

Collecting mortality data to drive real-time improvement in suicide prevention.

PubMed

Ahmedani, Brian K; Coffey, Justin; Coffey, C Edward

2013-11-01

To evaluate the use of government mortality records compared with internally collected data to drive quality improvement in suicide prevention programs using suicide mortality data from the Perfect Depression Care initiative. Perfect Depression Care (PDC) is a quality improvement suicide prevention initiative within the Behavioral Health Services (BHS) division of the Henry Ford Health System. Eligible subjects were all patients who received services from BHS, were members of the health maintenance organization, and had a medical group physician during the 11-year study period. Mortality data were collected internally and from government-collected death records, and were linked to treatment utilization data from the medical record. The mean suicide rate was 96.6 per 100,000 during the 2-year baseline period (1999- 2000) and declined to 19.1 per 100,000 during the initiative (2002-2009) using both sources of data combined. We observed a similar statistically significant (P <.001) reduction in the suicide death rate using both the internal and government data sources. There were no significant differences between the 2 sources of data in the mean suicide rates for the baseline and intervention periods (P >.05). The data sources did differ in the capture of unique suicide deaths. Internally collected data were an effective measure of suicide deaths in the PDC initiative. A combination of internal and government-collected records may be most effective for future suicide prevention programs.

Match Physical Performance of Elite Female Soccer Players During International Competition.

PubMed

Datson, Naomi; Drust, Barry; Weston, Matthew; Jarman, Ian H; Lisboa, Paulo J; Gregson, Warren

2017-09-01

Datson, N, Drust, B, Weston, M, Jarman, IH, Lisboa, P, and Gregson, W. Match physical performance of elite female soccer players during international competition. J Strength Cond Res 31(9): 2379-2387, 2017-The purpose of this study was to provide a detailed analysis of the physical demands of competitive international female soccer match play. A total of 148 individual match observations were undertaken on 107 outfield players competing in competitive international matches during the 2011-2012 and 2012-2013 seasons, using a computerized tracking system (Prozone Sports Ltd., Leeds, England). Total distance and total high-speed running distances were influenced by playing position, with central midfielders completing the highest (10,985 ± 706 m and 2,882 ± 500 m) and central defenders the lowest (9,489 ± 562 m and 1,901 ± 268 m) distances, respectively. Greater total very high-speed running distances were completed when a team was without (399 ± 143 m) compared to with (313 ± 210 m) possession of the ball. Most sprints were over short distances with 76% and 95% being less than 5 and 10 m, respectively. Between half reductions in physical performance were present for all variables, independent of playing position. This study provides novel findings regarding the physical demands of different playing positions in competitive international female match play and provides important insights for physical coaches preparing elite female players for competition.

Effect of Cervical Siphon of External and Internal Carotid Arteries.

PubMed

Singh, Rajani; Tubbs, Richard Shane

2017-10-01

Variant courses, configuration, and branching pattern of the external and internal carotid arteries, especially when curved in S-shape, are important for hemodynamic changes and clinical implications. Therefore, the aim of the study is to report abnormal cervical siphons observed in external and internal carotid arteries to explore clinical significance by review of literature and hemodynamic changes theoretically.The right common carotid artery bifurcated into external and internal carotid arteries at the level of the upper border of thyroid cartilage in a 70-year-old female cadaver. After bifurcation, the external carotid artery underwent severe tortuosity coursing through 5 bends at points A, B, C, D, and E from its origin to termination and 2 bends at A' and B' in internal carotid artery in the cervical region. The angles between inflow and out flow of the blood at the bends were measured and the change in velocity at each bend was computed for both arteries. Hemodynamic changes were calculated, compared and relevant clinical complications were theoretically correlated.The angles of 20°, 30°, 51°, 52°, 60°, and 28°, 48° were formed by 5 bends of external and 2 bends of internal carotid arteries, respectively. The curved courses of these arteries caused reduction in velocity/stasis, turbulence, and low shear stress. Such kinks might cause stroke, ischemia and mistaken for tumors and abscess in imagery leading to or otherwise producing iatrogenic repercussions. This study will be useful for anatomists, clinicians, and radiologists.

Pseudoaneurysm of the internal maxillary artery secondary to subcondylar fracture: case report and literature review.

PubMed

Moro, Alessandro; Todaro, Mattia; Pedicelli, Alessandro; Alexandre, Andrea; Pelo, Sandro; Doneddu, Piero; Gasparini, Giulio; Garagiola, Umberto; D'Amato, Giuseppe; Saponaro, Gianmarco

2018-04-01

Pseudoaneurysms are an uncommon complication of mandibular condylar-subcondylar fractures; however, if present, their recognition and management is mandatory to avoid life-threatening situations. The authors report a case of internal maxillary artery pseudoaneurysm rupture that occurred after an open reduction and internal fixation of a mandibular subcondylar fracture, along with a review of the literature.

The Effectiveness of Conservative Management for Acute Whiplash Associated Disorder (WAD) II: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

PubMed Central

Wiangkham, Taweewat; Duda, Joan; Haque, Sayeed; Madi, Mohammad; Rushton, Alison

2015-01-01

Objective To evaluate the effectiveness of conservative management (except drug therapy) for acute Whiplash Associated Disorder (WAD) II. Design Systematic review and meta-analysis of Randomised Controlled Trials (RCTs) using a pre-defined protocol. Two independent reviewers searched information sources, decided eligibility of studies, and assessed risk of bias (RoB) of included trials. Data were extracted by one reviewer and checked by the other. A third reviewer mediated any disagreements throughout. Qualitative trial and RoB data were summarised descriptively. Quantitative syntheses were conducted across trials for comparable interventions, outcome measures and assessment points. Meta-analyses compared effect sizes with random effects, using STATA version 12. Data Sources PEDro, Medline, Embase, AMED, CINAHL, PsycINFO, and Cochrane Library with manual searching in key journals, reference lists, British National Bibliography for Report Literature, Center for International Rehabilitation Research Information & Exchange, and National Technical Information Service were searched from inception to 15th April 2015. Active researchers in the field were contacted to determine relevant studies. Eligibility Criteria for Selecting Studies RCTs evaluating acute (<4 weeks) WADII, any conservative intervention, with outcome measures important to the International Classification of Function, Disability and Health. Results Fifteen RCTs all assessed as high RoB (n=1676 participants) across 9 countries were included. Meta-analyses enabled 4 intervention comparisons: conservative versus standard/control, active versus passive, behavioural versus standard/control, and early versus late. Conservative intervention was more effective for pain reduction at 6 months (95%CI: -20.14 to -3.38) and 1-3 years (-25.44 to -3.19), and improvement in cervical mobility in the horizontal plane at <3 months (0.43 to 5.60) compared with standard/control intervention. Active intervention was effective for pain alleviation at 6 months (-17.19 to -3.23) and 1-3 years (-26.39 to -10.08) compared with passive intervention. Behavioural intervention was more effective than standard/control intervention for pain reduction at 6 months (-15.37 to -1.55), and improvement in cervical movement in the coronal (0.93 to 4.38) and horizontal planes at 3-6 months (0.43 to 5.46). For early (<4 days) versus late (>10 days) interventions, there were no statistically significant differences in all outcome measures between interventions at any time. Conclusions Conservative and active interventions may be useful for pain reduction in patients with acute WADII. Additionally, cervical horizontal mobility could be improved by conservative intervention. The employment of a behavioural intervention (e.g. act-as-usual, education and self-care including regularly exercise) could have benefits for pain reduction and improvement in cervical movement in the coronal and horizontal planes. The evidence was evaluated as low/very low level according to the Grading of Recommendations Assessment, Development and Evaluation system. PMID:26196127

Mechanics of evolutionary digit reduction in fossil horses (Equidae).

PubMed

McHorse, Brianna K; Biewener, Andrew A; Pierce, Stephanie E

2017-08-30

Digit reduction is a major trend that characterizes horse evolution, but its causes and consequences have rarely been quantitatively tested. Using beam analysis on fossilized centre metapodials, we tested how locomotor bone stresses changed with digit reduction and increasing body size across the horse lineage. Internal bone geometry was captured from 13 fossil horse genera that covered the breadth of the equid phylogeny and the spectrum of digit reduction and body sizes, from Hyracotherium to Equus To account for the load-bearing role of side digits, a novel, continuous measure of digit reduction was also established-toe reduction index (TRI). Our results show that without accounting for side digits, three-toed horses as late as Parahippus would have experienced physiologically untenable bone stresses. Conversely, when side digits are modelled as load-bearing, species at the base of the horse radiation through Equus probably maintained a similar safety factor to fracture stress. We conclude that the centre metapodial compensated for evolutionary digit reduction and body mass increases by becoming more resistant to bending through substantial positive allometry in internal geometry. These results lend support to two historical hypotheses: that increasing body mass selected for a single, robust metapodial rather than several smaller ones; and that, as horse limbs became elongated, the cost of inertia from the side toes outweighed their utility for stabilization or load-bearing. © 2017 The Author(s).

Coalitions to engineer the climate

NASA Astrophysics Data System (ADS)

Moreno-Cruz, J. B.; Ricke, K.; Caldeira, K.

2012-12-01

Solar geoengineering is the deliberate reduction of the amount of incoming solar radiation absorbed by Earth's climate system with the aim of reducing impacts of anthropogenic climate change. The international politics of solar geoengineering differ markedly from those of greenhouse-gas emissions reductions. A central question is who will decide whether and how much solar geoengineering will be deployed. It is unlikely that a single small actor could implement and sustain global-scale geoengineering that harms much of the world without intervention from harmed world powers. Thus, in practice, some minimum amount of aggregate power would be needed to successfully impose will upon the rest of the world. Here we formulate a series of games, calibrated with physical and economic models of climate change, to evaluate how international coalitions to implement geoengineering may form. In the scenarios examined, climate models are assumed to correctly predict the future and damage is parameterized in terms of regional temperature and precipitation changes only, and do not consider other, possibly formidable, risks. The coalitions set the "global thermostat" to maximize benefit to coalition members. As a result, non-members would be better off under a global optimum solution, but would be worse off with no geoengineering at all. Nonetheless, it appears unlikely that solar geoengineering could be implemented by actors who are perceived in advance to be harming the interests of a majority of the world's powers.; Comparison of results under a globally optimal versus >50% military-spending power coalition over 6 decades of solar geoengineering implementation. (a) shows how the amount of solar geoengineering (in units of stratospheric aerosol optical depth, AOD) implemented by a Power Proportionate Distribution coalition under a military-spending-weighted power scheme (dotted), compared to the amount that minimizes net global damages (thick grey) (the population and GDP-weighted results from Figure 2 in the Main Text shown in grey, solid and dashed); (b) shows how the coalition members (in green) and non-members (in red) reduce their damages from climate change using solar geoengineering compared to reductions at the global optimum (thick grey). (c) shows the regional membership of the winning coalition in each decade.

Foraging across the life span: is there a reduction in exploration with aging?

PubMed Central

Mata, Rui; Wilke, Andreas; Czienskowski, Uwe

2013-01-01

Does foraging change across the life span, and in particular, with aging? We report data from two foraging tasks used to investigate age differences in search in external environments as well as internal search in memory. Overall, the evidence suggests that foraging behavior may undergo significant changes across the life span across internal and external search. In particular, we find evidence of a trend toward reduced exploration with increased age. We discuss these findings in light of theories that postulate a link between aging and reductions in novelty seeking and exploratory behavior. PMID:23616741

Transmasseteric antero-parotid approach for open reduction and internal fixation of condylar fractures.

PubMed

Wilson, A W; Ethunandan, M; Brennan, P A

2005-02-01

The morbidity that results from surgical approaches to the condylar neck, and the time-consuming nature of the operation inhibits many surgeons from using open reduction and internal fixation for the treatment of condylar fractures. The many approaches that have been described stand testimony to the disadvantages of the individual techniques. The most common problems are limited access and injury to the facial nerve. We describe the transmasseteric antero-parotid (TMAP) technique, which offers swift access to the condylar neck while substantially reducing the risk to the facial nerve and eliminating the complications associated with transparotid approaches.

Comparison of the ilioinguinal approach and the anterior intrapelvic approaches for open reduction and internal fixation of the acetabulum.

PubMed

Archdeacon, Michael T

2015-02-01

The ilioinguinal and anterior intrapelvic approaches to the acetabulum often involve different strategies for the treatment of acetabular fractures. The ilioinguinal approach allows access to the entire internal iliac fossa and pelvic brim, including indirect access to the quadrilateral surface. In contrast, the anterior intrapelvic approach allows access to the anterior elements from inside the pelvis with the surgeon standing opposite the fracture pathology. Therefore, the goal of this article is to clarify the advantages and disadvantages for each approach with respect to exposure, reduction, and fixation.

FOURTH FORUM ON INNOVATIVE HAZARDOUS WASTE TREATMENT TECHNOLOGIES: DOMESTIC AND INTERNATIONAL - TECHNICAL PAPERS

EPA Science Inventory

On November 17-19, 1992, the U.S. Environmental Protection Agency's Technology Innovation Office and Risk Reduction Engineering Laboratory, Department of Energy, Corps of Engineers, and California Environmental Preotection Agency, hosted an International conference in San Francis...

Surgical treatment for pilon fracture of the ankle-open reduction and internal fixation.

PubMed

Chen, Y W; Huang, P J; Hsu, C Y; Kuo, C H; Cheng, Y M; Lin, S Y; Chen, L H; Chiang, H C

1998-01-01

From 1991 to 1994, 39 ankles of 38 patients underwent surgical open reduction and internal fixation for pilon fractures. These patients included 29 males and 9 females with an average age of 38.6 y/o (range 28 y/o-58 y/o). The follow up and evaluation period averaged 31.7 months (range 22Ms-44Ms), during which time a standing x-ray for arthrosis grading and functional scale was used for clinical evaluation. Complications included 1 case of infection, 1 case of loss reduction, 2 cases of partial skin necrosis and 2 cases of delayed union. Post-traumatic arthritis occurred in 23 ankles (59%) but only 4 ankles of grade 4 arthrosis resulted in poor functional scale and the overall satisfactory rate was 82%. It was found that anatomic reduction, rigid fixation and early motion exercise are important to successful treatment of ankle fractures. Regarding pilon fracture, specifically the severity of fracture pattern and delay of reduction are important problems to overcome to ensure successful results. Therefore, adequate surgical approach for entire view of ankle joint, reduction and fixation of fibula, sufficient bone graft for articular support, intraoperative x-ray check and postoperative immobilization are essential for the achievement of better clinical results.

A case-control study of surgical site infection following operative fixation of fractures of the ankle in a large U.K. trauma unit.

PubMed

Korim, M T; Payne, R; Bhatia, M

2014-05-01

Most of the literature on surgical site infections following the surgical treatment of fractures of the ankle is based on small series of patients, focusing on diabetics or the elderly. None have described post-operative functional scores in those patients who develop an infection. We performed an age- and gender-matched case-control study to identify patient- and surgery-related risk factors for surgical site infection following open reduction and internal fixation of a fracture of the ankle. Logistic regression analysis was used to identify significant risk factors for infection and to calculate odds ratios (OR). Function was assessed using the Olerud and Molander Ankle Score. The incidence of infection was 4% (29/717) and 1.1% (8/717) were deep infections. The median ankle score was significantly lower in the infection group compared with the control group (60 vs 90, Mann-Whitney test p < 0.0001). Multivariate regression analysis showed that diabetes (OR = 15, p = 0.031), nursing home residence (OR = 12, p = 0.018) and Weber C fractures (OR = 4, p = 0.048) were significant risk factors for infection. A low incidence of infection following open reduction and internal fixation of fractures of the ankle was observed. Both superficial and deep infections result in lower functional scores.

Radiographic Evaluation of Ankle Joint Stability After Calcaneofibular Ligament Elevation During Open Reduction and Internal Fixation of Calcaneus Fracture.

PubMed

Wang, Chien-Shun; Tzeng, Yun-Hsuan; Lin, Chun-Cheng; Huang, Ching-Kuei; Chang, Ming-Chau; Chiang, Chao-Ching

2016-09-01

The aim of this prospective study was to evaluate the influence of sectioning the calcaneofibular ligament (CFL) during an extensile lateral approach during open reduction and internal fixation (ORIF) of calcaneal fractures on ankle joint stability. Forty-two patients with calcaneal fractures that received ORIF were included. Talar tilt stress and anterior drawer radiographs were performed on the operative and contralateral ankles 6 months postoperatively. The average degree of talar tilt on stress radiographs was 3.4 degrees (range, 0-12 degrees) on the operative side and 3.2 degrees (range, 0-14 degrees) on the contralateral side. The mean anterior drawer on stress radiographs of the CFL incised ankle was 6.1 mm (range, 2.4-11.8 mm) and on the contralateral ankle was 5.7 mm (range, 2.6-8.6 mm). There was no statistically significant difference of talar tilt and anterior drawer between the CFL incised side and the contralateral side (P = .658 and .302, respectively). The results suggest that sectioning of the CFL without any repair during ORIF of a calcaneal fracture does not have a negative effect on stability of the ankle. Repair of the CFL is, thus, probably not necessary following extended lateral approach for ORIF of calcaneal fractures. Level II, comparative study. © The Author(s) 2016.

Mental health problems in college freshmen: Prevalence and academic functioning.

PubMed

Bruffaerts, Ronny; Mortier, Philippe; Kiekens, Glenn; Auerbach, Randy P; Cuijpers, Pim; Demyttenaere, Koen; Green, Jennifer G; Nock, Matthew K; Kessler, Ronald C

2018-01-01

Mental health problems in college and their associations with academic performance are not well understood. The main aim of this study was to investigate to what extent mental health problems are associated with academic functioning. As part of the World Mental Health Surveys International College Student project, 12-month mental health problems among freshmen (N = 4921) was assessed in an e-survey of students at KU Leuven University in Leuven, Belgium. The associations of mental health problems with academic functioning (expressed in terms of academic year percentage [or AYP] and grade point average [GPA]) were examined across academic departments. Approximately one in three freshman reports mental health problems in the past year, with internalizing and externalizing problems both associated with reduced academic functioning (2.9-4.7% AYP reduction, corresponding to 0.2-0.3 GPA reduction). The association of externalizing problems with individual-level academic functioning was significantly higher in academic departments with comparatively low average academic functioning. Limited sample size precluded further investigation of interactions between department-level and student-level variables. No information was available on freshman secondary school academic performance. Mental health problems are common in college freshman, and clearly associated with lower academic functioning. Additional research is needed to examine the potentially causal nature of this association, and, if so, whether interventions aimed at treating mental health problems might improve academic performance. Copyright © 2017 Elsevier B.V. All rights reserved.

Salmonella Enteritidis Deposition inside Eggs after Experimental Infection of Laying Hens with Different Oral Doses

USDA-ARS?s Scientific Manuscript database

The continuing attribution of human Salmonella Enteritidis infections to internally contaminated eggs has necessitated the commitment of substantial public and private resources to risk reduction and testing programs for commercial laying flocks. Cost-effective risk reduction requires a detailed und...

New concept of 3D printed bone clip (polylactic acid/hydroxyapatite/silk composite) for internal fixation of bone fractures.

PubMed

Yeon, Yeung Kyu; Park, Hae Sang; Lee, Jung Min; Lee, Ji Seung; Lee, Young Jin; Sultan, Md Tipu; Seo, Ye Bin; Lee, Ok Joo; Kim, Soon Hee; Park, Chan Hum

Open reduction with internal fixation is commonly used for the treatment of bone fractures. However, postoperative infection associated with internal fixation devices (intramedullary nails, plates, and screws) remains a significant complication, and it is technically difficult to fix multiple fragmented bony fractures using internal fixation devices. In addition, drilling in the bone to install devices can lead to secondary fracture, bone necrosis associated with postoperative infection. In this study, we developed bone clip type internal fixation device using three- dimensional (3D) printing technology. Standard 3D model of the bone clip was generated based on computed tomography (CT) scan of the femur in the rat. Polylacticacid (PLA), hydroxyapatite (HA), and silk were used for bone clip material. The purpose of this study was to characterize 3D printed PLA, PLA/HA, and PLA/HA/Silk composite bone clip and evaluate the feasibility of these bone clips as an internal fixation device. Based on the results, PLA/HA/Silk composite bone clip showed similar mechanical property, and superior biocompatibility compared to other types of the bone clip. PLA/HA/Silk composite bone clip demonstrated excellent alignment of the bony segments across the femur fracture site with well-positioned bone clip in an animal study. Our 3D printed bone clips have several advantages: (1) relatively noninvasive (drilling in the bone is not necessary), (2) patient-specific design (3) mechanically stable device, and (4) it provides high biocompatibility. Therefore, we suggest that our 3D printed PLA/HA/Silk composite bone clip is a possible internal fixation device.

Intracardiac impedance response during acute AF internal cardioversion using novel rectilinear and capacitor-discharge waveforms.

PubMed

Rababah, A S; Walsh, S J; Manoharan, G; Walsh, P R; Escalona, O J

2016-07-01

Intracardiac impedance (ICI) is a major determinant of success during internal cardioversion of atrial fibrillation (AF). However, there have been few studies that have examined the dynamic behaviour of atrial impedance during internal cardioversion in relation to clinical outcome. In this study, voltage and current waveforms captured during internal cardioversion of acute AF in ovine models using novel radiofrequency (RF) generated low-tilt rectilinear and conventional capacitor-discharge based shock waveforms were retrospectively analysed using a digital signal processing algorithm to investigate the dynamic behaviour of atrial impedance during cardioversion. The algorithm was specifically designed to facilitate the simultaneous analysis of multiple impedance parameters, including: mean intracardiac impedance (Z M), intracardiac impedance variance (ICIV) and impedance amplitude spectrum area (IAMSA) for each cardioversion event. A significant reduction in ICI was observed when comparing two successive shocks of increasing energy where cardioversion outcome was successful. In addition, ICIV and IAMSA variables were found to inversely correlate to the magnitude of energy delivered; with a stronger correlation found to the former parameter. In conclusion, ICIV and IAMSA have been evidenced as two key dynamic intracardiac impedance variables that may prove useful in better understanding of the cardioversion process and that could potentially act as prognostic markers with respect to clinical outcome.

Comparative anatomical study of internal brooding in three anascan bryozoans (Cheilostomata) and its taxonomic and evolutionary implications.

PubMed

Ostrovsky, Andrew N; Grischenko, Andrei V; Taylor, Paul D; Bock, Phil; Mawatari, Shunsuke F

2006-06-01

The anatomical structure of internal sacs for embryonic incubation was studied using SEM and light microscopy in three cheilostome bryozoans-Nematoflustra flagellata (Waters,1904), Gontarella sp., and Biflustra perfragilis MacGillivray, 1881. In all these species the brood sac is located in the distal half of the maternal (egg-producing) autozooid, being a conspicuous invagination of the body wall. It consists of the main chamber and a passage (neck) to the outside that opens independently of the introvert. There are several groups of muscles attached to the thin walls of the brood sac and possibly expanding it during oviposition and larval release. Polypide recycling begins after oviposition in Gontarella sp., and the new polypide bud is formed by the beginning of incubation. Similarly, polypides in brooding zooids degenerate in N. flagellata and, sometimes, in B. perfragilis. In the evolution of brood chambers in the Cheilostomata, such internal sacs for embryonic incubation are considered a final step, being the result of immersion of the brooding cavity into the maternal zooid and reduction of the protecting fold (ooecium). Possible reasons for this transformation are discussed, and the hypothesis of Santagata and Banta (Santagata and Banta1996) that internal brooding evolved prior to incubation in ovicells is rejected. J. Morphol. (c) 2006 Wiley-Liss, Inc.

Accelerated rehabilitation compared with a standard protocol after distal radial fractures treated with volar open reduction and internal fixation: a prospective, randomized, controlled study.

PubMed

Brehmer, Jess L; Husband, Jeffrey B

2014-10-01

There are relatively few studies in the literature that specifically evaluate accelerated rehabilitation protocols for distal radial fractures treated with open reduction and internal fixation (ORIF). The purpose of this study was to compare the early postoperative outcomes (at zero to twelve weeks postoperatively) of patients enrolled in an accelerated rehabilitation protocol with those of patients enrolled in a standard rehabilitation protocol following ORIF for a distal radial fracture. We hypothesized that patients with accelerated rehabilitation after volar ORIF for a distal radial fracture would have an earlier return to function compared with patients who followed a standard protocol. From November 2007 to November 2010, eighty-one patients with an unstable distal radial fracture were prospectively randomized to follow either an accelerated or a standard rehabilitation protocol after undergoing ORIF with a volar plate for a distal radial fracture. Both groups began with gentle active range of motion at three to five days postoperatively. At two weeks, the accelerated group initiated wrist/forearm passive range of motion and strengthening exercises, whereas the standard group initiated passive range of motion and strengthening at six weeks postoperatively. Patients were assessed at three to five days, two weeks, three weeks, four weeks, six weeks, eight weeks, twelve weeks, and six months postoperatively. Outcomes included Disabilities of the Arm, Shoulder and Hand (DASH) scores (primary outcome) and measurements of wrist flexion/extension, supination, pronation, grip strength, and palmar pinch. The patients in the accelerated group had better mobility, strength, and DASH scores at the early postoperative time points (zero to eight weeks postoperatively) compared with the patients in the standard rehabilitation group. The difference between the groups was both clinically relevant and statistically significant. Patients who follow an accelerated rehabilitation protocol that emphasizes motion immediately postoperatively and initiates strengthening at two weeks after volar ORIF of a distal radial fracture have an earlier return to function than patients who follow a more standard rehabilitation protocol. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Does the use of orthoses improve self-reported pain and function measures in patients with plantar fasciitis? A meta-analysis.

PubMed

Lee, Sae Yong; McKeon, Patrick; Hertel, Jay

2009-02-01

To perform a meta-analysis examining the effects of foot orthoses on self-reported pain and function in patients with plantar fasciitis. MEDLINE, SPORTDiscus, and CINAHL were searched from their inception until December 2007 using the terms "foot", "plantar fascia", "arch", "orthotic", "orthoses" and "plantar fasciitis". Original research studies which met these criteria were included: (1) randomised controlled trials or prospective cohort designs, (2) the patients had to be suffering from plantar fasciitis at the time of recruitment, (3) evaluated the efficacy of foot orthoses with self-reported pain and/or function, (4) means, standard deviations, and sample size of each group had to be reported. We utilised the Roos, Engstrom, and Soderberg (Roos, E., Engstrom, M., & Soderberg, B. (2006). Foot orthoses for the treatment of plantar fasciitis. Foot and Ankle International, 8, 606-611) night splint condition to compare our pooled orthoses results. The meta-analysis results showed significant reductions in pain after orthotic intervention. The Roos et al.' (Roos, E., Engstrom, M., & Soderberg, B. (2006). Foot orthoses for the treatment of plantar fasciitis. Foot and Ankle International, 8, 606-611) study also showed significant reduction in pain after night splint treatment. The meta-analysis results also showed significant increases in function after orthotic use. In contrast, the Roos et al.' (Roos, E., Engstrom, M., & Soderberg, B. (2006). Foot orthoses for the treatment of plantar fasciitis. Foot and Ankle International, 8, 606-611) study did not show a significant increase in function after night splinting for 12 weeks. The use of foot orthoses in patients with plantar fasciitis appears to be associated with reduced pain and increased function.

Four-dimensional MRI using an internal respiratory surrogate derived by dimensionality reduction

NASA Astrophysics Data System (ADS)

Uh, Jinsoo; Ayaz Khan, M.; Hua, Chiaho

2016-11-01

This study aimed to develop a practical and accurate 4-dimensional (4D) magnetic resonance imaging (MRI) method using a non-navigator, image-based internal respiratory surrogate derived by dimensionality reduction (DR). The use of DR has been previously suggested but not implemented for reconstructing 4D MRI, despite its practical advantages. We compared multiple image-acquisition schemes and refined a retrospective-sorting process to optimally implement a DR-derived surrogate. The comparison included an unconventional scheme that acquires paired slices alternately to mitigate the internal surrogate’s dependency on a specific slice location. We introduced ‘target-oriented sorting’, as opposed to conventional binning, to quantify the coherence in retrospectively sorted images, thereby determining the minimal scan time needed for sufficient coherence. This study focused on evaluating the proposed method using digital phantoms which provided unequivocal gold standard. The evaluation indicated that the DR-based respiratory surrogate is highly accurate: the error in amplitude percentile of the surrogate signal was less than 5% with the optimal scheme. Acquiring alternating paired slices was superior to the conventional scheme of acquiring individual slices; the advantage of the unconventional scheme was more pronounced when a substantial phase shift occurred across slice locations. The analysis of coherence across sorted images confirmed the advantage of higher sampling efficiencies in non-navigator respiratory surrogates. We determined that a scan time of 20 s per imaging slice was sufficient to achieve a mean coherence error of less than 1% for the tested respiratory patterns. The clinical applicability of the proposed 4D MRI has been demonstrated with volunteers and patients. The diaphragm motion in 4D MRI was consistent with that in dynamic 2D imaging which was regarded as the gold standard (difference within 1.8 mm on average).

Neglected Posterior Dislocation of Hip in Children - A Case Report.

PubMed

Pal, Chandra Prakash; Kumar, Deepak; Sadana, Ashwani; Dinkar, Karuna Shankar

2014-01-01

Traumatic dislocation of the hip in children is a rare injury. We report the outcome of 2 patients of neglected hip dislocation which were treated by open reduction and internal fixation by k-wires. We treat 2 children both girls (one was of 4 years and other was 7 years of age). In both cases dislocation was unilateral and was not associated with any facture. Both cases were of posterior dislocation. in both cases open reduction and internal fixation was done by k wires. Hip spica was applied post operatively in both cases. The k wire was removed at 3 to 4 weeks. Patients were allowed to bear weight from gradual to full weight bearing after 6 weeks. We conclude that open reduction is a satisfactory treatment for neglected hip dislocation. It prevents not only deformity but also maintains limb length.

Sexual behavior in pregnancy: comparing between sexual education group and nonsexual education group.

PubMed

Wannakosit, Salakjit; Phupong, Vorapong

2010-10-01

Sexuality usually decreases during pregnancy. To evaluate sexual behavior during pregnancy, comparing two groups. One had sexual education and the other had none. After randomizing two groups of pregnant women, they completed self-administered questionnaires regarding attitudes and sexual behavior before and during pregnancy. Sexual education was provided in one group and a second self-administered questionnaire was completed 12 weeks later. Responses were summarized using descriptive statistics. Comparison of change of sexual behavior between two groups was analyzed using chi-square and student t-tests. The change in frequency of coitus during pregnancy was compared between the sexual education group and the noneducation group. There was no statistically difference in changes of sexual behavior between the two groups. There was a reduction in frequency of coitus (90.6% vs. 94.9%, P>0.05) between the nonsexual education group and the sexual education group and no statistically significant change in mean reduction of sexual desire (8.9 vs. 4.4, P>0.05), sexual arousal (14.3 vs. 13.1, P>0.05), satisfaction from coitus (15.4 vs. 7.2, P>0.05), and orgasm from coitus (12.3 vs. 12.3, P>0.05). The change of sexual behavior during pregnancy in the sexual education group was not different from that in the nonsexual education group. © 2010 International Society for Sexual Medicine.

Fabrication of cylindrical superhydrophobic microchannels by replicating lotus leaf structures on internal walls

NASA Astrophysics Data System (ADS)

Das, Ajit; Bhaumik, Soubhik Kumar

2018-04-01

Cylindrical superhydrophobic microchannels are fabricated by replicating lotus leaf structures on internal walls. The fabrication process comprises of three steps: the creation of a cylindrical mold of a glass rod (125 µm) with polystyrene films bearing negative imprints of lotus leaf (superhydrophobic) structures; casting polydimethylsiloxane (PDMS, Sylgard 184) over the mold; and solvent-assisted pulling off of the glass rod to leave a positive replica on the inner wall of the PDMS cast. The last crucial step is achieved through selective dissolution of the intermediate negative replica layer in the cylindrical mold without any swelling effect. The high fidelity of the replication process is confirmed through scanning electron microscope (SEM) imaging. The attained superhydrophobicity is assessed by comparing the dynamics of the advancing meniscus in the fabricated microchannels with that over a similarly fabricated smooth microchannel. Contact angle studies of the meniscus reveal a lower capillary effect and drag force experienced by the superhydrophobic microchannel compared to smooth ones. Studies based on velocity lead to a prediction of a drag reduction of 35%. A new avenue is thus opened up for microfabrication and flow analysis of closed superhydrophobic (SH) conduits in lab on chip and microfluidic applications.

ILM peeling in nontractional diabetic macular edema: review and metanalysis.

PubMed

Rinaldi, M; dell'Omo, R; Morescalchi, F; Semeraro, F; Gambicorti, E; Cacciatore, F; Chiosi, F; Costagliola, C

2017-10-31

To evaluate the effect of internal limiting membrane (ILM) peeling during vitrectomy for nontractional diabetic macular edema. PUBMED, MEDLINE and CENTRAL were reviewed using the following terms (or combination of terms): diabetic macular edema, nontractional diabetic macular edema, internal limiting membrane peeling, vitrectomy, Müller cells. Randomized and nonrandomized studies were included. The eligible studies compared anatomical and functional outcomes of vitrectomy with or without ILM peeling for tractional and nontractional diabetic macular edema. Postoperative best-corrected visual acuity and central macular thickness were considered, respectively, the primary and secondary outcomes. Meta-analysis on mean differences between vitrectomy with and without ILM peeling was performed using inverse variance method in random effects. Four studies with 672 patients were eligible for analysis. No significant difference was found between postoperative best-corrected visual acuity or best-corrected visual acuity change of ILM peeling group compared with nonpeeling group. There was no significant difference in postoperative central macular thickness and central macular thickness reduction between the two groups. The visual acuity outcomes in patients affected by nontractional diabetic macular edema using pars plana vitrectomy with ILM peeling versus no ILM peeling were not significantly different. A larger prospective and randomized study would be necessary.

Protection by Isoprene against Singlet Oxygen in Leaves

PubMed Central

Affek, Hagit P.; Yakir, Dan

2002-01-01

Isoprene (2-methyl-1,3-butadiene) protection against effects of singlet oxygen was investigated in Myrtus communis and Rhamnus alaternus. In M. communis, singlet oxygen produced in the leaves by Rose Bengal (RB) led to a 65% decrease in net assimilation rates within 3 h, whereas isoprene emission rates showed either a 30% decrease at ambient CO2 concentrations or a 70% increase under high CO2. In both cases, these changes led to an increase in calculated internal isoprene concentrations. The isoprene protection effect was directly demonstrated by fumigation of young (non-emitting) leaves, treated with RB or bromoxynil (simulating photoinhibition). There was 42% and 29% reduction in the damage to net assimilation compared with non-fumigated leaves for RB or bromoxynil, respectively. In R. alaternus, similar effects of RB on net assimilation were observed, and additional fluorescence measurements showed a significantly smaller decrease in Fv/Fm in isoprene-fumigated young leaves treated with RB (from 0.78 to 0.52), compared with non-fumigated leaves (from 0.77 to 0.27). The internal isoprene concentrations used in this study and possible rate of 1O2 production in leaves indicate that the protective effects observed should be beneficial also under natural conditions. PMID:12011357

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

PubMed

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

2017-01-25

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

Well-to-wheels analysis of fast pyrolysis pathways with the GREET model.

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

Han, J.; Elgowainy, A.; Palou-Rivera, I.

The pyrolysis of biomass can help produce liquid transportation fuels with properties similar to those of petroleum gasoline and diesel fuel. Argonne National Laboratory conducted a life-cycle (i.e., well-to-wheels [WTW]) analysis of various pyrolysis pathways by expanding and employing the Greenhouse Gases, Regulated Emissions, and Energy Use in Transportation (GREET) model. The WTW energy use and greenhouse gas (GHG) emissions from the pyrolysis pathways were compared with those from the baseline petroleum gasoline and diesel pathways. Various pyrolysis pathway scenarios with a wide variety of possible hydrogen sources, liquid fuel yields, and co-product application and treatment methods were considered. Atmore » one extreme, when hydrogen is produced from natural gas and when bio-char is used for process energy needs, the pyrolysis-based liquid fuel yield is high (32% of the dry mass of biomass input). The reductions in WTW fossil energy use and GHG emissions relative to those that occur when baseline petroleum fuels are used, however, is modest, at 50% and 51%, respectively, on a per unit of fuel energy basis. At the other extreme, when hydrogen is produced internally via reforming of pyrolysis oil and when bio-char is sequestered in soil applications, the pyrolysis-based liquid fuel yield is low (15% of the dry mass of biomass input), but the reductions in WTW fossil energy use and GHG emissions are large, at 79% and 96%, respectively, relative to those that occur when baseline petroleum fuels are used. The petroleum energy use in all scenarios was restricted to biomass collection and transportation activities, which resulted in a reduction in WTW petroleum energy use of 92-95% relative to that found when baseline petroleum fuels are used. Internal hydrogen production (i.e., via reforming of pyrolysis oil) significantly reduces fossil fuel use and GHG emissions because the hydrogen from fuel gas or pyrolysis oil (renewable sources) displaces that from fossil fuel natural gas and the amount of fossil natural gas used for hydrogen production is reduced; however, internal hydrogen production also reduces the potential petroleum energy savings (per unit of biomass input basis) because the fuel yield declines dramatically. Typically, a process that has a greater liquid fuel yield results in larger petroleum savings per unit of biomass input but a smaller reduction in life-cycle GHG emissions. Sequestration of the large amount of bio-char co-product (e.g., in soil applications) provides a significant carbon dioxide credit, while electricity generation from bio-char combustion provides a large energy credit. The WTW energy and GHG emissions benefits observed when a pyrolysis oil refinery was integrated with a pyrolysis reactor were small when compared with those that occur when pyrolysis oil is distributed to a distant refinery, since the activities associated with transporting the oil between the pyrolysis reactors and refineries have a smaller energy and emissions footprint than do other activities in the pyrolysis pathway.« less

Advanced Rotorcraft Transmission (ART) program

NASA Technical Reports Server (NTRS)

Heath, Gregory F.; Bossler, Robert B., Jr.

1993-01-01

Work performed by the McDonnell Douglas Helicopter Company and Lucas Western, Inc. within the U.S. Army/NASA Advanced Rotorcraft Transmission (ART) Program is summarized. The design of a 5000 horsepower transmission for a next generation advanced attack helicopter is described. Government goals for the program were to define technology and detail design the ART to meet, as a minimum, a weight reduction of 25 percent, an internal noise reduction of 10 dB plus a mean-time-between-removal (MTBR) of 5000 hours compared to a state-of-the-art baseline transmission. The split-torque transmission developed using face gears achieved a 40 percent weight reduction, a 9.6 dB noise reduction and a 5270 hour MTBR in meeting or exceeding the above goals. Aircraft mission performance and cost improvements resulting from installation of the ART would include a 17 to 22 percent improvement in loss-exchange ratio during combat, a 22 percent improvement in mean-time-between-failure, a transmission acquisition cost savings of 23 percent of $165K, per unit, and an average transmission direct operating cost savings of 33 percent, or $24K per flight hour. Face gear tests performed successfully at NASA Lewis are summarized. Also, program results of advanced material tooth scoring tests, single tooth bending tests, Charpy impact energy tests, compact tension fracture toughness tests and tensile strength tests are summarized.

Decreased rates of shoulder dystocia and brachial plexus injury via an evidence-based practice bundle.

PubMed

Sienas, Laura E; Hedriana, Herman L; Wiesner, Suzanne; Pelletreau, Barbara; Wilson, Machelle D; Shields, Laurence E

2017-02-01

To evaluate whether a standardized approach to identify pregnant women at risk for shoulder dystocia (SD) is associated with reduced incidence of SD and brachial plexus injury (BPI). Between 2011 and 2015, prospective data were collected from 29 community-based hospitals in the USA during implementation of an evidence-based practice bundle, including an admission risk assessment, required "timeout" before operative vaginal delivery (OVD), and low-fidelity SD drills. All women with singleton vertex pregnancies admitted for vaginal delivery were included. Rates of SD, BPI, OVD, and cesarean delivery were compared between a baseline period (January 2011-September 2013) and an intervention period (October 2013-June 2015), during which there was a system-wide average bundle compliance of 90%. There was a significant reduction in the incidence of SD (17.6%; P=0.028), BPI (28.6%; P=0.018), and OVD (18.0%; P<0.001) after implementation of the evidence-based practice bundle. There was a nonsignificant reduction in primary (P=0.823) and total (P=0.396) cesarean rates, but no association between SD drills and incidence of BPI. Implementation of a standard evidence-based practice bundle was found to be associated with a significant reduction in the incidence of SD and BPI. Utilization of low-fidelity drills was not associated with a reduction in BPI. © 2016 International Federation of Gynecology and Obstetrics.

Decarbonizing the international shipping industry: Solutions and policy recommendations.

PubMed

Wan, Zheng; El Makhloufi, Abdel; Chen, Yang; Tang, Jiayuan

2018-01-01

Ship-source greenhouse gas (GHG) emissions could increase by up to 250% by 2050 from their 2012 levels, owing to increasing global freight volumes. Binding international legal agreements to regulate GHGs, however, are lacking as technical solutions remain expensive, and crucial industrial support is absent. In 2003, the International Maritime Organization adopted Resolution A.963 (23) to regulate shipping CO 2 emissions via technical, operational, and market-based routes. However, progress has been slow and uncertain; there is no concrete emission reduction target or definitive action plan. Yet, a full-fledged roadmap may not even emerge until 2023. In this policy analysis, we revisit the progress of technical, operational, and market-based routes and the associated controversies. We argue that 1) a performance-based index, though good-intentioned, has loopholes affecting meaningful CO 2 emission reductions driven by technical advancements; 2) using slow steaming to cut energy consumption stands out among all operational solutions thanks to its immediate and obvious results, but with the already slow speed in practice, this single source has limited emission reduction potential; 3) without a technology-savvy shipping industry, a market-based approach is essentially needed to address the environmental impact. To give shipping a 50:50 chance for contributing fairly and proportionately to keep global warming below 2°C, deep emission reductions should occur soon. Copyright © 2017 Elsevier Ltd. All rights reserved.

Recurrence rate and need for reoperation after surgery with or without internal limiting membrane removal for the treatment of the epiretinal membrane.

PubMed

De Novelli, Fernando José; Goldbaum, Mauro; Monteiro, Mario Luiz Ribeiro; Aggio, Fabio Bom; Nóbrega, Mario Junqueira; Takahashi, Walter Yukihiko

2017-01-01

To compare the recurrence rate and need for reoperation after epiretinal membrane surgery with and without removal of the internal limiting membrane. In this retrospective study, 125 patients operated for epiretinal membrane removal were evaluated, with a minimum 6-month follow-up. Removal of the epiretinal membrane (ERM) was performed in 78 patients, while 47 had removal of the epiretinal membrane associated with internal limiting membrane peeling (ERM + ILM). The mean age in the ERM group was 65.8 years old, ranging from 41 to 80 years old. In the ERM + ILM group, the mean age was 67.2 years old, ranging from 52 to 82 years old. The mean preoperative visual acuity in the ERM group was 20/80p, and in the ERM + ILM group, it was 20/80. The mean postoperative visual acuity in both groups was 20/30. The mean preoperative macular thickness in the ERM group was 467 µm ranging from 281 to 663 µm; in the ERM + ILM group, the preoperative macular thickness was 497 µm, ranging from 172 to 798 µm. After surgery, a reduction in macular thickness was observed in both groups. In the ERM group, the mean macular thickness reduction was 361 ± 101. µm, whereas in the ERM + ILM group, it was 367 ± 75.2 µm. Twenty-two patients presented with a recurrence of epiretinal membrane, of which 16 (20.5%) were from the ERM group and 6 (12.8%) were from the ERM + ILM group (p = 0.39); one patient (2%) was retreated in the ERM + ILM group, whereas 5 patients (6%) where retreated in the ERM group. We postulate that ILM peeling for the treatment of epiretinal membrane is not a relevant factor either for visual recovery or macular thickness reduction, but it may reduce the recurrence and reoperation rate.

Understanding the emergence of the tobacco industry's use of the term tobacco harm reduction in order to inform public health policy

PubMed Central

Peeters, Silvy; Gilmore, Anna B

2015-01-01

Objectives To explore the history of transnational tobacco companies’ use of the term, approach to and perceived benefits of ‘harm reduction’. Methods Analysis of internal tobacco industry documents, contemporary tobacco industry literature and 6 semistructured interviews. Results The 2001 Institute of Medicine report on tobacco harm reduction appears to have been pivotal in shaping industry discourse. Documents suggest British American Tobacco and Philip Morris International adopted the term ‘harm reduction’ from Institute of Medicine, then proceeded to heavily emphasise the term in their corporate messaging. Documents and interviews suggest harm reduction offered the tobacco industry two main benefits: an opportunity to (re-) establish dialogue with and access to policy makers, scientists and public health groups and to secure reputational benefits via an emerging corporate social responsibility agenda. Conclusions Transnational tobacco companies’ harm reduction discourse should be seen as opportunistic tactical adaptation to policy change rather than a genuine commitment to harm reduction. Care should be taken that this does not undermine gains hitherto secured in efforts to reduce the ability of the tobacco industry to inappropriately influence policy. PMID:24457543

Reducing youth internalizing symptoms: Effects of a family-based preventive intervention on parental guilt induction and youth cognitive style

PubMed Central

McKEE, LAURA G.; PARENT, JUSTIN; FOREHAND, REX; RAKOW, AARON; WATSON, KELLY H.; DUNBAR, JENNIFER P.; REISING, MICHELLE M.; HARDCASTLE, EMILY; COMPAS, BRUCE E.

2014-01-01

This study utilized structural equation modeling to examine the associations among parental guilt induction (a form of psychological control), youth cognitive style, and youth internalizing symptoms, with parents and youth participating in a randomized controlled trial of a family-based group cognitive–behavioral preventive intervention targeting families with a history of caregiver depression. The authors present separate models utilizing parent report and youth report of internalizing symptoms. Findings suggest that families in the active condition (family-based group cognitive–behavioral group) relative to the comparison condition showed a significant decline in parent use of guilt induction at the conclusion of the intervention (6 months postbaseline). Furthermore, reductions in parental guilt induction at 6 months were associated with significantly lower levels of youth negative cognitive style at 12 months. Finally, reductions in parental use of guilt induction were associated with lower youth internalizing symptoms 1 year following the conclusion of the intervention (18 months postbaseline). PMID:24438999

[Epidemiologic reasons for screening programs in the national health service].

PubMed

Ottó, Szabolcs

2003-11-30

The author describes the current health state of the Hungarian population in terms of cancer mortality and morbidity. Based on the comparative analysis of national and international, mainly European, data he describes the unfavourable Hungarian indices trying to identify their causes and the possible breaking free from them, as well. The greatest potential lies in the organised, continuous screenings within the frame of "Johan Béla National Programme of the Decade of Health". Since tumour diseases pose severe and alarming problems in national health care the reduction of extremely high mortality in three tumour localisation (cervix uteri, breast and colorectum) by regular screenings is absolutely justified.

37 CFR 1.704 - Reduction of period of adjustment of patent term.

Code of Federal Regulations, 2013 CFR

2013-07-01

... TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES Adjustment and Extension... patent office in a counterpart foreign or international application or from the Office, and this... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Reduction of period of...

Children with Disabilities in Disability-Inclusive Disaster Risk Reduction: Focussing on School Settings

ERIC Educational Resources Information Center

Ronoh, Steve; Gaillard, J. C.; Marlowe, Jay

2017-01-01

Every year, worldwide, disasters affect approximately seven million children with disabilities, highlighting their potential vulnerability. Although there is a growing move internationally to promote the rights of children with disabilities, they still receive little attention from disaster risk reduction (DRR) researchers and policy makers. They…

Disaster Management through Experiential Learning

ERIC Educational Resources Information Center

Rijumol, K. C.; Thangarajathi, S.; Ananthasayanam, R.

2010-01-01

Disasters can strike at any time, at any place. The world is becoming increasingly vulnerable to natural disasters. From earthquakes to floods and famines, mankind is even more threatened by the forces of nature. The Theme of the 2006 to 2007 International Day for Disaster Reduction was "Disaster Risk Reduction begins at schools" and…

The Relationship of Cultural Similarity, Communication Effectiveness and Uncertainty Reduction.

ERIC Educational Resources Information Center

Koester, Jolene; Olebe, Margaret

To investigate the relationship of cultural similarity/dissimilarity, communication effectiveness, and communication variables associated with uncertainty reduction theory, a study examined two groups of students--a multinational group living on an "international floor" in a dormitory at a state university and an unrelated group of U.S.…

Scapular Resting Position and Gleno-Humeral Movement Dysfunction in Asymptomatic Racquet Players: A Case-Control Study

PubMed Central

Shimpi, Apurv P.; Bhakti, Shah; Roshni, Karnik; Rairikar, Savita A.; Shyam, Ashok; Sancheti, Parag K.

2015-01-01

Background: Racquet sports, especially lawn tennis and badminton have been gaining popularity in Asian countries like India. With this increase in popularity, the injury rate in the sport has also increased. Objectives: The study will help detect the presence of gleno-humeral movement dysfunction and scapular resting position abnormality in asymptomatic racquet players, thus providing basis for screening the players and allow the clinician to determine if the asymmetry is a normal adaptation in the player or an abnormal change associated with injury. Materials and Methods: 46 asymptomatic professional players were divided into a study group of 23 players (16 tennis and 7 badminton) and control group of 23 football players. Assessment of passive gleno-humeral range of motion and distance of spine and inferior angle of scapula from corresponding spinous process were measured bilaterally and between groups. Results: There was statistically significant reduction in range of internal rotation (62.17 ± 8.09), extension (39.78 ± 4.12) and an increase in the external rotation (106.95 ± 7.49) of dominant compared to non-dominant arm of racquet players and a statistically significant decrease in internal rotation (78.69 ± 10.24), extension (44.78 ± 3.19), adduction (37.39 ± 6.54) and an increase in external rotation (102.6 ± 5.19) of dominant arm of racquet players compared to football players. Study also showed statistically significant increase in the spino-scapular distance at the level of inferior angle of scapula (10.23 ± 1.43) on dominant side compared to non-dominant. Conclusions: The dominant side scapula of asymptomatic racquet players showed increased external rotation and elevation as compared to the non-dominant side. Also, reduced shoulder internal rotation, extension and adduction and gain in shoulder external rotation was observed on the dominant side of racquet players when compared to the control group. PMID:26715968

Scapular Resting Position and Gleno-Humeral Movement Dysfunction in Asymptomatic Racquet Players: A Case-Control Study.

PubMed

Shimpi, Apurv P; Bhakti, Shah; Roshni, Karnik; Rairikar, Savita A; Shyam, Ashok; Sancheti, Parag K

2015-12-01

Racquet sports, especially lawn tennis and badminton have been gaining popularity in Asian countries like India. With this increase in popularity, the injury rate in the sport has also increased. The study will help detect the presence of gleno-humeral movement dysfunction and scapular resting position abnormality in asymptomatic racquet players, thus providing basis for screening the players and allow the clinician to determine if the asymmetry is a normal adaptation in the player or an abnormal change associated with injury. 46 asymptomatic professional players were divided into a study group of 23 players (16 tennis and 7 badminton) and control group of 23 football players. Assessment of passive gleno-humeral range of motion and distance of spine and inferior angle of scapula from corresponding spinous process were measured bilaterally and between groups. There was statistically significant reduction in range of internal rotation (62.17 ± 8.09), extension (39.78 ± 4.12) and an increase in the external rotation (106.95 ± 7.49) of dominant compared to non-dominant arm of racquet players and a statistically significant decrease in internal rotation (78.69 ± 10.24), extension (44.78 ± 3.19), adduction (37.39 ± 6.54) and an increase in external rotation (102.6 ± 5.19) of dominant arm of racquet players compared to football players. Study also showed statistically significant increase in the spino-scapular distance at the level of inferior angle of scapula (10.23 ± 1.43) on dominant side compared to non-dominant. The dominant side scapula of asymptomatic racquet players showed increased external rotation and elevation as compared to the non-dominant side. Also, reduced shoulder internal rotation, extension and adduction and gain in shoulder external rotation was observed on the dominant side of racquet players when compared to the control group.

Radiative Effects of Atmospheric Aerosols and Impacts on Solar Photovoltaic Electricity Generation

NASA Astrophysics Data System (ADS)

Lund, Cory Christopher

Atmospheric aerosols, by scattering and absorbing radiation, perturbs the Earth's energy balance and reduces the amount of insolation reaching the surface. This dissertation first studies the radiative effects of aerosols by analyzing the internal mixing of various aerosol species. It then examines the aerosol impact on solar PV efficiency and the resulting influence on power systems, including both atmospheric aerosols and deposition of particulate matter (PM) on PV surfaces,. Chapter 2 studies the radiative effects of black carbon (BC), sulfate and organic carbon (OC) internal mixing using a simple radiative transfer model. I find that internal mixing may not result in a positive radiative forcing compared to external mixing, but blocks additional shortwave radiation from the surface, enhancing the surface dimming effect. Chapter 3 estimates the impact of atmospheric aerosol attenuation on solar PV resources in China using a PV performance model with satellite-derived long-term surface irradiance data. I find that, in Eastern China, annual average reductions of solar resources due to aerosols are more than 20%, with comparable impacts to clouds in winter. Improving air quality in China would increase efficiency of solar PV generation. As a positive feedback, increased PV efficiency and deployment would further reduce air pollutant emissions too. Chapter 4 further quantifies the total aerosol impact on PV efficiency globally, including both atmospheric aerosols and the deposition of PM on PV surfaces. I find that, if panels are uncleaned and soiling is only removed by precipitation, deposition of PM accounts for more than two-thirds of the total aerosol impact in most regions. Cleaning the panels, even every few months, would largely increase PV efficiency in resource-abundant regions. Chapter 5 takes a further step to evaluate the impact of PV generation reduction due to aerosols on a projected 2030 power system in China with 400GW of PV. I find that aerosols reduce PV generation by 22% and increase baseload power generation, with almost no additional capacity needed. Due to intermittency of solar generation, 160 GW of backup power is needed to maintain grid stability. However, storage provides an opportunity to reduce the backup power capacity by 66%.

Nox reduction system utilizing pulsed hydrocarbon injection

DOEpatents

Brusasco, Raymond M.; Penetrante, Bernardino M.; Vogtlin, George E.; Merritt, Bernard T.

2001-01-01

Hydrocarbon co-reductants, such as diesel fuel, are added by pulsed injection to internal combustion engine exhaust to reduce exhaust NO.sub.x to N.sub.2 in the presence of a catalyst. Exhaust NO.sub.x reduction of at least 50% in the emissions is achieved with the addition of less than 5% fuel as a source of the hydrocarbon co-reductants. By means of pulsing the hydrocarbon flow, the amount of pulsed hydrocarbon vapor (itself a pollutant) can be minimized relative to the amount of NO.sub.x species removed.

[Economic efficiency of renal denervation in patients with resistant hypertension: results of Markov modeling].

PubMed

Kontsevaia, A V; Suvorova, E I; Khudiakov, M B

2014-01-01

Aim of this study was to evaluate the cost-effectiveness of renal denervation (RD) in resistant arterial hypertension (AH) in Russia. Modeling of Markov conducted economic impact of RD on the Russian population of patients with resistant hypertension in combination with optimal medical therapy (OMT) compared with OMT using a model developed by American researchers based on the results of international research. The model contains data on Russian mortality, and costs of major complications of hypertension. The simulation results showed a significant reduction in relative risk reduction of adverse outcomes in patients with resistant hypertension for 10 years (risk of stroke is reduced by 30%, myocardial infarction - 32%). RD saves 0.9 years of quality-adjusted life (QALY) by an average of 1 patient with resistant hypertension. Costs for 1 year stored in the application of quality of life amounted to RD 203 791.6 rubles. Which is below the 1 gross domestic product and therefore indicates the feasibility of this method in Russia.

Some advanced parametric methods for assessing waveform distortion in a smart grid with renewable generation

NASA Astrophysics Data System (ADS)

Alfieri, Luisa

2015-12-01

Power quality (PQ) disturbances are becoming an important issue in smart grids (SGs) due to the significant economic consequences that they can generate on sensible loads. However, SGs include several distributed energy resources (DERs) that can be interconnected to the grid with static converters, which lead to a reduction of the PQ levels. Among DERs, wind turbines and photovoltaic systems are expected to be used extensively due to the forecasted reduction in investment costs and other economic incentives. These systems can introduce significant time-varying voltage and current waveform distortions that require advanced spectral analysis methods to be used. This paper provides an application of advanced parametric methods for assessing waveform distortions in SGs with dispersed generation. In particular, the Standard International Electrotechnical Committee (IEC) method, some parametric methods (such as Prony and Estimation of Signal Parameters by Rotational Invariance Technique (ESPRIT)), and some hybrid methods are critically compared on the basis of their accuracy and the computational effort required.

Conceptual design study of advanced acoustic-composite nacelles

NASA Technical Reports Server (NTRS)

Nordstrom, K. E.; Marsh, A. H.; Sargisson, D. F.

1975-01-01

Conceptual studies were conducted to assess the impact of incorporating advanced technologies in the nacelles of a current wide-bodied transport and an advanced technology transport. The improvement possible in the areas of fuel consumption, flyover noise levels, airplane weight, manufacturing costs, and airplane operating cost were evaluated for short and long-duct nacelles. Use of composite structures for acoustic duct linings in the fan inlet and exhaust ducts was considered as well as for other nacelle components. For the wide-bodied transport, the use of a long-duct nacelle with an internal mixer nozzle in the primary exhaust showed significant improvement in installed specific fuel consumption and airplane direct operating costs compared to the current short-duct nacelle. The long-duct mixed-flow nacelle is expected to achieve significant reductions in jet noise during takeoff and in turbo-machinery noise during landing approach. Recommendations were made of the technology development needed to achieve the potential fuel conservation and noise reduction benefits.

Experimental analysis of refrigerants flow boiling inside small sized microfin tubes

NASA Astrophysics Data System (ADS)

Diani, Andrea; Rossetto, Luisa

2017-07-01

The refrigerant charge reduction is one of the most challenging issues that the scientific community has to cope to reduce the anthropic global warming. Recently, mini microfin tubes have been matter of research, since they can reach better thermal performance in small domains, leading to a further refrigerant charge reduction. This paper presents experimental results about R134a flow boiling inside a microfin tube having an internal diameter at the fin tip of 2.4 mm. The mass flux was varied between 375 and 940 kg m-2 s-1, heat flux from 10 to 50 kW m-2, vapor quality from 0.10 to 0.99. The saturation temperature at the inlet of the test section was kept constant and equal to 30 °C. R134a thermal and fluid dynamic performances are presented and compared against those obtained with R1234ze(E) and R1234yf and against values obtained during R134a flow boiling inside a 3.4 mm ID microfin tube.

Simultaneous multislice diffusion-weighted MRI of the liver: Analysis of different breathing schemes in comparison to standard sequences.

PubMed

Taron, Jana; Martirosian, Petros; Erb, Michael; Kuestner, Thomas; Schwenzer, Nina F; Schmidt, Holger; Honndorf, Valerie S; Weiβ, Jakob; Notohamiprodjo, Mike; Nikolaou, Konstantin; Schraml, Christina

2016-10-01

To systematically evaluate image characteristics of simultaneous-multislice (SMS)-accelerated diffusion-weighted imaging (DWI) of the liver using different breathing schemes in comparison to standard sequences. DWI of the liver was performed in 10 healthy volunteers and 12 patients at 1.5T using an SMS-accelerated echo planar imaging sequence performed with respiratory-triggering and free breathing (SMS-RT, SMS-FB). Standard DWI sequences served as reference (STD-RT, STD-FB). Reduction of scan time by SMS-acceleration was measured. Image characteristics of SMS-DWI and STD-DWI with both breathing schemes were analyzed quantitatively (apparent diffusion coefficient [ADC], signal-to-noise ratio [SNR]) and qualitatively (5-point Likert scale, 5 = excellent). Qualitative and quantitative parameters were compared using Friedman test and Dunn-Bonferroni post-hoc method with P-values < 0.05 considered statistically significant. SMS-DWI provided diagnostic image quality in volunteers and patients both with RT and FB with a reduction of scan time of 70% (0:56 vs. 3:20 min in FB). Overall image quality did not significantly differ between FB and RT acquisition in both STD and SMS sequences (median STD-RT 5.0, STD-FB 4.5, SMS-RT: 4.75; SMS-FB: 4.5; P = 0.294). SNR in the right hepatic lobe was comparable between the four tested sequences. ADC values were significantly lower in SMS-DWI compared to STD-DWI irrespective of the breathing scheme (1.2 ± 0.2 × 10(-3) mm(2) /s vs. 1.0 ± 0.2 × 10(-3) mm(2) /s; P < 0.001). SMS-acceleration provides considerable scan time reduction for hepatic DWI with equivalent image quality compared to the STD technique both using RT and FB. Discrepancies in ADC between STD-DWI and SMS-DWI need to be considered when transferring the SMS technique to clinical routine reading. J. MAGN. RESON. IMAGING 2016;44:865-879. © 2016 International Society for Magnetic Resonance in Medicine.

Willingness-to-pay function for two fuel treatments to reduce wildfire acreage burned: A scope test and comparison of white and hispanic households

Treesearch

John B. Loomis; Hung Le Trong; Armando González-Cabán

2009-01-01

We estimate a marginal benefit function for using prescribed burning and mechanical fuel reduction programs to reduce acres burned by wildfire in three states. Since each state had different acre reductions, a statistically significant coefficient on the reduction in acres burned is also a split sample scope test frequently used as an indicator of the internal validity...

Internal derangements of the temporomandibular joint: A review of the anatomy, diagnosis, and management

PubMed Central

Young, Andrew L.

2015-01-01

Internal derangements of the temporomandibular joint are conditions in which the articular disc has become displaced from its original position the condylar head. Relevant anatomic structures and their functional relationships are briefly discussed. The displacement of the disc can result in numerous presentations, with the most common being disc displacement with reduction (with or without intermittent locking), and disc displacement without reduction (with or without limited opening). These are described in this article according to the standardized Diagnostic Criteria for Temporomandibular Disorders, as well as the less common posterior disc displacement. Appropriate management usually ranges from patient education and monitoring to splints, physical therapy, and medications. In rare and select cases, surgery may be necessary. However, in for the majority of internal derangements, the prognosis is good, particularly with conservative care. PMID:26929478

Internal derangements of the temporomandibular joint: A review of the anatomy, diagnosis, and management.

PubMed

Young, Andrew L

2015-01-01

Internal derangements of the temporomandibular joint are conditions in which the articular disc has become displaced from its original position the condylar head. Relevant anatomic structures and their functional relationships are briefly discussed. The displacement of the disc can result in numerous presentations, with the most common being disc displacement with reduction (with or without intermittent locking), and disc displacement without reduction (with or without limited opening). These are described in this article according to the standardized Diagnostic Criteria for Temporomandibular Disorders, as well as the less common posterior disc displacement. Appropriate management usually ranges from patient education and monitoring to splints, physical therapy, and medications. In rare and select cases, surgery may be necessary. However, in for the majority of internal derangements, the prognosis is good, particularly with conservative care.

The reductive effect of an anti-pollinosis mask against internal exposure from radioactive materials dispersed from the Fukushima Daiichi Nuclear Disaster.

PubMed

Higaki, Shogo; Hirota, Masahiro

2013-02-01

The reductive effect of an anti-pollinosis mask against internal exposure from radioactive materials dispersed following the Fukushima Daiichi Nuclear Disaster was investigated. A single mask was worn continuously for 18 h from 15:00 JST on 15 March to 09:00 JST on 16 March 2011 at the Hongo campus of the University of Tokyo, Japan. An adult without a mask was exposed during this time to radiation of 6.1 μSv over ambient background in effective dose and 33 μSv in dose equivalent to the thyroid. Radionuclides were dispersed not only in their gaseous and particulate state but also as components that agglomerate to other aerosols and pollens. Wearing a mask for anti-pollinosis could reduce internal exposure from inhalation.

FREQUENCY OF POST-OPERATIVE FAECAL INCONTINENCE IN PATIENTS WITH CLOSED AND OPEN INTERNAL ANAL SPHINCTEROTOMY.

PubMed

Ghayas, Nighat; Younus, Syed Muneeb; Mirani, Abdul Jabbar; Ghayasuddin, Mohammed; Qazi, Aamna; Suchdev, Sunil Dutt; Bakshi, Saqib Kamran

2015-01-01

Fissure in ano is one of the commonest benign and painful proctologic diseases causing considerable morbidity and reduction in quality of life. There are medical as well as surgical treatment options for anal fissure. The study was conducted to compare the frequency of postoperative faecal incontinence in patients with closed lateral internal anal sphincterotomy with von-greaves knife versus standard Park's operation (open method) for chronic anal fissure. This was a randomized controlled trial (RCT) was conducted at the Department of Surgery, KVSS, S.I.T.E. Hospital, Karachi, for a period of six months from 13th February to 12th August 2011. Ninety four consecutive patients having chronic anal fissure were assigned through blocked randomization to groups A & B, with 47 patients in each group. Closed lateral internal anal sphincterotomy (CLIAS) via von-greaves knife was carried out in patients of group-A whereas patients of group-B were subjected to open internal anal sphincterotomy (OIAS) also known as Parks' procedure. Faecal incontinence was noted on the 5th post-operative day. Data was analysed using SPSS 16. There were 81 (86.2%) males and 13 (13.8%) females with male to female ratio being 6:1. Mean age was 38.38 mp ± 14.56 years. Post-operative faecal incontinence in patients undergoing CLIAS was 4.3% while it was 21.3% in those undergoing OIAS with a p-value of 0.027. CLIAS with von-greaves knife is effective in reducing faecal incontinence on 5th postoperative day as compared to standard OIAS. CLIAS with von-greaves knife is effective in reducing faecal incontinence on 5th postoperative day as compared to OIAS (Park's procedure). Therefore, this technique may be used in future regularly to treat chronic anal fissure for prevention of this morbidity.

Extension Resources for International Trade

ERIC Educational Resources Information Center

Seal, Susan D.

2016-01-01

With the opening of additional trade partnerships, the reduction of global transportation and communication costs, and the increase in demand for U.S. agricultural products and services, international trade is an area of great importance to more and more Extension clients and stakeholders. This article provides information about the primary…

26 CFR 1.881-0 - Table of contents.

Code of Federal Regulations, 2010 CFR

2010-04-01

... participation of intermediate entity is pursuant to a tax avoidance plan. (1) In general. (2) Factors taken into account in determining the presence or absence of a tax avoidance purpose. (i) Significant reduction in... Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED...

Internal structural changes in keratin fibres resulting from combined hair waving and stress relaxation treatments: a Raman spectroscopic investigation.

PubMed

Kuzuhara, A

2016-04-01

The objective of our research was to investigate the influence of chemical treatments (reduction, stress relaxation and oxidation) on hair keratin fibres. The structure of cross-sections at various depths of virgin white human hair resulting from permanent waving treatments with stress relaxation process was directly analysed at a molecular level using Raman spectroscopy. In particular, the three disulphide (-SS-) conformations in human hair were compared by S-S band analysis. The gauche-gauche-gauche (GGG) and gauche-gauche-trans (GGT) contents of -SS- groups remarkably decreased, while the trans-gauche-trans (TGT) content was not changed by performing the reduction process with thioglycolic acid. In addition, the high-temperature stress relaxation process after reduction accelerated the disconnection of -SS- (GGG and GGT) groups in the human hair, while the low-temperature stress relaxation process after reduction accelerated the reconnection of -SS- (GGG and GGT) groups. Moreover, the S-O band intensity at 1042 cm(-1) , assigned to cysteic acid, existing in the cuticle region and the surface of the cortex region increased, while the GGG content significantly decreased by performing the oxidation process after the reduction and the high-temperature stress relaxation processes. The author concluded that the high-temperature relaxation process after reduction accelerated the disconnection of -SS- (GGG and GGT) groups, thereby leading to the remarkable local molecular disorganization (an increase in the cysteic acid content and a decrease in the GGG content) on the cuticle and cortex cells during the oxidation process. © 2015 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

Bioadhesives for internal medical applications: A review.

PubMed

Zhu, Wenzhen; Chuah, Yon Jin; Wang, Dong-An

2018-04-22

Bioadhesives such as tissue adhesives, hemostatic agents, and tissue sealants have gained increasing popularity in different areas of clinical operations during the last three decades. Bioadhesives can be categorized into internal and external ones according to their application conditions. External bioadhesives are generally applied in topical medications such as wound closure and epidermal grafting. Internal bioadhesives are mainly used in intracorporal conditions with direct contact to internal environment including tissues, organs and body fluids, such as chronic organ leak repair and bleeding complication reduction. This review focuses on internal bioadhesives that, in contrast with external bioadhesives, emphasize much more on biocompatibility and adhesive ability to wet surfaces rather than on gluing time and intensity. The crosslinking mechanisms of present internal bioadhesives can be generally classified as follows: 1) chemical conjugation between reactive groups; 2) free radical polymerization by light or redox initiation; 3) biological or biochemical coupling with specificity; and 4) biomimetic adhesion inspired from natural phenomena. In this review, bioadhesive products of each class are summarized and discussed by comparing their designs, features, and applications as well as their prospects for future development. Despite the emergence of numerous novel bioadhesive formulations in recent years, thus far, the classification of internal and external bioadhesives has not been well defined and universally acknowledged. Many of the formulations have been proposed for treatment of several diseases even though they are not applicable for such conditions. This is because of the lack of a systematic standard or evaluation protocol during the development of a new adhesive product. In this review, the definition of internal and external bioadhesives is given for the first time, and with a focus on internal bioadhesives, the criteria of an ideal internal bioadhesive are adequately discussed; this is followed by the review of recently developed internal bioadhesives based on different gluing mechanisms. Copyright © 2018. Published by Elsevier Ltd.

Cost-effectiveness analysis of rotavirus vaccination in China: Projected possibility of scale-up from the current domestic option.

PubMed

Cui, Shuhui; Tobe, Ruoyan Gai; Mo, Xiuting; Liu, Xiaoyan; Xu, Lingzhong; Li, Shixue

2016-11-15

Rotavirus infection causes considerable disease burden of acute gastroenteritis (AGE) hospitalization and death among children less than 5 years in China. Although two rotavirus vaccines (Rotarix and RotaTeq) have been licensed in more than 100 countries in the world, the Lanzhou Lamb rotavirus vaccine (LLR) is the only vaccine licensed in China. This study aims to forecast the potential impacts of the two international vaccines compared to domestic LLR. An economic evaluation was performed using a Markov simulation model. We compared costs at the societal aspect and health impacts with and without a vaccination program by LLR, Rotarix or RotaTeq. Parameters including demographic, epidemiological data, costs and efficacy of vaccines were obtained from literature review. The model incorporated the impact of vaccination on reduction of incidence of rotavirus infection and severity of AGE indicated by hospitalization, inpatient visits and deaths. Outcomes are presented in terms of quality-adjusted life years (QALYs) gained and incremental cost-effectiveness ratio (ICER) compared to status quo. In a hypothetical cohort of 100,000 infants, the two international vaccines showed very good cost-effectiveness, with ICER of Rotateq and Rotarix shifting from LLR of $1715.11/QALY and $2105.66/QALY, respectively. Rotateq and Rotarix had significantly decreased incidence compared to LLR, particularly among infants aged 6 months to 2 years. RotaTeq is expected to introduce in the national routine immunization program to reduce disease burden of rotavirus infection with universal coverage.

Measurement of turbulence decorrelation during transport barrier evolution in a high-temperature fusion plasma.

PubMed

Nazikian, R; Shinohara, K; Kramer, G J; Valeo, E; Hill, K; Hahm, T S; Rewoldt, G; Ide, S; Koide, Y; Oyama, Y; Shirai, H; Tang, W

2005-04-08

A low power polychromatic beam of microwaves is used to diagnose the behavior of turbulent fluctuations in the core of the JT-60U tokamak during the evolution of the internal transport barrier. A continuous reduction in the size of turbulent structures is observed concomitant with the reduction of the density scale length during the evolution of the internal transport barrier. The density correlation length decreases to the order of the ion gyroradius, in contrast with the much longer scale lengths observed earlier in the discharge, while the density fluctuation level remain similar to the level before transport barrier formation.

Complications of the retromandibular transparotid approach for low condylar neck and subcondylar fractures: a retrospective study

PubMed Central

2018-01-01

Objectives The goal of this study was to evaluate the rates of complications, morbidity, and safety with the transparotid approach. Materials and Methods A retrospective study was conducted and consisted of 53 surgically treated patients in the past five years for low condylar neck and subcondylar fractures. Only patients with malocclusion and who underwent open reduction with internal fixation with the retromandibular transparotid approach were included. The examined parameters were postoperative suboptimal occlusion, deflection, saliva fistula, and facial nerve weakness. Results Fifty-three patients had an open reduction with internal fixation on 55 sides (41 males, 77.4%; mean age, 42 years [range, 18–72 years]). Four patients (7.5%) experienced transient facial nerve weakness of the marginal mandibular branch, but none was permanent. Four patients had a salivary fistula, and 5 patients showed postoperative malocclusion, where one needed repeat surgery after one year. One patient showed long-term deflection. No other complications were observed. Conclusion The retromandibular transparotid approach is a safe procedure for open reduction and internal fixation of low condylar neck and subcondylar fractures, and it has minimal complications. PMID:29732312

Comprehensive stroke units: a review of comparative evidence and experience.

PubMed

Chan, Daniel K Y; Cordato, Dennis; O'Rourke, Fintan; Chan, Daniel L; Pollack, Michael; Middleton, Sandy; Levi, Chris

2013-06-01

Stroke unit care offers significant benefits in survival and dependency when compared to general medical ward. Most stroke units are either acute or rehabilitation, but comprehensive (combined acute and rehabilitation) model (comprehensive stroke unit) is less common. To examine different levels of evidence of comprehensive stroke unit compared to other organized inpatient stroke care and share local experience of comprehensive stroke units. Cochrane Library and Medline (1980 to December 2010) review of English language articles comparing stroke units to alternative forms of stroke care delivery, different types of stroke unit models, and differences in processes of care within different stroke unit models. Different levels of comparative evidence of comprehensive stroke units to other models of stroke units are collected. There are no randomized controlled trials directly comparing comprehensive stroke units to other stroke unit models (either acute or rehabilitation). Comprehensive stroke units are associated with reduced length of stay and greatest reduction in combined death and dependency in a meta-analysis study when compared to other stroke unit models. Comprehensive stroke units also have better length of stay and functional outcome when compared to acute or rehabilitation stroke unit models in a cross-sectional study, and better length of stay in a 'before-and-after' comparative study. Components of stroke unit care that improve outcome are multifactorial and most probably include early mobilization. A comprehensive stroke unit model has been successfully implemented in metropolitan and rural hospital settings. Comprehensive stroke units are associated with reductions in length of stay and combined death and dependency and improved functional outcomes compared to other stroke unit models. A comprehensive stroke unit model is worth considering as the preferred model of stroke unit care in the planning and delivery of metropolitan and rural stroke services. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

Locked nailing for the treatment of displaced articular fractures of the calcaneus: description of a new procedure with calcanail(®).

PubMed

Goldzak, Mario; Mittlmeier, Thomas; Simon, Patrick

2012-05-01

Although open reduction and internal fixation is considered the best method for treating displaced articular fractures of the calcaneus, lateral approach is at high risk for wound healing complications. For this reason, the authors developed a posterior approach and a new implant to perform both intrafocal reduction and internal fixation. The aim of this technical note is to describe this method of treatment for displaced articular fractures of the calcaneus, which offered the following advantages: (a) the creation of a working channel that provides also a significant bone autograft, (b) the intrafocal reduction of the displaced articular surface, (c) the insertion of a locking nail that maintains the reduced articular surface at the right height, (d) the possibility to switch from an ORIF to a reconstruction arthrodesis with the same approach and instrumentation in case of severely damaged posterior facet.

Treatment of mature landfill leachate by internal micro-electrolysis integrated with coagulation: a comparative study on a novel sequencing batch reactor based on zero valent iron.

PubMed

Ying, Diwen; Peng, Juan; Xu, Xinyan; Li, Kan; Wang, Yalin; Jia, Jinping

2012-08-30

A comparative study of treating mature landfill leachate with various treatment processes was conducted to investigate whether the method of combined processes of internal micro-electrolysis (IME) without aeration and IME with full aeration in one reactor was an efficient treatment for mature landfill leachate. A specifically designed novel sequencing batch internal micro-electrolysis reactor (SIME) with the latest automation technology was employed in the experiment. Experimental data showed that combined processes obtained a high COD removal efficiency of 73.7 ± 1.3%, which was 15.2% and 24.8% higher than that of the IME with and without aeration, respectively. The SIME reactor also exhibited a COD removal efficiency of 86.1 ± 3.8% to mature landfill leachate in the continuous operation, which is much higher (p<0.05) than that of conventional treatments of electrolysis (22.8-47.0%), coagulation-sedimentation (18.5-22.2%), and the Fenton process (19.9-40.2%), respectively. The innovative concept behind this excellent performance is a combination effect of reductive and oxidative processes of the IME, and the integration electro-coagulation. Optimal operating parameters, including the initial pH, Fe/C mass ratio, air flow rate, and addition of H(2)O(2), were optimized. All results show that the SIME reactor is a promising and efficient technology in treating mature landfill leachate. Copyright © 2012 Elsevier B.V. All rights reserved.

Barriers for progress in salt reduction in the general population. An international study.

PubMed

Newson, R S; Elmadfa, I; Biro, Gy; Cheng, Y; Prakash, V; Rust, P; Barna, M; Lion, R; Meijer, G W; Neufingerl, N; Szabolcs, I; van Zweden, R; Yang, Y; Feunekes, G I J

2013-12-01

Salt reduction is important for reducing hypertension and the risk of cardiovascular events, nevertheless worldwide salt intakes are above recommendations. Consequently strategies to reduce intake are required, however these require an understanding of salt intake behaviours to be effective. As limited information is available on this, an international study was conducted to derive knowledge on salt intake and associated behaviours in the general population. An online cohort was recruited consisting of a representative sample from Germany, Austria, United States of America, Hungary, India, China, South Africa, and Brazil (n=6987; aged 18-65 years; age and gender stratified). Participants completed a comprehensive web-based questionnaire on salt intake and associated behaviours. While salt reduction was seen to be healthy and important, over one third of participants were not interested in salt reduction and the majority were unaware of recommendations. Salt intake was largely underestimated and people were unaware of the main dietary sources of salt. Participants saw themselves as mainly responsible for their salt intake, but also acknowledged the roles of others. Additionally, they wanted to learn more about why salt was bad for health and what the main sources in the diet were. As such, strategies to reduce salt intake must raise interest in engaging in salt reduction through improving understanding of intake levels and dietary sources of salt. Moreover, while some aspects of salt reduction can be globally implemented, local tailoring is required to match level of interest in salt reduction. These findings provide unique insights into issues surrounding salt reduction and should be used to develop effective salt reduction strategies and/or policies. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

SOMAR-LES: A framework for multi-scale modeling of turbulent stratified oceanic flows

NASA Astrophysics Data System (ADS)

Chalamalla, Vamsi K.; Santilli, Edward; Scotti, Alberto; Jalali, Masoud; Sarkar, Sutanu

2017-12-01

A new multi-scale modeling technique, SOMAR-LES, is presented in this paper. Localized grid refinement gives SOMAR (the Stratified Ocean Model with Adaptive Resolution) access to small scales of the flow which are normally inaccessible to general circulation models (GCMs). SOMAR-LES drives a LES (Large Eddy Simulation) on SOMAR's finest grids, forced with large scale forcing from the coarser grids. Three-dimensional simulations of internal tide generation, propagation and scattering are performed to demonstrate this multi-scale modeling technique. In the case of internal tide generation at a two-dimensional bathymetry, SOMAR-LES is able to balance the baroclinic energy budget and accurately model turbulence losses at only 10% of the computational cost required by a non-adaptive solver running at SOMAR-LES's fine grid resolution. This relative cost is significantly reduced in situations with intermittent turbulence or where the location of the turbulence is not known a priori because SOMAR-LES does not require persistent, global, high resolution. To illustrate this point, we consider a three-dimensional bathymetry with grids adaptively refined along the tidally generated internal waves to capture remote mixing in regions of wave focusing. The computational cost in this case is found to be nearly 25 times smaller than that of a non-adaptive solver at comparable resolution. In the final test case, we consider the scattering of a mode-1 internal wave at an isolated two-dimensional and three-dimensional topography, and we compare the results with Legg (2014) numerical experiments. We find good agreement with theoretical estimates. SOMAR-LES is less dissipative than the closure scheme employed by Legg (2014) near the bathymetry. Depending on the flow configuration and resolution employed, a reduction of more than an order of magnitude in computational costs is expected, relative to traditional existing solvers.

77 FR 26824 - Agency Information Collection; Activity Under OMB Review; Reporting Required for International...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-07

... RITA 2008-0002] Agency Information Collection; Activity Under OMB Review; Reporting Required for International Civil Aviation Organization (ICAO) AGENCY: Research & Innovative Technology Administration (RITA... Reduction Act of 1995 (44 U.S.C. 3501 et seq.), this notice announces that the Information Collection...

ECO LOGIC INTERNATIONAL GAS-PHASE CHEMICAL REDUCTION PROCESS - THE REACTOR SYSTEM - APPLICATIONS ANALYSIS REPORT

EPA Science Inventory

The ELI Eco Logic International Inc. (Eco Logic) process thermally separates organics, then chemically reduces them in a hydrogen atmosphere, converting them to a reformed gas that consists of light hydrocarbons and water. A scrubber treats the reformed gas to remove hydrogen chl...

Removal of Arsenic, Iron, Manganese, and Ammonia in Drinking Water: Nagaoka International Corporation CHEMILES NCL Series Water Treatment System

EPA Science Inventory

The Nagaoka International Corporation CHEMILES NCL Series system was tested to verify its performance for the reduction of multiple contaminants including: arsenic, ammonia, iron, and manganese. The objectives of this verification, as operated under the conditions at the test si...

77 FR 24730 - Submission of Information Collection Under the Paperwork Reduction Act; Reinstatement

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-25

... regulatory authorities to establish and implement tribal internal control standards that provide a level of... system that, at a minimum, complies with the tribal internal control standards established by the tribal... DEPARTMENT OF THE INTERIOR National Indian Gaming Commission Submission of Information Collection...

77 FR 9261 - Submission of Information Collection Under the Paperwork Reduction Act; Reinstatement

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-16

... regulatory authorities to establish and implement tribal internal control standards that provide a level of... system that, at a minimum, complies with the tribal internal control standards established by the tribal... DEPARTMENT OF THE INTERIOR National Indian Gaming Commission Submission of Information Collection...

78 FR 26573 - Federal Acquisition Regulation; Irrevocable Letters of Credit

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-07

... requirements that require the approval of the Office of Management and Budget under the Paperwork Reduction Act... Practice (UCP) for Documentary Credits, 2006 Edition, International Chamber of Commerce Publication No. 600... Documentary Credits, International Chamber of Commerce Publication No. (Insert version in effect at the time...

ISEE/ICE plasma wave data analysis

NASA Technical Reports Server (NTRS)

Greenstadt, E. W.

1989-01-01

The work performed for the period 1 Jan. 1985 to 30 Oct. 1989 is presented. The objective was to provide reduction and analysis of data from a scientific instrument designed to study solar wind and plasma wave phenomena on the International Sun Earth Explorer 3 (ISEE-3)/International Cometary Explorer (ICE) missions.

FORUM ON INNOVATIVE HAZARDOUS WASTE TREATMENT TECHNOLOGIES: DOMESTIC AND INTERNATIONAL. Third, Dallas, Texas, June 11-13, 1991 - TECHNICAL PAPERS

EPA Science Inventory

On June 11 -13,1991, the U.S. Environmental Protection Agency's Technology Innovation Office and Risk Reduction Engineering Laboratory hosted an international conference in Dallas, TX, to exchange solutions to hazardous waste treatment problems. This conference, the Third Forum...

When Personal and Political Processes Meet.

ERIC Educational Resources Information Center

Swenson, Gay Leah

1987-01-01

Reports and critiques the Rust workshop conducted in 1985 in Vienna, Austria. Provides an analysis of the challenges to the person-centered approach as applied to international tension reduction. Concludes with issues for further exploration and a declaration for an ongoing program in person-centered approaches in international relations. (BR)

International Tension-Reduction Through the Person-Centered Approach.

ERIC Educational Resources Information Center

Solomon, Lawrence N.

1987-01-01

Evaluates the Rust Conference held in 1985 in Vienna, Austria. Explains that the workshop topic, "Central American Challenge," was used as an experimental application of the person-centered approach to conflict resolution in an international context. Concludes by admitting limitations and expresses optimism that this approach can be used…

Reduction in hospitalisations and emergency department visits for frail patients with heart failure: Results of the UMIPIC healthcare programme.

PubMed

Cerqueiro, J M; González-Franco, A; Montero-Pérez-Barquero, M; Llácer, P; Conde, A; Dávila, M F; Carrera, M; Serrado, A; Suárez, I; Pérez-Silvestre, J; Satué, J A; Arévalo-Lorido, J C; Rodríguez, A; Herrero, A; Jordana, R; Manzano, L

2016-01-01

Heart failure (HF) is a disease with high morbidity and mortality. We evaluated the usefulness of the Comprehensive Management Units for Patients with HF (Unidades de Manejo Integral para Pacientes con IC [UMIPIC]) programme. We analysed the patient data from the UMIPIC programme, which was recorded in the HF registry (RICA) of the Spanish Society of Internal Medicine. We compared emergency department visits and hospitalisations for any cause and for HF during the year prior to inclusion in the programme against those that occurred during the subsequent follow-up year, using the chi-squared test. A total of 258 patients (mean age, 80years; 51.9% women) were included in the study. During the previous year, there were 693 hospitalisations for all causes and 174 hospitalisations during the follow-up (75% reduction, P<.001). There were 613 hospitalisations for HF during the previous year and 92 during the follow-up (85% reduction, P<.001); 655 vs. 302 in terms of emergency department visits for any cause (53.9% reduction, P<.001); and 440 vs. 120 for emergency department visits for HF (72% reduction, P<.001). There were no significant differences in the number of hospitalisations or emergency department visits for causes other than HF. The UMIPIC programme based on the comprehensive care of elderly patients with HF and comorbidity reduces the rate of hospital readmissions and emergency department visits during the first year of follow-up. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Truck Noise X : Noise Reduction Options for Diesel Powered International Harvester Trucks : Volume 1. Development Work.

DOT National Transportation Integrated Search

1977-04-01

Noise reduction option development work was carried out on two inservice diesel powered IH trucks, consisting of a Cab-over model and a Conventional model with a baseline exterior noise level of 87 dB(A) each. Since no specific noise goals were set, ...

Vowel and Consonant Lessening: A Study of Articulating Reductions and Their Relations to Genders

ERIC Educational Resources Information Center

Lin, Grace Hui Chin; Chien, Paul Shih Chieh

2011-01-01

Using English as a global communicating tool makes Taiwanese people have to speak in English in diverse international situations. However, consonants and vowels in English are not all effortless for them to articulate. This phonological reduction study explores concepts about phonological (articulating system) approximation. From Taiwanese folks'…

26 CFR 25.2701-5 - Adjustments to mitigate double taxation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Adjustments to mitigate double taxation. 25....2701-5 Adjustments to mitigate double taxation. (a) Reduction of transfer tax base—(1) In general. This... − $187,500). (g) Double taxation otherwise avoided. No reduction is available under this section if— (1...

26 CFR 25.2701-5 - Adjustments to mitigate double taxation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 14 2011-04-01 2010-04-01 true Adjustments to mitigate double taxation. 25.2701... Adjustments to mitigate double taxation. (a) Reduction of transfer tax base—(1) In general. This section... − $187,500). (g) Double taxation otherwise avoided. No reduction is available under this section if— (1...

The International Polar year 2007-2008; the Arctic human health legacy.

PubMed

Parkinson, Alan J

2007-01-01

Life expectancy in Arctic populations has greatly improved over the last 50 years. Much of this improvement can be attributed health research that has resulted in a reduction in morbidity and mortality from infectious diseases, such as tuberculosis, and the vaccine-preventable diseases of childhood. However, despite these improvements in health indicators of Arctic residents, life expectancy and infant mortality remain higher in indigenous Arctic residents in the US Arctic, northern Canada, and Greenland when compared to Arctic residents of Nordic countries. The International Polar Year (IPY) represents a unique opportunity to focus world attention on Arctic human health and to further stimulate Circumpolar cooperation on emerging Arctic human health concerns. The Arctic Human Health Initiative (AHHI) is an Arctic Council IPY initiative that aims to build and expand on existing Arctic Council and International Union for Circumpolar Health (IUCH) human health research activities. The human health legacy of the IPY will be increased visibility of the human health concerns of Arctic communities, revitalization of cooperative Arctic human health research focused on those concerns, the development of health policies based on research findings, and the subsequent implementation of appropriate interventions, prevention and control measures at the community level.

[Balloon osteoplasty as reduction technique in the treatment of tibial head fractures].

PubMed

Freude, T; Kraus, T M; Sandmann, G H

2015-10-01

Tibial plateau fractures requiring surgery are severe injuries of the lower extremities. Depending on the fracture pattern, the age of the patient, the range of activity and the bone quality there is a broad variation in adequate treatment.  This article reports on an innovative treatment concept to address split depression fractures (Schatzker type II) and depression fractures (Schatzker type III) of the tibial head using the balloon osteoplasty technique for fracture reduction. Using the balloon technique achieves a precise and safe fracture reduction. This internal osteoplasty combines a minimal invasive percutaneous approach with a gently rise of the depressed area and the associated protection of the stratum regenerativum below the articular cartilage surface. This article lights up the surgical procedure using the balloon technique in tibia depression fractures. Using the balloon technique a precise and safe fracture reduction can be achieved. This internal osteoplasty combines a minimally invasive percutaneous approach with a gentle raising of the depressed area and the associated protection of the regenerative layer below the articular cartilage surface. Fracture reduction by use of a tamper results in high peak forces over small areas, whereas by using the balloon the forces are distributed over a larger area causing less secondary stress to the cartilage tissue. This less invasive approach might help to achieve a better long-term outcome with decreased secondary osteoarthritis due to the precise and chondroprotective reduction technique.

Implications of Sustainability for the United States Light-Duty Transportation Sector

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

Gearhart, Chris

Climate change is a problem that must be solved. The primary cause of this problem is burning of fossil fuels to generate energy. A dramatic reduction in carbon emissions must happen soon, and a significant fraction of this reduction must come from the transportation sector. This paper reviews existing literature to assess the consensus of the scientific and engineering communities concerning the potential for the United States' light-duty transportation sector to meet a goal of 80 percent reduction in vehicle emissions and examine what it will take to meet this target. It is unlikely that reducing energy consumption in justmore » vehicles with gasoline-based internal combustion drivetrains will be sufficient to meet GHG emission-reduction targets. This paper explores what additional benefits are possible through the adoption of alternative energy sources, looking at three possible on-vehicle energy carriers: carbon-based fuels, hydrogen, and batteries. potential for the United States' light-duty transportation sector to meet a goal of 80 percent reduction in vehicle emissions and examine what it will take to meet this target. It is unlikely that reducing energy consumption in just vehicles with gasoline-based internal combustion drivetrains will be sufficient to meet GHG emission-reduction targets. This paper explores what additional benefits are possible through the adoption of alternative energy sources, looking at three possible on-vehicle energy carriers: carbon-based fuels, hydrogen, and batteries.« less

Model assessment of atmospheric pollution control schemes for critical emission regions

NASA Astrophysics Data System (ADS)

Zhai, Shixian; An, Xingqin; Liu, Zhao; Sun, Zhaobin; Hou, Qing

2016-01-01

In recent years, the atmospheric environment in portions of China has become significantly degraded and the need for emission controls has become urgent. Because more international events are being planned, it is important to implement air quality assurance targeted at significant events held over specific periods of time. This study sets Yanqihu (YQH), Beijing, the location of the 2014 Beijing APEC (Asia-Pacific Economic Cooperation) summit, as the target region. By using the atmospheric inversion model FLEXPART, we determined the sensitive source zones that had the greatest impact on the air quality of the YQH region in November 2012. We then used the air-quality model Models-3/CMAQ and a high-resolution emissions inventory of the Beijing-Tianjian-Hebei region to establish emission reduction tests for the entire source area and for specific sensitive source zones. This was achieved by initiating emission reduction schemes at different ratios and different times. The results showed that initiating a moderate reduction of emissions days prior to a potential event is more beneficial to the air quality of Beijing than initiating a high-strength reduction campaign on the day of the event. The sensitive source zone of Beijing (BJ-Sens) accounts for 54.2% of the total source area of Beijing (BJ), but its reduction effect reaches 89%-100% of the total area, with a reduction efficiency 1.6-1.9 times greater than that of the entire area. The sensitive source zone of Huabei (HuaB-Sens.) only represents 17.6% of the total area of Huabei (HuaB), but its emission reduction effect reaches 59%-97% of the entire area, with a reduction efficiency 4.2-5.5 times greater than that of the total area. The earlier that emission reduction measures are implemented, the greater the effect they have on preventing the transmission of pollutants. In addition, expanding the controlling areas to sensitive provinces and cities around Beijing (HuaB-sens) can significantly accelerate the reduction effects compared to controlling measures only in the Beijing sensitive source zone (BJ-Sens). Therefore, when enacting emission reduction schemes, cooperating with surrounding provinces and cities, as well as narrowing the reduction scope to specific sensitive source zones prior to unfavorable meteorological conditions, can help reduce emissions control costs and improve the efficiency and maneuverability of emission reduction schemes.

Offset Compound Gear Drive

NASA Technical Reports Server (NTRS)

Stevens, Mark A.; Handschuh, Robert F.; Lewicki, David G.

2010-01-01

The Offset Compound Gear Drive is an in-line, discrete, two-speed device utilizing a special offset compound gear that has both an internal tooth configuration on the input end and external tooth configuration on the output end, thus allowing it to mesh in series, simultaneously, with both a smaller external tooth input gear and a larger internal tooth output gear. This unique geometry and offset axis permits the compound gear to mesh with the smaller diameter input gear and the larger diameter output gear, both of which are on the same central, or primary, centerline. This configuration results in a compact in-line reduction gear set consisting of fewer gears and bearings than a conventional planetary gear train. Switching between the two output ratios is accomplished through a main control clutch and sprag. Power flow to the above is transmitted through concentric power paths. Low-speed operation is accomplished in two meshes. For the purpose of illustrating the low-speed output operation, the following example pitch diameters are given. A 5.0 pitch diameter (PD) input gear to 7.50 PD (internal tooth) intermediate gear (0.667 reduction mesh), and a 7.50 PD (external tooth) intermediate gear to a 10.00 PD output gear (0.750 reduction mesh). Note that it is not required that the intermediate gears on the offset axis be of the same diameter. For this example, the resultant low-speed ratio is 2:1 (output speed = 0.500; product of stage one 0.667 reduction and stage two 0.750 stage reduction). The design is not restricted to the example pitch diameters, or output ratio. From the output gear, power is transmitted through a hollow drive shaft, which, in turn, drives a sprag during which time the main clutch is disengaged.

Treatment of type II odontoid fracture with a novel technique

PubMed Central

Zhu, Ce; Wang, Lei; Liu, Hao; Song, Yueming; Liu, Limin; Li, Tao; Gong, Quan

2017-01-01

Abstract Surgical methods for type II odontoid fracture can be classified into 2 main groups: anterior or posterior approach. A more effective way to achieve bone fusion with the lowest possible surgical risk is needed. Therefore, the aim of our study was to describe and evaluate a novel technique, cable-dragged reduction/cantilever beam internal fixation for the treatment of type II odontoid fracture. This was a retrospective study enrolled 34 patients underwent posterior cable-dragged reduction/cantilever-beam internal fixation surgery. Medical records, rates of reduction, the location of the instrumentation and fracture healing during follow-up were analyzed. Once fracture healing was obtained, instrumentation was removed. Neck pain (scored using a visual analog scale [VAS]), neck stiffness, patient satisfaction, and neck disability index (NDI) were recorded before and after removing the instrumentation during follow-up. The mean duration of follow up was 22.8 ± 5.3 months. There was no iatrogenic damage to nerves or blood vessels. Radiographic evaluation showed complete reduction in the 20 patients with fracture displacement and satisfactory fracture healing in all 34 cases. Titanium cable breakage was observed in 4 patients after fracture healing. After removal of instrumentation, significant improvements were seen in neck-pain VAS score, neck stiffness, patient satisfaction, and NDI (all P < .01). Posterior cable-dragged reduction/cantilever-beam internal fixation was an optimal salvage maneuver to conventional surgical methods such as anterior screw fixation and C1–C2 screw-rod system. The operative difficulty and incidence of nerve and vascular injury were reduced. Its major disadvantage is the exposure and screw-setting at C3, which is left intact in traditional surgery, and it is suitable only for patients with intact C1 posterior arches. PMID:29095313

Historic Landslide Data Combined with Sentinel Satellite Data to Improve Modelling for Disaster Risk Reduction

NASA Astrophysics Data System (ADS)

Bye, B. L.; Kontoes, C.; Catarino, N.; De Lathouwer, B.; Concalves, P.; Meyer-Arnek, J.; Mueller, A.; Kraft, C.; Grosso, N.; Goor, E.; Voidrot, M. F.; Trypitsidis, A.

2017-12-01

Landslides are geohazards potentially resulting in disasters. Landslides both vary enormously in their distribution in space and time. The surface deformation varies considerably from one type of instability to another. Individual ground instabilities may have a common trigger (extreme rainfall, earthquake), and therefore occur alongside many equivalent occurrences over a large area. This means that they can have a significant regional impact demanding national and international disaster risk reduction strategies. Regional impacts require collaboration across boarders as reflected in The Sendai Framework for Disaster Risk Reduction (2015-2030). The data demands related to the SDGs are unprecedented, another factor that will require coordinated efforts at the global, regional and national levels. Data of good quality are vital for governments, international organizations, civil society, the private sector and the general public in order to make informed decisions, included for disaster risk reduction. The NextGEOSS project evolves the European vision of a user driven GEOSS data exploitation for innovation and business, relying on 3 main pillars; engaging communities of practice, delivering technological advancements, and advocating the use of GEOSS. These 3 pillars support the creation and deployment of Earth observation based innovative research activities and commercial services. In this presentation we will explain how one of the 10 NextGEOSS pilots, Disaster Risk Reduction (DRR), plan to provide an enhanced multi-hazard risk assessment framework based on statistical analysis of long time series of data. Landslide events monitoring and landslides susceptibility estimation will be emphazised. Workflows will be based on models developed in the context of the Copernicus Emergency Management Service. Data envisaged to be used are: Radar SAR data; Yearly ground deformation/velocities; Historic landslide inventory; data related to topographic, geological, hydrological, geomorphological settings and ground observations from field trips. The development of NextGEOSS pilots opens up for interactions with international communities. Contributions from communities engaged in SDG activities and the implementation of the Sendai Framework for Disaster Risk Reduction are welcome

Stormwater management criteria for on-site pollution control: a comparative assessment of international practices.

PubMed

Sage, Jérémie; Berthier, Emmanuel; Gromaire, Marie-Christine

2015-07-01

Over the last decade, a growing interest has been shown toward innovative stormwater management practices, breaking away from conventional "end of pipe" approaches (based on conveying water offsite to centralized detention facilities). Innovative strategies, referred to as sustainable urban drainage systems, low impact development (LID) or green infrastructures, advocating for management of runoff as close to its origin as possible, have therefore gained a lot of popularity among practitioners and public authorities. However, while the need for pollution control is generally well accepted, there is no wide agreement about management criteria to be given to developers. This article hence aims to compare these criteria through literature analysis of different state or local stormwater management manuals or guidelines, investigating both their suitability for pollution control and their influence on best management practices selection and design. Four categories of criteria were identified: flow-rate limitations, "water quality volumes" (to be treated), volume reduction (through infiltration or evapotranspiration), and non-hydrologic criteria (such as loads reduction targets or maximum effluent concentrations). This study suggests that hydrologic criteria based on volume reduction (rather than treatment) might generally be preferable for on-site control of diffuse stormwater pollution. Nonetheless, determination of an appropriate management approach for a specific site is generally not straightforward and presents a variety of challenges for site designers seeking to satisfy local requirements in addressing stormwater quantity and quality issues. The adoption of efficient LID solution may therefore strongly depend on the guidance given to practitioners to account for these management criteria.

Stormwater Management Criteria for On-Site Pollution Control: A Comparative Assessment of International Practices

NASA Astrophysics Data System (ADS)

Sage, Jérémie; Berthier, Emmanuel; Gromaire, Marie-Christine

2015-07-01

Over the last decade, a growing interest has been shown toward innovative stormwater management practices, breaking away from conventional "end of pipe" approaches (based on conveying water offsite to centralized detention facilities). Innovative strategies, referred to as sustainable urban drainage systems, low impact development (LID) or green infrastructures, advocating for management of runoff as close to its origin as possible, have therefore gained a lot of popularity among practitioners and public authorities. However, while the need for pollution control is generally well accepted, there is no wide agreement about management criteria to be given to developers. This article hence aims to compare these criteria through literature analysis of different state or local stormwater management manuals or guidelines, investigating both their suitability for pollution control and their influence on best management practices selection and design. Four categories of criteria were identified: flow-rate limitations, "water quality volumes" (to be treated), volume reduction (through infiltration or evapotranspiration), and non-hydrologic criteria (such as loads reduction targets or maximum effluent concentrations). This study suggests that hydrologic criteria based on volume reduction (rather than treatment) might generally be preferable for on-site control of diffuse stormwater pollution. Nonetheless, determination of an appropriate management approach for a specific site is generally not straightforward and presents a variety of challenges for site designers seeking to satisfy local requirements in addressing stormwater quantity and quality issues. The adoption of efficient LID solution may therefore strongly depend on the guidance given to practitioners to account for these management criteria.

Life-cycle analysis of greenhouse gas emissions from renewable jet fuel production.

PubMed

de Jong, Sierk; Antonissen, Kay; Hoefnagels, Ric; Lonza, Laura; Wang, Michael; Faaij, André; Junginger, Martin

2017-01-01

The introduction of renewable jet fuel (RJF) is considered an important emission mitigation measure for the aviation industry. This study compares the well-to-wake (WtWa) greenhouse gas (GHG) emission performance of multiple RJF conversion pathways and explores the impact of different co-product allocation methods. The insights obtained in this study are of particular importance if RJF is included as an emission mitigation instrument in the global Carbon Offsetting and Reduction Scheme for International Aviation (CORSIA). Fischer-Tropsch pathways yield the highest GHG emission reduction compared to fossil jet fuel (86-104%) of the pathways in scope, followed by Hydrothermal Liquefaction (77-80%) and sugarcane- (71-75%) and corn stover-based Alcohol-to-Jet (60-75%). Feedstock cultivation, hydrogen and conversion inputs were shown to be major contributors to the overall WtWa GHG emission performance. The choice of allocation method mainly affects pathways yielding high shares of co-products or producing co-products which effectively displace carbon intensive products (e.g., electricity). Renewable jet fuel can contribute to significant reduction of aviation-related GHG emissions, provided the right feedstock and conversion technology are used. The GHG emission performance of RJF may be further improved by using sustainable hydrogen sources or applying carbon capture and storage. Based on the character and impact of different co-product allocation methods, we recommend using energy and economic allocation (for non-energy co-products) at a global level, as it leverages the universal character of energy allocation while adequately valuing non-energy co-products.

Immune depression in Rhodnius prolixus by seco-steroids, physalins.

PubMed

Castro, D P; Figueiredo, M B; Ribeiro, I M; Tomassini, T C B; Azambuja, P; Garcia, E S

2008-03-01

A comparative study of the effects of physalins, seco-steroidal substances of Physalis angulata (Solanaceae), on the immune reactions of R. prolixus was carried out. Ecdysis and mortality were not affected by treatment with physalins B, D, F or G (1-10 microg/ml of blood meal). R. prolixus larvae fed with blood containing physalins and inoculated with 1 microl of Enterobacter cloacae beta12 (5 x 10(3)/insect) exhibited mortality rates three times higher than controls. The insects treated with physalin B, and F (1 microg/ml) and inoculated with E. cloacae beta12 showed significant differences on lysozyme activity in the hemolymph compared to untreated insects. Furthermore, physalin D (1 microg/ml) significantly reduced the antibacterial activity. Concerning cellular immune reactions, all insects treated with physalins (1 microg/ml), exhibited drastic reductions in the quantity of yeast cell-hemocyte binding and subsequent internalization. Insects inoculated with bacteria and treated with physalins B, F and G showed reductions of microaggregate formation but physalin D did not. Physalins B and F also reduced total hemocyte count in the hemolymph. These results suggest that, in different ways, probably due to their different chemical structures, physalin B, D, F and G are immunomodulatory substances for the bloodsucking insect, R. prolixus.

Combining Ballast Water Exchange and Treatment To Maximize Prevention of Species Introductions to Freshwater Ecosystems.

PubMed

Briski, Elizabeta; Gollasch, Stephan; David, Matej; Linley, R Dallas; Casas-Monroy, Oscar; Rajakaruna, Harshana; Bailey, Sarah A

2015-08-18

The most effective way to manage species transfers is to prevent their introduction via vector regulation. Soon, international ships will be required to meet numeric ballast discharge standards using ballast water treatment (BWT) systems, and ballast water exchange (BWE), currently required by several countries, will be phased out. However, there are concerns that BWT systems may not function reliably in fresh and/or turbid water. A land-based evaluation of simulated "BWE plus BWT" versus "BWT alone" demonstrated potential benefits of combining BWE with BWT for protection of freshwater ecosystems. We conducted ship-based testing to compare the efficacy of "BWE plus BWT" versus "BWT alone" on voyages starting with freshwater ballast. We tested the hypotheses that there is an additional effect of "BWE plus BWT" compared to "BWT alone" on the reduction of plankton, and that taxa remaining after "BWE plus BWT" will be marine (low risk for establishment at freshwater recipient ports). Our study found that BWE has significant additional effect on the reduction of plankton, and this effect increases with initial abundance. As per expectations, "BWT alone" tanks contained higher risk freshwater or euryhaline taxa at discharge, while "BWE plus BWT" tanks contained mostly lower risk marine taxa unlikely to survive in recipient freshwater ecosystems.

Reconciling sectoral abatement strategies with global climate targets: the case of the Chinese passenger vehicle fleet.

PubMed

Pauliuk, Stefan; Dhaniati, Ni Made A; Müller, Daniel B

2012-01-03

The IPCC Forth Assessment Report postulates that global warming can be limited to 2 °C by deploying technologies that are currently available or expected to be commercialized in the coming decades. However, neither specific technological pathways nor internationally binding reduction targets for different sectors or countries have been established yet. Using the passenger car stock in China as example we compute direct CO(2) emissions until 2050 depending on population, car utilization, and fuel efficiency and compare them to benchmarks derived by assuming even contribution of all sectors and a unitary global per capita emission quota. Compared to present car utilization in industrialized countries, massive deployment of prototypes of fuel efficient cars could reduce emissions by about 45%, and moderately lower car use could contribute with another 33%. Still, emissions remain about five times higher than the benchmark for the 2 °C global warming target. Therefore an extended analysis, including in particular low-carbon fuels and the impact of urban and transport planning on annual distance traveled and car ownership, should be considered. A cross-sectoral comparison could reveal whether other sectors could bear an overproportional reduction quota instead. The proposed model offers direct interfaces to material industries, fuel production, and scrap vehicle supply.

A reliable ground bounce noise reduction technique for nanoscale CMOS circuits

NASA Astrophysics Data System (ADS)

Sharma, Vijay Kumar; Pattanaik, Manisha

2015-11-01

Power gating is the most effective method to reduce the standby leakage power by adding header/footer high-VTH sleep transistors between actual and virtual power/ground rails. When a power gating circuit transitions from sleep mode to active mode, a large instantaneous charge current flows through the sleep transistors. Ground bounce noise (GBN) is the high voltage fluctuation on real ground rail during sleep mode to active mode transitions of power gating circuits. GBN disturbs the logic states of internal nodes of circuits. A novel and reliable power gating structure is proposed in this article to reduce the problem of GBN. The proposed structure contains low-VTH transistors in place of high-VTH footer. The proposed power gating structure not only reduces the GBN but also improves other performance metrics. A large mitigation of leakage power in both modes eliminates the need of high-VTH transistors. A comprehensive and comparative evaluation of proposed technique is presented in this article for a chain of 5-CMOS inverters. The simulation results are compared to other well-known GBN reduction circuit techniques at 22 nm predictive technology model (PTM) bulk CMOS model using HSPICE tool. Robustness against process, voltage and temperature (PVT) variations is estimated through Monte-Carlo simulations.

Lagrangian-averaged model for magnetohydrodynamic turbulence and the absence of bottlenecks.

PubMed

Pietarila Graham, Jonathan; Mininni, Pablo D; Pouquet, Annick

2009-07-01

We demonstrate that, for the case of quasiequipartition between the velocity and the magnetic field, the Lagrangian-averaged magnetohydrodynamics (LAMHD) alpha model reproduces well both the large-scale and the small-scale properties of turbulent flows; in particular, it displays no increased (superfilter) bottleneck effect with its ensuing enhanced energy spectrum at the onset of the subfilter scales. This is in contrast to the case of the neutral fluid in which the Lagrangian-averaged Navier-Stokes alpha model is somewhat limited in its applications because of the formation of spatial regions with no internal degrees of freedom and subsequent contamination of superfilter-scale spectral properties. We argue that, as the Lorentz force breaks the conservation of circulation and enables spectrally nonlocal energy transfer (associated with Alfvén waves), it is responsible for the absence of a viscous bottleneck in magnetohydrodynamics (MHD), as compared to the fluid case. As LAMHD preserves Alfvén waves and the circulation properties of MHD, there is also no (superfilter) bottleneck found in LAMHD, making this method capable of large reductions in required numerical degrees of freedom; specifically, we find a reduction factor of approximately 200 when compared to a direct numerical simulation on a large grid of 1536;{3} points at the same Reynolds number.

In vitro studies on radiosensitization effect of glucose capped gold nanoparticles in photon and ion irradiation of HeLa cells

NASA Astrophysics Data System (ADS)

Kaur, Harminder; Pujari, Geetanjali; Semwal, Manoj K.; Sarma, Asitikantha; Avasthi, Devesh Kumar

2013-04-01

Noble metal nanoparticles are of great interest due to their potential applications in diagnostics and therapeutics. In the present work, we synthesized glucose capped gold nanoparticle (Glu-AuNP) for internalization in the HeLa cell line (human cervix cancer cells). The capping of glucose on Au nanoparticle was confirmed by Raman spectroscopy. The Glu-AuNP did not show any toxicity to the HeLa cell. The γ-radiation and carbon ion irradiation of HeLa cell with and without Glu-AuNP were performed to evaluate radiosensitization effects. The study revealed a significant reduction in radiation dose for killing the HeLa cells with internalized Glu-AuNPs as compared to the HeLa cells without Glu-AuNP. The Glu-AuNP treatment resulted in enhancement of radiation effect as evident from increase in relative biological effectiveness (RBE) values for carbon ion irradiated HeLa cells.

Impact of Vacuum Cooling on Escherichia coli O157:H7 Infiltration into Lettuce Tissue▿

PubMed Central

Li, Haiping; Tajkarimi, Mehrdad; Osburn, Bennie I.

2008-01-01

Vacuum cooling is a common practice in the California leafy green industry. This study addressed the impact of vacuum cooling on the infiltration of Escherichia coli O157:H7 into lettuce as part of the risk assessment responding to the E. coli O157:H7 outbreaks associated with leafy green produce from California. Vacuum cooling significantly increased the infiltration of E. coli O157:H7 into the lettuce tissue (2.65E+06 CFU/g) compared to the nonvacuumed condition (1.98E+05 CFU/g). A stringent surface sterilization and quadruple washing could not eliminate the internalized bacteria from lettuce. It appeared that vacuuming forcibly changed the structure of lettuce tissue such as the stomata, suggesting a possible mechanism of E. coli O157:H7 internalization. Vacuuming also caused a lower reduction rate of E. coli O157:H7 in stored lettuce leaves than that for the nonvacuumed condition. PMID:18344328

Increased CSF aquaporin-4, and interleukin-6 levels in dogs with idiopathic communicating internal hydrocephalus and a decrease after ventriculo-peritoneal shunting.

PubMed

Schmidt, Martin J; Rummel, Christoph; Hauer, Jessica; Kolecka, Malgorzata; Ondreka, Nele; McClure, Vanessa; Roth, Joachim

2016-06-29

Studies in animal models, in which internal hydrocephalus has been induced by obstructing the cerebrospinal fluid pathways, have documented an up-regulation of the concentrations of aquaporin-4 (AQP4) in the brain. In this study, the concentrations of aquaporin-1 (AQP1), AQP1, AQP4 and interleukin-6 (IL-6) were determined in the CSF of dogs with idiopathic communicating hydrocephalus before and after the reduction of intraventricular volume following ventriculo-peritoneal shunt (VP-shunt) treatment. The concentrations of AQP4 and IL-6 were increased in the cerebrospinal fluid of dogs with hydrocephalus compared to controls. Both parameters significantly decreased after surgical treatment, accompanied by decrease of ventricular size and the clinical recovery of the dogs. AQP1 was not detectable in CSF. Brain AQP4 up-regulation might be a compensatory response in dogs with hydrocephalus. Future determination of AQP4 at the mRNA and protein level in brain tissue is warranted to substantiate this hypothesis.

Methylene blue internalization and photodynamic action against clinical and ATCC Pseudomonas aeruginosa and Staphyloccocus aureus strains.

PubMed

Pereira, André Henrique Correia; Pinto, Juliana Guerra; Freitas, Mirian Aparecida Alves; Fontana, Letícia Corrêa; Pacheco Soares, Cristina; Ferreira-Strixino, Juliana

2018-06-01

Bacterial infections have been a major challenge to health. Increasing resistance to antimicrobial agents, according to World Health Organization, could be the major cause of death until 2050. Photodynamic therapy emerges as an alternative in microbial inactivation, due to its selectivity and to decreasing or dismissing antibiotic use. This study aimed at evaluating, in vitro, the internalization of the Methylene Blue and its photodynamic activity against a clinical and ATCC strain of Pseudomonas aeruginosa and Staphyloccocus aureus. Thus, the strains were incubated with MB in concentrations of 100, 300 e 500 μg/ml and then irradiated with a LED (±660 nm) at fluence of 10 and 25 J/cm 2 . The MB internalization was evaluated using a confocal microscope (Zeiss LSM 700), to capture the MB and the DAPI (for DNA staining). It was possible to observe that the MB was internalized by the bacterial cells, in all concentrations tested. The CFU/ml count demonstrated significant reduction (p ≤ 0,01) at the average 5.0 logs comparing with control group for the two species in all the tested concentrations. In conclusion, the strains tested were capable of internalizing the MB. PDT with MB was able to decrease the growth of the tested strains in vitro, being a promising alternative to the future treatment of infections caused by these species. Copyright © 2018 Elsevier B.V. All rights reserved.

Comparative analyses for selected clean coal technologies in the international marketplace

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

Szpunar, C.B.; Gillette, J.L.

1990-07-01

Clean coal technologies (CCTs) are being demonstrated in research and development programs under public and private sponsorship. Many of these technologies could be marketed internationally. To explore the scope of these international opportunities and to match particular technologies with markets appearing to have high potential, a study was undertaken that focused on seven representative countries: Italy, Japan, Morocco, Turkey, Pakistan, the Peoples' Republic of China, and Poland. The results suggest that there are international markets for CCTs and that these technologies can be cost competitive with more conventional alternatives. The identified markets include construction of new plants and refurbishment ofmore » existing ones, especially when decision makers want to decrease dependence on imported oil. This report describes potential international market niches for U.S. CCTs and discusses the status and implications of ongoing CCT demonstration activities. Twelve technologies were selected as representative of technologies under development for use in new or refurbished industrial or electric utility applications. Included are the following: Two generic precombustion technologies: two-stage froth-flotation coal beneficiation and coal-water mixtures (CWMs); Four combustion technologies: slagging combustors, integrated-gasification combined-cycle (IGCC) systems, atmospheric fluidized-bed combustors (AFBCs), and pressurized fluidized-bed combustors (PFBCs); and Six postcombustion technologies: limestone-injection multistage burner (LIMB) systems, gas-reburning sorbent-injection (GRSI) systems, dual-alkali flue-gas desulfurization (FGD), spray-dryer FGD, the NOXSO process, and selective catalytic reduction (SCR) systems. Major chapters of this report have been processed separately for inclusion on the data base.« less

Health as freedom: addressing social determinants of global health inequities through the human right to development.

PubMed

Fox, Ashley M; Meier, Benjamin Mason

2009-02-01

In spite of vast global improvements in living standards, health, and well-being, the persistence of absolute poverty and its attendant maladies remains an unsettling fact of life for billions around the world and constitutes the primary cause for the failure of developing states to improve the health of their peoples. While economic development in developing countries is necessary to provide for underlying determinants of health--most prominently, poverty reduction and the building of comprehensive primary health systems--inequalities in power within the international economic order and the spread of neoliberal development policy limit the ability of developing states to develop economically and realize public goods for health. With neoliberal development policies impacting entire societies, the collective right to development, as compared with an individual rights-based approach to development, offers a framework by which to restructure this system to realize social determinants of health. The right to development, working through a vector of rights, can address social determinants of health, obligating states and the international community to support public health systems while reducing inequities in health through poverty-reducing economic growth. At an international level, where the ability of states to develop economically and to realize public goods through public health systems is constrained by international financial institutions, the implementation of the right to development enables a restructuring of international institutions and foreign-aid programs, allowing states to enter development debates with a right to cooperation from other states, not simply a cry for charity.

Two degree of freedom internal model control-PID design for LFC of power systems via logarithmic approximations.

PubMed

Singh, Jay; Chattterjee, Kalyan; Vishwakarma, C B

2018-01-01

Load frequency controller has been designed for reduced order model of single area and two-area reheat hydro-thermal power system through internal model control - proportional integral derivative (IMC-PID) control techniques. The controller design method is based on two degree of freedom (2DOF) internal model control which combines with model order reduction technique. Here, in spite of taking full order system model a reduced order model has been considered for 2DOF-IMC-PID design and the designed controller is directly applied to full order system model. The Logarithmic based model order reduction technique is proposed to reduce the single and two-area high order power systems for the application of controller design.The proposed IMC-PID design of reduced order model achieves good dynamic response and robustness against load disturbance with the original high order system. Copyright © 2018 ISA. Published by Elsevier Ltd. All rights reserved.

A Summary of Research on Energy Saving and Emission Reduction of Transportation

NASA Astrophysics Data System (ADS)

Cheng, Dongxiang; Wu, Lufen

2017-12-01

Road transport is an important part of transportation, and road in the field of energy-saving emission reduction is a very important industry. According to the existing problems of road energy saving and emission reduction, this paper elaborates the domestic and international research on energy saving and emission reduction from three aspects: road network optimization, pavement material and pavement maintenance. Road network optimization may be overlooked, and the research content is still relatively preliminary; pavement materials mainly from the asphalt pavement temperature mixed asphalt technology research; pavement maintenance technology development is relatively comprehensive.

Accuracy of the ECG for differential diagnosis between hypertrophic cardiomyopathy and athlete's heart: comparison between the European Society of Cardiology (2010) and International (2017) criteria.

PubMed

Zorzi, Alessandro; Calore, Chiara; Vio, Riccardo; Pelliccia, Antonio; Corrado, Domenico

2018-05-01

Interpretation of the athlete's ECG is based on differentiation between benign ECG changes and potentially pathological abnormalities. The aim of the study was to compare the 2010 European Society of Cardiology (ESC) and the 2017 International criteria for differential diagnosis between hypertrophic cardiomyopathy (HCM) and athlete's heart. The study populations included 200 patients with HCM and 563 athletes grouped as follows: 'group 1', including normal ECG and isolated increase of QRS voltages, which are considered non-pathologic according to ESC and International criteria; 'group 2', including left atrial enlargement or left axis deviation in isolation and Q-waves with an amplitude ≥4 mm but <25% of the ensuing R-wave and a duration <0.04 s which are considered pathologic according to the ESC but not according to the International criteria; and 'group 3', including abnormalities which are considered pathologic according to ESC and International criteria. Overall, the 2010 ESC criteria showed a sensitivity of 95.5% and a specificity of 86.9%. Considering group 2 ECG changes as normal according to the International criteria led to a statistically significant (p<0.001) increase of specificity to 95.9%, associated with a non-significant (p=0.47) reduction of sensitivity to 93%. Among patients with HCM, there was a significant increase of maximal left ventricular wall thickness from group 1 to 3 (p=0.02). The use of 2017 International criteria is associated with a substantial increase in specificity and a marginal decrease in sensitivity for differential diagnosis between HCM and athlete's heart. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Involvement of Caveolin in Low K+-induced Endocytic Degradation of Cell-surface Human Ether-a-go-go-related Gene (hERG) Channels*

PubMed Central

Massaeli, Hamid; Sun, Tao; Li, Xian; Shallow, Heidi; Wu, Jimmy; Xu, Jianmin; Li, Wentao; Hanson, Christian; Guo, Jun; Zhang, Shetuan

2010-01-01

Reduction in the rapidly activating delayed rectifier K+ channel current (IKr) due to either mutations in the human ether-a-go-go-related gene (hERG) or drug block causes inherited or drug-induced long QT syndrome. A reduction in extracellular K+ concentration ([K+]o) exacerbates long QT syndrome. Recently, we demonstrated that lowering [K+]o promotes degradation of IKr in rabbit ventricular myocytes and of the hERG channel stably expressed in HEK 293 cells. In this study, we investigated the degradation pathways of hERG channels under low K+ conditions. We demonstrate that under low K+ conditions, mature hERG channels and caveolin-1 (Cav1) displayed a parallel time-dependent reduction. Mature hERG channels coprecipitated with Cav1 in co-immunoprecipitation analysis, and internalized hERG channels colocalized with Cav1 in immunocytochemistry analysis. Overexpression of Cav1 accelerated internalization of mature hERG channels in 0 mm K+o, whereas knockdown of Cav1 impeded this process. In addition, knockdown of dynamin 2 using siRNA transfection significantly impeded hERG internalization and degradation under low K+o conditions. In cultured neonatal rat ventricular myocytes, knockdown of caveolin-3 significantly impeded low K+o-induced reduction of IKr. Our data indicate that a caveolin-dependent endocytic route is involved in low K+o-induced degradation of mature hERG channels. PMID:20605793

Internal Tooth Structure and Burial Practices: Insights into the Neolithic Necropolis of Gurgy (France, 5100-4000 cal. BC).

PubMed

Le Luyer, Mona; Coquerelle, Michael; Rottier, Stéphane; Bayle, Priscilla

2016-01-01

Variations in the dental crown form are widely studied to interpret evolutionary changes in primates as well as to assess affinities among human archeological populations. Compared to external metrics of dental crown size and shape, variables including the internal structures such as enamel thickness, tissue proportions, and the three-dimensional shape of enamel-dentin junction (EDJ), have been described as powerful measurements to study taxonomy, phylogenetic relationships, dietary, and/or developmental patterns. In addition to providing good estimate of phenotypic distances within/across archeological samples, these internal tooth variables may help to understand phylogenetic, functional, and developmental underlying causes of variation. In this study, a high resolution microtomographic-based record of upper permanent second molars from 20 Neolithic individuals of the necropolis of Gurgy (France) was applied to evaluate the intrasite phenotypic variation in crown tissue proportions, thickness and distribution of enamel, and EDJ shape. The study aims to compare interindividual dental variations with burial practices and chronocultural parameters, and suggest underlying causes of these dental variations. From the non-invasive characterization of internal tooth structure, differences have been found between individuals buried in pits with alcove and those buried in pits with container and pits with wattling. Additionally, individuals from early and recent phases of the necropolis have been distinguished from those of the principal phase from their crown tissue proportions and EDJ shape. The results suggest that the internal tooth structure may be a reliable proxy to track groups sharing similar chronocultural and burial practices. In particular, from the EDJ shape analysis, individuals buried in an alcove shared a reduction of the distolingual dentin horn tip (corresponding to the hypocone). Environmental, developmental and/or functional underlying causes might be suggested for the origin of phenotypic differences shared by these individuals buried in alcoves.

Missing the target: including perspectives of women with overweight and obesity to inform stigma‐reduction strategies

PubMed Central

Himmelstein, M. S.; Gorin, A. A.; Suh, Y. J.

2017-01-01

Summary Objective Pervasive weight stigma and discrimination have led to ongoing calls for efforts to reduce this bias. Despite increasing research on stigma‐reduction strategies, perspectives of individuals who have experienced weight stigma have rarely been included to inform this research. The present study conducted a systematic examination of women with high body weight to assess their perspectives about a broad range of strategies to reduce weight‐based stigma. Methods Women with overweight or obesity (N = 461) completed an online survey in which they evaluated the importance, feasibility and potential impact of 35 stigma‐reduction strategies in diverse settings. Participants (91.5% who reported experiencing weight stigma) also completed self‐report measures assessing experienced and internalized weight stigma. Results Most participants assigned high importance to all stigma‐reduction strategies, with school‐based and healthcare approaches accruing the highest ratings. Adding weight stigma to existing anti‐harassment workplace training was rated as the most impactful and feasible strategy. The family environment was viewed as an important intervention target, regardless of participants' experienced or internalized stigma. Conclusion These findings underscore the importance of including people with stigmatized identities in stigma‐reduction research; their insights provide a necessary and valuable contribution that can inform ways to reduce weight‐based inequities and prioritize such efforts. PMID:28392929

Functional electrical stimulation of gluteus medius reduces the medial joint reaction force of the knee during level walking.

PubMed

Rane, Lance; Bull, Anthony Michael James

2016-11-03

By altering muscular activation patterns, internal forces acting on the human body during dynamic activity may be manipulated. The magnitude of one of these forces, the medial knee joint reaction force (JRF), is associated with disease progression in patients with early osteoarthritis (OA), suggesting utility in its targeted reduction. Increased activation of gluteus medius has been suggested as a means to achieve this. Motion capture equipment and force plate transducers were used to obtain kinematic and kinetic data for 15 healthy subjects during level walking, with and without the application of functional electrical stimulation (FES) to gluteus medius. Musculoskeletal modelling was employed to determine the medial knee JRF during stance phase for each trial. A further computer simulation of increased gluteus medius activation was performed using data from normal walking trials by a manipulation of modelling parameters. Relationships between changes in the medial knee JRF, kinematics and ground reaction force were evaluated. In simulations of increased gluteus medius activity, the total impulse of the medial knee JRF was reduced by 4.2 % (p = 0.003) compared to control. With real-world application of FES to the muscle, the magnitude of this reduction increased to 12.5 % (p < 0.001), with significant inter-subject variation. Across subjects, the magnitude of reduction correlated strongly with kinematic (p < 0.001) and kinetic (p < 0.001) correlates of gluteus medius activity. The results support a major role for gluteus medius in the protection of the knee for patients with OA, establishing the muscle's central importance to effective therapeutic regimes. FES may be used to achieve increased activation in order to mitigate distal internal loads, and much of the benefit of this increase can be attributed to resulting changes in kinematic parameters and the ground reaction force. The utility of interventions targeting gluteus medius can be assessed in a relatively straightforward way by determination of the magnitude of reduction in pelvic drop, an easily accessed marker of aberrant loading at the knee.

Brief communication: Sendai framework for disaster risk reduction - success or warning sign for Paris?

NASA Astrophysics Data System (ADS)

Mysiak, Jaroslav; Surminski, Swenja; Thieken, Annegret; Mechler, Reinhard; Aerts, Jeroen

2016-09-01

In March 2015, a new international blueprint for disaster risk reduction (DRR) was adopted in Sendai, Japan, at the end of the Third UN World Conference on Disaster Risk Reduction (WCDRR, 14-18 March 2015). We review and discuss the agreed commitments and targets, as well as the negotiation leading the Sendai Framework for DRR (SFDRR) and discuss briefly its implication for the later UN-led negotiations on sustainable development goals and climate change.

NEHRP turns 40

USGS Publications Warehouse

Leith, William S.

2017-01-01

This year, the National Earthquake Hazards Reduction Program (NEHRP) turns 40, four decades since the Earthquake Hazards Reduction Act of 1977 was enacted establishing the Program, spurring numerous federal, state, and community actions to reduce earthquake losses in the U.S.A. and its territories and setting a standard for earthquake loss‐reduction projects internationally. Four agencies are partners in NEHRP: the Federal Emergency Management Agency (FEMA), the National Institute of Standards and Technology (NIST, the lead agency), the National Science Foundation (NSF), and the U.S. Geological Survey (USGS).

Intra-Articular Entrapment of the Medial Epicondyle following a Traumatic Fracture Dislocation of the Elbow in an Adult

PubMed Central

Hassan, Youssef G.; Joukhadar, Nabih I.

2018-01-01

Medial epicondyle entrapment after an acute fracture dislocation of the elbow is a common finding in the pediatric population, but a rare finding in adults. We present a case of an adult patient diagnosed with a traumatic fracture dislocation of the elbow joint with intra-articular entrapment of the medial epicondyle. After initial evaluation, closed reduction was done. Stability testing after reduction showed an unstable joint; thus, open reduction and internal fixation was decided. PMID:29666736

Evaluation of acoustic testing techniques for spacecraft systems

NASA Technical Reports Server (NTRS)

Cockburn, J. A.

1971-01-01

External acoustic environments, structural responses, noise reductions, and the internal acoustic environments have been predicted for a typical shroud/spacecraft system during lift-off and various critical stages of flight. Spacecraft responses caused by energy transmission from the shroud via mechanical and acoustic paths have been compared and the importance of the mechanical path has been evaluated. Theoretical predictions have been compared extensively with available laboratory and in-flight measurements. Equivalent laboratory acoustic fields for simulation of shroud response during the various phases of flight have been derived and compared in detail. Techniques for varying the time-space correlations of laboratory acoustic fields have been examined, together with methods for varying the time and spatial distribution of acoustic amplitudes. Possible acoustic testing configurations for shroud/spacecraft systems have been suggested and trade-off considerations have been reviewed. The problem of simulating the acoustic environments versus simulating the structural responses has been considered and techniques for testing without the shroud installed have been discussed.

Rechargeable internal neural stimulators--is there a problem with efficacy?

PubMed

Harries, Anwen M; Major, Shannon; Sandhu, Mandeep; Honey, Christopher R

2012-01-01

With the advent of rechargeable internal neural stimulators (rINS) for deep brain stimulation, our aim was to survey patient satisfaction and clinical efficacy in an early cohort of patients receiving this new technology. This is an observational study on nine patients with rINS. All patients had initially received non-rechargeable INS with established efficacy of their deep brain stimulation system for either dystonia or pain. Patient satisfaction and efficacy with their rINS were established by completion of a questionnaire, a quality of life assessment (SF-36), and calculation of the total electrical energy delivered (TEED) by the rINS. A reduction in efficacy of their rINS was noticed in 22% of patients. In 78% of patients, there was a problem with recharging their rINS because of poor contact. Two patients (22%) felt that recharging the rINS interfered with their lives and it was a daily reminder that they had a deep brain stimulator system in situ. Eight out of nine patients (89%), however, would recommend to other patients to have an rINS. Most patients were happy with their rechargeable internal neural stimulator. A reduction in efficacy was noticed in 22% of patients, which is similar to the proportion of patients noticing a reduction in efficacy when replacing with a non-rechargeable system. Thus, all patients require close monitoring post-replacement of rINS, in case possible adjustment of parameters is required. © 2011 International Neuromodulation Society.

Internal fixation in pelvic fractures and primary repairs of associated genitourinary disruptions: a team approach.

PubMed

Routt, M L; Simonian, P T; Defalco, A J; Miller, J; Clarke, T

1996-05-01

Associated urological and orthopedic injuries of the pelvic ring are complex with numerous potential complications. These patients are treated optimally using a team approach. The combined expertise is not only helpful initially when managing these difficult patients, but also later as problems develop. This study describes a treatment protocol and reports the early results of 23 patients with unstable pelvic fractures and associated bladder or urethral disruptions, or both, treated surgically with open reduction and internal fixation of the anterior pelvic ring injuries at the same anesthetic and using the same surgical exposure as the urethral realignments or bladder repairs or both. Early complications occurred in four patients (17%): one patient sustained a fifth lumbar nerve injury caused by the pelvic reduction procedure, and three patients had anterior pelvic internal fixation failures. Late complications occurred in eight patients (35%). There was one deep wound infection (4.3%) that presented 6 weeks after injury. Late urological complications occurred in seven patients (30%). Four of the nine male patients with urethral disruptions had urethral stricture after their primary urethral realignments (44%). Three of the 18 male patients admitted to impotence (16.7%). One of the three had a residual thoracic paraplegia caused by a burst fracture. One of the five female patients had urinary incontinence and required a bladder suspension operation to restore normal function (20%). A low infection rate can be expected despite the use of internal fixation. Early urethral "indirect" realignments avoid more difficult delayed open repairs; however, late urological complication rates are still high. Early "direct" bladder repairs are easily performed at the time of anterior pelvic open reduction and internal fixation. Suprapubic tubes are not necessary to adequately divert the urine when large diameter urethral catheters are used in these patients.

Clinical and electrodiagnostic characteristics of nitrous oxide-induced neuropathy in Taiwan.

PubMed

Li, Han-Tao; Chu, Chun-Che; Chang, Kuo-Hsuan; Liao, Ming-Feng; Chang, Hong-Shiu; Kuo, Hung-Chou; Lyu, Rong-Kuo

2016-10-01

Nitrous oxide-induced neuropathy is toxic neuropathy occasionally encountered in Taiwanese neurological clinics. Only several case reports described their electrodiagnostic features. We used a case-control design to investigate the detailed electrodiagnostic characteristics and possible factors relating to severe nerve injury. We retrospectively reviewed 33 patients with nitrous oxide-induced neuropathy over a 10-year period and reported their demographic data, spinal cord MRI, laboratory examinations and nerve conduction studies. 56 healthy controls' nerve conduction studies were collected for comparison analysis. We noted significant motor and sensory amplitudes reduction, conduction velocities slowing, and latencies prolongation in most tested nerves compared to the controls. Similar nerve conduction study characteristics with prominent lower limbs' motor and sensory amplitudes reduction was observed in patient groups with or without abnormal vitamin B12 and/or homocysteine levels. Among those with lower limbs' motor or sensory amplitudes reduction <20% of the lower limit of normal, higher homocysteine levels were detected. Severe impairments of the lower limbs' sensory and motor amplitudes were frequently noted in patients with nitrous oxide exposure. Nitrous oxide exposure itself is an important factor for the development of neuropathy. Our study contributes to the understanding of electrodiagnostic features underlying the nitrous oxide-induced neuropathy. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Everolimus immunosuppression for renal protection, reduction of allograft vasculopathy and prevention of allograft rejection in de-novo heart transplant recipients: could we have it all?

PubMed

Gude, Einar; Gullestad, Lars; Andreassen, Arne K

2017-06-01

De-novo introduction of everolimus (Eve) in heart transplant recipients opens for early reduction of calcineurin inhibitors (CNI) and potential of preserving renal function, attenuate progression of coronary allograft vasculopathy (CAV) and maintain rejection efficacy. The first trials demonstrated adequate rejection prophylaxis and favorable outcomes on CAV, but observed enhanced nephrotoxicity because of insufficient CNI reduction. The SCHEDULE trial compared de-novo Eve with significantly reduced CNI exposure and conversion to CNI-free treatment week 7-11 postheart transplant, with standard CNI immunosuppression. Improved renal function and attenuation of CAV was found among Eve patients, with higher numbers of treated acute rejections observed. With sustained superior renal and CAV related data also after 36 months with the Eve protocol, cardiac function was equally well preserved in both groups. According to the International Society of Heart and Lunge Transplantation registry, mammalian target of rapamycin inhibitor treatment is uncommon during the first postoperative year, with a prevalence of 20% in patients after 5 years. Current evidence suggests a greater benefit from these immunosuppressives if introduced at an earlier timepoint. Immunosuppressive protocols based on Eve treatment in de-novo patients should be further investigated and developed, enabling CNI avoidance before accelerating side-effects lead to irreversible damage.

An allosteric disulfide bond is involved in enhanced activation of factor XI by protein disulfide isomerase.

PubMed

Zucker, M; Seligsohn, U; Yeheskel, A; Mor-Cohen, R

2016-11-01

Essentials Reduction of three disulfide bonds in factor (F) XI enhances chromogenic substrate cleavage. We measured FXI activity upon reduction and identified a bond involved in the enhanced activity. Reduction of FXI augments FIX cleavage, probably by faster conversion of FXI to FXIa. The Cys362-Cys482 disulfide bond is responsible for FXI enhanced activation upon its reduction. Background Reduction of factor (F) XI by protein disulfide isomerase (PDI) has been shown to enhance the ability of FXI to cleave its chromogenic substrate. Three disulfide bonds in FXI (Cys118-Cys147, Cys362-Cys482, and Cys321-Cys321) are involved in this augmented activation. Objectives To characterize the mechanisms by which PDI enhances FXI activity. Methods FXI activity was measured following PDI reduction. Thiols that were exposed in FXI after PDI reduction were labeled with 3-(N-maleimidopropionyl)-biocytin (MPB) and detected with avidin. The rate of conversion of FXI to activated FXI (FXIa) following thrombin activation was assessed with western blotting. FXI molecules harboring mutations that disrupt the three disulfide bonds (C147S, C321S, and C482S) were expressed in cells. The antigenicity of secreted FXI was measured with ELISA, and its activity was assessed by the use of a chromogenic substrate. The effect of disulfide bond reduction was analyzed by the use of molecular dynamics. Results Reduction of FXI by PDI enhanced cleavage of both its chromogenic substrate, S2366, and its physiologic substrate, FIX, and resulted in opening of the Cys362-Cys482 bond. The rate of conversion of FXI to FXIa was increased following its reduction by PDI. C482S-FXI showed enhanced activity as compared with both wild-type FXI and C321S-FXI. MD showed that disruption of the Cys362-Cys482 bond leads to a broader thrombin-binding site in FXI. Conclusions Reduction of FXI by PDI enhances its ability to cleave FIX, probably by causing faster conversion of FXI to FXIa. The Cys362-Cys482 disulfide bond is involved in enhancing FXI activation following its reduction, possibly by increasing thrombin accessibility to FXI. © 2016 International Society on Thrombosis and Haemostasis.

Timber markets and fuel treatments in the western US

Treesearch

Karen L. Abt; Jeffrey P. Prestemon

2006-01-01

We developed a model of interrelated timber markets in the U.S. West to assess the impacts of large-scale fuel reduction programs on these markets, and concomitant effects of the market on the fuel reduction programs. The linear programming spatial equilibrium model allows interstate and international trade with western Canada and the rest of the world, while...

26 CFR 1.1248-8 - Earnings and profits attributable to stock following certain non-recognition transactions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... of this section. (5) Reduction in earnings and profits attributable to stock to prevent multiple... reduce the CFC3 earnings and profits attributable to its CFC2 stock by $9. These reductions occur without... 26 Internal Revenue 11 2011-04-01 2011-04-01 false Earnings and profits attributable to stock...

Truck Noise X : Noise Reduction Options for Diesel Powered International Harvester Trucks : Volume 2. Cost-Noise Analysis and Field Installation.

DOT National Transportation Integrated Search

1977-04-01

Noise reduction option development work was carried out on two inservice diesel powered IH trucks, consisting of a Cab-over model and a Conventional model with a baseline exterior noise level of 87 dB(A) each. Since no specific noise goals were set, ...

Dissonance and Healthy Weight Eating Disorder Prevention Programs: Long-Term Effects from a Randomized Efficacy Trial

ERIC Educational Resources Information Center

Stice, Eric; Marti, C. Nathan; Spoor, Sonja; Presnell, Katherine; Shaw, Heather

2008-01-01

Adolescent girls with body dissatisfaction (N = 481, SD = 1.4) were randomized to a dissonance-based thin-ideal internalization reduction program, healthy weight control program, expressive writing control condition, or assessment-only control condition. Dissonance participants showed significantly greater decreases in thin-ideal internalization,…

Setting the Standard. International Forum on Education in Penal Systems Conference Proceedings (Adelaide, Australia, April 5-7, 1998).

ERIC Educational Resources Information Center

Semmens, Bob, Ed.; Cook, Sandy, Ed.

This document contains 19 papers presented at an international forum on education in penal systems. The following papers are included: "Burning" (Craig W.J. Minogue); "The Acquisition of Cognitive Skills as a Means of Recidivism Reduction: A Former Prisoner's Perspective" (Trevor Darryl Doherty); "CEA (Correctional…

Microsatellite-aided detection of genetic redundancy improves management of the International Cocoa Genebank, Trinidad

USDA-ARS?s Scientific Manuscript database

Cacao (Theobroma cacao L.), the tree from which cocoa butter and chocolate is derived, is conserved in field genebanks. The largest of these ex situ collections in the public domain is the International Cocoa Genebank, Trinidad (ICG,T). Reduction of genetic redundancy is essential to improve the acc...

Environmental assessment of combustion modification controls for stationary internal combustion engines. Final report Sep 78-Jul 79

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

Lips, H.I.; Gotterba, J.A.; Lim, K.J.

1981-07-01

The report gives results of an environmental assessment of combustion modification techniques for stationary internal combustion engines, with respect to NOx control reduction effectiveness, operational impact, thermal efficiency impact, capital and annualized operating costs, and effects on emissions of pollutants other than NOx.

Organizational Impact of the Introduction of a New Portable Syringe Pump for Iloprost Therapy in Italian Hospital Settings

PubMed Central

Restelli, Umberto; Faggioli, Paola; Scolari, Francesca; Gussoni, Gualberto; Valerio, Antonella; Sciascera, Alba; Croce, Davide; Mazzone, Antonino

2015-01-01

Purpose: The study aims at assessing the organizational and economic impact related to the use of a new portable syringe pump (Pompa Infonde®, Italfarmaco S.p.A., Cinisello Balsamo, Italy) at a hospital level. Methodology: Based on the HTA approach, the analysis assessed the organizational and economic impact of the new device at hospital level, using the traditional methods of Iloprost infusion as comparator. After a pilot evaluation, the organizational impact was assessed within 24 Italian hospitals. Structured interviews were conducted with clinicians and nurses. According to the Hospital-Based HTA approach, a questionnaire assessed the impact on human resources, training activities, internal meetings, spaces needed, facilities, clinical practice implications. Using Activity Based Costing approach, the economic evaluation was performed within the pilot center “Ospedale Civile” of Legnano, Italy. Findings: The new device leads to a positive managerial impact, with a substantial reduction of time to monitor patients by nurses. This resulted in a better management of human resources and in a reduction in nursing cost. Although a mild negative impact on training time for personnel, the structured interviews allowed the identification of three main areas of positive impact: (i) efficiency of internal processes, (ii) clinical pathways, (iii) synergies between wards. Originality: The organizational impact of Pompa Infonde®, showed that it is an efficient alternative to traditional methods, with benefits in the management of patients administered with Iloprost.

Fluctuations in running and skill-related performance in elite rugby union match-play.

PubMed

Lacome, Mathieu; Piscione, Julien; Hager, Jean-Philippe; Carling, Chris

2017-03-01

This study investigated end-game and transient changes in running activities and whether these were concomitantly associated with reductions in skill-related performance in senior international rugby union match-play. Altogether, 18 official matches were analysed (322 individual observations) using computerised video-based tracking and event coding (Amisco Pro ® , SUP, Nice, France). In forwards and backs, trivial to small reductions (% difference: -2.1, ±1.3 to -10.0, ±4.0%) in total distance and that covered at high speeds (>18.0 km h -1 ) occurred in the second- versus the first-half while there were trivial differences in skill-related performance measures (-2.3, ±4.5 to 7.5, ±14.0%). In both positions, small to moderate declines (-42, ±10 to -21, ±7%) occurred in high-speed running in the final 10-min and 5-min periods versus mean values for all other 10-min and 5-min periods throughout the game while only small changes (-18, ±51 to 13, ±41%) in skill-related performance were observed. Trivial changes in running and skill-related performance (-11, ±74 to 7, ±39%) were observed in the 5-min period immediately following the most intense 5-minute periods of play compared to mean performance over the other 5-min periods. These findings suggest that international rugby union players were generally able to maintain skill-related performance over the course of match-play even when declines in running performance occurred.

Cardiac and Vascular Responses to Thigh Cuffs and Respiratory Maneuvers on Crewmembers of the International Space Station

NASA Technical Reports Server (NTRS)

Hamilton, Douglas; Sargsyan, Ashot E.; Garcia, Kathleen; Ebert, Douglas; Whitson, Peggy A.; Feiveson, Alan; Alferova, Irina V.; Dulchavsky, Scott A.; Matveev, Vladimir P.; Bogomolov, Valery V.;

Effect of leaded glasses and thyroid shielding on cone beam CT radiation dose in an adult female phantom

PubMed Central

Goren, AD; Prins, RD; Dauer, LT; Quinn, B; Al-Najjar, A; Faber, RD; Patchell, G; Branets, I; Colosi, DC

2013-01-01

Objectives: This study aims to demonstrate the effectiveness of leaded glasses in reducing the lens of eye dose and of lead thyroid collars in reducing the dose to the thyroid gland of an adult female from dental cone beam CT (CBCT). The effect of collimation on the radiation dose in head organs is also examined. Methods: Dose measurements were conducted by placing optically stimulated luminescent dosemeters in an anthropomorphic female phantom. Eye lens dose was measured by placing a dosemeter on the anterior surface of the phantom eye location. All exposures were performed on one commercially available dental CBCT machine, using selected collimation and exposure techniques. Each scan technique was performed without any lead shielding and then repeated with lead shielding in place. To calculate the percent reduction from lead shielding, the dose measured with lead shielding was divided by the dose measured without lead shielding. The percent reduction from collimation was calculated by comparing the dose measured with collimation to the dose measured without collimation. Results: The dose to the internal eye for one of the scans without leaded glasses or thyroid shield was 0.450 cGy and with glasses and thyroid shield was 0.116 cGy (a 74% reduction). The reduction to the lens of the eye was from 0.396 cGy to 0.153 cGy (a 61% reduction). Without glasses or thyroid shield, the thyroid dose was 0.158 cGy; and when both glasses and shield were used, the thyroid dose was reduced to 0.091 cGy (a 42% reduction). Conclusions: Collimation alone reduced the dose to the brain by up to 91%, with a similar reduction in other organs. Based on these data, leaded glasses, thyroid collars and collimation minimize the dose to organs outside the field of view. PMID:23412460

Development of reduction scenarios for criteria air pollutants emission in Tehran Traffic Sector, Iran.

PubMed

Mohammadiha, Amir; Malakooti, Hossein; Esfahanian, Vahid

2018-05-01

Transport-related pollution as the main source of air pollution must be reduced in Tehran mega-city. The performance of various developed scenarios including BAU (Business As Usual) as baseline scenario, ECV (Elimination of carburetor equipped Vehicle), NEM (New Energy Motorcycles), HES (Higher Emission Standard), VCR (Vehicle Catalyst Replacement), FQE (Fuel Quality Enhancement), DPF (Diesel Particulate Filter) and TSA (Total Scenarios Aggregation) are evaluated by International Vehicle Model up to 2028. In the short term, the ECV, VCR, and FQE scenarios provided high performance in CO, VOCs and NOx emissions control. Also FQE has an excellent effect on SOx emission reduction (86%) and DPF on PM emissions (20%). In the mid-term, the VCR, ECV, and FQE scenarios were presented desirable mean emission reduction on CO, VOCs, and NOx. Moreover, NOx emission reduction of DPF scenario is the most common (14%). Again FQE scenario proves to have great effect on SOx emission reduction in mid-term (86%), DPF and HES scenarios on PM (DPF: 49% and HES: 17%). Finally for the long term, VCR, ECV, FQE, and NEM scenarios were shown good performance in emission control on CO, VOCs and NOx. For SOx only FQE has a good effect in all time periods (FQE: 86%) and DPF and HES scenarios have the best effect on PM emission reduction respectively (DPF: 51% and HES: 27%) compared with BAU scenario. However, DPF scenario increases 12% SOx emission in long-term (2028). It can be generally concluded that VCR and ECV scenarios would achieve a significant reduction on gaseous pollutants emission except for SOx in general and FQE scenarios have desirable performance for all gaseous pollutants in the short term and also for SOx and VOCs in long term. In addition, the DPF and HES would be desirable scenario for emission control on PM in Tehran Traffic Sector. Copyright © 2017 Elsevier B.V. All rights reserved.

Continuous cognitive task promotes greater postural stability than an internal or external focus of attention.

PubMed

Polskaia, Nadia; Richer, Natalie; Dionne, Eliane; Lajoie, Yves

2015-02-01

Research has demonstrated clear advantages of using an external focus of attention in postural control tasks, presumably since it allows a more automatic control of posture to emerge. However, the influence of cognitive tasks on postural stability has produced discordant results. This study aimed to compare the effects of an internal focus of attention, an external focus of attention and a continuous cognitive task on postural control. Twenty healthy participants (21.4±2.6 years) were recruited for this study. They were asked to stand quietly on a force platform with their feet together in three different attentional focus conditions: an internal focus condition (minimizing movements of the hips), an external focus condition (minimizing movements of markers placed on the hips) and a cognitive task condition (silently counting the total number of times a single digit was verbalized in a 3-digit sequence comprised of 30 numbers). Results demonstrated improved stability while performing the cognitive task as opposed to the internal and external focus conditions, as evidenced by a reduction in sway area, sway variability in the anterior-posterior (AP) and medial-lateral (ML) directions, and mean velocity (ML only). Results suggest that the use of a continuous cognitive task permits attention to be withdrawn from the postural task, thereby facilitating a more automatic control of posture. Copyright © 2014 Elsevier B.V. All rights reserved.

Effectiveness of Manual Therapy and Stretching for Baseball Players With Shoulder Range of Motion Deficits.

PubMed

Bailey, Lane B; Thigpen, Charles A; Hawkins, Richard J; Beattie, Paul F; Shanley, Ellen

Baseball players displaying deficits in shoulder range of motion (ROM) are at increased risk of arm injury. Currently, there is a lack of consensus regarding the best available treatment options to restore shoulder ROM. Instrumented manual therapy with self-stretching will result in clinically significant deficit reductions when compared with self-stretching alone. Controlled laboratory study. Shoulder ROM and humeral torsion were assessed in 60 active baseball players (mean age, 19 ± 2 years) with ROM deficits (nondominant - dominant, ≥15°). Athletes were randomly assigned to receive a single treatment of instrumented manual therapy plus self-stretching (n = 30) or self-stretching only (n = 30). Deficits in internal rotation, horizontal adduction, and total arc of motion were compared between groups immediately before and after a single treatment session. Treatment effectiveness was determined by mean comparison data, and a number-needed-to-treat (NNT) analysis was used for assessing the presence of ROM risk factors. Prior to intervention, players displayed significant ( P < 0.001) dominant-sided deficits in internal rotation (-26°), total arc of motion (-18°), and horizontal adduction (-17°). After the intervention, both groups displayed significant improvements in ROM, with the instrumented manual therapy plus self-stretching group displaying greater increases in internal rotation (+5°, P = 0.010), total arc of motion (+6°, P = 0.010), and horizontal adduction (+7°, P = 0.004) compared with self-stretching alone. For horizontal adduction deficits, the added use of instrumented manual therapy with self-stretching decreased the NNT to 2.2 (95% CI, 2.1-2.4; P = 0.010). Instrumented manual therapy with self-stretching significantly reduces ROM risk factors in baseball players with motion deficits when compared with stretching alone. The added benefits of manual therapy may help to reduce ROM deficits in clinical scenarios where stretching alone is ineffective.

10 kHz High-Frequency Spinal Cord Stimulation for Chronic Axial Low Back Pain in Patients With No History of Spinal Surgery: A Preliminary, Prospective, Open Label and Proof-of-Concept Study.

PubMed

Al-Kaisy, Adnan; Palmisani, Stefano; Smith, Thomas E; Pang, David; Lam, Khai; Burgoyne, William; Houghton, Russell; Hudson, Emma; Lucas, Jonathan

2017-01-01

To explore the effectiveness of 10 kHz high frequency spinal cord stimulation (HF10 therapy) treatment of chronic low back pain in patients who have not had spinal surgery. Patients with chronic low back pain without prior spinal surgery were evaluated by a team of spine surgeons to rule out any spinal pathology amenable to surgical interventions and by a multidisciplinary pain team to confirm eligibility for the study. After a successful (>50% back pain reduction) trial of HF10 therapy, enrolled subjects underwent permanent system implantation and were followed-up one year post-implant. About 95% of the enrolled subjects (20/21) received the permanent system. At 12 months post-implant, both back pain VAS score and ODI were significantly reduced compared with baseline values (by 73% and 48%, respectively); an estimated quality-adjusted life year gain of 0.47 and a reduction in opioid use by 64% was observed. Four more patients among those unable to work at baseline due to back pain were employed at 12 months post-implant. There were no serious adverse events. HF10 therapy may provide significant back pain relief, reduction in disability, improvement quality of life, and reduction in opioid use in chronic low back pain not resulting from spinal surgery. © 2016 The Authors. Neuromodulation: Technology at the Neural Interface published by Wiley Periodicals, Inc. on behalf of International Neuromodulation Society.

Nitrite reduction by biogenic hydroxycarbonate green rusts: evidence for hydroxy-nitrite green rust formation as an intermediate reaction product.

PubMed

Guerbois, Delphine; Ona-Nguema, Georges; Morin, Guillaume; Abdelmoula, Mustapha; Laverman, Anniet M; Mouchel, Jean-Marie; Barthelemy, Kevin; Maillot, Fabien; Brest, Jessica

2014-04-15

The present study investigates for the first time the reduction of nitrite by biogenic hydroxycarbonate green rusts, bio-GR(CO3), produced from the bioreduction of ferric oxyhydroxycarbonate (Fohc), a poorly crystalline solid phase, and of lepidocrocite, a well-crystallized Fe(III)-oxyhydroxide mineral. Results show a fast Fe(II) production from Fohc, which leads to the precipitation of bio-GR(CO3) particles that were roughly 2-fold smaller (2.3 ± 0.4 μm) than those obtained from the bioreduction of lepidocrocite (5.0 ± 0.4 μm). The study reveals that both bio-GR(CO3) are capable of reducing nitrite ions into gaseous nitrogen species such as NO, N2O, or N2 without ammonium production at neutral initial pH and that nitrite reduction proceeded to a larger extent with smaller particles than with larger ones. On the basis of the identification of intermediates and end-reaction products using X-ray diffraction and X-ray absorption fine structure (XAFS) spectroscopy at the Fe K-edge, our study shows the formation of hydroxy-nitrite green rust, GR(NO2), a new type of green rust 1, and suggests that the reduction of nitrite by biogenic GR(CO3) involves both external and internal reaction sites and that such a mechanism could explain the higher reactivity of green rust with respect to nitrite, compared to other mineral substrates possessing only external reactive sites.

[Caesarean section and anal incontinence].

PubMed

Kalis, V; Stipán, J; Chaloupka, P; Karbanová, J; Rokyta, Z

2008-04-01

Summary of the impact of Caesarean section on anal incontinence. Review. Department of Gynaecology and Obstetrics, Charles University and University Hospital Plzen. Review of the current international literature. Currently, Caesarean section is not considered to reduce symptoms of anal incontinence. If there is any reduction of symptoms, that remains only for a short term (40% in 3 months after the delivery in the largest trial). In a long term, virtually in no trial has been observed any difference, and others, non-obstetrical factors (particularly aging) prevail. Current knowledge does not allow to assess sufficiently pros and cons of Caesarean compared to vaginal delivery. High risk groups, that would profit from elective Ceasarean, have not been clearly identified yet.

Michigan Energy and Cost Savings for New Single- and Multifamily Homes: 2012 IECC as Compared to the Michigan Uniform Energy Code

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

Lucas, Robert G.; Taylor, Zachary T.; Mendon, Vrushali V.

2012-07-03

The 2012 International Energy Conservation Code (IECC) yields positive benefits for Michigan homeowners. Moving to the 2012 IECC from the Michigan Uniform Energy Code is cost-effective over a 30-year life cycle. On average, Michigan homeowners will save $10,081 with the 2012 IECC. Each year, the reduction to energy bills will significantly exceed increased mortgage costs. After accounting for up-front costs and additional costs financed in the mortgage, homeowners should see net positive cash flows (i.e., cumulative savings exceeding cumulative cash outlays) in 1 year for the 2012 IECC. Average annual energy savings are $604 for the 2012 IECC.

Ohio Energy and Cost Savings for New Single- and Multifamily Homes: 2012 IECC as Compared to the 2009 IECC

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

Lucas, Robert G.; Taylor, Zachary T.; Mendon, Vrushali V.

2012-07-03

The 2012 International Energy Conservation Code (IECC) yields positive benefits for Ohio homeowners. Moving to the 2012 IECC from the 2009 IECC is cost-effective over a 30-year life cycle. On average, Ohio homeowners will save $5,151 with the 2012 IECC. Each year, the reduction to energy bills will significantly exceed increased mortgage costs. After accounting for up-front costs and additional costs financed in the mortgage, homeowners should see net positive cash flows (i.e., cumulative savings exceeding cumulative cash outlays) in 1 year for the 2012 IECC. Average annual energy savings are $330 for the 2012 IECC.

Study on vibration characteristic of the marine beveloid gear RV reducer

NASA Astrophysics Data System (ADS)

Wen, Jianmin; Cui, Haiyue; Yang, Tong

2018-05-01

The paper focuses on the vibration characteristic of the marine beveloid gear RV reducer and provides the theoretical guidance for vibration reduction. The cycloid gears are replaced by the beveloid gears in the transmission system. Considering the impact of the backlash, time-varying meshing stiffness and transmission error, a three-dimensional lumped parameter dynamic model of the marine beveloid gear RV reducer is established. The dynamic differential equations are solved through the 4th-5th order Runge-Kutta numerical integration method. By comparing the change of the time-displacement curves and amplitude curves, the impact of the external and internal excitation on the system vibration characteristic is investigated.

A VLSI VAX chip set

NASA Astrophysics Data System (ADS)

Johnson, W. N.; Herrick, W. V.; Grundmann, W. J.

1984-10-01

For the first time, VLSI technology is used to compress the full functinality and comparable performance of the VAX 11/780 super-minicomputer into a 1.2 M transistor microprocessor chip set. There was no subsetting of the 304 instruction set and the 17 data types, nor reduction in hardware support for the 4 Gbyte virtual memory management architecture. The chipset supports an integral 8 kbyte memory cache, a 13.3 Mbyte/s system bus, and sophisticated multiprocessing. High performance is achieved through microcode optimizations afforded by the large control store, tightly coupled address and data caches, the use of internal and external 32 bit datapaths, the extensive aplication of both microlevel and macrolevel pipelining, and the use of specialized hardware assists.

Event-related potentials during recognition of semantic and pictorial food stimuli in patients with anorexia nervosa and healthy controls with varying internal states of hunger.

PubMed

Nikendei, Christoph; Friederich, Hans-Christoph; Weisbrod, Matthias; Walther, Stephan; Sharma, Anuradha; Herzog, Wolfgang; Zipfel, Stephan; Bender, Stephan

2012-01-01

To elucidate maladaptive central processing of food cues during recognition tasks in anorexia nervosa (AN), while considering influences of nutritional preload and presentation modality (word versus picture). Event-related potentials to food-related word and pictorial stimuli were assessed during recognition tasks in 16 patients with AN, 16 control participants with food intake before the study, and 16 control participants with a fasting period before the study. Patients with AN showed a P3b amplitude reduction especially at the midline parietal site compared with satiated controls (5.7 [standard deviation = 3.3] versus 8.7 [3.1] μV, p < .03). Subtle recognition deficits in patients with AN were indicated by smaller "old/new" effects compared with satiated (p = .049) and fasting controls (p < .003) for pictorial stimuli. Hunger-modulated enhanced old/new effects for food pictures compared with neutral pictorial stimuli could be observed in fasting controls only (2.7 [2.6] versus 0.8 [2.2] μV, p < .01). The presented data provide evidence for a midline parietal P3b amplitude reduction in patients with AN, which might point to reduced network activation in AN even during satiety. Observed subtle recognition deficits either represent a stable trait characteristic or a "scar" effect of chronic starvation that may play a role in the development and/or persistence of the disorder.

Reduction of Iron-Oxide-Carbon Composites: Part II. Rates of Reduction of Composite Pellets in a Rotary Hearth Furnace Simulator

NASA Astrophysics Data System (ADS)

Halder, S.; Fruehan, R. J.

2008-12-01

A new ironmaking concept is being proposed that involves the combination of a rotary hearth furnace (RHF) with an iron-bath smelter. The RHF makes use of iron-oxide-carbon composite pellets as the charge material and the final product is direct-reduced iron (DRI) in the solid or molten state. This part of the research includes the development of a reactor that simulated the heat transfer in an RHF. The external heat-transport and high heating rates were simulated by means of infrared (IR) emitting lamps. The reaction rates were measured by analyzing the off-gas and computing both the amount of CO and CO2 generated and the degree of reduction. The reduction times were found to be comparable to the residence times observed in industrial RHFs. Both artificial ferric oxide (PAH) and naturally occurring hematite and taconite ores were used as the sources of iron oxide. Coal char and devolatilized wood charcoal were the reductants. Wood charcoal appeared to be a faster reductant than coal char. However, in the PAH-containing pellets, the reverse was found to be true because of heat-transfer limitations. For the same type of reductant, hematite-containing pellets were observed to reduce faster than taconite-containing pellets because of the development of internal porosity due to cracking and fissure formation during the Fe2O3-to-Fe3O4 transition. This is, however, absent during the reduction of taconite, which is primarily Fe3O4. The PAH-wood-charcoal pellets were found to undergo a significant amount of swelling at low-temperature conditions, which impeded the external heat transport to the lower layers. If the average degree of reduction targeted in an RHF is reduced from 95 to approximately 70 pct by coupling the RHF with a bath smelter, the productivity of the RHF can be enhanced 1.5 to 2 times. The use of a two- or three-layer bed was found to be superior to that of a single layer, for higher productivities.

Feasibility of using piezoelectric actuators to control launch vehicle acoustics and structural vibrations

NASA Astrophysics Data System (ADS)

Niezrecki, Christopher; Cudney, Harley H.

2000-06-01

Future launch vehicle payload fairings will be manufactured form advanced lightweight composite materials. The loss of distributed mass causes a significant increase in the internal acoustic environment, causing a severe threat to the payload. Using piezoelectric actuators to control the fairing vibration and the internal acoustic environment has been proposed. To help determine the acoustic control authority of piezoelectric actuators mounted on a rocket fairing, the internal acoustic response created by the actuators needs to be determined. In this work, the internal acoustic response of a closed simply-supported (SS) cylinder actuated by piezoelectric (PZT) actuators is determined using a n impedance model for the actuator and boundary element analysis. The experimentally validated model is used to extrapolate results for a SS cylinder that emulates a Minotaur payload fairing. The internal cylinder acoustic levels are investigated for PZT actuation between 35 and 400 Hz. Significant reductions in the structural response due to increased damping do not equate to similar reductions in the acoustic SPLs for the cylinder. The sound levels at the acoustic resonant frequencies are essentially unaffected by the significant increase in structural damping while the acoustic level sat the structural resonant frequencies are mildly reduced. The interior acoustic response of the cylinder is dominated by the acoustic modes and therefore significant reductions in the overall interior acoustic levels will not be achieved if only the structural resonances are controlled. As the actuation frequency is reduced, the number of actuators required to generate acoustic levels commensurate to that found in the fairing increases to impractical values. Below approximately 100 Hz, the current demands reach levels that are extremely difficult to achieve with a practical system. The results of this work imply that PZT actuators do not have the authority to control the payload fairing internal acoustics below approximately 100 Hz.

Comparative Analysis of Miniature Internal Combustion Engine and Electric Motor for UAV Propulsion

NASA Astrophysics Data System (ADS)

Chiclana, Branden Mark

This thesis compares the performance of an engine/fuel tank based propulsion system to a motor/battery based propulsion system of equal total mass. The results show that the endurance of the engine/fuel system at the same thrust output is approximately 5 times greater than that of the motor/battery system. This is a direct result of the fact that the specific energy of the fuel is 20 times that of the lithium-polymer batteries used to power the motor. A method is also developed to account for the additional benefits of fuel consumption (and hence weight reduction) over the course of the flight. Accounting for this effect can increase endurance exponentially. Taken together, the results also demonstrate the dramatic performance improvements that are possible simply by replacing motor/battery systems with engine/fuel systems on small unmanned air vehicles.

Glutathione reduces cytotoxicity of polyethyleneimine coated magnetic nanoparticles in CHO cells.

PubMed

Strojan, Klemen; Lojk, Jasna; Bregar, Vladimir B; Veranič, Peter; Pavlin, Mojca

2017-06-01

Polyethyleneimine (PEI) is a polycationic compound frequently used as a transfection agent. However, cytotoxicity of PEI and PEI-coated nanoparticles (PEI NPs) is still a major obstacle in its use. In this study we report a method for reducing cytotoxicity of PEI NPs by addition of glutathione in NPs synthesis. Glutathione reduced cytotoxic effects for at least 30% and decreased observed oxidative stress response compared to standard formulation. Results showed that the effect was partially due to reduced zeta potential and partially due to protective antioxidant properties of glutathione. Addition of glutathione to cell culture media with concurrent exposure to PEI NPs proved to be insufficient for cytotoxicity reduction. Additionally, we compared internalization pathways of both PEI NPs and GSH NPs. NPs were only found in endosomes and no NPs were found free in the cytosol, as would be expected according to so called proton sponge hypothesis. Copyright © 2017 Elsevier B.V. All rights reserved.

Conservative versus invasive stable ischemic heart disease management strategies: what do we plan to learn from the ISCHEMIA trial?

PubMed

Cheng-Torres, Kathleen A; Desai, Karan P; Sidhu, Mandeep S; Maron, David J; Boden, William E

2016-01-01

Over the past decade, landmark randomized clinical trials comparing initial management strategies in stable ischemic heart disease (SIHD) have demonstrated no significant reduction in 'hard' end points (all-cause mortality, cardiac death or myocardial infarction) with one strategy versus another. The main advantage derived from early revascularization is improved short-term quality of life. Nonetheless, questions remain regarding how best to manage SIHD patients, such as whether a high-risk subgroup can be identified that may experience a survival or myocardial infarction benefit from early revascularization, and if not, when should diagnostic catheterization and revascularization be performed. The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches trial is designed to address these questions by randomizing SIHD patients with at least moderate ischemia to an initial conservative strategy of optimal medical therapy or an initial invasive strategy of optimal medical therapy plus cardiac catheterization and revascularization.

Economic tools to promote transparency and comparability in the Paris Agreement

NASA Astrophysics Data System (ADS)

Aldy, Joseph; Pizer, William; Tavoni, Massimo; Reis, Lara Aleluia; Akimoto, Keigo; Blanford, Geoffrey; Carraro, Carlo; Clarke, Leon E.; Edmonds, James; Iyer, Gokul C.; McJeon, Haewon C.; Richels, Richard; Rose, Steven; Sano, Fuminori

2016-11-01

The Paris Agreement culminates a six-year transition towards an international climate policy architecture based on parties submitting national pledges every five years. An important policy task will be to assess and compare these contributions. We use four integrated assessment models to produce metrics of Paris Agreement pledges, and show differentiated effort across countries: wealthier countries pledge to undertake greater emission reductions with higher costs. The pledges fall in the lower end of the distributions of the social cost of carbon and the cost-minimizing path to limiting warming to 2 °C, suggesting insufficient global ambition in light of leaders’ climate goals. Countries’ marginal abatement costs vary by two orders of magnitude, illustrating that large efficiency gains are available through joint mitigation efforts and/or carbon price coordination. Marginal costs rise almost proportionally with income, but full policy costs reveal more complex regional patterns due to terms of trade effects.

Prospective randomized trial of barbed polyglyconate suture to facilitate vesico-urethral anastomosis during robot-assisted radical prostatectomy: time reduction and cost benefit.

PubMed

Zorn, Kevin C; Trinh, Quoc-Dien; Jeldres, Claudio; Schmitges, Jan; Widmer, Hugues; Lattouf, Jean-Baptiste; Sammon, Jesse; Liberman, Dan; Sun, Maxine; Bianchi, Marco; Karakiewicz, Pierre I; Denis, Ronald; Gautam, Gagan; El-Hakim, Assaad

2012-05-01

Study Type - RCT (randomized trial) Level of Evidence 2b. What's known on the subject? and What does the study add? In a previous randomized controlled trial, barbed polyglyconate suture for vesico-urethral anastomosis was associated with more frequent cystogram leaks, longer mean catheterization times and greater suture costs per case. In the current randomized controlled trial, we show that barbed polyglyconate suture is associated with decreased anastomosis time, decreased need to readjust suture tension, cost reduction, and equal continence and early/late urinary complication rates. To examine the effectiveness of barbed polyglyconate suture (V-Loc 180; Covidien, Mansfield, MA, USA) compared with standard monofilament for posterior reconstruction (PR) and vesico-urethral anastomosis (VUA) during robot-assisted radical prostatectomy (RARP). A prospective randomized controlled trial was conducted in 70 consecutive RARP cases by a single surgeon (K.C.Z.). Standard VUA was performed using three 4-0 poliglecaprone 25 (Monocryl; Ethicon Endosurgery, Cincinnati, OH, USA) sutures secured with absorbable suture clips (LapraTy, Ethicon; one single 6-inch [15.2 cm] for PR and two attached 6-inch [15.2 cm] for VUA). Barbed suture VUA was performed using two 3-0 6-inch (15.2 cm) barbed polyglyconate sutures. Time to complete the suture set-up by the nursing team, anastomosis time and need to adjust suture tension were recorded. Suture-related complications, validated-questionnaire continence and cost were also examined.   Compared with a conventional reconstruction technique, there was a significant reduction in mean nurse set-up time (31 vs. 294 s; P < 0.01) and reconstruction time (13.1 vs. 20.8 min; P < 0.01) for the barbed suture technique. Need to readjust suture tension or to place additional suture clips for watertight closure was greater in the standard monofilament group than in the barbed suture group (6% vs. 24%; P= 0.03). •  A cost reduction was recorded at our institution (48.05 vs. 70.25 $CAN) with the barbed suture technique. •  With a mean follow-up of 6.2 months, no delayed anastomotic leak or bladder neck contracture was observed in either group. •  Pad-free continence outcomes for the monofilament suture vs the barbed suture groups at 1 (64 vs. 69%, P= 0.6), 3 (76 vs. 81%, P= 0.5) and 6 months (88 vs. 92%, P= 0.7) were similar. •  Compared with standard monofilament suture, the unidirectional barbed polyglyconate suture appears to provide safe, efficient and cost-effective PR and VUA during RARP. •  Use of the interlocked barbed polyglyconate suture technique prevents slippage, precluding the need for assistance, knot-tying and constant reassessment of anastomosis integrity. © 2012 THE AUTHORS. BJU INTERNATIONAL © 2012 BJU INTERNATIONAL.

Comparing the short and long term stability of biodegradable, ceramic and cation exchange membranes in microbial fuel cells.

PubMed

Winfield, Jonathan; Chambers, Lily D; Rossiter, Jonathan; Ieropoulos, Ioannis

2013-11-01

The long and short-term stability of two porous dependent ion exchange materials; starch-based compostable bags (BioBag) and ceramic, were compared to commercially available cation exchange membrane (CEM) in microbial fuel cells. Using bi-directional polarisation methods, CEM exhibited power overshoot during the forward sweep followed by significant power decline over the reverse sweep (38%). The porous membranes displayed no power overshoot with comparably smaller drops in power during the reverse sweep (ceramic 8%, BioBag 5.5%). The total internal resistance at maximum power increased by 64% for CEM compared to 4% (ceramic) and 6% (BioBag). Under fixed external resistive loads, CEM exhibited steeper pH reductions than the porous membranes. Despite its limited lifetime, the BioBag proved an efficient material for a stable microbial environment until failing after 8 months, due to natural degradation. These findings highlight porous separators as ideal candidates for advancing MFC technology in terms of cost and operation stability. Copyright © 2013 Elsevier Ltd. All rights reserved.

Enhanced Reverse Transcription-PCR Assay for Detection of Norovirus Genogroup I

PubMed Central

Dreier, Jens; Störmer, Melanie; Mäde, Dietrich; Burkhardt, Sabine; Kleesiek, Knut

2006-01-01

We have developed a one-tube reverse transcription (RT)-PCR method using the real-time TaqMan PCR system for the detection of norovirus genogroup I (NV GGI). By introduction of a novel probe based on locked nucleic acid technology, we enhanced the sensitivity of the assay compared to those of conventional TaqMan probes. The sensitivity of the NV GGI RT-PCR was determined by probit analysis with defined RNA standards and quantified norovirus isolates to 711 copies/ml (95% detection limit). In order to detect PCR inhibition, we included a heterologous internal control (IC) system based on phage MS2. This internally controlled RT-PCR was tested on different real-time PCR platforms, LightCycler, Rotorgene, Mastercycler EP realplex, and ABI Prism. Compared to the assay without an IC, the duplex RT-PCR exhibited no reduction in sensitivity in clinical samples. In combination with an established NV GGII real-time RT-PCR, we used the novel assay in a routine assay for diagnosis of clinical and food-borne norovirus infection. We applied this novel assay to analyze outbreaks of nonbacterial acute gastroenteritis. Norovirus of GGI was detected in these outbreaks. Sequence and similarity plot analysis of open reading frame 1 (ORF1) and ORF2 showed two genotypes, GGI/2 and GGI/4, in semiclosed communities. PMID:16891482

Critical evaluation of root causes of the reduced compactability after roll compaction/dry granulation.

PubMed

Mosig, Johanna; Kleinebudde, Peter

2015-03-01

The influence of lubrication and particle size on the reduced compactability after dry granulation was investigated. Powder cellulose, lactose, magnesium carbonate, and two types of microcrystalline cellulose were roll compacted, granulated, and sieved into particle fractions. Particle fractions were compressed into tablets using internal and external lubrication. Internal lubrication resulted in an overlubrication of the granule material compared with the powder material. This resulted in extraordinary high reduction of compactability after dry granulation for lubricant-sensitive materials. The granule size can cause differences in strength, whereby the degree of this effect was material dependent. The loss in strength with increasing compaction force was comparable for different particles sizes of one material, suggesting a change in material properties independently of the size. Granule hardening could be one reason as for higher compaction forces the integrity of the granule structure survived the compression step. The results demonstrated that granule lubrication mainly influence the degree of the reduced compactability after dry granulation and must be considered for the evaluation of mechanism for this phenomenon. Hardening of the material as well as size enlargement will cause the loss in strength after recompression, but the influence of both depends strongly on the material. © 2015 Wiley Periodicals, Inc. and the American Pharmacists Association.

Therapeutic intervention for internalized stigma of severe mental illness: A systematic review and meta-analysis.

PubMed

Tsang, Hector W H; Ching, S C; Tang, K H; Lam, H T; Law, Peggy Y Y; Wan, C N

2016-05-01

Internalized stigma can lead to pervasive negative effects among people with severe mental illness (SMI). Although prevalence of internalized stigma is high, there is a dearth of interventions and meanwhile a lack of evidence as to their effectiveness. This study aims at unraveling the existence of different therapeutic interventions and the effectiveness internalized stigma reduction in people with SMI via a systematic review and meta-analysis. Five electronic databases were searched. Studies were included if they (1) involved community or hospital based interventions on internalized stigma, (2) included participants who were given a diagnosis of SMI>50%, and (3) were empirical and quantitative in nature. Fourteen articles were selected for extensive review and five for meta-analysis. Nine studies showed significant decrease in internalized stigma and two showed sustainable effects. Meta-analysis showed that there was a small to moderate significant effect in therapeutic interventions (SMD=-0.43; p=0.003). Among the intervention elements, four studies suggested a favorable effect of psychoeducation. Meta-analysis showed that there was small to moderate significant effect (SMD=-0.40; p=0.001). Most internalized stigma reduction programs appear to be effective. This systematic review cannot make any recommendation on which intervention is more effective although psychoeducation seems most promising. More Randomized Controlled Trials (RCT) on particular intervention components using standard outcome measures are recommended in future studies. Copyright © 2016. Published by Elsevier B.V.

Transoral Open Reduction for Subcondylar Fractures of the Mandible Using an Angulated Screwdriver System.

PubMed

Nam, Seung Min; Kim, Yong Bae; Cha, Han Gyu; Wee, Syeo Young; Choi, Chang Yong

2015-09-01

The management of subcondylar mandibular fractures has been a matter of controversy. Although closed reduction is the most useful method, it can be difficult to achieve anatomical reduction with this technique compared with open reduction and internal fixation (ORIF). Most surgeons prefer to treat subcondylar fractures by extraoral approaches rather than intraoral approaches because extraoral approaches provide good visualization of the operative field. The retromandibular, submandibular, and perilobular approaches are commonly performed in the treatment of displaced condylar or subcondylar fractures and that the functional results of these treatments are good. However, extraoral approaches have a high rate of surgical complications such as salivary fistula formation, visible scarring, and facial nerve injury, compared with intraoral approaches. Therefore, this clinical study evaluated the clinical results of ORIF for mandibular subcondylar fractures through a transoral approach using an angulated screwdriver system without endoscopic assistance. A study was conducted between March 2011 and October 2012. Eleven patients with subcondylar fractures of the mandible were treated through a transoral approach using an angulated screwdriver. There were 10 male patients and 1 female patient aged 21 to 72 years (mean, 38 years). Nine patients had a symphyseal or parasymphyseal fracture, and 2 patients had isolated subcondylar fractures of the mandible. Eleven patients with subcondylar fractures of the mandible were treated with a transoral approach using an angulated screwdriver. The subcondylar fracture was on the left side in 6 patients and on the right in 5. All patients achieved satisfactory ranges of temporomandibular joint movement with an interincisal distance of more than 40 mm without deviation and stable individual centric occlusion. The maximum operation duration was 165 minutes, and the average duration of ORIF was 97 minutes. The association between the operation duration and the number of operations was statistically significant. Our clinical study shows that subcondylar fractures of the mandible can be treated using an angulated screwdriver system through a transoral approach and that this technique provides reliable, satisfactory, and safe clinical outcomes.

Bariatric Surgery Promising in Migraine Control: a Controlled Trial on Weight Loss and Its Effect on Migraine Headache.

PubMed

Razeghi Jahromi, Soodeh; Abolhasani, Maryam; Ghorbani, Zeinab; Sadre-Jahani, Solmaz; Alizadeh, Zahra; Talebpour, Mohammad; Meysamie, Alipasha; Togha, Mansoureh

2018-01-01

There is evidence that substantial weight loss through bariatric surgery (BS) may result in short-term improvement of migraine severity. However, it still remains to be seen whether smaller amounts of weight loss have a similar effect on migraine headache. This study has been designed to compare the effects of weight reduction through BS and non-surgical modifications. Migraine characteristics were assessed at 1 month before (T0), 1 month (T1), and 6 months (T2) after BS (vertical sleeve gastrectomy (VSG) (n = 25) or behavioral therapy (BT) (n = 26) in obese women (aged 18-60 years) with migraine headache. Migraine was diagnosed using the International Classification of Headache Disorders (ICHDIIβ) criteria. There was significant reduction in the visual analog scale (VAS) from the baseline to T1 and T2 in both groups. The number of migraine-free days showed a significant increase within each group (p < 0.001). The BS group had a significant reduction in attack duration (p < 0.001) while there were no changes observed within the BT group. Following the adjustment of ANCOVA models for baseline values of migraine characteristics, age, changes in weight, BMI, body fat, and fat-free mass from T0 to T2, the BS group showed statistically significant lower VAS and duration of migraine attacks and a significantly higher number of migraine-free days than the BT group at T1 and T2 (p ≤ 0.028). Our results indicated that far before significant weight reduction after BS (VSG), there was marked alleviation in the severity and duration of migraine and a significant increase in the number of migraine-free days in obese female migraineurs. However, the effects in the BT group were not comparable with the effects in the BS group.

SU-F-T-447: The Impact of Treatment Planning Methods On RapidPlan Modeling for Rectum Cancer

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

Lu, S; Peng, J; Li, K

2016-06-15

Purpose: To investigate the dose volume histogram (DVH) prediction varieties based on intensity modulate radiotherapy (IMRT) plan or volume arc modulate radiotherapy (VMAT) plan models on the RapidPlan. Methods: Two DVH prediction models were generated in this study, including an IMRT model trained from 83 IMRT rectum plans and a VMAT model trained from 60 VMAT rectum plans. In the internal validation, 20 plans from each training database were selected to verify the clinical feasibility of the model. Then, 10 IMRT plans (PIMRT-by-IMRT-model) generated from IMRT model and 10 IMRT plans generated from VMAT model (PIMRT-by-VMAT-model) were compared on themore » dose to organs at risk (OAR), which included bladder, left and right femoral heads. The similar comparison was also performed on the VMAT plans generated from IMRT model (PVMAT-by-IMRT-model) and VMAT plans generated from VMAT (PVMAT-by-VMAT-model) model. Results: For the internal validation, all plans from IMRT or VMAT model shows significantly improvement on OAR sparing compared with the corresponded clinical ones. Compared to the PIMRT-by-VMAT-model, the PIMRT-by-IMRT-model has a reduction of 6.90±3.87%(p<0.001) on V40 6.63±3.62%(p<0.001) on V45 and 4.74±2.26%(p<0.001) on V50 in bladder; and a mean dose reduction of 2.12±1.75Gy(p=0.004) and 2.84±1.53Gy(p<0.001) in right and left femoral head, respectively. There was no significant difference on OAR sparing between PVMAT-by-IMRT-model and PVMAT-by-VMAT-model. Conclusion: The IMRT model for the rectal cancer in the RapidPlan can be applied to for VMAT planning. However, the VMAT model is not suggested to use in the IMRT planning. Cautions should be taken that the planning model based on some technique may not feasible to other planning techniques.« less

The concept and method of closed reduction and internal fixation: a new approach for the treatment of simple zygoma fractures.

PubMed

Uda, Hirokazu; Kamochi, Hideaki; Sugawara, Yasushi; Sarukawa, Syunji; Sunaga, Ataru

2013-11-01

The authors have developed a new minimally invasive surgical procedure for simple zygoma fractures, a closed reduction and internal fixation method, that uses a cannulated cortical screw system. From 2007 to 2012, 42 selected patients with simple zygoma fractures without ocular problems or shear at the zygomatic frontal portion were treated with this method. The mean age of the patients was 33 years (range, 13 to 77 years). The authors achieved good repositioning, equivalent to results achieved with conventional procedures in all cases. No notable complication occurred except for minor infection in two cases. Mean operative time was 32 minutes (range, 19 to 58 minutes). Postoperative relapse was found only in the posterior direction (p<0.001), but the distance of that was so small (mean, 0.47 mm) that it did not cause any problem clinically. Although further improvement might be needed, such as screw specification, the closed reduction and internal fixation method has many advantages: short operative time, less effect on soft tissue, maintenance of bone healing potential, and decreased postoperative pain and swelling. The authors concluded that this method has the potential to become a future surgical procedure for simple zygoma fractures. Therapeutic, IV.

78 FR 2692 - Agency Information Collection Activities; Proposed New Collection; Comments Requested: COPS...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-14

... Collection; Comments Requested: COPS Comparative Assessment of Cost Reduction by Agencies Survey ACTION: 30...; comments requested. (2) Title of the Form/Collection: COPS Comparative Assessment of Cost Reduction by... will be asked complete the COPS Comparative Assessment of Cost Reduction Survey. The survey will be...

Surgical treatment of intra-articular calcaneal fractures.

PubMed

Stapleton, John J; Zgonis, Thomas

2014-10-01

Most intra-articular calcaneal fractures are a result of high-energy trauma. The operative management of calcaneal fractures has been based on achieving anatomic reduction and minimizing complications of the compromised soft tissue envelope. The traditional extensile lateral approach offers advantages of achieving adequate fracture reduction with the risk of wound-healing complications and infection. Limited open reduction and internal fixation techniques with or without using external fixation focuses on achieving fracture reduction with less risk of wound complications but higher risk of malunion. This article discusses key points of operative management for various intra-articular calcaneal fracture patterns and clinical presentations. Copyright © 2014 Elsevier Inc. All rights reserved.

Effects of soil oxidation-reduction conditions on internal oxygen transport, root aeration, and growth of wetland plants

Treesearch

S.R. Pezeshki; R.D. DeLaune

2000-01-01

Characterization of hydric soils and the relationship between soil oxidation-reduction processes and wetland plant distribution are critical to the identification and delineation of wetlands and to our understanding of soil processes and plant functioning in wetland ecosystems. However, the information on the relationship between flood response of wetland plants and...

26 CFR 1.934-1 - Limitation on reduction in income tax liability incurred to the Virgin Islands.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Islands will be computed as follows: (A) Add to the income tax liability incurred to the Virgin Islands...) Add to the income tax liability incurred to the Virgin Islands any credit against the tax allowed... 26 Internal Revenue 10 2010-04-01 2010-04-01 false Limitation on reduction in income tax liability...

26 CFR 1.934-1 - Limitation on reduction in income tax liability incurred to the Virgin Islands.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Islands will be computed as follows: (A) Add to the income tax liability incurred to the Virgin Islands...) Add to the income tax liability incurred to the Virgin Islands any credit against the tax allowed... 26 Internal Revenue 10 2013-04-01 2013-04-01 false Limitation on reduction in income tax liability...

26 CFR 1.934-1 - Limitation on reduction in income tax liability incurred to the Virgin Islands.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Islands will be computed as follows: (A) Add to the income tax liability incurred to the Virgin Islands...) Add to the income tax liability incurred to the Virgin Islands any credit against the tax allowed... 26 Internal Revenue 10 2011-04-01 2011-04-01 false Limitation on reduction in income tax liability...

26 CFR 1.934-1 - Limitation on reduction in income tax liability incurred to the Virgin Islands.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Islands will be computed as follows: (A) Add to the income tax liability incurred to the Virgin Islands...) Add to the income tax liability incurred to the Virgin Islands any credit against the tax allowed... 26 Internal Revenue 10 2012-04-01 2012-04-01 false Limitation on reduction in income tax liability...

26 CFR 1.934-1 - Limitation on reduction in income tax liability incurred to the Virgin Islands.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Islands will be computed as follows: (A) Add to the income tax liability incurred to the Virgin Islands...) Add to the income tax liability incurred to the Virgin Islands any credit against the tax allowed... 26 Internal Revenue 10 2014-04-01 2013-04-01 true Limitation on reduction in income tax liability...

Restoring Fiscal Discipline for Poverty Reduction in Peru: A Public Expenditure Review. A World Bank Country Study.

ERIC Educational Resources Information Center

Lopez-Calix, Jose; Melo, Alberto

Since his inauguration in July 2001, Peruvian President Alejandro Toledo has proposed to take actions in the areas of macroeconomic stabilization; reopening of country's access to international financial markets; budget modernization and state decentralization; social policy; revamping of the armed forces, police, and internal security services;…

Sentinel Lymph Node Biopsy: Quantification of Lymphedema Risk Reduction

DTIC Science & Technology

2006-10-01

dimensional internal mammary lymphoscintigraphy: implications for radiation therapy treatment planning for breast carcinoma. Int J Radiat Oncol Biol Phys...techniques based on conventional photon beams, intensity modulated photon beams and proton beams for therapy of intact breast. Radiother Oncol. Feb...Harris JR. Three-dimensional internal mammary lymphoscintigraphy: implications for radiation therapy treatment planning for breast carcinoma. Int J

Maritime Science and Technology Experimentation Capability Project: Maritime Capability Evaluation Laboratory (MCEL) Data Centre Requirements

DTIC Science & Technology

2014-08-01

as represented by the Minister of National Defence, 2014 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la...12 2.2 Recommended Internal LAN Connections...35 vi 6.1 External Noise Reduction............................................................................................ 35 6.2 Internal